Last week we welcomed our fourth child into the Fagan home via a successful induced VBAC. I hadn’t planned on being induced, via the doctor breaking my waters, but neither did I think my daughter would have very low amniotic fluid at her 40 week doctor’s appointment. Her birth story is different than my others (read my son’s VBAC birth story and my twin daughters’ scheduled C-section birth story), but I am grateful that everything went great and my baby and I are healthy and home. We were able to go home on my 27th birthday.
The Condensed Successful Induced VBAC Birth Story
Monday, July 27, 2015
9:00 am – 40 week 1 day doctor’s appointment. I am 4cm dilated, 50% effaced, and at a -2 station. Doctor strips my membranes.
9:30am – Ultrasound shows low amniotic fluid.
10:00am – Non-Stress Test at the Office
11:00am – We are allowed to go home, drop off our kids, etc but are expected to go to the hospital to be induced in 2 hours
2:30pm – Arrive at Hospital
6:30pm – 5cm dilated, 70% effaced, and at a -2 station. Doctor breaks my water and places an internal fetal monitor.
10:00pm – Got an epidural
11:00pm – 6cm, 75% effaced, and a -2
Tuesday, July 28, 2015
1:15am – Lowest dose of Pitocin started
3:25am – Fully dilated and ready to go! I start pushing!
3:32am – Emily Louise Fagan is born after 3 contractions!
The Full Induced VBAC Birth Story
After my first successful Vaginal Birth After Cesarean (VBAC) with my son, there was no question in my mind that I wanted to have another successful VBAC delivery for my fourth baby. But, we would be starting over with a new doctor, in a new state, and in a new hospital, all of which could potentially make it hard for me to have a Trail of Labor After Cesarean (TOLAC) and a successful VBAC, even though I have already had one before.
All during this pregnancy I have been a tad nervous because I was seeing an OB/GYN and not going to a midwife practice (who worked at a hospital) like I did for my son. I guess after my first experience with OB/GYNs, back when I was pregnant with my twins, I have always been a bit leery of them as that first practice often left us feeling more like a number than an individual.
But, my doctor came recommended and he was the only OB I saw during my prenatal care visits and ended up delivering my baby as he was on call that night. He did cause me concern as he, more than I, worried about the likelihood that my baby would be large. I told him it’s in my genes. My mother had all large, overdue babies. I was 10lbs 13oz at birth. My husband was a large baby too at 9lbs 15oz at birth. And my previous VBAC son was also 9lbs 8oz. I felt like I had to keep reassuring him that size wouldn’t affect the outcome and to trust me and relax!
Surprising no one, I hit my due date and still didn’t have my baby in my arms. I had always known that I would see that due date come and go, and told myself that in order to keep my spirits high. After all, my son was born 13 days past his due date.
Here I am the day before my due date, after I climbed a nearby “mountain” hoping to get those contractions going. Thankfully this time around more dilation and progress were being made than with my son.
At 37 weeks, my doctor checked me, and I was about 2cm dilated, 10% effaced.
The next week, at 38 weeks, when he checked me, he apparently couldn’t get to my cervix, even with my hands in fists under my butt, as I carry high and back (I’ve also been told I have a tilted uterus by my midwife). However, he sure hurt me trying, and caused me to spot and the next day I lost my mucus plug. In fact, that week I started to feel my first real contractions (I have Braxton-Hicks contractions regularly throughout my pregnancies, feeling them as early as the second trimester) where I’d feel that heavy ache in my lower abdomen.
At my 39 week appointment, I asked him to strip my membranes as he checked me. I mean, if he’s going to be getting up there, he might as well try to make it worth while. Plus, his concern about the baby’s size had prompted him at an earlier appointment to say he’d start stripping my membranes at this point. So, he checked me, and I was at almost at a 3, and about 20-30% effaced, and then stripped my membranes.
I felt a little weak and light-headed after the exam, but did not go into active labor that week. I experienced more real contractions, and sometimes a bit more regular, but nothing that would signal I should go into the hospital. I could still easy move, talk, and carry on while I experienced these contractions.
My 40 Week Doctor’s Appointment
My due date came and went and I went into my 40 week appointment the day after my due date, at 9am. The doctor checked my cervix, said I was at 4cm dilated, 50% effaced, and at a -2 station. Clearly, things had been progressing, and I had been having good contractions, but still nothing super regular. He stripped my membranes again. I was very optimistic that baby would come soon.
Little did I know how soon.
My doctor did an ultrasound in the office just to check on baby, and see how large she was (again with the freaking out about her size….). He estimated her weight to be about 8lbs 11oz. However, what did concern him was that there was so little amniotic fluid around my baby.
With low fluid there come some risks involving the cord and the placenta and other things, and since I was already full-term, he said that he would go ahead and send me over to the hospital and break my water, because it wouldn’t be good to let me and baby go for potentially another week with such a low amount of fluid, as it continues to decrease the longer you’re pregnant. Low amniotic fluid levels, called oligohydramnios, can cause complications in about 12% of pregnancies that go past 41 weeks (source).
My husband and I were a little shocked by this. And worried. Breaking my water? That would mean a point of no return. It would mean being “on the clock.” Plus, doesn’t it seem worrisome to break the little water that my daughter had around her?
We asked the doctor if we could go home first, especially since we had our three other children with us at the appointment, and needed to make arrangements for them, and still had to pack overnight bags for them and hospital bags for us (oops! Totally didn’t get that one done ahead of time!). He said he’d let us go if I did a Non-Stress Test first and it looked okay.
I sat on the monitor for a while, as my husband entertained our children in the small room, playing Simon Says (I have such a great husband, who’s such a great dad). We ended up being at the doctor’s office for two hours that morning.
The NST looked good, and he let me go, giving us two hours to take care of things and then get over to the hospital.
We made some phone calls, packed some bags, cleaned our messy post-weekend kitchen, put some clothes in the dryer, and dropped off the kids at a friend’s house.
Because I was nervous and worried about being induced, as I really just wanted to go into labor naturally, which I felt like wasn’t that far off anyway, my husband and I decided we would do some walking before we’d head to the hospital, and go over that 2 hour mark. It’s not like they could do anything about it!
We went to Target and bought a few things like a robe for me to wear at the hospital. We did a few laps at Target, and I even had a couple contractions naturally. We then went next door to the Walmart where we also bought a few more things, like socks for our kids. We also went to Rack Room Shoes and bought some new church shoes for our daughters, as they were needing a new pair. Call the last minute shopping a final nesting period, or just fearing too much hospital intervention, but we stalled going in to the hospital.
Going to the Hospital
We finally made our way to the hospital, checking in at about 2:30pm. I got changed, hooked up to the monitors, signed all the paperwork, which, in case you don’t know, is basically a bunch of terrible information to consider and read before giving birth, as various things could cause terrible defects, surgeries, or even death. Totally awesome.
After an hour sitting in that terribly uncomfortable bed, doing nothing but joking and having a great time talking to my husband, I asked if we could at least walk around for a little bit to maybe get me to have some contractions on my own. Plus, it would give us something to do for the next few hours until my OB got off from his regular shift next door and could come over and break my water.
They agreed to hook me up to the telemetry monitors. Unfortunately, I have a super round basketball-like belly when pregnant, so getting these monitors to stay put, and stay connected and reading properly proved fairly difficult.
We often had to make pit stops back in our room for the nurse to adjust the monitor, again. Bless her for being so patient, and not just telling us to stop walking and just sit in the bed. Our walking loop was super small, and I didn’t have many contractions, but at least my husband and I had fun talking and walking. For whatever reason, we both become quite the jokers when we wait for our babies to be born.We eventually ended back in the room for a bit, sick of the monitor issue, and sick of the same loop.
My doctor finally came in a little after 6pm and went over a few more things. He checked me before breaking my water, and I was now at 5cm dilated, 70% effaced, and at a -2 station. Looks like things had progressed (on their own), and I was in a very (slow) active labor anyway, so he was optimistic that everything would be great and that breaking the water would speed things along and be best for the baby.
Breaking My Water
He broke my water at 6:30pm and inserted an internal fetal monitor, which was super weird. The heart rate stopped sounding like a warm swooshing sound on the monitor to a steady knocking sound instead. I also had a metal wire coming out of my vagina, and taped to my inner thigh. Talk about weird.
And now we waited. I could still get up and walk around for a while, even using the bathroom, but it was weird because I was dripping small amounts of amniotic fluid wherever I went. The contractions did eventually start to come, though pretty slowly at first.
To switch things up I got on an exercise ball, which I felt like was too low to be super effective, but at least I could move around a bit and try to stretch out my back, where I started to feel those contractions more intensely.
The contractions started to pick up more, and the pain in my lower back increased as they did. I cannot stand lower back pain. I hate it. So, at 10pm I got an epidural, my first one done by a female anesthesiologist, and she wasn’t even foreign. She had just had twins five months prior, so we had fun talking about twins as she put my epidural in place.
At 11pm the doctor came in and checked me and I was at 6cm, 75% effaced, and a -2.
However, I wasn’t progressing super fast, after that, so the doctor had me start on the lowest dose of Pitocin at 1:15am.
I enjoyed sleeping some after the epidural was placed, even though the right side of my body still felt some pain during the contractions. I rolled onto my right side hoping it would spread over to that area better.
Shortly after 3am the nurse came in and checked on me, asking me if I felt any pressure to push yet. I said I didn’t yet. So, she left. And about 5 minutes later I started to feel much more pressure during contractions and the baby’s heart rate decreased during them. After a few contractions, the nurse came in, and said it was time. The doctor came in, and everything was prepped for delivery.
This was it! We were going to have a baby! And it wasn’t going to be a C-Section!
At about 3:25am I started pushing. Three contractions later, she was born at about 3:32am, Tuesday, July 28, 2015, two days after her due date, and put on my chest.She was here! And she was ours!
My husband cut the umbilical cord, and he cried his happy new father tears.We named her Emily Louise Fagan.
She weighed 9lbs 4oz and was 21.5″ long (so much for that 8lbs 11oz ultrasound guess earlier). She has super long fingers, big feet with long toes that can spread apart really far, and had a squished, crooked nose when she came out. She has several birth marks, and we suspect she will be a blond. She has blue eyes and is a great little babe.After I delivered the placenta, the doctor put in some internal stitches as I tore a little inside. I did later, when I finally got up to go the bathroom on my own, several long hours after delivery, pass a fairly large blood clot, but everything since has been fine and normal.
Having an induced VBAC was not exactly what I had planned. I had wanted to go into labor on my own, like I had for my son, even if it would have meant another 36+ hour labor.
I do not care much for medical interventions or hospitals. Breaking my water, using an internal fetal monitor, and using Pitocin to augment labor, were not exactly things I had planned or really wanted. But, I hadn’t really planned on my daughter having such low amniotic fluid, which presented its own set of risks if I had let it go and waited longer for my labor to progress, especially since my previous labor was so very long.
But, I am thankful for modern medicine and for the fact that I still had the type of delivery I wanted most of all – vaginal.
Welcome to our family baby Emily! I am so glad you are here, and that I didn’t have to wait 13 days after my due date again.
C-Section Vs VBAC – The Pros and Cons of Both