Breech VBAC birth story
By a mama of 3 children in the greater NYC area
I have 2 kids age 15 and 10. When I got pregnant this spring with my last child, I realized that after having 2 kids, I never gave birth. I had my first child in the hospital setting being heavily medicated and not remembering much. My second child was in breech position and with limited knowledge, no support and pressure from the doctor, I had to agree on the c-section.
Forward ten and a half years... I was stepping into my last pregnancy and I was determined to have a better outcome and did not feel guilty that I wanted more than just a healthy baby. I was older and for the first few months I was very cautious about it. I started my care with an OB at Brooklyn Methodist Hospital who was highly recommended and VBAC friendly. Towards the beginning of the second trimester, I started to learn more about the birth process that my OB could offer and her limitations around my age and prior c-section. I did not like what I heard. After she said that she does not induce VBAC patients and that if I go over my due date by 2 days I will have to agree to the c-section, I decided to look around.
As I was getting more educated on the hospital birth and VBAC, I came to the realization that to have a successful VBAC, I better stay away from the hospital. The idea of a home birth became more and more appealing. I think my doula Nubia's conversations about different birth options were also guiding me to consider home birth. I found a midwife team that was comfortable with my 10 year old c-section, and by the time of second appointment the news came. My worst nightmare materialized -- I was carrying a breech baby again. Deep down inside I knew my baby would not turn. Despite the news, I decided to stay with the home birth team, and it turned out to be the best decision of the whole pregnancy. At some point I asked C (one of the midwives) if breech home birth was completely off the table and she said "We can think about it." And so we did.
In a meantime, the next 5 weeks went by in efforts to turn the baby and learning about VBB. Around week 37 I had attempted an ECV. It was not successful, and I feel that the doctor performing it did not try hard enough. He claimed that the head was in the ribs and he could not get it out. I feel that had he allowed me to sit or walk for a minute, gravity would help move baby a little down. But I did not speak up and he did not want to try more. We did talk about options afterwards and the doctor pretty openly admitted that he does occasionally let women birth breech babies as long as they are not in a risk-category and come in late in labor. Nevertheless, although VBB after a c-section is not riskier than cephalic birth, according to hospital policies he would not be able to offer it to me. I had a consult with 2 more doctors for ECV and VBB and was told the same. At this point, even though the baby was still breech, home birth remained my first choice. It also ended up being the only choice to avoid a c-section.
Planning for home VBB took time and effort. C and S -- my midwife team -- did not have breech birth experience and we all agreed that we need an experienced set of eyes and hands. Ladies reached out to the local midwives who had experience in breech birth, but prior c-section made most of them hesitant. We considered E, a midwife in PA that took course with Breech Without Boarders and had a few breech births under her belt. We would need to travel to E at the early signs of labor and give birth in the hotel. We also were in touch with Dr. Hayes but for some time his availability was not certain. In the end we partnered up with a local midwife, Y, who became available. A huge thanks to my care team for proactively searching for support, interviewed providers, and being open to travel with me. Also thank you to Dr. Rixa Freeze, who put out a word among participants of the prior training course in the area.
The first signs of labor came on Sunday November 21st. I lost the mucus plug in the morning and felt menstrual cramps in the evening. I woke up on Monday to stronger cramps that felt more like contractions -- they were coming and going. Throughout the day, I took two long walks on the beach, which felt nice and loosened the hips. Around 5 pm contractions started to be more regular, coming every 10-12 minutes and lasting 30-40 seconds and uncomfortable although not painful. And from this point on, labor started to pick up. By 9pm I set up my birth room: candles, drum-based music, snacks, fluids, pillows. I was dancing through contractions for a while.
At this time, I don't think they ever came consistently 3 min apart. Some were 2, some were 5 min apart. Some lasted a minute some up to 2 minutes. But the intensity was building up. By 11pm I was moaning through each wave and slowing down my breathing through the breaks. I could not stand anymore and was sitting on the floor and getting on my hands and knees, rocking back and forth or side to side. By 11:30pm I got in the bathtub. It was relaxing to lay down, but I still had to get on my hands and knees to get through the waves. Although I love water, it did not bring the relief I was hoping for.
I stayed in the bath for about 40 minutes and then transitioned back to the room. Nubia came around at 12:30am and her hugs, fan and essential oils felt very comforting. C came around 1am and I asked for a cervical check. Since it was my first real birth, I did not know what was happening. If there was no progress, I needed a different plan. Fortunately there was great progress -- I was 7cm and the cervix was very soft. From this point on I felt like I was on a train that got off the tracks and was flying into nowhere at the speed of light. Y and S came but in my mind it's a bit of a blur. At some point I felt a lot of pressure and my water broke and I declared that I had "delivered my water."
After that, it felt like there was no more breaks: just few breaths and a new wave was coming. Waves were hugging me by starting at the mid back, moving to the lower back and then to the lower front. The back pain was unbearable: there was no movement or position that would ease it. I was periodically checking with the team on what was happening and if the intensity would continue climbing. I switched to screaming through contractions. At some point I got frustrated with nothing happening and got up and moved and squatted a bit. I also tried a birthing stool. Leaning back on it did not work at all. I remember thinking at that point -- thank God I am not in the hospital where I would not be able to have freedom of movement. Leaning forward was better. I also tried climbing on the couch and being on my knees with my torso upright. I also tried an asymmetrical lunge but always ended up on hands and knees rocking back and forth.
And at some point, when it felt like it would never end, baby started moving down. I did not feel an urge to push, but I did feel movement and lots of pressure and I just went with it. I held my breath and kept the movement going without squeezing my perineum (I have done this little trick a few times earlier) until baby was out. It felt like he slid out in one breath. And then the pain stopped. And everything stopped. The Earth stopped spinning for a few seconds and took a deep breath. A little human was just born. And I could not believe that it happened.
Early postpartum was easy and relaxing. The placenta came out easy I think 10-15 minutes after birth. Holding the baby felt amazing. He was just peacefully laying on my chest. He did not latch properly until the next day but I was not rushed or pressured. The first hours after birth were pure happiness. Thank you, oxytocin! Being home with my family and being cared in a very gentle and nourishing way was very peaceful and felt like the right way to do it.
A couple thoughts afterwards.
- At 43 and having 2 children, I did not know how babies are born. Now I do. Home birth rocks!
- My husband -- thank you for trusting me on this! Thank you for being a tree during pregnancy, birth, and now into the parenthood. Thank you for holding my hands for most of the last 5 hours of labor. Thank you for making me smile.
- My team was amazing. We planned, talked through things, and created a space for different scenarios. It made me ready and open to other outcomes in case birth took an unexpected turn. At the same time, during the birth my space was respected except one check upon my request as well as periodic heartbeat checks. I felt there were women in the room and not medical professionals. I don't have any friends that I would want to be around during birth, and the ladies turned to be my special circle, my community, my support.
- Nubia's support was amazing. From the time we connected till our last chat this week, I always felt I have someone to talk to about my concerns. There are no stupid questions and there is always more than 1 right answer. During the birth having Nubia by my side was very comforting. I had serious thoughts about unassisted birth, but for me personally having support worked out well. I don't know if my husband and I would be able to handle the birth alone.
- Pain is important. All the sensations that we go through during the birthing process provide important information. It is important how it changes and evolves throughout the birthing process. It is our internal monitor when combined with ancestral intuition and ancient instincts. To ensure a safe birthing process it should not be suppressed or ignored. It should be listened to, respected and embraced. In the last few days, when I was thinking about the pain I experienced during the birthing, I reflected on my first heavily medicated hospital birth. There was no pain and there were no clues or information. I did not feel much and in the hospital setting there was no one to watch my progress. Monitors and meds replaced pain. Nurses who popped into my room once in a while were only interested in my progress and my comfort so they could keep an eye on many of us.
- Lastly, it's sad how much misinformation there is about home birth. A few people told me that I am a hero, but to me my pregnancy and birth felt real and normal -- just how it was supposed to be.
Thank you for taking the time to read my story.