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Episode 363

Mel’s Homebirth after a Caesarean

In this beautiful episode Mel compares her emergency caesarean with her homebirth after caesarean (HBAC) and sees the beauty, hope and healing in both experiences. She admits that she would never trade her birth journeys for the world, despite the trauma she experienced as a result of an induced labour and the cascade of intervention. Determined to do things differently for her second birth, she informed herself, advocated for what she wanted and had continuity of care with a private midwife alongside the physical and emotional support of a doula. She also embraced psychological support to process her birth trauma which she describes as a gift to herself as a woman and a mother.

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“We were really lucky and fell pregnant on the first try. It was a great pregnancy and I had no issues but I had a gut feeling that I wanted a natural birth and I was gravitating towards a home birth but I’ve heard it a lot in the podcast that you get quite nervous in the first pregnancy. I really talked myself out of a homebirth even though it felt most right. I ended up going to the other end of the spectrum and chose a private obstetrician and that was an interesting experience. I was so naive thinking my birth was going to go so perfectly that I almost disregarded my choice of obstetrician because I didn’t think I’d need him and to be honest, I didn’t really like him that much. As I got closer to 40 weeks he changed his tone around natural birth; instead of being really optimistic he started saying: we’ll see…..as long as there’s no complications. My concerns really started to consume me.

“I felt that because my pregnancy had gone so well my birth would go well too. I’m an avid researcher so I felt like I was well informed and that did cause some rift with my obstetrician because if I questioned something he wouldn’t like it. I can see that in hindsight I swept a few red flags under the rug. He ended up calling a lot of the shots in my birth and I wish I had found someone who was more aligned with my preferences.

“My hind waters started leaking which I’ve since realised is quite normal but my obstetrician was concerned enough to induce me the next day. I wasn’t feeling afraid of labour but I was nervous about being induced. It was the one thing I really didn’t want so I managed to negotiate 72 hours to see if I could go into spontaneous labour and I tried everything in those three days but she just wasn’t ready. So I went to the hospital and I was hooked up to the drip straightaway. I didn’t know much about induction and I didn’t know that there was a syntocinon dial so they can adjust how much is administered. They had me on the maximum amount from the moment I was hooked up.

“I just remember an onslaught of contractions; 90 second contractions that were a 9/10 pain and there was only a 30 second gap in between. My body just freaked out; it couldn’t deal with it. I started panicking and that went on for about three hours. The midwife came in and asked me if she wanted me to turn it down and I agreed and that helped quite a bit. It had been four hours and I was only 2 cm which was quite discouraging. In the moment I was just trying to survive and have a natural labour and I remember my husband looking at me while I was shaking and crying and he suggested an epidural. He looked at me and basically told me with his eyes that it would be okay to have an epidural. I remember getting the epidural and thinking it was a godsend. It was the most amazing feeling of relief. That lasted thirty minutes but then I started having a bad reaction to the epidural; I was shaking and constantly vomiting and they were concerned about Emmy’s heart rate.

“At that point the obstetrician came in and checked me and I was 9.5 cm and my waters had broken. He said that because I was having such a bad reaction to the epidural and because of that he called an emergency caesarean. Within thirty minutes Emmy was born and she was screaming but sadly we didn’t get optimal cord clamping or skin to skin; they took her for five minutes and checked her over. She finally came to me and in that moment I almost forgot what had just happened. To be honest it took me over a year to recognise the trauma and understand that I wasn’t okay. It wasn’t until her first birthday that I recognised it was far deeper than physical trauma. It prompted me to seek our professional help and I’m so glad I did because it gave me a lot of peace. I’m so glad I had that one hour a week where someone was asking me questions about myself and forcing me to face a lot of things that I had suppressed.

“Emmy was almost two-and-a-half when we felt like we were ready to try again. I knew how I was going to approach pregnancy and birth because I felt like I’d really nourished myself through therapy. We fell first try again but that was a complicated pregnancy as I miscarried at 11 weeks and it was a partial molar pregnancy. Everything looked relatively fine at the 7 week dating scan but at the 9 week scan they were concerned about a few abnormalities about the shape of the gestational sac even though there was a heartbeat. At the 11 week scan there was no heartbeat and it was the middle of covid lockdown so I was by myself. The sonographer was so beautiful and gave me the biggest hug – lovingly but quickly – and she explained that she felt there was something quite wrong.

“With a partial molar pregnancy it embeds in the uterine wall and it starts to grow like a tumour. A lot of women who have these kinds of pregnancies have to go on chemotherapy because it just keeps growing so it’s important to get it out quite quickly. By 6am the next morning I was in hospital for a D+C and I knew I’d have to do blood tests for 5-6 months following. I went back to therapy which really helped and my psychologist helped get my mum out from Canada which made a huge difference.

“My hCG levels took five months to go back to zero and I finally got my period back. I found out I was pregnant on Christmas morning with Callum. As soon as I saw those two lines I knew this baby was going to stay. I didn’t feel nervous at all; I was really confident although I admit I was really reassured by the strong heartbeat at my scans. As time passed I focussed less and less on the health of the pregnancy and more thinking about birth preparation.

“I think the first thing I said when I found out I was pregnant was: we’re having a homebirth. The homebirth community flies under the radar but once I was in it it’s hard to believe that I missed it. I started to put things in place to make sure it could happen for me. I initially went to the midwifery program at the Royal Women’s at Randwick and my midwife was beautiful. She said I wasn’t able to do the program because I’d had an emergency caesarean but she gave me the nudge to go private so I reached out to a private midwife the next day and I spoke to her on the phone and she just said: right, we’re having a VBAC. There was never any doubt from her and that continued throughout my pregnancy. It was such a shift in the energy compared to my first pregnancy where there was a lot of doubt and concern.

“We had a doula as well and my mum was still here from Canada so I had a lot of support. His original due date was the sixth and yet Emmy kept saying throughout the pregnancy that he was going to come on the five, on number five. I woke up at 3am and felt my first contraction. Labour was so nice and it was lovely to just be in it by myself when the house was quiet. It was a really nice way to start labour. At 5am I woke my partner and at that stage I was timing them so I sent my midwife and doula a text. Jerusha, my doula, came over at about 7:30am and at that stage my breathing was really deep and I was focussing on the contractions. I felt like I was gearing up for a long labour. Jerusha called my midwife and she was just finishing up at another birth.

“My partner started filling the birth pool and then at 9am things started to slow down. I got really nervous and was worried that I’d need to transfer to hospital. At about 9:30am Jerusha encouraged me to have a shower to wake up a bit and then we’d go for a walk. I went upstairs and I sat on the toilet to do a wee and I had the most insane contraction; it lasted about four minutes and it felt like I was just surviving. Hamish pulled me off the toilet and put me in the shower and 20 seconds later I had another huge contraction and I started to feel Callum move down.

“Jerusha came in and said we needed to get in the pool. I just had to hold on and let my body do its thing. Jerusha let me do everything myself and she talked me through what to do, how to breathe and what to do with my hands. Looking back, she really gave me so many gifts that I don’t know I would have had otherwise. There were a few more contractions and then he floated out and I caught him and I just remember thinking: I did it and a human just exited my body. 

“He came right to my chest, looked up and then he went to sleep. My midwife arrived minutes later. I stayed in the pool for about thirty minutes and then I stood up and walked over to the couch and then I birthed the placenta twenty minutes later.

“If anything sold homebirth for me it was the fact that afterwards, I got to sleep in my bed. There’s nothing quite like having all your people around you, in your home, as you birth your baby. It helped me understand that there was a purpose to my first birth; it made it clear to me what I really wanted and it gave me the confidence to do it. It was so healing, especially to know that Emmy saw it all unfold.

“It’s been really meaningful for me to look at both my births and see them as incredible experiences. The journey to get to the birth is significant and important but now having contrasting experiences and reflecting on them…it really is about the fact that you get to meet your baby, your best friend, the person who is most important in your life.”

Topics Discussed

Doula, Emergency caesarean, HBAC, Induction, partial molar pregnancy, Private midwife, Private obstetrician, Two Babies, VBAC

Episode Sponsor

This episode is brought to you by The Birth Class, my online childbirth education course.

Featuring 10 audio lessons with perinatal health specialists, you can listen from the comfort of your home when you’re relaxed and receptive to new information. The Birth Class is a conversation starter between you and your birth partner that informs, encourages and empowers you to journey towards labour with knowledge and confidence.

In The Birth Class you’ll be guided through every stage of labour and birth, including:

– the powerful role of your hormones to prompt contractions and moderate pain
– what to expect from each stage of labour; from the first contraction to birthing your baby and the placenta
– practical breathing and sound skills to help you navigate contractions and overwhelm
– the benefit of staying active in labour and how it can assist cervical dilation
– how optimal maternal positioning in late pregnancy can encourage your baby into an ideal birth position
– how to prepare for a successful vaginal birth after caesarean (VBAC)
– your pain-relief options, both non-pharmacological and pharmacological
– the risks and benefits of birth interventions and how they can help or hinder labour
– typical complications that lead to an emergency caesarean and what’s involved in the process
– what to expect in the hours after birth, including breastfeeding and blood loss
– breastfeeding advice to guide you through the fourth trimester with confidence.
– and so much more.

Check out The Birth Class here.

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