Prayers in the Darkest Hours

Shari, you are such an amazingly beautiful woman; tenacious, steadfast, and headstrong! You committed yourself to the birth you wanted it, and although you battled your mind and heart through a trying process, you came out victorious!

Your provider, although he was supportive of a VBAC, his nurse practitioner and his back up weren't. When you learned of his plans for vacation, you began to get worried. When his NP started discouraging you with false statistics, induction talk, and the benefits of scheduling a repeat cesarean, you became even more discouraged and worried.

I talked with you about how we would manage labor if your doctor was out of town and we discussed how to stall any hasty scheduling of cesareans or inductions. And I reminded you that it wasn't too late to transfer care to a home birth midwife. I could hear the wheels turning after that conversation.

So, at 39 weeks, you hired a home birth midwife. Early labor had been going on for days. Prodromal, bothersome, discouraging stuff... You would have evening through early morning labor, but nothing much during the day time. At the same time, you were starting to show slightly elevated blood pressure and low amniotic fluid levels. Your midwife put you on a strict diet and daily practice routine and your blood pressure equalized.

Then, one morning, you woke and labor hadn't stopped. You were getting some mucousy show, and I felt you were really entering your true birthing time. Your husband ran past another doula's house to get a last-minute birthing pool and set it up.

Your midwife arrived to your home to check on you before she committed to going to another clients house a few hours away. When she got there, you were found to be early/active laboring, and your cervix was 3cm and 80% effaced.

I headed right over and your midwife cancelled her evening plans. You were making ready to have a baby. When I arrived, you were very chatty and we talked a lot about your last minute choices and how encouraged you were with your birth team. I massaged your back, offered counterpressure, gave cold washcloths, and recommended position changes.

You were intuitive, happy, but serious. I could tell that days of early labor, along with the stress of your last week of pregnancy and prenatals, had really taken their toll on your emotional and physical health. So we set out to emotionally encourage you while giving you as much rest as your labor would allow.

You moved from the bedroom on your side, to the bathroom on the toilet, to the ball in your living room... restless and active, tired and stoic. Nearly every hour I would  hear you mumble, to no one in particular "I'm done"... And I would pipe up "Done with the bathroom?" while helping you back to the ball, or "Done with your water?" before refilling it again. I knew you were feeling empty, but I was going to be your optimism, even when you felt far from finished.

Soon, you began making lots of pushy noises and you moved from 7cm to complete rather rapidly. You finally sank into the pool, only to have to get out right away when babies heart rate dipped low and didn't recover very fast.

You then began pushing on your side, but it only worked for a short time before babies heart rate again began to dip. So, to the birthing stool we moved, where, again, babies heart rate tolerated it for the space of a contraction or two before getting wonky again.

After FHTs dipping too low and staying too low too long, we talked with you and your husband about the need to move to the hospital. We weren't giving up the goal of a VBAC though, and we had a plan in place for when we arrived.

After you were both packed into your car and your midwife had given me a secondary E-childbirth kit (mine was already in my trunk) we sped off toward the hospital. On the way, I was pulled over for our speeding, but I was glad to see your tail lights continue on around a corner, because, although you were in knee chest position in the back seat, your urges to push were becoming overwhelming.

I arrived about 10 minutes after you had, and you were already in your room. The hospital was not being all that accommodating and they were attempting to separate you and your husband regardless of the fact that you were actively pushing with every contraction, which were nicely spaced to 5 minutes apart. When I arrived in your room, I had had the opportunity already to talk with administration in the hallway and notify them of why you both were unwilling to separate for admitting (which was standard practice at this hospital).

You were admitted to a room and were going through preliminary paperwork while the doctor was on his way to the hospital - the doctor who was not supportive of VBAC. The nurses were not happy that you were 10 and pushing at arrival, but you and I worked quickly and diligently to change their attitudes to ones of support for your desires to VBAC.

After he arrived, the doctor assigned to you was less than willing to support your desires for a low-intervention VBAC; but with one nurses help and both of our gentle encouragement, you began pushing again in earnest and your baby was quickly brought to crowning. As you brought your baby out into the world, you beamed from ear to ear with confidence - you had done it!

Little baby girl had a slow start and they did need to help her get pinked up, but you had birthed your baby in your own power and in your own time. You achieved what your first doctor, your doctor's NP, and the back-up doctor all tried to dissuade - a vaginal birth!

Later, when we talked about what you were 'done' with, you admitted that you were trying to convince yourself that you were giving up and ready to check yourself in for another cesarean. Even up until you were really getting into a rhythm of pushing, you felt like you wanted to throw in the towel. But, in hind-sight, you said something profound, "It wasn't that I wanted to give up, I just wanted to be done. I thought, it took me that long to get to this point, I really didn't believe I was really almost done. It is the fear of all that lead up to this moment being in the future that makes a woman want to throw in the towel".

In the end, your birthing time began, not when the first crampy contractions started, but 4 months earlier when you sought out a more VBAC friendly doctor, and later, a home birth midwife. Your journey was also truly a journey. You went from a planned hospital cesarean, to a planned hospital VBAC, to a planned home VBAC, to an unplanned hospital VBAC. There was so much uncertainty, worry, and adversity during your pregnancy-birth journey... but also so much growth, education, and empowerment!

I watched you wrestle with your own very real and tangible demons throughout your pregnancy and birthing time, and you still rose above the enemy, doubt and fear. Your husband's prayer in the corner of your bed in the darkest hour of your labor was right, 'you were not given more than you could handle, and you were given the strength to run the good race'.

Welcome baby girl! You have a marvelous role-model to look up to!

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