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Episode 445

Kate – elective caesarean, private Ob

In this episode Kate takes us through her journey to motherhood with her two daughters. In her first pregnancy she opted for care with a private obstetrician and after navigating a very tight pelvic floor from early on, she planned an elective caesarean. Her second and third pregnancies ended in miscarriage and she talks at length about how that made her feel. Her anxiety peaked at the beginning of her fourth pregnancy but thanks to her beautiful, reassuring obstetrician she felt held and supported. At her 13 week scan an anatomical difference in her baby’s heart was detected and over the following 10 weeks, Kate and her husband navigated the possibility of a chromosomal abnormality alongside an amniocentesis, genetic counselling and termination for medical reasons (TFMR). At 24 weeks baby Ruby was given the all-clear and Kate finally felt like she could embrace the pregnancy she so dearly wanted.

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“It took about two months to conceive our first daughter, Audrey. We were rapt! I was due in June 2020 but then of course covid it. It was a strange time but we felt very fortunate to be pregnant. I’ve always wanted to be a mum, ever since I was little, and I wanted to share that journey and have that connection with my mum. Lucky we had facetime so she could see my body change…but also it was a super scary time to be pregnant. I just craved my mum.

“My GP recommended a private obstetrician in Hobart – Dr Tania Hingston – and it was the best decision I’ve ever made. She was contactable 24/7 and she was a calming presence and assured me that she was always going to be there for me.

“I’d been seeing a pelvic floor physiotherapist from nine weeks because my pelvic floor was quite tight. I started having trouble with my sacroiliac joints at 32 weeks and my physiotherapist couldn’t even examine me; I was so tight. I really felt like I wanted a vaginal birth but she was concerned that a vaginal birth may really damage my pelvic floor because of how tight it was so a few weeks after that I elected to have a caesarean.

“I was starting to feel anxious so I was booked in to be the first one in theatre. I had a spinal block which I was so nervous about but then it just felt surreal. The anaesthetist lifted my head up and I could see Audrey and I was just overcome with emotion. We were so overwhelmed and so in love. They put her on my chest and she suckled and then we went to recovery. Brendan was able to stay with me the whole time and once we were back on the ward he took his shirt off and held Audrey on his chest. You just fall in love with your partner all over again when they’re holding your new baby.

“I stayed in hospital for seven days as I had a few breastfeeding challenges. I was quite naive about it; it was so much harder than I ever thought. I stayed longer because it was covid lockdown and I really wanted to get it right before we were discharged.

“Audrey was nine months when we conceived again but I had a miscarriage at 11 weeks with our little boy. We started trying again and fell pregnant a few months later and miscarried again – it was early and spontaneous. It was still the biggest blow. I even said to Brendan that I wasn’t sure I could go through another loss; my body and my mind needed time to process and heal. And then there’s the fact that we hadn’t told anyone so people ask you things and there were days that were really hard. We decided to give it a break, we enjoyed Audrey and really took care of each other.

“In February 2022 we found out we were pregnant and my anxiety was very, very high. I knew if we had another miscarriage we really needed support. All the tests we did came back normal and low risk. My obstetrician and midwife were both so reassuring and our little baby was growing and I was having scans every two weeks for my peace of mind. At 12 weeks my obstetrician did a scan and everything was looking brilliant and the next week I had my nuchal scan at 13 weeks. I had an inkling that something wasn’t right because the sonographer was taking her time and then the head sonographer came in and I remember her saying that our baby had a right sided aortic arch which occurs in one in 1000 babies. She told me she’d called my obstetrician and that she would go through all the abnormalities and I just cried.

“We went to see Tania straight away and she went through the possible scenarios and what it can mean and she outlined the statistics. I went to the worst case scenario. The main abnormality that is associated with a right sided aortic arch is de georges syndrome which is concerned with the 22nd chromosome but the only way they can diagnose is to scan the baby when it’s bigger. Tania was explaining this to us and told us we would be speaking to a genetic counsellor so we could make an informed decision about what to do. She said we could do an amniocentesis at 17 weeks but we couldn’t have confirmation till a scan at 24 weeks. She was giving us all the options and scenarios and it was so overwhelming; Brendan was silent crying and I was just shocked.

“We kept the pregnancy a secret. We told Tania that if our baby did have that abnormality we would terminate because we wouldn’t be able to give them the life they deserved and we wouldn’t be able to give Audrey the life she deserved. The night before the amniocentesis Brendan tested positive to covid so I phoned one of my close friends from work and asked her to come with me and she held my hand throughout the whole procedure. Tania called us the night after and she told us the amniocentesis was really low risk so we just had to wait for the heart to get bigger. At our 20 week scan the sonographer thought it all looked good but she wanted to scan again at 24 weeks to be really confident that it was just an anatomical difference.

“I was so attached to this baby, feeling kicks and flutters, and I felt so connected. At 24 weeks it was confirmed that the aortic arch was a defect but also completely normal; we’d have a scan and ECO after birth and we were told she was going to be okay. I just exhaled, stopped holding my belly in and the looks I got at work…everyone was so shocked.

“I had another elective caesarean and the moment Ruby was lifted out of my tummy was the greatest relief. I was sobbing hard…I would do it all again to have a beautiful little baby. The scans showed a perfect heart and it was just full relief for me and I dove into the newborn bubble and enjoyed every moment without a care in the world.

“Instead of the apps and timing everything, I was so happy to have her on me no matter the day or night. I just felt at ease with her and I just embraced her and everything that postpartum was for us.”

Topics Discussed

Breastfeeding, Elective caesarean, Miscarriage, Private obstetrician, Two Babies

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