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Episode 413

Larissa – VBAC2, PCOS, caesarean, induction, weight-loss surgery

In this episode Larissa takes us through her three births across 14 years. She fell pregnant for the first time when she was 18 and followed her doctor's advice to have a caesarean. In her second pregnancy - six years later - she attempted a VBAC but had to be induced and an emergency caesarean was recommended. Her third and fourth pregnancies ended in second-trimester miscarriages and Larissa takes us through her choice to have medical management and birth her babies vaginally. Her next pregnancy continued to full term and as well as being educated about achieving a VBAC2, she surrounded herself with a supportive team and birthed her baby in “the best moment of her life.”

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“I was 18 when I fell pregnant with my first and I had him the day after I turned 19. I’ve never had regular cycles because I’ve got PCOS but I just had a feeling I was pregnant. I’m from a religious family so it was hard to tell my family but they were supportive of me. My boyfriend was okay about it and he was prepared to support me throughout it and we did well.

“All I knew about birth was from my mother who had two very traumatic births and I just went to my GP who was also a public obstetrician and trusted the medical team at my local hospital. I wasn’t scared of birth but it was just an unknown; I thought it would be straightforward like the movies; your water breaks and you have a baby. I was young, naive and excited to have a baby and it was a really good pregnancy.

“I woke up the morning after my birthday and my waters broke in bed. I went to the hospital to confirm that my waters had broken and they had but I had absolutely no contractions. My obstetrician came to see me and he said there was no way I was close to being in labour so I could be induced and end up with an emergency caesarean at midnight or I could have a caesarean at lunchtime which he referred to as the ‘safer option’. Being 19 and trusting my doctor, I just said okay. I don’t remember getting any sort of education about what was involved. It all became real when I had to have the epidural and I got really scared at that moment. I just handed it all over to someone else; I didn’t have any understanding of my other options.

“He was on my chest after birth but then I went to recovery without him. It took me four hours to get back to the ward and I was so immobile and the next few days were really hard. I remember the bad stuff more than the good moments, including the fact that I didn’t have a shower till day three but I think that was pretty normal back then.

“I conceived my second boy at a time in my life that wasn’t great but the point that changed my life was when my grandmother told me she believed in me and that she’d support me as a single mother and I’ll always be grateful for that. I went to a female GP and assumed I would have another caesarean and late in my third trimester she asked me why I wasn’t preparing for a VBAC and that was when I told her I didn’t know that was an option and that I’d been told my pelvis was too small. She checked me and she reassured me that I absolutely could attempt a VBAC and she referred me to another hospital who would support me because even eight years ago it was harder to access care for a VBAC.

“My waters broke again – all over the carpet – my mum came and got me and my little boy went to my grandparent’s house. They sent me home and then the next morning I got a call from the obstetrician telling me I shouldn’t have been sent home. I had an IV antibiotic drip, then next morning I was induced, I then got an epidural and my baby’s head was turned to the side and not pressing on the cervix and although the obstetrician tried to move him but he would and then his heart rate was dropping so it was decided that an emergency caesarean was best. I freaked out on the way to the theatre but when he was born I requested he be in recovery with me because I knew how important that initial breastfeed was and he latched and then fed for 12 months. I didn’t take any pain relief after the caesarean and I recovered really quickly and really well and I was discharged a few days later.

“Parker was born in February and I met my now-husband in October that year. He’s a calculated and logical man and he was very serious about making the right decision because it wasn’t just me he was committing to, it was the boys, too. I got pregnant in April 2019 and I was really sick but super happy but then we lost it. I had my 12 week scan and the NIPT was clear. I was in prac on ICU and I noticed a tiny bit of light brown discharge but I didn’t think much of it. I went back onto the ward and had a panic attack so my colleague told me to go straight to ED. As soon as they did the ultrasound I could see there was no heartbeat.

“I went home, waited for my husband to return home from FIFO and we went back to the hospital the next day and I was given the options of a D+C or medical management. I was given the medication and my midwife was amazing; I had a bit more medication that evening and then I started getting some pains and I delivered it into a pot on the toilet. My midwife wrapped my baby and we said goodbye and I went home that night because all I wanted to do was sleep in my own bed.

“Eighteen months later we still weren’t pregnant. We started to work with an obstetrician for fertility and we got pregnant again in June 2021 and everything was looking really good. Sadly, we had another miscarriage; I saw the baby on an ultrasound at 13+6 and at our next ultrasound at 14+5 and in that scan I knew straight away again.

“I went straight to the hospital to see my obstetrician and I chose to have medical management again. I was strong and this time my husband really needed me. I held my baby, I cut the cord and said goodbye…it was comforting that I’d been there before. We did testing again but we didn’t get any answers.

“We decided to take a break and around that time I started to look into weight loss surgery for myself. I worked really hard and lost 30kg in six months and was the healthiest I’ve ever been. Eight months after the surgery I conceived and it was really scary. I had a lot of anxiety because there wasn’t a 12 week safety net for us. I went to my 14+5 scan and it was terrifying but my baby put on the show of the lifetime in that scan; he wanted us to know he was okay.

“I really wanted a vaginal birth and I felt like I started the process of a VBAC with the two babies I’d lost. I couldn’t get a private midwife so I went to a private midwifery clinic who just did antenatal and postnatal care. I took it day by day…the pregnancy was riddled with anxiety.

“We did a VBAC education course and that really shifted my husband’s perspective. Towards the end we were really ready and I just monitored my baby’s movements really closely. I had a couple of false starts with labour but one morning I woke up and I was definitely having contractions. We took the dogs for a walk and then I came home and realised I’d been focusing on the contractions and not the movements and I started panicking. That’s when I realised I wanted to be at the hospital; I felt comfortable there.

“I asked for a vaginal examination to confirm I was in established labour; I was 2cm and the baby’s head was low and my cervix was soft and short and I was really happy with that, it was the furthest I’d ever got. I got into the birthing suite at 2pm and at 4pm I had bulging waters but I didn’t want them broken because I knew I’d be on the clock. The obstetrician came in and told me he’d read the birth plan and was happy for me to keep labouring and that I knew what I was doing.

“At 8pm my waters were ruptured and then it was on. I got in the shower and I was in my own world and I was really struggling. I told my husband that I wanted gas and he just agreed with me but then didn’t do anything because we’d talked about the difference between me managing and really needing relief.

“I was starting to lose control but I knew that each contraction was three big exhalations/moans and I knew I could get through that. And then I felt the need to push and it was so overwhelming. My midwife told me to slow down and breathe my baby out and I pushed for 2 minutes and he was born. They passed him through and I grabbed him and I couldn’t stop saying: “I did it!” It was the best moment of my life. I got on the bed and he latched straightaway. I delivered the placenta 40 minutes later and that’s when they cut the cord.

“We were home before my boys woke the next morning. The recovery between a caesarean and vaginal birth is completely different. I had very minimal pain apart from the afterpains…they were horrific. I was terrified of feeding because I knew they’d get worse every time he latched.”

Topics Discussed

Caesarean, Induction, PCOS, second-trimester miscarriage, Three births, VBAC2, weight-loss surgery

Episode Sponsor

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