Lisa woke up from a lucid dream that she had a baby kicking in her tummy. Within the week Lisa had confirmation that what she had was no dream – she was 17 ½ weeks pregnant with her third child. After delivering her first two babies by caesarean, Lisa set out in search of the practitioner who would support a VBAC.
I woke up from a lucid dream that I had a baby kicking in my tummy. Within the week I had confirmation that what I had was no dream, I was expecting my 3rd child and was already 17 ½ weeks pregnant. Wow.
So I decided to visit my private obstetrician who had delivered my two sons Benjamin and Jonathan via caesarean. He however was on leave and had a substitute obstetrician temporarily standing in his place. Through her, I had asked and found that under no circumstance would he consider giving me a VBAC after having had two prior caesareans, despite the fact that I had no other contraindications for giving a normal natural birth.
My first son was breach, which left me with no option other than to give birth via caesarean according to my obstetrician’s choice of practice. Of course he gave me the option of switching obstetricians, but at 36 weeks, this did not feel like a viable alternative at the time.
My second son, Jonathan, was caesarean by choice. I suppose it was a matter of ‘going with the devil you know.’ Besides, I had felt like I had recuperated rather quickly from my previous caesarean, and that this time should not be much different. I also had fears about a bad and long bout of respiratory flu that had befallen me a couple of weeks before my due date and that I would not be able to recuperate as well from a trial of labour that turned into an emergency caesarean. Thus, my choice for a second caesarean.
I felt most comfortable with my obstetrician’s skills, however, to my surprise, he decided to let his assistant/partner in training perform the 2nd caesarean surgery. I also found that I did not heal quickly from my second caesarean at all. As a matter of fact, a year later I still suffered debilitating pains from walking medium to long distances in my lower abdomen where the caesareans occurred. This made parenting my two boys for the 1st year extremely challenging as I was going through a number of issues including recuperation from the pain of major surgery, bonding with new baby, and trying to deal with the guilt I felt from not being able to give my No 1 son the same level of attention I used to be able to give him. Between my long and painful recuperation and the demands of a new baby it was really too much for me to cope with on my own as my husband and I are a nuclear family with no extended family to request any assistance from.
So, when I found I was pregnant with my third, I realised I was going to have to have a much more in depth look at my options, to see if I really did have any options at this point. Thank goodness that I live in The Information Age. I didn’t even know what the term VBAC meant before typing caesarean + natural birth into Google.
So at 18 weeks, I started visiting obstetricians, with the creeping knowledge that I was going to have to interview quite a few to find out their views, beliefs & opinions as well as practices in the case of VBAC after 2 prior caesareans. After having been recommended by my obstetrician’s substitute obstetrician to the head doctor at Royal North Shore, and discussing my choices I would now move toward a public hospital system which would support a ‘trial of labour’ before considering moving me to the more extreme option of a 3rd caesarean. I was also appropriately warned by the head doctor, that although he supported my choice, it would be rather difficult for him to enforce as everything depended upon the beliefs and practices of the doctor on duty at the time of my delivery. So he recommended I choose a private doctor who would be more likely to comply with my wishes in the public hospital setting.
In the meantime, I had heard through other mothers at my oldest son’s school that there was such a practice called independent midwifery, and that many of the mothers utilised their services with very positive outcomes. Thank goodness for word of mouth. At about 24 weeks I decided to employ the help of a private midwife and drop the private obstetrician.
I found a local midwife, Robyn Dempsey, who had extensive experience in the field, and who seemed to have an open yet conservative approach with regards to safety and an ability to work within hospital settings. I had no idea at the time how invaluable her presence and input would be until that last hour when we actually delivered within the hospital setting and the following days my bub and I spent in hospital.
Robyn had told me she wouldn’t be surprised if I went past my due date, as this was common in first time deliveries.
Perhaps I didn’t feel ready. Perhaps there was just too much on with my eldest’s 5th birthday to prepare for and mom and dad staying with us and all the new and strange family dynamics that sometimes come into play when grandparents meet and integrate with their grandchildren for the first time. I also found that my mother’s natural concern and anxiety for me was causing me to feel anxious about having them around during a home labour & birth.
The Braxton-Hicks came for the first time on the 28th of February. Robyn looked with a hint of merriment when I told her I thought “Is that all there is to labour? This should be a breeze!” My due date was March 9, so I felt sure I would deliver at or prior to the time. Mom and Dad arrived from overseas for 3 weeks on the same morning, and I thought I had plenty of time to deliver. As it turned out, I wouldn’t deliver until 26 of March (21/2 weeks after my due date and 6 days after mom and dad went back home to the US).
So Tuesday night on the 22nd Braxton-hicks started at 10pm and ended about 4 hours later. I thought this was the beginning of labour, but my midwife knew otherwise from the sound of my voice on the phone. The following night I felt my first labour pains. Now I understood why Robyn looked with a hint of merriment when I told her I thought upon feeling my first Braxton Hicks back on the 28th of February. Real labour pains were quite an intense experience. Robyn told me to try to sleep between contractions, which was great advice, but I wondered how anyone could do such a thing when the pain was so intense. I ate very little on Wednesday as the contractions continued intermittently. A few grapes, some yogurt and water. That night when the contractions intensified and were coming every 5-9 minutes I took a warm/hot shower to relieve my lower back pain and threw up what little I ate earlier.
My lower back felt like it was on fire during each contraction. I was starting to understand how some women recommend “drugs.” Contractions are not a very pleasant feeling at all. They are highly difficult to mask and simply impossible to ignore. It is a very deep pain, like very very very bad menstrual cramps that never seem to end. I found this quite difficult to cope with alone, and my husband, Martin, was a tremendous source of support and relief. Although other birthing team members were extremely helpful, I found that no one seemed to have the same soothing capacity as my husband. I think this was due to our decision and belief that we could go through this together as a family and I believe there was also a highly emotional element to my requirement for his support. His availability and willingness to physically support and massage my lower back whenever I beckoned - despite his exhaustion due to a heavy work week - helped immensely. When my contractions were at their worst, it was him I would call for relief.
The birth support team was small enough to manage without distraction, and Martin’s Mum became a tremendous and constant support throughout the whole process. We could not have gotten through it so well without her, and our relationship has deepened since the experience. Robyn, was a pillar of strength and totally focused, as you would expect any professional in their field to be. But she was more than just a professional. She was facilitating and sharing a very unique and intimate experience with us all. Her assistant, Margo, joined us toward the last stages, and I found her extra help very comforting (and probably a relief for the rest of the birthing team).
My two sons, Benjamin (who had just turned 5) and Jonathan who was just under two, adjusted to the whole event as they heard their mum moaning, groaning and trying to sing, coo, (whatever would get me through the process!). They went between watching movies and coming in to check on me and talk to me or see if I was okay.
Toward the end, as the baby’s head was crowning as I sat in my birth pool at home, Benjamin was logically explaining the process of birth to me and telling me to relax. Jonathan insisted on holding my hand and singing Bob the Builder to me. I will never forget how tremendous they were. At times I felt concern for the boys and how they would be able to take watching me go through labour to the point of distraction. Jonathan seemed the most concerned about me going through labour pains. But in the end I can see – and truly believe – we experienced a very important milestone together as a family.
After 38 hours of labour and what seemed to Robyn to be a long 2nd stage of labour we decided to head to the hospital. I think back now about how truly magnificently Robyn managed the whole process. Both from a technical and psychological perspective. Always allowing me to make the decisions and feel like I was in control.
Once I was in hospital it was a different matter. That last hour I was put under time pressure to have the baby – otherwise a VE would be used), I also became engaged in an ‘argument’ with the junior paediatrician, who was loath to give in to my request for Martin to cut the cord and for the baby to remain close to me as long as there were no other contraindications. These were the kind of pressures and battles I was trying to avoid, and it was this clinical urgency and lack of respect for my requests or birth choices during the process which led me to decide to do as much of the birthing process as possible from home.
Robyn and Margo were an amazing asset in the hospital setting. Margo went with us in the car and explained to Martin and I what was happening and assuring us both that everything was fine and going well. Robyn drove behind us on the way to hospital. After the birth Robyn stayed with me and Margo went with Martin and the baby so both could support and interpret what the doctors ‘in charge’ were saying or suggesting we do so that both Martin and I were empowered to make the best decisions for us and our baby.
I also found that Robyn’s diplomatic, yet inquisitive nature in the hospital setting, got us to avoid unnecessary interventions even to the point of getting my baby ‘released’ from ICU early so he could be with me. Her inquiries had actually revealed that nurses were only keeping my baby in ICU because of low staffing ratio to patients on the floor where I was staying. 15 minutes after she left, they delivered my baby to my room to be with me, saying as a 3rd time mum I would be… “low maintenance” I finished the nurse’s sentence.. and she agreed.
I wasn’t upset that the final hour of the birth process had occurred in hospital. Delivering the placenta is a rather messy event and I was glad the hospital was left with the sheets to clean! I also had a chance to rest away from duty’s and distractions at home.
So, in the end I was extremely happy with having experienced the entire process and the beautiful outcome, our son Yukon Isaak Curiel Aranovitch