Neonatal nurse has a homebirth VBAC

by | Jun 16, 2008 | An inside perspective, Birth stories, Home birth, Large/macrosomic babies, VBAC | 15 comments

This is a great birth story, published with permission, of a woman who had a cesarean for “small pelvis” and then VBACed a larger baby at home!  Since she is a neonatal nurse, it’s interesting to read why she chose HBAC and how she thinks her birth would have gone differently had she labored in a hospital.


I just wanted to let everyone know that I gave birth to a healthy baby girl Wednesday June 11th. I had a C/S with my son 2 years ago.

He was 8lbs 2oz and I was told that my pelvis wasn’t big enough to birth an 8lb baby. Well my VBAC baby was 9lbs 2 oz. Exactly a pound bigger than they told me. I knew I wasn’t broken.

I chose to have a homebirth  because I felt I would always have to fight for what I wanted in the
hospital. My labor went great. Started around 3am contractions coming 10 minutes apart. Then progressed to 3-5 min apart at around 6:30am.

My midwife got there around 7:30am. Later I wanted to go into the birthing tub to try to get through the contractions. My midwife wanted to check to see how far I was. 4cm and 100% effaced. She told me to try to hold off on the tub because it would be better when I am
further in labor. I then took a hot shower.

For me the contractions were more bearable standing up. When one would come on I would bend my knees and lean over onto either the couch, my bed or my husband. The worse position for me to labor on was my back and my side.

After the shower I asked if I could go into the tub again. She checked me and I was 6cm with a bulging bag. I did go into the tub which for me didn’t make much difference in the contractions. But at that point I stayed in there for quite a while because it took too much energy for me to
move.

For me the worse part was going from 6 cm to complete. I thought it would have been the pushing part but it wasn’t. In the tub I did feel like pushing a little bit. We couldn’t tell if my water had broken since I was in the tub. I decided to get checked in the tub to see if the water had indeed broken and plus since I was feeling “pushy.” Still at 6cm but the bag was bulging more.

They think that was why I was feeling like I had to push. They let me push a couple of pushes to see if that would break my water but it didn’t. Then they told me not to push and just try to breath through the contractions. My water still wasn’t breaking and it was the hardest thing trying not to push when that overwhelming feeling was there. They gave me the option of breaking my water and felt that once they did that the baby’s head would apply to the cervix and help with dilation. I agreed. They broke the water and sure enough baby’s head came right
down and I was 8-9cm.

The pushing feeling let up and I labored more for a while. I then started feeling pushy again and they decided to check to make sure I was fully dilated before I fully pushed. I just had an anterior lip. Again they told me not to push so that the anterior lip would pull back over the baby’s head and not swell. I was dying to push but breathed through each contraction for an hour or two. (I lost all sense of time so I don’t know exactly how long it was.)

The best position for me was on my hands and knees but they said that with the anterior lip that the position was actually making it worse. They wanted me to lie on my back to help take pressure off the cervix to facilitate it moving around the baby’s head.

Lying on my back was so unbearable but I did it to help with the dilation. The midwife decided to try to help push the cervix over the head. She told me to push while she held it out of the way. Finally her head came down and I could fully push to my heart’s desire. That felt great.

They asked if I wanted to go back to the hands and knees position since the cervix isn’t an issue now but I said I just could not bear to move to another position. Then the “ring of fire came” Boy did that burn.

Finally her head came out and, surprise, so did a hand. They said that her hand was across her face. They pulled the hand out along with the head and since one shoulder was in and one was out she was having a little bit of trouble maneuvering.

They wanted me to flip to my hands and knees to open up the pelvis more. I thought they were crazy. Me trying to flip over with a head hanging out. I knew that I just had to do it as quickly as I could or it wouldn’t have gotten done. My husband said he had never seen me move so quickly in my life. I pushed a little more and she was out!

Amazingly I had no tears. Personally I thought that was pretty amazing to have my first full term vaginal birth of 9lbs 2oz with no tears what-so-ever!

So to all of those women who have been told that you would have died in childbirth because you couldn’t push out your own baby YOU CAN! I am proof that I delivered a baby 1 pound bigger than what they said.

I am a nurse who works in labor & delivery so I see all of the unnecessary interventions that they do.

I was pondering about my birth. If I would have chosen a hospital birth I probably would have ended up with another c/s or an episiotomy. There were times during my birth where I thought, “Am I crazy? I can’t deal with this pain!” The midwives and doula helped me through the intense contractions.

If I was at the hospital they would have bullied me into an epidural and therefore I wouldn’t have been able to move around to get her to come down. Also I wouldn’t have been able to feeling the progression of her head coming down when I pushed.

With my son I pushed and couldn’t really feel any progress so mentally I was losing hope. With this birth it didn’t feel like I pushed for an hour because I could feel the accomplishment of her
coming down. I see this happen all of the time at the hospital.

If a mom isn’t pushing quick enough for the doctor or they think the head is too big then they will automatically do an episiotomy. They probably would have done that and it just shows that it would have been for nothing and I would have had a longer recovery time.

So therefore I am grateful that I found homebirth and such wonderful midwives. I hope this inspires all of you who are having the normal feelings of “what if I can’t do it.” Good luck
to your future births, You CAN do it!

What do you think? Leave a comment.

15 Comments

  1. I am pregnant with #2 about 32weeks along. I had a c-section with my first due to “High risk” he had gastroschisis and the doctors told me it would put him at risk for having bowel abstructions if we tried to have the birth go naturally. So far with this baby my pregnancy has felt great! I have no “high risk” with this one, but I am very worried that I will not make the right choice as to have a vbac or another c-section. I still have not decided. Does the way you were “cut” during your c-section have anything to weigh the risks? Or how long in between children matter? My first was 5 years ago and wondering if this factors a more positive outcome on vbacs? So many questions and my doctors response isnt very reassuring, I have looked into second opinions but get so many different responses. We plan on having at least one or two more babies by the time I am 30, so in about 4yrs we plan on 2 more 🙂 Thank you for your story as it has really made me want to try a vbac, granted everything goes as planned I am now leaning towards this choice. Thanks again!!

    Reply
    • Jessica,

      Yes, what type of incision you have determines whether you are a VBAC candidate per ACOG. Their latest recommendations state,

      The preponderance of evidence suggests that most women with one previous cesarean delivery with a low transverse incision are candidates for and should be counseled about VBAC and offered TOLAC [trial of labor after cesarean]. Conversely, those at high risk for complications (eg, those with previous classical or T-incision, prior uterine rupture, or extensive transfundal uterine surgery) and those in whom vaginal delivery is otherwise contraindicated are not generally candidates for planned TOLAC.

      They also state that having an unknown or low vertical scar should not prevent a woman from planning a VBAC. I recommend getting a copy of your medical records to confirm the type of incision you have on your uterus.

      You can read about birth intervals here. If you want more information, you can review the information I share here.

      With your intentions of having at least four kids, VBAC would certainly be a safer option for you provided that you are a candidate for vaginal birth. The risks of cesareans increase with each surgery and make each subsequent pregnancy riskier regardless of if you plan a VBAC or a repeat cesarean.

      Finding a VBAC supportive care provider is the #1 thing you can do to have a successful VBAC. Once you get a copy of your medical records & operative report from your cesarean, get the names of VBAC supportive providers, and ask the right questions. Read more about planning a VBAC.

      Best of luck!

      Jen

      Reply
  2. Thanks for the inspiring stories ladies. I had a c/s after 3 hours of pushing in an induced labor with my son, and am very much hoping for a vbac with my next pregnancy. It just so happens that I’m a neonatal RN, also.

    Reply
  3. Thank you so much for posting your story! I am a NICU nurse. I am pregnant with #3. My first was induced. My second was natural in a hospital setting which was supportive of a natural delivery but I still had to fight the medical ‘fix a problem’ mentality. This time I really want a birth center or home birth but am struggling with the what if’s & misinformed co-workers. My insurance only covers me delivering at the hospital I work at so everyone will know if I choose not to deliver there. Anyway, you have inspired me. J need to take control of the situation & do what I know is best for me & my baby. Thanks!

    Reply
    • Melissa,

      Please update us when you do have your baby! I hope it all goes perfectly and if your co-workers give you a hard time, then they’re not very nice people to begin with. 🙂

      Reply
  4. I too am a Labor and Delivery nurse! Great Story!! We need more midwives!!! OB’s are so conservative and it takes us nurses to convince them to give the patient time and teach the patients to stand up for themselves and give themselves more time when it is appropriate. I am working on a natural comfort measures class to help them learn to trust themselves and not rely on medication to get them delivered. Great story! I do want to express that I have seen all of this done in a hospital and I do feel it is safer to deliver there than at home–maybe I will feel differently someday!

    Thanks for sharing your great story–we need more people like you to talk in our classes!!!!

    Reply
    • Hi Kristin!

      Thank you for your comment! I am excited that your hospital is moving more towards non-interventive birth. I hope you can continue to create change in your hospital and surrounding hospitals.

      Warmly,

      Jen

      Reply
  5. Does anyone know if it is possible to have a VBAC after 2 c-sections??

    A good friend of mine has had 2 and is thinking of having a 3rd child. But her last c-section scar opened and she had to get it re-sewn. I don’t know if it was because it was badly done or she just tried to do too much too soon, but it also got infected. So she is not sure if it would be possible for her to have a VBAC or if the risk of rupture would be too great.

    I know she wants to try a homebirth if she can.

    Reply
    • Kate,

      Yes, it is possible to have a VBAC after two cesareans, also referred to as VBA2C.

      Did the scar on her uterus open up or just the skin? Wound dehiscence (when the abdominal incision on the skin, not the uterus, reopens) and infection are two of the more common complications of cesareans.

      To read an extensive analysis on VBA2C, please read Kmom’s VBAC After Multiple Cesareans FAQs.

      To learn more about planning a VBAC, please read I’m pregnant and want a VBAC, what do I do?

      I recommend bringing copies of her surgical reports when she interviews providers.

      Reply
  6. <>>

    I’m a birth professional who chose homebirth.
    My years of study taught me that no data supported the contention that homebirth was riskier for mother and baby provided the following conditions were met:
    the mother is low risk
    the homebirth is planned
    she has a trained, experienced birth attendant
    there is a hospital within a reasonable distance

    I find it interesting to think that the mother is somehow more responsible for outcomes at a homebirth than she would be if the birth took place in a hospital. Sorry but we can’t abdicate our responsibilty that easily Amy!
    If the woman chooses a caregiver or a facility that deprives her of food and drink, induces her labor, hyperstimulates the process with oxytocin, puts the woman on her back to birth, then deprives the newborn of her oxygen by cutting the cord prematurely and then routinely send the baby for observation in a nursery which may also undermine breastfeeding how has that mother made choices to safeguard her baby’s well being?

    Why not take a look at the gold standard of evidence based medicine which is The Cochrane Data Base. If you visit
    http://www.childbirthconnection.org you can read the Guide to Evidence Based Care in Pregnancy in its entirety.

    Homebirth is a viable and respectful alternative to both the hospital and the birthing center. As a professional I move among all three and always encourage each woman to choose the one that provides her with the sense of being loved and protected. If she thinks the hospital is that place we “dig” a little deeper to make certain its practices are congruent with what she REALLY needs and that usually isn’t an IV, lots of vaginal exams and multiple laboratories. It is a environment where she can freely move and express herself throughout labor and the actual birth (no restrictions in birthing positions) and one in which she doesn’t have routines foisted upon her. It is one where she can select who will accompany her at any moment in the process and one in which she doesn’t have to worry about the baby being removed from her arms at any time. If the hospital the woman chooses can meet these expectations then perhaps the hospital will work for her. If not she will do far better to stay at home! Here’s to health!
    Joni

    Reply
  7. I’m another medpro who birthed at home– I had an unassisted birth after two cesareans. My first c/s was for breech; my second was the dreaded “CPD/FTP,” despite the fact that I progressed to complete and pushed for over two hours. In actuality, my son– 10 lbs 5 oz– wasn’t too big for my pelvis, but slightly malpresented– his head was crooked just a little to one side, and since they’d broken my water, he got stuck. Three years later I birthed his brother– all 10 1/2 lbs of him– over an intact perineum with no trouble at all and not so much as a skidmark.

    I was a nurse at the time, but a new one– I actually went to nursing school in self-defense after my horrific CBAC. I really didn’t any useful knowledge of or experience with birth in school– all my education was extracurricular. I do wonder sometimes if there can be such a thing as too much knowledge: during labor, I felt like I had a CNN-style crawler under me ticking off labor signposts! Of course I was afraid– I don’t think any woman can approach any birth completely fear-free. I used a lot of affirmations and positive self-talk, and I solicited a LOT of support from my online birth community. In the end I realized that I really felt safer laboring and birthing at home than going to the hospital.

    The birth was, well, lovely. 🙂 I’ll take an unmedicated, natural labor over a horrid pit-hell induced labor any day of the week! There was very little pain– the ring of fire was a little ouchy, but other than that, it didn’t hurt. It was… relentlessly intense. But it didn’t hurt. And the recovery, compared to my cesareans, was BLISS.

    We took our new son to the ped six hours after he was born. They were taken aback but handled it very well, and pronounced him “perfect.” I did have a complication to contend with– a retained placenta– but I dealt with it, and everything turned out just fine.

    (((hugs))) and the best of luck to you!

    Jer

    Reply
  8. Thank you for sharing your story!
    I had a scheduled c-section with my twins. My doctor told me that my babies were too small and needed to come out at almost 37 weeks. He knew that I wanted a vaginal birth and had promised that we would attempt one if they were both head down. They were both head down but at the end he said that they are too small and a vaginal birth would put too much stress on them. He also said that my pelvis is too small and I would have a difficult time pushing. Anyway, my boys will be 2 this summer and I think it’s a good time to expand our family. I am 100% hoping for a VBAC and the idea of a home birth is looking good time. I just don’t know if I can overcome the fear of what if something goes wrong? I don’t think I can deal with something going and the whole thing being on me and my decision to have a home birth. Did being a nurse give you some extra confidence? Were you scared at all about the “what ifs”?
    What about afterward? Did you have a lot of pain after giving birth? I don’t know anything about what happens afterward. What about the baby? I see myself running to see the pediatrician the next day.
    Sorry for the lengthy message. I find the whole process sooooo fascinating! Thank you again for posting your experience.

    Hi Amy! I’ve forwarded your comments on to the original poster and hope that other medical professionals who chose hbac/homebirth will step forward with their experience and perspective. I’ve had a hbac, but I am not a medical professional, just a resourceful researcher! Best, Jen

    Reply
  9. Hello! Thank you for the wonderful story! I too am contemplating a VBAC home birth but am very scared because, like you, the doctors told my mother and grandmother that they were too small to deliver naturally. Although my doctor sis not tell ME this, he induced my first labor and I failed to progress. I really need some encouragement, do you think the whole “small pelvis thing” is a crock? you can email me. thanks alot!

    Reply
  10. What a great story – thank you for sharing it, and congratulations! I particularly appreciate your story because you work in the hospital environment and KNOW what goes on there.

    Reply
  11. Thanks for this inspiring story. Your personal account, both of your homebirth success and your experience as a neonatal nurse tells so much and will be a ray of home to so many women afraid of VBAC.

    Reply

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Jen Kamel

Jen Kamel is the founder of VBAC Facts, an educational, training and consulting firm. As a nationally recognized VBAC strategist and consumer advocate, she has been invited to present Grand Rounds at hospitals, served as an expert witness in a legal proceeding, and has traveled the country educating hundreds of professionals and highly motivated parents. She speaks at national conferences and has worked as a legislative consultant in various states focusing on midwifery legislation and regulations. She has testified multiple times in front of the California Medical Board and legislative committees on the importance of VBAC access and is a board member for the California Association of Midwives.

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