ALISON’S WILD RIDE – A Birth Story

On Christmas Eve 1997, my maternal grandmother, Nana, asked me if I was going to have any more children. (I didn't know then that she also had the same chat with my husband, Dean.) I should have known, based on previous experience, that this was a premonition of things to come. (With my first daughter, the day that I called my mother to tell her I was pregnant, my grandmother told her that she found my baby sweaters in her attic.) That night in bed, out of the blue, Dean asked me if I still wanted to have another baby. The following Christmas day, Alison Nicole Thompson was conceived. Never underestimate the power of a grandmother, that's for sure!

My four-year old daughter, Jessica, had been born via C-section after a successfully induced labor. (I was induced due to mild pre-eclampsia.) I never regretted my C-section because it had been necessary – arrested descent and unsuccessful vacuum attempt. (There was no clear reason for Jessica's arrested descent, although my pelvis is small.) However, I really wanted this birth to be as "natural" as possible. I read everything I could about VBAC (Vaginal Birth After Cesarean). I read newsgroups, surfed websites, and joined email lists. I also took the VBAC class offered by my hospital. All this strengthened my desire to have a VBAC and encouraged me to believe that I could do it.

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September, 1998 – I have made it to the ninth month of pregnancy without pre-eclampsia and with only a few bumps along the way: a borderline case of placenta previa at 20 weeks which corrects itself, one high blood pressure reading which turns out to be nothing, and switching doctors at 33 weeks to the doctor that delivered my first daughter. (He had left the group practice during this pregnancy.) At 37 weeks, my OB offers me the option of pitocin induction, but I really want to go into labor on my own. He will allow me to go one week past my due date before he considers induction necessary. He doesn't think that it will not decrease my likelihood of successful VBAC, and that the risks to the baby (meconium aspiration, placental dysfunction, etc.) of waiting more than one week are far greater. He estimates my chances of successful VBAC are good (about 80%). However, as my due date nears and my belly increases, I sense he's getting nervous about whether this baby will fit through my pelvis better than the first.

Wednesday, September 16^th – Yet another weekly OBGYN visit. No change from the previous week – still 2 cm dilated, 70% effaced, baby's head at –1 or -2 station. The doctor reminds me that this does not mean I won't go into labor the next day, but am discouraged by this news nonetheless. I spend the afternoon having a good cry, which makes me feel better. I am resigned to at least a few more days of pregnancy. Later, I take Jessica to craft time at the library, then meet my friend Pam at the mall for dinner and shopping. I have some different feeling pains, but I am convinced it's wishful thinking or just a result of the pelvic exam.

Thursday, September 17^th – Throughout the day I continue to have occasional pains like the ones from the evening before. They feel different from the Braxton Hicks I've recently experienced, but do not feel like "it". I figure either it's due date psychosis, or maybe (just maybe) the baby will come this weekend and I won't have to be induced.

Shortly before 5:00 p.m. – I realize these pains are coming more often. (Are they true labor contractions? – I still have no clue.) I decide to start timing them. They are approximately 10 minutes apart, but I figure they are still too far apart and not painful enough to call this "it". My husband, Dean discovers me scribbling down contraction times, but tell him that this does not mean that I am really in labor. I have heard too many stories of women sent home from L&D either in false labor or not dilated enough to admit. Meanwhile, I cook dinner and we eat. Looking back, I don't think shrimp scampi qualifies as the "light diet" my doctor allows in early labor, but I was convinced that this is not "real" labor.

Approximately 8:00 p.m. – After coming every 10 minutes for an hour, my contractions become more frequent but very irregular. They are everywhere from 2 to 8 minutes apart. Sometimes they come in clusters of mild ones that I don't even time separately as they are so close together. Some contractions are pretty painful, but most are not bad. I keep waiting for the infamous "every 5 minutes". After 2 hours of irregular contractions, this does not appear to be happening so I call my doctor's service. We talk shortly afterwards. He says that if I am in a hurry to get to the hospital, I can come in right now. (Me – in a hurry to get to a hospital? Never!) However, since I am handling the contractions quite well (I never get a painful one while on the phone with him) and they are still very irregular, he doesn't think I'm more than 4 cm dilated. We agree that he will call me back in an hour. We call Dean's Aunt Jean (our "backup" for watching Jessica) to see if she can watch Jessica until my mom can come up to stay with her, if necessary. I am hesitant to call my mom, who lives an hour and half away, in case this is just a "false alarm". (Why I was so hesitant to think this is really "it", I have no idea.) Meanwhile, about 10 minutes after I spoke to the doctor, my contractions become 2 – 3 minutes apart and very painful. I try to do a puzzle with Jessica, but it is impossible. I call the doctor again, and he tells us to meet him at the hospital – this is "it". Dean calls my mom who says she must finish packing her bags first, then she'll meet us at the hospital where Dean can give her directions to his aunt's house. (There's no time now.) We put the dog out, pack some stuff for ourselves and Jessica, and head out. Unfortunately, the contractions now are very painful and I am scaring Jessica.

9:00 p.m. – We drop Jessica off at Aunt Jean's house and leave for the hospital. Dean asks if I want to go to the local hospital, but I insist on going to my own. It's only 20 minutes away and I do not want a strange doctor delivering my baby. (This turns out to be a very good decision; my OB later informs me the other hospital doesn't do deliveries anymore.) The contractions really hurt now. I am moaning, swearing and far from calm. Dean keeps reminding me to "breathe" during contractions. I tell him "I can't breathe! I hurt too much!". (Yes, I am really rational now!) Already I am feeling a slight urge to push. I have no idea how far along I am.

9:15 p.m. – My water breaks all over the front seat of our new car. I suspect Dean is less than thrilled with this news. He asks what this means. I reply "It means you should keep driving!"

9:30 p.m. – Almost at the hospital. While exiting the highway, Dean points out that the traffic light at the end of the ramp is green, so we don't have to stop. He's trying anything to make me feel better. As we pull up, I tell Dean that I need him to get a wheelchair, as I don't think I can walk to L&D. As we park in front of the hospital, another contraction starts to hit. Dean wants to wait with me until it's over. I yell at him that there's nothing he can do, just get the wheelchair, I'll be fine. He has some difficulties getting the volunteer at the front desk to understand that he knows how to get to L&D, but his wife is in no shape to walk. Eventually he returns with the wheelchair. I hope I'm not too far along to get drugs. Physically, I am in rough shape - laboring without drugs is one thing, but sitting in a dark car, not knowing what's going on or if you'll make it to the hospital is quite another. Emotionally I am a wreck, consumed with guilt. I am certain that Jessica seeing me in pain will scar her for life and I'll have to take her for therapy.

L&D – The three fastest, most hectic, most roller-coaster-ride three hours of my life. Good news: I'm fully effaced/dilated and can push whenever I feel the urge (at this point – with every contraction). Bad news: the baby's head is still not fully engaged. My OB says this is bad because her head will need to do a lot of molding to fit through my pelvis. To top it all off, he thinks she's sunny-side up. Great, I think to myself. Like I need this baby to be any harder to push out. (Fortunately, she later turns.) The doctor hopes that her head hasn't descended because my bladder was full and I progressed too fast for her head to mold. and not because of size. The doctor feels that, based on my previous labor, it will take a while before I can push the baby out, so he suggests an epidural. Not only as pain relief, but also in the hopes that it will slow down labor a bit so her head can mold and to give her a break. He warns me that the baby only has so many resources, and once those are up, he'll have to do a C-section. My original "plan" was, if I had an epidural, to have it lowered or shutoff during the pushing phase. I felt that being upright and squatting would increase my chances of the baby fitting through my pelvis. But, at this point, Alison and I both need the epidural. We have to use the internal fetal monitor and Alison is watched very closely throughout my labor. Her heart rate later has some bad decelerations that they watch closely. Also, my OB discovers meconium in my fluid; yet another thing to watch. The nurses I have when I am first admitted are great – very sympathetic and reassuring, something I definitely need at this point. The anesthesiologist comes in to do the epidural and starts talking to my OB about my previous labor. My doctor says my first C-section was not because I didn't dilate; it was due to CPD (cephophalic pelvic disproportion). My OB had never quite put it in those terms before. This scares me, but at this point I'm not changing my mind about attempting the VBAC, as long as Alison’s okay. Later, Alison’s heart rate drops and the doctor almost has to perform an emergency C-section. He thinks, however, that her heart rate dropped due to the epidural and gives me epinephrine, which brings it back up. For much of my labor, I have to have oxygen. I find the mask very distracting, especially while pushing, but everyone keeps reminding me to breathe deeply for the baby.

11:00 p.m. - My night nurse, Annafay, is totally different from the previous shift's nurses, but just what I needed at this point. She is very nice, but no-nonsense in a way. She and my OB make small talk. He leaves and she takes over. (She's in the room with us without the doctor for what seems like quite a while.) She is great at coaching us through the contractions. Every time I feel a contraction, she and Dean each grab one of my legs, pushing it up and back, trying (I think) make my pushing as effective as possible. All I know is that it feels so wonderful to push, as it relieves the pressure. Dean does an outstanding job as labor partner. Occasionally, I have to stop pushing because of Alison’s heart rate. It's easier on her when I don't push, but harder on me. At some point, my mom comes in to get directions from Dean. The doctor is in the room then and starts asking her about her deliveries and the size of her babies. Mom holds my hand and talks me through a "no-pusher". This all seems sort of strange, but I am so caught up in pushing and not pushing that it really doesn't phase me. When Alison’s head starts to crown, the doctor lets me look in the mirror. He thinks it will help with the pushing if I can watch and tells me jokingly to "shoot for the mirror". I notice that the baby's hair is lighter Jessica's was and that there's much less of it. I can't wait to see what this baby looks like.

Some time after midnight – The doctor tells me that, just like with Jessica, the baby is stuck at +1 or +2 station. He will try to vacuum her, but if it doesn't work he'll have to do another C-section. I have to stop pushing again to give both Alison and myself a rest – the doctor wants me to push extra hard while he tries the vacuum. Off to the operating/delivery room. For a brief moment, it seems I am alone in the room. I tell Alison she had better come out the right way, because if she makes Mommy have a C-section and stay in the hospital even longer, that her sister is not going to appreciate it. Everyone returns and my OB calls for a pediatrician and two more nurses. He explains that it's pretty standard to have the pediatrician there in cases like mine (meconium, etc.) and tells me not to worry. I can feel the doctor when he examines me, so he shoots me full of local anesthetic. He starts using the vacuum with my next contraction, with a nurse pushing on my abdomen to help get the baby out. It's the same sounds through the next several contractions – a long "slurp" followed by a loud "pop" as her head goes back up and the vacuum loses suction. The doctor doesn't say anything and I don't need him to; I know what the sound means. I keep pushing with each contraction because it's the only way to relieve the pressure. (Dean later tells me the nurse kept pushing on my stomach during contractions.) I hear my OB call for betadine. In the back of my mind I remember that's what the OB swabs your abdomen with before he performs a section. All of a sudden, I feel something sliding down the birth canal with one of my pushes. I hear the doctor whisper "I think she's going to do it!". I keep pushing. Her head is out! The doctor shouts, "Look! There's the head! There's your baby's head! You're going to do it!" (Dean later tells me I should've seen the shocked look on the doctor's face. I didn't have to – I could hear the surprise in his voice!) Suddenly, everyone in the room is shouting "C’mon, Lisa! You can do it!", "Keep pushing!", "You're going to do it!". This baby has quite a cheering section. A few more pushes and she's out!

They rush her over to the table to clean her up and check her out. My OB tells me not to worry that she isn't crying yet – that's perfectly normal. I'm so out of it from all that's happened, I don't even notice. The OB comments on how pink she is. Alison is fine; her APGAR scores are 8 and 9. The pediatrician shows her to me before they take her to do the Vitamin K shots, etc., while my doctor stitches up my episiotomy.

Later, they wheel me into Recovery. My OB comes in to see me. He's still surprised that I pushed Alison out by myself when I did. (He's not the only one.) He tells me they'll keep Alison a little longer than usual so they can really check her out because of the meconium, etc., but that she is fine. Dean brings her in to me about 1:00 a.m. I have forgotten how tiny (and floppy) a newborn is! The nurse from the hospital nursery told Dean that Alison was born wanting to nurse, and she's right. We agree that Alison looks nothing like her big sister as a newborn. Everything about them is so different.

Finally, they take me down to Maternity about 3:00 a.m. and Dean goes home. I am too excited to sleep, but that's okay – I nap the next day with my new, healthy baby girl!

Dean (proud daddy) with baby Alison

Lisa, big sister Jessica and Alison