“I’m still on cloud nine after the birth” – the VBAC birth of Eleanor Rose!

It was such a pleasure to work with Emily & Chris again for their second child. Their first-born Alfie was about to become a big brother and Emily was seeking a VBAC (vaginal birth after caesarean)…

“Thought I’d send you some more details on the birth of our daughter, Eleanor (Elle), born 31.12.2020 at 5pm, just in time for an NYE party somewhere!
I thought that as per my first labour, this birth would happen around 38 weeks, be fast and furious and that I wouldn’t have any pre-labour beforehand. I was wrong, it was pretty much the opposite experience.
For context, my first was frank breech with a failed ECV at 36 weeks and a natural breech birth attempt (supported by Dr Bisits at the RHW public hospital).
Having taken a Hypnobirthing group course with Kerry prior to learning my son was breech I was feeling empowered and educated about birth and variations of normal so was very keen to have a trial of labour. Still full of energy and with no hints of pre labour I thought I’d probably go past my due date as most first time mum’s do so I was rather surprised when it all kicked off with a bang (literally my waters went like a bang!) spontaneously at my own house warming party at 38 weeks.
Due to my son being breech I went into the hospital for monitoring and all was very relaxed while I stayed in overnight. I woke up to feel some tightenings in the early hours and listened to the Hypnobirthing tracks and dozed between them. At about 7am the midwise said I could go up to the delivery suite and as my husband arrived the surges ramped up in intensity. Within 3hrs I was ready to push. The labour was textbook, just two vaginal examinations and no drugs or interventions. Dr Bisits had the delivery kit ready and asked my husband if he was keen to cut the cord. As bub was breech they asked me to go onto the birthing stool to push and there was (what seemed like) a small crowd of people around me. It was intense.
Unfortunately that is where the textbook slammed shut. After pushing for an hour I could feel that nothing was moving down, babies head was still high underneath my ribs. His heart rate was failing to recover after each surge and all eyes in the room were glued to the monitors. Dr Bisits apologised and said we needed to go for a caesarean. I was prepared for this outcome and had a plan in case this happened, I asked for the screen to be lowered so I could see baby be lifted out. I don’t know what happened next but the room became a blur with people rushing in, shouting and instructions. I was told there was no time for an epidural and that I had to go under general anaesthetic. I was still calm until they shut the theatre door on my husband and asked someone for a pair of scissors to cut off my bra. The last thing I remember is shouting, ‘that bra was expensive I can take it off myself’ then a mask was on my face and I was out.
Four hours later I woke up, alone in recovery, no bump, no baby, no husband. I was quickly taken up to postnatal ward and met my son which was a beautiful union. The second I heard him screaming in the lift I knew he was mine. I can honestly say that the labour was fantastic and I would to it again in a second. My situation was rare and I suffered trauma from the theatre experience as well as postnatal depression, I knew if I had another I’d get baby across the finish line under my own steam.
Two years later and I fell pregnant with our daughter. I knew I wanted a VBAC and was supported from the start with the midwifery group practice care I was under at the Royal Hospital for Women. My pregnancy was once again very straight forward and I just needed to convince the assigned OB that I wanted to have a VBAC. I’d been warned he wasn’t the most pro-VBAC, however, he was thrilled to support me and was very confident it would happen.
My husband and I took a Hypnobirthing refresher course with Kerry and discussed the fears and trauma from my first birth and how I could be supported in this labour to work through it with tools and strategies to feel safe. This was a great opportunity to remember the toolkit and consider it in the context of having laboured previously. It also gave my husband and I an opportunity to talk about our wishes and things that had and hadn’t worked in the previous labour.
At my 33 week appointment it seemed my daughter had other plans as after being head down the whole time she’d flipped to the dreaded “breech”. So once again, I was back on the spinning babies, doing everything I could to turn her. Although I’d always said that if my second was breech I’d book in a caesarean, the reality of not going into labour made my heart sink. I started researching ECVs on previous caesarean and was ready to even go back to Dr Bisits to ask if he’d support a breech VBAC if it came to it. At my 36 week appointment, an ultrasound confirmed she had indeed turned head down and I did a little dance of joy. The last few weeks of my pregnancy I felt rotten. With lots of pre-labour I felt like every night I’d wake up with my waters breaking but every morning I’d wake up with no labour. At my 39 week appointment we discussed induction and I felt the pressure set in to get this baby out before 40 weeks. However, again feeling educated and empowered I knew that 42 weeks was the real due date if there was no medically strong reason to get her out any sooner.
Luckily, I didn’t have to have any induction conversation as on the day before New Year’s Eve having brunch with a friend I knew I was having contractions. That day the surges came and went and I grew excited knowing that soon I’d be meeting my baby.
Unlike with my first birth the surges were very light and quick and occasionally fizzled out if I changed what I was doing. So New Years Eve morning rolls around and I called the midwife and told her the length of the contractions. Given how quickly my first labour progressed she recommended coming in and I was keen to not birth in the car so we strapped on the tens machine and headed into the Royal at about 8am. I knew that the tightenings although frequent weren’t strong and indeed the midwife confirmed I was just 2cms upon arrival. So, she helped us make the room our own fitted the mobile monitors. She was supportive of our decision to decline antibiotics (GBS positive) and to not have a cannula inserted into my hand which are policy for VBAC at this hospital and left us to it. Me with my tens machine, glam gown and noise cancelling headphones (toggling between Hypnobirthing affirmations and a house and techno playlist) and my husband ready to do light touch when I indicated.
Four hours later, I’d been working hard and feeling good. I was 4cms. Not quite as far along as I’d hoped but not bad. Another 2 hours later, 5cms. At this point I felt like I was working VERY hard to be only half way to the magic 10. The mobile monitors didn’t like it every time I moved my body into a surge and kept losing signal. I’d originally requested the scalp clip monitor but this can only be attached once the waters have broken and they can reach the babies head. I felt like my progress was slow because my waters hadn’t gone so when my midwife offered to break them and attach the scalp clip I was happy to consent.
Unfortunately, every time I was examined or there was an intervention I was bleeding and this became more and more. It was pretty scary seeing so much blood and not getting a good read on my daughter’s heart rate. When the OB came in she commented that if this continued I’d have to go for caesarean. Of course I was prepared for this and said to her I was comfortable with a caesarean if it came to it but I needed to be awake when my daughter was born. She said if I wanted to be awake I needed to get an epidural now else we might end up going under general anaesthetic again. In that comment all of my confidence was gone, totally gone. I shouted to get me the epidural right away. My midwife kindly tried to soften what the OB had said and continued to encourage me but I was freaked. I could not be asleep again when my baby was born. I demanded the epidural. I knew it was still possible to have a VBAC with one but it would slow things down and there’s a much higher chance of having an assisted birth (forceps/vacuum). The midwife went away and came back to say that the anaesthetist had 3 women in front of me and he’d be about 1.5hrs to get to me. During this time, the scalp clip was on and they could see that baby was looking good. My midwife continued to encourage me to ‘just have my baby’. I remember she made it sound so simple and this really helped get my head back in the game.
The surges were growing in intensity and I headed onto a mat and a ball on the floor to try and refocus. My husband said that I was only feeling unnerved because I was in transition but I didn’t believe him, I’d only been 5cms about 20minutes ago. No sooner had I gotten down on the mat but I felt the contractions changing and I wanted to start baring down. I couldn’t believe it but as I struggled back over to the bed the midwife calmly said, ‘oh yes, you’re 10cms now, do you still want that epidural?’
My midwife adjusted the bed so that I could lean over the back of it on an all fours position. She helped guide me to harness the energy into the pushing and get behind the baby. When I did this I started to feel her move down. It was THE most satisfying feeling ever. It was everything I’d wanted to feel with my son. With each surge I quietly (this is probably the only time I was quiet in my labour) got behind the baby and moved her along. This really felt like I was able to work with my body. The pushing was slow but stable and about 45 minutes after I felt that first urge to bear down I knew I was at the finish line.
How did I know? Well. I had a huge hunger pang and really REALLY fancied a white chocolate Toblerone. Seeing as I was considering dessert choices I knew we were almost there and with the next push out came her head and quickly after…her body.
I heard her cry and the OB passed her between my legs right up to me. There she stayed for about 3 glorious hours. No one tried to weigh her or clean her. She was just mine and it was perfect. Due to my bleeding the midwife had recommended having the injection for a managed third stage which I had consented too in my birth plan if the labour had bleeding so out it came shortly after the baby. I had a second degree tear which I couldn’t feel at all and the OB took about 10mins to administer stitches, all while my daughter was on my chest. The recovery felt incredible compared to my first and the bonding and my milk supply far better.
I’m still on cloud nine after the birth and so pleased that Hypnobirthing taught us both how to understand and embrace birth but research and question hospital policy where we feel we should and seek other options”.
Emily
x

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