Birthrites: Healing After Caesarean.

Birth Diary.

By Debby Miller.

Month One
I knew I had ovulated on 15 Dec as I had been using ovulation predictor kits but I was absolutely elated when that first positive home pregnancy test came back on Christmas Eve. What a Christmas present!! We had been trying for this, our third baby, for eight months. This might not sound too unusual but for me who fell pregnant within the first two months of trying with the other two it felt terrible. I was so sure I had developed a fertility problem I had even had my first appointment with an OB/GYNE to find out what the matter was. (Being over 35 ÒtheyÓ say to see someone after six months.) He had done blood tests on me the previous cycle which had come back normal and it was with great to be able to go back to him the next appointment and say ÒdonÕt worry about it I am pregnantÓ.

I should have got suspicious then that things werenÕt going to be any easier this time in getting the birth I wanted, even though I had had a successful VBAC. He asked if I would like him to treat me, to which I replied Òno thankyou I am going to the Birthing Centre at Royal WomenÕsÓ to which he replied Òyou wonÕt get in you have a scarÓ. Seeing as I had already booked into the Birthing Centre (the minute I got the positive result) I rang them up again as soon as I got home. After a bit of confusion with one of the newer midwives I finally got it from the Centre supervisor that they did accept women who had had a successful VBAC and would be more than happy to have me.

Month Two
Life was not meant to be easy. I had no morning sickness with the boys but have become very good friends with the toilet in the past couple of weeks. Everyone keeps saying ÒitÕs a girl, itÕs a girlÓ Ð I just wish it would stop making me sick. (Yes I am a pathetic sick person).

A little scare this month, I had been having quite severe pains in my left hand side and after doing a bit of reading was becoming rather worried about the possibility of an ectopic. I had a chat with my GP and they agreed to send me for an ultrasound just to check. The ultrasound was done at 5wks 3days. No ectopic thankfully, but I had had a corpus luteum cyst that had burst and they said there was some minor bleeding but nothing to worry about. The sonographer said everything looked fine, but gave me a heart attack at one stage when she thought there were two sacks. It turned out the 2nd ÒsackÓ was actually a small implantation bleed.

Found out about a new first trimester blood test called the PAAP-A test. It provides a risk of Downs and trisomy 18 in the first trimester instead of having to wait until the 15week triple test. I found out the test is only done down at Royal North Shore (Sydney) but I was able to have the blood taken here and sent down for analysis.

Month Three.
The morning sickness has subsided to queasiness thankfully. The draw was done at RWH for the Birthing Centre place, I came in 4th on the waiting list, but by the end of the first week had already reached 2nd on the waiting list. The midwives assured me that I would get in as the drop out rate is quite high.

My nuchal translucency scan went well and my risk of Downs Syndrome dropped from 1 in 324 to 1 in 795. A few days later I got the blood test results back and the risk is now even lower at 1 in 2000+ for Downs and 1 in 1180 for trisomy 18. We had decided that if the risks had been 1 in 200 or worse we would have amniocentesis done but seeing as the risk is so low, we are not going to take the associated risk of miscarriage.

The scan also seemed to indicate the baby is a girl based on some studies I found on first trimester gender identification. But we will wait and see.

I thought I was going to leave first trimester on a nice high, but it was not to be. I had a phonecall from the Birthing Centre last night to advise me that the Senior Nurse Practitioner of the Birth Unit (being the Delivery Suite and the Birthing Centre) was instituting a new policy that NO women with prior uterine scars would be allowed to birth at the Birthing Centre. Fuming is an understatement for the emotion I felt.

The midwife I spoke to, Marion, who is the Birthing Centre senior was very sympathetic. She did not agree with the decision and stated that it was because of pressure from some of the obstetricians and their belief that the Birthing Centre midwives were not strictly adhering to the protocols for care and transfer. Basically it was a political decision. I asked Marion to keep my place on the list, and advised her that I was going to fight this. She was more than happy to keep my place and gave me the name and phone number of the Senior Nurse Practitioner.

I tried to ring straight away but she had already left. I spoke with the senior nurse who advised that these policies were made by a board not by one person. I said that was fine but I was not going to be a pawn to their political ramblings and that I needed to speak to Lillian about how I can gain an exemption from this policy. The nurse wasnÕt sure I could, but I advised her that given my education level and knowledge of EXACTLY what my risks were it would be worth Lillian at least listening to me. I explained to her in further detail my history, knowledge of current research and position, at which point she become significantly more sympathetic, and asked her to advise Lillian it was in the hospitals best interest to discuss this with me or they were going to find themselves landed with a lot of media and political attention and a very uncompliant patient. She assured me she would get the Senior Nurse Practitionerto ring back on Monday, although if she doesnÕt I have her direct number so I can call her anyway.

Philip and I then had fun spending the rest of the night plotting how we could be as difficult as possible. So far we have come up with refusing to go to the Birthing Suite and insisting on having the baby in the ward and of course refusing to let a doctor near me unless the midwife attending me can show us a valid reason why we need one. DonÕt worry most of this was just venting frustration we probably wouldnÕt do it, but it would be funny if we did Ð well funny to us.

Anyway Philip and I have started our further research, with PhilipÕs suggestion being that I should find Royal WomenÕs Hospital research papers and policies that support my position. So having just started my mad search I have found a lovely policy to which RWH are signatory, it is called WOMEN FRIENDLY HOSPITALS, and talks beautifully about consumer rights, evidence based guidelines, support, understanding and awareness of the consumer. Boy am I going to enjoy using that one!

Anyway enough of my winging stay tuned for the next episode of the YOUNG and the RESTLESS.