Almost a VBAC

She was so close. The midwife said she could see the baby's hair. It seems crazy to me that we could see the baby's hair, but he wouldn't come down anymore. I guess I don't have a very good image of the pelvis, cause I really thought that once we could see the head, there was no way he wasn't coming out. But he didn't come out.

This mom was absolutely amazing. Baby #1 was a cesarean after 15 hour labor, 5 hours of which was at 8 cm. She never got past an 8. During the stall, they tried breaking her water (and found light mec), tried an epidural (and got slight decels), and when he wouldn't drop and she didn't dilate, they went to cesarean. Turns out baby was posterior. He was a 9.5 lb baby on his due date.

With baby #2, he decided to come 4 days after his due date. We knew he would be big. One major goal was to encourage baby away from posterior. Well, mom was 4 cm before labor even started, and when checking into the hospital she was 4-5 cm. 14 hours later, she was 6 cm. Her labor pattern was still variable, and contractions really should have been stronger. Something was amiss. We tried tons of things to encourage good positioning (the midwife said baby was anterior, but I was leery of asynclitism) and to bring on stronger contractions. The OB on call started interferring and demanded either progress or a cesarean. So mom agreed to AROM at 6 cm. A few minutes later, she was getting slammed with back-to-back 90-second contractions. I knew it was transition. She didn't believe me. Twenty minutes after the AROM, she started pushing. Unfortunately, in 90 minutes of the most incredible pushing I've ever seen in a half-dozen different positions, baby had only gone from 0 to +1 station. Mom was done. She was in terrible pain. The OB came in, took one look, and said the baby wasn't coming out. So off to cesarean she goes. Baby was 9 lbs 13 oz. And he was posterior afterall.

Unfortunately, because of the long recovery after surgery, I wasn't able to see mom and baby before I really needed to head home. This was my first all-night birth. I had 90 minutes to drive home. I talked to the mom today and she sounded really happy with her experience. We tried so many different things and she got so much further than last time. Having it end this way also gives her a sense of justification for her first cesarean too. In the end, she pretty much had a complete vaginal birth, except for the ring of fire part.

As a doula, this is the first cesarean client I've had, and it is the first client who didn't achieve exactly what she was shooting for. I have mixed feelings about it. I'm THRILLED she got to push and feel that power for so long. I just can't help second-guessing what we did. Could we have tried a different position? Should she have pushed for longer? Was this going to be a cesarean no matter what? I guess it shouldn't matter as long as mom is happy.