Ali’s Two Birth Stories: Preeclampsia, Maternal Assisted Cesareans, and Breastfeeding Journeys

Ali conceived Evie quickly and had a relatively smooth pregnancy until around 30-32 weeks when her blood pressure began rising. “My blood pressure wasn’t like super duper high, like it was very much up from the 140 over 90 and it was starting to creep up to the 150s and 160 over 90,” Ali explains. She had a family history of preeclampsia – both her grandmother and mother had experienced it, with Ali herself being born at 30 weeks weighing under a kilo.

By 35 weeks, her blood pressure was dangerously high despite medication, and her fundal height measurements had slowed significantly. “My fundal height was like measuring only 27 weeks. So I kind of had like stopped growing essentially,” she recalls. Her obstetrician, Dr. Pete Jurcevic, gave her the option of induction or cesarean.

“I was very much aware of the model of care that I had chosen being private health and knowing that there is potentially the higher percentage of births that do go through private health where there is more interventions,” Ali shares. After careful consideration and having prepared through hypnobirthing classes, Ali chose a maternal assisted caesarean.

“If I could control that factor that she would be delivered in a more peaceful and calm environment… I just had a gut feeling that if I had been induced things would have gone in our way,” she reflects.

The caesarean birth was a positive experience, with Ali describing the profound moment of pulling her daughter from her own body: “Dr. Pete pulled her out with forceps some of the time because she was still quite high up. She definitely wasn’t like ready to be birthed essentially. So that was another reassurance as well that she wasn’t ready to be born… And under her armpits and lifted her up and I’ve got some lovely photos and videos of her birth which is nice to look back on.”

Evie was born at 2.55kg and spent three days in special care due to low blood sugar levels. This separation impacted Ali’s breastfeeding journey, as she wasn’t able to establish early breastfeeding or pumping. “I didn’t get to do my first breast pump for like a full sort of maybe 12 or more hours essentially. And even hand expressing, it just didn’t happen,” she explains.

Ali’s determination to breastfeed led her to triple feed for three months – an exhausting schedule that included pumping up to 12 times a day. “I triple fed for three months. So for those that don’t know what triple feeding is, it’s you breastfeed your baby and then top them up with either formula or breast milk. I was topping her up with breast milk and then pumping.”

Despite taking medication to boost her supply, the milk transfer during breastfeeding was never optimal. “I distinctly remember seeing her playing on the floor and watching her rolling around and happy… I’m like, I’m not on the floor playing with her. And at that point, I’m like, I want to be able to enjoy my time with her. I don’t want to be stuck to a pump anymore.”

When Evie was around one year old, Ali and Brad decided to try for another baby while living in a rental during a house rebuild. Again, conception happened quickly, and Ali returned to Dr. Pete for care. This time, she took low-dose aspirin from early in pregnancy to help manage her blood pressure.

“I’ve got endometriosis and PCOS so I was aware that it could potentially take a while,” Ali shares, but both pregnancies happened quickly. For her second pregnancy, she was hoping for a VBAC and prepared extensively, “I was like, right, I’m going to be armed to the absolute with all the education I could do. I looked up the Great Birth Rebellion podcast as well. And I joined a VBAC group on Facebook and read heaps of VBAC stories online.”

She also had a breastfeeding debrief with lactation consultant Joellen Winders-Pay to prepare for feeding her second baby. “It was incredible. It was so good to discuss the ins and outs of what my breastfeeding journey was like with Evie, what I wanted for this time around.”

Unfortunately, around 32 weeks, her blood pressure began rising again, and by 36.5 weeks, her amniotic fluid levels had dropped dangerously low. “He looked at the amniotic fluid levels and anything under five is not good. It’s like considered that there’s less than 500 mil of amniotic fluid. And he said, combined with the preeclampsia as well, it was time for Iris to come out.”

Once again, Ali opted for a maternal assisted cesarean. “The maternal assisted part of the birth is like, if you can’t have a vaginal birth and you do want to have a cesarean, I definitely recommend it to anyone because it’s just being able to pull your baby out and have that connection with them and feel their arms as they’re coming out of your body. It’s just so magical.”

Iris’s birth and early breastfeeding journey was much more positive. She didn’t require special care and was able to breastfeed in recovery, which Ali describes as a “redemption journey.” “I just want to bawl my eyes out because it was such a redemption sort of journey. Only being able to breastfeed her in recovery and have her come back to our room and not be in special care.”

However, around eight weeks, Iris’s weight gain plateaued, and by ten weeks, she was having green, acidic, explosive stools. “She went from maybe six to eight nappies a day to over 12 dirty nappies a day. It was like, well, something’s not right here.”

After consulting with multiple specialists, Iris had a tongue tie released, and Ali eliminated dairy from her diet, which made an immediate difference. “Literally within three days, the poo had changed. So we knew that that was one of the reasons.” Later, she also eliminated soy and worked with a nutritionist to ensure her own nutrition remained balanced while breastfeeding.

After addressing these issues and having Iris’s tongue and lip ties lasered, her weight gain improved dramatically. “I think there was a six week timeframe just recently where she put on like a kilo and she’s just absolutely going gangbusters.”

Ali emphasizes the importance of preparation, trusting your instincts, and finding practitioners who align with your values: “A word of advice or wisdom or learnings that I’ve learnt from this journey in particular is just, even if you do have to see a bunch of different specialists, just really stick with your gut feeling and what you feel is right.”

Despite not having the vaginal births she initially hoped for, Ali feels empowered by her maternal assisted cesarean experiences. “I don’t feel like jibbed that I didn’t get a vaginal birth. Even though I’ve never been in labour, I don’t feel like I’ve missed out.”

Now, she’s continuing to breastfeed Iris for as long as they both want to continue, having overcome significant challenges to establish their feeding relationship. “I’m just going to keep going for as long as she wants to feed… I’m just going to feed her as long as I’m comfortable feeding her.”