Birthrites: Healing After Caesarean.

Birthing Matters.

I feel that the journey leading to the birth of my second son actually started with the birth of my first son Mitchell.

My pregnancy with Mitchell was great. I was nauseous for 2 weeks, but for the rest felt wonderful and excited. I wanted a natural birth, so read some books and attended an antenatal yoga class weekly. I also did extra antenatal birth classes through the yoga instructor, who is a childbirth educator focusing on natural birth. We chose to go to the private hospital so I could have my own room thinking that being a first time mum I might want some privacy. We were aware of the high caesarean rate in the private hospital, but thought that we could overcome this with preparation. How nave we were.

Mitchell was 11 days overdue when I was induced (we had to negotiate this date with our obstetrician). I had tried natural induction methods including sex, hot curry, ride a motorbike and acupuncture, to no avail. I mistakenly thought that the high caesarean rate resulting from induction was due to the increase use of pain relief drugs therefore effecting the activity of birth. I now know that your body just isn't ready and is being forced to do something it is not ready for which may make your contractions ineffective leading to a caesarean, but why don't doctors tell woman this? The first lot of gel was inserted at 8am and the second at 3pm afterwards I started to feel uncomfortable. My waters broke at 2:30am and my contractions became more painful. I sat on a birthing ball in the shower until the obstetrician around 8am. I was still only 1cm dilated and he said a drip for syntocin would need to be inserted. I expressed concern that I may not be able to deal with the pain, but they assured me they would turn it up gradually. I went back to the birthing ball in the shower with drip attached. I discovered then that if I relaxed my shoulders during a contraction and breathed then it wasn't as painful. My labour progressed. At midday the midwife wanted to check my progress so I got out of the shower and onto the bed. She did an internal and said I was 6cm and that it wouldn't be long now. I then stayed out of the shower and laid on my left side and used gas during the peak of the contractions. I felt the urge to push, but was told not to as I was not fully dilated. An hour and a half later I was checked and told I could push. I got as far as seeing his hair when the doctor arrived and said he wanted to attach a vantuse to pull him out. I was exhausted, so agreed. After two tugs this failed and I was told a caesarean was the only option. I was so scared and unsure. I asked if a different position would help. The obstetricians reply was that he didn't feel it would do anything at this stage. I looked to my husband for support and he said that I had tried my best, but he agreed with the obstetrician. A couple of years later when my doula asked me to draw a picture of Mitchells birth this is the moment I draw the obstetrician, bigger than life, and my husband, mum and the midwife beside him looking down on an insignificant me. As my baby heartbeat was fine, I was asked ifI wanted an epidural or a general for the operation. I asked which would give my baby the least amount of drugs. The obstetrician said that my baby would be out before the placenta starts to process the drug (no mention of breastfeeding here) so I agreed to the general. I missed what was supposed to be the most important moment of my life and lost my image of childbirth that slimy little baby being placed on my chest.

I didn't start really thinking about Mitchell's birth and why I felt the way I did until I became pregnant with Ashton. I knew I didn't want that to happen again so felt it was time to think back on a deeper level. I now accept that it was not any one factor that led to me having a caesarean. I believe it was a number of factors including the private hospital, private obstetrician, induction, maybe Mitchells position, lack of fluid during labour, long labour therefore exhaustion, big baby (9lb 14oz) and lack of support.

Afterwards I felt like a failure. I couldn't get out of bed to care for Mitchell the next day. One minute I had a bay inside me the next he was gone and I didn't know if he was OK or not while I was in recovery. I look back on the video of Mitchell when he was first born and I see him howling as he gets passed around my family, but I am not there for him, to comfort him. The image I had throughout my pregnancy was not of the pain I would feel in labour, it was of my slimy, newborn baby coming from inside me to lying on my chest and that I would fall instantly in love with him. I didn't get that experience. I didn't even really love Mitchell for about the first four months of his life. I felt disconnected from him I often describe it as doing all the things a good mother should ie breastfeed, care for him, cuddle him, but I felt empty like I was looking after him for someone else and they would come and take him away from me.

I felt all of these things at the time, but was unable to articulate (nor confess) them until I started to think about them when I became pregnant again. Needless to say I had issues to deal with.

When I became pregnant the second time with Ashton I knew that I wanted it to be different to Mitchell's birth. I wanted a VBAC. I identified what I thought impacted on the caesarean outcome and set about putting things in place to lessen the chance on them happening again. I spoke to numerous people (obstetricians, midwives, childbirth educators, birthrites contacts, etc) and started reading books on caesareans (to know that what I felt many other woman also felt) and books on VBAC.

 

We wanted to go to a hospital just is case anything should happen and medical intervention was required. Most of the people I spoke to said to try and get into a birthcentre as this is where minimal intervention is likely to occur. We chose to go to a large public hospital that had a birthcentre. The midwife at the birthcentre I spoke to was encouraging, and they base their induction on mine and the baby's wellbeing, monitored through heartbeat and fluid level, rather than the due date. I wanted to go to the birthcentre, but I needed to be referred there by a hospital doctor. The first doctor I spoke to said that not only would she not refer me to the birthcentre, but would actually recommend another caesarean! She also tried to frighten us into compliance by talking about the risk of uterine rupture. Thankfully I had already done my own research and spoken to the midwife in charge of the birthcentre about uterine rupture and she gave me the rundown. I then told the doctor that I didn't agree with what she said and would be seeking another opinion. I then made an appointment with a doctor at the hospital who I had been advised was OK with VBAC births in the birthcentre. He once again spoke about uterine rupture and then said that I was an adult who could make up her own mind and if I wanted to go to the birthcentre and accepted the risks involved then that was fine with him. I also hired a doula who had previously been a midwife for 22 years so I could rely on her to know if I was being lied to during the birth. I also trusted that she would be my voice if I needed one and would consider my feelings in case things went wrong. So then I just relied on Ashton coming on time (didn't happen) and an uneventful pregnancy (did happen right to the end).

On the Thursday before Ashton was born the doctor stripped my membranes and told me I was already 3cms dilated (I then knew that Ashton was ready to come). This brought on very mild contractions which lasted for 2 days and then disappeared. As you can imagine by this stage I was getting very anxious that I would be medically induced again and would have the same labour as with Mitchell and ending in a caesarean. Actually to say I was anxious was an understatement I threw myself on my bed a balled my eyes in pain and frustration that I may be forced into something I didn't want. On Sunday afternoon I visited the birthcentre midwife in a last ditch effort to try to get things going again. She stripped my membranes again and instantly I felt more painful contractions (was still only 3cms dilated). These contractions eased off at around 11pm and I fell asleep. At this point I accepted that I would probably be induced the following day as I was now over two over due by the ultrasound date, but over three weeks over due by my dates which the hospital also had on file and my doctor was concerned about.

At 2am I woke to painful contractions 9mins apart. I knew then that this labour was starting without any drugs and my fear of being forced into induction that day disappeared. I phoned the hospital at 6am and they said to come straight in. By the time our babysitter arrived for Mitchell and we travelled in peak traffic it was 9am when we arrived at the hospital. My contractions were still 8-10 mins apart so they attached the monitor to me to see how the baby was going. They were concerned about his heartbeat not recovering as quickly after a contraction at this stage of my labour (3cms) so insisted on me staying in the maternity ward and attached to the monitor. They then proceeded to breaking my waters to move things a long. Would you believe when the doctor broke my waters (different doctor) at 9:30am I was 6-7cms dilated and still having contractions 8-10 mins apart. As soon as my waters were broken his heartrate behaved the way it should at that stage of labour. I was thrilled. They still insisted on me staying in the maternity ward and attached to the monitor, but Denise (my Doula) said it would not be for long and therefore was not worth the argument. I managed to talk my way into the shower when they transferred me to another room, but they insisted on me getting out and onto the monitor. Because I felt things were so far along and the pain was bearable I didn't argue about being monitored, but I was of the opinion that if they wanted to monitor me then it was their responsibly to keep it on my belly. This task was difficult for the midwife as I had an active birth - standing and leaning over a bean bag on the bed, kneeling on all fours, into a squat and I hardly noticed the thing falling off me all the time. Finally I went into a reclined position with my legs up after I could see the top of his head. Andrew held the mirror and I watched my beautiful 9 lb 7 oz baby boy being born at 1pm. Denise said my labour did not conform to the norm ie still having contractions 3-4 mins apart at the pushing stage. This allowed me time to recover from the last contraction, regain energy ready for the next. And I did it all without any drugs. The things I missed from Mitchell's birth were not missing from this one. I held a slimy little new baby on my chest for about three hours (except when I was being stitched - Andrew held him then), he hardly cried for me in that time, and I saw him being born and bonded with him right from the beginning.

Still today as much as the benefits I gained from Ashton's birth ie bonding and my self confidence, I still feel guilt about what Mitchell may have missed out on in the time after his birth. I wonder if it has any impact on his behaviour now and my responses to him. I don't know. I love deeply and tell him so everyday so that he knows.