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What A VBAC Feels Like

2/25/2018

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I am a firm believer in any birth having the ability to be empowering. Natural vaginal birth, medicated vaginal birth, elective caesarean, emergency caesarean, caesarean under general anaesthetic - and everything else in between.

But I didn't always feel this way. I did a Hypnobirthing course and thought that made me some sort of birth goddess with no limits. And it did in a way.

I didn't write a caesarean birth plan. I didn't know what happened during this procedure nor what my options were during it. I didn't pack any high waisted underwear or any appropriate clothing.

I thought birth just happened. I thought that everything always went smoothly if you could just get through the pain. I thought the rate of caesareans was low. I thought all medical professionals believed in a woman's body and ability to birth. I'm no longer so naive.
I'm no longer so naive.
Actually, I'm now extremely educated. And that's exactly how I got my VBAC.

Without rambling too much - I will say that I got my VBAC by owning it. I made it very clear what I wanted and what I didn't want during my labour and birth. I was my own advocate - because no one else was going to do that for me. It's your body - your baby - your birth.

My two births were two totally different experiences.

If you've followed the blog for a while, you may have read my first birth story before - so I apologise for repeating myself.

With my first, I had a stretch and sweep, had a massive bleed and had to go to hospital. I went into labour 2 days later at 10pm 26/6/15. We lived out of town at the time and Telstra was down that night. It was the middle of the night and we drove about 10km to get phone signal. We phoned maternity and they advised us to come in. We arrived at hospital and despite not wanting too many vaginal examinations (see, I thought I was so educated), I agreed to one (the first of many) and was 4cm. I stayed in hospital and laboured on all night. I was having hourly vaginal examinations by the end and my body wasn't agreeing to being on my back. I was very vocal and wanted to be on the fitball. I remember a cycle of waiting in agony on my back for the doctor to arrive to check me again. It's hazy but it was awful. Eventually, the doctor broke my waters - and the waters were not a nice colour. No one was worried as baby's heart rate was fine. By this point, after only 10 hours of labour, I was 8cm. After another hour, I was still 8cm. So, a failure to progress emergency caesarean was deemed necessary and off I went (although I waited a few hours before I was prepped for surgery). I had only had gas for pain relief and no other interventions. At the time, I was made to feel like the meconium in the waters was the issue - but my notes say "maternal exhaustion" which disappoints me to no end. During my caesarean, I didn't feel like I was birthing my baby. I felt scared - I'd never had surgery before let alone major surgery. They announced the gender and I was just frozen. I swore I could feel them cutting me - it hurt so I was given more pain relief once baby was out. They took her aside and Brad cut a piece of the cord off. He then held her because I was shaking. I couldn't find a smile within myself and I still feel such guilt about that. I was just focused on finishing the task at hand and couldn't concentrate on anything else until I knew I was stitched back up and the sensations I was experiencing had stopped. I'm so grateful that Brad was so present with our daughter. I breastfed in recovery and struggled immensely. I struggled with just about everything for weeks, months and even years. Recovering from surgery, breastfeeding, postnatal depression... Things were so bad that Brad and I decided against more children. This was a heartbreaking decision but we felt it was the right one for our family. Brad even had a referral for a vasectomy!

As time went on, I took ownership of my recovery from postnatal depression. I felt like I was in a good place. I actually felt like I had a new level of self awareness - one I'd never had before. I needed to experience such a low point in my life to be able to feel such a high.

We started toying with the idea of another child. At first, it felt like a dream. Even deciding to try was a very momentous decision. We figured it would take many months but I tested positive first time and it suddenly felt very real. This baby was destined to be in our lives.
This baby was destined to be in our lives.
Again, I was very, very ill during the pregnancy. But my self talk and thoughts throughout this was very positive in comparison with my first pregnancy. I think having a toddler helps! You literally do not have time to feel self pity.

I was determined to have a VBAC (vaginal birth after caesarean) and booked in with a doctor who I had heard was supportive of this. I had everyone around me asking when my caesarean date was. "Don't you know you can't have a natural birth after a caesarean?" I had family think I was lying about having a date booked.

I started to feel kicks down low and self diagnosed a breech positioned baby at 30 weeks. I shook it off but my doctor unfortunately confirmed this at 32 weeks. Breech birth is obviously possible. However not in Port Lincoln, and when wanting a VBAC, your options are extremely limited even in the city.

I felt like I'd failed my baby already. I felt like I'd failed everyone around me because I'd been so vocal about having a natural birth. I didn't tell anyone what I was going through. 1. Because I didn't know what the outcome would be. I wanted to wait until I knew what I was facing until I was open. 2. I was struggling emotionally and couldn't bear the thought of people constantly asking me: "has baby turned yet?"

I knew that babies could turn on their own but I did some research and travelled to Adelaide when I was 36 weeks to see a very experienced and pro-VBAC obstetrician in Adelaide. Normally, obstetricians prefer not to attempt an ECV (external cephalic version or manual turning of the baby) if you've had a previous caesarean - but the obstetrician examined me and showed me some positive research supporting it. We booked in an ECV for the following week. I had been warned that it may not be successful and had read (too much) on the internet that it can be very painful and traumatic.

The ECV was an amazing experience. I had a muscle relaxant and although it was quite painful, it only took one attempt and baby was head down! Brad and I were in absolute awe of my body and of the process. For the next week, I worried about the position of movements and that the baby had turned again. But baby stayed head down until birth - just amazing. I felt like I was back on my way to my VBAC and it's as if the past 10 weeks of agonising over baby's position and what that meant for my birth had never happened.

I knew I wasn't going into labour before 40 weeks. I just knew it. And I wasn't one bit worried armed with the knowledge that a normal pregnancy is between 37 and 42 weeks. My doctor was very aware of my position on induction and with my options being limited due to the previous caesarean anyway, we cruised on.

I had a bit of a "show" and started getting irregular tightenings on the Tuesday night (40+5). I couldn't sleep through them and position changes didn't help so I knew they were real. However, I woke up the next morning and not much was happening. I messaged my midwife friend who suggested I rest. I did the opposite and took Cadence on the walking group run by the local children's centre! Pushing a pram up the hill in the heat definitely helped because I was having tightenings every 10 minutes and my waters were leaking the whole time. Thankfully, nobody cottoned on (and it's become a bit of a joke at the centre now). We went about our day as normal. I took Cadence to the afternoon playgroup and to Target to look at toys. By 4pm, I decided to go home as I could no longer talk through the tightenings and you can imagine what that's like with a toddler in a department store. Things seemed to be happening quite consistently and I messaged Brad to come home from work a bit early (4:30pm). I settled Cadence for bed through tightenings after dinner then tried to get some rest.

Cadence woke and was really unsettled from about 9pm. This was really tricky as I having regular tightenings still and needed to rest. It's almost as if she knew. I put on a brave face and we both gave her our full attention. She eventually drifted off to sleep.

It occurred to me then that I was going to have a baby tonight or the next day because things were intense. I got out of bed at about 11pm after no sleep and set up a little sanctuary in the lounge room - with the fitball, Netflix, a blanket fort and cushions. I didn't tell Brad how full on things were and left Brad to sleep so that he could be useful when I called upon him. I really, really wanted to watch Mean Girls. I have no idea why. But Netflix, the buggers, didn't have it. So I watched Juno instead - and didn't even realise how ironic that was until just now as I write this. At about 1:30am, I rang Brad because I physically couldn't get up and walk to our bedroom from my blanket fort in the lounge. He didn't answer and I pictured myself crawling to him in slo-mo but he came into the lounge and seemed very confused. Obviously, had no idea I'd be labouring away for nearly 5 hours and nearly didn't believe me because I was so calm and hadn't asked for help. He helped me with the TENS machine (which really took the edge off) until I felt the need to hop in the shower. I loved the warm water on my back and our shower is quite large so I could pace in there too. Brad was wonderful and lit a candle gifted to me at my blessingway and read birth affirmations to me and had me repeat them back to him. He could be a doula if he wanted! He believed in my body but knew my mind was strong and needed support to stay on track as I started to say: I can't do this.
He believed in my body but knew my mind was strong and needed support to stay on track as I started to say: I can't do this.
Tightenings had now been a couple of minutes apart for hours and were starting to change slightly. I felt a sharper pain in my coccyx area. I started to think about going to hospital and decided that we'd call my mum about 5:30 to come at 6am. It was now 3am. I wanted to be available to Cadence if she woke. But at 4am, my waters broke in the shower and things got even more intense. I decided I actually wanted gas (no idea why - just felt really strongly about that!) We called maternity and let them know what was happening and they said they were ready for us. We then called my mum who by some miracle answered - because her phone is always on silent at night time. She and her partner arrived with their double swag and settled in. Apparently, Cadence woke just after we left but was absolutely fine with the disruption and eventually went back to sleep. We were at the hospital around 4:30am.

We had a lovely midwife who was more than happy to follow my birth plan (no vaginal examinations or interventions) however recommended continuous monitoring. I said that if she got me some gas first and the monitor could be used in the shower, I didn't particularly care. I used the toilet and the midwife asked whether I did in fact want an examination because she felt that I was further along than she thought. Although, I knew I was probably quite far along - due to the feelings of pressure I was having in the shower at home. She checked me and I was indeed 10cm. The doctor was called and whilst I was in the shower, my doctor and midwife were both absolutely wonderful in supporting me through tightenings and position changes. I declined a routine cannula as per my birth plan. I couldn't believe the difference in my two births. With my first, I was saying I couldn't do it - and was then whisked away for a caesarean. This time, I was being encouraged and told I could do it and WAS doing it. Gas was doing nothing by this point and I spat it out on the floor. I alternated between squatting on the floor in the shower and standing and swaying with Brad. It was our birth dance. I was telling him that I loved him and apologising for getting his clothes wet (the things you think of when you're in labour). It was really beautiful.

The rest is so hard to describe. It was the most challenging yet most magical hour or so of my life. I always thought I'd breathe the baby down using the contractions. But baby wasn't moving and the coached pushing really helped. Once the baby's head had emerged, the pain just went away. I didn't feel the "ring of fire" that is feared so much. I wasn't scared of tearing. I felt this primal instinct and acted on it and felt so supported by every single person in the room. I felt like I had a cheer squad. My beautiful baby daughter, Asher Lane, was born at 6:26am Thursday the 8th of February - 8 pound 8 and 52cm long. She was passed to me through my legs as I was squatting down in the shower.

I'd done it. I'd beaten so many odds with my breech, VBAC baby. I have never been so proud of myself - after how hard I worked in my pregnancy and my labour - and would go as far as to say that giving birth on that shower floor was my greatest achievement and probably always will be. The entire experience helped me to forgive my previous doctor, let go of the hurt, move beyond the trauma and feel proud of my first birth - because if I hadn't experienced any of that, I would never have felt this intense love for myself and my body in this present moment - and into the future. I looked around and realised that I'd just birthed in the same room that I'd laboured in with my first child. I am so glad for this as it intensified the forgiveness and joy I was experiencing.
I was so glad for this as it intensified the forgiveness and joy I was experiencing.
I had only pushed for 40 minutes and we had about 15 minutes of delayed cord clamping which was great because it didn't feel as though we were being rushed through our initial bonding. The placenta was birthed naturally 20 minutes later.

I had a second degree tear (which I didn't even feel) and lost a lot of blood (1850ml). I had fluids in recovery as well as drugs to stop the bleeding. When on the maternity ward, I had two blood transfusions and was slightly delusional after no sleep, the loss of blood and lots of visitors. I was asked my name and gave my birth name (my father's surname which I haven't had since I was 18) and was asked my birthdate to which I repeated my name again. Everyone was quite worried about me and I felt intensely frustrated because my words were not matching my thoughts. Eventually, after a bit of rest, I came good and left hospital the next day. To be able to walk normally and get into the car on my own was an amazing difference to last time.

A day later, after visitors (not trying to blame them but it does take it out of you!), I went downhill again and went back to hospital. They ordered another blood transfusion and my haemoglobin was back up to 102 after that. I have felt amazing ever since.

After all the doubt and fear that I overcame - to then labour at home using my internal strength and support of my partner and arrive at hospital 10cm dilated, I feel as though I became the birth goddess I always thought I was. I look down at Asher and cannot stop kissing her head. I said for days after the birth: I can't believe you came out of my vagina!
I said for days after the birth: I can't believe you came out of my vagina!
And if I'm going to compare birth experiences, I may as well compare postpartum experiences also. At the time of writing this, just over two weeks postpartum, I feel entirely different to last time. Last time, I already had a referral to a psychologist by this point, multiple professionals were involved, I had a prescription for antidepressants, I was having nightly panic attacks, I had an intense post traumatic stress response upon returning to the hospital for breastfeeding support, I had an infection in my c-section wound from it opening up, I wasn't sleeping, I was hardly eating, I was crying all the time, I had no independence or strength. I felt nothing but love for my daughter, Cadence, but I couldn't figure out how to love myself through the process of becoming a mother. I couldn't stop the feeling of failure or absolute hopelessness.

This time round, I couldn't even imagine feeling any of that. I feel like an entirely different person having the same postpartum experience, however, how I got there, and how I was respected through it, was so different. After reading the brilliant book How To Heal A Bad Birth (which I urge you to read - even as a health professional or someone who has not experienced birth trauma first hand), I am convinced that what I experienced postnatally was indeed triggered by birth trauma. A trauma that is not often recognised because the rate of caesarean and intervention is so high and the birth culture has shifted. (Not to say that all caesareans are traumatic - as I mentioned in my first paragraph - but birth is very personal and if your birth doesn't end the way you expected or you felt like you weren't heard, it can be traumatic). A trauma that wasn't honoured and a trauma that I wasn't supported through - simply because there just isn't enough awareness or specialised support for women and their families experiencing this. "At least you had a live birth", "healthy baby is all that matters" and "it could have been worse" are all very unhelpful statements.

I hope that by shouting from the rooftops, I can encourage others to pursue a healing journey from birth trauma and advocate for themselves to get the treatment and respect they deserve. I also hope I can raise awareness about birth, normal birth and how magical it can be. Let's shift our perspective of birth from pain, fear, control and move back to the way birth always was - about life, empowerment, souls reuniting.
Let's shift our perspective of birth from pain, fear, control and move back to the way birth always was - about life, empowerment, souls reuniting.
Thanks for reading if you got this far. This was a very personal piece for me to write and I hope it was useful, enjoyable, affirming and everything in between.
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