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Episode 310

Lewarna

In today’s episode Lewarna shares the story of her first baby who stayed in a breech position despite embracing all the turning and spinning techniques. She talks about her birth preparation and her fear, and while her caesarean was planned, she actually went into spontaneous labour and felt comforted by the fact that her baby chose her birth date. Her caesarean experience was incredibly positive yet she admits she started planning a VBAC while she was still in hospital. In her second pregnancy she talks at length about her informed choices regarding a VBAC, induction or planned caesarean as she weighed up the benefits and risks of each. “I didn’t want to push the boundaries of risk but I also didn’t want to have unnecessary intervention,” she says.

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After falling pregnant soon after trying, Lewarna saw her GP who made her initial appointment really straightforward and guided her in the right direction. She was fortunate to land in the coveted birth centre programme where she had continuity of care with her own midwife. She also had a first-year midwifery student who was available throughout the pregnancy and was on call for her birth. She admits that while she felt grateful to have access to birth centre care, she was also comforted to know that hospital assistance was literally around the corner if she needed it during labour or birth. At 30 weeks, Lewarna’s baby was in a breech position but her midwife reiterated that it was nothing to worry about and she would most probably turn.

“I was doing spinning babies and acupuncture but they didn’t work. I booked in for an ECV at 37 weeks and I used my breathing techniques throughout the process but it didn’t work for us. I processed my disappointment before the ECV because I really believed that my baby wasn’t turning for a reason. But I felt quite funny about choosing my baby’s birth date and I really wanted to go into spontaneous labour but the obstetrician felt that the risks outweigh the benefits. He was happy to support me to go to my due date and I was happy with that.

“I was 38 weeks and I’d been nesting, the house was spotless, we’d been out for coffee and in the afternoon I had a nap. I remember thinking that it had been such a lovely day and I thought that if my baby came soon, I’d be so happy. I lost my mucous plug and I had a contraction in the evening but I just thought it was late pregnancy twinges. I went to bed at 10:30pm and then I was getting up every ten minutes to go to the toilet. I eventually got up and watched a movie while bouncing on the ball and about 1:30am I woke my husband and he encouraged me to call the midwife. My waters broke soon after and we made our way into the hospital…I could feel my waters in my shoes.

“I got changed and prepped for theatre and at this point I was vomiting and from there everything went really fast. The anaesthetist was taking me through the risks of the anaesthetic and I remember wishing he would shut up so I could go into theatre. By the time I got in there I was 6cm so there was a bit of a rush to birth her. I thought they’d explain things as they went but next thing they’ve pulled this baby up, I was completely shocked that she was born and I didn’t even know we were at that point yet. We had skin on skin while they stitched me up and she was with me all through recovery and when I was taken back to my room my parents were there waiting for me.

“I got everything I wanted; I went into labour spontaneously, I got to experience labour while also knowing my baby was going to be born safely and from that moment I started planning my VBAC because the obstetrician told me there was no physiological reason for her to be breech. We had to go for a few ultrasounds for her hips because she was frank breech and that did worry me even though it didn’t end up being an issue for us. We stayed in hospital for three nights and physically I felt really well. Lily had lost quite a bit of weight in that time and we couldn’t be discharged until I’d had assistance with feeding her and that was really hard.

“My milk came in when the baby blues hit and I had some really irrational thoughts. I remember thinking that I would have to go back to work so my husband could stay at home and look after Lily. That passed but I felt like it was so easy for my thoughts and fears to spiral in those first few weeks.”

Lewarna fell pregnant with baby Ruby when Lily was two. She had the same student midwife as she did in her first pregnancy and she also managed to have a birth centre midwife, even though she had to birth in the hospital birthing unit because a VBAC is considered a higher risk. She listened to The Birth Class and read Rhea Dempsey’s books and once again had to navigate a breech presentation.

“I accepted the fact that I would be having another caesarean. I was so content with it because my first was such a great experience but my midwives were positive and they kept telling me that my baby could definitely still turn. Ruby actually did turn at 36 weeks and we had a bedside ultrasound just to confirm. It was a bit of a rollercoaster; planning for a VBAC then a caesarean and then a VBAC.

“My due date came and went and I felt physically great; I never got to the point where I was over it. I didn’t want to be induced, I was really adamant about that and my midwife was great at advocating for me. I didn’t want to push the boundaries of risk but I also didn’t want to have unnecessary intervention. They looked at the dates and the only available date for a scheduled caesarean was when I was 42 weeks. Things were still a bit up in the air because I was also on the cancellation list for a caesarean but there was also the possibility I would go into spontaneous labour.

“The second I lay down in bed, the night before my scheduled caesarean, I started having regular contractions. I got the TENS machine on straight away and I thought then that I might actually get the VBAC I wanted. My contractions were a bit all over the place but my husband was getting organised to go to hospital. At about 1am I called my midwife and my student midwife and we all headed into the hospital. I vomited in the car all the way there. Weirdly I didn’t mind it; it was a sensation I knew and it had a bit of a rhythm to it.

“They recommend monitoring and a cannula when you’re having a VBAC. I’d written a birth plan which actually never left my bag so I never had the opportunity to talk to my midwife about what I wanted in labour so I never actually communicated my wishes to my birth team. In labour I was non-verbal; I looked at the bath and I really wanted someone to fill it up but I couldn’t verbalise it. I was having a crisis of confidence and that’s when I knew I wanted them to check me so I could know where I was and I was 7-8cm. I spent a lot of time leaning on the bed doing the bicycle movement with my legs but the thing that worked the best for me was sitting on the edge of my bed with my legs hanging and I had my arms around my husband’s neck and I was pulling down, I kept telling myself to move down with the contractions.

“I got to the point where I thought it would be comfortable to sit on the toilet. My water’s hadn’t broken by this point and I didn’t like the pressure of them; I started to involuntarily push with the next contraction and my student midwife helped me off the toilet and onto the bed. I went on my back for a little while and I eventually lay on my side with my knees pulled back and my midwife used a warm compress while I was pushing; I felt the ring of fire and I’m pretty sure I felt when I tore, too. I was just going with the contractions. I was pushing for just under an hour and my waters broke while I was pushing and it made it so much easier to push once they were gone.

“I was in complete disbelief that I’d birthed my baby. After I’d spent some time with Ruby and birthed the placenta the obstetrician recommended I go to the theatre for a spinal block so my 3A tear could be repaired. It was really upsetting. Ruby had a little feed before I went. I had expressed colostrum so my husband held her and I was comforted that the colostrum was there if she needed it. I managed to get two physio appointments in the hospital two and six weeks after birth to assess my tears and my pelvic floor which I was really grateful for.”

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