Loving Violet flipped a switch in my head, and there was no turning back. I'd say 99% of mothers end up feeling this way--the remaining 1% leave their babies in dumpsters or in alleys. I know it's not unique, this kind of life transformation, but it sure feels unique when it happens to you. From the time Violet was only a few months old, I wanted a sibling for her, and another baby for myself; I wanted our family to grow. And, because motherhood was my calling, I wanted to improve at it as I went forward.
Part of my quest to be the best Mama I could be began with my plans for a better birth for Baby Pierce #2. Violet's birth was the best learning experience I've had in all of my life, even though it was NOT the birth experience I had hoped for. I can see that now, through the lens of where I am 4.5 years later. I could not see that immediately after she was born. During the years that followed, all I saw was a big scar on my stomach that could have been avoided had I been better informed. The particularly infuriating thing about the choices that lead me to a cesarean section was that these choices would haunt me for the rest of my childbearing years. That scar on my uterus really limited my options for all subsequent births. The OB that performed the c-section was clear about that. But, by narrowing my choices, I was forced to make very well thought out, very well researched decisions this time around. I don't know if I would have had the same outcome without the kind of planning that attempting a VBAC required from me. And I know I wouldn't have learned as much. So, that primary c-section did serve a purpose--two purposes, actually. It made me a Mama to an angelic little girl and it taught me a lot about being my own best advocate.
So after what seemed like an interminable wait to get pregnant (talk about a growth experience in life--wow), I got a positive pregnancy test on February 26th, 2012. The preparation for a vbac had already begun before that test result, but as the weeks ticked by and I realized this pregnancy was going to stick, I kicked myself into high gear to find a health care provider who would support my choice. Indianapolis's go-to natural birth ob-gyn retired from practice in February, the same month I finally got pregnant. After the doc who delivered Violet had refused my request for a trial of labor with a future pregnancy, I had transferred to her care. She shared an office with two other ob-gyns who both have decent reputations for being low-intervention, but I really wanted to do my own research and find the right provider rather than choosing hastily this time around.
So, the (frustrating, annoying, time-consuming) task of interviewing providers began. If you haven't called a doctor's office lately requesting an appointment to just meet the doctor before becoming a patient, you may think I am exaggerating. Doctors do not like to be interviewed. Speaking to the office staff to try to set up such a meeting is like calling your mechanic to schedule your root canal.
Office Staff: "So you want to schedule a new patient visit? We'll need you to have your records faxed to our office prior to coming in."
Me: "Well, I don't want to transfer my care yet, I would just like to meet with Dr. XYZ to see if he might be a good fit for me."
Office Staff: "So, that's not a new patient visit. I don't know how to code that."
Me: "Okay. Sorry. Can I still make the appointment?"
Office Staff: "Can you hold?"
And so it went. With all four doctors. And one hospital based midwifery practice. The home birth midwife was much more used to being interviewed, but was still really hard to get an appointment with. So through this process, I continued seeing Dr. Gallagher, the ob-gyn with the decent reputation who shared an office with my now retired natural-birth friendly ob. Around 30 weeks, I met with a midwife who was simply wonderful, but for a variety of reasons, mostly bureaucratic, I decided to remain in the care of Dr. Gallagher for this birth.
Equally as important was my quest to find a doula to guide me through the birth process. I had read that women with a doula are at a much less likely to undergo a c-section than women who go it alone or rely solely on their partners for birth support. My friend Haddie (who would have been my doula had she not up and moved to Florida) told me to interview at least 3 doulas to see who I best clicked with. I'm so glad that she suggested this, because, while all 3 were excellent, the last doula I met with, Jenny, was a perfect fit for me. I simply cannot imagine this birth without her there. She worked so hard to try to help me have a good, safe, birth. Jenny was instrumental in making sure I followed through with my desires.
By October, I had pretty much laid all the groundwork for a VBAC. I spent my pregnancy with Violet buying baby clothes and thumbing through Pottery Barn Kids catalogues. This pregnancy I purchased virtually nothing and spent my time reading Ina May Gaskin's Spiritual Midwifery. I prepared for birth in a whole different way, determined to have ownership over the process this time. That preparation was key, it turns out, because I was more than ready to throw in the towel on several occasions.
A Change of Plans
The end of October was the hardest. I didn't know if I could still have the VBAC that I'd been trying to orchestrate for 9 months. I didn't know if I even still wanted that VBAC. But when I walked into my doctor's office for my 39 week appointment and the ultrasound revealed a breech baby, I felt like I had been coldcocked. All along, there were a few situations that I knew would automatically disallow me a vaginal birth. Breech presentation was one of those things. So that Monday morning, Dr. Gallagher gave me my options, such as they were. I could schedule a cesarean for the following morning, I could schedule for Wednesday-Halloween-morning, or I could schedule for that weekend. I spoke to Shawn, and we decided Saturday, November 3rd would be best. That allowed me to go all the way to my due date, which I wanted, and it gave Shawn time to wrap up loose ends at work in order to take time off.
That week of Halloween was an emotional tug-of-war. I felt simultaneously terrified about the impending surgery and somewhat relieved that the uncertainty of a natural birth was gone. I would have to have an icky surgery on Saturday, sure, but by lunchtime, I'd be holding my new baby. The only way out was if the baby could somehow miraculously turned and assumed a head-down position before Saturday. After speaking with my doula Jenny, my friend Haddie, and a few others, I decided that, even if the chances were slim, I had to at least try to get the baby to turn before surrendering to a section. I had worked too hard to prepare for a vaginal birth to sit around all week waiting to have a c-section without even trying to flip that baby.
So try I did. I shined a flashlight on my belly. I did yoga poses to help the baby rotate. Violet and Shawn talked to my belly and encouraged Mystery Baby to put turn his head toward their voice . Finally, on Friday, November 2nd, in a last ditch effort to avoid my appointment with a scalpel the following morning, I visited a chiropractor. She performed "The Webster Method" on me to turn the baby and gave me homework to go home and spend as much time as possible on my hands and knees. I stopped at Le Peep and enjoyed one granola blueberry pancake on my way home--figuring it was my last breakfast pre-baby--and then did my best to spend as much time on hands and knees as I could while I organized the new baby's room. I was in a foul mood that day. I hated that my lovely pregnancy was going to end with a c-section.
My mom spent the night at our house that night so she could be with Ms. Vi in the morning. It was the worst night of sleep I can recall in recent memory (and that is saying quite a bit because as I write this I have a newborn). I was awake worrying most of the night. Shawn and I arrived at the hospital shortly after 6 am for surgery. We were checked in and they put me in a triage bed to get me prepped. I asked the nurse if I could still have a final ultrasound to make sure the baby was breech and had not turned. She spent the next 20 minutes trying to track down an ultrasound tech to perform the scan. There must not be a surplus of them in the hospital on a Saturday morning because we wited so long I almost said forget about it. A midwife walked through triage after we'd been waiting quite awhile and said she could do the ultrasound. It took her all of 20 seconds from the time she turned the machine on to put the wand on my pelvis and declare the baby head down.
I was stunned! I hadn't felt anything resembling a fetal somersault in the 5 days since the previous ultrasound. Nonetheless, Shawn told me he had never seen me dress faster than I did that morning when I slipped out of my gown and back into my clothes! I felt like a dead man walking as we left the hospital. We had packed for a 3 day stay, so I'm sure we looked bizarre walking out loaded with bags, big sister gifts, pillows, and a still pregnant woman. We stopped at the coffee shop in the lobby as we left. Let me tell you, a cup of coffee has never tasted so good! Despite being super-relieved to get out of surgery (at least for the time being), I couldn't shake the feeling that I had forfeited my baby when we left empty-handed.
When we got home, we had some explaining to do to my Mom and Violet. I knew everyone else would understand, but I was worried that Violet would freak out when we walked back through the door with no baby. She had been so very patient and now was so very excited to meet her new baby. All day Friday, we had been telling her "Tomorrow is the day!" and now we had to circle back on that promise. She took the news much better than expected. After enjoying breakfast with my Mom, I took a nap and we made the baby-delay up to Violet by taking her to go see Wreck-It Ralph. It was a rainy, cold, Saturday and I had never loved being pregnant so much!
Wow--just realized that is an awful big lead up. Now, onto the actual birth of this kiddo!
Go (and go and go and go and go)Time!
We were both very excited and going back to sleep was not possible. I was having mild contractions and felt like I should give the doctor a call. I spoke with Dr. Gallagher at 3:30 am. She (in a very sleepy voice) told me to take a shower, eat some breakfast, and head into the hospital. We pretty much did just that. I texted my mom and my doula, showered and prepared to go to the hospital. Though my contractions were still mild, I knew that my doc wanted to start antibiotics soon because I was positive for Group B Strep at 37 weeks. I had done a lot of research on GBS and had decided that, though I wasn't excited about it, I would receive the antibiotics intravenously to attempt to prevent the transmissions of the bacteria to the baby. Though it is usually harmless, IV antibiotics are hospital protocol and I didn't want to fight a battle over that point when I had so many other things to worry about. After my mom arrived and before Violet woke up, Shawn and I left for the hospital for the 2nd time in two days to have the baby.
When we were parking the car in the garage at Methodist, I got a text from my doula. She was warning me that being admitted to the hospital before being in active labor decreased my chances of a natural birth. Though I knew this and had planned all along not to go to the hospital until labor was well underway, the breaking of my water had really thrown me for a loop. On the one hand, labor had not really started yet. I was contracting, but only mildly and the contractions all but stopped when I sat or lay down. On the other hand, my water had broken and I knew that my doctor wanted me on antibiotics. We faced a really tough decision, but, once again, my desire for best odds for a VBAC won out. We headed home baby-less again. My mom and Violet were again pretty surprised to see us!
I spent that morning walking all over the house, going up and down the stairs, and bouncing on the birth ball. While I could work up a pretty decent contraction pattern in motion, it would fall apart if I rested. Around 10am my doc called me wondering why I hadn't checked into the hospital yet. I explained my apprehension about heading in before I was in active labor. She understood, but still wanted me to get started on antibiotics sooner rather than later. We agreed that I would come in sometime shortly after lunch. It was a clear, brisk day. Shawn and I put on our coats and went for a long walk around our neighborhood to try to jump start my contractions. The things I most remember about that walk were the uncomfortable feeling of leaking amniotic fluid every dozen steps and the way every one's jackolanterns were starting to collapse.
After the walk, we headed to the hospital for the final time. I was feeling like a fugitive for hiding out for so long and just wanted to comply with the doctor so she didn't hate me. She was going to have to be my ally through this and I didn't want her pissed off at the beginning. I also felt like our walk had helped and that my contractions might be going somewhere. So we checked in around 1pm. The hospital was much busier than it had been the morning just two days earlier when we'd checked in for the c-section. After some confusion, the staff got me to a labor and delivery room around 2pm. My contractions had slowed down quite a bit.
I was a bit dismayed that I had been assigned a male Labor and Delivery nurse. He looked sort of like Santa and wasn't who I had pictured working with during this first stage of my birth experience. He put my IV in and got me started on my first round of antibiotics. After those were administered, Shawn and I left the room and started walking the halls. Jenny arrived, we chatted, and she left to get some dinner while I tried to stay in motion. Shawn and I walked the Labor and Delivery floor non-stop that evening.
My doc went off shift that night and her partner, Dr. L, was in charge of my care. Around the time the nurses shift changed, Dr. L had ordered me to start a pitocin drip to get a regular labor pattern established. I had MAJOR reservations about using pitocin at all since it can lead to uterine rupture in women with a prior section. I really hoped that, with time, my body would call game on and get busy contracting without help. Wonderful Melissa helped me advocate for just that. Since the doctor was managing my care remotely, Melissa relayed to her that I felt okay waiting to start pitocin, especially since I had been on IV antibiotics for several hours. I asked to be allowed to wait until 3am to discuss Pitoicin again. That gave me a full 24 hours from the time my waters had broken at home to get some good contractions going.
By sunrise that morning, I was contracting stronger and more regularly and having contractions that were really all consuming. By the time the nurses changed shift around 7am, it seemed like there would be a baby very soon. Little did I know, I was just getting started on the real difficult part of labor. My new nurse, Dawn, was accompanied by a trainee nurse, whose name I flat out cannot remember. Both nurses were very supportive, but honestly, I don't remember much about them other than their presence. That morning, as my contractions came harder and more frequently than I felt was possible, it was my doula Jenny who kept me afloat. Her encouragement and advice were like a lifeline for me, and I think Shawn felt the same way.
My doctor, Dr. Gallagher, was back in charge of my care that morning, and she paid me a visit as she headed into the office. The doctor checked my cervix to see if the pitocin and stronger contractions were helping me progress. At that point, I was dilated to 7cms. Dr. Gallagher also felt a part of the bag of waters--a bubble of sorts--that had gotten pushed under the baby's head. She felt that if she further ruptured the fore bag, it would allow the baby's head to press more firmly into my pelvis and make my cervix dilate the rest of the way. The process of rupturing was easy and the doctor was right, it did quickly intensify my labor.
By 10 am the contractions were extremely intense and coming one on top of another. I was managing--just barely--but I was managing with the knowledge that I would be holding my baby very soon. So when my doctor came in to check my cervix for progress mid-morning and found no change, I was crushed. The nurses upped my pitocin to 7 milliunits and I started to lose it. I had been laboring for over 30 hours, hadn't slept a wink, and was experiencing overwhelming contractions with little break in between each one. I asked for help of the narcotic variety.
Though I had really wanted a drug free birth, since I had agreed to the pitocin drip, I had been tethered to an IV. I also had to have constant fetal monitoring which severely limited my mobility. I can't say how my pain relief techniques might have changed had I been able to move around freely, but I can say that I was at the end of my rope by that point. Nubain was the drug of choice to try to get me some rest between contractions. It does nothing--NOTHING--to numb the pain of a contraction when you are in the midst of it, but did allow me to relax more quickly and completely between each one. I clearly remember Jenny leaning over me in the dark of that hospital room during each contraction telling me it would be over soon and I would get a break. As quickly as they come, they go away. She stroked my hair and I got so comfortable between each contraction, I almost fell asleep.
But as the pitocin was increased to 8 and the nubain wore off, I knew I was at my breaking point. The exhaustion combined with the intensity of the contractions had me spent. I asked for an epidural. Though it felt like a bit of a failing somehow, or if not a failing, at least a deviation from my original plan, that choice really may have been what preserved my chances at a vbac and allowed me to relax enough to go on.
The epidural was placed around 2 or 3 pm and it was the most wonderful brand of relief. I am sure L & D nurses see it all the time, but I really felt like I was Jekyll and Hyde. Where I had been moaning, crying, cursing, begging, and generally behaving horribly, when the epidural took, I was mild mannered, polite, even joking. The epidural was a really good one. Though the pain was gone, I could still feel the tightening of each contraction and had enough sensation and mobility to change positions. After resting for awhile, my doula and nurses helped me get into several different positions to help the baby labor down.
I wish I could have slept during the afternoon, but I was still a bit on edge. I knew that my doctor would be coming back to check my progress after her day at her office was over. I also knew that if I wasn't dilated to 10cms, it would be a c-section. At that point I was flirting with 40 hours in labor and ending it all with a cesarean was just about the most heartbreaking thing I could think of. So I closed my eyes and visualized my cervix opening and my baby descending. I meditated on the kind of birth I wanted. And I nervously watched the clock and waited for my doctor to arrive.
5 o'clock came and went. 6 o'clock rolled by signaling that I had missed my self-imposed deadline of giving birth before the polls closed on Election Day. At 6:45, just before the 3rd nursing shift change I had the pleasure of witnessing in the hospital, Dr. Gallagher arrived. She had been held up in surgery which had given me extra time to labor. As I laid back so the doctor could check my cervix, I was keenly aware that the next ceiling I looked at could very well be that of an operating room. I was petrified.
But, I wasn't headed an O.R. that night. Dr. Gallagher pronounced me 10 cms and a plus one station. It was pushing time! I was so excited and relieved. Jenny had been cautioning me throughout labor that I needed to reserve some energy for pushing, but honestly, that was the easy part. I was so flipping glad that I was going to get a shot at pushing this baby out--something I hadn't gotten close to with Violet--that I got a huge rush of adrenaline that got me through.
I should really also give some credit to little Mystery Baby for allowing me to get to this point. No matter what we threw at him, the little critter stayed calm and happy. Even during my most intense contractions, there was virtually no change in the fetal heart rate monitor. This baby was already dropping clues about his mellow demeanor.
We started pushing around 7pm. I got a new nurse. She was wonderful. I have no clue what her name was. The trainee nurse from the previous shift asked if she could stay. Of course I said yes. She had seen me at my worst--she might as well get to see the end of this ordeal!
a Pierce family favorite) and the atmosphere in the room was pretty fun. Though I needed some coaching on pushing at first, I got into the groove after awhile. We tried pushing in a few positions, but what worked the best and made the most progress was modified side lying. And I used a mirror. I didn't know if I would want a mirror, but it was actually very helpful. I couldn't imagine pushing without seeing my progress.
The pushing stage of labor seemed to go by quite quickly. At first there was nothing. Then there was hair. Then there was nothing. Then there was hair again. More hair. More hair. Holy shit--there is a head!! By that point, I had been pushing for 3 hours. Really seemed like far less. I knew the baby was almost out when the doctor called the NICU team and told them to get their shit in gear. Since there had been meconium staining in the fluid, the NICU had to be there at birth.
The doctor told me to hold my last push--a very hard thing to do, by the way--so she could get ready. I don't know if I held it long enough or not, but I had to get that baby out. I gave a really big push and out came the head. In an instant, the baby's shoulders and body were out and I heard Shawn exclaim with surprise, "It's a boy!"
The NICU team took Sullivan for just a moment. He cried almost instantly and--God LOVE my doctor!!--Dr. Gallagher demanded they bring him back from the isolette where they were dawdling around with him and give him back to me. "Bring him to Mom! Bring him to Mom! Bring him to Mom!" I was so glad she did that! I got to hold Sullivan mere moments after his birth. He peed all over me, in fact, when I was delivering the placenta. Ahhh, the romance of childbirth!!
It really was romantic, though, and having my newborn laid on my chest all slimy and squinty-eyed was the ultimate rush. Shawn and I were in awe and in love immediately. Our son, our boy, my VBAC baby, this cool, calm character, was finally with us, safe and sound.
Sullivan Ray Pierce
8lbs 10 oz
Born at 10:14 pm, November 6, 2012