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VBA2C makes 7

I remember meeting Felicia for the first time like it was yesterday. My schedule was full for the month she was due, but she said a facebook group told her that I was what she needed, and she was hoping I would reconsider. 

Felicia and her husband Tom each came into their marriage with two children. This baby would make number five, and be their first together.  The other four children were all born via cesarean section.  Felicia told me that while Tom was nervous, he was also very supportive of her having a VBA2C. 

While Felicia's current practice told her that she could try, they wanted her to go into spontaneous labor, with no induction assistance, prior to 39 weeks.  This is not a practice that is supportive of VBAC's.  In the birth world we call them "VBAC tolerant", which overall means they say yes, but with a lot of restrictions and rules, that make it almost impossible.

When I explained to Felicia how much a provider could impact her birth, she decided to call the list of supportive vbac practices I gave her.  I was super excited when she told me later that day, that With Women's Wellness had a spot open.  I was shocked actually.  They usually fill up quite fast and Felicia was already into her third trimester. It was a huge win. 

On the morning of January 8th, Felicia had texted me that she was having some cramping and that she didn't think the baby was moving very much.  I had her do some things to get him to move a bit more, but she was still very nervous. Early afternoon, she told me that she was having mild contractions every 3 minutes, and that she felt as though the baby wasn't moving again.

I suggested that she call into her practice and they decided to have her come in for check. 

Felicia was at the hospital and still feeling very anxious. She texted me, "No one is telling me if he is fine or not."  I had her send me some video of her the baby's monitoring strip, so that I could reassure her and explain what was going on. 

The strip would also lean me way more towards a UTI, then labor. UTI's, if significant enough, can sometimes cause preterm labor, and while Felicia was technically term, she was not in labor. Felicia hadn't had any cervical dilation and her contraction pattern on the strip was too close, to be anything else. 

I sent her back this explanation of the strip and that seemed to ease her a ton. Her baby was great. Her bladder though, not so much. A UTI was confirmed and treated. 

On the morning of January 22nd, I received a text from Felicia that she was at the hospital again. They had gone in the middle of the night, because she wasn't feeling the baby move. I called her and could tell she was once again very nervous, even though nurses had confirmed everything with the baby was fine. 

I believe that most anyone can have a VBAC. That physically, there are very few cases, where someone cannot birth vaginally. The biggest hurdle, tends to be that of our own mind. One of the ways I often see this manifest, is in fear of lack of fetal movement. 

Felicia decided she wanted to have an induction, even though her midwives were supportive of her heading back home. She was having some contractions here and there, and had fear that something would happen with the baby again and they'd be right back in this place.  Their other four children were safely in the care of someone else, and she was ready, whatever the outcome. 

I arrived at the hospital in just a short time and discussed with her the next steps. 2 hours after my arrival, they started pitocin.  While Felicia was feeling some cramping here and there, her body wasn't responding as we had hoped to the Pitocin. I told them that sometimes inductions can take days. Both of their eyes widened but they were committed. 

We chatted and laughed through out the day. I encouraged rest and nutrition, but both Tom and Felicia were buzzing with energy and struggling to sleep. Suzanne and Erin, the midwives, would also spend lots of time with us.

At 8:30pm with the Pitocin at its max level, contractions had gotten to 3 minutes apart, but Felicia was still coping with them quite nicely.  At 9pm her cervix was evaluated and she was 3cm dilated. She was 2cm upon a arrival and I could tell they felt disappointed by hearing that not much had changed. 

After a bit of a discussion, Felicia decided to have her water broken at 10:20pm.  Within 30 minutes or so, Felicia was in full blown labor, and struggling a bit more than before. We started doing some counter pressure, and then eventually found her some relief in the shower.  She would stay there for a few hours, before deciding to come out and try to lay down. 

She was unable to get any rest at this point and at 1:40am, Felicia decided to try nitrous. The nitrous was allowing for her to sleep in between her contractions.  Felicia said that she had a lot of pressure in her bottom around 2:30am and a cervical check would reveal she had made a ton of progress and was now 8cm dilated.  

Felicia started to get a bit grunty around 3am. The nurse asked if she felt like she had to push and she said, "I don't know if I have to push. My body is telling me to run!" Felicia was having extreme pain in her back and was saying that she felt very sore. We started to hear her bear down with contractions.

Suzanne did another check and Felicia's cervix had swollen back to 6cm.  I know some people are like, WHAT!?!?!, so here's a short explanation. If you begin to push before being fully dilated, your cervix doesn't usually just get out of the way, it swells from having all of the pushing pressure on it instead. Felicia's cervix had swollen on one side and thickened back to 6cm. 

Felicia wailed from the news, "Everything was going so well! What is happening now?!".  Since Felicia had been bearing down with each contraction prior, she was now struggling not too.  She was so tired from having been up the night before, and now all night tonight.  We all suggested that getting an epidural could help her rest and stop pushing.  She was in full agreement. 

Suzanne checked one more time before the placement of the epidural at 4:30am, and she had swollen now all the way around the cervix.  Felicia got an epidural and was now able to sleep.  We all rested for a bit, and I went back into the room to check on her at 7:50am. 

Felicia was in absolute great spirits. She had gotten a few hours of rest and she told me that she was a bit scared to find out what was going on. Through this entire process, Felicia had a pretty good game face, but for totally valid reasons, now she was a bit nervous. 

At 8:30am, after chatting for a bit, opening the curtains, and sitting Felicia up, she said she felt like she had a lot of pressure in her bottom.  A cervical check would tell us that it was for very good reason! 

Felicia was fully dilated and the baby was at +1 station at 8:43am. Felicia pulled her legs back just a little bit, did not engage in pushing, and we all saw the top of her babies head. The whole room erupted with joy! She had no idea what was going on, until I suggested she reach down and touch her baby's head, "Whoa! I am not even doing anything and he's right there!".  Her husband Tom looked down and said "Holy shit! Knew you could do this! You look beautiful." 

Felicia breathed her baby out for 9 minutes and at 8:52am Torsten would come earth side into the arms of his mother. This was the first time she ever had skin to skin with any of her babies.  

He was perfect, and had started to cry even before being fully born.  Tom and Felicia took him in and inspected all of his little fingers and toes.  The space was quiet and filled with love, until the discussion of who won the bets came up. 

Tom was right for most of the things they made guesses on, which seemed quite unfair since Felicia did all of the work. It was an absolute honor to be part of such a huge occasion for this family. Thank you for sharing it with me as well. 

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