Rachel reached out for the support of a doula because she had a strong desire for a VBAC after welcoming her first son by a c-section for breech presentation. She attended my refresher childbirth class and learned all she could about labor and birth since this would technically be her first experience with labor.

Rachel’s labor started in the least likely way and that is with her water breaking first! Thankfully, her body got going with contractions very soon after. In fact, they were surprisingly close and strong! This made things confusing since her labor wasn’t following the “typical” pattern, which is laughable since we can’t really put labor (and babies!) in a box, can we? Rachel and Josh called the midwife sooner than she thought she would need to, foregoing laboring around her home in favor of driving to the hospital. It’s a good thing Josh’s mom arrived from Iowa just 12 hours before so they could leave for the hospital easily!!

They arrived at the hospital just past 7:00 am on March 26, and within the hour it was confirmed that Rachel’s cervix was very thin and dilated to 4 cm with her baby’s head well applied. She would be staying to have a baby! She was shocked by the intensity of her labor—she was hardly dilated at her previous appointment—so it had made rapid change.

Not knowing what was left to come, Rachel requested an epidural. There was a delay since she had to receive enough fluids first, but by 9:00 am they were able to call anesthesia. In the meantime, Rachel labored in upright positions, including pulling the rebozo tied to the squat bar for leverage. Since she was laboring for a VBAC, the protocols required she remain on the monitor, but staying active helped her feel less tethered.

By 9:30 am the epidural was completed, and Rachel was feeling a bit more relaxed. Josh grabbed a quick bite to eat since we suspected he wouldn’t have a better chance considering how quickly Rachel’s labor was moving. And when he got back, he tried to take a power nap. We encouraged the same for Rachel, but I think her mind was too busy thinking. Rachel used the peanut ball to keep her pelvis open as she rotated from side to side.

Votives and twinkle lights help to set the scene for serenity and calm. But Rachel felt a nagging pain on her left side and general pressure all over that continued. We suspected her body was moving along so her midwife came in to see what was happening. She did an exam and held up her open hand to Rachel who thought “5 fingers, so I must be 5 cm dilated.” But no! Her midwife meant, “High five because you are COMPLETE!”

They got busy setting up the delivery table, clearly not expecting Rachel to progress so rapidly! (I love when that happens!) And by 11:45 am Rachel gave her first push. She really liked the rebozo, so she pushed by doing the tug of war with it tied to the squat bar and her feet braced upon it. Josh was her partner in the tug of war and Rachel remembers this part of her labor fondly!

She pushed in various positions. She pushed with her knees pointed in, then she pushed on the left side and the right side. Her baby was OT (occiput transverse), so he was needing some creative positioning to help him navigate the pelvis. We did a side-lying release and then Rachel went back to pushing on her right side with the peanut ball between her ankles and her knees pushed in to open her pelvic outlet. Then she did some pushing semi-reclined using the trusty rebozo for some tug of war pushing.

By 3:00 pm, her baby had rotated from looking at 11:00 to looking at 9:00 so he had made some adjustments. But Rachel had been pushing over 3 hours, so it was a good time to evaluate. The next step was to add Pitocin to add some force to her contractions and maybe helped nudge her baby to rotate. This was a less invasive option than using a vacuum which was another possibility. The doctor stopped by to talk through options including a potential vacuum assist if Pitocin wasn’t enough. Rachel preferred to start with Pitocin and go from there and her doctor agreed. He said, “It’s best for you and your baby if you push him out and don’t get any help from me.”

So the Pitocin was increased incrementally, and by 4:22 it was at 6 mu which was the magic level for Rachel. By 4:30 she reached down to feel her baby’s head with her own hand and a short time later, at 4:42 pm her son was born!! Isaac William was born about 5 hours after Rachel’s first push. Rachel’s vaginal birth was largely due to her stamina and her providers’ patience. It was a dream team for sure!

The first full song of Izzy’s life was “One Headlight”, but he came into the world to an awesome collection of songs. He was born into Rachel’s midwife’s hands with the doctor standing by, but not needed. She relished having her baby in her arms immediately after the birth and was singing to him just minutes afterward. It was so touching.

After an hour with his mom skin-to-skin, Izzy weighed in. And he was not small! He weighed 8 lb. 11 oz. and was 20.5 in. long, quite stocky. So, his OT positioning was made more challenging by his chunky size. But Rachel had the moxie to do what she had to do, and we are so proud of her for sticking with it!

Rachel discovered such strength in her body through this birth, but she also was able to realize her hope of a vaginal birth. Not only did she push out a big baby for many hours, but her labor also took off quickly. She spent more time in the second stage of her labor than the first! And that is saying something. VBACs are extra special but thankfully, with a supportive provider and good preparation, it’s an excellent option for most women who have had c-sections. Well done to everyone on Rachel’s team for believing in her and believing in vaginal birth.

The Birth of Isaac William 3/26/22