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Episode 213

Bianca – Down Syndrome baby and VBAC

In this week’s episode I interview Bianca who, at the age of 22, fell pregnant unexpectedly and navigated the complex reality of a Down Syndrome diagnosis. Despite multiple health professionals advising her to terminate, she chose to keep her baby, journeyed through a tumultuous pregnancy and delivered him at 34weeks via cesarean. Baby Oliver was born with a heart condition and spent 12 weeks in NICU before being transferred to Melbourne Children’s Hospital for lifesaving surgery. During her second pregnancy, Bianca was determined to actively prepare for a VBAC and with the support of her caregivers she delivered another beautiful boy.

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“We had only been together for a few months when I discovered that I was pregnant and early on we discussed what we would do if the baby had Down Syndrome and we agreed that we would terminate. But then at 12weeks the ultrasound showed a thick nuchal fold which is a marker for DS and I knew then that there was absolutely no way I would be terminating my pregnancy. Our relationship ended around that time but I was happy to keep my baby and do what I needed to for him,” says Bianca.

Her first trimester was challenging as her HCG levels were low and only increasing slowly. At first doctors thought she was miscarrying and then they suspected an ectopic pregnancy but once the ultrasound results suggested Down Syndrome, everything stated to make sense. That said, Bianca’s GP simply advised a termination without offering further testing. It was confronting advise and as she admits, many health professions have very outdated information regarding prenatal testing options and the reality of life with a Downs Syndrome baby.

After doing her own research, Bianca opted to take the harmony test which showed there was a 99% chance that Oliver had DS and while she knew in her heart that it was correct, she still wanted the certainty of an amniocentesis. It was performed at 16weeks and during the procedure the specialist noticed that Oliver had a heart defect; a giant hole in the wall of his heart which caused the oxygenated and deoxygenated blood to mix. From then on Bianca knew that Oliver would need heart surgery shortly after birth and met with a cardiologist in her third trimester to discuss the steps that would be taken once he was born.

“There’s actually no severity to DS, you either have it or you don’t. The way we like to say things, is that DS children have different strengths and weaknesses, like any other kids. Heart conditions are common in children with DS though and therefore, there are many who have heart surgery after birth. It was really stressful and just really hard, there was so much to process and so many tests.”

Bianca was 30weeks pregnant when her doctors realised that Oliver had Intrauterine Growth Restriction (IUGR) and she was advised to fly from her hometown of Darwin to Melbourne where regular CTG and doppler tests could keep a close eye on Oliver’s progress.

“I flew down that night and was admitted to the Royal Women’s. They did a CTG twice a day and it was clear as the weeks progressed that he wasn’t coping that well anymore but they really wanted me to get to 34weeks. I let go my dreams of a natural birth, I was given two shots of steroids at 33weeks and then at 34weeks the blood flow through the umbilical cord was intermittent, he had stopped growing and the CTG showed a very flat ready with no movements and a few decelerations. It got to a point where it dropped to 48 and that’s very low (the average is 120-160) and they told me that they were going to push the emergency button and that everyone would run in. I remember one doctor and my midwife calmly talking me through it while everything else and everyone else was just white noise behind me.

“The paediatric team and cardiologists were in theatre waiting for me when I arrived. I knew there was a chance I might not hear him cry but the relief of hearing him cry and seeing him kicking was just indescribable. They took him straight into the incubator, he needed oxygen and he was really small – 1.4kg – but his colour was great, he had an Apgar score of 8 and I was able to give him a kiss and put my face on his before they took him to the NICU.

“Once he was out I didn’t feel as afraid as I did when I was pregnant. I wasn’t worried. It’s strange but I knew he was safe and getting the help he needed. I expressed colostrum and they wheeled me up and fed it to him through the nasal gastric tube and from then on I just focussed on expressing breastmilk and being by his side every day.”

Bianca was discharged on day four and stayed in hospital accomodation, an experience that absolutely shattered her but once she was in a routine she accepted the reality of the situation and just supported Oliver to get to 3kg so he could have his operation. At 12 weeks he was transferred to the Children’s Hospital and had lifesaving surgery. Two-and-a-half weeks later they flew home to Darwin and now he’s a thriving, cheeky, loveable boy who is reaching all his milestones.

He also recently became a big brother. Bianca met her partner, Tyler and they knew they wanted a child from the start. Tyler has two children from a previous marriage so they now have a beautiful, big blended family and couldn’t be happier.

They say that if you’ve had a child with any chromosomal abnormality then your chances of having another one are higher. But it’s all just chance, really and I wasn’t overly concerned. I did however realise how much I pined for a natural birth experience so I spoke to the OB about my plans for a VBAC and they were incredibly supportive right throughout the pregnancy.

After going to hospital exhausted from three days of early labour, Bianca was sent home and told to return the next day for her regular appointment. Her contractions had eased and after crying about the fact that her labour was going nowhere, he waters broke. They looked dark in colour so the midwives encouraged her to present to hospital immediately as they suspected meconium.

“One I got to hospital they confirmed that Teddy had done a poo but they monitored him and he was happy. However, they encouraged me to have an induction which I did and after eight or so hours I was only 1-2cm. I cried and cried but knew I just had to go with the flow so I opted for an epidural to combat my exhaustion and help me relax. And it worked! I pushed for 40minutes and Teddy was born and placed straight on my chest. He was perfect with so much dark hair and I just held him and loved him.”

Bianca admits that the first three weeks after birth were quite tough. She developed an internal infection so needed three rounds of antibiotics to combat it, Teddy had a tongue tie so breastfeeding was challenging and it was the first time she’s ever had to look after a newborn considering Oliver was in hospital for his first four months of life. She got through it all and Teddy is now a gorgeous six-month-old who makes everyone smile.


Topics Discussed

Down syndrome, IUGR, NICU, Two births, Vaginal birth after caesarean (VBAC)

Episode Sponsor

Today’s episode is sponsored by ErgoPouch. It’s hard to believe summer will be over next month, but the silver lining is that the ergoPouch Summer Sale is now on! If you haven’t heard of Australian sleepwear brand ergoPouch, they make premium, certified organic and natural fibre TOG-rated sleepwear and sleep solutions for newborns to
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