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VBAC was Healing

Here is Iain's birth story, as shared by his mum Kathryn

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5am, I woke and suspected that my waters were leaking (I'd like to think I'd know if I'd lost control of my bladder - and I had just got up to use the toilet anyway). About an hour and a half later (of not sleeping as it was so damn uncomfortable) I decided that my waters *must* be leaking, as I was getting soggier and soggier.

I told Gareth but made him go to work, as last time when my waters broke and nothing happened he insisted on coming home and then just sat around worrying nothing was happening. Becca went out with MIL & cousin Renee to Lollypops Playground so I did some stuff around the house to see if I could get anything moving (I couldn't) and then had a bit of a rest.

Midwife (from now on referred to as S) called at about 11am (I'd told her what was going on at a reasonable time) and arranged to meet me at the hospital - she promised I'd get to go home again to establish labour, but she really wanted to make sure baby boy wasn't breech or stressed at all. I was hooked up to the EFM machine and baby was fine and I was having weak but pretty regular contractions. The obs eventually got a scanner to me and confirmed he was head down and well in place. They were fine for me to go home, but wanted me back at 11pm as I would need antibiotics after 18 hours of waters breaking.

Went home - posted on here, picked Becca up... then that's when the trouble started.

A few minutes after getting her back I noticed that my waters dripping were no longer clear, they'd gone a nasty green colour. I know it could have been old meconium, but it was more a of concern that it could be fresh (as water had been leaking so long, and no new gushes to suggest it was coming from a new place around baby) or that it could already be some sign of infection. So, Becca was dropped back with MIL with arrangements that Carol would get her later in the evening (as we knew once we were back in especially with green fluid there was no way we'd be 'let' back home) and we called S and arranged to meet her at hospital.

Got to the hospital and they put me back on the EFM, just after arriving I lost my show - which gave me confidence something was happening at least. Then (again, eventually) an ob came by to take a look, baby was looking well but he was still a little concerned, especially as really there wasn't much in the way of contractions going on. He gave me a vaginal exam and said I was 3 - 4 cm (about where I got with Becca - and without anything in the way of painful contractions!) and asked for consent for a membrane sweep just to try to get me going (he also suggested a Syntocinon drip too but I said catagorically not for that - especially as I'd got as far as I had without any real contractions yet)- I agreed to that, but then while he was doing that he found a pocket of waters that most definately had not broken and asked the assisting midwife to get him an amnio-hook... at which point I freaked out and told him that he was most definately not bringing one of those near me. He backed off and asked why not, I just said I wasn't happy with it, and although he didn't seem happy with that he didn't push it (I think I was most freaked & unhappy with the fact he didn't ASK if I was OK with it, he would have just gone ahead if I wasn't listening and protesting.

S arrived after that and went over everything - it was all looking good but I think she was really hoping that strong contractions would be kicking in by then (heh, after the ob came in and freaked me out I was getting NOTHING). She stayed for a while, then left to get her kids to bed and have some rest, as she knew it would be a long night! Shortly afterwards an ob registrar came through and put a IV lure in & took "a little" blood (if 5 large tubes is a little, then what is a lot I wonder?) - at that point Gareth had popped of to get himself some food (and he was quite upset that he'd not been there for the lure going in, as he knows how much I hate that sort of thing).

The midwife who was looking after me at that point said I was to have no food from them on - but to keep drinking heaps (she was originally told that I was to just have water, but I made a fuss because I'd been wanting tea, and after pushing matters I was told I could, but to keep the sugar & milk to a minimum). If I'd wanted food I would have caused a fuss, but I had lots to eat just before going in and was still quite full! She also kept taking me off the EFM so I could walk around, then at about 7 she took me through to L&D (I'd just been in the antenatal checks room until then - I don't think they'd have moved me through then except that there was noone else in the delivery suites at that time, and they were nicer rooms to be in).

I tried a few different positions - it was limited because of the EFM, but she tried to keep me comfy - I spent most of that time sitting leaning forwards, but it was awkward as everytime a contraction came the monitoring belts lifted off (as baby boy was making me a funny shape). By this point the contractions were all over the place, but a bit stronger. S came back at about 9pm and did another examination - she said I was a good 4cm, but that meant it was only a little more than 4 hours earlier, and the contractions were still not settling... and the obs weren't going to be happy with that. Also (despite me sitting & leaning foward) baby had gone from a good position to posterior. She kept popping in and out, but nothing changed (well, it got a little more regular but not totally) and at about 10.30 an ob registrar (I will refer to her as AL from now on) came through.

At first she tried to tell me that they were going to put a Syntocinon drip on me, but quickly backtracked and said our choices were a drip, a c/s or leaving things as they were, but that the preferred option was the drip if we would agree, and that they would like to put a scalp clip on baby so I could have more mobility and not have to hold the belts on half the time. We agreed to the scalp clip, and said we wanted to think/talk about the drip before agreeing to anything - as they wanted to do another VE at just gone 11pm she said that she'd leave us until then.

We discussed it with S, but (though neither me nor Gareth were totally happy with the idea) as my contractions had stopped altogether again we agreed the drip was probably looking like the best option - as I felt (and S agreed) if each time the ob entered the room my contractions stopped and took forever to get going again then we wouldn't be getting anywhere anytime soon, and the chance of infection/baby getting upset would rise. I said I wanted the VE first before the drip being set up though, just in case I was progressing - but I didn't feel it was likely.

AL did the exam this time around - baby was moving from posterior, and that pocket of water (the one that was felt at 5pm) was back (S had a good feel for it at 9 and she couldn't feel anything at that point, but it was porbably due to baby boy's changed position) and AL asked if I was OK for it to be broken, I agreed this time around. There was SO MUCH fluid there. It soaked immediately through 2 large towels (I commented that I though there was only supposed to be 1 litre total - S said that normally there is, but obviously my boy had himself a swimming pool). They put the scalp clip on baby, and the drip on me, but S kept me moving about and in good positions.

From when the drip went on the contraction got bad - but apparently the first few were more likely from that pocket of waters being broken (as there was apparently no way the drip could take effect that fast - annoying to know as maybe I wouldn't have needed it if I'd let me waters be broken earlier... but oh well, hindsight is a great thing, and it may not have kept the contractions up anyway). After a while didn't feel I was coping that great (heh, screaming for gas, getting annoyed when it wasn't given in the next contraction as they machine was missing a part and someone had to go find it). I was doing crushing Gareth's hand all the while too, but he just kept telling me it was OK and that I was doing well (it was wonderful to have such support, and I really don't know what I'd have done without it, I really feel for woman who don't get it, must make the job so much harder). When they finally got the gas working I used it twice, and after (or halfway through more accurately) the second time I threw it at someone screaming to take it away as it was horrible and I didn't want it.

At this point I asked for pethidine - but no one would give it to me.... I'm marked as allergic to it as I have a reaction where it screws with my mind. I'm not technically allergic, but last time I was given it (in hospital) I was told I should be put as allergic as I could put myself or others in danger by not understanding/thinking through all I do when under the influence (anyone ever tried shutting a garage door as the car is backing out of it? Not a great idea... oh and I become unable to understand where to find phone numbers, or to dial them when I am given them... not the best reaction to a medicine ever - but I have it with pethidine, tramol and sometimes codeine). Anyway I was pissed off at that, but not much I could do.

Around this point I asked S not to put the drip up any higher as I couldn't cope with any stronger/faster contractions - and she told me that she hadn't put it up for an hour already. Things got worse, I changed position a few times, used the toilet a few times and generally screamed dureing hte contractions. Gareth looking back (and apparently at the time too, but he iddn't dare show it them) thought it was hilarious that I was screaming "ouch" during the contractions, then apologising between them for the screaming. I remember the screaming - but not the apologising - except for when I through the gas piece at someone because I didn't think that was really called for.

I wanted to start pushing at about 1am, after a few contractions of wanting to and being told that AL would come and check me "soon" I told S that I was GOING to push unless someone checked me to prove it wasn't ready - at that she did check me, and was calling for another midwife to make sure AL would be ready if needed. I was checked, and was nearly there, but there was still a bit of a lip, so was told to wait for just a bit longer. Because I was having such a struggle I was suggested to try the gas again - I wasn't convinced, but tried and it did help this time around (not sure if I was doing it wrong first time, or just wasn't in enough pain at that point). Somewhere during transition I told Gareth we were never having more babies (he asked if I wanted him to have a vasectomy, and I told him yet - but now three weeks later I confess the words "next time" have already been used... though hopefully a few years off yet!). And I have recollections of asking people to "make it stop", apparently no one listened to me on that one though, as it didn't stop.

Eventually I got there - S knew exactly when it was, she said to me "that one felt different, didn't it?" and it did - at the time I couldn't explain how, but thinking back I think most of the time when I wanted to push it was just short sharp urges at the beginning and end of the contractions, but from then it was a more general but sustained need to push. She got AL in and another midwife (M) - I was checked and definately fully dilated so was told to go ahead and push from the next contraction. AL was a little concerned that baby's heart tones were taking longer to rise after the contractions by this point (not worryingly so, but enough for her to say I had one hour to push, and no more as he was getting tired - and to be honest I was so exhausted by this point I didn't really care what happened - it was past 2am at this point). She also turned the drip down to the base level - I didn't know this until right near the end though.

Oh, and at this point AL decided to slip a catheter in - I wasn't happy about that at all (as I'm sure that the catheter used in my c/s has left lasting pain) but wasn't in a state to argue given that she decided and put it straight in during a contraction.... apparently S wasn't too pleased about it either as I should have been asked, and she saw no need for it (as it wasn't so long ago I'd been using the toilet and I'd not drunk heaps) I found this out because she was discussing it with M when I was taken to my postnatal room. She thought that AL was too interfering, she said obs are used to being called when there are problems/emergencies, and some of them just don't understand that when they are just there for backup/to keep an eye on things they forget that is why they are there and that they aren't really needed.

S kept telling me I was pushing well, but it didn't feel like it, and both her and M were concerned that the contractions were spacing out again (still as strong, but they'd gone down to about 10 minutes apart). After a while of this AL came back in and took a look and said baby was decended enough to use the ventouse and that because baby was looking tired she would give me 5 more pushes... she came back a little after this and assumed my 5 must be over - well due to her turning the drip down it was only the second! She turned it back up a little but started to get things ready for the ventouse. At this point I am on my back (yeah, working against gravity, but I was so tired and M had shown me a good on my back position) - on the last of the 5 pushes baby's head came right down, and I could feel him ready to come out - AL realised she wasn't going to be needed after all as one more push and he would be out easily! M talked me through it, telling me to push through the fire (to be totally honest I didn't find it that bad, I found the lure, the catheter and not pushing through transition worse personally) and his little (!) head was out. They checked his cord wasn't around his neck, and next lot of pushes he came right out. S picked him up, let him pee and poop on me (yep, that was the first thing he did, right before he starting crying!) then he was put on my tummy and Gareth cut the cord (I think I remember the word "spongy" being used as he did). He was born at 3.50am!

I confess - the first thing I said about my Iain was that he was ugly. Of course he is gorgeous now, but he did come out wrinkled like an old man, with orange swollen skin for his eyebrows. I know it's normal, but at that moment he DID look ugly, though a couple of hours later when his face had settled he looked pretty. I spent the first couple of hours calling him "Friar Tuck" as with that face, a hat on, the size of him and the amount he was feeding it was very appropriate.

AL wanted to know if I needed to be stitched - S commented that all I had was a tiny bit of a tear and a graze - and that trying to stitch anything would make more of a mess in itself! A 9lb 6 1/2 oz baby, and hardly a tear!!

The placenta came right out a minute or two later (I hardly noticed, I had my baby!) and then S, AL & M cleared up and after quickly checking Iain and me were OK we were left for family time.

We called someone back in about 20 minutes later to help me get him latched on for a feed (I was far too exhausted to move at this point, I don't know how women can labour for days and still make it through - unless those labours are mostly like before I got the drip in and they can get rest/sleep - I was so tired that even during the worst of the transition contractions I was trying to sleep between) and he fed, and fed and fed.... and pooped on mummy again... and then fed and fed and fed on the other side. Oh, and his apgars were 9 & 10

About 5.30 am Gareth left the hospital to go home and get some rest, and shortly afterwards S came back through to get us ready to go through to the postnatal ward.

She took Iain, wiped the poop off him (he was not washed, he still had all the muck in his hair 3 days later when I gave him a sponge bath) weighed him and dressed him, while I showered. At that point I found out just how bad I was feeling (so so dizzy - I had to get dressed sitting down and they took me to the room in a wheelchair!). When he was weighed S told me that she knew he was going to be a big boy (but said she hadn't said anything as she didn't want to scare me), but she didn't realise quite how big! Also both her and M commented on the length and girth of his cord, apparently it was very impressive.

We went through to postnatal at about 6.30am and I was told to get some sleep - how I was supposed to do this I don't know with breakfast coming in at 7am, then drinks at 7.30, then someone coming to turn the drip off at 8am.... I napped between 8 and 9 though when Gareth arrived back.

S gave me the go ahead to go home so long as Iain was cleared by the paediatrician (she wanted him checked due to the potential meconium/infection risks - it seemed unlikely there were any problems but rather safe than sorry), which he was early afternoon but the on duty midwife wanted to speak to S to make sure it was all OK so I didn't get the all clear until about 7pm. Not that Iain even noticed - he slept nearly all day!

What was interesting was the differences in care post birth. With the c/s I had BP/O2 levels/temp taken every hour for 24 hours, and Becca's were too because of the waters being broken for 24 hours. With the VBAC, my BP/temp were taken before going to the postnatal ward and that was it. They had Iain marked for observations because of the waters being broken for nearly 24 hours - but that consisted of his temp being taken early afternoon, and then again before we left, along with his breathing rate being checked... and then we were told we needed to take his temp 3 times over the next 24 hours. Also with Becca midwives came and checked on us really regularly and trying to make me drink more, making sure I was feeding her etc etc. With Iain a midwife came in twice to tell me that she was trying to get hold of my midwife, and ask if there were any problems with anything, was he feeding OK etc. I don't know if this is because he's the second child they assume I know what I'm doing and left me to get on with it on the assumption I'd say if there were problems, or if it was because they interfere more after c/s. Oh, and they lost my chart for a chunk of the day - I was a little worried about that I must say!! For the record - that first day he responded best to the name "Peaches and Cream". I don't know why I called him that, but when trying to get him to feed and such I'd run through lists of names, and that one would get him to latch. Go figure.

The differences between the c/s and the VBAC are like night and day. I'm so glad I made it (though there were times I didn't think I would - especially after agreeing to the syntocinon, at that point I figured it was all going wrong and I felt like I might as well sign the consent for c/s form then) even if it didn't go to plan. Even if I let things happen that I shouldn't have for a truely "natural" birth. I got my VBAC, I was so proud (and amazed), Gareth was so proud and happy for me. I feel like I did right by Iain, I had to say no to some stuff, and I did, when I made choices they were informed choices, not just because I was told to. In some way I feel sad that I didn't do the same for Rebecca, I was uninformed and signed her birth away without even trying, but in another way I'm more at peace with it now. I made choices based on the information I was given at the time - I made what I believed to be the best choice for her. Maybe it was, maybe it wasn't, but either way at the time it was what I believed to best, even if now I don't know. And isn't that all a mother can do for her babies - choose what seems like the right/best option?

And one last thing - my heart goes out to all of those mothers who haven't had the births they hoped for - Iain's may not have gone all as I hoped, but it was enough to heal me. I hope every mother who has had a bad birth gets a healing birth, or if that is not possible then I hope they at least get acceptance/closure on the birth that didn't happen the way they hoped.

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