My VBAC Journey


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My VBAC Journey

26 June 2014

My VBAC journey started 24 years ago.

As they all do – with an unplanned and unnecessary C-section; after I was induced. Labour had spontaneously started and then stopped at 38 weeks. Baby went into distress after 9 hours of induction. Robert was born weighing 3.11 kg. My parents were in theatre with me and took photos of the C- section. I was under general anaesthetic. I woke up and was told: “You have a son…”. I was only allowed to touch his little foot after begging them for an hour… This birth set me up on a journey that would eventually lead to my successful HBA2C (Home Birth After 2 Caesareans)

Here is my birth story:

Soon after my first birth my aunt gave me a book called Vaginal birth after Caesarean, which I never read.

19 years later in 2009 I was pregnant with my 2nd baby and my eye fell on this book in the bookcase. I read it and was convinced that this was the way I wanted to birth my child this time. As I was a state patient (no medical aid, so no private hospital) I was allowed the opportunity to try for a VBAC without any objection. Granted, this was at Mowbray Maternity in Cape Town which is a specialised hospital.

My water broke at 41 + 3 weeks at 03:00 and by 09:00 I felt it was time to go to the hospital as the contractions were 5 minutes apart. Once at the hospital I was checked into a general ward and my husband was not allowed to be with me except for visiting hours – it was terrible! So I laboured all by myself, contractions getting stronger and stronger… walking up and down that hallway… hugging the wall and swinging my hips with every contraction… until I insisted they check me at 19:00 and I was found to be 7 cms dilated. I was transferred to the active labour ward and finally hubby was allowed to be with me. I was no longer allowed to be active… a monitor was strapped to my belly and I was told to lie as still as possible even through contractions so that they could get a clear monitor reading of baby’s heartbeat. It was hell! By 06:00 the next morning I was so tired and feeling as if there was no end to this birth… I had been in labour for more than 24 hours and the contractions were becoming unbearable. I begged for pain relief and finally was given some morphine. It was however around this time that I also started feeling the urge to push. My body started bearing down and I was coached to push lying flat on my back (yes, I know..). After 1 1⁄2 hours of pushing her little head started crowning and suddenly we saw panic in the doctor’s eyes. Baby wasn’t coming out and I was too tired to push anymore. The doctor called for help and with a nurse on each side with my feet on their hips and hubby behind me pushing me up, I gave one more push and the doctor pushed her hands inside me and pulled baby out. I tore badly… 16 stitches. Millah was born weighing 4.065 kg and was rushed off for oxygen, but was back and on my chest skin to skin within 10 minutes. I was on cloud nine for the rest of that day. My family were incredulous that I had birthed such a big baby and that I was smiling so much after such a long labour, but I just couldn’t stop smiling!

2 years later I was 37 weeks pregnant with baby #3 and at my gynae for a last scan. He had agreed that I could try for a VBAC – looking back I realise he was never eager and never encouraging, always noting at scans how wide my baby’s shoulders were. At this scan he showed me how the umbilical cord was wrapped around my baby’s neck and that if this was his wife, he would absolutely do a C-section. He also described how if I went into labour now, the contractions would cause the cord to cut off my baby’s oxygen and blood supply and my baby would die or be brain damaged. I sat in my car in front of the doctor’s office and cried… I remembered the photo’s I saw of my first c- section… the blood, the ripping my tummy apart (my mother had graphically described the whole operation to me)… I was petrified! Hubby was so supportive on the phone – he calmed me down so that I could drive back home. And so we scheduled the C-section for the next week at 38 weeks. I remember being so scared that whole week that I would go into labour after what the gynae had told me. As I was lying in pre-op, I was fighting the panicky feeling. Knowing what would be happening on the other side of the green sheet while I was awake, was terrifying! During the operation I insisted my husband keep looking at me so that I had him to focus on. I was so scared of hyperventilating and being put under… Reuven was born at 38 weeks weighing 3.8 kg. Lying in post-op I was all alone, heart aching to see my little son. I only saw him 45 minutes after he was born… Recovery from surgery was very difficult and took much longer than with the VBAC.

Fast forward 3 years. I was 26 weeks when I discovered the VBAC in SA Facebook group and Marianne Littlejohn – the only midwife who would give me a chance to at a home birth after 2 x c-sections (HBA2C). First we thought I would have to go to a town that had a hospital (our little Villiersdorp doesn’t have that luxury and a hospital is a 40 minute drive away) but as I continued my research and gained knowledge and confidence, I decided to birth right here at home where I was familiar with my surroundings and had my husband and children with me. As Marianne was going to be on holiday around my due date, we met with Debby, her trainee midwife, who lived an hour away from me. Hubby was not very excited about this homebirth adventure we were embarking on, but I sat him down one day and shared with him how I had experienced the c-section of our son. The cold, stark surgery… the fear while they were cutting me open… the terrible feeling when they took my son away straight after… lying in recovery on my own for 30-45 min afterwards wondering where my baby was and how he was doing… not being able to pick up my daughter for so long afterwards… sleeping on the couch in the lounge for 2 months because getting up at night hurt so much…

You see, to hubby it was the most wonderful carefree experience. Take the baby out and recover. He didn’t realise how I had experienced it at all. Now he truly saw how it had affected me and our son.

And so my pregnancy continued with only one more scan at 28 weeks, no internals (yes, NO internals!!) and just generally learning to tune into my body and listen to what it was telling me. At 32 weeks it seemed that baby had turned breech so I started looking at breech birthing videos on Youtube whilst doing the spinning babies moves to turn her right again. Nothing fazed me anymore. Gaining knowledge is just so empowering! Especially reading birth stories, watching birthing videos and chatting to my midwives about every possibility that came to mind. And of course hubby was praying for a good outcome all the way.

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At 38 weeks I was very uncomfortable. This baby was so low! I could not stand for very long… or sit… or lie.. Then we got the news that my granny had died after a long illness. I was heartbroken… she would not be meeting my little Leah… On Friday we went to the memorial service, leaving straight after as I was so upset that I couldn’t control my emotions. Saturday morning I woke up feeling period-like pains around my lower belly and lower back. I spent the day relaxing in bed because Marianne (midwife) wasn’t due back from holiday for another week and I really wanted her to be here. By Sunday evening the contractions were definitely regular at around 10 min. Debby (trainee midwife) and her doula friend came over that evening around 19:00. I walked around, finished off some work and just chatted with everyone as the contractions still just stayed around 10 min. At midnight I went to bed and woke up the next morning with the contractions completely gone. Debby left again.

I realised that I’d have to hand over my workload and so spent the whole of Monday and Tuesday finalising work – it was very stressful (I am a travel agent) as I had not planned to hand over until the next week! On Tuesday evening 18:00 I was at my wits end with my 3 year old son. As I snapped at him–Pop! I wet my pants! I walked to the bathroom, sat on the toilet and realised that my water had broken. I sent Debby a message and she said she would come over soon.

Between 18:00 and Debby’s arrival at 19:15 I started having a few more painful contractions and my blood pressure rose a bit. By 21:00 my blood pressure was even higher and on Debby’s suggestion I went for a bath to relax. Contractions were now 3 minutes apart. In the bath I felt the contractions become more intense and ended up lying on my side to get that floating feeling – it works wonders! At 22:00 my blood pressure was normal again, some mucus plug appeared, but the contractions subsided to every 9-10 minutes. (Pretty sure this is where I would have gotten my c-section for “failure to progress”!!) I went to bed and got up again around 01:00, feeling restless and uncomfortable with lower back pain and mild contractions. Went to bed again at 03:00 and slept until 08:00 – woke to contractions every 9-10 minutes. Debby assured me that us VBACs do this. The contractions prepare our scarred uterus in a gentle way and so I just relaxed into it.

Debby was however concerned that we should get labour going within 24 hours after my waters had broken to avoid infection (I started taking Echinacea for this). She advised us that the protocol was to refer to hospital if there was no labour within 24 hours, but that is was ultimately our choice. I started walking all over town and these were faster walks than I had ever taken in months! Still only mild contractions. At midday I drank some castor oil – boy that stuff works to clean out your system!! – but still no active labour. I slept for 2 hours that afternoon – contractions were a bit more regular, but still not strong.

At 18:00 Debby asked us to consider going to hospital. I knew that they would cut me open… I looked at my husband and said: “Aren’t there more bugs in a hospital than at our own home? Isn’t there more chance of infection there, where they would do internals?” So with common sense as our weapon, we decided to stay at home. I had not had any internals during my entire pregnancy and labour so far and did not intend to have any. It was not really a conscious decision to not have internals, I just didn’t need to know how far I’d dilated. It wasn’t an indication for me of how long it would still be. It would take as long as it took and no amount of knowing how dilated I was, was going to change the process.

Suddenly things started changing. An hour later the contractions became more intense and regular at 3 1⁄2 minutes and 40 secs – 1 min long and by 21:00 it was every 3 minutes and I had to stop mid-sentence when having one. Yay! Things were starting to happen and I felt a relief sweep over me. BUT my blood pressure rose again and I went to have a relaxing bath. The contractions kept on coming and stayed at 3 minutes and 40-60 secs long for the next few hours. I went to bed to try to get some sleep at midnight.

Around 02:00 I woke to strong contractions. Hubby was sound asleep next to me and Debby had also gone to sleep on the couch in the lounge. The house was quiet and I was lying there trying to keep quiet as the contractions just got more and more intense. Eventually I couldn’t lie down anymore, so I sat on the bed rocking. That didn’t work, so I got up and started walking through the house. I was timing my contractions on my phone and they were still every 3 minutes at 50 seconds long, so I thought this was just going on as it had for so many hours. Then at 03:30 it started getting intense. So much so, that I could no longer do the timing myself. I woke hubby up with a smack on the arm, saying: “Time this!!” Poor guy didn’t know what was going on. Contractions were now 1 minute apart and 1-1 1⁄2 minutes long – here we go!!

I woke Debby at 04:00 saying things are definitely happening here – I need her!! I was so desperate to get into the birthing bath that we had set up in the room, but it was still empty. Debby had put us off filling it because it could stall my contractions. Now I really needed it and hubby had jumped into action. While I’m sitting on the bed, draped over a pile of pillows breathing through every contraction, hubby is running back and forth between our en-suite bathroom and the bath. Filling it as fast as he can. I started feeling pressure, but no bearing down yet. At 04:20 I literally jump into the bath – I am now so desperate for the floating feeling of water that no amount of “No the water isn’t warm enough yet!!” from Debby could keep me out of that bath. The incredible relief of that water is indescribable and I just wish I had done it much earlier, because within 20 minutes I started feeling like my whole body was trying to push this baby out. The bearing down was so incredibly strong. I breathed and relaxed through the first two without Debby even realising it was happening – I just didn’t have the breath to tell her, but when the third one came I was desperate to push and instinctively knew that it would be such a relief, so that’s what I did. I pushed! Debby then said: “Hey, are you pushing?!” and I said “Yes, I have no choice!”. Little did I know that she had phoned Lana (2nd midwife) and Lana was still a few minutes away stuck behind a truck on the pass. Within 10 minutes of pushing with my body’s bearing down, I felt the ring of fire and knew that my beautiful baby girl was about to come into this world. I was so excited! I reached down and sure enough, I felt the mushy head crowning just before I had another urge to push and her head slipped out. I was elated – the worst was over! But it wasn’t… instead of feeling another urge to push her little body out, Leah started making jerking movements that were quite painful to me. I told Debby something was wrong and Debby said I needed to get out as she couldn’t see what was happening in the water.

Now I can tell you that I had no strength at that stage to be getting out of that bath, let alone do it with a baby dangling between my legs, but somehow I managed to gather the strength and pull myself up by my arms and lift that leg over to hop onto the bed. Debby had by now realised that little Leah had her shoulder stuck behind my pubic bone (shoulder dystocia). I went onto all fours on the bed and then turned over onto my back with Debby’s help – Gaskin Manoeuvre. Debby then managed to help baby out by slipping her finger in and guiding baby out.

During all this time I had no urge to push, but Debby insisted that I push as she felt that it was already 12 minutes since her head had been born and this was way longer than the textbook allowed.

Leah did not start breathing immediately. In fact, it took so long to get her to breathe that there was mild panic in the room, but as I sat there with my baby girl lying between my legs, I knew she just needed time to adjust to this world. I rubbed her back and gently spoke to her, hubby was hovering over us praying audibly, while Debby cleared her pathways and applied PPV, also praying fervently. It took about 3 minutes (a very looong 3 minutes!) for Leah to start crying and turn pink. Lana finally walked in just as we all breathed a sigh of relief.

We waited for the cord to stop pulsating which took 30 minutes and then I cut it. Leah wasn’t interested in latching, but I kept her skin to skin while I birthed the placenta and Lana stitched my small 2nd degree tear (extremely painful!!) Then my good friend, Adilia, who had been pacing the hallway all night, helped boil water and just prayed nonstop, came in with a delicious tuna sandwich and rooibos tea – now that is something I would never have gotten in hospital!

It was time to weigh the baby – a whopping 4.68 kg!

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I am so grateful that Debby was there to help with the shoulder dystocia as it was something I had not read up on. I can sincerely tell you that throughout this home birth I never experienced any fear. I never felt any pressure and no anxiety whatsoever. The only thing I would do differently is to utilise the birthing bath/water more effectively. I can truly say that I’ve experienced every birth option – CS under general, VBAC in hospital, CS with spinal block and home birth VBAC – and of these the home birth was the most amazing and incredible experience. It was as humbling as it was empowering and we, my husband and I, are changed because of it. I hope that this story will inspire more women to take their births home where they belong, where no interventions are possible and you have the opportunity to truly connect to your body and your baby during birth. Lots of hope and love to you all.

 

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by Tasmin