Essential Baby is running a series of real-life birth stories illustrating the different birth choices women make - and why. Here, we share the story of an Essential Baby forum member who chose a vaginal birth after caesarean (VBAC).
My first daughter was born by emergency caesarean section after induction for pregnancy-induced hypertension. After the birth I struggled with postnatal depression and found it hard to reconcile with my birth experience. I knew then that I would be attempting a vaginal birth after caesarean (VBAC) for my next pregnancy. I found an eligible midwife, Karen*, who had a Medicare provider number and who could admit me to my local hospital with her.
The week before
I had high blood pressure, which turned into pre-eclampsia. I spent a night in hospital and had a lot of monitoring. An induction attempt was looking likely – and that would have really put my VBAC plans in jeopardy.
Luckily Karen was available all the time to help me navigate through the process; having someone to advocate for me and give me the information I needed to make decisions was excellent. I declined an induction a couple of times, and instead we kept a close eye on the baby through blood tests and CTG monitoring.
I had been having very mild tightenings a couple of nights in a row, but they would stop as soon as I got up. On Saturday morning (at 39+5 weeks) they didn't stop – but I was so unconvinced my body was capable of going into spontaneous labour that I assumed they'd fizzle out.
When I had a hospital appointment with Karen at 11am I mentioned I was having tightenings, and had to breathe through a few of them when I was with her. She gave me a knowing look and said she'd expect to hear from me by midnight.
I was really huffing through the contractions by about 3pm. I spent a lot of time in and out of the shower and leaning over the recliner, and also spent some time on my hands and knees on the bed. I still wasn't convinced I was in labour, but at about 9pm I texted Karen and asked if she would check me to see if I was getting anywhere. She came around to see me; the contractions were coming every three minutes and lasting 45 seconds at this point.
At 10.30pm I was 3cm and 75% effaced. Active labour is from 4cm onwards, so while I was surprised to be that far, I still thought it was 'pre-labour'. I most definitely had a lack of faith in my body!
I had agreed to some monitoring in labour because of the VBAC and the pre-eclampsia, so I had one more hot shower then went to hospital with my partner. It was an interesting drive with me kneeling on the passenger seat backwards and hanging on!
I’d agreed to have an admission trace and then intermittent monitoring after that. I asked for the gas, knowing I'd have to keep still for the trace, so was standing up and leaning over the side of the bed to use the gas. Once Karen was satisfied with the trace, the monitor came off and I stripped off and jumped into the shower. The hot water on my tummy during contractions was lovely, but as the contractions intensified I asked for the gas too.
At about 2.30am, I had a vaginal examination and some monitoring. I was 6cm and Karen asked if she could rupture my membranes to check for meconium. I was happy with this and the waters were clear.
Rupturing membranes definitely took labour up a level or 10. Almost immediately the contractions got incredibly intense, and during contractions I was thinking that I must ask for an epidural when the contraction finished. Then between them, I would think, "I'm sure it wasn't THAT bad." But after about four contractions, I asked for an epidural, and the anaesthetist was called. She arrived at about 3.25am, by which time I was just barely hanging in there. It took an hour and a half to get the epidural in and working.
By 5am the epidural was in and working. I lay down for 20 mins on my side to have some monitoring while Karen had a quick well-earned cuppa and my partner a nap.
At 5.45am I was examined and found to be fully dilated. The baby’s heart rate had been dropping temporarily but became stuck in the 90s. The obstetrician was called in, along with a few extra pairs of hands, in case the baby was in trouble.
Karen got me to start pushing. Being the first time I had pushed out a baby, I expected this to take about an hour – and in fact I still believed I would be having a caesarean. I was on my knees leaning over the inclined head of the bed, pushing, while the obstetrician got the vacuum ready.
Pushing was surreal: I could feel the pressure of contractions but couldn't feel any type of crowning. The obstetrician asked me to flip over onto my back because he wanted the baby out now, so I rolled over, pulled my own legs back, and kept pushing. Very soon he and Karen told me to stop pushing, then start again – and suddenly my squishy, wet baby was born, 17 minutes after my last vaginal examination.
I assumed the doctor had given me an episiotomy and used the vacuum without consent. I didn't realise I had pushed him out myself!
The placenta was delivered quickly, I was given a fundal rub and then bimanual compression (thank you epidural!). They found that I'd torn through a big blood vessel – they got it under control very quickly but I lost just over a litre in a short amount of time. I also had a second degree tear that was sutured. While all this was happening I was skin-to-skin with my new baby, and was in absolute awe of him.
The incredible feeling of walking from the birth suite to a room was amazing. I was very tired but on such a high, and it all felt very surreal. Over the next few days the surreal feeling faded but the birth high didn't.
Despite all the work getting nice and fit, hiring our wonderful midwife and planning for a VBAC, I never actually believed it was going to happen. At 6.16am, I still felt that I would be having a baby born by caesarean.
I can't believe how good I felt physically afterwards – I was able to drive home the next day, and despite the postpartum hemorrhage, I haven't felt all that tired or sore. I also had the placenta encapsulated, but whether that helped or not I'm not sure.
And perhaps best of all, there’s been no sign of a repeat of the postnatal depression which was so awful last time.
Little G: born 6.17am, 14/7/13, 3160g, 49cm. I did it!
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*All names have been changed.