A long labor with an attempted VBAC ends in a repeat cesarean. This baby is being placed for adoption in an open adoption situation...and this baby is going to the same family that adopted her first baby.

Mom sits on the birthball while leaning back on her doula so that the nurse can check the fetal heart tones. Mom had has a premature urge to push that's overwhelming and that she needs to fight against with every contraction.

Nurse prepares for a vaginal exam...and declares that she beleives mom is at 8cm. Later, there will be a debate as to how far along she actually is. During this exam, it is found that her membranes have ruptured.

Mom leans on the bed while sitting on the birth ball. Doula provides warmth and counter pressure by using a Hot Sox (grain-filled sock that's warmed in the microwave) to push against her lower back. In this position, with her arms raised above her head, it's not as easy for her to push with the contractions.

More resting against doula....

...but she finds that having those arms up WAS helping her after all. At this point, the doctor came in and checked her. He declared her at 4cm with a swollen anterior lip. The nurse strongly disagreed, and rechecked her. Nurse said she still beleived mom to be at 8cm. Another nurse was called in to give HER assessment...and she said 5-6cm. All 3 agreed on 5-6cm with a swollen lip. Mom began to get frustrated.

Mom found relaxing in the bath to feel good, so she headed back there. In this picture, doula is using a hand-held showerhead to spray warm water directly onto mom's belly.

The urge to push was still powerful, so she tries different positions. On all fours...

...and on her side.

With her eyes closed, she still takes comfort in knowing her doula is beside her by holding her hand.

A pillow on the side of the tub made it more comfortable to do the all-fours position. With a hep-lock in her wrist, it was uncomfortable for her to try to support her weight with that arm. However, even in this position, the urge to push was intense.

Mom heads back to the bed to try the all-fours position with the help of the back of the bed.

but that position wasn't working for her, either.

After struggling not to push unsuccessfully for over 2 hours, and having a swollen cervix, the decision is made by mom to have an epidural. Here, she battles through some of her last contractions while clinging to her doula's hand.

Preperation for the epidural begins. An IV is started, a pulse-ox monitor is put on her finger, and a blood pressure cuff is placed on her arm.

The anesthesiologist come in and questions mom as to her medical background and pertinent information.

Mom is required to sign a consent form, and everyone except anesthesiologist, nurse, and doula leave the room.

The epidural has been administered.

The expectant mom sits in a chair next to the laboring mom. Fatigue has shown no mercy to anybody, and she struggles to stay awake. After a flight from several states away as well as the stress of the last 2 days (and the fact that it's now 4am)...she's exhausted, but remains in good spirits for the laboring mother.

Even with the epidural, mom LOVED having her doula rub on her belly, while recieving counter pressure from the adoptive mom.

Ana, the backup doula, provides support and counter pressure while oxygen is administered to mom. The heart tones aren't looking good, and mom expresses her concern of a repeat cesarean.

Her doctor comes in and confirms her fear...it looks like a repeat cesarean will be necessary. For some reason, strong contractions are causing the baby's heart tones to dip...at the wrong time, showing that something is wrong. Knowing she has done EVERYTHING within her power, and that this is not something which she has control over...and so she agrees to the cesarean.

Mom closes her eyes and tries to rest and accept the fact that she is going to have a repeat cesarean.

Doula stays close to mom and talks her through some of the preperations for the surgery. Her belly is being washed, and mom is frightened.

The final washing of her belly...

...while doula tries to comfort mom.

The belly is sterile and ready for surgery...

..and only 3 minutes later, it's covered and the doctors prepare for the surgery.

The incision site.

The surgery has begun, and the doctor uses a cauterizing wand to seal off any bleeding blood vessels.

Smoke wafts up as the wand singes the tissues and the room takes on the scent of burned flesh.

The doctor gets a tool that he will use to pull back the layers of the incision. The pressure that mom feels is intense, and she begins to complain that "It hurts!". The anesthesiologist, not certain if she's feeling 'normal pressure' or if she's feeling 'pain' decides to err on the side of caution and decides he is going to put mom under general anesthesia..and everyone is asked to leave the room. Almost immediately, mom changes her mind and everyone is invited back into the OR...

..at which time the baby has JUST been pulled out of mom's belly. The cord is clamped and now the baby is being suctioned.

He lets out a strong wail as he's lifted up by the doctor.

the nurse carries the 16-second old newborn in a towel over to the warmer.

In the warmer, an oxygen mask is placed near his head just to allow some richer oxygen to flow near the baby's face.

The adoptive mom cuts the cord.

Baby is bundled up in preperation for meeting the woman who'd cared for him for 9 months.

Baby is handed to the doula, who in turn hands the baby to birthmom to hug, and kiss, and meet.

After a few moments of kisses, and tears, and "he's so beautiful"..the birthmom looks up at her doula and says, "He's ready to go with his Mommy." Adoptive mom says, "Are you sure you're ready?" Birthmom replies with a smile, "He's YOUR baby." Doula, at the request of birthmom, hands the baby into the waiting arms of his new mommy.

Doula turns her attention back to the birthmother while the adoptive mother, still crying, takes her new baby to meet his family.

A crying daddy and an excited big brother meet them in the waiting room on the way to the nursery.

Baby is weighed! 8 pounds, 10 1/2 ounces...20 1/4 inches long!

The reason for the cesarean? A true knot in the cord! All were surprised to see that...

The maternal side of the placenta.