A Queensland VBAC story - Nikki Dummett.
I live in a city in Queensland with an abominable Caesarean rate.
It has consistently ranged between 30 - 40% in the last few years.
I think currently it is running at about 37% at our 2 private hospitals
and in the low 30s at our public hospital. Only our newest OB in town
seems to support and encourage active birth in a genuine way, the
rest seem to be highly interventionist in varying degrees. The problem
is not just with the doctors but with the women who seem to accept
this as being normal. Things have got a long way to go here with both
the doctors and with the education of women to change this horrible
way of bringing our babies into the world unless absolutely necessary.
Not just for the Caesarean deliveries, but all those other deliveries
that end up with lots of intervention.
My first pregnancy started off a little bumpy and ended up a minor
disaster. We had fallen pregnant within about 3 months of trying but
I started bleeding at 6 weeks. It was continual spotting not a heavy
bleed like a period but it would ebb and flow and it is was emotionally
exhausting for us not knowing whether we were losing the baby or not.
We had an early ultrasound which showed that we were carrying twins
but one embryo had died and we would just have to wait and see whether
the other one would make it or not.
Luckily it did and I then proceeded to have a very healthy and easy
pregnancy until I reached 34 weeks. I woke up after a Saturday afternoon
nap and my waters broke all over the floor. It was a big gush and
then slow continual trickle. We went into hospital and I naively thought
they would keep me for 24 hours and then let me come home. Wrong.
I was admitted and monitored and given antibiotics but was given very
little information about what was happening and what was likely to
happen other than being told we would just have to wait and see. The
baby was living with only 1/5th waters. We were both stressed and
scared about what would happen with the baby and if it would be ok
when it was born.
In the early hours of Tuesday morning I woke up to strong period
pain. I rang the nurse who gave me a couple of panadol and told me
to call her if I needed her (that was the last I saw of her, she didn't
bother checking on me during the night). Not having a clue what was
happening, I tried to time the pains that were coming all over the
place, 20 mins, 5 mins, 10 mins etc with no pattern but the pain getting
gradually worse. At 7 am when my OB did his rounds I was quite cranky
with lack of sleep, pain and had been vomiting for a while to the
point where I was throwing up bile. After monitoring me for a while,
they still couldn't tell me whether I was in labour or not so gave
me a shot of pethidine to try to give me some rest. I didn't like
it much but it did give me a little bit of rest although it did nothing
for the pain and by mid morning my hubby had arrived and they moved
me up to birth suite where I made use of the hot shower to some relief.
I was scared and tired but coping ok when the midwife examined me
and misdiagnosed how dilated I was. She said 5 cm but when my OB checked
later, I was only 3 cm. In the meantime, I had agreed to an epidural
when given the ultimatum that if I wanted one, I had to have it now
as the anaethist was leaving the hospital and it would be very hard
to get one later (a standard tactic I have since discovered). I was
so exhausted that I fell asleep for 2 hours. I woke up feeling refreshed
and enthusiastic about delivering the baby. Of course, having had
the epidural too early, my contractions had dropped off and I then
needed syntocinin to keep the labour going.
After an hour or so, I was told I was 7 cms dilated and felt excited
however, due to the fact that my baby was premmie, the artificial
contractions were too much for her and she went into foetal distress
with her heartbeat going down to 60 beats (very terrifying) as of
course, by now I had an internal EFM attached to track the progress
of the labour. Within 20 mins, she was born by Caesarean. I was absolutely
terrified of the surgery the whole time (almost panic stricken) and
experiencing a bad reaction to the strengthened epidural (violent
shivering and feeling sleepy and drugged out of my brain).
When Tara was born, the OB let my husband cut the cord (at my earlier
request) and they checked her (10 apgar score and crying so we knew
she was ok) and placed her on my chest. I remember feeling so relieved
that she was ok (and being surprised that she was a girl as we had
thought we would have a boy) and thinking ̉that's nice, now please
take her away and just sew me up!" The whole Caesar experience was
terrifying and very traumatic for me and although my husband, friends
and family were sympathetic, I don't think they really understood
how devastating the whole thing had been for me.
Of course, with Tara being premature and needing to be in special
care nursery for 3 days and the hospital for 2 weeks and all the expressing
and struggling to get her to breastfeed compounded my negative birth
experience. Although I didn't suffer from Post Natal Depression, I
don't think I really bonded with her until she was about 3-4 months
old. She didn't even feel like she was my baby until I got her home.
I took a while to 'get over' the disappointment of the what had happened
and my sense of loss of being pregnant and having the birth that I
had worked so hard towards. Luckily for me, I discovered Birthrites
when Tara was about 9 months old. I bawled my eyes after reading the
newsletter as I related so much with the feelings of grief expressed
by other mothers about their Caesareans. At last, I felt normal and
that my feelings were perfectly justified. It was the first step to
healing the wounds of the past and working out how I could make things
different the next time.
I fell pregnant quite quickly again with my second child when Tara
turned 3. It was again a very much longed for baby but this time I
knew the birth was going to be VERY different. I went back to the
same OB as the new guy had only just arrived and I had faith in mine
as a surgeon and believed his assurances that there was no reason
why I wouldn't be able to have a natural birth this time. I worked
much harder at staying fit and healthy leading up to my pregnancy
which I continued throughout and started my antenatal yoga classes
at 12 weeks. That's where I met wonderful Karen who is very wise,
extremely supportive and almost single handedly trying to change women's
expectations of birth in a city with extremely limited birthing options.
Basically, you have your baby in hospital with an OB - that's it.
No homebirths, no birth clinics, no waterbirths etc. The process of
the yoga classes and her active labour class (with the husbands) really
prepared me mentally for the challenge of having my natural birth.
I read many books on natural births, especially after Caesareans and
read many birth stories from the Birthrites website as well as listened
to the birth experiences of my yoga mums which inspired me. I asked
my friends to tell me again all about their births and read magazines
and anything else I could to inform myself as much as possible. I
had my support team organised and my standbys as well and felt fully
armed for whatever was going to happen.
I proceeded to have a very healthy pregnancy and was relieved to
get past the 34 week mark without a hiccup. In the last weeks of my
pregnancy, my trusted OB became very negative about my determination
for a natural delivery. I got the ̉this is going to be a very large
baby, 8 pounds for a woman of your size (I'm 5 ft tall)", ̉there is
a greater risk of utrine rupture which will need to have you closely
monitored" and various other negative seeds planted in my mind. I
was devastated by his apparent change of heart but I was going to
have this baby the way that I believed was best for me and my baby
even if I had to fight for it. I seriously considered changing to
the new OB as some of the other yoga mums had their babies with him
and had very positive experiences.
When my OB was on holidays, I had a fill in appointment with the
new guy. He started off by asking me when I was booked for my Caesarean!
Apparently the idea that once a Caesar, always a Caesar was concreted
into their brains during their training. Although he seemed like he
wanted to help, I was despairing at being 'allowed' the opportunity
to birth my baby because of a set of circumstances in a previous delivery
that didn't apply this time around. I reached out to Karen and a girlfriend
that lived in a city nearby ( that had her own children by homebirth)
for encouragement and support which they both gave in truckloads.
On Karen's advice, I took my husband with me to my next weeks appointment
and that made a huge difference to the attitude of my OB. After some
tough questions from both me and my husband, basically we reached
an understanding that I fully understood the risks of going for a
natural delivery but I was doing it anyway.
Although I still believed I would go early, my due date came and
went and I was still pregnant (and surprised to be) and I was becoming
very impatient and anxious. I understood that the longer I remained
pregnant, the greater chance I had of intervention and the various
outcomes that entailed and I had been down that road before! The appointment
the day before my due date, my OB suggested booking me in for a Caesar
late the following week and when I refused, suggested that he break
my waters which I also refused. The baby was doing fine and I felt
that as long as both me and the baby were ok, we had some time up
our sleeve to let things happen on their own. I allowed him to do
an internal (I was 1-2 cm dilated) and stretch the cervix to see if
things could be started that way. I had been having very strong Braxton
Hicks contractions for about 2 weeks and had had a couple of false
alarms so I knew my body was getting ready.
That night, I had very strong Braxton Hicks and in the early hours
of the morning, strong period pains and cramps. Alas, by morning,
it was all over AGAIN. I was so angry and frustrated. The next day,
I had Braxton Hicks contractions on and off all day which was more
than usual, but not painful so I didn't suspect anything. We walked
our dogs that night after my hubby finished work and had dinner and
watched TV as normal. I showered and got into bed at 11 pm when we
both heard a little pop. I stood up and my waters had finally broken!
We were so relieved that it was finally under way. We made our phone
calls and within half an hour, my contractions had set in at about
5 mins apart but not too painful. It took a while for me to settle
and find the right place that I wanted to labour which ended up being
on our bed kneeling over a pile of cushions so that I could slump
down and rest between contractions.
We thought we were in for a long night and would meet our baby by
lunchtime. Wrong. By 12 am, the contractions were happening more strongly
and I was breathing my way through them like we had learned in yoga.
We started to time the contractions to find a 'base point' to measure
our progress and though they seemed to be a lot stronger and coming
closer together, they were still only lasting about 30 seconds long.
I threw up my dinner but we thought this was just my body's reaction
to pain as I had thrown up during my first labour before it had really
begun. My husband was getting a bit nervous about going to hospital
but we believed that we needed to try to stay at home as long as I
could manage (not by my OB who wanted me in to be monitored when the
contractions were 15 mins apart!) but I felt like I was managing fine.
I was pretty sure that the books said that real labour was when the
contractions were lasting for 60 - 90 seconds and mine were still
only 30 seconds long. After about another hour I started barking demands
and the pain was getting stronger to deal with but my husband calmed
me down and reminded me that we were in for the long haul and had
a long way to go yet. By this time he was racing back and forth to
the microwave reheating my hot packs for my back and tummy, and I
needed to change position and sit upright. My hubby brought a dining
chair into the bedroom which I sat on back to front with a pillow
on the back to rest between contractions. We both got a bit concerned
after a while when my grunts from strong contractions seemed to be
turning into pushing grunts and I was bearing down strongly. I thought
̉great, now I am pushing before I am fully dilated and I've just added
on about 6 hours to my labour".
My husband demanded that I get up and walk about while he called
my girlfriend who was coming over to stay with my daughter and call
the hospital to let them know we were coming in. I got as far as the
lounge room when I got the urge to squat and I really pushed down
with the contraction. I felt something inside me move and put my fingers
inside me where I felt something hard. I asked my husband to take
a look and sure enough, there was a head! He quickly dialed 000 and
we just relaxed and concentrated on what was happening as it was now
obvious that I wasn't going anywhere. The ambos arrived as Darren
was holding my emerging baby's head which was slowly being born. It
was amazing to be doing it!!! After about 20 mins of pushing and a
slight pause and 3 contractions after the head was born but the shoulders
weren't (at which point the ambos were getting worried), my baby boy
Lucas slid out into the world on our lounge room floor. He was blue
and the ambos were a bit worried about getting him breathing but Darren
and I could see his chest moving and his little breaths and we knew
he was ok. After they suctioned him and gave him a little oxygen,
they finally gave him to me to hold naked on my chest. Darren and
I just stared at him and it felt so good to be holding him in my arms,
all wet and warm.
My contractions had stopped and my placenta still hadn't been delivered
so after about 10 mins, they packed us up and off to hospital where
I finally delivered the placenta (after the injection and a breastfeed)
and had my torn labia stitched up (my perineum was fine after all
the preparation and massage). My OB was less than happy but I didn't
care, I felt elated and powerful that I had a 3 hour, drug free, natural
delivery with a beautiful healthy baby that didn't require intervention
or even a doctor to be born!!!
It was a tremendously healing experience for both my husband and
me. It felt so good to know that my body was capable and birthed my
baby well. Lucas and I were both a bit bruised and battered from the
fast and furious labour but it was worth it for the end result. We
still plan on having a third child and I have no expectations about
what kind of birth it will be but I do know that I can do it!!! Both
my children were born in dramatic circumstances so we are hoping for
a more low key delivery next time!
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