Birthrites: Healing After Caesarean.

Connor's Birthstory.

By Fiona Slattery

A little bit of background

Six and a half years ago, my daughter Eleanor was born by Caesarian section. She had been posterior and stayed high while turning towards anterior. I was in a hospital and although I felt fine and she was never stressed, it was taking too long for them. The next OB on duty was not going to "allow" me to labour without an oxytocin drip, and I permitted myself to be talked into it. Of course (although I didn't know it at the time) with Ellie in the wrong position for labour it did nothing. After a couple of hours on the oxytocin (gas only for relief, almost one continuous contraction) the OB did an internal and announced that I was too narrow and that "the baby would never come out of there". He had me in for a c/s as fast as he could get me. Later he told me that if it wasn't for him, my baby and I would both have died, and that I would never have a baby vaginally because I had a "narrow outlet".

I would not have another child for a few years, but I could not help wondering. I could not believe that what he said was true. Some time later, I had a loop excision on my cervix, and my gynaecologist was also an obstetrician (although not practicing it any more due to back problems). I spoke to her about it and she was appalled. "Nobody does internal pelvimetry any more!" she said. She told me that statistically, I had an 80% chance of a subsequent vaginal delivery.

It was about this time that I met my current husband, Bernie. We decided we would have a child as soon as we were married (I am 37 and he is 42). I knew I wanted a vaginal delivery. However, having had a previous c/s, I was discriminated against. I could not go to a birth centre, and at a hospital, would have to be continuously monitored. During a tour of the hospital I told my story to the midwife doing it and she said, "well most of the obstetricians here aren't like that". Most? Not good enough. I became very anxious about the thought of having my baby at that hospital.

I learned that despite the c/s it was possible to engage a midwife and have a homebirth. Although it would cost $2000, a small windfall meant that we could afford it. So this was the route I chose, finding my very competent and lovely midwife Sheryl. I discovered (during a run in with a hospital OB) that the local hospital was not homebirth friendly and it would be better, if I had to transport, to go somewhere that was. So I arranged to have King George V as a backup instead. I was ready.

First Signs

I was woken at about 3.30 am on 17 October by a contraction. They continued at intervals for a couple of hours moderately enough for me to doze between. By 5.30 they were stronger and so I got up and hopped on the Internet for a bit and made a few emails.

A bit after 6, my husband's alarm went off, so I told him what was happening. He wondered whether he should go to the Riverview basketball training session (he is a coach) to be back by 9am and I told him I didn't think much would happen before then but I would prefer him at home! So he stayed home.

A bit after 7am, I called my midwife Sheryl and told her what was happening and she said call back when they were all strong and lasting a minute. I had estimated them to be about 30 sec long but I was trying to time them on my own so I think that was a bit off. Some were stronger and some weaker. I also told my mother what was happening but not to come straight away.

Labouring at home

By 8am they were all pretty strong, lasting about a minute, and were about 3-5 minutes apart. (We have a record from 7.14 to 9.14.) So we called Sheryl back and she left home to come over here. We also called my mother to come. I was very glad Bernie had decided not to go to training! While we were waiting, we filled the pool.

Sheryl got here about 9ish. She doesn't tend to do many internals but she felt that from how I was going that it would not take too long.

It was pretty soon here that I started getting back pain. I could not understand this because Connor was anterior! However it was getting worse progressively. It soon got to the stage where the back pain was the most painful bit.

Sheryl was suggesting I think about an internal and at about 11.30 or so I decided that we should check. She told me Connor was at &endash;1 and well applied, that my cervix was paper thin, and that I was at 4cm. I had been hoping for more than this, but later she told me that the 4cm part was a little white lie, and that I had not been at 4cm but at 2cm but she didn't want to discourage me. 4cm was discouraging enough, however it was progress, and so I kept going.

I was trying different ways of pain relief. The uterine contractions were fine, I could handle them, but it was the back pain that was getting me. I was in the pool, on all fours leaned over a low table, standing in the shower, on my side in bed ... nothing seemed to help much. Back counter pressure was not too good, but did a bit (I would press my hand into my lower back during a contraction) and ditto back massage. It was a particular point, on my pelvis, either side of the sacrum, that was really hurting. The best place was in the shower, standing. Thank heavens we have an endless hot water system.

My main labour support people at this stage were my mother and my husband. My sister was there also with her daughter (who is 4) and Ellie and Georgia basically played most of the day, with Ellie coming in to see me regularly wherever I was. Bernie was finding it pretty hard going, my pain was pretty obvious. I think he felt he wanted to do more than he was, but he really was wonderful, he was like an anchor to me. My mother was also wonderful. These two people helped me get through it. Sheryl later told me that I was experiencing a lot more pain than is normal in a birth.

At about 3.30 we did another internal. I was in the bedroom at this stage, on my knees leaning into the bed. Sheryl told me that I was clenching my bottom too much (she later said she had never seen such a clenched bottom before, my cheeks were "like rocks"). I was trying to relax myself but it was the only way I could get through the back pain.

Anyway the internal showed 5-6cm dilation, still paper thin, and very stretchy. However she wanted to check what I did during a contraction since I was so tense. She discovered that during a contraction my cervix got very hard and stiff and went down to about 3cm. Not good. I really tried to not tense up but just couldn't do it. We decided to go the hospital and get pain relief so that I would not tense up and fight the contractions, to see if we could get progress that way. I was not going to progress the way I was.

We had to wait a bit before leaving as my sister was off feeding the horses (she and my mother run an Arabian stud) and we had to wait for her to come back for the girls. I wanted my mother as well as my husband at the hospital with me. Under Sheryl's direction a hospital bag was hastily packed with things for me and for Connor.

At the hospital

Well the car ride was interesting to say the least. It lasted about an hour, since we had decided to use a back up hospital that was homebirth friendly (absolutely the right decision as it turned out).

When we arrived at about 7pm I was whisked into a labour room, given gas which helped a lot, and prepped for an epidural. We'd decided to go in as public patients and see what sort of medical staff we got, and switch to private if we needed (we're still in the obstetric exclusion period on our private insurance). As it turned out, everyone was just fine, very good, and we didn't need to switch.

I was given an IV for fluids (I was pretty dehydrated, even though I'd been drinking) and given the epidural. When it kicked in the relief from pain was wonderful. I went from monosyllabic (mostly "aaaarrghh") to being able to talk in sentences, and even make stupid jokes again.

Would I VBAC or repeat C/S?

We arrived at the hospital (King George the Fifth Women's and Children's Hospital, coincidentally where I and my two sisters were born) a few hours before the end of a shift. Our midwife was called Alice (mnemonic "Alice in Wonderland") and the resident OB was Sue ("A Boy Named Sue" &endash; Johnny Cash). Sue came in and had a talk to us and got my history. She went through our options. She said she thought a c/s was likely but not inevitable. It depended on my progress with the epidural. We were going to wait and do another internal in about 3 hours.

During this time the epidural started to wear off and I got a top up a bit before it was time to do the next internal check. Unfortunately the top up wasn't 100% effective but I thought it would be OK (that taught me a lesson!). We discussed what we would do if I did end up with another c/s, who would stay overnight, where I would recuperate, etc.

Also the shift changed and the new hospital midwife was someone Sheryl knew, Louise ("Thelma and Louise") who is due in January and is a homebirth client of Sheryl's partner Shea. The new resident OB was a Kiwi called Deirdre (I remembered her name because of a girl I went to school with whom we spoonerised to "Teirdre Dilley"). They were even better than Alice and Sue.

At about 10.30 it was time to do the next internal. What would happen next depended on what we found. Had I progressed?

All systems go!

Louise did the internal and much to our great joy and elation found me at 9cm! In fact, all I had left was an anterior lip, which Louise pushed back, and then I was complete! I could push! Hooray!

We decided that with the epidural wearing off it would help me to push better to feel what I was doing, so I got to work. Because I still couldn't feel much I was being coached in pushing but was doing the right thing. He started moving down my birth canal.

While I was pushing I started feeling the back pain again. At first it was handleable but as the epi wore off it came in stronger. I tried different positions but nothing seemed to work. It was not going away between contractions, just staying put, and nothing I could do would reduce it. I was pretty incoherent with it by now (I recall some screaming) and I could feel my body shutting down, I could not concentrate enough to push, it really was a hideous pain (ah the blessed relief of forgetfulness, it's only a memory now).

Anyway I was given the choice of go ahead and push the baby out or have another epidural top up and deliver assisted. Well I knew I could not co-ordinate myself to push him out, they said it would take another 30-45 minutes. I could not go that long with this pain which was without relief and getting worse. So I got the top up.

After it took effect (with me coping with the gas in the meantime) Deirdre came in to do the ventouse; I didn't need forceps, thankfully. I had already pushed effectively with coaching and so I did it again. At one stage Connor was in my birth canal with the ventouse cup on his head and was wiggling his head, making the ventouse thing wiggle. Sheryl told Deirdre and Louise that the OB who had sectioned me had said I was too small to ever deliver vaginally. They all looked at Connor's head wiggles and said "there's HEAPS of room in there!"

Anyway Sheryl started taking photos and then ran out of film. While she was changing it I had another contraction and they said "push" and I said "can I wait till she has the new film in?". "NO!" So I pushed but he didn't come out in that sequence of pushes anyway. (He came out the next one and so we got it on film.)

Connor is born

Reaching down and feeling his warm slippery head was AWESOME. For someone who wondered whether they would ever deliver vaginally, it was a very powerful moment. I'm getting teary just writing this. Along with his head his little hand came out too. I didn't tear with the head delivery but Deirdre decided to deliver the arm to reduce the risk of his elbow making a big tear and I got a slight second degree tear then (I hardly feel it). The next thing I knew, a warm slippery baby body was on my tummy! Oh, wow, the whole thing was unbelievable!

Connor had passed a huge lot of meconium just as he came out so after he was wiped a bit on my tummy and Bernie cut the cord, the baby doctor gave him a bit of suctioning in case he'd inhaled any, but he hadn't. Then he was bundled and given right back to us.

He wasn't interested in feeding straight away. Instead he spent time looking around at everything. He didn't cry (and still doesn't much). Of course he's the most perfect baby in the world!

Vital Statistics

Connor Jye Webber Slattery was born on 18th October, 2000, at 1.18am. He was 51cm (20 inches) long and weighed 3145g (6lb 15oz). His Apgars were 6 and 7.

Last few things and back home

It was now the early hours of the morning and Sheryl thought she might go home, which sounded sensible to us. She was due to start night shifts the next day. Louise would do the measuring etc. My mum and Bernie stayed until he was measured. If we'd been able to get a room without anyone else in it my mum would have stayed the night but we couldn't. I had to wait until I got my legs back, have a shower, and so on so I would stay till the morning and then Bernie would pick me up and take me home.

I breast fed Connor while waiting for the epidural to wear off, had some toast and a drink (was I starving!), had a shower, and was in bed by 5.30am (ready for breakfast at seven!). By 10am Connor and I had both been assessed and pronounced healthy, Bernie had arrived and we'd checked out. And by 11am, ten hours after Connor arrived into the world, we were home!

Connor has taken to breastfeeding beautifully and has a lovely, easy nature. I'm feeling really good apart from some residual soreness and some rotten haemorrhoids, and a bit of nipple soreness from my unpractised nipples! But boy, does it beat a Caesarian recovery hands down!

Afterthoughts

I didn't get exactly the birth I was hoping for, but I really feel like it was a positive, empowering, amazing experience. It was "my" birth experience (and Connor's, and Bernie's ...). The interventions I had were all necessary under the circumstances and I am happy that we made the best choices we could. I knew before I went into this that I could not anticipate what happened, that we would have to take what came, and we did. Any choices we made were our choices. I'm happy with those choices. I could not have anticipated the back pain, the result of a serious horse riding accident I had at 22 which injured my pelvis. I was traumatised by my previous c/s, an unnecessary one (and this proved how unnecessary!). However this birth has taken me through that and I am whole again, but a lot more aware and informed.

And best of all, I have my lovely Connor!