Birth Story - Keely
Rebekah McNeill
The story of Keely Rebekah's birth
really begins with the Caesarean birth of Stephanie Caitlin
3 years ago. At the time of her birth, a Caesarean was the
only way of getting Stephanie out safely, and thankfully we
ended up with a very healthy, energetic little girl. When we
decided we were finally ready to add onto our little family,
I actually said "I would rather have an elective Caesarean,
than to go through all that pain again and still end up with
a Caesarean".
I wanted to have a natural birth of
course - didn't everyone?, and didn't think that having had
a previous Caesar would stop me from doing this. I went to
see the same obstetrician as I had with Stephanie, and asked
him if there were any reasons why I could not give birth
naturally last time, and if this would stop me from having a
natural birth this time. The answers were satisfying -a
combination of posterior position, fetal distress and
failure to progress for the last birth, which would not
necessarily repeat themselves. It was only as an
afterthought that I rang the Vaginal Birth After Caesarean
(VBAC) support group, and picked up a VBAC book at my local
library.
My phone conversation with Leisa of
the VBAC group was not at all reassuring - would I be
expected to be constantly monitored, or to have a Cannula
(needle) inserted "just in case", had my obstetrician spoken
to me about my scar and how long I would be allowed to
labour or push? My initial reaction was "what does all this
have to do with having a baby?" but once I started doing
some research into the subject of VBACs, I was shocked at
how ignorant I was.
Several months of intense research
gave me a different view on my first birth experience - a
combination of induction from prostaglandin and oxytocin,
artificial rupture of the membranes on an unripe cervix,
lack of support, frequent monitoring requiring me to lie on
my back, withholding of food and drink, a baby that just was
not ready to come out, and a mother not ready to give birth,
were what led to my Caesarean, not an inability to give
birth!
I started to question what had
happened to me, and what would happen to me this time, and
the answers were not reassuring. I got support and advice
from my husband, the VBAC support people, the Internet,
books, and the Homebirth Association, and ultimately decided
not to continue seeing my obstetrician. I booked into a
public hospital, as I could not find an obstetrician whom I
would trust not to intervene in what I saw as a natural
experience. Research convinced me that the help of a
professional support person during the labour and
particularly at the hospital would be invaluable, so after
some searching, and extending the credit card limit, we
hired a midwife through the Home Midwifery Association - I
immediately felt more relieved and relaxed.
Dierdre, our midwife, was wonderful
- she had experienced two Caesars (one was a homebirth
transfer) and a homebirth, as well as having helped other
women deliver their babies the way they were intended to be
born - in a relaxed, comfortable and loving environment. I
was not ready for a homebirth, as I felt more secure in a
hospital environment, but Dierdre was the buffer I needed to
help me get the birth I wanted.
As well as the shared care between
the hospital and my family GP, I now also had ante-natal
visits with Dierdre - what a difference! An average of 2
hours per visit, in my home, with someone who really cared
about me, and was able to answer any question I could think
of asking. We also did Refresher classes (through Childbirth
Education Association) which were great, as they gave us a
chance to compare notes with the other couples there, and
ask questions of our educator, Lily, about hospital
practices and how to prepare for them. I kept researching,
listened to relaxation tapes, and also did Hypnotherapy
sessions with Anne Hall, which I found quite relaxing and
helpful.
My pregnancy was uneventful, except
for a breech baby which finally turned itself at 35 weeks
with a great deal of upheaval, pain in the placental area
and the start of contractions, which thankfully eased off
(after a frantic call to Dierdre). I had been having rather
strong, and frequently painful, Braxton Hicks contractions
since the 20th week of my pregnancy, but at 41 weeks was
starting to feel that I would never be able to get this baby
out without an induction. Dierdre kept reassuring me that
everything was fine - my Braxton Hicks were increasing and
getting my uterus ready, and I just had to stay positive
that I could do this!
Well, I guess she was right - I
ended up with 3 days of pre-labour (although I didn't think
it was anything other than Braxton Hicks at the time), and
when I was speaking to Dierdre on the phone on Monday night,
she told me to go to bed early (advice which I did not
follow of course). I did not want to be in labour and have
to go to the hospital during the night as this would disrupt
Stephanie, so I ended up waking up at 4am on Tuesday 25th
January 2000 with enough pain to convince me to get a
heat-wheat pillow. I thought to myself "This is labour - I
am really in labour!" and tried to go back to bed, as all
the books tell you to do, but the pain was definitely worse
lying down! So I wandered around the house for an hour,
making lunch for Stephanie (it was her Daycare day
thankfully), squatting every few minutes with my heat-wheat
pillow, and breathing throughout the
contractions.
At 5am I was just making a cup of
coffee for my husband, when he got up and we had a wonderful
hug - "this was it". Dierdre was awake at 6am when we rang -
things were still rather slow, with contractions every 3 to
6 minutes, and lasting between 30 and 45 seconds, and quite
"comfortabe". Things slowed down when Stephanie got up - it
was hard for me to moan and groan while she was there, as I
didn't want to scare her. At about 7.30am Dierdre arrived,
Stephanie went to Kindy, and contractions gradually
increased until at about 8 or 8.30am they were coming every
2 minutes, which they pretty much stayed at, getting longer
and more intense as time went by.
At about 10am I started thinking
about the 20 minute trip to the hospital, and how
uncomfortable this would be, so Dierdre did a Vaginal
Examination (the first one during this labour) and said that
my cervix was progressing nicely and very squishy, with the
baby moving down. The car trip was horrendous, and I am
amazed at how Rod was able to concentrate on driving with a
screaming/howling banshee in the back of the car. After
several contractions on the way through the car park and
hospital (and funny looks), we arrived in the birthing suite
of the Caboolture hospital at shortly after 11am.
The midwife who greeted us had
obviously read my birth plan, as I was not asked to submit
to the "usual" 20 minute Electronic Fetal Monitoring, which
hospitals seem to favour, and was asked if I wanted to stay
at the hospital, or go home again. This was because my birth
plan stated that I wanted the option of returning home if I
was less than 5 cm dilated upon arrival (still 4cm). The
hospital midwife, Sue, also said that at this point they
would normally be inserting the cannula, which I refused, so
no more was said about it.
The shower which I headed for
straight away was unfortunately not hot enough, so we filled
up the big bath tub, and I managed to get through
contractions for the next half hour, until my waters broke.
That was an interesting experience - the last time it had
been painful as my cervix had not been dilated enough, where
as this time was just a gushing sensation, with contractions
immediately becoming more intense. As there was meconium in
the waters, Sue asked us about suctioning the baby when it
was born, which we ended up agreeing to, and I had to submit
to having the heartbeat checked after every single
contraction. That was the worst bit, as it meant having to
stand up in the bath during the 30 seconds or so that I had
in-between contractions - not an easy
accomplishment.
After about 15-20 minutes of very
intense contractions, I started thinking "only 4cm - I can't
stand this level of pain for the hours it is going to take
before the baby is ready to come out." I looked at Dierdre
and told her that I didn't think I could do this, at which
stage she re-assured me that yes, I could - I was a woman
and designed to do this, and that if I wasn't serious about
having a VBAC she wouldn't even be there. I believed her -
she had been through it all herself, and helped other women
get through this. I couldn't tolerate gas or pethidine -
they just make me ill with no pain relief, and I didn't want
an epidural, as I knew that would be the first step on the
road to a Caesarean section, so I gave up any thought of
pain relief.
After another 15 minutes or so of
contractions, I suddenly felt an urge to grunt and push down
at the end of a contraction, and Sue rushed into the
bathroom saying "Are you pushing?" - my reply was "I don't
know" as it was not something I had ever felt before. I
stayed in the bath for another 5 or 10 minutes, at which
time I had to get out as the hospital staff did not want me
pushing a baby out in the bath tub. It felt good to have my
feet grounded - I was on a mat on the floor, leaning over a
beanbag, and pushing with most contractions. Sue wanted to
examine me as I did not seem to be making any progress, but
as I did not want to move from my position she had to do it
with me being on all fours. She said that yes, I was fully
dilated, although the baby was still fairly high considering
I had been pushing for a little while. All this happened at
1pm - less than 2 hours after my second examination had me
at 4 cm, and here I was fully dilated and pushing!
Unbelievable for someone who had "failure to progress" and
'got stuck' at 6cms last time!
I ended up pushing for close to 2
hours, with Keely's heart beat never once dipping or showing
any signs of distress (fetal distress was another hangover
from last time). She ended up crowning, and slipping back
several times, so I kept changing and changing positions,
but she just would not come out. Rod's back and neck had
been well and truly worn out as he was supporting me for a
lot of the second stage, and Dierdre ended up with bruises
on the insides of her knees, where I had been gripping her
during contractions.
At one stage Sue said to me that I
had been pushing for 1.5 hours, where as hospital policy for
a VBAC was 1 hour, so she got the doctor to come in and see
me. All he said was "do you want to keep pushing?" to which
my reply was "yes", so he said okay, and left me to it. I
got the feeling however that no matter how hard I pushed,
this baby was not coming out, so I ended up asking about a
vacuum extraction. After a few more contractions, I got up
on the bed for the first time since my arrival, and the
doctor did an episiotomy whilst I was sitting up. The sight
of my baby's head in the mirror was incredible, but she just
looked stuck! As she was so close, the doctor only put a
little bit of anaesthetic in, so the episiotomy hurt worse
than the contractions (he couldn't do it during a
contraction because of her position).
I was waiting for him to get the
vacuum or forceps out, but all he did was look at me and
told me that I could do it from here. Julie, the other
hospital midwife who had been very supportive, and Dierdre
both encouraged me and held my legs for me during the next
contraction, and the head popped out - finally. With the
very next contraction the rest of her flew out, along with a
humungous mess which had everyone jumping out of the way. I
just sat there saying "It's a baby, it's a baby" as I could
not believe that I had gotten this baby out by myself.
Dierdre said to Rod "Aren't you going to tell her what
you've got" as I could only see from the umbilical cord up,
so Rod told me that Keely Rebekah had arrived. It was 2.49pm
- just under 11 hours after the very first contractions
started.
I had refused the usual injection
of syntocinon for third stage, but ended up delivering the
placenta 6 minutes after the birth - and it was completely
green. Apparently Keely had had an episode of meconium
sometime before the birth - probably when she turned herself
from breech at 35 weeks, and yet her heartrate during the
entire birth was perfect. I was in slight shock while I was
being stitched up - the episiotomy as well as some muscle
damage and grazing I had sustained during the pushing, and
it was good to just watch Rod look after Keely while Dierdre
was looking after me.
I had planned to come home as soon
as possible after the birth, but with being rather shaky,
and then needing a catheter due to the swelling after
pushing and the episiotomy, we came home 2 days later.
Stephanie is overjoyed with Baby Keely, and was quite
nonplussed about the whole event. Giving birth this time was
a really empowering experience - it brought Rod and I even
closer together, and made me realise just how much I am
capable of doing when I set my mind to it!
Martina McNeill
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