Second VBA2C - with TWINS!

VBA2C with TWINS? Everyone I talked to asked me crazy questions like "why not just have a repeat section with twins?" and "are you going to try to have them natural?" Well, I had my last baby naturally as a VBA2C so why not? See, I'm a great candidate - at least that's what I was told. With 2 vaginal deliveries before my 2 c-sections, I was told I was a great candidate to VBA2C baby #5 and I did -- all natural with the help of an awesome husband, fabulous nurse and a wonderful doula, Fredia Nelms. So, when I found out I was pregnant with my 6th child, I had no doubt I would VBA2C again. Then the ultrasound technician said twins and my heart sank. Would I find a doctor who would LET me VBA2C twins? So I went out searching for that healthcare provider who would let me birth these twins the way I wanted to. After consulting with one that I was happy with but not happy with the hospital, I discussed it with my husband, Ricky, and decided I felt it was best to return to my previous practice and ask the doctors there how they felt about it. After all, they had allowed me to VBA2C once so maybe they would again.

At my first visit with Dr. Ross, he brought up the discussion about VBA2C the twins and said he saw no reason I couldn't do it. I was beyond excited! Obviously he would need to discuss it with his partners to make sure everyone was ok with it, but I had hope! At my next visit, I was informed that all partners were on board with me attempting a TOL (trial of labor) with these twins!! I knew then that God had answered my prayers and all would be ok. My pregnancy progressed well and without complications. I had what the doctors considered a "textbook" twin pregnancy. No complications, worked up until I went into labor and really didn't feel too uncomfortable until about a week before delivery.

Labor started and stopped several times in the last week of my pregnancy however, at 38 weeks I thought the real deal was here. I was already dilated to 3cm at my last checkup and when the contractions started coming, they started coming hard and fast. I labored at home for hours and finally decided to head to Brookwood on Friday evening. When we got there, I was only dilated to 4cm but it was progress and I had hopes it would continue - and quickly since I was so uncomfortable. Boy was I wrong! I labored all night Friday night with Fredia helping me to get in different positions to encourage baby A to come down more, but by Saturday morning, things had fizzled out and it was time to decide what to do. So I walked, and walked, and walked the halls of L&D at Brookwood. By Saturday afternoon, I was 5cm and almost completely effaced. Since things were continuing to progress, Dr. Adcock was willing to discuss some "induction" options. Ricky and I discussed our options and decided to try to break my water and start some pitocin. Mind you it would be a tiny dose of pitocin but maybe that would be all I needed to kickstart my body and get things moving along again.

Around 9pm on Saturday evening, Dr. Adcock broke my water and started pitocin at the lowest rate possible. At this point, I was about 5.5cm and almost fully effaced. Labor wasn't nearly as unbearable as it was the last time. Maybe it's because I was better prepared and knew what to expect, I don't know. I progressed well and stayed pretty relaxed - even joking with Fredia, Ricky and Kelly (another doula who had come to help). Both Fredia and Kelly attempted many different positions to help the process and kept the mood light. Of course, that's until I got to around 8cm -- then it started to hurt! Dr. Adcock had been insistent on placing an epidural catheter to have in place in case an emergency arised and I needed an emergency c-section. See, by having the catheter in place, it would be easy for the anesthesiologist to just "turn the pump on" and boost me with numbing meds so I could be awake for the birth of my babies. This made sense and I was fine with that but really wasn't thrilled about the "test dose" they would have to do to ensure the catheter was in the right place. But by 8cm, when the pain was getting unbearable again, I decided we could do the epidural test dose and then turn the machine off. That might help my body relax enough to get my cervix complete and bring my babies faster. Around 1:30am on Sunday morning, the anesthesiologist came in and placed my epidural catheter. After he gave me the test dose, my blood pressure bottomed out and I blacked out. Once I was conscience again, I noticed the epidural was still running and asked it be turned off. My lower half was numb so I decided to try to take a little nap to get the energy I needed to finish what I had started. Fredia got me the "peanut" ball and put it between my legs and I took about a 30 minute snooze.

I woke up to feeling pressure and realized baby A was going to make his entrance very soon. Thankfully, I couldn't feel pain because of the epidural test dose but I could move my legs so I was pretty happy about that. I told the nurse I felt baby A was coming soon and she checked. Sure enough, I was complete and baby A was +2 or +3 station --- he was coming really soon. The nurse started getting things ready to move me to the OR. She was taking her time getting stuff done though and I told her then we weren't going to make it there. He was coming now! In the end, we emergently moved to the OR with the nurse riding the bed with me holding baby A's head in so he would not be born in the hall.

Dr. Adcock came in the OR. The room was packed with plenty of nurses, the anesthesiologist, my two wonderful doulas and Ricky right by my side. With very little pushing, obviously, baby A was born at 2:55am. At my last doctor's appointment, an ultrasound had revealed baby B had flipped and was breech. This wasn't a huge concern since she was baby B but Dr. Adcock was prepared for this. However, after baby A was out, he started feeling around in my uterus and found that baby B was vertex. She had flipped herself around again! Dr. Adcock broke my water and I started pushing. Once she crowned, he let me feel her head before I continued to push. Then, once her head was out, he unwrapped the cord from around her neck and let me pull her out. It was the most awesome experience ever!!! I pulled her to my chest and it was so surreal. She was born at 3:03am and once she came out, I realized that I DID IT! I had successfully delivered VBA2C TWINS! My birth experience could not have been more perfect.

My twins are now 8 weeks old and sometimes I still can't believe I did it. People ask me everywhere I go, "did you have a c-section?" I love the look on their face when I tell them that I did not have a c-section, that I went into labor and had them vaginally AFTER 2 previous c-sections. My husband tells me I am an example for others and it's amazing what I did. I guess I don't see it as amazing but merely that I achieved what I wanted! And knowing that these two little blessings have completed my family -- I feel good knowing I finished birthing my babies the way I wanted to do it! I'm beyond thankful to Fredia and Kelly for believing in me and helping me accomplish my goal.

A vaginal birth after FOUR c-sections!

VBA4C?!?  I mean, seriously, what crazy person attempts a vaginal birth after four c-sections?  What about the risks and possible complications?  Wouldn't it be easier to just have that fifth c-section?

So, why not have another c-section?  My husband, Gregg, and I may want more children.  We both agreed that having any more than five c-sections was just too much of a risk on my health.  
Honestly, the odds were not in my favor.  Wait, wait...I'm not talking about rupture statistics.  Through ICAN (www.ican-online.org) I was quickly made aware that the risks were definitely higher in attempting another c-section.  So what wasn't in my favor?  Almost every doctor in the area.  Almost every hospital in the area.  Except one...Dr. Davis and UAB.  This doctor and this hospital were willing to provide me the means to try for a vaginal birth.  But the odds were still against me.  For this vaginal birth to be a success so much had to be just right.  I had to go into labor on my own, baby had to be head down and not posterior, baby's heart rate couldn't decrease at all during labor, and lastly my c-section scar couldn't rupture.  None of this would be possible without the grace of God - so I prayed and I trusted He would have a hand over it all!

When I started out on my VBA4C journey I was determined to do everything within my power to make it happen.  My first pregnancy ended up in a c-section because of mal-position and because after having an epidural I had no idea how to push out a baby effectively.  So, my first decision - this baby was to be born naturally.  If you know me, you know that pain is something I'm not a fan of and am also completely terrified of.  So, my second decision - hire a doula that would help me through the pain of childbirth.  I checked references and found the best doula (seriously, she is!) in all of Birmingham - Fredia Nelms.   

Armed with my doula and loads of reading and watching birth stories my pregnancy advanced.  I warned Fredia ahead of time that my babies come early.  Child #1 came at 37 weeks, child #2 at 37 weeks, child #3 at 36 weeks, and child #4 at 35 weeks.  I was certain we would be having another early baby.

Sure enough at 33 weeks the contractions began.  And they continued for 6 whole weeks.  It became a regular thing for me to be up all night with contractions 10 minutes (or less) apart for hours.  Several times I was sure "this was it" and would text Fredia.  By 38 weeks I was certain I was going to start screaming at her if she told me I was just having false contractions again.  Did she not hear me?  These things hurt!  They most certainly were not false!  Thankfully, she knew my body better than I did and advised me to rest instead of rushing off to the hospital.  Each time the contractions would fizzle out and I would mope around fat and miserable.

Friday night - July 18th.  I was just a couple days shy of 39 weeks.  (Did you read that??  39 weeks!  I'd never been pregnant that long!)  I had a horrible night of contractions.  They stayed 4-5 minutes apart throughout most of the night.  I sent my usual text to Fredia the next morning, and she once again told me to rest.  I wasn't too mad at her this time because she did add that "you will need the rest if you have this baby later tonight."  Seeing that word tonight was thrilling to me!  

I of course took my doula's advice to heart - and then promptly gathered up my family and headed for the zoo!  It was a wonderful day!  I think it was needed by us all.  That evening, after my heart was full of happiness from our day, I finally settled into bed at about 12:30am.  Within five minutes I felt 2 very distinct pops in the front of my belly.  I knew exactly what it was!  Within 5  minutes the contractions started and I was visibly leaking fluid.  I yelled at my husband, Gregg, who was fast asleep.  He helped me put towels on the bed so I could lie down and try to rest for awhile.  As soon as I laid down a contraction hit and, oh my goodness, it was horrendous!  I was immediately screaming.  

We sent Fredia a text at 12:50am, and after talking back and forth for an hour or so we collectively decided it was time to head to the hospital.  I was still screaming through contractions and had decided that there was no way I was having this baby without an epidural.  

Our friend, Denise, was called to sit with the kids so we could head off to the hospital.  She was a Godsend.  She was able to start counter-pressure on my back that immediately helped the contractions.  She showed Gregg what she was doing so he could take over.  I don't know what I would have done without the counter-pressure.  It was still horrible, but it would have been so much worse!

At 1:56am we sent a text to Fredia, "On our way."  This was immediately followed by another text, "I really think I want meds."  The contractions were no joke!

At about 2:15am we finally arrived at the hospital only to be stopped at the front desk so Gregg could get a nametag.  Seriously??  We were then told at triage to have a seat in the waiting room.  Again, seriously??  Keep in mind that I am still screaming through each contraction.  They finally got me back to triage at about 2:30am.  

They checked me and found that I was only 5cm.  Sweet Fredia had sent me this text on our drive up, "I want you to remember the number assigned to your cervix when you get there is not a reflection of how hard you are working or how far you have to go.  It's not the whole picture."  With that in mind hearing that I was only 5cm wasn't devastating.  Of course part of the reason it wasn't devastating was because I was certain I was going to be getting drugs in the very near future!

At UAB they require you to stay in triage until a room is available in labor and delivery.  And of course, a room wasn't available right away.  Oh, and guess what else, they can't give you drugs until you're in labor and delivery.  Didn't they know I was dying?  I literally was screaming for God to save me, help me, just make it stop.  This is only mildly embarrassing to me now!

At 3:04 am we were finally taken to labor and delivery.  Within minutes two angels arrived - Fredia and the anesthesiologist.  To my horror they both wanted me to be checked before I was given an epidural.  At this point the only position that I could handle was standing and leaning over.  I somehow managed to make my way into the bed to be checked. 

I was completely dilated!  Oh my gosh - I was complete!  I clearly remember Fredia locking eyes with me and telling me I could do this.  And all I could think was - crap, I have to do this!

I immediately went into a strange sort of primal mode.  The ridiculous screaming stopped and I focused on what I had to do.  For around 40 minutes I pushed and pushed.  I started on all fours at the head of the bed.  The doctor quickly got bored with my progress and left leaving just the nurse, Fredia, Gregg, and I in the room.  (So much for me being such a high risk patient!)  I'm not sure who suggested it but Fredia helped me get into a squatting position at the foot of the bed.  I pushed about 15 more minutes and started feeling the burning.  After the next push I could reach down and feel my baby's head.  I remember Fredia telling me I needed to breath through the next contractions - don't push - the doctor has to get here.  But it was impossible not to push.  This was the point where I learned that the "ring of fire" was truly no joke!  My next push his head came out and with the next our little Stephen Michael came out into the hands of the nurse at 4:06am.  I can still hear my husband saying, "Devon, you did it!"

My little man was put immediately on my chest!  I've had five children and this is the first time I've ever held one of my babies right after they were born.  What an amazing feeling!

It took me about 2 weeks to really wrap my brain around the entire experience.  I truly never thought I would experience a normal delivery of a child.  I always questioned whether my body could even do it.  And I surely never thought I would do it without an epidural.  But I did!  My body does work!  

One of the biggest things I struggled with after the delivery was the loss of my birth plan.  I had envisioned this beautiful labor experience.  I had a playlist all ready to listen to while I bounced on a birthing ball.  The fast, hard labor I had was almost traumatic in a sense.  It's taken me until now to accept that things happened just as they were supposed to - just as God planned.  If labor had lasted 5 minutes longer maybe I would've ended up getting that epidural which could have changed the entire outcome.  So many things might have been different.  But they weren't, they were perfect!

I know without any doubt that I couldn't have done it without the 2 hours of counter-pressure my amazing husband provided (I had the bruises to prove it!) or the awesome support of my doula!  I don't know if we'll have more children, but if we do I'll want both of them by my side once again!  And again, Dr. Davis and UAB were amazing.  They gave me a chance when no one else would!  

My husband tells me I need to be humble when telling my story.  That's a very hard request because I'm just so darn proud of myself!  With the help of God, I did what so many considered to be impossible.  I had a vaginal birth after FOUR c-sections!  And I did it naturally!  I rocked my VBA4C!

Accomplishment, joy, and leaving a legacy of natural birth

Before I had a natural birth, I was a natural birth. Back in the 80’s, when epidurals were the cool new thing and very few moms were going the natural route, my mom did. She told me her birth stories,and my dad told me how proud he was of her. I grew up knowing that when I had babies of my own, I wanted to birth them naturally.

However, that’s not how it happened with my first baby. As soon as I made it to 40 weeks, my doctor pressured me to schedule an induction. I reluctantly agreed, feeling that I didn’t really have an option. So, early on the third day past my due date, my doctor broke my water and started Pitocin. It got very intense very quickly, and I took an epidural as soon as I could just to save my strength. My sweet boy was born safely that afternoon, and I was thrilled.

For several months, I was content with my first birth. But occasionally I would meet someone who’d had a natural birth, and I still felt tingles in my spine as they talked about it. I had a deep need to fully experience the birth of a child, in all its challenge and for all its glory. I knew I would never be content if I didn’t. Three years later, when we were pregnant with our second baby, I was determined that it would be different this time. I found a new doctor, I hired Kelly as my doula, and I took a childbirth class taught by Fredia.

Apparently I bake my babies a long time. My due date came and went again, with only erratic contractions. Finally, on the fifth day past 40 weeks, I woke up at 1 AM with crampy contractions! I got up and ate a little bit while I timed my contractions. They kept coming, and I coped easily using deep breathing and relaxation techniques. I got my husband up when I was sure this was the real thing. I moved from a sitting position to lying on my side, and eventually I settled into an all-fours position. That’s where I was when Kelly got to my house. I was so excited to see her; it was really time!

Then the contractions really started getting intense. Standing or sitting upright during a contraction was almost unbearable because of the downward pressure. When deep breathing was no longer enough to help me relax, I started vocalizing a deep moan. This helped me continue to cope through those stronger contractions. After several of those, Kelly started encouraging us to get ready to move to the hospital. I was well past the stage when the doctor tells you to call, but we knew I wanted to labor at home as long as possible in order to streamline my admission to the hospital. We left the house around 6 AM. We drove fast down I-59, with our flashers on, me on my knees in the reclined front seat, facing the back. Once we got there, I had a deep urge to get settled in my room, to be on my knees in a bed again and stay there until this baby came out. I hustled inside, stopping to lean on something during contractions. I remember people kept asking if I wanted a wheelchair (as if I could have sat down!). When I got in my room, I got back on all fours in the bed. The contractions were really intense by then, and some of them were doubling up on the previous one. I remember thinking I couldn’t do this much longer. Those 5 minutes were evidently my transition phase. About that time, I was rather curtly telling the nurse that she couldn’t check my cervix until I was ready to push. She was a good sport and left me to it while she gathered her equipment. Not long after she left the room, my body kicked into a whole different gear. I was in the middle of a contraction, and all of a sudden, completely involuntarily, my back curled up like a cat and I was bearing down. I managed to tell Kelly, “Urge to push! Urge to push!” We had no idea what my cervix was like since I had so tactfully dismissed the nurse’s requests to check it. So to be on the safe side, I really needed to resist that urge to push until she came back. When you’re in childbirth class and they tell you to “blow out the candle” when you’re trying not push, I just don’t think it’s possible to convey what a monumental a task that is. It’s like trying not to sneeze with a feather in your face, only 10 times stronger. But for the most part, we managed. We finally got the nurse back to the room, and I still don’t think she really checked me because my baby’s head was already in the birth canal. That’s usually a good sign that your cervix is open. Wow, the relief! I got to push through the second half of that contraction, and then I got a break. Everyone around me was scrambling, I think; I had only been in the room about 30 minutes, and they were trying frantically to get my doctor in the room. But I was in another place. I was vaguely aware of all that going on around me, but my task was inside my own body. I knew it was doing its job, everything was going to be fine, and wow, it was already almost over. I was tired and ready to have a break, but I was not afraid.

My doctor made it just in time. The baby was crowning. My body pushed her head out with very little active effort from me. One more contraction and we had her shoulders out – she was born! Praise God! I had done it! I cannot describe what an amazing, exhilarating feeling I had right then. Up until that very moment, I still felt just a bit of nagging uncertainty. What if something went wrong? What if I needed an emergency C-section? What if I just got tired and discouraged, or I didn’t stand up for the kind of birth I wanted, and I accepted unnecessary interventions? What if it went like last time? But in that moment when she was born, when I gave birth to my baby, all those little what-ifs popped like bubbles all around me and I was left with exceeding joy and accomplishment. And then, as if that weren’t enough, I turned over and they handed me my baby. I held her close against my chest, skin to skin. She was sooooo soft. I nuzzled my mouth and cheek against the top of her fuzzy little head, and she snuggled into me. She started rooting, so I helped her find my breast. She latched on easily, and we were nursing! Soon I had another contraction, and I gently pushed my placenta out. Dr. Stone stitched up a small laceration while my baby and I cuddled. For several hours I just felt warm and fuzzy and wonderfully happy.

Altogether, my labor was about six and a half hours. I stayed in the bed afterwards and rested with my baby, ate a big breakfast, and took a shower. By the time all the family arrived, I was fresh and clean and moving around. My recovery was so much easier the second time – no swelling from IV fluids, far fewer stitches, no narcotic pain medication (or its side effects), and less muscle stiffness thanks to my mobility. But by far the best thing about my recovery was the emotional high. My body created its own pain relief with oxytocin and endorphins (and no medicine interfered with that process), I was in a natural state of euphoria that carried me all the way through the postpartum period. I was emotionally healthier after my second birth, in large part due to its being a totally natural labor. I had done it. I carried the art of natural birth through to another generation. And I was finally content.
~Jennifer