Feb 12 2008

My choice -Vaginal Birth after Caesarean (VBAC)

Published by at 1:21 pm under Birth stories

I experienced a difficult birth with my first child. I wasn’t really prepared mentally or physically, and didn’t have much of a plan. After a long first stage, an epidural, which eased the pain but restricted me to bed, and failure to progress I needed a caesarean. When I fell pregnant a second time two years later I choose to use the same obstetrician providing he was comfortable with me perusing a VBAC. I had already begun to research and prepare for my VBAC I ramped up the preparation by attending a calmbirth course with my husband, organizing the hire of a labour TENS machine, reading lots of positive VBAC stories and books about natural ‘active’ births and writing a list of ‘birth wishes’. I prepared a bag of labour aids including heat packs, relaxation music, essential oils and sponges

Labour began at around 7am; 4 days past my due date. Looking back, I had probably been having Braxton Hicks throughout the night but had mostly slept through them. It was only when I decided to check the clock that I realized these surges were only 3 mins apart! I finished my cereal and we made some phone calls to arrange care for my toddler and inform the hospital of my progress. They told me to come in whenever I felt ready or if I wasn’t coping. I put the labour TENS on my lower back, and used a heat pack on my lower belly. It was a beautiful warm summer morning so I just walked around the house and back yard quite comfortably. As each surge came, I leant against a bench or wall, I hit the ‘boost’ button on my labour TENS and my husband held a cold flannel to my forehead and heat pack on my belly.

After about 3 hours, the surges were closer to 2 mins apart and lasting longer so we decided to make the 10min trip to the hospital. When we arrived at the hospital I was informed I’d have to be on the bed attached to the CTG monitor for at least 20min to get a good trace of the baby heart rate. I wasn’t too happy about this as I’d been coping well in upright positions but figured if it wasn’t for too long I’d be OK. I was also asked if I’d like to be internally examined at this point and was told I was 3cm dilated but my waters hadn’t broken yet. I was given the option of having them artificially ruptured but declined that since I felt there was no need to rush things only having been in labour for about 4 or so hours. About 1 hour after being strapped to the foetal monitor I was struggling to relax with the surges in this position. By this stage my husband was using the labour TENS boost button for me as I needed to solely focus within. During one surge he accidentally put it to ‘rest’ mode instead of ‘boost’ and I wasn’t too calm after that one ended, let me tell you.

The seated position on the bed wasn’t helping things and I started to get cranky and demanded to know when I could get off this monitor and the bed. The midwife patiently explained that the baby’s position and movement was making it difficult to get a good trace and admitted I’d probably need to stay on the monitor for the entire labour. At this point I just about lost it and said “well if I’m forced to labour this way, I may as well have the caesarean!” She offered me an alternative of using a wireless monitor that needed to be inserted in the babies scalp and would allow me to walk around but this would mean breaking my waters to get it in. At this point I gladly agreed – anything to get off the bed. After breaking my waters, I felt a warm gush and then a strengthening of the surges as the babies head put pressure on my cervix. Having a surge while the midwife was inserting the monitor is something I’d never want to repeat but once it was in and I was given the all clear I just about cart wheeled off the bed with glee. I was told I was about 5cm dilated when she broke my waters.

The bed was raised so I could stand and lean over it. My husband continued to boost the labour TENS and reassure me that I was doing well, and the baby was coming. After what seemed like only 3 or 4 surges in this position I started to get transition ‘shakes’ in my legs and feelings of wanting to push. At first the midwife didn’t believe me but after a quick check she said sure enough I had dilated remarkably quickly in this position with my waters broken.

I was told I’d have to get back on the bed to deliver which I wasn’t too keen about but managed to find a comfortable all fours position with my upper body resting on pillows. When the doctor arrived (not my normal Ob as it was a public holiday and a on call roster was in place) he wanted me in a side lying position which again I wasn’t too keen to move to but by this point I was feeling so positive that I could do this, I didn’t let it put me off. It only took a few surges to push the baby out and I don’t even remember at what point the head and shoulders came out, it just all seemed to happen in one surge. Before I knew it a baby was passed to my belly and my husband was telling me it was a little girl.

It was barely 6 hours since I had been breakfasting with my toddler and felt the first signs of labour. There was a bit of commotion at the other end as the doctor was worried about how short the cord was, but I was just happy she was out and I was looking into her big dark eyes. The placenta was delivered without problem and I required some stitches, which wasn’t too pleasant but at least I got to hold my little girl throughout. When all was said and done…and cleaned up we were left to feed and get to know our little girl. My husband opened the curtains to let in the warm sunlight and we were full of amazement and happiness at how alert and eagerly she fed. My husband and I joke this was a very ‘civilized’ birth. Given the choice I would definitely choose a VBAC over the repeat caesarean.

Lisa. Sydney

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