A tale of two births - c-section 27/09/07 and VBAC 27/11/09 (sorry long)
Part one, the c-section.
My first birth started well enough. At 38 weeks I saw one of my midwife team at the Birthing Centre (who told me jokingly not to go in to labour in the next 48 hours because she was the only midwife on the team available). That night I lost my plug. Two days later at 3am my waters broke getting out of bed to go to the toilet. Contractions started and by 6am I was up and walking around. Pre-labour went for hours with contractions slowing down whenever I sat or lay down. At midday, after an hour's sleep, I jumped up to answer the phone and the rest of my waters rushed out. Immediately I had much stronger contractions and within the hour I got DH home from work to drive me to hospital. My first exam showed me at 4cm (yay!) but the midwife was sure she felt a bottom (not good, we were told baby had turned). An ultrasound was done (last one was at 20 weeks) to confirm position and the OB came in to discuss our options. As baby was frank breech, they were prepared to let me attempt a natural birth, but it meant leaving the birthing centre and being fully monitored on a bed in the delivery suite. They also warned me that with baby's head coming out last that it could get stuck and the baby's oxygen supply could be cut off. DH panicked and wanted the c-section, but I wasn't giving up my natural birth so easily. In the end, the natural labour on offer sounded anything but 'natural' and it was too hard trying to make an 'informed decision' whilst in active labour. I couldn't bear the thought that my baby might die or be permanently disabled because I wanted a quicker recovery, so I agreed to an emergency c-section. I continued to labour right up to being wheeled in to theatre, still with no pain relief except DH rubbing my back. The exam right before the c-section had me at 7.5cm dilated. I was given a spinal block (near impossible to stay still while contracting) and both my arms were strapped down. They drew on my tummy and I felt the pen, then started to cry with fear because I thought I would feel the incision. I didn't feel it, but I did feel every tug, clamp and pull while they delivered our baby. DH asked if he could look over the sheet and after checking that he wouldn't faint, they let him. Then he says 'Is that what I think it is?' and I think to myself, 'it's a boy!' DH disappeared from my side, while my midwife (who had stayed with me the whole time) held my hand. Why was everyone so quiet, what was wrong? After what seemed like eternity I heard a cry, then DH came over holding our baby. We both cried. A baby boy! My arms were strapped so I couldn't even hold him and the theatre nurses said just put him next to your cheek. I said 'Hello Jack!' and DH said, 'Well actually, I was thinking of Craig...' Then DH took him off to be weighed and measured. We finally got to BF back in my room.
Name: Craig Angus
Born: 18:50 27th September 2007
Weight: 4315g
Length: 52cm
HC: 38.5cm
Craig was left with me overnight. We got no sleep between BFing and observations. The next morning the OB came to see me to reassure me that I made the right decision, especially because he was so big. In fact she had almost made the incision too small to get him out, no one expected me to have such a big baby. A nurse came in to remove my catheter and help me to the shower. While I showered they heel *****ed Craig, found him to have low blood glucose and jaundice which is an automatic admittance to the Newborn Intensive Care Unit (NICU). I have never cried so much. He was given phototherapy and had a feeding tube inserted. It was days of expressing before I got him completely off formula and late in day 4 before he was allowed back down to the ward. Day 5 they removed the feeding tube and I could BF, then day 6 we were discharged BFing with a nipple shield. It was 2 more weeks of battling with BF before we finally caught up to his birth weight. We went on to BF for 11 months.
Now for Part 2 of my birth story, the VBAC.
I was told straight after my c-section that I was a good candidate for a VBAC. The midwives said to wait until DS was 12 months old before falling pregnant again, my GP said 6 months was enough to heal the scar. I went back to work full time when DS was 11 months old and falling pregnant was the last thing on my mind. But when I got that BFP test, I started to read up on VBACs. I booked back in with the birthing centre. Preparing for a VBAC is a long and emotional journey but by the time I was 9 months pregnant I felt ready. I'd read as much as I could, kept active, kept my weight gain within a normal range and dealt with my feelings about my c-section. I was so ready I started to get impatient about giving birth. Every other night I was having BH that sometimes seemed like labour starting. Both my babies had the same due dates, just different months, both originally the 5th and then adjusted to the 9th. DS arrived on the 27th, 12 days early and I was really hoping that Baby 2 wasn't going to go much later. In fact, I had just posted my FB status as "OK little one, your brother was out by now! Consider these your marching orders! <sigh> Who am I kidding?" when half an hour later I had a contraction.
This time there was no plug, no bloody show or waters breaking, so when the contractions were still there after an hour I wasn't sure if I should be excited or not. My Mum rang a bit later to say she wasn't going to available that week to mind Craig if I went in to labour and pretty much said she thought the baby wasn't going to arrive until it was due. I didn't let on that I was having contractions and contacted my brother instead. DH and I had a chuckle about how perfect the 27th would be, making it easy to remember birthdays for both kids. We took some photos, I had a shower, did some housework and made sure the baby's room was organised. I tried listening to my birth hypnosis labour CD on my iPod but couldn't get in the 'zone', then decided to sleep. After 3 hours a contraction woke me and I dozed between contractions for another hour then got up and had another shower, some breakfast and posted on BB. By 6am I was confident I was in active labour (5 or 6 minutes apart and 60 seconds long), so I rang my midwife. We agreed to meet her at hospital at 7:15. We got DS up and dropped him off on the way. As soon as I got to the delivery suite (just before 8am) I burst into tears, a combo of hormones and relief.
My first internal exam at 8:00 had me at only 2cm dilated. I was devastated to have such little progress after more than 12 hours. I thought a second labour was meant to be faster?! My MW did a Stretch & Sweep, hooked me up to the wireless monitor for 15 minutes and put in a cannula (part of my agreement as a VBAC). The contact for baby's heartbeat kept slipping so I had to hold it in place but my contractions had dropped back to every 10 minutes. My MW suggested we go for a walk, take some stairs and get DH some breakfast. That did the trick and when I got back to the ward and when my MW put the monitor on again I had made some progress, the contractions were getting longer. But not closer together or stronger in intensity. The OB came in and asked if I was being monitored, if I had a cannula in and if an internal exam had been done. He was happy with the MW's answers and left. After he'd gone, my MW took the monitor off again and explained that if they complied with the hospital policy then the OB wouldn't feel the need to step in and things could be done in a more relaxed way. We went for another walk, this time outside because the room in the delivery suite was cold. Again it fired up the contractions and we returned. I tried to eat a sandwich in between contractions.
My second internal exam at 12:00 was weird. My MW couldn't feel my cervix or determine what was going on. She was going to call the OB in but he wasn't available. In the half hour following I had only 2 contractions. My MW said she had to leave for an appointment and was sorry she couldn't stay, but that another from their team would take over until my MW's backup started her shift. The other MW arrived and they chatted about what options we had for helping my labour along. As a VBAC I wasn't allowed any pharmacological induction or augmentation. Clary Sage was suggested, but I didn't have any with me. My birth plan said my preference was a SROM, but I told DH they could break them, because I was getting tired after 16 hours and didn't want my labour to stall. So DH stepped in and said we needed another walk and that when we got back they could do another exam and break my waters. So off we went, in 33 degree heat, saying we would be back at 1:30pm. I wanted to walk up the hill towards the local shops because I got the strongest contractions using stairs. We walked and walked. Then we turned around and came back down the hill and DH started to time my contractions. There was barely a minute between them, they were up to 2 minutes long and I was unable to walk when they peaked. We got to the bottom of the hill, but it wasn't time to return. DH asked me what I wanted to do and I said my contractions weren't strong enough yet so DH marched me up a different hill near the hospital. By the time we were walking back I was hanging on to DH at the peak of contractions and really yelling to match the strength of the contractions (I'd stopped caring if people were watching by this stage). Our MW rang my mobile to see if we were on our way back as the OB was looking for me. In the last 100m I was offered help or a wheelchair by 3 different nurses and I can remember my yells echoing up the stairwell.
My third internal exam had me at 5-6cm dilated. Our MW broke my waters using her hand by getting me to 'push' against it. It both hurt and was a relief. Then the backup MW from our team arrived with a new team member (who I hadn't met before) and they took over. They'd driven past us on the hill and when they heard me in the stairwell they came straight up because they knew I was close. They suggested the shower and helped me strip down to just a sports bra. DH alternated holding the shower nozzle over my back then over my lower belly. Suddenly I vomited up my lunch and realised this must mean I was in transition. My MWs had also worked it out (from watching and listening). I moved to the bed and they used a mirror and a torch to confirm I was fully dilated (they were concerned that I might have a 'lip') then asked me if I wanted to push. It had only been 10 minutes since the internal!
DH rubbed my back and I started to push. I didn't want to leave my position on the bed, but after 15 minutes the MWs knew I needed to change position. They got me back in to the shower where I clung on to the bar on the wall and tried to squat. Then back to the bed. Then the side of the bed kneeling on a mat on the floor. Finally I realised I needed to get my knees higher than my hips, but I couldn't hold myself up. One MW suggested the toilet, so I headed there. Fantastic! But pushing wasn't so good without the warm compress on my perineum so after a few contractions I headed back to the mat on the floor beside the bed. I felt the heading crowning and then sliding back up. I'd read about this and about the burning so it didn't bother me, but I was worried that I would be too exhausted to push our baby out and was frightened of tearing. At this moment I realised that I was actually going to have a VBAC and not a repeat C-Section if I could just push hard enough. I stopped worrying about tearing and pushed with all my strength. One of the MWs asked if I wanted to touch my baby's head, then warned me it would feel weird because the plates were sitting at a point. It was weird but feeling it made me want to push even more. That final push to get the head out was the most painful. They had DH supporting baby's head, then warned him that when I pushed again that the baby would turn and then suddenly slip out so he had to be ready to catch it. I'd put in my birth plan that he was to be allowed to catch the baby if he wanted, but he didn't realise until then that he was actually going to! The release I felt after that final push was the best feeling ever and I looked down to see my baby boy. The cord was wrapped once around his neck but DH was coached through removing it and then he passed our baby between my legs to me (a boy!). DH ran straight to the sink to wash all the after birth off his arms that he got splashed with when he caught our baby :rofl: He came straight back and took a photo of me with our new son. They let me lie down on the bed and rest while trying our first breastfeed. He was so alert, his eyes wide open and slowly turning pink. Then after the cord had stopped pulsating, they got me to push again. I had to stand beside the bed because I couldn't push lying down and the placenta was out intact in one push. DH clamped and cut the cord. Then our son was weighed and measured and DH got to have a cuddle. The OB came back in, but this time it was because the MWs had called him to suture 2 grazes and a tiny 2nd degree tear that I got when I pushed out his head.
The care I received from our MW team was outstanding. While DH cuddled our son, I went and had a shower and our MWs handed me my toiletries in the shower, organised a hospital dinner for me, helped me dress and wheeled me back to the birthing centre. DH and I got to stay the night in the empty birthing centre in peace, rather than up on the noisy postnatal ward. My brother brought in DS for a visit that night. The next morning we were able to help ourselves to breakfast and after the hearing test and newborn exam we were discharged (25 hours after we had arrived). It was by far a completely difference experience to my c-section. My recovery was much faster and BF has been easier. I am now at peace with my surgery and feel it actually makes me appreciate my natural birth experience much more. I also appreciate my DH so much more :). We worked as a team, especially in the last 2 ½ hours of the birth and without his support I was destined for another c-section. I would never have gotten to push if it wasn't for him. He is so proud of his involvement in the birth, especially of catching his new son. But when it came to the final push it was down to me to do it and I am proud to say that I did it.
Name: Ryan James
Born: 15:10 27th November 2009
Weight: 3840g
Length: 52cm
HC: 34.5cm
