Birth Story: "Labor is a Mind Game"; A VBAC story in SWFL

Today's birth story is shared with permission and authored by Ellen Hinkle. Ellen is a mom of two, a business owner of Ellen Hinkle Photography, and a terrific writer.

Baby Jayce Thomas 4/9/20

This story actually starts 2 years ago with the birth of my first son, Bryce. He was delivered via emergency C-section at a hospital in my home state of South Carolina. When I was discharged, the nurses and doctors with this hospital team were all very encouraging and said they would do their best to work for a VBAC (vaginal birth after cesarean) next time.

Life happened within those two years and I ended up in Southwest Florida at my first OB appointment for my second baby. The doctor asked what my birth plan was and I naively admitted “I would like to have a VBAC,” (thinking having a baby out of the vagina was the norm), to which the doctor replied, “Oh, we don’t do VBACs here, in fact the hospital here doesn’t allow them either.” After I picked my jaw up off the floor, I went home confused and distraught over this. My husband and I would like a quiver full of children and I know scheduling repeat cesareans puts my future fertility at risk and increases the chances of birthing complications, not to mention surgery recovery is very painful. I had done my research and knew that a VBAC was the safest option going forward. I knew the risk of potential uterine rupture, and I also knew that rupture is rare, happening in fewer than 1 percent of women who attempt a VBAC.

I immediately started doing research on labor and delivery practices in Southwest Florida and was saddened to find that the C-section rate is high and the doctors willing to do VBACs was low. This is a huge disservice to women’s health and I soon figured out this is a nation wide issue as well. The USA can do better for its mommies and babies, and more evidence based practice needs to be implemented in the medical world of labor. I decided to put all this frustration and disappointment toward advocating for myself, my baby and any future babies. I found Christine with Mindful Birth Services and Doula Care, and I was so relieved to find a group of women who supported my birth plan. They reassured me that I wasn’t crazy for wanting a VBAC and my research on VBACs was correct.

Christine helped guide me in the right direction to find a group of providers and another local hospital that were VBAC friendly. After my first appointment with the new group of providers, I learned that a VBAC was in fact the safest and best option for me, pending no late term complications arise. What satisfying justice to have a medical team confirm my birth plan was realistic, doable and totally reasonable!

Fast forward to 36 weeks and 6 days - It’s Wednesday April 8th, and my family and I were excited to share a Passover meal that evening. There was a pink full super moon the night before as the Hebrew calendar always lines up its Holy days based on the lunar calendar. There was also this whole global pandemic thing going on forcing my husband, Josh, to work at home. I stay at home with my toddler, Bryce, so our routine was relatively unchanged. Bryce and I went for our usual bike ride around our neighborhood that morning. I dressed him up in a cute Spring Jon Jon suit to take pictures of him outside for Passover. We saw an alligator on our nature ride, climbed Banyan trees, and checked in on some elderly neighbors.

When we got home, we ate some lunch and decided to go for a swim in the pool before Bryce had to go down for a nap. My husband did not want any lunch because he said he wanted to save his appetite for the Passover lamb roast he was going to prepare for that evening. Once in the pool, I began to notice that I was having some mild contractions (this was around 1pm). I didn’t think much of them because they weren’t too painful or consistent and I had been experiencing some contractions off and on for the past week, usually at night time though. This pregnancy was particularly hard on my body with first trimester nausea and fatigue, along with persistent back and ligament pain that limited my mobility. Swimming was the best thing I discovered for exercise and completely took all the pressure off my back. We had all been swimming together every day for the past 3 or 4 weeks, and we enjoyed the family bonding time. After Bryce and I got out of the pool, we rinsed off in the shower and I put him down for a nap.

The contractions were still coming, but they were still irregular, so I decided to lay down, drink some water and see if they would go away. They didn’t. I called my doula Emily, to let her know what was going on and she suggested some spinning babies maneuvers to see if the contractions would get more consistent or stop. My husband was grilling the lamb over at my in laws house, so I called and asked him to come home and help me do some spinning babies. He came home, we did the maneuvers, and I told him to go finish grilling and we will wait and see what happens. Within the hour I was having more consistent contractions and my toddler woke up from his nap. I called Josh and told him to get home quick, get the toddler over to the in-laws because this might be the real deal. He actually did finish roasting the lamb, but heartbreakingly, he did not get to enjoy it hot of the grill. I called my doula Emily again, and she could tell by my voice and pauses with contractions that this was real labor and active labor at that. She said, “It seems like you’ve skipped out on a long early labor and you may want to just meet me at the hospital” (This was after 5pm).

Since I was near term at 36 weeks, our hospital bags were not even packed. Josh and I packed quickly between contractions as they were coming fast with only a minute of downtime in between. We had to keep pausing, focusing on breathing and getting through contractions together. I had my husband use counter pressure on my lower back to help me endure the pain. We finally made it to the car and all I could do was breath deeply and ritualistically bob my head to help mentally and physically get through the contractions while sitting and enduring the motion of the ride. Our plan was to labor at home with our doula’s help as long as we could, but things were moving faster than anticipated.

Once at the hospital, my husband pulled up to the maternity ER section only to be greeted by a healthcare worker who screened us for COVID 19 before we could enter. They told Josh to wait in the parking lot as no visitors were allowed in the OB triage area. In fact, Josh and I were still unsure if he would be present for the delivery or if the doula would, as only one support person was allowed in the hospital due to COVID 19 precautions. We actually already had difficult conversations about Josh potentially not being there for the birth of his child if we didn’t feel confident in his lone doula abilities. Josh had been coaching me through my emotions and contractions wonderfully so far, and his techniques were working, so in that moment I knew I needed him there. Once the healthcare worker wheeled me into OB triage, I was greeted by two CRNA’s who again screened me for COVID 19 and then handed me a mask to wear. I thought it was a cruel joke as I was doing my best to breath through contractions that were coming less than a minute apart. I told them that would suffocate me right now and I was unable to even physically put the thing on my face. They attempted to lecture me about COVID 19 precautions...again, am in super active labor and just doing my best to remember to breathe! They wheeled me to my triage room and left me there alone with my mask, which I promptly threw to the ground and begged someone to stay with me. I did not want to be trapped in a room laboring alone. I just needed someone present to feel safe in case I needed something. In active labor you are unable to do much for yourself except focus on your breath. Being isolated and alone put me out of my mindfulness labor groove, and put me into an animalistic fight or flight mode. Women in labor should be supported by their birthing tribe so they don’t have to turn into defensive mama bears.

The nurse came in and checked my cervix, and said I was dilated to a 3 or 4 and my “bag of waters was bulging.” She then forgot to use the therapeutic communication techniques she learned in nursing school and stated, “you need to relax honey, you’ve got a long ways to go.” She then left me alone again, shutting the door saying she had to go get doctors orders. Not sure why she had to run out of the room to do this when all staff have IP phones on them to call doctors, and there was a computer in the room where she could see any new orders that would come up. Also, leaving a frightened patient alone and half hanging off a stretcher is a safety issue, but what do I know with my silly nursing experience?

Finally, a patient support tech came in and wheeled me to the labor and delivery floor. I was so relieved to see Josh in the room waiting for me! He immediately went back to work using the pain management techniques he had learned in our Birthing From Within class and through our prenatal chats with our doula. The labor and delivery nurse and the midwife were both there and were impressed with how well I was coping through contractions with Josh. They knew I was in active labor and said they would let us continue doing what we were doing, and to let them know if we needed any help with pain management.

When laboring you have no real concept of time, but I knew Josh was getting weaker as the evening turned to night and it was hard for him to keep holding pressure on my lower back. We arrived at the hospital after dinner was served and the cafeteria wasn’t opening again until 1am. I asked the nurse if our doula could at least come in to bring him food or drop it off at the nurses station. The nurse said “no” so I told her she would have to scrounge up food somewhere or she was going to have two patients on her hands. By the grace of God, there was an extra food tray that had been delivered to the floor that no one had claimed. The nurse brought it to Josh and he scarfed it down between contractions. I also took a dose of Stadol IV pain meds so I could rest and give Josh a break. I had been standing, hunched over the side of the bed the whole time because the back pain was so bad. The pain meds took the edge off enough that I could actually lay down and breath through contractions on my own for a bit. Of course the relief is temporary, so I then got on my knees and hunched over the back of the bed to continue laboring and use gravity to help get baby out.

After a while in this position, the nurse asked if I was feeling pressure, and I sure was as I felt the need to bear down. The nurse called in the midwife as pushing was needed and baby would be here soon. My bag of waters had been slowly leaking for most of the time I was in the delivery room, but at around midnight they completely ruptured. The nurse verified with the midwife that it was okay for me to continue to labor on my knees and the midwife was cool with whatever position I needed. As the pushing continued, the babies heart rate started having decelerations that the midwife was not cool with. I then had to lay on my aching back as they ensured the monitor was hooked up correctly. They brought in the obstetrician that was on call and I had to stop pushing for a few contractions so the birth team could rule out the dreaded uterine rupture. They determined my uterus was okay and that the baby just needed to come on out. They called in the NICU team due to the heart rate worry and because the baby just turned 37 weeks at midnight. All this added commotion made it hard for me to get my mind at peace again and go forward. The baby wasn’t liking the birth canal and I thought my pushing was ineffective.

The obstetrician got real with me and said, “You have plenty of room, this is not a big baby, he is right there, you can touch his head. I don’t want to do a surgery and you don’t want a surgery, so let’s do this. You get this baby out and get him out now. You push and push hard.” Easier said than done, but I needed tough love in that moment to get out of my worried doubtful thoughts and into strong warrior mama mode. I refocused and pushed through two more contractions (I think, who’s counting at this point?) and that baby did indeed come out!

Jayce Thomas Hinkle was born on April 9th, 2020 at 0126am weighing 6lbs 8oz.

Everyone in the room was excited and relieved but all my adrenaline came crashing down and I felt the burning pain of a successful vaginal delivery. I looked at the nurse and midwife and said, “Okay, now I need the pain meds.” They laughed and said, “But it’s over and too late for the epidural now!” The NICU nurses gave baby Jayce 9 out of 10 for his APGAR scores and promptly placed him back on my chest for some much needed skin to skin time. Josh got to cut the umbilical cord and then he ran to the vending machine for more snacks.

I couldn’t believe this all happened within 12 hours, but I was so thankful it did not drag on for my husband’s sake. Josh wins the title of doula dad of the year as he had an amazing poker face the whole time. The nurse told me he was so funny during the pushing as he was laboring along with me, vocalizing pushes and cheering for every inch gained. Josh did however express how traumatized he was with being the lone doula a few days after the delivery. I’m not sure if this whole quarantine and isolation thing actually did any good in combating this pandemic, and we may never truly know. People need socialization and their livelihood to survive. Laboring moms and dads need support and their doulas are essential members of the birth team. I can’t imagine the uncertainty for the poor laboring mothers who have to face delivering alone in some hospitals of this country right now. My doula, Emily, was disappointed she could not help us with the delivery or even simply drop off food for Josh.

Our Mindful Birth doulas, Emily, Tara, Tanya and Christine, have been so uplifting to us postpartum. They told us this will be an amazing birth story to tell Jayce someday. We survived birth on our own during a pandemic. I was able to VBAC against the odds of a broken healthcare system and a nation infected with fear and anxiety. Even Jayce’s pediatrican was impressed by how well the baby and I were doing at his first check up. She saw that we were a VBAC on his chart and congratulated us. She knew what was stacked against us as many doctors feel their hands are tied and can’t do what is best for laboring moms with all pressures of litigation in the state of Florida.

Ultimately, what I have learned through all this is that labor is a mind game; life itself is learning to have a sound mind. Fear is dangerous. It exacerbates pain and anxiety and ultimately, fear can’t be trusted. Perfect love casts out all fear. Distancing brings desensitization. Human touch is a basic necessity- with washed hands of course. It would have been difficult to get through this labor with the outcome I wanted without Josh’s physical touch and readily available presence. But be encouraged, you are capable and you are enough; even when circumstances aren’t ideal, you can learn to find peace in the storm. Jayce is a little piece of heaven for our family and we are so glad he is here!

Written by Ellen, mom of 2 boys, Bryce and Jayce

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