The Birth of Naomi Blair 9/13/22
Amber and Nathan welcomed their second child into the world on September 13, 2022. Amber’s first birth ended in c-section, and she was very motivated to have a VBAC this time. She aligned herself with providers who were supportive and chose a doula this time as well. We had our prenatal visit in which she reiterated with me her strong desire for not only a VBAC, but an unmedicated one. She was determined and motivated and had assembled a team to support her every step of the way.
The first I heard from Amber about labor was a text that came through about 2:40 am on September 13, the day she would welcome her baby. She had timed her contractions for about an hour and had a regular pattern of 5 minutes apart, on average, with the duration of a minute with some shorter and some longer. The app told her it was time to go to the hospital, but she didn’t feel it was time yet. Some were painful but most were still tolerable. They began around midnight. I told her to stop timing and wait until they were consistently longer than a minute and more like 3 to 4 minutes apart before heading in, assuming she was comfortable doing that.
Over two hours later, the text came in that they were heading to the hospital. Contractions were 2-3 minutes apart and longer at 1-1 ½ minutes in duration. Plus, she thought her water started leaking. They were also stronger, so it was a very goo d time to head in! Upon arrival, Amber was dilated 4 cm and 90% effaced—a good place to be. But there was some concern as to whether her sutures were optimal for a safe VBAC, however, Amber held her ground and made it clear to her doctor that her desire was to move forward with a VBAC. They would monitor her and baby throughout and as the nurse said, “watch baby like a hawk” for any signs of a rupture happening. The likelihood was still very slight, but more elevated due to the sutures done at her previous birth out of state.
I arrived within the hour, shortly after Amber was in her rightful room. Her water had broken at the hospital, and she was laboring on her hands and knees over the peanut ball. We placed a heating pad on her lower back where she felt the most pain. The wireless monitor was being charged nearby, with plans to be used later to allow the chance for the shower. And an hour later at 9:00 am she was dilated to 5, 100% effaced, and her baby was at -1 station. Things were moving along nicely, and her baby’s heart rate sounded perfect.
Amber’s contractions were coupling, however, which means they were coming two at a time and then spaced. This was a compelling indication that her baby’s position was not optimal. So, we got to work being strategic! I did some “shake the apple tree” with the rebozo around Amber’s bottom, and then had her do lunges on both sides. And then her contractions adjusted to every 2.5 minutes! She preferred the hands and knees position, so she continued it over the cub chair as she breathed calmly through her growing contractions. “Hand,” she would gasp from time to time, and either Nathan or I would extend our hand out for her to squeeze. Amber had quite the labor grip!
In time, every position hurt, but this was to be expected. Amber felt most of the discomfort in her back, hips, and belly, but they were hurting in unison which was reassuring to us that her baby was moving down, and her cervix was opening. Her contractions intensified and we secured a fan to help cool her as her body worked harder. Amber moved to the bathroom and sat on the toilet to labor for nearly an hour. She felt her contractions get stronger and she said, “ouch” through each one. I encouraged her to change her word to “out” and that became her mantra to her baby through each surge.
By 11:12 am, Amber stood back up and was ready to do some upright positions. She squatted with the rebozo tied overhead, she slow danced with Nathan, and even stood beside the bed and leaned over the peanut ball. At one point her nurse couldn’t get a good read of baby’s heart rate, so Amber lay on her side in the bed. This can be challenging late in labor, but she talked herself through it saying, “I can do this,” and managed quite well. When her midwife returned 1 ½ hours later at 12:50 pm to check on her progress, Amber said, “Good news please.” And her midwife was happy to report with a smile on her face that Amber was fully dilated, and her baby’s head was at +1 station! “Oh, thank goodness,” or something similar was Amber’s reply.
She began pushing a short time later as her body began bringing the urge to bear down. She started out pushing on her side but didn’t feel that was productive for her. But when Amber sat upright in bed holding the rebozo tied to the squat bar she felt like she was making more progress pushing. She pushed in this position for a while, and then leaned a bit more back to push. Amber reached down to feel her baby’s head and was encouraged to know how close her baby was. She felt it after pushing a bit longer and could really feel how much more head was out! And after just an hour of pushing, Amber welcomed Naomi Blair at 1:45 pm! This beautiful baby girl weighed 8 lb. 3 oz. and was 20.5 in long.
Amber embraced her baby girl, her triumphant VBAC baby, and let all of the oxytocin wash over her. It’s quite an accomplishment to labor without pain medication in the hospital setting, but when pursuing a VBAC, it can be more challenging physically and emotionally. I was so proud of how Amber allowed her labor process to unfold and didn’t allow voiced concerns by her doctor to change her plan. She took their information in and considered her options and weighed the risks and moved forward knowing she and her baby were being closely monitored. Amber’s birth is a reminder that a VBAC is nearly always a better plan than a repeat c-section, especially when the risks can be managed, and safety measures are in place.
