The Two Week Wait
10 Questions To Ask Your Care Provider
Pregnancy After Miscarriage: How Long to Wait Before Trying Again
Bleeding In Pregnancy
Birthing Your Placenta : Active Management versus Physiological Management
5 Common Postpartum Experiences
In this week’s episode I chat to Elodie about her three births. As a first-time mum she was happy to let her birth unfold without doing much preparation. By the time she was pregnant with her third baby and preparing for a VBAC2 (Vaginal Birth After 2 Caesareans) she understood the power of knowledge, embraced months of mental and physical preparation and surrounded herself with educated, informed and encouraging support people who could advocate for her during labour and birth. If you are currently preparing for a VBAC or you’re considering one in the future, this episode is for you.
Elodie’s first pregnancy ended in miscarriage and she admits she was unprepared for the heartache and grief. Eight months later she conceived but was hesitant to celebrate as she found the anxiety and fear overwhelming. By 20 weeks she settled into the experience and apart from general pregnancy symptoms, she sailed through to full term.
Her waters broke at 40+3 but contractions hadn’t started so she was sent home from hospital. When she returned 24 hours later for a scheduled induction, there was meconium in her waters and her midwife discovered that baby Frankie was breech.
“They were rushed and they strongly emphasised that they didn’t recommend a breech delivery. It was out of my control, I was off on another journey and going through things I never expected to. It was practical and fast but not panicked. Immediately following birth, Frankie had a code blue and was taken to the resuscitation table. Thankfully it was resolved really quickly and he was brought over to me.
“During the birth classes at the hospital they told us that 1 in 4 women in the room would have a caesarean and I thought in my head that it wouldn’t be me. So, I hadn’t done any mental preparation for the possibility that I would have one…I didn’t realise a caesarean can delay your milk coming in and at the first night at home I couldn’t get him to latch and he didn’t feed all night so we went to ED the next morning and we saw a lactation consultant. It helpted but breastfeeding was an uphill battle for the weeks that followed and that coupled with a caesarean recovery was really challenging.”
Elodie fell pregnant with Rosie when Frankie was 14months and was referred to the Mercy Hospital where she was supported in her attempt to have a VBAC.
“I was fairly certain that I wanted to try for a VBAC as long as there were no underlying risks. I definitely wanted to labour; I felt like it was something I’d missed out on in Frankie’s birth. I’d discovered after I had Frankie that I had hemochromatosis (too much iron in the body) which had to be monitored throughout the pregnancy but it didn’t cause too much concern.”
At 40+3 her waters broke and she had a show, she went straight into the birthing suite and labour kicked off quickly.
“I found labour quite frightening…I was GBS positive so I had the drip in and I had to be continually monitored and I found the constant hovering to be quite frustrating. I admit that I hadn’t done much preparation as a VBAC candidate. I accepted the gas but I wasn’t coping and I eventually agreed to an epidural. I was at 7cm then and it really helped me calm down – I felt good and safe again. It was so exciting when I got to 10cm but the pushing process with an epidural is so strange; you can’t feel anything and it’s impossible to follow instructions. Yes, the epidural calmed me down but it also stalled the labour. I knew I was on the clock – they told me I could push for an hour – and Rosie was posterior. I started to feel defeated and the contractions slowed down and there were signs of distress so the OB recommended a caesarean.
“It was the best decision for Rosie but I was distraught that I had gotten so close and hadn’t achieved my VBAC. Everyone was so kind and she was put on my chest straight away and she wasn’t taken away; she stayed with me in recovery and it just felt so different to our first birth. We really advocated for us all to be together – the three of us – in recovery and it was really special. I felt like everything we experienced there really softened the disappointment of not having a VBAC. Rosie chose her birth date, I got to experience labour, and the medical staff advocating for us in theatre really made it a beautiful experience.
“We fell pregnant really quickly the third time. I wanted to be really pragmatic about risks vs benefits when it came to a VBAC2. As time went on it became clear that it was something I wanted to attempt and at the end of every appointment I was asked what my mode of delivery would be and I began sharing my plans to have a VBAC2.
“I wanted to make sure I had processed my past birth experiences so I had birth counselling; it was really important for me and it was around this time that I recognised how much the interventions in Rosie’s birth affected the outcome; having an epidural and being on my back with a posterior baby definitely affected my chances of having a vaginal delivery.”
At 22weeks she was booked into the perinatal unit and classed as high risk because of her hemochromatosis. The unit functions like a regular clinic but she was teamed up with a group of obstetricians, a hematologist and a midwife. She took her situation and her plans for a VBAC2 appointment by appointment knowing that things could (and would) change week to week.
“The appointment-by-appointment approach worked for us, and I highly recommend it as it’s really easy to get overwhelmed by the unknowns, even though everything in pregnancy can change so quickly. I knew I had to be practical that a VBAC may not eventuate and I just had to take it one appointment at a time. They wanted to book me in for a caesarean five days post estimated due date (EDD) which gave me time to go into spontaneous labour. My birth plan focussed on no pain relief and no intervention and staying active to get the baby in the best position.
“My contractions started at midnight and my waters broke. The grandparents arrived and the hospital encouraged us to come in very quickly. Labour was intensifying really quickly and once we reached the hospital my first internal showed I was 8cm. They were a bit confronted by my case and there was a lot of double-checking. I said lots and lots of mantras over and over: this is good pain, this is all going in the right direction. I was offered pain medication over and over but I knew I needed to feel everything; I didn’t want to be disrupted or railroaded. I used my voice the whole time; I was roaring but it was working for me. Three hours into labour I started to push and the obstetrician came in and I could sense that time was stretched and she said she could get Leo out in two pushes with the vacuum so we did that. I had to go to the theatre to get stitched up but I was really vocal that I wanted to keep Leo with me so they agreed.
“It was pure joy. Ecstasy! I couldn’t believe that we had done it. But I’d done so much preparation. I did body work with an occupational therapist, abdominal massage and some inter-vaginal massage and practiced breathing into it to really overcome the doubt in my physical body. It was really fostering the mind-body connection and a really practical way to prepare for a VBAC
“There’s definitely an
element of peace within, after achieving it. It was so important that I could trust my instincts and that I was able to do it mentally and physically. It was quite transformative.”
Vaginal birth after caesarean (VBAC), Three babies, Breech baby, Lactation consultant, Hemochromatosis, Low platelets, Attempted VBAC, GBS, Emergency caesarean
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