Luke's Birth Story (HBAC)

Another birth story!  This time from a mama who chose an HBAC (home birth after cesarean). Thank you, Sarah, for allowing us to share your story (oh, and for blessing me with my nephew Luke)! For stories from other mamas who have experienced previous cesarean deliveries, please visit ICAN of the Twin Cities' web site:  www.icantwincities.org/birth-stories.html
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Why would anyone choose to go through this again?  I would never consider giving birth at home. I could have died the last time.

These were all things I thought or said at one time or another after my traumatic cesarean birth with my first child. How things change given the right support, time to heal, and empowering education! 

My contractions with Luke began around 11:30pm on Sunday night, May 25th. My "due date" had passed that Friday and I was continuing to struggle with fear that I would not go into labor. This was a powerful fear for me, because I was induced with Micah and so had never experienced going into labor on my own. It was one of the ways I felt like I had failed the first time around. I had been having similar contractions at about the same time each night, but they would go away after three or four intervals of 20 minutes, so I really didn't think much of these. 

Until they didn't stop... 

I laid in bed resting, watching the clock and noting that the contractions were about ten minutes apart. I really didn't believe I was in labor. At about 1:15am I decided I would wake Jerry up if they hadn't stopped by 2:00am. 

At 1:30am, I woke Jerry up. 

The contractions were coming just a few minutes apart now and were getting more painful. Jerry asked if I wanted him to call our midwife. I said yes. He also went downstairs to start filling the birth tub. I moved to the bathroom and the contractions were coming hard and fast now. I started having bloody show. Jerry, on the phone with the midwife, asked if I wanted her to come now. I said that I did, but asked if she (our midwife) would be upset if it ended up being nothing. I laugh at this now, because I know now that I was in transition at the time, but in that moment I really still believed that I wasn't really in labor! 

Around 2:00am, our apprentice midwife arrived. I think I was back in bed by this point. I think she may have taken my vitals and listened to the baby and started jotting notes while we waited for the midwife. At 2:30am, the midwife arrived. While we were waiting for the birth tub to fill (I could not wait to get in that thing!), I filled our bathtub with some water and spent some time on all fours in the tub. For some reason, I also liked kneeling on the floor outside of the tub with my hands in the water. Something about the water was really calming. While in the tub, one of the midwives massaged my tailbone. It felt miraculously soothing and so calming. At one point, I asked the midwife, "What do you think?" She said, "Well...I think this is probably going to be a pretty quick labor." That was my feeling as well, especially since I had gone so quickly from pretty moderate contractions to transition in just a few hours. 

I'm not sure exactly what time it was, maybe around 3:30 or 4:00am, I started pushing. No big deal. No cervix check to make sure I was dilated to ten (in fact, I did not have one single cervical check the whole labor, or the entire pregnancy!). It was so simple. I just said to my midwife, "I think I'm pushing." A few minutes later I heard her say to the apprentice, "She's been pushing for a while now." 

Finally the birth tub was filled! The walk downstairs from the bathroom to the tub in the dining room was excruciating. I had to stop once in the middle of the stairway to push - legs shaking and my midwife holding me up. Once I got in the tub, I was relieved. I needed that water to contain my labor, contain my pain. I felt safe in that pool. The idea of pushing any longer outside of the tub scared me. I'm not sure why. But it would have taken wild horses to pull me out again! There was, however, some discussion over the temperature of the water. It wasn't quite as warm as my midwife likes it to be for birth. She was concerned that it would be too cold for the baby. The midwives boiled water on the stove and (I think) Jerry brought buckets of hot water up from the laundry sink. Throughout it all, I was aware that the controversy was going on, but not worried. As I said, it would have taken wild horses to pull me out of that tub! Eventually, it seemed to reach a temperature that was agreeable. 

Pushing went on for three and a half hours before Luke was finally born. I never really worried about it. The whole time I was just pushing as the urges came in the tub. The midwives and Jerry were all very encouraging. The most amazing part, to me, after not feeling a thing during my first labor due to the epidural, was that I could actually feel the baby moving down the birth canal. So, I knew that what I was doing was productive; the baby was coming. I spent most of the time in the tub on my knees with my arms over the side of the tub, squeezing someone's hand (usually Jerry's) when the contractions came. It was quite painful! The volume was definitely turned up on my vocalizations over time. 

At one point, my water broke and it scared the daylights out of me. It was during a push and it just burst into the water. I said, "Oh my gosh, what was that?" One of the midwives said, "I think your water just broke." Oh, of course! I forgot that hadn't happened yet!

 Throughout the process, my midwife would periodically listen to the baby's heartbeat using a waterproof dopplar. Each time it was reassuring; the heart tones were strong and of the right beats per minute. Upon one listening, I remember our midwife saying, "Well, you're just not at all bothered by labor, are you?" to the baby. Since drops in fetal heart rate are the #1 sign of uterine rupture, this was a big relief. 

Finally, at around 6:30am (maybe a little earlier), the midwife got up and came to check the baby's head position. I'm not sure what she was seeing in my labor process; it felt to me like she knew something was happening or needed to happen at that point. The baby's head was very close. She said, "You've got lots of room," which gave me confidence that I could birth the baby. Another of my big worries after my cesarean was that my baby would be "too big" to fit through my pelvis since my first son was so large (10 lbs, 14oz). 

The midwives encouraged me to change positions so that I was squatting with my back against the side of the tub and Jerry supporting me under my arms. At first, I was resistant. It hurt a lot to be in that position. This was probably a sign that I needed to be in it to get through the final pushing process. I'm not sure if we were stalled out in my previous position, but it was clear that there was more action after I moved. Soon I heard the midwife say, "We have our first crown." It was excruciating. I knew the end was getting close, but it hurt so much. My vocalizations got even louder, and probably a bit more desperate. 

My memory of what all happened from here on is a little fuzzy; understandably so, I guess. I remember the head being born and my midwife saying she was reaching to check for the cord around the neck. Then I heard her say something like, "We have fingers." At this point, I was hollering quite a bit with my pushes. I heard the midwife say, "Sarah, I need you to focus all of that energy down to push your baby out." So I tried. Soon, I felt the baby come completely out. I have a hazy memory of reaching down to pull him to my chest. The midwife said that the cord was plenty long, so it was no problem for me to have Luke in my arms. I was in utter astonishment that I had done this, and totally blissed out to be holding my baby in my arms fresh from my womb. 

After things calmed down, I learned that Luke had had a nuchal arm. That is why the midwife felt fingers when she reached to check his neck. She had to take Luke's hand and pull it up and out in order that his shoulders could be born. Once she did that, he slipped right out. No wonder I was in such pain and pushing took so long! The little guy was trying to be born with his fist at his neck. It made me realize that had I been laboring like this in the hospital, they probably would have wanted to operate. But there was really nothing wrong! Luke and I worked it out together with our midwife's added wisdom and experience. Amazing how simple it was! 

While still in the tub, we called all the grandparents and my sister to share the news. Providentially, my parents had Micah, the brand-new older brother, up at the lake cabin with them. So, we never had to worry about what to do with him while I was in labor. Everyone was amazed that it had worked out so well and happened so fast. I had just talked to my mom and sister the day before when nothing was happening. 

Birthing the placenta was a breeze. After Jerry cut the cord, once it stopped pulsing, it was time for me to stand up and get out of the tub. I handed off the baby for Jerry to snuggle against his chest while I got up. The midwives simply held a plastic bowl under me while I stood up and out slipped the placenta! 

I made my way upstairs to the bathroom. At this point, I did start to feel quite lightheaded, as if I might faint. My midwife gave me some Emergen-C as well as some herbal tinctures under the tongue (I'm not sure what they were). Then I moved to my bed and felt better lying down. Under inspection, it was clear that I was bleeding from inside fairly heavily. I asked the midwife if I was in trouble. She said no, that my uterus just needed to clamp down. It would help if I could empty my bladder. Problem! I have terrible performace anxiety about this and my perineum was stinging quite a bit. So, I wasn't able to. But the midwife reassured me that I would be fine, massaged my uterus and taught me how so that it would go down. Later in the day, I was able to empty my bladder and there were no problems with excessive bleeding. 

Despite Luke's hefty birthweight (9 lbs, 5 oz), I had only one, very minor tear. No doubt the water and my midwife's gentle coaching in pushing helped keep me from more significant tearing.

The rest of the day was spent laying in bed, cuddling with Luke, and welcoming family as they came to visit. I was so proud of myself, I could hardly stand it! I felt victorious, vindicated, redeemed! No longer defined by the scar on my belly; a women who CAN birth her babies, even if they are big! 

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