Birthrites: Healing After Caesarean.

Suzanne's Stories.

BIRTH OF JAMES MICHAEL - 2.4.98

My husband and I were ecstatic to find I was pregnant, as our first pregnancy had ended in a miscarriage at 10 weeks. It then took another 10 months to fall pregnant again. My pregnancy went wonderfully until 30 weeks when I was diagnosed with gestational diabetes. I was lucky enough to be able to control it with diet alone and my pregnancy progressed on uneventfully. We were very naïve in relation to the treatment of gestational diabetes, and also about the possible effects of induction of labour. My obstetrician informed us at my 39 week check up that he would be inducing me in 2 days time even though I had informed him that my family had a history of overdue first babies &endash; my mother went 3 weeks over with her first, and 3 of my sisters all went 2 weeks over with their first babies. Being so uninformed, we didn't query his decision and dutifully turned up at the hospital for our induction. The baby had not engaged, was posterior and nearly a week early. My cervix was thick but he went ahead and broke my waters anyway. I was then hooked up to the drip and within 2 hours I was having very mild contractions 2 minutes apart. I call them contractions, but in hindsight they were just like the Braxton Hicks tightenings with very little pain. I can remember at 3pm one of the midwives asking me if I wanted to push yet &endash; not at all. My obstetrician came back about 6pm and did an internal and said that I had not made any progress. He recommended that I have a caesarean as he thought it might take another 12 or more hours for things to really start happening and that I would end up tired and that the baby might get distressed. What first time mum is going to ignore those kind of comments? So I agreed &endash; not having any idea of what how this decision would impact of future births/pregnancies. James was born at 8.35pm, weighing 8lb12oz, 51 cm long and head circumference of 37.5 cm. I had a spinal anaesthetic and my husband was with me. I remember the obstetrician holding the baby up and showing us that he was a boy. The paediatrician checked him out and then my husband brought James over for me to see. Unfortunately, I was being sewn up and promptly threw up and wasn't particularly interested in seeing him. After what seemed like hours in recovery I was finally taken upstairs to see my baby. After a quick feed he was taken back to the nursery and after a shot of pethidine I was asleep. I recovered very well from the caesarean (some of the midwives said I was the best cesar they had seen) &endash; Up and in the shower at 9 the next morning and walking around (although at a severe angle as I thought I would split open!) James was born on Thursday and I was home on Monday morning. We settled in well, James was a text book baby &endash; fed well, was sleeping 8 hours overnight at 4 weeks of age and 12 hours overnight from 7 weeks of age. This is probably why I fell pregnant again when he was only 10 weeks old. We had not yet started the mini pill (you should be ok til he is 12 weeks old said the Ob.) and hadn't really thought we would get pregnant so easily after so much trouble having James.

BIRTH OF MATTHEW JOHN - 15.4.99

In hindsight the worst decision I have ever made was to go back to the same obstetrician who delivered James. Naively I thought that as he knew my history I would be better served by him. On my first visit, he said he would pencil me in for an elective c/section. My husband and I had already started planning for a VBAC and so I told him that unless there was a medical reason why I would not give birth vaginally I wanted to at least try. I should have realised there and then that he did not truly support me in my plan for a vaginal delivery. He already had my antenatal card labelled VBAC &endash; trial of scar, gestational diabetes and CPD? He ordered a pelvimetry, the results of which were well within normal limits and I was told to treat myself as if I had gestational diabetes, even though I had not been tested in this pregnancy. My husband and I did a lot of research on VBACs. I contacted BACUP and read lots of books. I saw a naturopath who prepared lots of foul tasting potions to help my uterus. My obstetrician made it quite clear to me that if I didn't go in to labour spontaneously I would more than likely end up with another c/section. We tried acupuncture, acupressure, evening primrose oil, regular sex, hot curries and even good old castor oil to try and hurry things along. We thought we had an agreement with the obstetrician that as long as my diabetes was well controlled he would let me go to 41 or more weeks before intervening. At my 39.5 week check up he said he would book me in for an induction. My husband looked at me in disbelief and said "is that what you want?" Before I even had a chance to answer the obstetrician said, "Well, it's what I want". We were absolutely dumbfounded, as my sugar levels had been excellent. The next couple of days we spent madly trying to bring labour on but to no avail. When I was having one of my weekly CTG's a wonderful midwife who listened to our concerns said "you realise you don't have to turn up for the induction, and that you are entitled to get a second opinion". What a brilliant idea, so we went to another obstetrician who said no need to induce due to gestational diabetes, and no reason to doubt my ability to give birth vaginally. We would have jumped ship at this stage, but this obstetrician was going on leave the next day and would be unavailable to take me on. Having our thoughts about the induction being unnecessary being confirmed by the second opinion, I did one of the bravest things I have ever done. At 40 weeks pregnant I defied the obstetrician, and on the morning of the planned induction I phoned the hospital and said that I would not be coming in and that I wanted an appointment to see my obstetrician. Surprising he wasn't too upset, and agreed to let me have another 6 days &endash; he would induce me on Thu 15/4 if I hadn't gone in labour (he was going on holidays on the Friday) as long as I had a daily CTG. So we kept on trying to get labour started, and on the morning of Thursday 15/4 I had a show. We had hoped that the obstetrician would realise that things were going to happen by themselves but he went ahead with the induction anyway. The obstetrician broke my waters at 10am. The baby still wasn't engaged was posterior and my cervix was 2-3cm (I'm not sure if effacement was happening though). Within 2 hours contractions had begun &endash; 20 minutes apart, then 15, then 10 and by 1.00pm they were down to 5 minutes apart. My obstetrician came back in at 1.30pm and did an internal. He said, "thought as much, not much progress &endash; I'll be back at 6.00pm to check how things are going but I'm not expecting too much". Well, that did it. I became so disheartened and can remember saying to my husband "he may as well just cut me up now". My contractions completely stopped. My husband and the midwife tried to focus me on getting labour going again, and2 or 3 hours later things were really heating up &endash; contractions 2 minutes apart. I can remember my husband saying, "We are going to do it this time". The obstetrician came back in at 6.00pm and did another internal. He said, "not much progress - I suggest a caesarean". My husband said "look, she has only had really strong labour for 1 or 2 hours, can we have a few more hours and see how things go?" "Oh no" said the obstetrician, " the theatre staff are about to go home, and that means we would have to call them back in the middle of the night".

I agreed to the caesarean. As I tried to explain to my husband later, I found it impossible to labour and fight my obstetrician at the same time. I had another spinal anaesthetic and again my husband was present. At 9.35pm Matthew was born, weighing 9lb 12oz, 52.5 cm long and 35.5cm head circumference. My obstetrician did not say one word to me during the caesarean. He came and saw me on my last day in hospital and said "any more babies will be elective caesarean &endash; no if's or but's". I decided there and then that my next baby would be born vaginally and that I would have a different obstetrician. Again I recovered well, although it was very hard coming home from hospital after a c/section with a 12 month old and a newborn. (I went on the mini-pill when Matthew was 4 weeks old &endash; no more surprises).

BIRTH OF LUKE ALEXANDER - 21.12.2000

As we only had 12 months between James and Matthew, we decided that we shouldn't wait too long to have number 3. I promptly fell pregnant and made an appointment to see the same obstetrician who had given us the second opinion during my pregnancy with Matthew. He was wonderfully supportive. I can remember saying to him "look if you think it is too risky then I will just have an elective c/section". He said, "I'm not going to tell you what to do &endash; I'll give you all the information and let you make your decision". What a breath of fresh air &endash; to be allowed to make choices and not be told what to do! He said he could not think of any reason I would need another c/section, and was just so supportive. At 28 weeks, I was again diagnosed with gestational diabetes and this was again controlled by diet alone. He was also happy for me to go in to labour naturally and could see no benefit in inducing me unless an emergency occurred. We were so much more relaxed &endash; no castor oil!!! This time, everything went as hoped. I finished work on Monday afternoon and on Tuesday morning had a show. I woke up on Wednesday morning at 3.00am thinking I had been dreaming about contractions but I soon realised it wasn't a dream and that contractions were actually happening. The contractions were about 10 minutes apart right through until 1.00pm when we decided to go out for lunch. We came home from lunch and rang Mark's mum to come and mind the kids who had been in family day care for the day. Contractions were now 5 minutes apart and continued on until about 11pm. They then slowed down a bit and I managed to get a bit of sleep. The next morning they were 20 minutes, 10 minutes, 15 minutes, and 5 minutes &endash; all over the place. By this stage I was pretty tired &endash; not much sleep the last two nights. We rang the midwife we had organised to care for us and she suggested we come around for a cuppa. I was pretty teary and discouraged by this stage. I wanted to know whether I had made any progress &endash; but was scared to find out in case I hadn't. I was also concerned that if things kept stopping and starting for too much longer I would be too tired to cope with labour when it really heated up. She gave me a wonderful back and tummy massage and we spoke about fears that I had. We decided to ring my obstetrician and he offered the option of coming in to the hospital and having my waters broken to get things moving along. We weren't too sure whether this would be the right thing to do &endash; maybe the baby wasn't ready to come yet and we would be going down the wrong road by trying to hurry things along. Deep down inside I knew I wanted to get things going and that I was ready to do this. So we went home and packed things up and went off to the hospital. Both labour wards were busy so we were in the father's room &endash; only a bed and a TV pretty basic. Did I mention that it was 40 degrees outside? My obstetrician came in at 12.30pm and did an internal examination and announced I was 3-4cm and fully effaced. I felt so clever &endash; all these contractions had been doing something after all &endash; my body did know what to do. When we broke my waters there was old meconium &endash; nothing to panic about, he said, it just means they would need to keep a closer eye on me and do more monitoring of the baby's heartbeat. I got up and we spent the next hour or so walking around trying to get some kind of labour established. By 2pm things had really hotted up &endash; contractions about 2 minutes apart and lasting 45 seconds to a minute in duration. Most of my time was spent lying down, kneeling or leaning on my husband or the bed. My wonderful midwife gave lots of lovely back-massages although I must admit I didn't have too much back pain this labour. As it was so hot she also had an atomiser with cold water and peppermint oil, which was sprayed liberally all over my body and my face. She was lovely music playing softly in the background and essential oils burning &endash; such a wonderful relaxing atmosphere! I found the easiest way to cope was to squeeze my husband's thumb every time I had a contraction &endash; he could tell how bad each one was by the colour that his thumb turned &endash; I think it was purple most of the time! My obstetrician came back around 6pm and did another internal. He said I was still about 4cm but that the baby had moved right down and that I was where he had expected me to be. Silly old me got very discouraged &endash; I had hoped to be further dilated and started to think that maybe there was something wrong with me and that I wasn't going to make any more progress. My midwife suggested pethidine - which I wasn't too keen on but accepted anyway. Well, it was wonderful. I lay on the bed in a delightful haze &endash; I must have dozed in between contractions as they seemed to take forever to come around but they were still 2 minutes apart but lasting a minute each time. I can remember getting a funny sensation, but trying to ignore it and before I knew it I was saying, "I think I have to push". It was 8.30pm &endash; from 4 cm to fully dilated in just over 2 hours &endash; pretty amazing, huh? By this stage one of the labour wards was free so we packed up and moved over. I had always been more concerned about the dilating stage &endash; not knowing how long it would take. I had never paid much thought to pushing &endash; but this I found to be the hardest part to deal with. The thing that amazed me is that once I had the urge to push the contractions became completely painless. I never really felt I knew what I was doing when I pushed &endash; first I tried the birthing stool &endash; then tried leaning over the bed. Then I tried kneeling on the bed and leaning over the pillows, but none of these was remotely comfortable. I didn't realise it had been so long but by now I had been pushing for about an hour and a half. I finally found a position I was comfortable with &endash; kneeling upright on the bed and really pushing down into each contraction &endash; I finally felt I was making progress. But the baby's heartbeat was dropping each time I had a contraction &endash; and not coming back up again straight away. The midwife called the obstetrician in and I can remember thinking, "just get it out" &endash; I was really worried by this stage that my baby was in trouble. He said he would use a vacuum extractor to help baby out &endash; fine by me and the quicker the better. It was very uncomfortable having the vacuum fitted to be baby's head but before I knew it I was having another contraction and was told to push as hard as I could for as long as I could. The baby was about halfway out after the first contraction, and I was told that I would feel a burning, stretching sensation (which I didn't) and to keep pushing past it. Someone said, "put you hand down and feel your baby's head" &endash; and then my hand was moved and I could feel a soft wet head! Amazing! Once the baby's head was born his airways were suctioned and he was delivered on to my tummy. I was in heaven &endash; he raised his head and looked up at me and he was wet, and bloody and new and smelt absolutely divine. My husband cut the cord &endash; he said it was like trying to cut calamari with a blunt knife! We were ecstatic - we'd done it! Our dream of a vaginal delivery had come true. After a minute or so the paediatrician asked if he could have a look at the baby &endash; I said of course and after a quick kiss, handed him over. No stitches were required and even though we had been concerned about the size of the baby he was only 8lb 11-_ oz &endash; nowhere near the 9 1/2 or 10lb we had expected. The placenta took nearly an hour and a half to come away &endash; we were a bit concerned I might have to be taken down to theatre but when the midwife said one last try I gave an almighty push and out it came. For the first time, my husband and I were able to see a placenta &endash; and we found it absolutely amazing. Once it was all over I got up and had a shower, and then had a cuppa and some sandwiches &endash; so much nicer than the recovery after a c/section! Dreams really do come true &endash; especially when you surround yourself with supportive people &endash; obstetricians, midwives and husbands! Thank you all. I feel that a lot of the emotional pain from the first 2 deliveries has been healed by this wonderful experience. I'm ready to do it again!