Birthrites: Healing After Caesarean.

The Birth of Baby Sam
(Dreams really can come true!).

I suppose an account of my previous births would help put things into perspective as to why I refer to the birth of baby Sam being a dream come true.

My first child was born in 1997. He was a honeymoon, planned baby with a very healthy, normal pregnancy. My husband and I had moved from our 'home town' to another town an hour away just before we were married. When we were choosing our hospital (as I had no idea of any other options) I really wanted to go back to Bendigo to be closer to home, friends and family. I am ashamed to say that the idea of having 'the good room' was of great importance to me. Very little thought went into the hospitals policies and philosophies and so forth.

However, after saying that, the way in which I was treated by people during my pregnancy was a big deal. I suffered quite badly from morning sickness and when I had my first antenatal visit I experienced what was going to be a regular occurrence. I was asked how I was feelingة "Like shit." Was my reply. A little crass I know but I was feeling really bad for ages. What happened next should have rung the warning bells loud and clear, instead they only chimed in the distance. The male doctor said to me he knew how I felt (re the morning sickness). Rather curtly I replied that as he was a male he has no idea of how I felt. "But my wife has had three children." Well good on her! She would know how I felt then, but "unless you have a chronic case of gastro for twelve weeks morning, noon & night and not be able to have any medication for it and be constantly told to grin and bear it, THEN you would begin to know how I feel." (Let me just clarify here, I was not seeking medication, I just resented his remarks.)

I walked out and had shared care with my GP. from Bendigo. It was a good excuse to go home. The pregnancy went on without complications. No medical complications that is. I mentioned to my GP. that I was a cat lover and people were giving me a hard time about putting my child at risk by keeping my cats. We decided to have a toxoplasma reading done and rechecked throughout my pregnancy to monitor my teeter. Each time I had a hospital visit I had to go through the explanation to stop the panic-stricken midwives & doctors. It was completely unnecessary.

On my 34-week hospital visit, my file was left out of the pile and I was 'missed'. After sitting in a waiting room watching women come and go for one and a half hours I asked what was going on. I was quickly rushed into a room and promptly forgotten about for another 15 minutes! Wasn't I feeling welcome that day?! My forgiving nature had run out and I was pretty cross by this stage. Finally a midwife came in and without looking at me directly, she read my file and started the barrage of questions? What is the toxo' problem? Why are you coming from Shepparton? Where are you going to stay before the birth? What do you mean you are going to drive down when in Labour? Oh, that due date is wrongةةshe uttered one too many 'tut tuts' and I felt my blood pressure rising further. Eventually after convincing her to just leave the due date as it was and refusing to jump on the scales she grumbled her way to taking my blood pressure. Shock! Horror! It was high! No Kidding!!! She went off to talk to someone and after yet another 15 minute wait I went out into the hall and asked someone what was going on. I was told I was not allowed to leave due to the blood pressure rise and I had to wait in the 'relaxation room'. The last thing that was going to lower my blood pressure was being told that I had to stay in the very place that caused it!

I should have read the warning signsةة.

My first bub was posterior. I did not know that or the implications ذ longer labours, back pain and so forth. I rang the hospital only two hours after the very first minor contractions. Because I was going to be traveling it was suggested I come in early. We did. I now know that the first 11 hours would have been classed as pre-labour. Mild, yet regular contractions with slow dilation. The hospital however started the clock ticking the moment I got there and took my labour from the first contraction. It took me the 11 hours to get to 5cm and then active labour kicked in. It was then that all of the 'hurry up' interventions began to be inflicted on me.

First pethadine, which made me loose all concentration, vomit and start to panic. Followed by an artificial rupture of membranes to speed things up. Next step on the intervention conveyer belt was the fetal monitoring. The circumstances then stood at a posterior baby without the benefit of the fore waters trying to turn, whilst I was stuck on my back with a fetal monitor stuck on my belly. Optimal chance for rotation!

According to the hospital two years later, stage one decelerations occurred sometime during the following 4 hours. (the labour charts the heart rate did drop to 100 once otherwise was not below 120ة..) If there were decals, perhaps they might have been caused by undue pressure on the child's head due to the lack of the cushioning by fore waters; or maybe it was the fact I was flat on my back with an OP bub? Who knows?

Eventually the men in white coats came in and deemed me a failure to progress. I had been stuck at 8cm for two hours. Naughty me for falling behind the 'normal progression'!! .

"Hi Ho Hi HO it's off to theatre you go!"

During the depression after, this point of my experience use to upset me most. I felt like people came from nowhere to strip my clothes, jewellery, insert catheters, shaving me. Some people have a problem with understanding how violated a woman can feel after a section. I felt like a helpless piece of meat, unable to help myself, watching my husband stand aside watching me looking pale and afraid. The midwife said as I was wheeled out of the room

"We are averaging a Caesar a day now."

The trip to the theatre was like out of a movie. You know the one, where you get the 'view' from the person on the gurney? White lights zipping past, the trolley being bashed and crashed into walls and doors etc.

The epidural did not work properly. I felt quite a bit more than I should have, but was told I was imagining it! One of the healing strategies after a c/section is to think of ten positive things from the c/section: well my main positive thing was when I looked over my shoulder and saw my beautiful husband and all decked out in scrubs. All I could see was his gorgeous eyes and smiling face. It was like the time we stood in front of all our friends and family and declared our love for each other. That memory is one I shall cherish for all eternity.

My baby was removed from my abdomen and put on a trolley behind me where I could not see him. The doctor announced to the room full of people (where they all came from amazed me!) that I had a boy. On my birth plan I had stated that my husband was the one whom I wanted to hear this wonderful newsة..how hard would it have been for them to respect even this, the smallest of courtesies? My husband stayed with him the whole time and even got to have a 'token cutting of the cord' (by trimming the already cut cord). This I was not even aware of until about 4 weeks after when my hubby was telling friends!

I was then left in recovery alone and feeling devastated. I did not see my baby for a few hours. No one was allowed to or encouraged to see me during recovery. I felt sick and alone. What did my baby look like? I didn't even get to see the placenta. "As little medical interventions as possible" was what my birth plan saidةةةةة

My post partum stay was the most demeaning experience I have ever felt. I had an allergic reaction to the epidural they used. This resulted in a nasty rash that affected my torso and down my legs. It was very painful and itchy. No one seemed to notice or care. I bitched for a day or two and finally they gave me something. I was given phernergon tablets. I asked what effect it would have on bubby, and the response nearly knocked me off my chair. "What would you care? You probably drink coke and eat junk food anyway." I don't drink coke or eat much junk food so I was insulted even further! I yelled this to her as she walked away. I was in shock so I did not mention it to anyone. I already felt like I was being too much of a hassle. A common thing for c/section mums in a busy public hospital. I used to lie there, not being able to pick up my son. Not being able to comfort him when he cried. Not being able to have him comfort me when I felt like my heart was going to break. Not without having to call a midwife to assist. For some one who is so self-sufficient it was very frustrating, embarrassing and demeaning.

Another common c/section side effect was trouble breast-feeding. No one really came to assist me. I was left to my own devices. Bub would not attach properly and thus my nipples became very sore. I asked many times but felt more and more like a failure each time I was told that someone would come and see me. Coupled with the pain of the section as well as the rash I became very distressed. I was given pethadine injections and panadine forte tablets regularly. I do not usually take a panadol for a head ach, so all these drugs in my system made me feel even worse.

On my second night I was given pethadine, panadine forte, 'the' phernergon tablets and just to keep me quite, sleeping pills. During the dead of the night a midwife put my son to my breast without even waking me. I went through the roof with pain and pushed her and my baby fair across the room! The next night I stayed up all night and refused all drugs. I spent the time packing my bags. I was going home! After all the "you cant go home on day 4" had fallen on deaf ears I walked out of there.

In the weeks following my wound became infected, burst, I had anal fissure, 14 weeks of bleeding, 5 pap smears to find that 'there was nothing abnormal' and continuous disappointment from family.

Needless to say that my first experience of birth was far from satisfactory! If I had to have another caesarean I would never have any more children. I had never been in such prolonged pain in all my life.

The worst of the pain was the isolation and confusion I felt emotionally. No one understood why I felt so betrayed, angry and hurt. "You have a healthy baby. What is wrong with you?"

I still do not say that I was depressed. Very, very sad, but mainly angry. I felt very detached to my son. I encouraged my husband to be the primary care giver. I still breast fed but passed everything else on to him. I did not feel that I deserved to love him and have him love me. I felt like I was on the outside looking in. I felt like I was a failure (that is what it is officially recorded asة failure to progress); thus I did not deserve to have the 'prize'ةthe love of my child.

My husband never knew if, when he got home from work, whether I would be crying hysterically or throwing something at him as he came through the door. They say that in every marriage there comes a time for testing the love and commitment. This was our time and we had been married just over one year. The hardest thing was hating the person I had become. Hating her for pushing away my husband whom I loved so dearly and beautiful son. Again, it was like watching a play. The woman playing me was certainly not the person I really was. I sat behind the wheel of my car at 3am one night, crying hysterically, desperately wanting to drive anywhere but not knowing where to go. I wanted to escape. The night I took a second glance at a blade with a scary notion to pick it up I knew that things had gone far too far. Things had to change. But how do you go back in time?

I went to a baby expo and saw a stall for the local independent midwives and homebirth. I read the birth stories, looked at the pictures and when the midwife asked me if I would be interested in a brochure, my reply was that homebirth would be out of the question as I would be too high risk from having a section. She said that was not necessarily true and I found myself crying on her shoulder with joy, relief that there was an option left for me to have another child and about six months worth of unshed tears! I kept that brochure in my 'special things' box and started planning my homebirth.

I became pregnant at the end of that year. I rang a few midwives and chose the one who was at the stand originally! We slowly worked through the many issues I had from my previous birth. Anger at the lack of control seemed to be the main factor. I had to do things differently this time. I had to do everything I could to avoid what happened last time. I went to yoga, learnt about active birth, and tried to work through my issues. I wrote to the hospital and complained. The response was less than satisfactoryةbasic fob off.

I decided that the anger and mistrust for doctors was not good and so sought a supportive ob for my back up. I found one whom I could ask straightforward questions. He did not seem to mind the massive chip on my shoulder; I think he enjoyed the challenge! We worked pretty well. He did not mind that I told him to his face that he might have years of experience watching the process, reading about women's bodies, but I knew my body better than anyone. We agreed on a few things. I told him what I did not want if I required a transfer. I think he got the point when I told him that I would need be nearly dying before I would allow a c/section. If I did have a c/section I wanted to go home within 24 hours. I had my independent midwife who was willing to look after me at home. I walked out of his rooms feeling a little better than I did going in. I could feel some of the mistrust dispersing.

Again bub was in a posterior position and labour was again very slow to progress. At 11pm I had the first contraction. I was so excited at the thought that I was going to get my homebirth! Labour did not scare me the last time but I was shocked by the lack of rhythm this time round. Due to the position, the back pain was just as bad between contractions.

I laboured at home for about 15 hours (a lot of that being pre-labour) and then started to get disillusioned by my slow progress. Perhaps it was my inability to do what is normal? We could not get the water in the birth pool hot enough and so I became less and less confident. I decided that I wanted to transfer to the hospital.

The plan was have an epidural for a 'break' then allow the epi' to wear off and push this baby out! That was the plan...

When getting to hospital it was evening, the room was dark, small and dingy. The midwife was nice enough but not really very supportive to me and my independent midwife. Then the clock watching, the monitoring, the silly fasting policy (I was starving!!!), the even sillier policy that after an epidural a woman is not allowed off her back! I was furious on the inside, but submissive on the outside. I was asked, "How do you feel about an episiotomy?" Oh! Yes please!!!

I desperately wanted my husband or my midwife to help me, stand up to 'them'. I wanted to get off my back. Inside my head I was screaming to get in a vertical position. I can't give birth on my back!

I was being made to push when I didn't feel the need. I had made it to fully dilated. I had not failed this time! I was shocked and overwhelmed with a sense of accomplishment that I had got to fully dilated! I didn't want to jump straight into pushing...I wanted to relish in my own success! I had gotten past 'the' point from last time!

But still they were cheering me on to "push, push!!" In the end I said that if they would not let me off my back and into a vertical position to allow my bub a chance to turn, then dam it I did not want to feel it. Top up the epidural thanks.

I knew that it would mean the forceps would be brought out. The doctor said that I had a "similar stretch" as another woman from the previous week and she ended up tearing so bad it took then four hours to stitch her up (four hours huh?). So out came the scissors and there went my peri!

Noah was born after a six-hour period of being in second stage. He was rotated by forceps and then born by me pushing him out with no sensation of doing so. I did not care however...he had come out the right place! Anything was better than a section. Five minutes later due to the shocking episiotomy and the fact that I was starved of nourishment for hours, I fainted. I can't really recall Noah's first few moments on 'the outside'. It gave my husband and midwife a big shock. Dean said he has never been so scared. Again I missed seeing the placenta.

I was so happy I had birthed another gorgeous boy and was full of confidence. The ob, who by the way was not there for the birth but came to see me during labour (even though he was not on that night) and instructed the registrars to not do anything without letting him know first. Not bad considering I was a public patient. He asked me to stay in for a day to have a transfusion due to the blood loss. I said yes.

The IV. that was in my hand was very painful and when they tried to flush it it hurt even more. It was decided to put another one in my other hand. After four very painful tries, (only one with a local), I demanded they stop and put it in my arm. They said it would make feeding and picking bub up difficult, so I said I would ask my hubby to come in stay to help. They agreed. I was proud of myself for being strong.

I kept my baby right next to me at all times. I put him in bed with me and did not care if there was any policy against it. The thought of having any problems with breast-feeding did not even enter my mind. The midwives were a lot nicer than the previous lot I had encountered. One of them sat and watched for the very last drop of blood to go through the IV. I think she would have let me pull the dam thing out if she was allowed! I was out of there!

On reflection the second birth was far more traumatic physically but emotionally it was a huge step towards healing. It was my choice to go to hospital, my choice to have an epidural, my choice to top it up. The control thing from the previous birth had been tended to, in some way. I was nowhere near that horrible angry woman from two years previous. My hubby was no longer worried as he put the key in the front door!

During the second pregnancy I found it important to seek those who had had a VBAC. My midwife said she could arrange a get together with some she knew through the Home Birth Network. A group of women met and I found it very beneficial. The strength and knowledge of these women combined was wonderful. We agreed that an official group should be started. The 'birth' of CARES SA occurred during 1999.

The third pregnancy was a joyous one for me. I had been working very hard for CARES SA and delving into birthing issues in the community. I sometimes forgot I was pregnant! I did not feel the need to 'plan' this birth. I just knew that everything would turn out ok. I knew even more than I did last time. I knew that I had to trust. Trust myself, trust my birth support people and trust birth.

I knew that if I wanted to stay home, that the independent midwives were more my 'friends'; the women involved with CARES were strong, supportive and inspirational. I knew that I still had issues and fears to face. I dreaded another long hard posterior labour. I knew there were many things I could do to help this bub to get into the right position... but for some reason I did not actively pressure myself to do all these things. I just 'felt' that it would be right this time.

I booked into a birth centre that had the best VBAC policies and the midwife who runs the bc is one of the best independent midwives ever. (There is a long story about trying to book into another birth centre, but that can wait).

Julie is strong, assuring and has a 'thing' about her which immediately makes you trust her and trust her trust in your ability to birth naturally. (It does make sense really!). Trust seems to be the key.

Again the first contraction was at 11pm!! I decided to sleep and ignore it as long as possible. I had still not decided whether or not to birth at home or go to the birth centre. I was going to let things sort themselves out. I woke again at about 2.30am and rang the birth centre to see if there were any rooms available and to see who was on duty. There was one midwife I did not seem to gel with and so if she was on I would take that as an indicator to stay at home. Both rooms were full, but one woman was going to go home so there would be a vacancy by 8am. Julie was due to start her shift at 8am also.

My choice was thisةstay home and ring either Julie or Deb and thus try for a home birth? The thought of transferring again and letting a repeat of the last time was not too tempting. Or I could stay at home and then travel through peak hour Friday morning traffic to the other side of the city to the birth centre. Or I could go to the hospital and make a stop in labour ward until 8am. MMmmmة.the thought of labour ward to me was risky. I had written a birth plan especially for labour ward, but I did not want to have to fight or be on my guard. I wanted to enjoy my last labour and birth!

I took a couple of panadol and went back to bed!

By 4am the contractions were pretty committal. I decided that I would go to labour ward but the birth centre had to tell Julie I would be waiting for her! We packed our bag and rang my mum and left at 5.30am. The trip was surreal. Dawn has a special kind of feeling. It had been a full moon the night before and I looked to it for strength and reassurance.

When we got to labour ward I just wanted to be left alone. Each contraction I breathed through and I felt stronger each time. Between the contractions I closed my eyes and visualized the poster that a dear friend had made for me. I sought out each and every one of the CARES members and each one gave me strength, faith, and love. When I opened my eyes I sought Dean's love, faith, strength and trust. There is no one in the world that can begin to compete with the love I feel for this man.

At 8am Julie walked into the room. Dean had not met her until then and instantly understood why I thought so highly of her. We made our way up to the birth centre very excited and labouring beautifully (if I do say so myself!). I had originally planned for a friend to video the birth so I could have a record of it in case something happened and again I could not recall the actual birth. Julie was aware of this desire and so asked if we would like to have a VE to see if we should hurry up and call Cheryl. I was hesitant because I was scared she would say I was not dilated very far. What if it was going to be another long labour?? I pushed the panic button away and agreed to a VE. 8cm! Yipee!!!!

I wanted to get into the bath and so made a bee-line. The water was great! I breathed through all the contractions and was amazed at how clear headed I felt after each one. Bub was OA and I knew it! No back pain, although I did enjoy the water on my lower back. What seemed like moments after getting in the bath Julie went out and got the peads trolley. Things were getting close! I remember looking into Dean's eyes and with no words expressed to him my joy. His eyes were sparkling too, this was itةmy dream birth.

The water proved to be too effective in dulling the pain. I had been fully for a while and did not even know that I was in transition. The pushing became involuntary. I refused to believe the head was crowning because I did not feel enough sensation. Julie suggested I get out of the bath.

Wo! Did I then feel it! I squatted and Julie grabbed a mirror. I never thought I would want a mirror but I was fascinated by this woman birthing in front of me! That is when I thought, 'no, I am going to split in two! This can not be possible!' The words "we had better get this baby out" were uttered and with two pushes and two high-pitched screams, my son was born.

For ages Dean and I just sat there staring at this wonder. The cord had well and truly stopped pulsating when Julie asked Dean if he wanted to cut the cord. I still sat there on the floor feeling utterly wonderful. (If someone could bottle the feeling of euphoria that birth can bring, distribute it to all human kind; they would be able to achieve world peace).

I had a natural third stage and finally got to see a placenta up close! After I got up and went and lay down on the bed watching Dean holding our son in his arms. Another member of CARES was having a baby around the same time and with Julie in the birth centre. She happened to be having an antenatal visit when I gave birth. Julie knew we were friends and asked if I wanted to see Shammy. How wonderful! Without any planning I was able to share the first few moments of my triumph with a CARES member!

Julie checked to see if I required any stitches and I was overjoyed to discover I would not! Dean and I lay looking at our miracle for a while and then I went to have a shower. After a cup of tea and some toast, made some phone calls to family, we all fell asleep on a big double bed. It was as close to my home birth as I could have got without actually being there.

A couple of hours later we decided that we had better get some stats on the baby, (yet to be named). He weighed 7 pound something and was 53cm long. He was beautiful. As much as I wanted him to stay naked on my chest, we thought it was about time to bath him and put the special outfit that all of our boys came home in. We left just after Friday night peak hour traffic had died down and went home to introduce our boys to their new little brother.

I am not sure how to end this birth story for I am still on cloud nine and far from reflective. I will end it properly one day but for now lets just sayة I did it.