Prepare for a positive birth experience with our new book

Episode 309


In today’s episode Cara shares her experience of a missed miscarriage followed by 11 months of trying to conceive. After blood tests revealed she ovulates on day 18 of her cycle (not day 14 as her fertility app suggested) she fell pregnant the following month. Following an epidural and episiotomy in her first labour, she experienced a 3C vaginal tear. She had significant fear and concern about birthing vaginally again but after much discussion with her midwives and proactive preparation techniques, she birthed a bigger baby with an episiotomy but no extended tearing. I know so many women want to hear stories like this because preparing for a vaginal birth after a third or fourth degree tear definitely requires active preparation in pregnancy and both physical and mental support in labour.

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Cara’s first pregnancy was planned but on her dating scan she was told she had experienced a missed miscarriage.

“It took us 11 months to fall pregnant again and that was 11 months of uncertainty, trying, planning and being sad. We have an amazing GP who is an old family friend and she has a special interest in fertility and women’s health. She sent us both off for testing and I discovered that I ovulate on day 18 (not day 14 like my app tracker told me) and once we knew that we fell pregnant the next month. I’m extremely grateful to have access to that test and discover that information. It also showed that I had low egg reserves which may indicate that I go through earlier menopause and this information definitely encouraged me to not wait too long to try for my second baby.

“I was so anxious once I was pregnant because I was always waiting for blood; I was constantly checking for blood and it was incredibly taxing. Once the baby started moving consistently I could relax a bit more.”

Cara did shared care with her GP and local birth centre for her first pregnancy. She admits she didn’t really have a birth plan but was open to listening to her midwives and following their guidance as well as embracing Calmbirth skills to navigate labour.

“In both my labours I woke up about 3am with a contraction. With my first I went to the toilet and water just kept trickling – I wasn’t in control of it – and I knew it was my waters. I had a shower and the hot water really helped my lower back and I used the TENS machine which allowed me to stay at home for as long as possible. I was 5cm when I got to the birth centre which I was really happy with.”

Cara laboured for a long time and opted for an epidural to help her relax; she could feel the pressure of the contractions without the pain. After an episiotomy her baby boy was a compound presentation (his hand was beside his face) which tore her further and resulted in a 3C tear so she needed surgery immediately after birth to repair the tear.

“I couldn’t feel anything so I didn’t realise how bad it was. They assessed it in theatre and at the time I was more anxious that I was away from my baby. The recovery was rough but it healed well but I really was anxious about having another tear in my future births. We were really lucky with our breastfeeding journey; I had really realistic expectations about what breastfeeding would be like and one of the most valuable things I took from a workshop we did was that breastfeeding is natural but it’s not easy.

“The midwives at St George Hospital are the most phenomenal group of midwives, they just really care about what they do and they’re good at it. Their confidence definitely rubbed off on me. I had two midwives assigned to me but when I went into labour they had both done long shifts and weren’t allowed to work but I was really well supported by the midwives on staff.

“My amazing calmbirth teacher did a refresher course and she told me about an epino – a device used to scratch the perineum – but I decided that it wasn’t something I wanted to do, plus it was a significant cost for a single-use item. Perineal massage was also suggested but it’s hard to do when you’re heavily pregnant. There are things that can help in labour – labouring and birthing in the water although hospital policy didn’t support me to birth in the water because of my previous tear. The warm compress on the perineum while I’m pushing and they push back on the baby’s head as they’re crowning. They also reiterated that if I did need an episiotomy again they would try to do it in the same place so my scarring was minimised.

“I woke up at 3am with a contraction and they just kept coming, there was no breaks between them, it just felt like one long contraction. My waters broke 15 minutes later and I used the TENS machine but it did absolutely nothing for me. It was all happening a bit too fast. I got my husband out of bed and his mum came to look after our son and we got in the car; it was really intense even though it was only a 7 minute drive. I couldn’t sit down so I was on all fours. The midwife checked me and I was 7 cm and the final 3cm was moving quickly. I didn’t want to birth on my back because it can cause tearing so I was on all fours and the midwives were proactive with supporting the perineum but my scar tissue wasn’t thinning out so they asked me if I wanted an episiotomy and I agreed. The episiotomy didn’t extend even though my daughter was bigger – 4.2kg. They did the repair in the room and I got to hold my daughter for hours which was beautiful.”


You can connect with Cara and her business Four Little Monkeys and enjoy 10% off your first order with the code AUSBIRTH10. Cara and Four Little Monkey’s proudly support The Pink Elephant Foundation.

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