August sixth was the night of the full moon so I went to bed wondering if something might happen. I woke up early on the seventh around 3 am with contractions. These felt stronger than Braxton Hicks and were coming at regular intervals. They were accompanied by an odd, searing sort of pain and pressure which didn’t feel right to me. I hadn’t remembered this pain when induced with the twins. I assumed it just meant I was dilated further than 5 cm, which was as far as I had gotten with the twins before the emergency c-section. Maybe labor that came on naturally, without the aid of a Foley, pit, or miso, would feel different, I thought… I started getting excited for my VBAC. I had been afraid to go past my due date, since my doctor was going to perform a repeat c-section if that happened. I hadn’t wanted a repeat c-section for several reasons, mainly because I needed to be able to care for all three children and didn’t want the hassle of recovery time, but also because my last c-section was so horribly traumatic and painful.
I woke up Jeff who was asleep on the couch in the family room. I gingerly poked him with my finger. I wondered if maybe I wasn’t really in labor and felt bad for waking him up. What if it turned out to be false labor? Then I would feel really silly. He woke up and I told him how I felt. It was around 4 am by this point. He told me to call the doctor. I called and got the answering service and I ended up speaking to Margaret, one of the midwives whom I really liked. I explained the pain I was experiencing and she agreed that it sounded abnormal and recommended I go to the hospital to be checked. She said she would meet me there. I called my parents to come and stay with the twins. I insisted on showering, even though the stabbing pain was worsening with each contraction. I figured, of course it will hurt, it’s labor, but in the back of my mind I was growing a bit nervous. The pain was right along where my incision was from my prior c-section, but only internally. “Scar separating…uterine rupture…” went through my head briefly but I cast those fears aside. Only 1% of all VBACers suffer ruptures- so my odds were so low I shouldn’t be worried… We finished packing my bag and Jeff quickly got dressed. We waited a little while for my parents to arrive. I could tell Jeff was nervous because he was doing what I call his “nervous cough.” He also screamed at me like a lunatic to quiet down so the children wouldn’t wake up every time I screamed in pain; I could tell he was getting very nervous about my level of pain. My parents arrived. They had my dad’s good car which I wondered about. We had planned on taking my mom’s RAV 4 to the hospital. So we ended up taking Jeff’s old car that barely runs, leaving the Odyssey with my parents in case they had to take the twins out. We drove for a bit and then I realized I had forgotten my camera. So we went back and got it. Then we left again and I realized I had forgotten to leave the keys to the Odyssey with my parents so we had to return home again. I think subconsciously I didn’t want to leave the twins.
We finally made it to the hospital after an excruciating car ride with me screaming in agony every 3-4 minutes. It was difficult to walk by then but I managed to walk inside and check in. A woman came down and escorted us up to Maternity Triage so I could be assessed. They directed us to a room and had me lie down on the bed. The nurse observed I was “favoring” my left side and asked me if I felt more pain on my right side. I answered yes. She said I might have to have a repeat c-section if my scar was opening up inside. I thought to myself, “Just like I thought! They’re going to threaten me, try and scare me into another cesarean just because it’s more convenient for them!” Jeff saw the look on my face and piped up, “She wants a VBAC!” because he knew how much it meant to me to experience a natural birth. I removed my pants, underwear and shirt and put on a gown. She put the fetal heart monitor on and the baby sounded perfect. I was relieved but still bothered by the degree of pain I was in with every contraction. Finally, the pain became so severe that I began howling uncontrollably. I screamed for help and I screamed not to let me die. The more I screamed the more doctors and nurses came running in. My midwife, Margaret, arrived and a doctor whom I did not recognize came in and did a quick ultrasound. Dr Lynch came in and couldn’t determine by the ultrasound what was happening internally, but he had a feeling my scar was opening up inside and my uterus was rupturing. According to the fetal heart monitor, the baby was doing perfectly so my pain was the only indicator that something was awry. I kept screaming, “Something is wrong! Please don’t let me die! It’s ripping open!” I could feel something tearing open. Dr Lynch told me we were going to have to do an emergency c-section right then and I began screaming, “Don’t cut me open! No!” I was truly delirious from pain and fear by then. Dr Lynch told us that if we didn’t do the c-section, the baby or I or both of us would die. Margaret reiterated the doctor’s concerns and I then decided to sign the paperwork to allow for the surgery. They then sprang into action, inserting the IV and wheeling me away. I saw Margaret and Meghan, another midwife in my practice. They tried to smile and gave me a sort of thumbs up sign but I could tell through my haze of pain they were worried. On the way to the OR, I said prayers. I truly thought I was going to die any second.
We entered the OR and the familiar smell hit me. I began shaking with the fear. I had to get onto the operating table. They yelled at me to hurry and tried to help me but the task seemed impossible. I finally got onto the table and they shoved me forward to administer the spinal. They had no time for general anesthesia. The nurse yelled at me to lean forward and curl up, which I remembered from last time and knew I had to do, but there was something in the way. “Round your shoulders! Look at me!” The nurse yelled and I could see every little fleck of her smudged mascara flaking around her eyes over her white mask. It felt like my pregnant belly had dropped down low and I could barely lean forward. They got it in in record time. I had an amazing team working on me. They laid me down on the table and the doctor immediately started applying what I believe is iodine all over my lower body, I guess to sterilize it. Later on, the doctor told me when they laid me down they knew the baby had dropped out of my uterus by the way my abdomen looked. They set up the blue curtain. The anesthesiologist poked me with a needle and asked me if it was sharp and I said “No, but I can feel it!” To which he replied, “That’s ok. That’s normal.” I remembered that from last time also. I was once again terrified that I was going to feel the doctor cutting me open. But at that point the pain had finally subsided due to the spinal so I almost didn’t even care what happened after that. I was pain-free and so happy. The anesthesiologist was extremely comforting and kind and stayed right by me throughout the procedure. They put the oxygen on and I could breathe more easily. I began asking where Jeff was by this point and wondered why he wasn’t there. I was worried he would miss the birth of the baby! Immediately, the nurses all began yelling, “Go get her husband!” They brought him in-finally-and I felt more at ease.
The baby was born, or should I say, lifted out of my body by Doctor Lynch at 7:18 am and we did not hear him cry. He was carried right out of the room to be checked out by the pediatrician. The doctor and nurses exclaimed, “She’s ok! She’s just fine!” and we said, “Wait, it’s a boy, right?” The doctor admitted he had been in such a rush to deliver him and fix me up that he hadn’t even looked. Suddenly, I heard him crying and I asked Jeff if he heard him and he said he hadn’t. The nurse had them open the door so we could hear him more clearly. She said, “Open the door so his parents can hear him cry!” We heard him crying away and he sounded very strong and healthy! I had felt confidant throughout the ordeal that he would be just fine. After all, he had been a miracle from the start so I knew everything was going to be ok. The nurse reassured us he was ok and said he was indeed a “he!” As Doctor Lynch left the OR, he warned me not to ever get pregnant again. He seemed pretty shaken up over what had happened. Doctor Tonzola took over and helped to finish up my reconstructive surgery. A nurse brought the baby in and Jeff got to hold him for quite awhile. I got to kiss the baby and see him all bundled up.
We found out later on what had happened. It turns out my scar had indeed opened up from my cesarean back on 8/1/08 with the twins. My uterus had ruptured. The baby had fallen out of my uterus and into my abdomen, twisting from vertex into a breech position. So not only had my uterus torn open, but the baby had fallen out along with his placenta. The chances of uterine rupture during a VBAC are 1%. Guess I had gotten very unlucky! But I was very lucky when it came to Logan and me- Logan was absolutely fine and I was alive. The doctor explained that if the placenta had detached during Logan’s fall, he would have suffered brain damage or died due to lack of oxygen. I shudder every time I think of what could have been. I hadn’t even lost that much blood. Unfortunately, it appeared I had lost the ability to have more children. I made a mental note to ask Dr Lynch about that at a later time. They had been able to save and repair my uterus so I clung to the hope that he would change his tune once everything had died down. (Later on, I did ask the doctor what he meant by his comment in the OR. He said if I really wanted more children, I could try it but I could never risk going into labor again. I would need an amnio at 36 weeks to determine lung viability and then a scheduled c-section at that time if the lungs were found to be mature. My instructions were to wait a minimum of two years before getting pregnant again.) When I got to the recovery room, Jeff broke down and cried because he had been so scared. I had never seen him cry like that. I was so relieved and thanked God I was alive and the baby was alive. How fortunate I had been! It had truly been a miracle. I held Logan and just wanted to cry but I was too weak!
All of the doctors and nurses who checked on Logan and me during our stay could not believe what had transpired. Every medical professional called him a miracle and gaped in disbelief at my recovery. Doctor Lynch came to visit me a few days later and he said he would never forget me or Logan, how when he had opened me up, there he was, just sitting in my abdomen!! Margaret also came to see me, and remarked it was a good thing I hadn’t gone back to the house a third time! Everyone remarked it was only a matter of minutes before that placenta would have detached, or I would have started hemorrhaging! Their words were, “A few more minutes and we would not have had a favorable outcome.” I am still in shock and shudder to think of how guilty I would have felt if the baby had suffered permanent damage or died…or if my children had lost their mother…and all over my desire for a VBAC. I have a follow-up appointment with Doctor Lynch on 9/21 and at that time I am definitely going to broach the subject of having more children and I am also hoping to get the green light to finally begin picking up the twins and doing more around the house! I haven’t taken a day in my life for granted since!
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Logan's Birth Story (VBAC/uterine rupture/read with caution)
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