I will never forget sitting on that bench outside the hospital… waiting. I had a mama seeking an unmedicated VBAC. She had been experiencing prodromal labor and went to the hospital where they decided to admit her. But unfortunately I was not allowed to be at her side until her Covid test came back negative, so I waited for hours. And what’s worse she waited for her doula for hours.
The last hour I waited at the door with my bags in my hands so I didn’t have to wait one more second than was necessary before I could be at her side. My client opted for an epidural before I was able to get back to the room. I fully support any informed decisions my clients make and it didn’t change my eagerness to be by her side.
When I finally got into the room my heart dropped when I looked at the monitor that was measuring her contractions and her baby’s heartbeat. She wasn’t in active labor, she was still in prodromal labor.
Prodromal Labor
Prodromal labor is a form of early labor. It is marked by often times stopping and starting and/or irregular contraction durations and time between them being erratic. Because they are un-patterned it can often be long and arduous.
Prodromal labor is usually the result of baby being in a less than ideal position. It is possible that it is the body’s way of trying to nudge baby into a better position before beginning active labor. Prodromal labor can also be a sign of exhaustion. So when it comes to prodromal labor I always tell my clients rest and then do something to get baby in a better position. Spinning Babies is a fantastic resource to help with that! Some of the techniques can be used with no tools at all and others use minimal tools such as a “>peanut ball, “You can try, but they aren’t going to work.” My client and I were not deterred by her negativity and got straight to work. We worked on 15 minutes pumping and 15 minutes off for an hour. In our 15 minute breaks I would rub a mixture of “>Clary Sage, “>lavender on her ankles and feet with extra time spent on the labor encouraging reflexology points. In that hour we got her to a beautiful active labor pattern! Her ob returned to the room and didn’t acknowledge that she was in active labor but said, “We will see how the labor goes and then re-evaluate in a few hours.” This happened multiple times over the course of the day, always with the “we’ll see” attitude instead of the “you’re doing it!” attitude, meanwhile my client and I were focused on the task at hand. I would keep my eyes on the monitor and the second her contractions looked less than perfect we would change her position in the bed and resume the reflexology massage. This amazing mama got to 6 cms dilated and +2 station with no Pitocin, while stuck in bed, with an epidural! Sadly her ob never did acknowledge how incredible it was or how incredible she was. Below is a chart that shows where in the pelvis +1 station is. It was then that baby’s heart rate started dropping dramatically after every contraction and it struggled to recover each time. One part of this story I haven’t shared yet is originally this mama was planning on delivering at a birth center, but her gut told her to go to the hospital instead at the last minute. And that is the most important part of this story, because medicine and statistics can tell us a lot, but they will never know as much as your God given gut will know! And this client’s story is a great example of that. When she had switched to a hospital birth at the last minute her records hadn’t fully transferred over and one part of this record was causing the extreme dips in heart beat. This baby’s placenta was special. It had what is called a marginal cord insertion. That is when the umbilical cord is attached to the side of the placenta instead of the middle. This causes the connection to be weaker. So every time a contraction tried to pull baby down it was causing a lack of blood flow to the baby and the heart rate was dropping. It is very possible and common to deliver a baby safely with a marginal cord insertion, but as was the case with this mama, it increases the risks of baby’s heart dropping during labor. That’s when I watched as this mama made an impossibly hard decision. Once the wheels are set in motion it happens quick. She was prepped and sent off while I moved their belongings to the recovery room where I waited and prayed. I prayed for safety and health for both the mom and the baby. I prayed for peace for her mother as she held her daughter’s hand during the c-section. But I also prayed for peace. I prayed for peace in the wake of shattered dreams and hopes. I prayed for confidence that this was the right decision. When they wheeled her back I was amazed at her strength and beauty as she held her sweet baby girl. I asked about the c-section and how it went. I was shocked when the mother said that she was told when they cut her for the c-section her baby’s knee was the first thing to be born because her baby was laying completely sideways across her pelvis. Babies can be born a lot of different ways from sideways to upside down. But you cannot deliver a transverse baby unless the change positions. You can see what a transverse position would look like in the picture below from Spinning Babies book, “When Baby Lies Sideways“. Let me summarize this information for you. She was 6 cm dilated, +1 station, with a sideways baby! I attempted to make a visual to show basically what this mother did, and it is remarkable! Once again she wasn’t told by her care provider how amazing she was, how amazing her baby was, or how amazing her body was. He chart likely read “failed VBAC” or at best it read “CBAC” (Cesarean Birth After Cesarean). And what in incomplete story that is. We throw around words like failure, false labor, and geriatric pregnancy like the are meaningless, but for too many mothers they become the lyrics to the song that gets stuck in their heads about their birth. They sing it over and over and it sets a tone for their motherhood. I was determined to do everything I could to make sure that this mother’s song, walking away from this incredible journey, was one of triumph and hope. So at the postpartum visit I brought my model pelvis and my baby doll that I use for childbirth classes. I showed her exactly what she did under impossible circumstances. It’s not too late. You can change the lyrics to your song or you can help someone else change the lyrics to theirs. Together we will be a mighty orchestra or empowerment. 
C-section.
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