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Vyckie and Kent Andrew
Homebirth Following Four Cesareans

If someone would have told me twelve years ago when I was pregnant with my firstborn that she was only the first of five (maybe more) children that I would bear, I might have put a little more effort into educating myself about the birth process and preparing for a natural delivery. I did take the hospital Lamaze class where I learned a lot of complicated breathing patterns that I never practiced. But at 19 years old, I was so terrified at the thought of labor that I just tried not to think about it; I was sure that once I got to the hospital, somehow "they" would get the baby out. I just hoped it wouldn't hurt too badly.

I arrived at the hospital about 10 in the morning after staying awake all night with "contractions," not at all painful, but very regular. The "tingling" feelings came every two minutes and lasted about 60 seconds. The nurse hooked me up to an external fetal monitor and checked my dilation. I was at one centimeter. After the doctor broke the bag of waters the contractions stopped completely. Next, I was taken to x-ray to determine if the baby could fit out. I am not very tall (5') and only weighed 119 lbs. at full term. The doctor informed me that there was not room for the baby to fit through my pelvis and said that I would need a c-section. At the time, he also mentioned a large bone spur which he saw on the x-ray. I inherited these benign tumors from my father and assumed that the reason the baby wouldn't fit through my pelvis was because the tumor was blocking the passage.

I was relieved to hear that I would not have to "do labor" and asked to be put to sleep since I'd already been awake all night. I also did not want to be awake when they cut me open. When I awoke in the recovery room the nurse informed me that I had a baby girl. Angel weighed 6 lbs. 2 oz. The recovery from my first c-section was not really so bad, mainly because I was young and healed quickly.

When I became pregnant again six years later, I told my new OB (I had moved out of state) that I had a bone spur in my pelvic area and because of it I would have to have another c-section. Berea was born by c-section on August 26, 1991. The recovery from the c-section was difficult, and I did have some postpartum depression. When she was only four months old, I became pregnant again. Since the c-section was still pretty fresh in my memory, I cried at the thought of having to go through that again. At the same time, I was happy that I would be having another baby, because they are so precious and lovable!

Our third girl, Chassé was born on October 16, 1991. This time the c-section was much easier since it was so soon after the last one. I could remember all the mistakes I'd made before (such as not getting up to walk right away) and avoided them this time. A few days after I came home from the hospital, I broke out in hives. The doctor prescribed some Benadryl for the swelling which was mostly in my eyes. The pain pills I was still taking must have affected my thinking, because after I took the pills I set them on my desk within Berea's reach. I even thought to myself, "Berea can probably reach those, I should put them up." But I was so "out of it" from the medication, that I just went back to bed.

I was awakened by my husband, Warren, who told me that Berea had eaten some of my pills. We had to take her to the emergency room, but since Warren is blind (and doesn't drive), and I still could not drive because I had just had surgery, we had to call my sister to take us to the ER. There I was at the hospital: with a 13 month old who had been poisoned and her week old baby sister; I was so drugged up that I barely knew what I was doing, my face was all red and my eyes were swollen shut from the hives--and I was thinking, "I can't go through this anymore! This is too much!"

After that my husband and I decided that it was too difficult (as well as expensive; we did not have insurance) for me to have more children. Warren had a vasectomy to make sure I wouldn't have to go through any more c-sections.

Two years later, we changed our minds. We really love our girls, and we wanted more (no, we were not especially interested in having a boy). We decided that even though it would be hard on me, I was willing to do it because we believe that babies are a blessing from God, and we did not want to deny ourselves any of His blessings. Warren had reversal surgery on Valentine's Day of 1995. It didn't take long to know that the surgery was successful; I got pregnant at the end of May 1995.

I should back up though. After Warren had his reversal, I got to thinking about how I might avoid another c-section. That's when I started checking with my doctors and discovered that the bone spur which the first doctor had seen on the x-ray was nowhere near my pelvic area and was not obstructing the passageway. In other words, there was really no physical reason for my first three c-sections! I was really angry, of course, but I was also glad to know that I could attempt a VBAC. I asked my OB/GYN if it was possible to have a VBAC after three c-sections. His answer was, "Well, we can let you try." Then he went on to explain all the conditions (only permitted 24 hours of labor, epidural already in place, surgical staff on standby in case my uterus ruptured and I needed an emergency c-section and hysterectomy). Afterwards, I heard him laughing about it in the hall with his nurse! "How's that for a challenge? And she's not even pregnant yet!" Well, I decided that I would not go back to that doctor!

Failed Homebirth Attempt

When I found out I was pregnant, I read Silent Knife and decided that this is something that I could do (VBAC), but I felt that I would not have a very good chance of a successful VBAC if I went to the hospital. So I found a lay-midwife who was willing to assist and decided to try a homebirth. (Imagine the reaction of my ladies' prayer-group!) I think the biggest problem that I had during the pregnancy was the weight gain. I am not a very big person (5 foot tall). I started out weighing 95 pounds. Within six months, I had gained about 40 lbs--more than my entire pregnancies previously.

I am not a person who naturally loves to eat, but I needed to eat literally every two hours, or else I would get shaky, a terrible headache, cold sweats, etc. My uterus was growing faster than normal also, which led Judy to suspect that I might be having twins. I debated about whether to have an ultrasound done, but I didn't have the money, plus I was afraid that if I went near a doctor I would be subject to immediate c-section. I had enough indications for twins to make us seriously suspect that this was the case, so I thought I probably needed the extra weight gain. By the end of my pregnancy, I had gained 75 lbs. My fundal height was 55 1/2 cm. I was spilling sugar in my urine, but every time Judy did a glucose test it registered LOW blood sugar, so she said I definitely did not have gestational diabetes. I had a lot of pre-term labor--very strong, regular contractions. They sure seemed like real labor--even fooled the midwife, but nothing was happening. I was not dilating.

About a week before my due date I came down with the flu and it was really terrible. For SIX days I could hardly eat or sleep. Finally, a good friend brought some homemade chicken noodle soup (the best meal I've ever had) which I was able to keep down. I felt so good that I was actually able to get about three hours of sleep. When I woke up I thought, "I'll probably survive!" That's when my water broke.

Needless to say, I was very weak and fatigued. I labored in and out of the bathtub all day and all night. The contractions did not seem to be accomplishing anything, so the midwife suggested that we try nipple stimulation (not too fun). That did help and I started dilating some although I never made it past 6 cm. Finally, about 24 hours after my water had broke, I decided that I had to get this over with. I ate some Access bars (energy bars--blech!), and bee pollen, tried some different positions--including the birthing stool, which was murder! While I was on the birthing stool, Judy noticed meconium in the amniotic fluid. That's when she got on the phone to consult with some other midwives, and they all decided it was time to transport me to the hospital. I cried, because I was very disappointed, and I really didn't want to have another c-section.

At the hospital, the doctors did not even give me a chance to try for a VBAC any longer. It is their policy to only let a woman labor for 24 hours, which I had done. I was pretty close to hysterics by the time I got there because for some reason I thought that once it was decided that I should have another c-section the labor would stop since it wasn't necessary! I couldn't believe I was still in pain! I wanted everything to be over with so badly that I insisted on general anesthesia--just to get it over with. When the doctor put the oxygen mask over my face, I couldn't feel myself breathing anymore (because I was already numb), so I started really struggling to get away from the mask. I had read enough books (in preparation for a VBAC) to know that c-sections were not altogether safe & that women have actually died from the surgery. I thought that's what was happening to me--something had gone terribly wrong & I was about to meet Jesus.

Instead I woke up in the recovery room & someone told me I had a baby girl. One girl, not twins, although she did weigh 8# 14 oz. (previously, my biggest baby had been 6 lbs, 7 oz). The doctor who did my c-section said that he thinks I had gestational diabetes. Also, he said the baby was posterior which is why my labor was not too effective. He did say that if I had not had the flu and if the baby had not been posterior, I probably could have had a VBAC. I had a really miserable time in recovery since I had the flu to begin with. I was in the hospital for 6 days and had to have an NG tube stuck down my nose and into my stomach to pump everything out & get my bowels working again. The nurses all knew that I had tried to have a homebirth, and they were especially nasty to me because of it. Two of them had delivered their babies by c-section and could not understand why I would want to have a vaginal birth. I asked them how many children they wanted--only one or two. I told them that I wanted lots of children, but I didn't want lots of c-sections.

The postpartum depression lasted nearly a year. Hazelle was such a good little baby. I kept thinking that she must feel guilty for all the pain she caused me and now she was afraid to fuss because she knew I'd had enough! If it hadn't been for Judy (the midwife) getting us started in a good nursing relationship, I don't know how long it would have taken for me to bond with her. I held her constantly and slept with her at night. Even so, it was about five months before I could look at my baby without thinking about her traumatic delivery.

My homebirth Success!

Although I was very excited to learn that I was pregnant again when our youngest was 19 months old, I was also filled with dread at the thought of another delivery. I was not too excited about attempting a vaginal delivery again considering the trauma I experienced during the previous delivery. On the other hand, I still had a strong desire to avoid another cesarean. Knowing that this probably would not be my last pregnancy, I felt that I should at least give it a try.

I was very hesitant about seeing the same lay midwife who was with me during my attempted homebirth. After thinking back on the prenatal care I'd received during that pregnancy, I decided that I would have been better off to seek some medical assistance rather than shunning the obstetricians altogether as I had done. It would have been beneficial to have an ultrasound done to determine that I was not having twins and, knowing it was a single pregnancy, I would have taken measures to avoid so much weight gain. In spite of these doubts, I began seeing Judy when I was about six weeks along although I was very doubtful that I would have a homebirth.

There was now a Certified Nurse-Midwife working at the OB clinic. I decided to see her also for my prenatal visits and probably deliver in the hospital in case I needed some medical intervention during the delivery. I was very encouraged that Gail seemed quite supportive of my VBAC plans.

This pregnancy went so smoothly that I nearly held my breath every day waiting for the inevitable complications. But they never came. I experienced only a little nausea the first few weeks. Other than that, the whole nine months were so problem-free that it was almost monotonous. Not that I was not extremely grateful for the relief! At the start of the pregnancy, I did gain a lot of weight (11 lbs. in the first 5 weeks), but at Judy's suggestion I took GTF Chromium which helped to regulate my blood sugar so that I did not need to eat excessively. In the end I gained a little less than 40 lbs.

At seven months, I mentioned to Gail that sometimes the baby would make some really spastic movements--almost like a startle reflex, but lasting a little longer. Since I had been pregnant four times already and had never experienced this type of movement, Gail became concerned that the baby might be having seizures. At her suggestion, I had an ultrasound done which revealed a perfectly healthy baby -- a boy!

At eight months along I had another ultrasound performed by Dr. Fleming, a neonatal perinatologist from Omaha. The ultrasound showed that baby Andrew was average sized and was in a posterior position (which he had been since about five months gestation). The doctor discussed with me my previous birthing (or non-birthing to be more accurate) experiences and was very encouraging about my chances of having a VBAC this time. He warned me that if I were to allow my labor to be induced the likelihood of success would be less than 30 %.

Although I had very positive feelings about this pregnancy and felt very confident that I would have a VBAC, I was worried about the baby being posterior since that was part of the reason why my previous attempt at VBAC was unsuccessful. I did lots of pelvic rocks, knee-chest exercises, etc. but little Andrew insisted on facing forward until just a few days before his birthday. Just a very sociable guy, I guess!

During the last six weeks I took three capsules of Evening Primrose Oil every morning and evening, as well as 5W, a formula which is supposed to prepare the cervix for labor. Despite some serious attempts to get things going (including Blue Cohosh, accupressure, mall walking, etc.) my due date of June 11th came and went. After about a week, I finally came to a point where I felt perfectly content to wait for God's timing for the labor to start. At my last clinic check-up, I declined the CNM's offer to "sweep the membranes" in order to induce labor.

I was starting to feel pretty hesitant about delivering in the hospital. I had submitted my birth plan to Gail, most of which she readily agreed to. But then, little by little, I found the most important parts of the birth plan were not going to be allowed. I would have to have continuous monitoring because, in Gail's words, "we would be negligent" not to monitor the baby in light of the concerns about possible in utero seizures; this in spite of the two ultrasounds and numerous non-stress tests all of which indicated that the baby was perfectly healthy. When she said "negligent," I realized that she, the OB, and the hospital have legal concerns which would probably dictate to some extent the outcome of my delivery.

On June 19th, about 6:45 a.m. I felt a "pop" down low near my cervix. I was leaking a little bit of water, so I decided to call Judy who arrived at our house around 9:00 a.m. I was only having a few light contractions, but somehow I knew that this was the real thing. My mother came to pick up Warren and the girls. I had decided early on that I only wanted Judy and my friend, Diane, at my birth. I felt that Diane would be an encouragement to me as she had her first child by c-section and her next two at home.

In order to get the contractions going stronger, we did a lot of walking. We went to Wal-Mart to walk around, then we walked around the neighborhood when we got home. While Diane fixed a delicious dinner, I walked around and around the house. About 7 p.m., I asked Judy to do a pelvic. I was at 3 cm. and the baby was at +4 station. Since he was so far down into the birth canal, I had a lot of back labor. As I walked around the house, I would stop during the contractions and lean against the freezer while Judy applied counter-pressure to my lower back.

Throughout the night I did more walking (including climbing the stairs which seemed to relieve the back pain) and slept on and off as I was able. Around 1:00 a.m. while I was laboring in the tub, Diane gave me a wonderful foot massage which was so relaxing that the contractions stopped completely, and I was able to sleep for about 25 minutes.

Early in the morning, around 5:00 a.m., I felt a very strong conviction that the baby would be born vaginally. My body was doing exactly what it was supposed to do (albeit, very slowly), there would be no complications, and, yes, I was going to give birth to this baby. Because I felt so strongly about this, I decided that I wanted my sister, Sandy, to be present for the birth. I called and invited her to come to my house. After she arrived, around 6:20 a.m., I started feeling very strange. I couldn't describe it to Judy, except maybe that I felt a little sick. All of a sudden, I started crying and shaking. I couldn't decide what I wanted to do, or where I wanted to be. I was thinking, "This seems a lot like transition, but I think I'm only about 7 cm. dilated." I told Judy that I wanted to crawl into the bathroom sink and go to sleep in there!

While this was going on, Diane and Sandy were setting up the birthing stool and preparing a place for me to have the baby. Judy was preparing her instruments and had put on her sterile glove. I told her I did not want her to check me because I was pretty sure that I was only dilated to about 7 cm and I didn't want to be disappointed. Suddenly, my body settled down, and I felt normal again. I went to use the bathroom and Judy followed me with her gloved hand raised to keep from touching anything with it. "She thinks I'm going to let her do an exam," I told my sister.

"No," Judy said, "I was just thinking how elegant you look with your hair up and lipstick on." Well, okay, that softened me up and I consented to an exam. Just as I thought, I was only at 7 cm. Judy applied Evening Primrose Oil to my cervix, which was very painful as she had to do it during a contraction. I continued to have mild contractions all morning. About 11:00 a.m., Diane gave me a back massage which relaxed me so much that the contractions stopped altogether, and I slept for about half an hour.

About three o'clock that afternoon, I was still laboring away--perfectly content because I still felt very confident that everything was going just as it should be. My sister-in-law phoned and I assured her that I felt better and had more energy at that point than I did when I started labor with my last baby. I joked with her that I had already been through transition, and it wasn't all that bad! (Judy said the transition-like symptoms were probably triggered by the baby's head being so low in the pelvis.)

It did not bother me that I was dilating so slowly. In fact, I was sure that the Lord was giving me just the kind of labor that *my* body needed--slow but sure! I was so sure about all of this that I got out the suitcase I had packed "just in case" I needed to go to the hospital and unpacked everything. Since I was getting plenty of Diane's good cooking to eat, and everyone was taking turns napping so we were all well rested, I could think of no reason why we couldn't go on like this all night--in fact, it seemed almost like a slumber party to me!

Little did I know, although I was content to let my body proceed at its own pace and was in no hurry to "get it over with," Judy had another lady in South Dakota whose water had broken. She was not having a lot of contractions yet, but Judy was concerned that she would not make it to the birth.

At 6:00 p.m., I started in with the transition feelings again--shaking, very emotional, crying, feeling like I couldn't go on any more. Diane and Sandy again set up the birth stool, this time in the livingroom. I was sitting in the glider-rocker concentrating on my abdominal breathing and relaxation. The contractions were fairly strong, but not unbearable. I had established a pretty good pattern of taking in a long, deep breath then slowly blowing it out. I remember that I was chewing a piece of gum, and I guess Diane didn't think it was too helpful for my breathing because she suggested I throw it away.

At 8:00 p.m. Judy did another pelvic exam. I could tell that she was not too pleased to find that I was still at 7 cm. She asked permission to hold the cervix forward during the next contraction to see if that would help speed things up. Although I was not really in any hurry and the contractions were extremely uncomfortable while I was laying down, I consented, "for ONE contraction only!" During that contraction I dilated to 9 cm!

Apparently, Judy was very encouraged by such progress because she then announced that she was going to hold the cervix for the next contraction also. Although I protested rather vehemently (okay, I was screaming!), Judy would not relent and after the next contraction, she said I was now fully dilated but she would need to hold the cervix over the baby's head during another contraction while I pushed in order to keep a "lip" of the cervix from falling back down over the head. "NO!!!" I was screaming in a very shrill voice! I wanted to stop and rest for a few minutes--those contractions while laying flat on my back were pure torture!

I screamed so much and had such a fit that I had really lost all control of myself. No more deep-breathing and relaxation! During the next contraction Judy told me I must push! Push? Why was she telling me to push? All the books I had read said that the worst position in the world to push in was the prone position; there I was laying flat and she wanted me to push??!!! I told her that I couldn't push laying down, and I begged her to let me up so I could just have a little break and get myself back together. Finally, Judy asked if I would like to sit on the birthing stool to push. "Yes, yes!" Anything to get her to let me up!

As soon as I got up from the bed, I screamed at Judy, "I am going to the bathroom--and then I am going to call the police! I'm going to tell them to get you out of my house! I told you to leave me alone and you refused! I'm going to tell the police to take you to jail!" I guess this is what transition is really like; my husband wasn't there for me to take it all out on, so the midwife got it instead!

After I went to the bathroom, I was on my way to call the police when I realized that I was shaking terribly and the contractions had become unbearable. Judy explained that I had a "cervical lip" and that I was basically stuck in transition and would not stop shaking until the "lip" was gone. I was infuriated that I could not call the police to come and take her away because I needed her to help me have the baby!

I went into the livingroom and sat in the recliner. I was crying and fuming and shaking, trying to breathe and relax. I needed to get control of myself! Sandy sat beside me and cried with me. "Don't give up now!" she pleaded. "Why did she do this to me?" I wanted to know. "I told her to stop! I told her that I wanted to take a break! and now I can't stop shaking!"

I decided to get in the bathtub to see if the warm water would relax me and stop the shaking. Judy came in the bathroom and used a washcloth and a jar of Noxema to demonstrate to me what a cervical lip is and explained why I would have to push the baby down into the birth canal while she held the lip back. I was still steaming mad at her, but I knew I couldn't handle the contractions any longer so I agreed to do as she said. I was wondering how I was going to push when I felt no urge.

Diane and Sandy set up the birthing stool in the bedroom on the side of my bed (they were getting pretty adept at this by now). I sat on the stool with my back against the bed for support. My bedroom is pretty small so less than two feet in front of me was the closet door--not much room for Judy to work in, but she managed pretty well in that little space!

At this time it was a little after 10:00 p.m. I was relieved that when I sat on the birthing stool the shaking completely stopped and I was able to relax again. Judy put on her glove and held the cervix. When the contraction came, I gave a low grunt (as Diane had instructed) and pushed. Wow! My body just seemed to know what to do! I could feel the baby moving down, and Judy encouraged me that I was going to have this baby very soon!

Was I ever surprised when Judy told me I would have to push *again*! For some reason, in all the reading I'd done in preparation for my VBAC, I had always skipped over the part about the pushing stage. I was so concerned about dilating. I guess I figured once I got to 10 cm. the baby would just slide on out! After a couple more pushes, my bag of waters broke with a huge splash. Judy said I was doing great and she could see baby Andrew's head. When I asked her what was taking so long, she exclaimed that I had only been pushing less than 30 minutes; she didn't seem to think that was long at all!

"Get him out!" I grunted. It became a chant which I repeated over and over very quickly instead of panting. "Gethimout! Gethimout! Gethimout!" Judy was working furiously to massage the perineum and keep me from tearing. I said I didn't care if I tore, "Just get him out!"

Judy suggested that Sandy should get a mirror so I could see the baby's head coming out, but I insisted that she stay right where she was. I was holding on to her arm with my right hand and did not want to lose the support. Diane wanted me to feel the baby's head and even though I told her I did not want to, she took my hand and placed it on little Andrew's fuzzy head. I am glad now that she did, but at the time I was so scared. I figured that if a baby was going to die during birth it would be during the pushing stage. That's why I just wanted to get it over with--no time for sentimental stuff like mirrors and touching the head! Just get him out and make sure he's alive!

All of the sudden the baby shot out of my body! It happened so quickly and forcefully that I am amazed Judy was able to keep him from hitting his head on the closet door. She put him up to my breast immediately and started suctioning him. His little body was so slippery and goopy--not at all like my other babies who were all bathed and dressed before I ever held them. He didn't seem too interested in nursing right away, but Judy seemed to think he needed to, so I worked at getting him to suckle. Andrew was born shortly before 11:00 p.m., though no one was really watching the clock. Judy cut the cord after it stopped pulsating and about 11:25 p.m. I pushed the placenta out.

I felt very weak immediately following the birth. I had to be helped into the bathtub and afterwards I went to bed and did not feel like I even had the strength to lift my head. Judy spent quite a bit of time getting the baby to latch on and nurse. After he finally nursed for a little while, I fell fast asleep and did not wake up at all until about 7:00 a.m.

Baby Andrew weighed 7 lbs. 11 oz. and was 20 1/2 inches long. Judy told me that his hand and shoulder were born with his head, which is why it took so long for him to be born after crowning. Judy said she had never seen a baby come out that way before, and in all of that I didn't even tear! The baby's apgars were 5 at one minute (because he was a little slow getting started breathing) and 8.5 at five minutes.

My recovery was quite a bit slower than I had expected. Somehow, I had imagined myself jumping up off the birthing stool and planning a celebration party! Instead, I had to take it easy, but it was nothing compared to the long, difficult recovery of a cesarean! No postpartum depression at all--glory be to God!

My good friend, Bennetta, who also had all her babies by c-section had her little Erica Kay eight days after Andrew was born. Gail attended her at the hospital and she had a beautiful VBAC! On July 31, we threw a Celebration of Thanksgiving to God and in appreciation of the two midwives, Judy and Gail. We were both very grateful for the opportunity to share how much the Lord has blessed us in allowing us to deliver our beautiful, precious babies naturally!

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