Jessica's Story-- HBAC
Tuesday, November 17, 2009 at 12:01AM Jessica’s HBAC and “The Green Glove”
By Susan Scott Gill, LM, CPM
Written on a green glove…TOB 9:55 pm, HR 140. That’s all that got charted up until Jessica’s birth. It was written by my apprentice Lindsey who had just walked in the door as Luther was being pushed out and into Jessica’s loving, waiting arms.
First let me tell you about Jessica. I met her October 12, 2006. She was kneeling on her couch, leaning over the arm of it, having a strong contraction. I walked in quietly and said, “Hi my name is Sue. I’m going to help you until your midwife gets here. She looked up with her big brown eyes, in the troughs of something she could never have anticipated, and smiled and said “I’m Jessica, thanks for coming,” then went right back into another strong contraction. Her tub was ready, so she got in and labored beautifully. After about an hour her water broke and I checked her. She was fully dilated and soon began pushing. She pushed for four hours. The baby just wouldn’t come down. We tried everything we could think of. Whatever we recommended, Jessica did, never complaining. Her midwife arrived after 3 hours of pushing. I prayed she would have an idea, something I hadn’t thought of. She didn’t and after another hour, they left for the hospital. I continued to call her midwife to try and find out what was going on, but her midwife was not allowed in the room. Later that night I found out Jessica had a c-section. I was so sad for her, just like I always am when a woman seeks out homebirth, because she believes it is the best for herself and her baby, does everything she can to make sure she is ready for the big day, and it ends up in a c-section. But there was something about this birth that haunted me. Was there something else I could have done? The baby was right there! I could see her head with all that black hair. I never heard from Jessica after that.
Move ahead to December (2007). My phone rings and a familiar voice said “my name is Jessica Garcia. I don’t know if you remember me, but you came to my house when my midwife couldn’t make it and helped me try to have a homebirth. I ended up needing a c-section. I am pregnant again and want to have a VBAC and I wonder if you would consider being my midwife.” It was so good to hear her voice. I had thought of her often and wondered how she was. I wondered if she blamed me for ending up in a c-section, if she felt I had let her down, gave up on her. Later I found out how terrible she was treated during her transport and eventual c-section and it broke my heart. She didn’t deserve that, no woman does! Anyway, we decided to meet and talk.
I was sitting at Corner Bakery and in walked Jessica and Omar carrying beautiful little Daphne. We talked about VBAC risks and benefits. I told her then that she isn’t the best candidate for VBAC. I mean heck, I was at the last birth. She did everything she could, I did everything I could, but Daphne just wouldn’t come out. Why should we think things would be different this time? But did we do everything? I didn’t know Jessica prenatally. Could her anxiety, caused by her midwives not showing up, have affected her labor? How could it not! Could having total strangers showing up to help with her labor cause her baby to rotate posterior and get stuck? Who knows? Do I owe it to Jessica to take the risk of attending her VBAC knowing I might end up in a transport after many hours of labor only to be crucified by the hospital staff? No, but I need to do it. Not just for Jessica, but for me. I want to believe that every birth is different. That you can do things prenatally to help achieve a different outcome. I wanted to see her face when she realizes she did it. She deserves the chance to try and she needs a midwife who believes in her. I told her I would commit to helping her if she would do some things I have researched and believed could help her to be successful. She and Omar agreed they would do whatever I thought might make a difference with this birth.
So in January we began our journey. First priority, nutrition. Jessica needed to have a very healthy diet, lots of good healthy protein, lots of dark green veggies, preferably, low glycemic foods and healthy fats and fish oil. She needed to add extra vitamin C rich foods to help build strong membranes, drink two cups of pregnancy tea daily (red raspberry to strengthen her uterus, alfalfa and nettle to build her red blood cells.)
Second, Jessica needed chiropractic care. I may be crucified for this but in my opinion, not just any chiropractor. She needed someone who is certified in and practices the Webster Technique. I had heard of a chiropractor, Anne Lundquist in Orange, who had had articles written about her work with The Webster Technique. Although we mostly hear about this technique being used to get breech babies to turn head down, it only made sense to me that it would work to get any baby to find the best possible position for birth. Women have lived a long life before becoming pregnant. Some have had injures, some have jobs that keep them sitting for long hours, some do what everyone tells them to do, “just go sit on the couch and prop your feet up.” All these things can cause a baby to settle into a “not so optimal” position prior to birth.
The numerous ligaments holding up the uterus, particularly the round and sacral ligaments, need to adapt to the changes caused by a growing fetus. If one or more of these are constricted, it will cause the uterus to not lie evenly and may cause the baby to lie in an unfavorable position. The Webster Chiropractic Technique “helps to correct sacral misalignment, balance pelvic muscles and ligaments which in turn removes torsion to the woman’s uterus, its resulting constraint to the baby, and allows the baby to get into the best possible position for birth.” EVERY client I have ever had complains at some point in her pregnancy about round ligament pain. A Webster Chiropractic adjustment usually helps them with this complaint.
The other information I believe ALL pregnant women should learn is optimal fetal positioning. I like the spinningbabies.com website for this. It is discussed in terms easy for anyone to understand with photos and even short videos to explain positioning for pregnancy and labor.
Third, Jessica needed to exercise. Labor is equivalent to a 50 mile hike. How are you going to prepare your body for this? Jessica walked and swam almost every day.
So now move ahead to Friday, June 13, 2008. My phone rang at 2:11 pm. It was Jessica saying her back hurt and she had sciatica pain running up and down her back and leg. I told her to get in to see Anne because I didn’t want her back to hurt all weekend. Well Jessica wasn’t due until the 30th but something made me call her back and ask her to pay attention to the pain. “Watch the clock and call me back in an hour to let me know if there is a rhythm to your pain,” I said. She called me back and said the pain was rhythmic every 13 to 17 minutes but only lasting about 5 seconds. I thought it was probably prodromal labor, but I was concerned all the pain was only in her back, so I told her to definitely call Anne. She did and planned to go see her when her husband Omar got home. Omar called me at 6:20 and said the back pain hadn’t let up. Pains were between 5-10 minutes apart, only lasting for 10-15 seconds. He said they were getting ready to go see Anne so I told him to call me when they arrived and I loaded my car just in case. If they wanted me to, I would meet them at Anne’s and see what was going on. At 7:45 pm Omar called and I could hear Jessica in the background making the familiar, “I am in active labor sounds.” I told him I would be right over. I got to Anne’s office 15 minutes later to find Jessica having STRONG contractions every 3 minutes, lasting a minute. I told her we needed to get her home, but I felt I should check her first to make sure we had time to get home. She agreed and I found her to be 9 centimeters dilated with a bulging bag of water. The baby’s head was high. Jessica’s pain was still only in her back, so all I could think was we had a posterior baby that was going to get stuck again. After all, this is what happened last time, right? So anyway, I was pretty sure we had time to get to Jessica’s house, but she was now having contractions on top of each other and extreme back pain. There was no room for me in Omar’s truck, because Daphne’s car seat was in the back and I felt like I needed to ride beside Jessica to give her sacral pressure during contractions. I asked Anne if she would drive my car and she didn’t hesitate. So at 8:45 pm we were finally on our way to Jessica’s house with Anne driving, me in the back with Jessica on her knees, bent over the back of my back seat and me trying to give her counter pressure. Needless to say, it was not a calm ride to Lakewood, but Anne drove great under pressure. When we arrived at Jessica’s we quickly started filling the tub while Omar put Daphne to bed. Luckily she had fallen asleep on the ride home. I do remember listening to heart tones once at Anne’s office and once when we got to Jessica and Omar’s house and the baby sounded great. I told Omar to get his bathing suit on, so he could sit in the tub and raise the water level. They both got in, but Jessica’s back pain was so intense and I’m sure the last two hours traveling had done nothing to help her relax. She could not get comfortable. We were all running around trying to get set up and ready for what appeared to be an imminent birth….water boiling, Jessica thrashing around the pool, me trying to calm Jessica during her contractions and get my bearings straight between contractions. During the car ride, I had called my assistant, Lindsey, but she was coming from Irvine so I didn’t know if she would make it. Luckily, Anne and Jessica’s friend Heather, who was there to photograph the birth and help with Daphne if needed, were helping me get set up. Finally Jessica had a small break in contractions and I asked her if I could check her again. I was still worried because the baby’s head had been so high at Anne’s office. She let me check her but being in the tub; I could not really tell if the baby had come down much. His head was still high, but Jessica was completely dilated with that strong, bulging bag of water (in my opinion, thanks to the great diet, extra vitamin C and pregnancy tea.) With the next contraction, her water broke and she looked up and said “my vagina’s burning.” I quickly put my hand on her perineum and felt Luther’s head crowning. I was so excited and knew then, we were really going to have this baby! I told Jessica to feel her baby’s head and when she did, she knew it too. Jessica only pushed for a few minutes (I can’t tell you how many, because I wasn’t able to chart in all the confusion.) Anne helped by holding one of Jessica’s legs and I held the other. Just then, Lindsey walked in the door. She quickly tried to see where all my equipment was set up as Jessica pushed again and Luther’s head came out. We all watched as he rotated beautifully, and with the next contraction, Jessica reached down to “deliver” her beautiful baby boy and bring him out of the water and onto her chest. Then I saw it!! That face, that beautiful smiling face that said it all. “I did it. I just delivered my baby, vaginally!” She was in the tub, leaning back against her husband. Then I looked at Omar. I saw the other face I had forgotten about. The face that said, “She did it.” All he wanted for his wife was to have the dream birth SHE wanted. He wanted it for HER. It had happened and his wife and son were safe, lying in his arms where they belonged.
After counting Luther’s heart beat through his healthy, thick umbilical cord and seeing him cry, turn pink, and gaze into his mother’s beautiful brown eyes; I just sat back and watched Jessica and Omar. They had come full circle. I will never forget the smiles on their faces. Anne leaned against the wall and cried. She had just witnessed the miracle of birth that I am so blessed to witness so often. Boy, I am a lucky woman!!
After 20 minutes of bonding in the tub, Omar cut Luther’s no longer pulsating cord and got out of the tub. He quickly dried off and held Luther to his chest to warm him up. Then Jessica looked up and said she was having a contraction. I knew the placenta was ready to be delivered, so I told her to hold onto the clamp, push with the contraction and gently pull on the cord. The placenta came right out into the tub. She looked down and said “I never got to see my placenta with Daphne.” She looked so sad, so I told her to pick up her placenta and look at it. She reached down and lifted up her placenta, then looked up at me with another smile that will be burnt into my mind forever. Again I realized how very lucky I am to be honored by people like Jessica and Omar, to help them achieve what can be the most incredible moment of a person’s life; the birth of their child!
When we put Jessica in bed and I finally grabbed the chart to begin writing, I saw it; the green glove, Lindsey’s green glove, the only thing she could find to write on when Luther was born. TOB (time of birth) 9:55 pm. HR (heart rate) 140. The green glove now sits in Luther’s baby book.
Reader Comments (4)
I am a doula, and vbacs are special to me. This is such a beautiful story and I can so empathize with that triumphant feeling. I was actually tearing up while reading it! Congrats Jessica and Omar! and To the midwife, I am so happy that you could look past your own fears and doubts so that this family could achieve their ideal birth! It takes a special person to be able to do that!
Wonderful story! It made me cry.
thank you for this story. i want to read it again and again to remind myself how very possible it is to have such a wonderful birth experience.
I had a ceserean for a transverse baby who would not come down. My dream birth would have been a home birth but that was not in the cards for us because we would have had to pay out of pocket. I thought I would never get to have a home birth now that I have had a c-section, but this story gives me some hope if we have any more babies! Thanks for sharing it!