Breech birth with Dr. Cummings

Last night I had the pleasure of listening to my beloved OB, Dr. Fred Cummings, speak to the Denton County Birth Network about vaginal breech birth. It was about so much more than just vaginal breech birth that he spoke on, but rather the normal process of birth in general. I know I often gush about my OB and maybe you are sick of hearing about him. The truth is, he is a rare gem. There is no other Doctor in this country like him. No one. Period.

My heart was full as I sat in a room with friends and fellow colleagues in the birth field. Two of my former students, who are now birth professionals themselves. My sweet doula Katie. Fellow VBA3C friends. Fellow Birth Boot Camp instructors that I don’t get to see too often. Beloved midwives in the community. Some I know personally, some I just know of their wonderful reputation in the birth community. Fellow doulas whom I love and respect. All in the same room. All listening to this amazing man talk. It was beautiful.

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Dr. Cummings started his talk by talking a little bit about breech birth. He said people get weirded out by breech, but he has never been afraid of breech birth. In the old literature he says, when talking about breech presentation, it always says to attempt delivery. It doesn’t say to automatically go to a c-section. The problem today is that most doctors are not trained to do it. They are now told to do an automatic c-section. Why? Complications equal problems and it’s “safer” for them to do the c-section. Safer for the Mom and baby, or safer for the doctors? According to Dr. Cummings, no surgery is safer than a vaginal birth. Of course he recognizes the situations when surgery is needed. But vaginal birth should always be safer first.

When speaking to birth professionals, mainly midwives and doctors, he gave three points:

  1. Have patience. There is no reason to rush a baby unless it is critical. Why would you rush a natural process if nothing is out of the ordinary?
  2. Know your patient and also know their spouse. Men get weird about birth and you need to know them and how they are going to handle things in birth. If you know your patient, when something becomes peculiar in the birth process, it will be a conversation and not an argument. If your patient trusts you, they won’t have to argue with you over the situation that has come up.
  3. Make sure you give your patient confidence. There is no reason not to be confident in the birth process. Never lose your brains while you are in the room with your patient. If you doubt them, they will start doubting themselves.

Having had two babies under the care of Dr. Cummings, I can attest that he adhered to all three of these things. This man practices what he preaches. He had patience with me. He took the time to know both my husband and myself. He gave me confidence from the get go. On day one, he told me I was going to do it. And I did.

He went on to talk about the current c-section rate and how it shouldn’t be happening 40-60% of the time. In one of our local hospitals it happens 1 out of every 2 births. (This happens to be the hospital that I had all three of my c-sections!) This should not be. Why is this happening? Because the doctors are impatient and are ready to go home for the day. He said, “You all go online after your births and share your stories with each other. Everyone has the same story! Your baby’s heartrate was dropping and suddenly the doctor swoops in to save the day. It happens too much.”

At 32-34 weeks, he says, a lot of babies are breech. It’s not time to worry quite yet. At 36 weeks, it is time to start talking about options. The first option is to try a version to flip the baby. Know the situation first though. What kind of pelvis does she have? There is still a good chance that they will turn again, because they were comfortable in that position. He will often turn a baby 3-4 times before birth. He says that some of the techniques found on spinning babies, like the inversion, are just as effective in turning the baby. But sometimes the baby will just not turn. But then, he will deliver the baby breech. 95% of the time if you go to a hospital with a baby breech, it is an automatic c-section. Women should ask, do I have a choice? Women never asks this, he says. They just go with what the doctor says. The problem is, most doctors simply are not trained in breech delivery and are not going to do it.

Side note, if you have a breech baby and live anywhere close to the DFW area, it is worth it to drive yourself to Denton, TX. Dr. Cummings delivers breech babies all the time, and will take any mom in labor, regardless if he has seen you before or not. If you call the hospital, he said to say that Dr. Cummings is expecting you, even if he is not. They will call him if you say that. He will show up.

He said when delivering breech, if the head gets stuck in the pelvis, it’s almost impossible to push back up. This is an appropriate time to use the scissors to get the baby out fast. Most women don’t want to be cut, but will do anything if it means the baby might die. Routinely he says, breech babies will come out. You just have to be patient. If you are there with your patient, everything should be fine. You will be there to act when needed.

He went on to talk about the normal act of birth. It’s simplistic, he says. You let the Mom do it. Watch and listen. It’s hard for most doctors with all that education to sit back and let the mom dictate her birth. She will let you know if it’s going to happen or not. She will know. Women can have babies, he says. They just need someone to let them do it!

He went on to share several amazing stories of breech births. One story he told of a woman from Austin who came to him late in pregnancy because no one in the Austin area would even consider a breech birth. He said, “All of you women must have told her on the internet about this doctor in Denton, TX and she listened!” We all laughed. It’s true. We tell everyone on the internet about Dr. Cummings. He met with them, and they decided they would wait and then come close to the due date and stay in the area until baby is born. Two days later he got a call from the husband who was clearly on the road. He said they were headed back to Denton because she was in labor. She walked right into L&D and said Dr. Cummings was expecting her because her baby was breech. Once he was there, she walked herself right into the OR. She just stood there and delivered her breech baby and then said, “Thank you!” Then she walked herself right back to her room. That woman was a beast, he said. Some kind of woman!

Another story he told of a woman who was having twins. “Again,” he said, “You women told her on the internet to come see the doctor who will deliver twins!” We laughed again. This woman was walking the famous sky bridge at the hospital and the husband comes running down the hall screaming that his wife was about to have the first baby right on the sky bridge! Dr. Cummings was with another patient and went running down the hall. There she was, just rocking and swaying. And then she just squatted down and delivered the first baby right there on the sky bridge. Then they got her back to the room and delivered the second baby breech. No problems. Women know how to do this, he says.

One of his patients brought in pictures and a video of her breech birth 15 months ago with Dr. Cummings. We watched on the edge of our seats as he had to very carefully maneuver the baby’s body and head out. It can be a complicated process yes. But it’s normal to him because he does it all the time. You don’t want an unskilled doctor attempting this.” You don’t want to be someone’s first,” he said. They just aren’t teaching this anymore.

He opened it up for questions. One woman asked, what is the biggest baby he has delivered, and is there any truth to the doctors having issues with big babies? His biggest breech baby was 11 lbs 4 oz. “Very few women make babies they can’t deliver. Usually a baby can fit.” he said.

Another woman asked, as consumers, what can we do to convince Doctors to do vbacs and breech births? “Very little,” he says. “If you get sued once, you’ll never take a chance again.” She went on to say, that it just leaves us as consumers and professionals, very frustrated. Yes, he said. There just isn’t much we can do. They aren’t about to change their minds. There are some out there who will do it, you just have to find them! I personally think this was such an important point for him to make. So many women out there on the internet are out there talking about trying to convince their doctors to do this. Most of the time, they just aren’t going to be convinced. It’s better to search until you find someone who will do it.

Eventually, he said, he won’t be around anymore. He has tried to retire 4 times, but we won’t let him! Now he is completely back in business again and plans to be around for a good while longer. But one day he will stop. When asked if he is teaching anyone to carry on his work, he said he has tried. He said he has tried over the years, but it takes a certain kind of crazy to do what he does! He has hopes for this though. He won’t reveal names yet, but he has hopes.

He ended by saying that his life is not directed by the laws of man. “If I put my trust where I know it should be, I have no worries. We don’t do fear in my office. I don’t make any excuses about this, but I trust God 1000%. When I put my trust in Him, I have nothing to fear. What are you going to do to me?”

“It’s pretty easy,” he says. “You guys do all the work!”

I can’t say enough about this great man. God truly did place him on this earth for a very special purpose. We are so blessed in the DFW area to have such an amazing OB who believes in the process of birth and isn’t afraid of higher risk situations. “If I have a woman who says she wants to do this, I’m going to help you. It doesn’t mean it will happen, but I will support you completely. I won’t lose a mom or baby. I have never lost a mom or baby.”

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(Me with my beloved Doctor!)

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(VBA3C sisters with the man that believed we could!)

 

 

It Takes a Village

I recently got an email from a doula friend Maria who told me that one of her clients had her baby and specifically mentioned my name that I was instrumental in her birth because I had recommended my OB to her. I remembered the conversation with this woman and hadn’t thought much about how I could have possibly impacted her having the birth she desired (a VBAC.) Maria said, “Sometimes it really does take a village!”

I started thinking about that line. It really does take a village! I have many aspects of life where I can say that it takes a village. It takes a village to homeschool my children, which is why I am a part of a wonderful homeschool community. It takes a village to parent my children. There are so many things in my life that I could say this about. I thought back to my initial experience with pursuing my first VBA3C. It was amazing to me as I recalled the many people who led me to that path and how each one played a role in my success.

When I first found out I was pregnant with my fourth child, I was terrified. I knew that it meant I would be having a fourth and final cesarean. I did not want to have another surgery, but I also knew that no Doctor would ever touch me after having had three cesareans. Two days after I saw that first positive test, I was nursing my son at church during VBS week and overheard one of the Moms in there talking about her wonderful OB. She said that she chose him because he would allow her to have a VBAC and just felt that he was in line with her wishes with birthing. I trusted this Mom’s opinion, so the next day in the nursing room I prayed that she would come in again at the same time. She did, and I asked her about her OB. I told her I had just found out I was pregnant again and would love to have a vaginal birth, but didn’t think any Doctors out there would allow it. She told me his name was Fred Cummings and that she thought I should definitely talk with him! She only had 1 prior cesarean, so she didn’t know what his stance was on multiple cesareans, but this was the first time I had ever heard about Fred Cummings. That night I emailed several people about my wishes to have a VBA3C. I didn’t think it was possible, but was praying that God would lead if it was His will.

My friend Robyn emailed her doula Kathy to see if she had a recommendation. My friend Marg that I met over the internet through Babyfit (love these ladies!!) asked her friend who is a childbirth educator if she knew of anyone. Robyn emailed me back with Kathy’s response, and sure enough she said that she found out through another doula named Katie, that Fred Cummings would be the one to go to. At the same time, Marg’s friend Sarah had asked on her business page for recommendations and sure enough, Fred Cumming’s name was given. That was the third time that day that I was told to call Fred Cummings. I made the call the next day.

I was so nervous to make the call, not sure if they would laugh at me over the phone. I told the receptionist that I had three prior cesareans and wondered if I could meet with Dr. Cummings for a consultation. Not only did she not laugh at me, she very quickly made an appointment for me for 2 weeks out! I was excited, and nervous at the same time. Meanwhile, I had made my first appointment with my other OB, but wasn’t able to get in with her right away. That appointment was scheduled after my appointment with Dr. Cummings, so I kept it on the calendar just in case. That weekend, I started light bleeding and feared the worst, that I was miscarrying. We were getting ready to go away on a family vacation and I wasn’t sure if I would have to go to the ER before leaving town. The bleeding never picked up, and we went away for the week.

All week, I really didn’t know what to expect. Was I really planning to try for a vaginal birth? Would Dr. Cummings even accept me as a patient? What if he looked at my operative report and said I was a bad candidate? What if I was really having a miscarriage and all this wondering is for nothing? We had a wonderful vacation and when I came home I worked on getting my operative reports.

A week later, with my reports in hand, my husband and I went to meet with the famous Dr. Cummings. I don’t think I have ever been as nervous as I was that day! We had a long wait in the waiting room, but fortunately our kids were over at their Grandparents house playing. When Dr. Cummings came in the room, he just put me immediately at ease. He was so kind and attentive. My husband made reference to the long wait, and Dr. Cummings quickly responded that yes, there would sometimes be a wait, because he gives as much time to each patient as they need. We were happy to hear that. He spent the next 30 minutes with us, attentively listening to us, and answering our questions. He looked at my report pretty quickly, and said, “So you’re going to have a VBAC then?” I asked him what he thought about where my former OB referenced my paper thin uterus. He shrugged his shoulders and said, “Not impressed. Your body has an amazing ability to heal. You’ll do this! We will do this!” I wanted to cry right there. We talked about the risks and again he put my mind at ease. I really could do this. We noticed a bracelet on his hand that said something about prayer. He talked a lot about his faith and he told us that he doesn’t fear lawyers, he fears God. He told us that he truly believes that God placed him in Denton to help women who desperately need a Doctor like him. He said Denton was never his first choice, but that was clearly where God had placed him! He told us we could think it over, but that we could go ahead and schedule my first appointment right away. We shook his hand and left the room. When my husband and I walked out to the elevator to leave, we looked at each other and we were both in tears! We knew there was nothing to think over. I went back and scheduled my first appointment. Later that day, I canceled the appointment with my former OB. I had finally broken up with her!

So far in my village: the Mom from church, Robyn, Kathy, Katie, Marg and Sarah. They all led me to Dr. Cummings. I decided to look up Katie on the internet, since she is the one that recommended him, and I learned that she also had a VBA3C with Dr. Cummings. I emailed her right away to see if I could interview her to be my doula. We met, and I absolutely loved her as I knew I would. Katie encouraged me to join ICAN, so I did. The women in ICAN quickly became part of my village as they encouraged me on the road to my VBA3C. I started a blog about my journey, and my followers quickly became part of my village. My Babyfit friends were some of my biggest supporters along the way. They cheered me on every step of the way and I always believed that I would do it. Marg’s friend Sarah who I mentioned earlier, posted one of my blog posts on her business page and encouraged her followers to cheer me on and pray for me! It was such an incredible journey. I couldn’t have done it without the amazing support of these women. Through ICAN and other local VBAC groups, I met other women who had also had a VBA3C. I was so encouraged by their successes. These women also encouraged me in pursuit of having a natural birth. I had decided that in order to succeed in my VBA3C, my best shot of success would be to do it naturally. The ICAN women and Katie all helped me so much in my pursuit of this. I started going to a chiropractor regularly (which I had never heard of such a thing during pregnancy!) to help get the baby in the best position. Let’s go ahead and add my chiropractor Erin to my village.

Once it came time to actually have my baby, I felt I owed so much to my village! I had to do this for them, as much as I did for myself! I knew that they were cheering me on and I didn’t want to let me down. I imagined in my head what it would be like to post that first picture saying, “I did it!!!”

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And when I did, it was glorious! My village cheered like they have never cheered before. It was as triumphant of an experience as I ever could have expected it to be! It was more. It was beautiful. It was perfect. It really does take a village. Thank you to my village for never doubting me, not once. Love to you all!

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Doula first moment

(My sweet doula Katie, I could not have done it without her!)

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(The amazing Dr. Cummings, there are no words to describe how thankful I am for him!)

 

 

Overcoming your fears of another cesarean

There is a lot of talk about fears surrounding VBACs, mainly because of the small risk of uterine rupture. But what if you have already decided to have a VBAC and have fears about ending up with another cesarean birth? This post is for you! When I first started my journey to have a VBAC, I knew without a doubt that I wanted (needed) to set myself up completely for success. No regrets, I was jumping in head first!

In order to overcome your current fears of having another cesarean, you need to do a little fact checking:

  1. Have you hired the right provider? There isn’t a right or wrong provider when having a VBAC other than he/she HAS to be 100% supportive. You just can’t compromise on this one. Midwife, OB, birth center, hospital or home, the support of your provider is the most important aspect to success with a VBAC, hands down. I think one of the biggest mistakes you can make is choosing a provider that you think may be supportive and then in the end really isn’t. I call it the bait and switch provider. He/she acts supportive in the beginning but then when it comes down at the end, finds an excuse to change the plans and you end up with a repeat cesarean. It happens too often. It happened to me. With a 100% supportive provider you will know that he/she will have your best interest and your baby’s best interest in mind. Be willing to drive a little (or a lot) to be with the right provider. I promise it will be worth it.
  2. Have you taken a childbirth class? Whether you plan on having a natural birth or epidural, your goal is a vaginal birth. A comprehensive childbirth class will teach you so much more than how to have a natural birth. There is a reason our classes are 10 weeks long. I think VBAC mamas can especially benefit from taking a class. One of the biggest reasons we ended up with a cesarean to begin with is because of medical interventions. In our classes we teach about these interventions and how to be prepared for them. Some interventions may be needed. In class you were learn when it may or may not be appropriate to have these interventions. You will be ready for these interventions and know when it would be appropriate to say yes or no thank you to them. Knowledge is power.
  3. Are you getting regular chiropractic care during your pregnancy? To some of you, this may seem like a foreign concept. Why on earth would I need to see a chiropractor while I’m pregnant? One of the biggest reasons for cesarean births today is the position of the baby. A Webster certified chiropractor adjusts your pelvis to help the baby get into the most optimal position for birth. Regular chiropractic care during your pregnancy opens your pelvis, giving your baby the best opportunity to move into the most optimal position for birth, which can also greatly reduce your labor time.
  4. Have you assembled a supportive birth team? Along with your supportive provider, you need to make sure you have a team of people supporting you in labor. Is your partner supportive of your wishes to birth vaginally this time? One of the best ways to get him on board is to take a class together. During the 10 weeks in class, he will learn how to best help and support you in labor. Have you hired a doula? Some women think that if they are birthing with a midwife, a doula isn’t needed. Some also think a supportive partner is all that is needed. I believe every woman should have a doula! My husband agrees, we couldn’t have done it without the support of our doula! She supports the partner too. It is so important that you find a doula that you click with. My doula and I clicked immediately because we had a shared experience in that she had also had a VBAC after 3 cesareans with the same OB. It isn’t necessary that your doula have had a VBAC, but it was something that immediately bonded us together. Studies have shown that doula attended births reduces the need for a cesarean by about 50%! Go hire a doula! You won’t regret it.
  5. Do you have a birth plan? No, it’s not a contract. It may not go exactly as planned every time. But if you don’t have a plan to begin with, how will you know what decisions to make when it comes down to crunch time? Plan it out with your partner. Decide what is most important to you in your birth. At my last birth, my charge nurse told me that she carefully read through my birth plan and hand-picked the most natural minded nurse for my delivery because she knew that was going to be important to me. That nurse ended up delivering my baby in the end because my baby came so quickly and the OB didn’t make it in time! A birth plan shouldn’t be a list of demands, but it should very clearly state what is most important to you.

Now that we have done a little fact checking, how do you feel moving forward? Are you confident that you have the right support, have a plan and have done everything you can to be successful with a vaginal birth? If the answer is yes, you can find comfort in knowing that IF you do end with another cesarean, it will be because it was necessary for the safety of you and your baby. I truly found comfort in this, because I knew without a doubt that my OB was not going to spring some unnecessary interventions that were going to spiral out of control and lead me to another cesarean. I knew that if I ended up with another one, it would be a needed cesarean.

If you are still struggling with these fears, what are some things you can do?

  1. Talk about it with like-minded people. I am a part of several different online VBAC support groups. I love talking with these women, because they understand what I’m going through! Find your local ICAN group. Go to a meeting, or just join a group online. Talk through your fears. These women get you. I promise. They’ve been through it all! When things come up on your journey that you are not sure about, ask the group. Chances are, someone in the group has experienced the same thing.
  2. Surround yourself with positivity. There will always be those voices around you that say, “Are you sure you want to do this?” Not everyone around you has done the research on VBACs that you have done. They don’t know the true risks of VBAC vs. a repeat cesarean and many people won’t listen to the facts even if you tell try to tell them. Don’t listen to the negative voices. If you have to distance yourself from certain people during your pregnancy, do it. Block out the negativity and surround yourself with positivity. It’s a mind game. Get your head in the game and don’t let that affect you!
  3. Write your thoughts down. One of the things I enjoyed doing during my first VBA3C was blogging about my journey. To me it was not only therapeutic, but it was also motivational for me. I knew that I had people cheering me on which was all the more motivational for me to come out successful in the end! If you enjoy writing, start a blog. If you are more of a private person, journal about your thoughts. Sometimes just writing things down can help you get through your struggles.
  4. Believe in yourself and the process of birth! Women have been doing this thing called birth for many years. My OB once said, “Don’t let your birth experience be stolen because you were afraid.” The process of birth is normal. Your body was made to do this. Yes, sometimes things go wrong, and a cesarean may be needed. Just trust that if you have done everything right, a cesarean will only be needed if absolutely necessary. Cesareans are not needed in 1 out of every 3 births.
  5. If you are still struggling after all of this, you may need to seek professional help. Find a counselor or therapist that specializes in birth trauma. The last thing you want to do going into a trial of labor is to have fears that are not dealt with.

Now that you have dealt with those fears, move forward in confidence! Believe in yourself. You can do this!

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The 2VBA3C birth of Cayden Daniel

This is the birth story of my second VBA3C. It was a long hard pregnancy. I’m not going to lie. With my first VBA3C, I talked about it daily. I blogged about my journey, and included everyone in it. With this pregnancy, I was pretty quiet. Not because I wasn’t excited about being, pregnant again (I was!!) It was just a different pregnancy this time. Even though I was doing all the right things (going to the chiropractor regularly, doing my pelvic tilts and sitting on my birth ball) I still had unbelievable back pain. My belly was huge almost from the moment of conception, so I was carrying around a lot of weight for a very long time. Halfway through the pregnancy, I got very sick and was sick for almost a month. It even landed me in the ER with panic attacks related to the illness. It was awful and I never quite recovered.

This is also the first time that we didn’t name the baby until the birth. I know that was hard on my husband as he always liked to have the name nailed down early on. We struggled between several names for a very long time, and I just knew I couldn’t decide until he was born. There was this disconnect that I have a hard time explaining. I wished I could have an amazing water birth at home or in a birth center but had chosen to stay with my supportive Doctor in the hospital. I was at peace with this decision but still wished I could have that Midwife birth I so longed for.

I learned at 37 weeks that I was Group B Strep positive again. This meant that I would have to try and make it to the hospital early in my labor to receive antibiotics before the baby was born. This happened the last time, so I was prepared for this. Since my last labor went super quick from the time my water had broken, I was prepared to head to the hospital soon after my water broke this time around. I just knew that I would end up delivering a baby on the side of the road otherwise.

Starting at about 38.5 weeks, I started what is called “prodromal labor.” For those of you who have not experienced this, it’s not fun. Stop and start contractions that can last anywhere from a day to several weeks before you actually give birth. Each time the contractions would start up, I would think something was happening, and then later on it would die down. I think I wore out my cell phone texting my doula that I was so tired of this stop and start pattern. At my 39 week appointment with Dr. C, I decided to let him check my cervix. I knew I was risking a mind game, but I really wanted to know if these contractions were doing anything. I was 3 cm, 50% effaced and -1 station! I knew I could stay this way awhile, but I was encouraged.

My due date was Easter Sunday, also one day after my birthday. The day before my birthday, I thought for sure labor was starting. I had strong contractions all evening, and then it suddenly stopped again. I sat on my floor and just cried. I knew that I could very well be pregnant two more weeks and was willing to go that far, but really couldn’t imagine two more weeks of this. I cried on the phone to my doula, Katie, and she encouraged me to get my mind off things. The next day I enjoyed my birthday with my family and friends. I didn’t have contractions all day. I just enjoyed my day. I went to bed that night thinking I was in for the long haul. I woke up around 1 am to contractions. They weren’t super strong, but they were enough to wake me up. I walked around a bit because I couldn’t get back to sleep. Around 2 am I was standing in my living room and felt a gush of water down my leg and saw a puddle on the floor below me. Was my water really breaking 2 hours past my due date? I walked around some more and then around 2:30, another big gush of water. So I called my doula. Typically, I wouldn’t suggest rushing once your water breaks, but I had in the back of my mind what happened the last time and I was concerned about getting the antibiotics in time. The contractions were picking up, so I decided to head to the hospital around 4 am. I called my photographer and another Birth Boot Camp instructor who was planning on observing my birth. Everyone was on the way to meet me there. My nurse’s name was April and she was fabulous. Caryn She checked my cervix and told me I was still only 3 cm and head had moved back to -2 station. Not only that, I tested negative for amniotic fluid. I felt so defeated. April called the on call Doctor, Dr. B and said she wanted me to walk the halls for an hour and then come back to be checked.

So we walked, and walked, and walked some more.

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I had my entourage of women following me, while my dear husband took a nap on the hospital bed! He said I was too calm to be in real labor… Steve sleeping

When I was re-checked, she said I was 4 cm, but still had a bulging bag of waters. So Dr. B. sent me home. She said despite my GBS status, I had a better chance of VBAC if I went home.

 

NurseSo home I went! We took a nap for a few hours while our kids were at Easter services with our friends. Then we had lunch with our kids and friends. My labor was stalled. Contractions were sporadic and didn’t hurt much. I was so frustrated! By evening, I was so discouraged that I called Katie for advice. She said it was best for me to lie down and get some rest, since a tired uterus is not a productive uterus. This was the best advice! I lied down around 8 pm and the contractions started picking up within 15 minutes! By 9 pm, the contractions were so strong and close together, I was pacing around the house for fear that the baby was going to be born on the way to the hospital! Our friend arrived around 9:30 to stay with the kids who were already in bed, and by 9:40 we were on our way back to the hospital.

Katie was already there waiting for us when we arrived around 10:15 to get checked back in. We were in the same room as the last time, and since it had been more than 12 hours since we left, April was back on shift and was our nurse again! She was the charge nurse this time and said that she had carefully read my birth plan and hand selected the most natural minded nurse for my delivery! April checked me again, and I was 5 cm. Not exactly where I wanted to be still, but I knew this time it was the real deal and there was no way I was leaving! Caryn2 She asked me to walk the halls again. This time, Steve did not get a free pass! He had to walk with us.

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This time, there wasn’t much talking on our walk. A lot of stopping through contractions, deep breathing and belly lifts to get baby’s head to engage. Around midnight I was checked again, and I was 6 cm. Finally, they officially agreed to check me in! Looking back, I am so thankful they took so long to “check me in” officially. Otherwise, I would have been on a time clock and who knows what would have happened. Since I was GBS positive, she immediately put in my IV and administered the antibiotics.

Once that was done, things started to get serious real fast. Contractions were strong and close together. I labored on all fours over the birth ball.

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I was so exhausted from being up all day, I really just wanted to sleep. We got out my essential oils and put Valor on my neck to help calm me.

 

OilsWithin minutes, I was asleep! I slept for about 20 minutes through some pretty hard contractions! I needed that power nap, because I was almost ready to push! We had music playing to help calm me and peppermint on hand for any nausea.

 

Playlist

I wish I hadn’t been checked so often, but again I asked the nurse to check my cervix. I was so certain that it was the end. 7 cm.  Judging from my last labor, I knew that it could happen at any moment. Last labor, I went from 8 cm to 10 cm in 5 minutes. The nurses left the room to call the Doctor to be prepared. Katie took me to the bathroom to have me sit on the toilet. Within seconds I was screaming to stand back up. I could feel the baby moving down and felt like he was ready to come out! I was so sure that the baby was going to come out right then and there. Katie and Jayde, the delivery nurse, quickly got me back to the bed. By this point my body was already telling me to bear down and push. Jayde checked me and said I was just about complete. I sat up in the bed and just began to push. No one in the room told me when to push.  They simply let me do my thing. I never heard any counting during my pushes.  Jayde was wonderful. She stayed out of the way, but was there the whole time. Dr. B. was still nowhere to be seen, but that didn’t matter. I kept pushing when I felt the urge and rested if I needed to. Then the head came out and I heard my baby cry. His body wasn’t quite out yet, but I never panicked. Jayde was calm and helped guide the shoulders out on the next push. I heard one of the nurses say that Dr. B. was in the parking lot.  I was so determined to have that body out, I yelled, “Come on baby, come out now!!” He must have listened to me, because he was out on the last push!

Baby bornBaby born1 Cayden4Cayden2

 

They immediately put him on me skin to skin, and I said, “Hello Cayden!” I knew in that moment that his name was Cayden. We had gone back and forth on names for so long, but it just felt right in the moment.

Cayden6Cayden7 Skin Steve2

He was born exactly at 2 am, 24 hours after I had felt my first gush of water at home. He was huge as far as I could see! He had cute little rolls in his legs and neck. He was just perfect in every way.  A minute or two later, Dr. B. was standing there beaming at me, saying “Great job Mama!” She was so sweet and patient. She waited for the cord to stop pulsing before cutting it.

 

Cord

She let the placenta come out without tugging impatiently on it.

I really didn’t think that this birth could possibly have topped my last VBA3C, but I have to say it did. Amazingly, Dr. C. was not even at this birth. I was so worried about whether or not he would be at my birth, but learned that it didn’t even matter. He has done such an amazing job training the other Doctors and nurses at that hospital.  They truly respected my wishes in every way imaginable. In the end, I even got that Midwife birth I was hoping for! I learned after the fact, that Jayde had recently moved to the U.S. from Australia where she was a Midwife!

 

Jayde

She was the perfect person to be there to help me bring my little Cayden Daniel into the world. I couldn’t have asked for a better birth team.

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Cayden weighed in at 9 lbs 4 oz (my biggest baby yet!) and 20 inches. Within 40 minutes, he was latched on and nursing!

Cayden11Cayden10Cayden12 FeetCayden1Cayden8

 

Cayden3Cayden9

We did it! Again! Hard work, determination and an amazing team. We did it!

A special woman with a special scar

Did you know that there are different types of scars when you have a cesarean section? There is a whole group called Special Scars dedicated to promoting awareness to this and supporting women who have them. Did you also know that a scar other than the traditional bikini cut can actually hinder you even further from having a VBAC?

A special scar is a scar resulting from a Classical, Inverted T, J, Low Vertical, Upright T or any other cesarean incision other than the most often used Low Transverse or bikini cut. Also, any scar resulting from a myomectomy incision, IUD puncture, rupture or other unusual uterine scar. Many providers will refuse to allow women to have a VBAC with a special scar, even though the risk of uterine rupture may only be slightly higher than a traditional scar.  My amazing doula, Katie, had a VBA3C with an inverted T scar. Her first provider told her that she would never deliver vaginally, or she and her baby would surely bleed out and die.

I found out recently that my own Mom has a special scar! I knew she had two VBACs, but had no idea they were with a special scar! I sat down with my Mom over the Thanksgiving holiday to hear a little more about her story. In 1973 when she was pregnant with her first child, she had the very strong desire to have a natural birth. She and my Dad prepared themselves by taking a Lamaze class. She was so disappointed when she went into labor and was told that the baby was transverse. She had a cesarean section and was given a classical incision. A classical incision is a vertical incision in the upper segment of the uterus, which was most used when they first started doing cesareans.  The Doctor who performed her surgery was not hopeful that she would ever have a vaginal birth.

 

Mom

When she became pregnant again in 1975 (with me!) she had just moved to a new area. She found a new Doctor who was, as she put it, “Old fashioned and laid back.” He told her that he saw no reason why she couldn’t have a vaginal birth. She went on to have a natural vaginal birth without any complications and then had another in 1985 when my brother was born. The birth in 1985 was with yet another Doctor as we were living in a whole new state by that time. Neither Doctor ever gave her any issues with having a vaginal birth after a cesarean with a special scar.

I asked my Mom, “Do you have any idea what an accomplishment that is?” She seemed surprised and had no idea that it was even a big deal! She knew it was a big deal to have a vaginal birth after a cesarean but had no idea that her special scar added an even bigger element to the equation. I’m not even sure she knew she had a special scar, since most cesareans at that time were given a classical incision.

Just a bit of a history lesson on VBACs, in case you are wondering why this is such an accomplishment. In the early 1970’s when my Mom had her first cesarean, the cesarean rate was only around 5%. Even though it was so low, the old saying “Once a cesarean, always a cesarean” was upheld most of the time. It wasn’t until the early 1980’s that the pendulum switched and women began fighting for vaginal birth after cesarean. The International Cesarean Awareness Network (ICAN) was first introduced in 1982 which brought much awareness to this issue. Doctors finally began to take notice that vaginal birth may be a safer route than previously thought. Despite this change, many providers were still hesitant and women had a hard time finding providers that would support them in their desires.

I began to think about all the women today who struggle so much to have the birth they desire. There are so many women who have to fight to get the birth they desire because it is hard to even get in the door with a supportive enough provider, let alone be able to stay the course and be successful in the end.

We have so many resources today to help us down the road, like ICAN, yet so many women just give up hope because they are told things like, “You will surely bleed out and die.” I keep hearing stories in my VBAC groups where providers tell these Moms that the risk of rupture is as high as 60-70%! This is not true, but without knowing the facts, what is a woman left to believe? My Mom did it without the help of ICAN or many of the other resources we have today. She just had the desire to have a natural vaginal birth. Maybe she just got lucky, finding a provider that truly supported her. She had a VBAC at a time when it was rarely done and the cesarean rate was already rising. Whatever the case, it’s just another reason for me to be reminded that my Mom is pretty amazing!

For more information on special scars, please visit: Special Scars