An HBAC Transfer Story
The birth of Aurora Dunbar Jacobs
18.08.2014 @ 17h43
The journey to my daughter’s birth started long before she was even conceived. I was born with a congenital deformity called an unicornuate uterus – half a uterus with one fallopian tube. With this comes various medical complications, such as endometriosis, infertility, early miscarriage, preterm birth and breech presentation. My first pregnancy was highly managed as he was conceived with fertility treatment, so we went for many scans, doctor and midwife appointments. My mind was consumed with coming out with a healthy term baby. He presented breech from day one and from around 30 weeks of pregnancy I did everything I could to turn him – spinning babies, homoeopathy, moxibustion, acupuncture, hand stands in the swimming pool, external cephalic version, it was a frantic and stressful time. My midwife wasn’t prepared to support me in a breech labour and birth, and frankly I wasn’t really keen on it either… I was born breech and the pure horror of my mom’s own birth story really left me feeling like a surgical birth was the best option. We scheduled the operation for 38 weeks and 6 days gestation. My son was born well and healthy. It took me many months to recover though and while the caesarean section itself was not traumatic, the after effects were. I experienced liver damage from the drugs and chronic fatigue syndrome subsequently. My milk took around 5-6 days to come in and breastfeeding was arduous and painful. I did persevere though and we had a wonderful breastfeeding relationship for just under 3 years. Around 6 months after my son was born, I started studying midwifery as I had been a doula for several years already and becoming an activist for women wanting to VBAC. I had a midwife friend and colleague willing to support me in my home VBAC wishes and throughout the years has always been supportive and encouraging to me.
I knew the next pregnancy would be different. I wasn’t prepared to let anyone “manage” me and all decisions made would be mine and my husbands. When we wanted to conceive our second, we experienced a catastrophic car accident which put conception on hold for a while as I experienced severe injuries to my spine, ribs, collarbone, wrist, internal organs and stomach fascia. My body had defied me again. We then also relocated and 3.5 years after my son was born we felt ready to approach fertility specialists again. I went for a couple of IUIs and further tests and there were the same problems as before as well as some new developments. I desperately wanted to conceive naturally though and we decided to take a break for a few months to enjoy Christmas with our family in our new home. We conceived that first month. My body does work! My husband and I decided to go the opposite route for this pregnancy, completely TRUSTING what was meant to be. Surrendering to the pregnancy and the blessing we received. I didn’t take any progesterone to support the pregnancy as I had the last time, went for no dating scans at all, had no blood tests and didn’t see a medical person until I was 27 weeks along. The midwife who had supported me all along was now still in Johannesburg, while we were 6 hours away in Johannesburg and without hesitation offered her support still in our homebirth plans. The pregnancy was easy, uncomplicated and blissful. Just putting my body and baby into my own hands made me take huge responsibility and I ate well and did yoga and had chiropractic treatments regularly. The connection between my baby and I was intimate and the calmness the baby (I didn’t know the sex at the time) gave me surrounded me the whole pregnancy and every choice I made was with conviction and complete sureness. We chose a doula who trusted the physiological process of birth, and most of all trusted me – for the choices I made knowing that ultimately birth belongs to the mother, not to the doctor or midwife.
Again towards 30 weeks, baby was presenting breech. My approach trying to turn the baby this time was with more discernment and I was much less frantic. I knew the “medical” things that were stockpiled against me – laboring with a scarred uterus and a breech baby. I continued with yoga and chiropractic, and had been doing spinning babies techniques since the first trimester anyway. I did a lot more visualization exercises as opposed to trying to physically turn him or her, and through these I still got the continual message of trust. Trust your body and trust your baby. This was another lesson in surrender. Again I needed to discuss the issue with my midwife, knowing full well that she could withdraw her support and I wouldn’t hold it against her. I knew she was nervous about it but she also knew that I would go ahead with my plans with her support or not. I think she also had to let go of a lot of things (and much criticism from within the midwifery community) to continue supporting me.
With much research we decided on a backup hospital and obstetrician based on the fact that he was extremely relaxed about us approaching him later in the pregnancy, as well as him supporting the fact that we would not be having an elective caesarean section, breech baby or not. My biggest regret with my first is that I did not go into spontaneous labour and then have the operation. He understood and was supportive. I gave him our 4 page birth plan, not really expecting him to read it and he was now our backup support should we need it.
By 38 weeks pregnant I was now starting to feel pretty uncomfortable and stupidly enough picked up my 40kg boerboel to take her to the dog parlour and “gapped” my symphysis pubis. I couldn’t walk and was put on bed rest by my chiropractor. Another lesson in surrender! I had been extremely active up until this point in my pregnancy and now I couldn’t even move. I needed to actually STOP and start thinking about this birth.
The last two weeks of my pregnancy were slow but wonderfully family focused. I enjoyed every minute with my eldest child knowing that we wouldn’t really have many more of those special moments for a while at least. I ignored all the criticism my birth team and I were receiving from the doula and midwifery community (rumours abounded that I was planning an unassisted birth, and even if I was, it really was none of their business). I was starting to not sleep too well and my only prayer was that I would be able to get some sleep before I went into labour.
At 4am on Monday the 18th of August (40 weeks + 2 days gestation) I woke up feeling like I needed to go to the toilet. I was also really uncomfortable and my hips were sore as I had gone to bed early the night before and lying down for so long was quite uncomfortable. I got up and went to the toilet, my body clearly emptying itself and readying me for labour. I wasn’t experiencing contractions but some tightening as I had been the last few days. I sat in the lounge and had something to eat and felt the need to get in the shower. I got into the shower and almost automatically onto my hands and knees. The warm water felt amazing. I was in a blissful state as I knew that my baby would be born soon, even if not today – soon! I washed my hair and got out and was freezing cold and I started experiencing contractions, absolutely no pain but an amazing power that I didn’t know my body possessed. I got back into the shower and just breathed and whispered the word OPEN every time. I sat on the floor and my waters broke (around 6am). I felt an instant release and the power became stronger. I got out of the shower and tried to get warm. Checked my baby’s heartbeat and called my midwife. I experienced a contraction when I was on the phone to her and she commented that they sounded pretty strong at this stage. I thought I was just getting started. I woke my husband and son at my son’s normal waking time (around 7am) and told my husband that this would be the day. He was calm and excited. I got back into bed and laboured there for the next 2 hours or so. In this time my doula arrived and helped my husband set up the birth pool. I didn’t want to get in too early as I know this slows the labour down. My husband made me some breakfast and kept offering me water and coconut water to keep me hydrated. At this stage my endorphins had kicked in and I literally felt high. I was floating on air between contractions, kissing my husband and son and feeling generally so happy and well.
I could feel a contraction coming on because I would start leaking water and I would be able to completely relax my body and just welcome it and not fight it away. At about 10am I decided I needed to get into the pool, and my midwife thought it was a good idea to try and spread my contractions apart so that she could make it in time. The water felt good but it wasn’t that amazing release that I hear so many people say it is. The warmth was the best part for me as I was quite cold the whole morning. My friend had made a floating pillow for her labour and I had borrowed it and it was absolutely amazing as I could sleep between contractions.
I was listening to my hypnobirthing CD, Eddie Vedder and Ani de Franco, and my husband and doula would occasionally read the affirmations I had stuck up around the room. At around 11am I started feeling “pushy”, my body was bearing down and I couldn’t believe it had happened so fast. I checked myself and I could feel baby’s bum right down, about 3-4cm near to the entrance of my vagina. Pushing through the contractions now felt much better than just breathing. I didn’t push with everything at this stage as I wanted the midwife to arrive and check that I was fully dilated (sometimes the urge to push comes a bit early with a breech baby). She arrived at around midday and checked and gave me the go ahead to push as much as I wanted. The pushing felt amazing. I’ve never experienced such command on my body before, the sounds I was making were guttural and animalistic. Around an hour in I started to feel quite a bit of pain in my legs from the previous injury that was extremely uncomfortable and I decided to get out of the bath. Then the gymnastics started, I pushed in every possible position that felt good. My baby was fine and happy the entire time. At every stage of this labour I had felt completely secure and happy in what was happening. About 2 hours into the pushing I started to have a feeling about the baby’s head being stuck. I couldn’t quite say what brought it up but I verbalized the fear hoping that I would be able to release it and continue. My midwife gave me some direction as to where to push. I knew at this stage that I had already made the decision to transfer. I was completely calm, ordering everyone around to pack a bag and dress me and preparing my son, my amazing doula child, to go visit his granny. I felt no fear in the decision, it was just something that had to be done. My still body bore down with each contraction. With retrospect discussion with my midwife and what I suspected, my baby’s head was deflexed and not able to navigate the pelvic brim in order to descend. A breech baby, even more so than a vertex baby, needs to be in the perfect position to birth easily. We travelled the 30 minutes or so to the hospital and with a little confusion I was admitted and checked by the doctor. I think he panicked a bit when he realized I was full and pushing but I knew that baby wasn’t going anywhere anyway. I remember joking with him to take the baby out with forceps. The anaesthetist was lovely and calming and inserted the spinal during a contraction which meant I didn’t feel the needle. I couldn’t sit on my bum as the baby’s bum was literally right THERE, the pressure was immense. The spinal kicked in and the gynaecologist came to speak to me about my wishes (delayed clamping, no vitamin K, skin to skin etc.) and said that they would do as much as they could to accommodate us. He had read my entire birth plan AND distributed it to the maternity ward so they all knew our wishes too. I knew I was in good hands and was able to surrender once more. Our little BIG baby came out with very swollen genitalia as I had been pushing for a fair amount of time with the rump in my birth canal and we all battled to tell the sex. Eventually we confirmed she was a girl and I just cried with joy. Her cord clamping was delayed, she was suctioned only gently and she went onto my chest. The nurse who was in theatre with us came to me and told me that they would absolutely not give vitamin k and I didn’t need to worry. My husband went up to the nursery with our darling girl and got to spend time with her. She knew his voice and was looking at him the whole time. At no time was she away from one of her parents.
They stitched me up and I went straight up to my room and as my naked baby was put onto my chest, she picked her head up herself and instantly latched. I balked at her weight (3.95kgs – a person with a unicornuate uterus is not meant to be able to grow such a big baby!) and size of her head. She lay skin to skin with me, no nappy, for the entire night, nursing whenever she wanted to. My recovery has been infinitely better this time and I am still running high on those endorphins I was able to experience. I took my placenta in smoothies for the first 2 days and am now taking them in capsule form. My milk came in within 24 hours and I’ve had to reduce my dosage as my supply is abundant. My sweet daughter is my greatest pleasure and I’m at my happiest when she, myself and my son are cuddled in bed reading books or chatting. This time is so sacred and I’m reveling in every minute of it. What a pleasure to be a mother, and what a journey to experience. I KNOW I am powerful, my body hasn’t failed me – it has surpassed every expectation I have ever had and I am powerful knowing that all the decisions I felt convicted to make were the right ones for us. Our sweet Rori is now a week old and it seems like she has always been part of our home. What a faithful God I serve who guided me, and what an amazing soul who waited for me all those years, my sweet goddess of a daughter, my healer who taught me to yield and who made me take back my femininity and power.