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July 9, 2015

I wanted a vaginal birth after c-section (VBAC)

In 2012, I was pregnant with my first child and despite a mildlybicornuate uterus, I enjoyed a low risk pregnancy; I had a great community midwife and had planned a homebirth.

A few days before my due date, I began to have itchy skin; a blood test indicated that I may have obstetric cholestasis (the diagnosis was never confirmed), but at 39 weeks, immediate delivery was advised and I was repeatedly told that delaying delivery would endanger my baby’s life. I was now facing a hospital induction and, within hours, our situationworsened when our little boy turned into the transverse position. I was devastated.

Three scans revealed that his position had become unstabledue to suspected polyhydramnios and turning him back to a head down position was not possible. Tearfully, I consented to an elective caesarean and our son was born weighing 9lbs 7oz. He was beautiful.  

The surgery itself was complex and took longer than anticipated. At delivery, he was in very poor health with zero apgar scores. Seven minutes of silence passed before he let out a tiny crythankfully he was OK and did not need to go to special care.

For me, as soon as the spinal took effect, I had a panic attack on the operating table and had to be given further medication. As a result, my memories of the delivery are vague and I was denied the first precious moments of his life as he was taken straight to the recovery area where he waited for us, alone, until my husband went to him. He was 45 minutes old before I held him for the first time. He went straight to the breast and fed beautifully, but looking at him, I felt no instant rush of love; he didn’t feel like mine – I was numb 

“I knew I wanted more children, but I couldn’t face being in hospital again and I needed to find alternative care.”

Following the surgery, we received extremely poor care on the post-natal ward. My husband was sent away and I was alone, in pain and in shock. In the hours after the birth I reacted very badly to the cocktail of medication I’d been given which resulted in me collapsing while holding my newborn. Consequently, he spent the next 48 hours in special care undergoing scans and x-rays. Special care were reluctant to let me breast feed exclusively (despite an ample supply and a perfect latch) and insisted on feeding him formula.

Thankfully he was unharmed from the ordeal, but more precious bonding time had been lost. My hopes of a homebirth turned into a traumatic four day hospital stay.

It would have been naive to think that I was going to get everything I’d planned for, but for the birth to be so different and to have received such poor care, was too much to comprehend. I had been looking forward to giving birth naturally, but now I felt cheated. Moreover, my son was born fighting for his life; I couldn’t give him the calm birth he’d deserved. I couldn’t stop feeling like I had failed as a mother already, and as a woman too, as if my body just didn’t work like it was supposed to.

Three months later we met with the consultant who had been in charge of my care for a debrief to try and understand how so much had gone wrongIt was made quite clear at that appointment that the hospital would not support a VBAC for me simply because I’d had a large baby

To even consider that any more children I had would be born in such a traumatic way was unthinkable and for a while I contemplated having no further children I was traumatised, jealous of women who’d had normal births and very emotional every time I had to speak about our experience. I’d lost all trust in the hospital and I decided to do everything I could to make a future birth experience a more positive one. I spent months researching VBAC statistics and successes, learning about obstetric cholestasis, natural methods of pain relief and avoiding malpresentation. I knew I wanted more children, but I couldn’t face being in hospital again and I needed to find alternative care.

Then one evening, while my little 5 month old boy slept, I was ‘googling‘ and stumbled across a thread on Mumsnet about independent midwifery.  After more research I picked up the phone and called Mal – the best phone call I’ve ever made.  I wasn’t even pregnant again, and what started as a fact finding call turned into an hour long counselling session as I poured my heart out. Mal was incredible, she listened, shocked by many of the details, and assured me that a natural birthat home, was completely possible. She was very knowledgeable and her empathy and compassion immediately put me at ease. I made the decision immediately that when the time came, we were booking with Mal.

The cost of independent care was a concern, but if it meant giving us the best chance of a calm homebirth, it was worth it. I knew that I had a higher chance of needing hospital care because of the complications during my first birth, and knowing that Mal or Jacqui would be with us through every appointment, and at the hospital as my advocate if we’d had to transfer, gave me so much reassurance and confidence that a price couldn’t be attributed to it.

In March 2014, I fell pregnant again. I was excited about having another baby and immediately called Mal. We met with her, at our home, when I was around 9 weeks and officially booked in after my 12 week scan. I declined routine consultant care, having complete trust that Mal and Jacqui would recommend it if they thought it was necessary.

With the pregnancy calmly underway, I set about the rest of my plan. A few friends had recommended hypnobirthing; I needed a strategy for coping with labour at home, and if another caesarean was necessary, I needed something that would help me remain calm. I was sceptical about it at first, but sticking with it, practising daily, I was so glad that I did!

Next, I needed to avoid malpresentationas my uterine abnormality puts me at higher risk of this happening. I was often told that baby turning into the wrong position very late in pregnancy is rare, but it had already happened to me once so I wasn’t taking any chances. I visited a great chiropractor throughout the pregnancy and my baby remained in a great position from about 35 weeks onwards.      

In early November, I was 37 weeks and was horrified to feel the itching return. I attended the hospital for blood tests and my worst fears were confirmed when we were asked to return to the hospital immediatelyI was admitted and told that I should have an emergency caesarean as a natural birth was simply not possible due to my bicornuate uterus and previous caesarean. Not prepared to accept this advice without fully discussing all options, we insisted upon seeing a consultant. The following morning we met with a consultant, a supervisor of midwives and Mal and Jacqui. We were relieved to hear that I did not have obstetric cholestasis, that a bicornuate uterus would not prevent a natural birth andthat a VBAC was possible. I was sent home returning for weekly bloodtests, which showed my levels were normalising as the weeks progressed.

I was, and still am, furious at how easily I could have been put through major surgery, needlessly. What I find even more disturbing, is to think,how many other woman have followed similar advice, without thinking they’d need to ask for a second opinion.

My due date passed. 41 weeks arrived and were back at the hospital with a caesarean looming. I began to question my due date and began re-checking all my cycle dates. This was a very planned baby and I had been using ovulation kits; my long, but regular, cycle means I usually only have 10 cycles a year, so I didn’t want to waste any chances to conceive.  Using online due date calculators, I entered my ovulation date and my cycle length and found that my due date was 8 days later than the date given at the scan. Interestingly, we recalled that the sonographers who performed the 12 and 20 week scans commented that the baby was a little small, but was ‘just within normal limits’.

After discussing all of this with Mal and Jacqui, a placenta scan and lots of monitoring of the baby that showed all was well, we went against hospital advice to deliver immediately and chose to wait for natural labour. My baby girl was always active and I was 100% confident that my dates were reliable. As a last resort, we planned a hospital birth at 42 weeks, following my revised dates.

We went home and waited, and waited. Days and days went by, with more hot curry, pineapple and long walks than I care to remember!

Finally, Baby Grace made a very speedy entrance into the world at 12:42am weighing 8lbs 4oz, a fashionably late little lady! Just hours before I was booked to have my waters broken as a last attempt before an elective caesarean. Luckily, Grace had other plans for us. Calling the labour ward to say that I’d had the baby and wouldn’t be attending was amazingAlthough, the midwife who took the call at 3a.m. was a little alarmed! 

Grace 10 x 12 inch

I had been having early labour signs for 10 days – giving me lots of time to practise the hypnobirthing, before two sweeps did the trick. Less than an hour after sweep two, mild contractions started. By 5p.m. they were 5 minutes apart and lasting over a minute and instinctively I felt like things were progressing quickly. I called Mal, and, during an exchange of calls my contractions grew rapidly closer together and I could no longer hold the conversation. They were on their way but I was afraid I’d be having the baby before they arrived. Mal talked me through some positions to get into to help slow things down, which worked brilliantly.

Mal and Elke arrived and by then the contractions were regularly 2-3 minutes apart and lasting over a minute. As soon as they arrived, afterchecks on the baby and I had been carried out, Mal and Elke set about creating a perfectly, calm quiet and peaceful environment for us; I mostly recall how comfy Elke’s floor mat was and the arrival of the TENs machine was very warmly welcomed indeed! 

At about 10:30p.m. I got into the pool to try to relieve back pain – it was amazing, relieving more discomfort than the TENS machine had, and I was the most comfortable I’d felt in weeks. The midwives felt that I still had a very long road ahead and began making plans to work in shifts throughout the night. 

The pool slowed things down for more than half an hour which was great as it gave me a chance to have a rest and relieve the back pain. Thencontractions came on very quickly and they were long and only moments apart. I remember hearing the Mal say to my husband that I was now in established labour and it was probably going to be a very long night. The hypnobirthing was an excellent strategy and I don’t think I would have coped at home, no gas and air either (although I did ask for some in the final moments when it was practically all over!) just the amazing water,without it.

“Having incredible Midwives with me through the whole journey of this pregnancy, birth was more healing and empowering than I will ever be able to put into words”


Suddenly, my waters popped and I got an uncontrollable urge to push and my husband had to run and get Mal from the other room. After that, the next 10 minutes were a blur and Grace arrived in 3 involuntary pushes. I felt like my body had been taken over and despite trying not to push and breathe through the contractions as I was I advised to, there was nothing I could do to stop it. The midwives were amazing at helping me control the speed and breathe through the panic I briefly felt when I realised how quickly the baby was coming. 

It was a big shock for everyone as I sat holding Grace in the pool.Catching her as she floated to the surface of the pool was one of the best moments of my life. She was finally here, absolutely perfect in every way; born calm, wide eyed, alert, feeding beautifully within minutes, and with no signs at all of being so very overdue.   Against many odds, she came when she was ready – and not a moment sooner.   

Having incredible Midwives with me through the whole journey of this pregnancy, birth was more healing and empowering than I will ever be able to put into words; I re-gained the confidence in body that I lost during my first birth. The standard of care throughout was simply outstanding. Thank you, thank you thank you… x

Elaine

In 2012, I was pregnant with my first child and despite a mildlybicornuate uterus, I enjoyed a low risk pregnancy; I had a great community midwife and had planned a homebirth. A few days before my due date, I began to have itchy skin; a blood test indicated that I may have obstetric cholestasis (the diagnosis was never confirmed), but at 39 weeks, immediate delivery was advised and I was […]

 
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