Wednesday, 1 February 2012

My VBAC Story

After the birth of our third son, via emergency section, the thoughts of having another baby were somewhat daunting. I knew our family wasn’t finished but I was very nervous about “going again” due to the drama surrounding Liam’s birth.  But one sunny summer day in 2010 saw me looking at a positive pregnancy test.  I knew my body could handle another pregnancy and a birth but my concern was how my caregivers would “ handle” me.  My GP had already told me that should I fall pregnant again, I would be given a “trial of labour” and at 6 weeks post delivery, I knew straight away I would have my work cut out for me trying to have a VBAC (Vaginal Birth After Caesarean Section).
I was mildly surprised then, at my first ante natal appointment to be asked if I wanted to “have the baby myself” and when I said yes, I want a VBAC, I was told this was the best decision.  Things were looking very positive indeed and I geared myself up for a natural birth. 
I was convinced from about 8 months that I was going to have the baby early.  He was very low down and I was getting regular and quite painful Braxton Hicks.  All of my clinic appointments were great.  I was receiving great support from the midwives and the consultant about my VBAC and I was full of confidence and very much looking forward to the birth. 
Then things shifted slightly.  I was on the final stretch and my previously ok’d birth plan was now looking like a school report.  The ground underneath my feet was beginning to feel decidedly shaky and I could feel my VBAC being taken away from me.  This was a blow to my confidence and to make matters worse, at one of my third trimester appointments, the consultant felt that my fluid levels were a bit low and I was sent to the hospital.  This happened again a few weeks later, but this time I was kept in overnight.  All of this only served to confuse and frustrate me.  I had been told that because I had already given birth myself twice before, the odds of me doing so again were high.  But every time I attended an appointment they contradicted themselves and made me feel like a number.  
Having been convinced that this baby would arrive on time or early, suddenly I was gone past my estimated due date and found myself at yet another tormenting clinic appointment.  I wasn’t a bit surprised to find it was the same scenario, in fact I was probably expecting it.  Each time it seemed to be getting more serious and again the fluid levels were found to be low. Lower in fact than the previous week. This time the consultant was finding it hard to get a reading of 4cms. He wasn’t even getting, he said, four proper pools of fluid. He thought it best that I go to the hospital on that Friday morning for ARM. (Artificial Rupture of Membranes)
I was still all this time, getting cramps and there was lots of show so I was hopeful things might happen of their own accord. The anxiety of that pending Friday morning interfered with my sleep so I was able to add tiredness to my stress levels. Everything in me and all I believed about Mother Nature doing her thang when she was good and ready, convinced me that I would not need any interventions at the eleventh hour.  So when I was examined on Friday and found not to be favourable for ARM, I didn’t know what to do. The doctor decided a sweep might help things soften and I would be assessed again the following day. Against my better judgement, I agreed to be “swept” and then Mister Husband and I were free to walk to our hearts content. We spent a lot of time walking the hospital grounds and I could feel the baby’s head in my pelvis. It was quite uncomfortable, kind of a bone against bone sensation and I had to stop frequently to catch my breath. Cramping was also slightly stronger but nothing to write home about.  It wasn’t lost on us that this was the first time in, we couldn’t remember when, that we were able to have several uninterrupted conversations.
The following morning saw me sat, waiting alone in the labour ward for the ARM assessment with just Matt Cooper on headphones for company. Oh, and the poor lady in active labour across the hallway. Nervous? Anxious? Me? You must be thinking about someone else.
This time it wasn’t so nice; not quite as comfortable as the day before. Of course, it didn’t help that the doctor was quite serious in his approach. None of the other doctor’s cheery banter and very politically incorrect comments to take my mind of things. I was also fixated on the plastic implement he kept waving as he spoke. I can’t look at a plastic ice-cream spoon in the same way anymore! I was very posterior so there was a lot of digging and pressure as he attempted to “pop” my waters but there were none forthcoming.  To be honest I was a bit relieved, thinking they were obviously correct about the fluid levels being low. From that moment on, however, I was officially on hospital arrest. I was to be constantly monitored which meant no lovely walks outside in the hospital grounds. I would be lucky if they “allowed” me to walk the hallways. There was to be a cannula inserted and I was fasting also. That put paid to the cappuccino and chicken tikka panini I had great plans for. I was ravenous and it was only 11am. I drew the line at being “gowned up” and wearing the paper knickers the midwife produced. My own granny knickers were seriously unsexy but I was wearing my own clothes, thank you very much! 
I made a quick phone call to Mister Husband who arranged care for the boys for the afternoon and he hot footed it to Kilkenny. When he arrived I was back in the labour ward and hooked up to the monitor. This ball and chain remained tightly secured to my swollen belly until I gave birth. I was sitting on a gym ball and contractions were still not doing anything much but they were definitely there. I alternated between standing at the side of the bed and bouncing on the ball. At about 4ish, our lovely midwife, Maria, asked if she could examine me. I was still very posterior and she wasn’t able to tell how dilated I was without really getting in there. I asked her not to do so and she said she would go in search of a midwife with nice, small hands. I had stated in my birth plan that I wanted VE’s kept to a minimum. The next midwife managed to move the baby’s head and on finishing the exam, there was a release of water. Seconds later followed by another. (A day later on reading my notes, it made for interesting reading to find that I released “copious amounts of fluid” and I continued to do so regularly for the next few hours. Hah! I thought, so the fluid levels weren’t low after all. But I digress.)
From then on there was a noticeable change in the contractions. They were more frequent and increased in strength. I stood at the side of the bed for the next hour and a half and filled my head with a home video of the three boys and played it over and over again. I closed my eyes, slowed my breathing right down and with Mister Husband standing behind me, I swayed and rocked gently.  Gravity is the labouring mother’s bestest friend.  Stand, walk, walk some more, keep standing, sway those hips and your body has no other choice than to allow the baby to move downwards and out into the world.  Mister Husband had his arm looped around my neck and I was able to put my face in the crook of his arm and inhale him. It was lovely. It really was. I kept visualising the kids, in particular our then youngest who was 21 months old.  I imagined his smell, his messy hair at the nape of his neck, the way he would wrap his legs around my waist when I hugged him, his mad grin. I shut the whole world out except for my home movie.  I rocked and swayed and at times felt Mister Husband stroke and kiss the side of my neck. I felt so safe, secure, protected, supported and loved. It was lovely. I remember whispering to Mister Husband that I was sorry for not talking to him and he said “you’re in your zone. Stay there.”
I had a cramp in the back of my thigh which was annoying and every so often I would sit on the gym ball to relieve it.  I noticed when I did this, the contractions stopped straight away. But I needed the odd break and didn’t stay seated for long. Once I stood up again the contractions picked right up and I felt each and every time, a nice trickle of water being released. I could feel the baby moving downwards all the time. It was almost time for Maria to finish her shift and a quick peak at the clock told me it was after 7pm. Just three hours after true labour began.  Maria said she felt our baby would be born in an hour and as if to give me a boost, she opened the birth pack and turned on the heat lamps. She asked to examine me again and found I was still very posterior but she reckoned I was more than 4cm, possibly 5 or 6. Mister Husband kept telling me it was just a number and reminded me that this was proving to be the very same as our second son’s birth.
It was hard to hear I was 4cm but I was starting to make different sounds and I knew I was in transition. Maria had left after a quick squeeze of my hand and a kiss on my forehead, and the new midwife asked me to tell her if I was feeling pressure. I was but not in my bottom. She told me not to worry or focus about this, to let another contraction or two do its thing and then she would examine me again. On doing this she said there was a bit of a lip and I needed to give it a couple more minutes. I was almost there.
At this stage the contractions were difficult to manage and thoughts of the epi began to make an appearance. I was covered in a thin sheen of sweat and shaking a little bit. I was definitely making birth sounds and finding it hard to focus. I had to really concentrate to calm down. After about 20 minutes or so there was different pressure and the midwife asked me to climb up onto the bed when the next contraction ended. I think she thought I was going to give birth standing up. To be honest so did I!! I didn’t think I was going to be able to get up on the bed but I somehow managed it and the midwife declared me ready to go. As if I didn’t know!!!!!!
I rolled onto my side; my leg was unceremoniously and without care, hoicked up into the air. The pressure was animal, unreal and I was so aware of the ejection reflex. I let out an almighty bellow that seemed to come from deep down inside me and with one push I felt the head being born. The cord was wrapped and there were lots of shouts and roars at me to “pant, pant”. I couldn’t hear a thing so they had to shout. There were two more incredible pushes and our fourth son, all 8lbs and 13 oz of him was born after four hours and nineteen minutes. I kept saying “I can’t believe you’re here, I can’t believe you’re here” and then “I can’t believe I’m not pregnant anymore,” much to the amusement of the midwife. He latched on straight away and oh god, the rush of adrenalin. The power, the return of the control I thought I had lost over the previous few days. It was amazing. It was so intense.
I “opted” not to have pain relief for the simple reason pethidine makes me sick and gas and air just burn my throat. And I can honestly, hand on heart, say that I didn’t need the epidural. Yes, transition was bloody tough. Very tough indeed and there was a definite “oh crap, I can’t do this” moment. But I regained my focus and did my best to let my monkey do it (Thanks Ina May). *
A little over four years ago now, I made my first enquiries about hypnobirthing, in particular, Tracy Donegan’s home course. (Birth Hypnosis Programme. Gentlebirth CD’s.  The Secret to a Positive Birth). This was when we were expecting our second son.  Fast forward to our fourth born nine months ago, and I can confirm with absolute certainty and delight that it truly does work. Forgive the irreverence but I recall saying to Mister Husband afterwards, “that shit really works. It really does!” This time round I found it nigh on impossible to listen to the CDs on a regular basis. In fact it was only in the three weeks prior to giving birth that I made a strong and conscious effort to listen to the VBAC affirmations. I used to put the CD on in the kitchen and try to listen to it over the shouts and roars of the three boys, but I did, however, manage to listen to it at night in bed. I do realise that this was my fourth baby and my body, having been there before, was nicely tuned into how to give birth.  But even with a first baby, your body knows what to do.   I am also of the firm belief that hypnobirthing helped me during a very frustrating and anxious few days when all I could hear was a very definite underlying, “well, we’ll probably end up sectioning you anyway.”
At the end of the day once you and your little bundle are delivered safely, that is all that matters. But I believe it is also very important that we as women are listened to and allowed the chance to birth our babies the way we want to. The way we are able to. I wish each and every pregnant lady reading this, the very best of luck and that you all get your heart’s (and your body’s!) desire.
If you are still reading, thank you and I hope my story serves some hope and inspiration to you all.
Some books I found to be of immense help to me are mentioned below.  If you decide to read any of them, I hope you find them as interesting as I did.
*Ina May Gaskin’s “Ina May’s Guide to Childbirth”
Tracy Donegan's “The Irish Better Birth Book” and “The Irish Caesarean and VBAC Guide”
Marie Mongan “Hypnobirthing:  The Mongan Method”

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