Prepare for a Positive Birth with THE BIRTH CLASS

Episode 496

Tanya – vaginal birth, vacuum, molar pregnancy, IVF, breech, planned caesarean, down’s syndrome, TFMR, VBAC

In today’s episode, Tanya takes us through her four birth experiences. Her first two babies are now teenagers and her second two are very little, so she speaks from the perspective of a mother in her 20s and her 40s and comments on how the maternity system has changed over the years to ultimately become more risk-averse. She conceived via IVF for her third baby and after two previous vaginal births, had a planned caesarean because of breech positioning. Two years later she conceived naturally, a little boy named Ollie who had a life-limiting health diagnosis and was terminated for medical reasons. Tanya speaks openly about that experience and the trust she found in her intuition. She says her heart was ready for one more baby so after another IVF conception and a healthy pregnancy, she achieved an incredible VBAC; empowered by knowledge and supported by her private obstetrician.

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“I have four children; my eldest is 17, and then 14, 3 and six months. My partner Michael and I live on the lower north shore and my ex-husband is also an important part of our extended family. I was 26 when I had my first baby. I’d been a nanny for many years so I felt really comfortable with children and I was really excited to have my own. I fell pregnant within three months of trying and I chose public maternity care through the Royal women’s in Randwick. It was a relatively easy pregnancy; my body just carried on and looking back, it was so simple.

“I was scheduled for an induction at 10 days overdue but my labour started the night before. The motherhood part didn’t worry me but I was so naive about birth. We did a hospital education class but looking back, I really didn’t know much at all and now I firmly believe that knowledge is power. I laboured for a long time and opted for an epidural which was a really positive experience; I was exhausted so I slept for a few hours. The timing worked well in the scheme of things. In hindsight I needed more guidance from the midwives but long story short, they used a vacuum and I had a second-degree tear which healed well.

“When Freddie was about two I started thinking about giving him a sibling. A three-year age gap made sense and I fell pregnant easily with Violet and the pregnancy was very smooth, too. We’d moved so we decided to go private; I was much more exposed to the options available. I went to the Mater and had a private obstetrician and it was a really lovely experience. She was breech for most of the pregnancy and we had scheduled a caesarean but at a scan at 38 weeks, we discovered she had turned and I hadn’t even felt it.

“I went into spontaneous labour at 38+6. My waters broke in hospital and while the gas+ air really helped with my breathing rhythm, I opted to have an epidural again. About 90 minutes later my obstetrician came in and helped me birth her; he encouraged me to reach down and bring Violet up onto my chest.

“Over the next eight years I got divorced and I met Michael, my husband, when I was 38. He didn’t have children and it was a conversation we had quite quickly. I got pregnant quite quickly but it was a molar pregnancy, diagnosed at 7 weeks. I had a blood test and had to wait five days to see what happened with my hCG levels and when the results came back, I was advised to have a D+C. I had to have regular blood tests to track my hCG levels and it took about six weeks to get back to zero and then I had to wait six months to start trying again. It was around that time that I started looking into IVF because I was so wary of my age; I was 39 by then. The doctor told me I had a 10 percent chance of conceiving through IVF and the same through natural conception.

“I went back to my obstetrician and he recommended a low-cost private clinic near us. We decided that we didn’t have time to keep trying naturally so we did a round of IVF and I got 13 eggs which was very exciting. Out of those, five fertilised and we did a fresh transfer. The whole process was miraculous and I’m grateful that it was easy for us. We did a NIPT and the results were all clear. I went to the same obstetrician and once again, my baby was breech. I tried everything – acupuncture, moxi – but nothing worked so I planned a caesarean birth. There was a big difference in my care over 11 years – they were a lot more risk-averse; generally-speaking, but I was also 41, it was an IVF baby and he was breech.

“As Lachlan was born, he did a massive wee and it hit my face. He stayed with me in recovery and it was lovely. My recovery was far better than I expected; I was terrified of a caesarean birth and what it would be like in postpartum. I really reinforced the fact that I couldn’t drive for six weeks so we had a really slow, newborn bubble and that was beautiful.

“We had four embryos on ice and we didn’t even discuss having another child. Having a baby at 41 felt like a miracle in itself. The IVF clinic contacted us a year later asking about what we wanted to do with them. We actually chose to discard them and later we really regretted it. When Lachie was about two I fell pregnant. It was a huge surprise and both Michael and I were over the moon. I changed obstetricians and booked in the NIPT and it never crossed my mind that we’d get anything but a positive result. I got a call and it floored me. My obstetrician was away so the OB who was covering, told me my baby has down’s syndrome. I have a nephew who has down’s syndrome so I was relatively comfortable with it but I was still shocked. I just couldn’t believe it. I know and love him so I wasn’t scared. The obstetrician told me we need to decide within two weeks if we were going to terminate or not.

“We had to have a CVS because the NIPT is only diagnostic. Every person in the medical world who we saw was so kind, gentle and supportive. It was really amazing to have that care. My obstetrician was happy to push out the termination for medical reasons and schedule an early anatomy scan so we knew more about what we were dealing with. We knew he was a boy and I felt like I needed to connect with him. At the 16 week anatomy scan we had a highly experienced doctor and he was so nurturing. We found that his lymphatic system was leaking so his heart and brain was filling with fluid and we knew then that he would never survive; the decision was taken away from us. I felt him move all the time; which was so special and so sad, too. The termination was really hard. We named him Oliver.

“And then we decided to have another child. Our heart had been opened. We decided to go back to the same IVF clinic as I was 42. It happened really quickly and it went smoothly. I got five eggs and two embryos. Two days before the transfer we decided to put two embryos in – I was in a really deep space of trust and gratitude. It sounds woo woo, but it was the path we were on after Ollie.

“We went to the sonographer for the seven week dating scan and that’s when we found out we had one baby. It was the way it was meant to work out. I definitely wanted to have a VBAC. I went with my same obstetrician and I felt so trusting of her and she was very supportive of my birth choices. Luckily Bella wasn’t breech. I went in at 39 weeks and they broke my waters and then I walked and walked and did lots of laps of the footy oval. We actually had a really lovely day; I was on the clock and returned to the hospital every few hours to check the baby but I had no contractions. By 5pm I was starting to accept that I may need to have a planned caesarean.

“I was in the birth suite in the evening and I got in the bath and this beautiful midwife came in and offered to put some lavender drops in the water. I put music on and then I looked outside and there was a super moon and I felt my first contraction. I had three mild contractions in the bath and then my obstetrician came and told me to stay where I was and she would come back to see me in an hour-in-a-half. When she came back I was in established labour and 6cm. It was so incredible; to feel Bella moving down. The contractions didn’t feel painful, they were just intense and I was just so happy to be experiencing labour.

“I was in the bath but they told me I couldn’t have a water birth so the midwife drained the bath and Bella was born. I had no tearing and it was just the most incredible experience.”

Topics Discussed

Breech, down’s syndrome, Epidural, Four babies, IVF, molar pregnancy, Planned caesarean, TFMR, Vacuum, Vaginal birth, VBAC

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