VBAC Success: I Will Push This Baby Out of My Vagina!

Despite everything stacking up against my desire for a VBAC (vaginal birth after cesarean) – previous big baby, ultrasound estimating an even bigger baby, being overdue and having gestational diabetes – I was ultimately successful and delivered my second daughter vaginally.

Going into the end of my pregnancy I realized I’d need help. Ultimately we booked with Rene’ at Birth Help because we felt a connection with her and she is the most experienced doula in town, having been supporting women in childbirth for as long as I’ve been alive!

My husband and I also took Rene’s Natural Birth Series, where we learned a lot and communicated with each other in new ways. Although we never felt fully prepared we definitely were coming into the homestretch of the pregnancy in a much better position than with our first when we were very much like deer in headlights.

During the class I fell in love with the idea of printed birth affirmations. Words are important to me, and I love fonts, text and graphic design. I had fun researching affirmations and laying them out before printing them on cardstock. Rene’ suggested we post the affirmations around the house, and a favorite one became “I will push this baby out of my vagina!” My 4-year-old especially loved saying that one, and I’m grateful I got to live up to that goal for us both!

I knew I was having a big baby. My first was 9 lbs, 10 oz, and ultrasounds late in the pregnancy were predicting an 11+ lb second baby. I knew in my heart that she wasn’t quite that big, especially given my strict diet and lack of weight gain (thanks, gestational diabetes!).

The fear of a big baby and an increased risk of shoulder dystocia led my doctor to recommend a repeat C-section. I appreciated her concern and where she was coming from. We carefully considered it, but I knew deep down that I had to at least try laboring. When I expressed my wishes to attempt a VBAC even with a big baby and explained my reasoning, she agreed to support me. I appreciated this respect for my body, my baby and my choice. I also trusted that she would keep a watchful eye and I could rely on her medical expertise should a C-section ultimately become a necessary rather than being an elective, if recommended, procedure.

This baby girl did not want to be born and was happy to stay inside me growing and growing! Ultimately we decided to induce at 41 weeks and 5 days. She was born the next morning, so very close to 42 weeks gestation! I had tried everything possible to jump start labor, from walking to pumping to chiropractic care to supplements to sex. She wasn’t budging unless forced!

My husband and I arrived at the hospital bright and early for our induction, and check in at admitting was straightforward. We were surprised by our pastor being there to pray with us before getting started, and I am beyond grateful for the support we had (and continue to have) from our St. John’s United Methodist Church family. Rene’ met us at the hospital just after that.

After getting set up and checked – 2 cm dilation but baby still high – the induction began with my doctor placing a Foley bulb. There was a bit of “who’s-on-first” about finding a Foley bulb. Eventually they found what we needed, and at about 8:30 a.m. the Foley bulb was placed. This is a mechanical dilator – basically two connected balloons, one goes inside the cervix and one is on the outside. Each is inflated with water, and the pressure helps get the cervix to open. Because I’d had a cesarean, chemical cervical ripeners were not an option.

Rene’ was critical to our success, giving recommendations and advice that really helped labor progress. I was attempting a natural birth, although VBAC was the greater goal. After a brief rest, I started alternating walking and using the breast pump, both of which stimulate contractions to effect cervical change as well.

My doctor was also key to my success, as she was very encouraging and even requested a natural birth-friendly nurse for me, something she said she’d never done in the years she’s worked at the hospital. As long as I was OK and the baby was OK, we were going to make it work, and we did.

The Foley bulb can stay in for about 12 hours, and after laboring all day, I had dilated to 5 cm and made great progress in effacement. The breast pump was especially effective to get contractions going. I kept laboring into the night in various positions, including in the Aqua Doula tub, on the bed with and without the peanut ball, on the couch, on the birth ball and even in the family room at the end of the hall. I had a lot of back pain, which scared me thinking that my baby was in a non-optimal position for delivery.

Eventually I found myself “stuck” at 7 cm. It wasn’t the number that was tripping me up or even the amount of time left to go, but the intensity of the pain and knowing things had to get a lot worse before they’d get better. My fear overcame me, including the fear of a big baby who might have been malpositioned. After discussing things with my husband and doula, I said my code word. At this point, I was certain I was headed for a C-section, so it was very emotional and scary for my husband and me.

The “no regrets” triangle started, I was checked – still 7. They called for the epidural, and I was checked again just before it was placed, still a 7. I was completely at peace with the decision at this point and there were no regrets in the moment. The epidural was placed, and I was looking forward to a break and hopefully a rest.

No such luck.

The epidural placement was kind of a fiasco because it only took on my right side and I was still rocked by contractions on the left. I was desperate for relief at this point since I couldn’t change positions to better manage the contractions. The anesthesiologist pushed some more medicine, but I never got complete pain relief. After the shift change, a new nurse checked me and said to forget having the epidural redone because I was 10 cm, complete and would soon be ready to start pushing. (So much for that C-section I thought was inevitable!)

After laboring down for about an hour with the peanut ball, I started pushing. I didn’t want to do the purple pushing, as I’d had a consultation with a pelvic floor specialist who had taught me how to push effectively and minimize tissue damage by breathing the baby down and letting my uterus work. But the nurses and Rene’ encouraged me to bear down and hold my breath. I felt like the epidural changed things and I should just do as I was told.

It took about an hour of pushing to get my daughter to come down. And at 8:54 a.m., she was born — huge, screaming and beautiful. I was so happy and in disbelief as my doctor placed her in my arms. There were about 10-12 people in the room in case she did get stuck. Thankfully they weren’t needed, although their collective gasp at the sight of the size of her head is a fun memory for me. I was able to hold my girl immediately after birth. Our wishes for delayed cord clamping and extended skin-on-skin contact were respected.

About an hour later, she was washed and weighed – everyone was anxious to know how much she actually weighed. She came in at 10 lb. 8 oz. So not quite an 11-pound baby, but certainly close.

Rene’ was key to the VBAC success with recommendations and advice that really helped labor progress. I know I couldn’t have gotten to 7 cm naturally without her, and her support to both me and my husband during labor and before and after the birth has been invaluable. My doctor’s support was important, as was the assistance of all the labor and delivery nurses who worked with us. My husband’s presence and hard work with me, loving me through the ordeal and after, might be my favorite thing about the experience, after my daughter’s existence of course!

Bottom line – I had a successful VBAC and proved that my body works and can birth the baby it created. I didn’t have to have any drug interventions. My body did all of the work of labor on its own, with just a little push from the Foley bulb and breast pump. I’m proud of that. I’m wildly proud of pushing out my bigger baby. Did I mention that I PUSHED A BABY OUT OF MY VAGINA?!

- Mari Walker