Two weeks before my due date I was getting strong practice contractions (Braxton Hicks) on and off throughout the day and night. Although it was my 4th pregnancy, I had never experienced labour before, not one contraction so there were many times where I thought ‘is this the real thing??’
During the evening and night of Sunday 26th June I was having Braxton Hicks contractions every 5-10 minutes that kept me awake but I felt sure that they were just practice and by morning they were still around but only every 30 minutes or so.
I carried on as normal as they didn’t seem to be ‘real’ contractions. It was a heat wave and I was so uncomfortable! I did the school run as usual and at lunch time my husband, Joe, decided to come home and take the afternoon off work. We now believe he had a feeling he should be here with me and we were right all along. In the late afternoon the pains continued and by evening I had to really concentrate through them and could find no relief no matter what position I got into.
At around 10pm I got into bed and tried to sleep but the rushes kept coming. I left Joe to rest and went to have a bath, sure that the warm water would ease the pain, but I was very wrong!
I had a contraction in the bath that was much worse than the ones before. I practically jumped out of the bath and wobbled downstairs to wake my husband. I felt we really needed to call a midwife as I was having very strong contractions.
I called ‘Medicom’ (a bit like a midwifery switchboard) at 11:30pm and was told the midwives would be here in 2 hours as they were at another birth. That seemed like forever to me and I felt things were getting out of control. I was very tired and wasn’t sure if I was even in labour. I had a ‘show’ and was bleeding quite a bit on and off.
I spent a lot of this waiting time leaning over the sofa breathing through the pain with Joe massaging my lower back hard every time I had a contraction.
The midwives turned up and I immediately asked for gas and air! I was not a happy bunny when I was told that I couldn’t have any as they didn’t have much and didn’t want to use it all at this early stage.
The midwives got me to lie down while they felt my tummy to see where baby was positioned. This hurt a lot and I jumped up and rolled over with another contraction. I was told that the baby was posterior (baby’s back facing my back). This really upset me because the baby had been anterior (baby’s back facing my front, often called the optimal position) all the way through the pregnancy, mostly on the right but pivoted towards the left in the last few weeks. Now I was worried how everything would progress now that baby’s position had changed.
I carried on contracting while everyone chatted around me, really not knowing what was going on. I was then told I was not in established labour and this could take a while. I have to admit that this crushed me. I was in a lot of pain, very tired and nobody could do anything to help me. I was advised to have a bath, relax, and try to get some sleep. I didn’t see how this would be possible as I was having painful waves every 5-8 minutes. I did have a bath, however, and although I hated being in the water due to not being able to move around fully, I did feel a bit calmer afterwards and managed to rest in bed between contractions.
The next day (Tuesday, day before my due date) was my husband’s birthday. I contracted quietly while he opened his presents and then he got the children ready for school while I moved into my ‘nest’ which was our boys' bedroom (the biggest and most comfortable room). We had planned to celebrate his birthday and I even made a cake the day before that never got iced!
By this time, I had been getting a lot of pain around my lower back and these strong pushing urges in my bottom that were impossible to control. I had never read anything about this before so I wasn’t sure if it was ‘normal’ or not but it was not nice! I now know it was the baby’s head pushing down and part of the posterior labour I was having. The contractions were still 5 minutes apart and occasionally closer and I wasn’t sure if I was any nearer to giving birth. In fact, through the whole labour right up until she was born, I still thought I had days left!
I spent a lot of this time on all fours. My whole plan had been to stay active and walk the contractions out. Although a couple of times I did walk fiercely and stamp with a contraction, mostly I just couldn’t cope with the pain of being upright. Joe encouraged me to walk so gravity could do its job but it felt like I was being torn in half every time I contracted standing up! When I wasn’t on all fours I was on the toilet with the strongest pushing urges in my bottom that made my uterus and lower back convulse. That scared me.
While having contractions I breathed in Ylang Ylang essential oil on a tissue which was very soothing. It had an almost trance-like quality to it, which was comforting during this time.
At about 12:30pm I was on the toilet with another strong contraction that made me push in my cervix and my bottom and I felt something come out of me like a plastic bag. That was my bag of waters!
The next contraction propelled me off the toilet with such force that it landed me on the floor. I had a tremendous involuntary push and screamed as my cervix burned. I shouted for Joe, this really scared me. I thought the baby was coming right away and my husband knew it was time to call the midwives again.
During the pregnancy I didn’t know how I would feel about having midwives in the room with me and I worried it would slow things down. But when actually in labour I was SO grateful when they turned up at 2:30pm. They quickly felt baby and listened to heartbeat and said baby is now anterior which was such a relief.
I was really starting to lose it at this point. I remember saying I want to go to hospital and just have a c-section. The pain was more than I could bear and I hadn’t slept in a long time. I was so tired I just wanted it over with at that point. I am so grateful to my husband for keeping me strong. He reminded me how long I had wanted this birth at home and that we were close to our dream.
I still thought I could be here for days and I said as much! The midwives thought it wouldn’t be too much longer though. I was still on all fours and sometimes on my side to rest. Joe massaged my lower back hard during each contraction. I was not a quiet labourer, I have to say! I was becoming very scared and out of control too which was a feeling I did not like.
I was told later that I had a small round bulge at the base of my spine where the baby’s head was pushing down. No wonder I was so uncomfortable (to put it mildly)!
I asked for gas and air and the midwives started to set it up but I couldn’t get it working! Joe tried to show me how but I just couldn’t do it. I couldn’t take long enough breaths to get anything out so gave up on the only pain relief I could have.
I started having more stinging pushing urges and was asked to be examined. I initially said no but I really believed I had a long time left and the midwife wanted to reassure me that we were close. I had to get on my back for this due to needing to be ‘looked at’ rather than felt (as we didn’t know where the placenta was the midwife didn’t want to feel blindly). It took a while, and many contractions, for me to be able to get into a good position.
I didn’t actually get to be examined though. As soon as I was on my back a mammoth contraction took over and the baby’s head started to crown. This, for me, was the most painful and I did scream a fair bit I must admit. I put my hand down and felt the baby’s head. Everything was surreal at this point. In just three more pushes she was born at 5:34pm on her daddy’s birthday, just 3 hours after the midwives turned up. She weighed 7lb 12oz and was perfect!
It was during a lovely storm and I laboured through thunder and lightning which now seems very fitting.
She was put straight on my chest and I was left to find out that we had a baby girl. That definitely balances out the hormones with the three boys and one girl we already had!
The cord was left alone until it stopped pulsing while our daughter gently nuzzled at my breast. Within just a few minutes the midwife could tell my placenta had come away from the womb and I was helped to stand to dispel it. It slipped out easily without me really needing to push.
I had 2 vaginal tears and lost a bit of blood but all in all everything went smoothly and was a ‘textbook’ birth. The old c-section scars are always the focus when VBAC is mentioned but I’m pleased to say I felt no pain at all around my scar and the thought of rupture never entered my head during my labour.
I have to say I was worried about having NHS care while striving for my HBA3C but my Community midwives were fabulous! Every one i met read my birth plan and I had no pressure from them.
I also want to praise my wonderful husband. He was the perfect birth partner. He kept me strong, and supported me and stayed with me through it all while also doing school runs and making sure our other four children were happy! He was my rock and I will always remember that. He is my hero.
My thoughts on my HBA3C? It was hard and it was painful. I won't pretend it was 'orgasmic' or anything like the ideal 'Ina May Gaskin' birth I had in mind. But it was what it was and that was real and natural and exactly how it was meant to be.
Cesarean Sections, also known as a c-section, is the surgical removal of the baby directly from the uterus. While many women now elect to skip labor altogether (and their practitioners usually oblige,) others are determined to avoid a c-section at all costs. C-Sections are major abdominal surgery despite the short duration of the procedure. An epidural or spinal block is typically administered, although in a true emergency the mother will often receive general anesthesia and be completely sedated for the procedure. The baby is usually born within the first 15 minutes of the procedure and another 30-45 minutes are spent closing the incision.
Maternal risks involved with having a c-section include blood loss, adhesions, organ damage, infection, and extended recovery time. Many mothers who have had a vaginal birth and then a c-section report significantly increased pain and healing time. Having a c-section also increases the risk of needing a c-section for subsequent births. VBAC (vaginal birth after cesarean) is a hot topic among the birthing community. Many OB’s will encourage a mother who has already had a c-section to elect to have another one rather than attempting VBAC citing risks for uterine rupture.
Babies born via c-section are at an increased risk for lower APGAR scores, breathing difficulties, and injury from the procedure. Elective c-sections (performing the procedure before labor begins) also increase the risk of premature birth, since gestation is an approximate estimate rather than an exact science. Some mothers carry all of their children past 42 weeks and go on to have natural deliveries with healthy babies. Other moms go into labor naturally around 38 weeks and have the same outcome. Waiting for labor to begin decreases many of the risks to the baby because the hormones from both the mother and baby work together immediately before and during labor. It is suggested that in a healthy pregnancy, the baby in some way triggers labor (possibly when her lungs have matured enough) through a biological process that we have yet to determine. Electing for a delivery before the baby has finished gestating is likely to increase complications after birth.
It should be noted that cesarean section may be the best option in a few circumstances where it is best for the safety and wellbeing of the baby, the mother, or both. Some of these situations include placenta previa, placental abruption, uterine rupture, cord prolapse, fetal distress, preeclampsia, and active genital herpes in the mother. There are a number of other reasons for a c-section, (including gestational diabetes, baby being in the breech position, failure to progress, and previous c-sections) but these reasons alone are not often reason enough to elect for a c-section prior to the onset of labor.
Many moms who are having c-sections are speaking to their provider of having an assisted-cesarean where the mother assists bringing the baby out of the uterus.
For more information about VBAC, please visit ICAN, VBACFacts, and Improving Birth. The risk of catastrophic complications from a VBAC are significantly lower than the risk of a repeat cesarean. Please do your own research and decide what is the best decision for your situation.
New mums in the UK are not presented with a bill when they leave the hospital, and they leave armed with lots of information too (info on contraception, safe sleeping etc, see below). Each baby is given an National Hospital Services (NHS) number and some hospitals have registrars on site where the baby’s birth can be registered for a birth certificate.
Advice is given on contraception, safe sleeping and post natal exercise. This advice is given from the midwife, the GP (at the six week postnatal check), physiotherapists and health visitors. Breastfeeding support is given at the hospital and many midwives prefer to discharge only when mother and baby are feeding well. Additional support can be sought from health visitors and the NHS itself ( see http://www.nhs.uk/conditions/pregnancy-and-baby/pages/breastfeeding-help-support.aspx), with advice and drop in sessions available in most areas, in addition to trained supporters who can be reached over the telephone. Once discharged, a community midwife will visit the family home the next day to talk to the mum and to check that all is well with the baby. After around ten days, the midwife will discharge mother and baby and the health visitors will take over the care, up until the age of five.
After all of this, I feel incredibly lucky to live in the UK and to have had my children here. My maternity experiences have not been perfect but the care that I have received has been mostly on par with any private hospital. Thanks to the NHS it has not cost me a penny to become the mother of three wonderful children. I have felt supported and cared for during my pregnancies and I firmly believe that our health care system will weather its current storm.
Once a woman is in labour, she is entitled to the very best of maternity care and in most cases, the National Health Services (NHS) provides this HOW?.
Unfortunately, there is a real shortage of midwives in the NHS in England at the moment and so sometimes labour and delivery wards can be very over stretched. This is one more reason why it is essential for pregnant women to know their rights.
Pain relief should be administered ONLY by request and once a woman is in established labour. Medical staff must give mothers ALL details of the RECOMMENDED pain relief should be it be necessary. Pain relief should not be given without consent. If a woman is unable to give consent at the time of an emergency, consent will sought from her next of kin. If a woman is given medication without medical consent, this is a breach of NICE guidelines and the woman has full rights to file a formal complaint which may bring a series of consequences against the medical staff and hospital.
In the UK, an organisation called the National Institute for Clinical Excellence (NICE) exists to provide guidance to medical professionals working in the NHS. Advice is given as to best practise for all areas of maternity healthcare and patients are encouraged to read and understand this if they have any concerns or issues. Currently, guidance exists for:
There is extensive advice for women who go over their due date or who need to be induced for other medical reasons. The guidelines state that “Treatment and care should take into account women's individual needs and preferences. Women who are having or being offered induction of labour should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals” (http://publications.nice.org.uk/induction-of-labour-cg70/woman-centred-care). Detailed information can be found on the site, including advice about when to induce labour and how to manage an induction.
The NICE guidelines advise that women should be entitled to choose their place of birth based on informed decisions. Women should also be advised of procedures that are in place should a hospital transfer be necessary. They should also be advised of the reasons why a hospital transfer might be best for a safe delivery. NICE acknowledges that women who give birth at home are more likely to have a normal birth but that they should be advised of the importance of a hospital environment if the pregnancy is deemed high risk. Ultimately, women should be free to make their own decisions about home births.
Vaginal Birth After Caesarean (VBAC)
NICE advises that good communication between women and their healthcare providers is essential so women wishing to have a vaginal delivery after a section, must meet with their obstetricians to discuss their birthing plans. Women must be informed that the “risk of fever, bladder injuries and surgical injuries does not vary with planned mode of birth and that the risk of uterine rupture, although higher for planned vaginal birth, is rare.” (http://publications.nice.org.uk/caesarean-section-cg132/key-priorities-for-implementation).
Women should be given evidence based information and all cases should be assessed individually. The risks of each type of birth should be presented and women should feel able to make an informed decision without pressure from her medical providers. Women should also be aware of the possible risks to the baby in each case. In some cases, NICE advises that “Consent for CS should be requested after providing pregnant women with evidence-based information and in a manner that respects the woman's dignity, privacy, views and culture, while taking into consideration the clinical situation.”. However, women are within their rights to refuse this and to opt for a vaginal delivery instead.
NICE also provide guidance and advice to medical professionals regarding the success rate of VBACs. It states that “continuous support during labour from women with or without prior training reduces the likelihood of CS” and that. “Women with an uncomplicated pregnancy should be offered induction of labour beyond 41 weeks because this reduces the risk of perinatal mortality and the likelihood of CS”. In addition, the guidelines also note that “Electronic fetal monitoring is associated with an increased likelihood of CS”, which indicates that women opting for a VBAC may request little or no monitoring whilst in labour. However, hospital policies tend to state that monitoring is necessary after a previous section; again, patients are within their rights to refuse. The following interventions are deemed to be of no affect to the likelihood of a c-section: walking in labour; adopting a variety of positions as opposed to lying on a bed; being in water; having an epidural and administering raspberry leaves.
Overall, the NICE guidelines provide women with lots of information as to the risks and benefits of both a vaginal delivery and a repeat c-section.
Pain Relief and Medication
NICE provides ample information and advice about pain relief in labour (http://publications.nice.org.uk/intrapartum-care-cg55/guidance#coping-with-pain-in-labour-non-epidural) and women are advised to discuss all options thoroughly with their midwife before the onset of labour. The guidelines advise of different strategies that have been found to be effective, such as breathing and relaxation; massage and labouring in water. In addition women should be advised that administration of Pethidine, diamorphine and other opoids will have an effect on the baby. Pain relief should not be denied if women have been given all the options and have made an informed decision. If requesting an epidural, women should be informed of all the risks and this should always be administered by an anaesthetist. NICE also advise that Oxytocin, the drug which is used to speed up labour, should not be given as a matter of course for women who have been given an epidural.
Elective Caesarean Sections
Recently, changes have been made to the documentation surrounding elective c-sections. This means that pregnant women are now being given more freedom to choose the way in which they give birth. Previously, a c-section would only be offered to women whose baby was breech or who had a life threatening (to herself or the baby) condition which prevented a vaginal birth. With the new NICE guidelines, women with emotional issues, such as arising from a previous traumatic birth, are now within their rights to request an elective c-section. However, all women are entitled to request an elective section and to have her request considered appropriately, whether or not she has suffered from a traumatic birth previously. The new guidelines also state that any obstetrician who is unwilling to agree to an elective section must refer the patient to a colleague who is. Obstetricians are required to take all concerns seriously and to respect a woman’s wishes in these cases. Counselling should also be offered in an attempt to empower women to feel able to give birth vaginally. (http://publications.nice.org.uk/caesarean-section-cg132)
The NICE Guidelines Are Just That- Guidelines
Some medical professionals may choose not to follow them, although this would be rare. The NICE guidelines are composed with the help from medical professionals in a bid to ensure good quality healthcare is provided to all patients. In cases where obstetricians or other medical practitioners do not adhere to the guidelines, patients may make an official complaint to their hospital. This means their case will be looked at and a full investigation will be launched.
This is the story of my third baby’s entry into the world, and how I gained respect for myself again. Evening, November 5, 2002: My membranes ruptured at nearly 38 weeks pregnant with my son Mathew. I wanted our birth to be natural and drug free, as this is what I had read what was best for mom and baby: to let your body do its thing during labor and childbirth. As soon as I arrived at the hospital I was on their clock. 1st intervention: Pitocin after an hour. Then more Pitocin and more monitoring. He was born the morning of November 7th, via ‘emergency’ caesarean. My recovery lasted weeks. (I finally started to have feeling in my lower abdomen around the time Matt turned 2 years old). He was weak, and bruised, and stayed at the hospital for a week for observation. Feeling as if I had already failed in providing a safe environment and a good start, I died a little inside then.
Morning, November 27, 2008: Contractions start at 40 weeks 5 days gestation with my daughter, six years later. I didn’t have much support. I received a lot of negativity from numerous people about my decision during my pregnancy. But I was hell-bent on having the birth women were intended to give their children. I was not going to take shit from anyone. When I felt ready to go in, my husband knew not to let me sign the surgery consent form. I go in to the hospital, and I automatically deny the surgery. The pressure’s on, along with comments of “you’re going to end up with a dead baby”, “you need to be quiet, you’re going to upset the other women in labor”, and “you need this IV and cervical check, stop squirming”, and “the anesthesiologist wants to send you to Spokane because he has to stay up here for you, away from other patients that need him”. My husband was scared and he had the bullying turned on him. He didn’t want to see me in pain. I was so vulnerable. I gave up, and gave in. And I died more. I feel they took part of my soul with the epidural insertion, along with my dignity. There was nothing left in me to care for my child, or myself. I was just a shell, walking around withthis vacant look in my eyes. Physically I healed slowly. I wasn’t strong as I had initially believed about myself, and most people let me know it.
At 1ish AM, December 1st, 2011: I am 40 weeks 5 days with my 3rd child, unknown sex. I have had consistent prodromal labor for what seemed like months (was more like a week, 10 days maybe),getting more intense each session. This one contraction woke me up. I went to the bathroom, walked around, chugged a glass of water. They kept coming. Meditative breathing techniques came in handy.
I was having back labor pains. Those are the worst! I woke Jon up in between a couple, told him I was going to get in the bath tub. He came in with me, and timed them. He called our midwife, Kristin. We were now in rush mode: him waking up the kids and shoving toothbrushes and phone chargers in the suitcase, I leaning over the side of the bed with each wave, and attempting to put pants on in between. We had a potentially long drive ahead of us.
When I found out I was pregnant with Jameson, I probably turned purple trying to not slip into a panic attack. I could not go through what I had before. I could not deprive my kids of their mother again. I would not. Jon and I discussed our options, and decided. We called the 1st midwife. Due to a couple technicalities, not health related, she was unable to take me on. The next midwife was at least 2 hours away. We decided to see if we could find an OB that would promise no pressure.
At about 5 months pregnant I had the worst appointment ever. I found that the OB I had chosen had gone on maternity leave herself until January. The other OB I saw at this appointment said I was stupid for wanting a natural birth after 2 surgeries. He ‘didn’t know of any studies anywhere regarding how successful they are, and frankly couldn’t see one done’. He actually believed that lying to me would make me comply with scheduling a surgery. Like women make decisions like this blindly. Dumbass. I never went to that office again.
I had emailed the 1st midwife and begged her for help. Jon and I had discussed unassisted birth, as a last resort, but I still needed the care and support. She gave my number to Kristin, a midwife a few hours away that was willing to talk with me to see what she could do. I am so thankful for her. We got my anxiety under control, my nutrition on a better track, supplemented by vitamins that made a world of difference. I was urged to do some sort of modified exercise.I was also given resources on birth and vaginal births after caesarean. My light-headedness stopped, I had more energy and could concentrate better. My outlook on this new addition changed to positive anticipation from dread.
Now that I was in labour, we were driving to our midwife. She couldn't come to me, but I could sure as hell go to her. During the drive, my 9 year old son slept. My 3 year old daughter talked. NWPR classical music was on the radio until we lost signal and couldn’t find it again. After that, silence. My husband drove and timed my contractions. I breathed through the quiet times, breathed and talked myself through the contractions, cluthing pillows or the dash. It was a 2-3 hour drive, approximately 180 miles. It sure didn’t feel like it was that long. My contractions were consistently 4 minutes apart. Baby was turned in a way to cause back pain. That was the worst part, besides having to make do with sitting up.
I kept chanting through my contractions: “I’m ok, I’m ok, I’m ok...” Jon would say, “You’re doing great,” and I would reply half the time irritably with “I KNOW...” It seemed to be the mantra of the whole incident. In the back of my mind, I was still worried something would happen and I would fail. I couldn’t fail.
We made it with no incident, between 3:30 and 4 AM. Kristin helped me inside, and then helped get kids situated. Lorri, the second midwife, helped me relax and move the baby by modified child’s pose, enough relief off my back. The tub was up and getting filled. I got my blood pressure taken, and fetal heart monitoring was done periodically by Doppler. I started losing the mucous plug about this time (obviously an indicator I was actually in labor). Kids were situated upstairs; Jon helped me by letting me hold onto him and talking with the midwives about what had happened so far. He also talked with me at this point, though I was not very talkative.
The tub was great. The warmth helped soothe, and the water helped lift some weight pressure off of my pelvis. At some point I just groaned in ecstacy: "I feel like I'm on druuuugs..." (Your body makes tons of oxytocin during labor). Apparently I was pretty funny. I was more comfortable during this time leaning over the edge of the tub on my knees. A few times I lost concentration and was unable to handle a contraction; either Kristin or Lorri was there to help me get back on track. Jon never left my side. Ella, my daughter, came down periodically to see what was going on. Matt, my son, stayed upstairs playing video games. I was worried that he would not go through it well, but he handled me screaming at the end. He didn’t care to be a witness to the dirty work though.
We could tell I was moving into the pushing stage when contractions slowed and came with more pressure. I feel like I dozed in between, alternating sips of water and juice. At one point I just started with this screaming that felt like it came from the very fiber of my being. I don’t know where it came from or who at the time. And oh God, it felt so good to let it all go. After that I felt detached but aware of what I was doing. Each wave came and went. The pressure became so intense. I kept trying to move around to get more comfortable. The head was moving down further and further, and I could feel everything.
During this time I remember sobbing a little, saying “I can’t do this” over and over. I’m not sure to what context I was talking for; I knew I still didn’t want to actually give up. Looking back I wonder if I was just getting impatient.
My body pushed a bit and out came a tiny head. At least I thought it was! What I had actually pushed out was a little bit of the amniotic sac. The flow of fluid in and out was the weirdest feeling! I thought constantly, ok, it just ruptured, it just had to have! It never did. Each time he moved downward fluid would flow back up, making room for his head.
I felt enormous pressure on my rectum. I felt the urge to push. I don’t think it was me that pushed. My body just did it on its own. I felt like I wanted to deliberately do something, but I couldn’t.I kept thinking, "This is taking too long!". I want to say it took 2 to 3 pushes for the head to completely descend out and replace the sac. I felt every little ridge of his face and head. I wouldn’t say it was excruciating, but it definitely was something new.
He stayed a few minutes that way, his head in the sac underwater. Lorri asked if I wanted Jon to catch our baby. I moved from my knees to reclining in the water. A contraction came, but nothing. Another, and I willed baby to come. Holy crap! Shoulders, chest, arms, bum, legs, feet! That push and he shot out of his warmth towards his father. I openmy eyes, and watch in daze as this other living part of me became separate, at full speed. Membranes ruptured at this time.
At the same time, I hear “oh no, Wow”, or something to that effect. Kristin had taken off from my side and Lorri’s arm shot in the water. The umbilical cord had ruptured completely, spilling blood into the water and from baby. Jon had already brought baby to me, and though there was this emergency, the product of my labor was in my arms- not taken to another place to be suctioned, scrubbed, wrapped, poked. Kristin got the cord secured. She had the oxygen tank on as well. Lorrie was holding the rest of the cord to ensure it didn’t go back inside me. Baby was pale, and not breathing as well as he should have due to the blood loss. I kept talking to him, though I wasn’t sure what to say. He kept coughing, upping a gob from his lungs each time. We did have to suction him.
It was decided that Jon should take him to work the crud out of his lungs while labor finished in the tub. As soon as the placenta was done (pains felt duller, and the birth was like a squishy baby mass), I was able to get up and out of the tub and into a robe- not wheeled to another completely separate lace down the hall to recovery. As I walked-walked!- into the rest of the room toward the bed, I got to see Jon, bare-chested with baby in his arms with the oxygen tube facing him. He coughed and a huge gob came out. His face darkened at least 3 shades immediately. Whew. Jon brought him back to me and I got to work on helping him adjust. His cry was bliss. (This is essentially similar to what a newborn in a hospital has to go through: look up benefits of delayed cord clamping). I was still in a daze through this entire time, thanks to my natural hormones.
We were able to have our first breastfeeding session within that first hour. He stayed on me, chest to chest, 95% of the time after he left Jon. Lights were still dim, quiet, Lorri and Kristin going about their business, kids and Jon at our side taking and oohing. His initial newborn check was done in bed right beside me. So in awe of what I just did, and that he was here with me. We were exhausted. So ecstatically exhausted.
I had a ‘barely’ 2nd degree tear that required a few stitches. This was probably caused by my body involuntarily pushing him out. Other than that, I had a few scratches that felt like paper cuts. Postpartum pain was handled with comfrey compresses, arnica, rest, and hydration. No overkill pain meds that made me puke or break out in hives. I didn’t need anything else.
Jameson Luke was born at 8:48 AM, approximately 7-8 hours of labor, approximately a half hour of actively pushing, in water. He was a surprise gender, 21 inches long, and 8 pounds, 5 ounces. He was the largest out of my 3 total children born. His birth was everything I had hoped it would be, outside of the cord shredding.
The cord issue was something that couldn’t be avoided. There was no obvious cause for this happening, but there are a few theories. Could have been the force he was born with, a weak spot in the cord, etc. It obviously could be taken care of by midwives outside of a hospital setting, for which I am grateful they are trained so well. Jameson has had no effects to the temporary loss of blood and oxygen, though he missed the benefits of them.
I have so many things I am thankful for with this postpartum recovery. I am thankful for no IV’s, tubes, or monitors. I am thankful I was able to walk after, and the only ‘out-of-itness’ I felt was due to my own hormones and not anesthesia. I remember everything from his first days. I don’t feel violated. I feel my baby was treated delicately, as infants should. I had support during pregnancy and labor. I am still enjoying the benefits of proper postpartum care now. Breastfeeding has been more of a joy and bonding opportunity than something I used to dread (thrush, engorgement, mastitis, inadequate coaching of latch, depression). My overall mental health is positive, though I do get weepy when I’ve had very limited sleep. I am still worried ifI’m going to end up having postpartum depression, but if I do, I am positive I will not endure the severity of last time.
The bottom line: Jameson’s birth was healing. I have healed physically and mostly emotionally; some scars will take years to process. I am no longer as bitter toward the maternal care system, and those that told me to ‘suck it up’. I would still like to say ‘middle finger up to the man’ though. For that I am able to truly focus on my children and family, and myself. I am a better parent for this, and we have all already benefited. I exceeded my goal in so many ways, and for that I am grateful for the lengths many are willing to go to help a woman succeed in her most desperate time. I would do it again in a heartbeat.
"Is he OK?" I asked over and over. I could just see his little feet kicking as he lay in the warmer on the other side of the OR. His cry sounded somehow wrong to me like he was struggling for air, and I was terrified and helpless on the operating table. I wanted to hold him, explore him, comfort him. Finally the anesthesiologist placed a hand on my arm to reassure me that my newborn son was OK. My husband came over and sat on the stool beside me and showed me my son for the first time. I kissed his sweet face and then...nothing. I have so few memories of the first hours of my son's life. The drugs running through my body made everything hazy and left me dizzy and nauseated. My recovery was long and uncomfortable. It was months before I was back to myself.
Every VBAC story begins with a Cesarean. A vast majority of them unwanted, some even unwarranted. The official reason for my Cesarean was "Non-reassuring fetal heart tones", and it was noted that he was occiput posterior. I also noted the time of delivery...6:30 PM on a Friday. Afterward, I struggled with my feelings about new-motherhood and an unwanted surgical birth. I was so in love with this child...yet at the same time devastated at the loss of my desired birth. While I was falling in love with my baby in his first days and weeks, and getting the hang of nursing and motherhood in general, I was struggling with grief and trying to understand what exactly went "wrong". I wrestled with shame, guilt and anger. I was angry at my husband, my midwives, my family and most of all myself. I felt guilty for even dwelling on the birth experience when I had a healthy baby. A healthy baby is all that matters, right? Not always...
Fast-forward 14 months. I'm sitting on the toilet holding a VERY positive pregnancy test. This was not the plan. Not yet. I wanted more children, but not YET. I think a big reason I was so afraid when I found out I was pregnant again was that I was afraid of birth. I no longer believed I was capable of having a normal physiological birth, and I was terrified of enduring another surgery and long recovery. My husband was surprised as well, but very supportive and excited nonetheless. I called the community midwives the next day and booked my 12 week appointment. We quickly became excited about this new baby and I tried to focus on having the healthiest pregnancy possible.
The topic of birth choices was in the forefront of my mind right away. VBAC? RCS? I wanted to know the facts. I joined ICAN, I researched options and talked at length with my midwives. I decided on VBAC for two reasons. Firstly, after pouring over the research, I truly believe vaginal birth is a safer, healthier option for my baby and myself. The second reason was that I felt a real need to experience a vaginal birth. I needed redemption. To bring my baby into the world under my own power. I wanted to go through that rite of passage and greet my new child alert, joyful and healthy!
My midwives and I discussed place of birth, and in their practice, they encourage VBAC moms to forgo homebirth and choose one of two hospitals as their birth place. I was disappointed, as I have always wanted a HB experience but could not go into a homebirth with a birth team that did not feel 110% confident in my choice. I knew I needed calm, fully supportive and confident people around me if I was going to VBAC. In the end, I felt so confident in the team I had assembled that the fact I would be birthing in hospital seemed less and less important as my pregnancy progressed.
I had said immediately after my Cesarean experience that the next pregnancy I would hire a doula. With my first labour, I felt afraid to ask for the kind of support I needed from my husband and even my midwives. I knew a doula could help my husband to help me, and make the birth about "us" through his involvement, which appealed to me greatly. I was given a few names from my midwives and I interviewed a few different doulas. I decided on a woman who was more of a peer to me; my doula was close to me in age, a mother herself, and she had a belief that I could have a VBAC. She had never attended a VBAC but I loved her enthusiasm about attending my birth.
My pregnancy progressed well, and I felt wonderful. I was doing the Hypnobabies Home Study Course and found it to be wonderful for relaxation and it gave me confidence that I could achieve the birth I desired. I was also more physically active in this pregnancy. I continued with my usual farm work and used my birth ball regularly. At about 35 weeks we discovered that my baby was breech. I did not know if I would have had the courage to attempt a breech VBAC and I was very upset. I found a Websters certified chiropractor and started going for treatment three times a week. I found a website called "spinningbabies.com" and read about fetal positioning. I did exercises on the birth ball, inversions to help get baby into that hallowed "LOA" position. I was almost preoccupied with fetal positioning. My first baby was OP and after hours of pushing had actually regressed back to a zero station. No way did I want another OP baby! By 38 weeks baby was vertex and I was relieved! My back also had never felt better! Even after baby was vertex, I continued to see the chiropractor to ensure my spine and pelvis were in ultimate condition to maximize my chance of a well-positioned baby.
I dealt with a lot of "What if's" during my pregnancy. I think most mamas do, but there seems to be a special set of doubts for VBAC women. For me, it was a fear of being the 0.7% of VBAC mama's who experience rupture, concern that there was something wrong with my pelvis to the extent that it could not accommodate a baby passing, fear that I would fall into the same cascade of intervention as I did in my first birth, and yes, fear of "failure". I was so afraid of ending up with repeat Cesarean and how I would feel about it. I know that there is no such thing a s failure in birth, but I wanted this birth to work out so badly and I knew I would be devastated if I didn't have the experience I was working for. I found the Hypnobabies "Daily Affirmations" great for keeping a positive attitude through times of doubt. My midwives were also very supportive and positive at my appointments, which eased my mind a lot.
The evening before my estimated due date, I went to bed feeling the same braxton hicks contractions I had been having for weeks. I woke at 2:00 AM on my EDD to what felt like more intense braxton hicks contractions. I was rolling around so much that I was worried that I would disturb my husband and co-sleeping son so I got out of bed and tried to play some solitaire on my computer. I realized after a few contractions that they were awfully close together and seemed to be getting longer. I even began to vocalize a little through the peaks. I pulled up contraction master and started timing while sitting on my birth ball. After about forty five minutes of timing, my surges were three and a half to two and a half minutes apart, and lasting from forty five seconds to over a minute in length. This was it! I smiled to myself and thought how cool it was that at this moment the only people who knew what was going on were me and my baby. I was at peace and excited. I listened to Hypnobabies scripts and laboured for about another hour or so before waking my husband. When I told him I was in labour he didn't believe me! We were so sure I would go over-due. When he saw me go to hands and knees through a contraction, he went and filled the bathtub and started getting things in order.
We laboured for a few minutes like this and than discussed about whether or not to call the doula and midwife. Hubby was not completely convinced that this was really my birthing time and honestly, I was in doubt myself. I convinced him to call my midwife eventually and she listened to me going through a contraction. She said she would leave right away and to call my doula. My doula arrived first and we fell into a great rhythm together working on the birth ball and talking between contractions. My midwife arrived and quietly watched me labour for a few minutes and asked if she could check my cervix. I agreed as I was so interested to discover if this was just horrible prodromal labour or the real deal. She gently checked me and found me to be a "good five". I was ecstatic!
With my first labour, I worked for 24 hours of erratic, strong and painful labour to get to five. We packed up and called my mother-in-law to come look after my son. I cried as I kissed him goodbye. What a strange feeling...leaving your child to welcome another! The drive to hospital was exciting. My husband and I were both excited and full of anticipation.
When we arrived at the hospital at about 6:00 AM, I checked into the same room that I laboured in with my son. We did not have to go to triage because my midwife had already checked me at home. The check-in process was the last nurse we saw throughout the entire process. Once in the room, we turned down the lights, got on the birth ball and turned on the music. I consented to a hep-loc as it was hospital policy and I have zero fear of needles. I stayed in my own clothing and moved as I wanted. I was in the zone and my doula was amazing. She guided my husband and had him actively supporting me. I sat on the ball, leaned forward, and rested my head in my husband’s lap. He gave me sips of Gatorade and rubbed my shoulders while my doula rubbed by back, said encouraging words and did lots of counter-pressure. She asked me what I was using for imagery so she could help me. I said, "All I see is black, and it's great." She responded, "It's working so go with it!"
I was moaning through all of my contractions and it helped to be reminded to keep the tone low and gutteral. If the tone got higher, I tensed up. Low tones helped me relax all of my muscles and just go with it. Hip circles and bouncing on the ball helped so much with long surges. I was constantly nauseated which is something I didn't expect, and something I found very irritating. Despite that, I still can't get over how happy I was in labour. Excited, relaxed and confident. I kept repeating to myself in my head "Just surrender. Relax more and more. Just let it take over!" I credit much of that to Hypnobabies, which encourages only positive thoughts about your birthing time.
At about 8:30 AM, I asked to have my cervix checked. I was so excited to know my progress, even though I know those little numbers didn't mean all that much. I was checked and found to be at seven centimetres. I was mildly disappointed because I was working hard in a good pattern with strong surges lasting well over a minute. I went back to the birth ball and got back into the zone. I was tired by now, and sleeping between contractions while leaning on the bed. I noticed my surges were getting further and further apart, and shorter in duration. My midwife suggested that I try doing some contractions in the lunge position (standing with one leg on a chair), three surges per side. Then I tried a little hands and knees. At about 10:30, I was still not in a good pattern again.
My surges which were previously only a minute to two minutes apart were seven to eight minutes apart, and only lasting for thirty seconds or so. I asked my midwife to check my cervix because I was getting nervous. She checked me and found me to still be at seven. I was devastated. This is what happened with my first labour. I stalled at seven centimeters for seven hours and fell into a cascade of interventions. I stated to cry. I could see the whole thing unraveling before my eyes. Just like before. My midwife discussed breaking my water. She knew this was something I wanted to avoid, but she saw how fragile I was at that moment and I think she saw I needed some help. I consented, and she gently broke my waters. She also gave me some herbal remedies as I got onto my hands and knees over the ball.
The next contraction took me by complete surprise. It was so incredibly strong that I actually screamed. I looked around wildly, and found my doula calmly by my side. I thought I would have time to prepare for the next surge, but before I recovered from the last one, another one was on me and I was wild. Like bat-shit crazy. For the first time in my labour, I was afraid. I felt the surge right over my old scar and I was scared. All my fears came rushing in and I was sure I was having a rupture. I thought I would be rushed to an OR and have to endure another surgery. I had lost control and needed someone to help anchor me. My doula took my hands and said to me "You are not the one percent", meaning the less than one percent of VBAC mamas who may experience a rupture. Just those words helped to much. The next contraction I handled a little better, but at the peak I screamed "I need to PUSH!" and I PUSHED, while heaving over the bed. No need to check my cervix - I was dilated and it was show time!
I tried to push on hands and knees but found the position very awkward for me. I laid on my side and held up a leg. This position was a little better, and it allowed me to easily use the mirror that had been put into place. I must say that I am not one of those women who's contraction pain gets easier once they start pushing. It was brutal. I said over and over "This SUCKS! I am an idiot for not having any drugs!" I pushed freely on my own for about 45 minutes and I seemed to be making progress, but couldn't get the baby's head under the pubic rim. It was infuriating to me. I was also having tremendous back pain now ( I have had back-pain most of my life) so I tried pushing on my back. I knew this was not a great position, but it was the only way I could stop the back pain and focus on getting my baby out. I would create counter-pressure by pressing my lower back into the bed and it felt great! I started getting more direction from my midwives (my back-up midwife and student midwife had arrived by this time) after about an hour or so of pushing. One midwife suggested the birth stool but I declined. I had a fear of the stool because It had been highly ineffective for me during my first birth. I felt quite unprepared for pushing. I was emotionally frail and very insecure. I needed a lot of reassurance and a sort of mothering. My wonderful doula was my rock through this time.
Finally, after over two hours of pushing, my baby's head came down and stayed down. I was thrilled! I watched in the mirror in awe. I was having a vaginal birth. This was it! I was praying like crazy and excited and scared all at once. I pushed for about 15 minutes more and watched the baby's head born to the cheers of my support team. This was such a joyful moment for me, and I screamed ``I did it!`` over and over again and was crying like crazy. I remember one of my midwives saying ``See how much your mommy loves you, baby, she is doing this all for you!``. I pushed a few more times and as her body slid out, my midwife took my hands and helped me guide my baby to my chest. I was crying hysterically and so full of joy and disbelief. I looked at my perfect baby girl and was just overwhelmed. This was how it was supposed to be. She was warm and wet on my chest, and the cord pulsed between us.
I looked into her face and explored her body before anyone else. She was perfect, pink and healthy. I knew I had missed out with the surgical birth of my son, but I had no idea how much. Those moments were pure magic. No one took her away from me and after a few lusty cries she laid on my chest and looked at me with big, blinking and alert eyes. My husband was smiling like crazy and so excited to meet his daughter. He said to me "You are the toughest man or woman I have ever met, and I'm so glad I got to see it (birth) this way!". I was so proud in that moment! After about twenty minutes of snuggling, I delivered the placenta, which was an odd feeling to say the least. The student midwife showed me the placenta and how amazing it is. They had simply discarded my placenta from my surgical birth without asking and it was something I felt cheated out of. Immediately after that I put my baby to the breast and she stayed there like a champ for almost an hour. I nursed sitting and then side-lying as I had a little rest.
During my first nursing, my midwives checked my perineum and discovered I had a third degree tear and an OB was called. This was the first doctor I had seen through my entire birth. The repair was worse than the birth, I will say. One of my midwives was so supportive, and held on to me through the entire process. I wouldn`t have gotten through if I hadn`t been holding my sweet little girl. The repair was a slow process, and I cried a little, but it was nothing compared to dealing with a surgical birth.
After the repair was done, two hours after my daughter was born, the midwives did the newborn exam. The cord was cut and all of my preferences were respected with regards to newborn procedures, which was wonderful. While they were doing this, my doula got me to eat a little toast and jam, and I had something to drink. I tried to have a shower, but I was very dizzy so it was cut short. I got into a fresh nightgown and snuggly robe and held my daughter again. We discussed going home or staying overnight and I opted to stay overnight because of the damage to my perineum and also because I was having difficulty urinating. In the end I had to have a catheter, so it was a good decision to stay. My daughter roomed in with me and we just snuggled and nursed. I went home two days later.
We named our beautiful daughter "Lauren Marie" and she weighed 7lbs, 10oz. She was such an easy - going baby and is a smart, energetic and loving 16 month old today. Some days I just look at her and think back to those first moments. No regrets, just pure joy. Her birth was a redemption for me. I felt like a rock star, like I had accomplished something, and I still draw on that confidence to this day.
I learned so much on the road to this birth. Through this journey I found the healing I was yearning for, and so much more. I am inspired to become a doula and help other families have wonderful, meaningful birth experiences. I learned that it is OK to care about birth. For some, birth is merely a "baby extraction", and that is fine, but for so many others, birth matters and that is wonderful.
I often think that I am thankful in a strange sort of way for my Cesarean experience; if I didn't have that Cesarean, would I be so passionate about birthing women and babies? Would I have the same sense of pride and accomplishment after Lauren's birth? Not likely. I am so grateful for both of my experiences, and for my two healthy, beautiful kids. I thought having a VBAC would somehow erase all of the negative feelings I have about my son's birth, but that is not the case. The slate will never be wiped clean, and I will always think back to my Cesarean with some sadness. However, time has given me perspective and I am grateful for the birth that put me on the road to VBAC in the first place.
Many people find it hard to believe that after 3 c-sections, homebirth is not possible. But that cannot be further from the truth. As we expand birthing knowledge, more women are avoiding c-sections and birthing by their own terms. In honor of this mama's baby's first birthday, she made a video of her birthing journey. After 3 c-sections, she finally got her homebirth.
Dr. Andrew Kotaskarecently spoke at the 56th annual meeting of the American College of Nurse Midwives held in San Antonio where he discussed VBACs and released a form patients give to their care provider, if the provider is denying a trial of labour for a vaginal birth after cesarean (VBAC). This is revolutionary, since when do everyday expectant mothers get to ask their doctor to sign anything...unless it's a prescription of course?!
We encourage women who are denied a trial of labour to print off this form and take it with them to their next prenatal appointment. Understand your rights as a pregnant mother, this is your body, your baby and your birth. A doctor cannot make you do anything you're not comfortable with. Many of you may think your doctor will abandon you and refuse to sign this form, if you do not agree to a repeat cesarean section. This very well could happen, although if your doctor has your best interests in mind they should understand that your relationship with him or her, known as the therapeutic alliance should be of the upmost importance in protecting.
If this is not the case and your doctor becomes offended, unfortunately it is possible that your doctor may choose to discontinue caring for you and your unborn child. Some doctors will abandon their patients if the woman rejects certain recommendations and if this is the case, you will need to find a new care provider. There are physicians whose main goal is protecting their own self interests in respect to time, money, insurance (malpractice suits) and at times external regulations (hospitals not allowing VBACs).
Ideally a physician should inform their patient of their recommendations, accept the fact that the woman is entitled to disagree with their recommendations and not withdraw their support from her. In the event the physician should need more support caring for a patient they should seek expertise from other qualified health care providers. The Royal College of Midwives policy says it best “If a woman rejects your advice, you must continue to give the best care you possibly can, seeking support from other members of the health care team as necessary”.
Note: this VBAC Form came courtesy of Birth Sense, see the full article from the conference here.
There has been much controversy over VBACs (Vaginal Birth After Cesarean), until recently the medical community believed that a woman attempting a vaginal birth after a previous cesarean, would be injured from the previous incision rupturing. This is beginning to slowly change, although many U.S hospitals still will not allow women to attemp VBACs. This outrages many women, especially those who feel the previous c-section was unnecessary. We believe women should be entitled to a vaginal birth, if they choose to have one. This video speaks of the recent VBAC summit, check out their website for more information.