One mothers journey to a vaginal birth after after caesarean with Gestational Diabetes. Late in this pregnancy, this mother changed care givers to midwives who supported her aims for a vaginal birth.
This is the story of the pregnancy and birth of my second son. My first son Sam was born by emergency caesarean after a dream pregnancy, 20 hour labour and getting stuck at 9cm dilatation with an anterior lip.
This time I had morning sickness for 16 weeks, back pain from 10 weeks, gestational diabetes from 29 weeks and frequent, often painful Braxton-Hicks from 26 weeks. Doctors and hospitals in Australia will not allow induction with drugs for women with previous caesareans. So if I was too overdue or labour slowed down, it was another caesarean. I switched from the private doctor who delivered Sam to 2 independent midwives – Robyn and Jane – who would attend the birth in a public hospital birth centre. My EDD was 16 Sep 2002.
I was keen for everything to start so at 38 weeks I started natural induction methods – walks, curries, massage with clary sage, acupuncture, internal examinations. This only served to provide me with what I now recognize as pre-labour from 9 Sep. From 15 Sep, the Braxton-Hicks started coming every 5-15 mins but slowed down overnight allowing me to sleep, making me realize it wasn’t the real thing. On 17 Sep my midwife was able to sweep the membranes and I was a stretchy 1-2 cms but she felt something hard inside the cervix. Off to the hospital for an ultrasound but nothing was detected. 19 Sep saw me examined by the head of the hospital and a compromise reached: if I had not had the baby by Monday (23 Sep) I could have my waters broken in the birth centre (if dilated enough) & if no baby by Tuesday, then a caesarean would be scheduled. I agreed, glad to know there was an end in sight. I hurriedly organised another round of massages and acupuncture.
As the head of the birth centre told me, “sometimes you just need a bit of a threat to get things going”. Later that day the mucous plug, which had been coming away for 10 days, progressed to a bloody show. The Braxton-Hicks became more intense but still irregular and I had only 3 hours sleep that night. The next day (Friday) I was feeling dreadful and managed to get my mother-in-law and mother out to help me with my toddler while I had a rest and a nap. Of course everything started in earnest at midnight when my husband had passed out after an exhausting week at work.
The contractions were more painful but I still kept telling myself that this wasn’t it as they were still irregular. Around 1am hubby had to apply pressure with heat packs on my lower abdomen and back during each contraction which were about 5-8 mins apart. We rang Jane at 2am and decided to wait a little longer. Around 3.30 am I rang her again and asked her to come. She arrived about 4am and we were in full swing with me leaning over the bed and groaning. We had lavender oil burning, ice chips (diluted apple juice) and rescue remedy and lots of heat packs. I was 3-4 cms. Contractions were getting more frequent and painful and I was terrified at the thought of moving to the car.
Called my mother and sister at 5am as Mum was staying with Sam and Justine was our other support person. Somehow I shuffled to the car but couldn’t bear to be upright so I leaned forward at 90 degrees onto my husband Bruce’s hands. The car ride was atrocious with me in the back seat leaning forward onto the passenger seat and screaming for Bruce to stop at every contraction. Luckily it was early Saturday morning and the car trip only took about 10 mins. Before I left I was 5 cms dilated.
I walked to the birth centre still at a 90 degree angle managing to have 2 contractions in the spaces of 10 metres. Once in I was back in my preferred position of leaning on the armchair kneeling on the floor with heat packs pressed firmly at the front and back. I could not have done without those heat packs. I quickly progressed to 2nd stage and was pushing at 7.30am. I tried squatting briefly but that only resulted in the bag of waters bursting with a pop on the midwife’s face and me feeling out of control so back to the kneeling position.
After 1 hr and 15 mins pushing, Max was born at 8.44am Sat 21 Sep. He was 8lb 2oz (3.64kg), 50.5 cms long with a 36 cm head. It was a natural birth with no drugs. I thought I would be elated but mostly I was relieved. My other main fear (besides the VBAC itself) was having stitches as I have a tendency to keloid scarring but luckily I got away with a couple of small tears that didn’t need stitches thanks to Jane coaching me slowly through the crowning. The placenta took longer to come away than the pushing and I had to get back into the kneeling position to help it. After 3 months of watching my diet, I celebrated not with champagne but a strong cup of tea and toast with strawberry jam. Max did not show signs of being a ‘diabetic’s baby” and his blood sugar readings were fine so we went home later that afternoon.
I had had the perfect labour, birth and baby.