Monday, 31 October 2011

Birth Special: From Emergency Caesarian to Blissful VBAC!

Today is Halloween, and it's also Samhain, the Celtic equivalent of New Year's Eve. This ancient festival looks towards nature for its symbolism, and celebrates endings and beginnings; taking seeds of hope for the future, spiralling deep into the dark of winter, facing our fears, waiting and enduring, and emerging anew when spring finally returns. What better time to bring you the first of a week long series of posts on the subject of birth!

Back in July I ran another Birth Special, and the most popular post by far was Michelle's story of how her planned home birth ended in an emergency c-section. Perhaps one of the reasons it spoke to so many people is because the tale is, sadly, all too familiar; of a birth in which hopes and dreams of a natural and positive experience slip slowly and painfully away and are replaced with trauma and disappointment.  I'm delighted to say that for Michelle, healing has come in the form of an incredibly empowering second birth, and here she shares her inspiring story, accompanied by the most beautiful images.

Michelle's Second Birth Story: Doula Assisted VBAC in Hospital

When I fell pregnant with my second child I was determined to have a different experience compared to my last labour and birth, preferably one that didn't result in a c-section. So I did everything I could to maximise my chances of achieving such a dream. I read huge amounts of research and VBAC birth stories, I watched VBAC birth videos, I hired a doula and also enlisted the help of a friend who was training to be a doula and I held a Blessingway. I also did a lot of soul-searching and talking about my previous birth experience, fears and expectations in an attempt to find some healing and to let go of certain worries.

I wholeheartedly believe that all of these things - being informed, supported and most of all trusting my body - played a huge part in achieving my empowered VBAC.

I would like to add here that I originally intended to have a home birth (or HBAC) but one of my worries was about the less than 1% chance of having a uterine rupture during labour. So after changing to a consultant I was more comfortable with, I made the decision to have my VBAC in hospital, as I personally felt safer to be there rather than 30 minutes drive away if anything did happen.

Here is the story of Genevieve's birth...

On the morning of my due date some mild contractions started while I was getting my other daughter's (Mathilda) breakfast. I didn't think much of it at first because two nights previously I had felt the same and they died off. But within half an hour they ramped up in intensity and frequency making me take notice of them.

This turned out to be very stressful because my husband, Rob, was still in bed suffering from a corneal abrasion (he has a form of Recurrent Corneal Erosion) which was looking like HE may have to go into hospital to have his eye scraped (you don't want to know) and my daughter was having a tantrum over me giving her the 'wrong juice' which ended up purposefully chucked all over the carpet. Suffice to say, I wasn't in a very good mood at that point!

Among all the chaos I somehow got in contact with both my friend/trainee doula (Jenn) and my doula. We arranged for Jenn to come over ASAP to help and for my doula to await another call if things really look like I'm in actual, full-blown labour.

By this point Rob was trying to get through to the hospital to arrange to see his eye specialist and also call relatives who offered to look after Mathilda.
 
I was having some good strong contractions while leaning on my birth ball with all this going on and Rob swearing at the phone in the background. I just buried my head in the ball and moaned through them, while Mathilda, bless her heart, hugged me from behind. Eventually Jenn arrived and things started to fall into place.

My contractions continued while hubby got his eye appointment and arranged for my sister to take Mathilda out and give Rob a lift to hospital. Some time after that he and Mathilda both left the house when my sister arrived to pick them up.

It was quite a weird moment, because I knew deep down that it was going to be the last time I saw Mathilda as my only child.

So it was just Jenn and I in the house now and we chatted in between contractions.
 
She asked me to tell her all about how Rob and I met, so I started telling her. This really seemed to bring on the contractions, to which Jenn explained that there must be a lot of love there to help trigger my body into putting more effort towards having the baby!

Soon Rob arrived home from his appointment with some new eye meds to keep him going and I was getting quite uncomfortable with the contractions now. So we all decided it was a good idea to run a bath for me. It was a bit of an experiment too, to see if it slowed down my contractions. If it didn't, then we we're full steam ahead!

Getting into the water felt gorgeous and really took the edge off the contractions. So I asked to be left alone for a while so that I could really focus in on myself and get in the 'zone'. I have no idea how long I was in there alone, but I managed to cope very well with a lot of the contractions. I discovered that talking to the baby and telling her I loved her worked a treat and I also kept repeating 'moving doooooowwwnnnn' during a contraction to help with the visualisation of the baby's head descending through my pelvis.
 
Then things started to get a little negative. I managed to trigger a nasty contraction out of nowhere by trying to check my cervix myself (I had been doing this occasionally throughout the last couple of weeks of pregnancy). It knocked me for six and I obviously made a lot of noise because I heard feet running up over the stairs and it was Rob and Jenn coming in to check if I was alright.
 
They offered me food and drink (I think I managed a spoonful of yogurt and a sip of water) and they stayed around to help me through. It was getting quite hard to integrate the pain now and I started getting nervous and doubting my strength to carry on. Next thing I know I'm thinking about packing it all in and getting a c-section! It really was as if I had two voices in my head. One was cheering me on, being all positive and the other was like a black cloud of fear, negativity and self-loathing. It was saying 'you can't do this! Who are you kidding? You failed last time and you'll fail again, so just cut to the chase and demand a c-section. It'll save a lot of grief on everyone's part.'

I tried desperately to push this voice out of my head but it remained lingering in the background as the contractions got worse.

Jenn suggested I try to get out of the bath and snuggle up in the 'nest' I had made downstairs to try and gain some control back and then decide what to do from there.It took a huge amount of effort and will-power to get out of the bath but I managed it and had a contraction or two down over the stairs. During one of these I decided to tell Jenn (as I clung on to her for dear life!) about the bad thoughts I had been having. She of course reassured me I was doing fantastically and was coping really well. It felt good to hear that I wasn't making a 'scene' and that everything so far was looking pretty normal for a woman in labour. I guess my previous experience was so 'abnormal' that I didn't really know what 'normal' felt like.

So I carried on labouring in the front room again, knees on the cushioned floor and upper body draped over pillows on the sofa. It was very snuggley and warm but not offering much relief from the contractions. Rob called my doula to let her know that things were really progressing and that she needed to come over ASAP. At this point it wasn't decided if Jenn would stay or leave once my doula arrived. Within minutes things seemed to progress even more. My contractions were coming thick and fast and I was off in 'la-la-labourland'. I think Rob then rang the hospital to let them know we were coming in and before I knew it we were leaving the house and piling into Jenn's car.
 
The journey to the hospital was not fun. Every tiny little bump triggered nasty contractions that didn't seem to have a build-up, so there was no way to prepare for them. I remember Jenn talking me through them as she was driving, telling me to imagine walking up a steep hill, then as the contraction would peak (top of the hill) it was time to walk down and breathe it out. I found this really worked for me. Sometimes it's easy to forget that contractions don't last forever and that you always come out of the other side.

When we arrived at the hospital I started to feel very teary and low. It was difficult to walk and hobbling down the corridors brought back a lot of memories from my previous labour. Rob and I checked in while Jenn parked her car (my doula had been informed to bypass our house and come straight to the hospital by this point). We were met by two midwives and they showed us to my room, which had just been cleaned out and the floor was still wet. It was stark and bright and cold (the windows had been flung open to release the smell of floor cleaner - lovely).

I instantly hit a wall. I bent over the bed, face down onto the mattress and struggled through intense contractions while the midwives nagged at me about VBAC patient protocols, to which they were informed that I didnt want to have continuous fetal monitoring.
 
They then had a bit of a to-do over the lack of birth plan in my notes (ok, my fault. It was on my list of things to do, ok?!) but luckily Rob and Jenn handled it very well for me while I spiralled into a very dark place.I started demanding a c-section under general anaesthetic. I said that I had been lying to myself and everyone else. There was no way I could handle any more pain and I didn't want to go through all the same as my previous labour again to end up with an emergency c-section. So let's cut to the chase and get it done. At some point my doula arrived, and between her, Jenn and the midwives I was told that I could not have a c-section because I didn't need one.

Oooh I was grumpy after that! I started whimpering and crying and felt totally crushed.

But then Jenn and my doula set about sorting things with the midwives (as in explaining what I wanted), drawing the curtains, closing the windows, wrapping me up warm, giving me food and water, rubbing my back and just generally working their magic.

I asked Jenn to stay for the time being as I felt I needed her there (the original plan was for her to keep me company at home during early labour and then for my doula to take over at the hospital).
 
The midwives wanted to do a quick check of the baby's heartbeat and rigged me up to a monitor. I wasn't too happy about this as it involved getting onto the bed, which was painful and difficult. My doula gave me a foot massage and talked me through contractions. Luckily all sounded well with the heart rate and I must've got off the bed soon afterwards (even though I don't remember doing it). I ended up on a birthing ball with Jenn and my doula on either side of me.
 
I can't remember much of what happened but I know it was tough. Some very intense contractions occurred and I can remember standing up and holding onto my doula while shuddering and nearly biting down on her wrist. Next thing I know the midwives appear and suggest checking my dilation progress. I did actually want to know what was going on as I had been labouring for a good while but I also knew it was going to hurt so with reluctance, I agreed.

I couldnt get up onto the bed again so one of the midwives checked me on the floor, on my side. I felt like a feral animal being examined by a vet. It was not one of my most elegant moments, to say the least! Fortunately, and to my surprise she was very quick and declared I was at 5cm but during a contraction I was going to 7cm. Which was really good news! I then started to feel much better and most negative thoughts left my head. I was going to have this baby! In hindsight, my doulas and I believe I must've hit transition when I got into hospital. Hence all the whining and c-section demanding on my part. I also believe that the drive and arriving at the place where it all went wrong last time had a HUGE psychological impact on me. Thank goodness I had my doulas to see me through it.

So I carried on labouring for a bit more on the birth ball, spirits lifted and managing to eat some melon my doula had brought in. It was still very intense through contractions and I felt like I was lagging. So there was a brief talk about pain relief (admittedly initiated my me), where the midwife almost excitedly told me all about the wonders of diamorphine. But in the end we all agreed to try a bath first and see where that lead us.

While the bath was being drawn I had to pee in a commode. Again, not one of my most elegant moments! After that, we all set off down the corridor to the bathroom (which was handily right at the other end). I held onto Rob and hobbled along like an old lady, my hips felt like they were popping and cracking with every step. At one point I actually found the strength from somewhere to walk through a contraction. This actually quite impressed me and made me realise I wasn't such a wimp after all!

The bathroom was very 'functional' but I didn't care, I just wanted to get into the lovely hot, enticing bath in front of me. My doula put some lavender essential oil in the water for me while I undressed and then climbed in.

Two words; utter bliss! Water really does take the edge off things when you're in labour. For me, it's not so much about relieving pain but more to do with supporting my weight and making it easier to move around. I tried all sorts of positions in that tub and could easily rest in between contractions.

Things were going nicely, so we sent Rob off to our room to rest his eyes. I continued to labour with Jenn and my doula mothering me with one of the midwives every now and again checking the heart rate of the baby with a Doppler.

I was well and truly in a hypnotic state by now. I can only remember snippets of events such as Jenn and my doula stroking my hair, singing to me, reminding me to keep my shoulders relaxed, feeding me honey and sips of fruit smoothies and pouring water over my bump. I remember also having what some might consider an outer body experience. While resting between contractions I saw myself lying in the tub with golden light radiating from me. Don't get me wrong, it wasn't all blissed-out, endorphin fuelled hallucinations while I was in the tub. I did have the odd 'bad' contraction that would take every ounce of self control not to writhe around screaming like Linda Blair in The Exorcist. I found that these would happen if the ambience of the room was broken by a siren outside or someone knocking on the door.

Eventually I felt the urge to push out of nowhere. Well it wasn't an urge, it was more like my body just started pushing. The feeling of pushing is indescribable. But I'll try anyway. It's not painful, but just incredibly intense and it hit me like a freight train. There's nothing I could do to control it, my body just did the work and all I could do was make the most crazy and primal noises to get through it.

It was a welcome relief to the intense burning ache of the relentless contractions and I remember just feeling in awe of my body and the sensations I was feeling. I often ended a push by repeating 'woah!' and 'oh my god!' over and over in sheer disbelief I was actually pushing my baby down. A completely different experience to last time where I pushed for 3 hours, on my back, paralysed from an epidural but still able to feel everything because it hadn't worked properly with midwives counting to 10 as I bore down to no avail.

The midwife asked to check me, to make sure I was fully dilated and within seconds she was finished and telling me the baby's head was about an inch and a half away from my vaginal opening, so she was coming either way! I then checked myself and yes, I could definitely feel a head there, along with the caul that was ballooning slightly - my waters still hadn't broken. I carried on pushing in the tub, trying various positions. The energy in the room was very positive. So we decided to let Rob know what was happening and within minutes he was in the room with us.
 
He looked so happy and proud, despite the fact I was making noises I never thought were possible for a human being to make. I was fully expecting him to take one step into the room and then high tail it out again! I guess he could see in my face that I was, dare I say it, actually enjoying pushing.
 
After a while, things were going well, but not actually progressing. Baby's heart rate was fine, I was fine, but her head was not moving. The midwives were itching to rupture my membranes but instead it was suggested by my doulas that I got out of the bath and move to the room next door - which had now been specially prepared for the delivery. I felt so lucky to be in an NHS hospital, with essentially 2 rooms and a bathroom all to myself. Must've been a quiet day on the ward!

The delivery room did look very nice from the bathroom. It was cosier than the last one and the early evening autumnal sun was pouring in through the blinds (it was about 6pm at this point). It still took some effort to get out of the bath, as I knew things were going to get REALLY intense once I was out of the water. I tried to pee on the toilet before I ventured into the delivery room. I remember having a good strong contraction while sat on there but I honestly cannot remember if I pee'd or not! I then 'John Wayned' it out of the bathroom and into the delivery room, completely naked. I think it's safe to say I had long ago let go of any modesty issues by then. I was covered up by teeny NHS towels and led by someone to the side of the bed where some mats and sheets had been laid. The room was very busy. There was me, Rob, Jenn, my doula and both of the midwives. I quite liked it this way.

I did at least one push sort of stood up/semi squatting with my elbows on the bed. My doula was behind me, working my lower back with some shiatsu.

It was then suggested that I squat properly during the next contraction. My doula gave me some massage oil to perform some nipple stimulation on myself to bring on some good contractions. This totally works by the way.

When I felt the next contraction approaching I squatted right down and pushed. I could feel the most intense pressure in my bottom area. It was slightly scary because in any other circumstance you'd be convinced you were suffering a prolapse or something. But I pushed with all my might and felt the baby moving down.

Afterwards I think I mentioned not being able to feel my legs. So the next thing I know, I'm being sat on a plastic birthing stool. I didn't even realise they still used them and remember thinking 'how retro!'. I have to admit, I thought the stool was wonderful. It saves your legs from going numb and it holds you in the optimum position for pushing out a baby.

I was handed a mirror to see what was happening down below but it was too dark to see properly. So a wind-up torch was found from somewhere. I had another good strong contraction and afterwards I became aware of a loud whirring noise. I looked up to see Rob feverishly winding up the torch and making some joke about finally finding something he's of some use for. We all had a chuckle about that and it crossed my mind how casual and laid back birth can be, as long as you allow it.

Another contraction came and I could feel burning. This was one of my fears. Due to having a c-section last time, crowning was unknown territory for me and I was worried about the pain and, of course, tearing.
But to my surprise, it really wasn't that bad. I was too busy being in awe of the fact that now armed with a very thoroughly wound up torch, I could see my baby's head approaching (complete with pearly white membranes still intact) in the mirror.

Another contraction came, and I felt a bit more burning, along with more incredible pressure in my bottom. I clutched onto Rob's hands and started seeing stars behind my clamped shut eyelids. I then heard from someone (maybe the midwife on my left) that the head was out. I just couldn't believe it, how could I push out a baby's head and not even know?!

So I reached down and felt it. It was still in the caul so all a could feel was a slick ball shape, kind of like a water balloon but with more goo.

I was euphoric. I was in disbelief. This was it, I'm actually birthing my baby. NATURALLY, with no pain relief, no interventions. How kick ass was I?!

There was a flurry of action from the midwives and they removed the stool and positioned me on my knees so that they could catch the baby when I did the final push. They were worried that she'd be very slippery due to remaining in the caul and didnt want to risk dropping her on the floor.
 
The final contraction came and my body pushed out her body. I felt something give (I later found out it was my perineum to a second degree tear) and then literally felt her shoulders, torso, legs and feet come flying out of me. That was a very bizarre sensation.

Her caul finally broke as she came earth side and spilled amniotic fluid all over the floor, it was quite dramatically impressive. She was then scooted through my legs by someone and I SAW her. I saw her take her first breath. I even found out her sex and announced it to the room. I saw how she looked just like her sister. And I named her, Genevieve Autumn, born 6.58pm on 07/10/11, 9lbs 6oz.

The next few minutes were like some sort of surreal dream. I was helped across the floor to a pile of pillows and I cuddled Genevieve with Rob beside me taking photos. She was very quiet and alert and started nursing not long after we settled into our little floor nest while the midwives cleared up the carnage. I birthed my placenta naturally and Jenn and my doula cut the cord. All while I gazed upon my second beautiful daughter.

Over 3 weeks on and I'm still on a high from the birth. It was the most liberating and empowering experience of my life. I'm also still in awe of my body and what it achieved.
 
I think that going through labour and birth without interventions was such a personal journey for me. Even though it was only 12 hours out of my life, I feel like I transformed and grew into a different person during that time. I had to let go of fears, self-doubt, control and vanity and embraced trust in my self and my body.

VBAC is most definitely something any woman can try to achieve and I'm happy to report that my hospital VBAC experience was wonderful. I have to say however, that having my doulas around was a huge help. They not only mothered me through my labour, but also shielded me from a lot of pointless hospital aggro that happened and also made sure my wishes were heard and accepted by the midwives. So if you're put off having a HBAC due to the tiny risk associated with VBAC and would rather be in a hospital environment 'just in case' (like me) then definitely look into your choices. Just don't forget your birth plan (like me!).






3 comments:

  1. You are awesome Michelle and I am so honoured to have been a part of your experience...

    xxx

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  2. Wonderful story, thanks for sharing it Michelle..I'm in the middle of 'training' your friend Jenn to become a Doula, but it's clear that she already is, in all the ways that truly count.

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  3. It was great to be part of your story Michelle...to see you in your power and beauty and see your joy and elation afterwards..and your beautiful little girl!

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