Sarala’s two VBACs in the Rosie Delivery Unit and the Rosie Birth Centre as told by her doula

This is the story of Sarala (and her husband Sajith), who had two VBACS in Cambridge, the first one in the Rosie Delivery Unit in 2013, the second one in the Rosie Birth Centre in 2015. Sarala has given permission for her doula Sophie Messager to share her birth story.

“For the birth of her second baby, Sarala hired several doulas to support her through her birth, myself, Maddie and Katie as part of a shared care team. Her second birth was attended by Sophie and Katie, and her third by Maddie and Sophie.

For the birth of her second child, Sarala and Sajith had originally hired us to look after their toddler and were planning to go to hospital on their own.

Sarala’s first baby had been breech and she’d had an elective caesarean. She was very disappointed to have to have a caesarean, as she had been preparing extensively for a natural birth. Because of this, Sarala didn’t want to write a birth plan for her next birth because she didn’t want to be disappointed again.

Sarala went into labour at 39 weeks on a Saturday evening. Contractions were spaced out at first, and they soon built up in frequency and intensity. I joined her shortly after midnight.

When I got there, contractions were about 30 sec long and 7 to 8 min apart. Sarala was leaning forward on an armchair during the contractions, doing some deep breathing. Sajith was close to her, massaging her back and hugging her.

The contractions spaced out, so we all went to bed around 2am. We got up again early in the morning, Sarala was coping beautifully, doing some lovely instinctive lunges during the contractions. Her contractions were 20 to 30 sec long but not yet regular.

I went back home to rest for a while in the morning. I rejoined them early in the afternoon, the contractions were still 8-9 min apart but Sarala was feeling a lot more pain.

Sarala was at the same spot by her chair, and dad was struggling trying to support her and entertain their toddler. I helped support Sarala with some back massage (she had a lot of lower back pain). Her contractions were a bit longer, 30 to 45 sec, and 5 to 7 min apart. I felt this was still fairly early labour and that things would pick up once their toddler had gone to bed in the evening.

Sajith and I carried on supporting Sarala through the afternoon. We used a heat pack for the back pain. She liked that and also asked me to massage her with it during and between contractions.

The second doula, Katie, arrived around 4pm and did a brilliant job entertaining their toddler which meant Sajith could concentrate on Sarala and we could take turns supporting her. We were using the heat pack a lot and I kept on running to the microwave to reheat it. Contractions were lasting 45 to 1 min and 5 to 7 min apart. I could tell Sarala was finding them harder to cope with.

I provided a lot of reassurance for both of them that things were normal and progressing despite the contractions not always being that regular. I told Sarala that she was doing really well and doing amazing instinctive moves: she was standing up during contractions, and doing lots of hip lunges and stepping movements. She said she didn’t know what she was doing and I told her her body did.

Dad and Katie took their toddler to bed and he was asleep by 7.30.

Shortly after that, as expected, things started to pick up. Contractions became closer to 1 min long and 4 to 5 min apart. Whilst Sajith and Katie were taking the toddler to bed, Sarala started to complain the contractions were too painful and she wanted to go to hospital for pain relief. I explained it was best to wait until she was in more advanced labour because otherwise her contractions might stop when she arrived there (I thought she still had a long time to go at that stage). I told her that during the next contraction I would try something new to help her. I did a technique called shaking the apples (shaking her thighs) and she said it helped.

I carried on shaking the apples, soon joined by Sajith and Katie. Sarala was kneeling forward on an armchair between contractions and starting to sit back, squat, then stand up bending forward on the chair during contractions. When she stood, Sajith and I shook one thigh each. Sarala said it really helped, and soon said she felt much better.

I had a strong sense that she was making fast progress.

Sometimes around 8 in the evening, Sarala’s waters broke and she said she wanted to go to hospital. We drove to the hospital (Katie stayed with their first child at home, providing some much-needed reassurance that he would be well looked after). Whilst we walked from the car park to the delivery unit (DU) she had about 4 contractions.

Once in the DU we got taken straight to a room. I asked for the pool room (Sarala was quite keen to try a pool) but we got told with VBAC using the pool was too much of a risk :-(. [Note: this was 2013, there is now a pool room available on Delivery Unit for VBACs]

The midwife seemed nice and caring. As expected for a VBAC (as per Rosie VBAC guidelines) she wanted to use continuous monitoring so I asked for a wireless unit (this was a totally new thing at the Rosie in 2013). The midwife examined mum by abdominal palpation and setup the wireless monitor but with the wrong kind of straps as she couldn’t find the proper ones. She said baby was a bit OP which fitted with the back pain and long, stop-start labour pattern. During the contractions Sarala got off the bed and stood leaning over it, and Sajith and I resumed shaking her legs. The problem is, this dislodged the monitor (the crappy straps didn’t help) and the machine kept losing the trace.

The midwife asked if we could stop shaking her and massage her instead for a while whilst she got the 20min trace, so I suggested we help Sarala onto the bed, kneeling and resting against the back of the bed with pillows. Even then the monitor sometimes got dislodged and Sarala found it so much harder to cope without the shaking.

Soon Sarala said she wanted pain relief. The midwife discussed gas and air and pethidine, but said she didn’t want to give her gas and air if she wasn’t 5cm dilated yet. As the contractions were 5 min apart, I could tell the midwife thought that mum was still in early labour. But having seen her labour develop, I suspected she may be much further advanced.

The midwife wanted to do a vaginal examination (VE) before agreeing to pain relief and mum agreed. When she took her knickers off there was a little bit of meconium on the pad and both Sarala and Sajith panicked a bit at that point, despite the midwife reassuring them that the baby’s heart rate was fine and that it might be old meconium.

The midwife did the VE and seemed very surprised that mum was “quite dilated” then announced 6 to 7cm. She also said she wasn’t sure if she could feel a head or a bottom.

So she got a doctor to do a scan. Sarala and Sajith and I had a bit of a wobble then thinking we were headed for another caesarean but the scan showed baby was head down. Phew.

Sarala was then given gas and air but soon said that it wasn’t helping and she wanted an epidural. The midwife said it was too late for pethidine.

I had a feeling at that point that Sarala was in transition (nearing full dilation). When her pad got changed there was fresh meconium and mum really panicked and shouted “get the baby out, get him out!”, I knew she was close to birthing her baby, because it is quite common for women to have big emotional responses during that stage of their labour.

The anaesthetist came and started setting up the epidural. I still had strong feelings mum was in transition. She was begging for the relief.

I told the midwife about my feeling and she took it on board and started to ask mum if she felt like pushing or felt pressure in her bottom.

Once the epidural tube was in place but no drugs had been put through the tube yet, the midwife did another VE and found mum fully dilated! She’d gone from 6 to 7 cm to 10cm in just a couple of hours.

At this stage I hoped she could just be left to push and the midwife suggested that it might be best to not give the drugs as the baby’s heart rate was dipping during contractions and the epidural could cause a drop a blood pressure and make things worse. She said she would need authorisation from the doctor to give the drugs. I was really hopeful by that point. Sadly, a more senior midwife came in to say it was ok to give the drugs and so they did.

Immediately after they started to coach her to push, telling her to hold her breath and push. Sarala was sitting on the bed at that stage.

The midwives weren’t happy with progress and there were dips in the baby’s heart rate so they put Sarala’s legs in stirrups and carried on coaching her to push. She had only pushed for 30 min or so when there were talks about her being a VBAC and not being allowed to push for long (Rosie VBAC guidelines suggests pushing for no more than an hour). They said they needed to help the baby out with an instrument and I asked did they mean forceps and they said probably a ventouse. I was still hopeful. A doctor came in and did a VE, and said “I’m going to do forceps”. He explained the risks and the episiotomy. I asked Sarala and Sajith if they were ok with that and they said yes.

The doctor applied the forceps, did a couple of pulls, and the baby’s head was out, he came face up.

I told Sarala and Sajith that the head was out. The doctor then took out the forceps and without waiting for next contraction, pulled the baby’s body out.

The doctor clamped the cord straight away and didn’t give Sajith the opportunity to cut it.

The baby was placed straight onto mum’s chest. It was just after midnight.

They gave Sarala a syntometrine injection without getting consent, and the doctor pulled the placenta out.

They then took baby to the resuscitaire to check him, he was ok and was soon returned to mum’s chest for skin to skin.

The doctor became concerned about Sarala’s tear and her blood loss and called another senior doctor in. They said she had a third degree tear, which needed stitching in theatre.

Sarala got prepped and wheeled into the theatre. Sajith was extremely worried for her (he wasn’t allowed in theatre, and neither was I) so I asked the doctor to reassure him that she was ok. Sajiith said I looked worried (I was very upset about how the birth had been handled) so I lied saying I was worried the stitches would make her sore.

We were left in the room, me feeling very upset and angry, and Sajith feeling shocked and upset too.

The midwife was concerned about baby’s grunting and got the paediatrician back in who did a heel prick sample. Baby perked up and the paediatrician wasn’t worried. But Sajith was really worried for both his wife and son at this point.

I told myself to put on a brave face for his sake and asked him if he wanted to hold his son and he said yes. The baby was alert and gorgeous, and rooting/sticking his tongue out. Holding him helped Sajith feel more calm I think.

After what felt like an eternity, probably around 2am, we got taken to recovery to meet mum. They said the repair had gone very well but she had lost 2 litres of blood and they needed to do some tests to see if she needed a blood transfusion.

Later, I went to give some of the cake I had made to the midwifes. I was angry at them for what had happened to Sarala but I thought anger isn’t going to help anybody here. So I went and gave them the cake anyway and it felt good to do that.

I helped Sarala put her son to the breast and I thought: at least this part is going to work. And it did. Baby latched on straight away and suckled like a champ. It felt good that something at least had worked well.

I drove Sajith home at 4.30am on Monday morning. He thanked me for my help. He also said he felt really upset. I told him I would be happy for him to talk about it at some point, and that it would be better to get it out than keep it in.

I got home at 5am.

I spent a lot of the next day crying for Sarala and what might have been instead.

Sarala ended up having to stay in hospital for 3 days due to blood transfusions.

After the birth I spoke to the Sarala and despite the outcome she was pleased she hadn’t had a repeat caesarean because she was much more mobile at this stage than the last time with a caesarean and that’s what she wanted, especially with a toddler to look after. She said she was glad I was there because if hadn’t been there they would have gone to hospital much earlier and would have probably had another caesarean.

Two years later, Sarala was pregnant with her third child.

She had reflected on what she felt had helped and hindered her last birth experience, and was very keen to avoid a repeat scenario, and therefore planned to give birth in the Rosie Birth Centre.

Sarala started having contractions at 41 weeks, around 6am on a Friday morning. We joined her about an hour later.

When Maddie and I got there, her contractions were already 45 to 50 secs and 3 min apart, so about 30 min later we went to the Rosie Birth Centre.

We arrived between around 8am and immediately got shown to a room close to the elevator to the DU (room 10-which is the room the Rosie tends to assign to VBAC mothers as it’s the closest to the DU in case transfer is needed). Sarala soon settled in, contractions were coming thick and fast and Maddie and I took turn in squeezing and rocking her hips with our hands or with a rebozo. I felt instinctively I didn’t want to shake her legs “apple style” because it might remind her of her previous birth. We starting filling the pool straight away.

Soon after the usual midwife checks Sarala got in the water (without asking anyone she just got in by herself really quickly), it was obvious she was in very strong labour and the water (and gas and air) helped a lot.

Me, Maddie and Sajith sat around the pool, me holding the gas and air to her mouth when she needed it, Maddie stroking her and offering her water, Sajith touching her shoulder. Things progressed very fast, she had a wobble (I can’t do this) around 9 or so, and then soon started to make pushy noises. She started putting her entire face under water during the contractions, blowing bubbles, I worried she was going to inhale water but she was completely fine.

Sajith was quite anxious, asking if things were ok, and we reassured him that things were fine and progressing as they should.

She pushed for about 20 min, being very vocal and loud and sobbing quite a lot, and around 9h45, the baby’s head was out already! There was meconium around his nostrils so the midwife pressed the emergency buzzer and asked for a resuscitaire. At this point I was worried because Sarala had said repeatedly she didn’t want any drama, and I thought oh dear here comes the drama! But no, the midwife passed the baby between Sarala’s legs and let her recline back in the pool (she had been pushing on all fours), and let her hold him for a minute or so whilst she clamped the cord (Sajith got to cut it this time), so she could take the baby (who had started to cry before the clamping) to the resuscitaire. Thankfully baby was fine and was returned to Sarala pretty soon.

Sajith hugged me and I sobbed. I couldn’t help myself-it was such a relief!

Sarala got out of the pool and to expel the placenta (Sajith handed me the baby to hold at this point which was very sweet).

Then Sarala sat in bed with baby skin to skin and had some proper cuddles. They stayed there for a while, the midwife checked Sarala and she had a tear that needed stitching but nothing serious. The midwife did the stitching in the room.

We had tea and cake and a lovely time talking about how much nicer it had been this time.

I felt such joy for them that they got to experience a positive, empowering birth. It was a very healing experience for them, and for me.

The next fews days we got texts from Sarala:

Hi Maddie and Sophie, thank you so much for everything. We decided to stay over at it was so relaxing. We will be going home soon, after baby check is done. such a different experience, I still can’t believe it! Many thanks again, lots of love, Sarala

And Sajith:

Hi Sophie and Maddie, I just wanted to say thanks again for your help. you guys really helped us a lot and exactly what we wanted. Thanks again for making that experience magical! Sajith”

Since Sarala’s births in 2013 and 2015 there is more choices at the Rosie Hospital for VBAC women, for example, there is now a newly furbished pool room available in the Delivery Unit, as seen in Chloe’s birth video.

If you want a midwife-led VBAC at home or in the Rosie Birth Centre, talk to your community midwife at the earliest opportunity and she will refer you to the Consultant Midwife clinic for an individualised care plan.

The Rosie’s VBAC guidelines and care pathway for VBAC outside Delivery Unit are available here.

Support is also available in our online peer support group.

There’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the first Friday of the month at Hinchingbrooke Hospital Huntingdon, the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

“My job is simply to be there to support my wife…”A story of homebirth after caesarean from the birth partner’s perspective

Rachel’s partner has written about the planning and homebirth of their daughter Lucy.

Without reading Rachel’s birth story, he has written a fair and frank reflection of the experience from his perspective, in the hope the two will complement one another and broadly agree (though recognising that perception of certain events could easily be quite different).

“The story really begins when we discovered we were expecting our second child. This was fantastic news for us and we could not have been more pleased. We decided again to entrust the pregnancy to the care of the West Suffolk Hospital (WSH) who had been so supportive first time around.

Rachel was adamant that this time around she wanted to deliver the baby naturally and with as little intervention as possible. At this stage I had never heard of VBAC and I had no idea that delivering vaginally after a previous caesarean was anything other than completely normal.

Being a scientist I admit to taking comfort in the presence of medical professionals and the easy access to emergency care a hospital offers. I was completely comfortable with a hospital delivery as an option but I was also aware that Rachel was strongly in favour of a home birth.

Over the coming months I was slowly and gently educated by Rachel into all that VBAC entailed. I quickly learnt that medical professionals can be, shall we say, ‘nervous’ about VBAC and our intention of having a home VBAC caused quite a stir with almost everyone we spoke to. Suffice to say, discovering the associated risks of VBAC did nothing to ease my underlying preference for a hospital birth.

It was around this time that we began speaking to doulas. All three of the doulas we spoke to seemed to be lovely, caring people and they were able to answer all of our questions in a supportive and comforting way. Discussing birth options with experienced people who were not bound by codes of conduct and therefore able to be a bit more free-thinking was liberating and we selected our chosen doula based on gut feel. Throughout the pregnancy, birth and postnatally, Tara was outstanding and I would strongly recommend others at least consider what a doula might be able to offer to you and your partner. One breakthrough step for me was the recommendation that I read a book written by Mark Harris, a male midwife. His book, ‘Men, love and birth’ dealt with nearly all my questions and concerns in an extremely accessible and entertaining way. The key message being ‘my job as a husband is simply to be there to support my wife in whatever ways are appropriate’. I took this on board and, after much deliberation and soul-searching realised that I needed to be fully on board with the home birth VBAC.

To say I did not have any concerns would be a lie. Of course I was concerned. I was scared for the wellbeing of the baby and I was scared for the wellbeing of Rachel. Being told that, although rare, a uterine rupture outside of a hospital environment leads almost inevitably to the death of the baby and a significant chance of death of the mother is sobering in the extreme. My one caveat to the homebirth idea therefore was that Rachel must promise to be mindful of the scar throughout the birth process and, at the slightest inkling of something not being right, we transfer to the hospital.

It is fair to say that the vast majority of the discussions and deliberations between Rachel and the staff at WSH occurred in my absence. I was blithely carrying on with my job largely unaware of the stress and strain our choice of approach was having. There were tears, fears and frustrations. Rachel was very aware that our preferences were extremely unusual and against the best advice of the medical profession. It is at this point that Jac Reeve must be mentioned. Dr Reeve was our obstetrician and if we had been under the care of perhaps any other obstetrician our outcomes may have been quite different.

Dr Reeve spoke plainly and for this I am thankful. She was happy to provide statistics and voice her concerns without dressing them up or creating any obfuscation. It was patently obvious from meeting her that she wanted us to give birth in the hospital. However, she quickly recognised that we are really quite stubborn people which, together with the fact that Rachel is extremely well read when it comes to pregnancy and birth, meant that we knew what we wanted and we intended to get it!

Although Dr Reeve maintained the stance that her medical advice would be to birth within the hospital, she actually went far above and beyond anything we expected in terms of support, guidance and facilitation of our wishes. The lengths and efforts that she, and in fact all, the staff we dealt with at WSH went to were remarkable. I cannot praise them highly enough. I am aware that the chances of any particular reader of this getting Jac Reeve to be their obstetrician is vanishingly small so my message would be:

‘Be clear on what you want and why you want it. Have evidence to support your position. Be firm and clear with your medical professionals. Stick to your guns. If that individual cannot support you, ask to speak to another, or another until you find the doctor with the experience to believe in you and support you. These wonderful people are out there you might just need to do a little leg work to find one’.

Nothing ever goes quite the way you plan it. We discovered very late in the pregnancy that our baby had turned breech. Cue more frantic visits to Dr Reeve and more alarm that we were now investigating the possibility of a home breech VBAC. By now I think our case was doing the rounds of the local midwifes and obstetricians. Everyone we spoke to said a similar thing along the lines of ‘oh yes, we heard about you’. I could fully imagine the discussions over a cup of tea about this crazy woman in Newmarket who just won’t be talked into a hospital birth! Nevertheless, the staff at WSH again stepped up and we arranged to attempt a ECV manipulation of the baby to spin her back around. Look one up on youtube if you can – they are amazing! Anyway, based on a number of factors we were given less than 20% chance of the ECV being successful. But guess what, Dr Reeve achieved what we could only hope for and spun the baby back into a head down position. Another outstanding outcome for us.

We were both a little shaken by the breech incident and were mindful that there was always the possibility the baby might turn again. We decided that at this point we would be most mentally comfortable birthing in WSH. It is important to note however, this change of plan largely stems from the staff agreeing to allow us into the midwife led unit rather than the labour suite. This was a wonderful gesture by the staff at WSH and would not have occurred without Dr Reeve again going above and beyond to facilitate it.

40weeks – Where is the baby? No concerns yet. Baby number 1 was 40+16.

40weeks + 11. Seriously now – where is this baby? Beginning to get anxious.

That night the waters broke. An hour later contractions were in full effect and we called our doula, our wonderful friend Helen who had agreed to mind our elder child, and the birthing unit. I began to load the car and make some sandwiches. No great rush I thought, the first stage takes hours and hours.

As the shouts and screams got louder and more frequent, Helen and I began to have questions about the progress. CALL THE HOSPITAL Rachel instructed in no uncertain terms. “Monitor the times and call back if she feels the urge to push” they said. Moments later, Rachel relays the desire to push – CALL THEM BACK – NOW she again gently instructed me. Contractions were happening rapidly and there seemed to be only around 40 seconds between them. The hospital explained that they were sending two midwifes and a paramedic crew out but the midwifes were 45 mins away. At this point Helen and I were like a couple of headless chickens – dashing between supporting Rachel through contractions and comically attempting to fill the (ultimately unused) birthing pool with a hose connector that didn’t properly fit any of our taps. In hindsight it’s a wonder we didn’t flood our kitchen to boot.

The paramedics arrived fairly promptly and did some stuff. Not sure what beyond turning all the lights on fully, checking blood pressure and telling a load of (somewhat inappropriate giving the circumstances) stories about their own kids. They were good though and I was really pleased they arrived and were able to explain that things were OK.

The remaining time before the birth is more of a blur, the midwives arrived and were exceptionally calm. They took control of the situation and the paramedics gas and air (which meant the poor paramedics were stuck in our kitchen drinking tea till 6am unable to leave without their equipment). At one point they did ask for the entonox back so they could leave but the midwife gave him quite a look and he didn’t ask again. We laboured in the lounge and Rachel became convinced that she was not going to achieve a natural delivery. Everyone was very encouraging of her and the Midwife had a look at progress. She was uncertain and gave Rachel a little more time to labour on. I wonder if this flexibility on time would have been given in hospital. Eventually the midwife encouraged Rachel to push as hard as she could – over the next 15 mins I could see the progression of something (a head as it turns out) down the birth canal.

Lucy was born at 5:01 on the family sofa (which needed a bit of a wash afterwards) and everyone was delighted. Even the paramedics didn’t want to leave until they had learnt the name. It was at this time that our elder daughter woke. She had slept through the noise and bustle of the labour and birth and came downstairs to meet her little sister. Although taken aback by the sheer number of people in the house at 6am, she was very pleased to meet Lucy and happily went off to play with Helen afterwards.

After the birth, the umbilical cord was left attached for quite some time before it was clamped and I cut it. Lucy had skin to skin with me whilst the placenta was delivered and follow up work was done. The placenta delivery did take some time and we opted for the syntometrine. The gas and air had left with the paramedics an hour previously so delivery of the placenta was painful but Rachel was excellent and never complained.

Despite the need for some stitches, we remained at home and the experience of the midwife paid off again as she was able to suture on the sofa by the light of my desk lamp.

Two weeks on and things are going well. Lucy is feeding quite well and we are looking forward to getting the chance to thank several key people personally for all their support and belief in us.”

If you would like to connect with other local women, like Rachel did, planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s research, blogs, birth stories and hot topics on the resources page.

And there’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the first Friday of the month at Hinchingbrooke Hospital Huntingdon, the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

FREE pregnancy and birth support in March

This month’s Cambridge Birth Choices FREE pregnancy and birth support drop-in sessions are on:

Friday 10th March 2017 from 12.30pm to 2.30pm at Cambridge Women’s Resources Centre, Hooper Street, Cambridge. CWRC is a women-only space, children welcome. Click here for full details.

Friday 31st March 2017 from 1pm-3pm at Satyam Yoga & Wellbeing Centre, 2-4 Hawthorn Way, Cambridge, CB4 1AX (next door to Stir Cafe). Partners and children welcome. Click here for full details.

Like our Facebook page or follow us on Twitter to keep up-to-date with news and views, and Cambridge Birth Choices’ community page and Twitter too.

Rachel’s (planned & accidental) homebirth HBAC with midwives from West Suffolk Hospital in Bury St Edmunds

Rachel M talked about her experience of planning a homebirth after caesarean (HBAC) in a previous blog “Have you really thought this through?”

Here she tells Cambridge VBAC Friends about the birth of her daughter, Lucy.

As 41 weeks arrived (41+4 by the scan), I was feeling pretty despondent. It felt like I was going to reach the hospital’s 42wk mark and have to go through yet more discussions on risk, even though my first child was born healthy at 42+2. That evening, I made my husband stop watching his film and come and cuddle up in bed, so that I didn’t just lie there fretting. Our daughter woke up shortly after we went up and asked for a big person to sleep with her, so I went in as I knew that my days of being able to do that were drawing to a close.

Stage one

I woke up at half twelve as my waters broke. Fortunately, we had waterproofed my daughter’s bed as well! I sent her off to get Daddy and a towel, and set about changing the bed. I left my husband to settle our daughter – who was wondering why Mummy had wet the bed and was now wearing a nappy (aka TENA Lady pants) – back to sleep and went downstairs. I put on the TV and got the big ball out to lean over as the contractions started. The timer on my phone showed they were about four minutes apart.

By half one, I needed the TENS machine so I woke my husband to help me put it on. Whilst he de-iced the car and made sandwiches, I called our doula, our friend who was to look after our daughter, and the MLBU. Contractions were about three minutes apart and a minute long but I could still talk through them, so I said I’d call the MLBU back in a bit.

Soon afterwards, I found myself urgently needing the loo. I spend a while labouring on the toilet, completely emptying myself. (I later found out that an OP baby tends to press on the bowels in labour.) My friend and my husband had a go at filling the pool but gave up, as it didn’t seem like it would be ready in time to be of any use. They did a great job of giving water, glucose tablets and encouragement instead.

My husband kept telling me not to push but I was starting to feel a bit “pushy” at times. (Having not really done many final stage, productive pushes last time, I wasn’t really able to recognise that whilst I felt a pushing urge, it wasn’t The pushing urge.) I was finding some of the contractions overwhelming and wailing like a steam train when I wasn’t able to keep my breathing steady. My husband phoned the MLBU again and they suggested I head in. However, I had now reached a stage where I was not confident I’d make it there in time and so I was too scared to get in the car. (It turns out it was an icy, foggy night and so our estimated 20-minute sprint there would have been much longer.) Now it was clear that the baby would be born at home, the MLBU called for an ambulance and two midwives. Although the community midwives had taken away their homebirth kit, we still had our sheets, towels etc ready from our original plan, and these came in handy.

The paramedics arrived first: two cheerful and chatty blokes. Fortunately I was done on the loo, so we went into the kitchen, where I laboured bent over the dining table in my leg warmers and a modesty blanket. I asked the guys to turn the lights back down and get the flashy, beepy machine out of my face, whilst they regaled us tales of their wives’ labours and sympathised about back to back labour… At that point, I set one of my playlists going. The best bit was that they brought the gas and air with them. Between us, my husband and I managed to ensure that I used it effectively but didn’t overuse it so I could stay lucid. (I was completely and unhelpfully boggled last time.)
At about half two, our doula arrived. The first thing she did was tie my hair back: a gesture of such female caring. She also started rubbing my sacrum firmly, which I found really helpful. I had her hand in one of mine and my husband’s in the other. I wasn’t scared at all about being at home. Everyone around me was calm and matter of fact about the baby being well on her way. The first thing I had told the paramedics was “I’m a VBAC” but they didn’t bat an eyelid and were happy to wait for the midwives to arrive.

End of stage one

The midwives had had quite far to come and so they arrived about half three. We moved to the cosier and more dimly lit lounge, where they examined me. I asked not to be told about my “progress” – last time it had been very upsetting to be told “only Xcms dilated” after I had been labouring for hours. However, the midwives found I was fully dilated, so our doula decided I would like to know that and told me (good call!). The midwives said I could push if I felt the urge to. I asked if they were absolutely sure there was no lip on my cervix. (My sister had been told she was fully dilated with a slight lip but that it was ok to push – this bad advice resulted in a hurried transfer from home to hospital and an episiotomy. An example of the history that we carry in with us.)

Transition

Unknown to me, the midwives had no gas and air with them but the paramedics kindly agreed to stay so that I could use theirs, bless them! There was, however, an issue with the tanks. The valve in the first tank froze, blocking the flow and causing that tank to leak and run out. The same thing kept happening with the second one, and I was vaguely aware of my husband trying to thaw it back out. It meant that we used the gas sparingly, trying to save some for later.

I laboured for a bit on the sofa but the idea of being on my back felt so wrong that I got up and bent over a tall chair. That was a really free position to be in, a kind of standing crouch where I could move in whatever way happened, the closest thing to the flexibility you get being in water. After about an hour, the midwives asked me to get back on the sofa so they could examine me. Although they were calm, they would have preferred to see more descent as the baby seemed to be going up and down. That was my first moment of slight worry: I was aware that baby descending and going back up is a potential sign of uterine rupture and therefore one of the factors that leads to transfer to hospital. Interestingly, at no point was I worried about my scar. There were two or three times when I remembered that I was supposed to be keeping an eye out for warning signs but I was generally a bit busy labouring! Clearly I didn’t feel any odd sensations worth mentioning.

In hindsight, I think that the hour between being found to be fully dilated and the final bit of pushing on the sofa was part transition/part labour, even though I was trying to push.

I felt I couldn’t do it and said so. I had discussed with my husband that I wanted it to be ok for me to voice this if that is how I felt, without people panicking or acting on it. We agreed that we would have a code word and that he would need to check with me three times that I really meant it before any augmentation was to take place. (In the event, we never got round to picking a code word, so it’s just as well we didn’t need it!)

There was genuinely a point during this phase when a c-section seemed like an ok option, to just get her out safely, and I might have raised it as a possibility had I been in hospital. Let’s read that again – I really did think that. Me, Miss Anti Unnecessary C-section. It just felt like I was not getting anywhere, that it wasn’t working, that the same thing was going wrong and happening again. It’s a real example of how doubt is part of this phase. I even muttered something about pethidine (me!), which fortunately they don’t carry. They said it was too late for that anyway. I was lucky enough to be surrounded by people telling me that I could do it, that I was doing it, and I shall forever be grateful for that.

I also wonder if this phase seemed “pushy” but “unproductive” was because the baby was turning, as she was not born back to back. Perhaps it was my body getting her in to a better position, i.e. working away doing exactly the right thing even if “nothing” appeared to be happening to the observer. I wonder if that’s what happened the first time round, which they counted as pushing time…

Birth

Now on my back on the sofa, the midwife held her fingers in the birth canal and asked me to push against them. Finally we saw some more consistent progress. I said again that surely being on my back was unhelpful but they pointed out that it seemed to be working, so just go with it! (A good example of how an idea about what is right might not actually serve you well in reality, however much it makes sense to your mind.) With my husband on one side and our doula on the other, I felt out baby move down and start to crown. Our doula reminded me that I wanted to feel the head (surprisingly squishy!), which I think helped me to believe this really was working. An absolutely brilliant tip our doula gave me for finding the right way to push was to make a fist, press the fleshy part below my thumb against my lips, and try and blow. Now we were getting there! The head was born and she stayed there for a few minutes, serenely getting her shoulders into place. With a big push and a gush, she shot out on to the sofa by my husband’s feet and immediately gave a cry. Lucy was here after just twenty minutes.

Straight up on to me, warm and slippery and alive and here. I couldn’t believe we finally had two children. A lot of cuddles and a little feed, before going to her daddy for skin-to-skin cuddles. Having slept through the labour, Rosie came down to finally meet her little sister.

Stage three

I was surprised as how uncomfortable this stage was. The paramedics had stayed to find out the baby’s name but then had had to go, taking the gas and air with them. After an hour of effort and discomfort, we agreed that syntometrine was a good next step. Even with that, it took some help from both midwives to deliver it. I was grateful it was done and I had avoided a transfer to hospital.

Another point where I think I was lucky was that my midwife was comfortable sewing up my second degree tear herself, whilst I was on the sofa. (I would have happily lain on the dining room table with every light on in the place had she said that position or visibility were an issue!) I actually sang through this bit, listening to some of my favourites blues tracks which are steeped in hours of blissful dancing memories. I suspect everyone else was just delighted to have something else to listen to, as due to a mistake on my part when setting the playlist going, we had listened to just one track on repeat for the whole labour…

Reflections

My sister said to me that this is something I will be proud of forever. She’s probably right. I have always wanted to birth my children under my own steam and did my best to make sure it happened this time. However, at this point in time, it is not having a VABC that stands out for me. I think that will float to the top over time. For now I am simply buzzing from having two children and not recovering from surgery. Honestly, I could skip (if it weren’t for my sorry perineum). It’s great. When I finally got off the sofa on Sunday, I went off to the loo. No loo paper. So I just walked upstairs to use the other loo, unaided. Simple pleasures.

Each to their own but for what it’s worth, here’s what I would recommend:

• Get a doula. Just get one. I am convinced that I would not have had the c-section had I had a doula. They are there for you and your partner, and worth their weight in gold. Ours gave us information and reassurance before and during the birth, as well as attending a hospital appointment I had to bring my daughter to, so I could concentrate. She gave me feedback on my birth preference document, to make it shorter and less confrontational. An experienced and calm voice, with the energy to look after you and your husband. Get one.
• Try that blowing into your fist thing for the final pushing if you are struggling. Worked a treat for me.
• Most useful items: glucose tablets, bendy straws, incontinence pants, over the knee legwarmers, music you love love love.

COMING SOON! Rachel’s partner has written about the birth from his perspective and her doula has too.

If you would like to connect with other local women, like Rachel did, planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s research, blogs, birth stories and hot topics on the resources page.

And there’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

“Have you really thought this through?” Rachel’s experience of planning a homebirth after caesarean (HBAC)

There is always a wider context in which we make decisions. It’s too personal for me to explain all of the reasons why I felt so strongly about delivering my babies under my own steam. At the very least, it was a right of passage I wanted to go through, as well as likely to be best for the health of mother and child. I was extremely disappointed to deliver my first baby by caesarean, particularly when it became clear to me that it could have been avoided. As we didn’t intend to have more than two children, this time was my only remaining chance to give birth vaginally. No pressure then!

“Have you really thought this through?”

It can be hard for VBAC mothers to get people to understand how important it is to them to give birth vaginally and why. Moreover, it is sometimes suggested that the mothers are being selfish or haven’t thought about what they are doing and the potential risks. I’m lucky that I am surrounded by people able to empathise or to keep their reservations to themselves but still, to those who don’t get it, let me say this:

It has not been fun, devoting countless hours to reading about risks and awful things that can happen, comparing the likelihood that my baby would die from one cause or another. As I genuinely believed that a vaginal birth was the best thing for both me and my baby, I wanted to maximise my chances of this happening. Moreover, I needed to get to a point where my husband and I were comfortable that we were making a fully informed decision, based on all the relevant information – a balanced picture that I did not feel was being presented by the medical profession, despite good intentions. In the extremely unlikely event that something terrible happened, my husband and I needed to be able to look at each other without any blame. Marriages often fall apart if a child dies, so this felt like I was working to protect my marriage and existing family, not just my unborn child. Please don’t say we VBAC mothers have not taken this seriously. We are probably better informed than many and are making very carefully considered choices.

Interestingly, maternal mortality didn’t really factor in it for me. That might seem selfish, given I already had a daughter who would then be without a mother, but that is how I felt. I was far more concerned about my physical and mental well-being if I lived, rather than ending up dead.

The more I thought and read about what does and does not facilitate birth – and I read a lot – the more I felt that a homebirth would give me the best odds of delivering vaginally. We agreed to proceed with planning a homebirth, on the proviso that my husband could veto it if new information gave us sufficient cause to reconsider.

Last time

West Suffolk Hospital invites all potential VBAC women in to review their medical notes from the previous birth – a great idea, as events might be blurry. I was shocked to find it recorded that I had asked for the caesarean, as if a request from me out of nowhere were the only reason it happened. For three years, I had viewed it more as something that had been done to me, a medically unnecessary recommendation that I had gone with rather than a path I had instigated myself. How was it possible that someone who had always dreaded the idea of labouring on my back and having a caesarean had ended up with both things happening, apparently at her own request?

Re-examining things, I could now see my part in the decision that was made. Basically, I couldn’t take the responsibility for our baby’s safety any more. We had waited a long time to get pregnant and wondered if this would be our only chance at parenthood. I was at 42wks+ and had turned down an induction against the generic advice (as there was no reasons specific to me as to why it was necessary). We had had a 1am dash to the hospital the night before I went in to labour because I had fallen asleep and missed her usual 10pm dance and couldn’t feel any movements when I woke up. (A colleague’s baby had died in the womb at 39wks a month earlier, so I was very conscious about reduced foetal movements.) After all this and nearly 30 hours of labour with a back-to-back baby, it felt like I was reaching my limit of risk that I was prepared to take, particularly given the vibes I was getting from the consultant. “Just get her out in one piece.”

From a medical perspective, I don’t know why they said yes. The baby was never in any distress at any point. I had only been pushing for an hour, if that. An instrumental delivery was not even discussed, nor any further changes of position. The baby’s chin wasn’t tucked in, so the presenting part of the head wasn’t ideal but she was not stuck. Failure to wait, failure to encourage.

Next time will be different

I learned many lessons from my first labour. My husband and I were overwhelmed and exhausted after the first nine hours at home, where I had no pain relief other than a quickly-fashioned wheat bag. I had no sleep, water or calories for most of the labour. The gas and air left me incoherent. I laboured in a brightly lit, medicalised room (I was excluded from the MLBU for being past their cut-off date). No-one reminded me to push through my bottom.

This time we would have a doula to help us cope. I would have people making sure I had sugar and water, that I went for a wee. We could have a pool and a TENS machine at home. My husband learnt some massage techniques and my mum made special bolsters for me. I went to yoga and practiced positions and breathing.

I was not the same person anyway. I understood what was and was not helpful, what support I needed. I was prepared to question the advice I received and decline what didn’t ring true for me. I found the BRAIN acronym a really useful tool, particularly the “what happens if we do nothing” part. For those who don’t know, it’s: Benefits (what are the benefits of doing this?), Risks (what are the risks involved?), Alternatives (are there any alternatives?), Intuition (what is my gut feeling?), Nothing (what would happen if we did nothing for a while?)

The care I received at West Suffolk Hospital

I have been extremely impressed with the care given to me by staff at West Suffolk Hospital. Even when we have not seen eye to eye, they have been able to state their point of view and listen to mine without applying guilt or pressure. That’s not to say that it hasn’t been a stressful process. Each time I have prepared for confrontation, feeling the need to arm myself with all the facts to add some balance to the picture presented. So much focus is place on certain risks but not others.

At 30wks pregnant, I met with a WSH midwife to review of the previous delivery and discuss what the plan might be for the next one. They agreed that I was a good candidate for VBAC. I had laboured spontaneously last time and got all the way to the end, with no medical reason for the c-section. Low BMI, no health conditions. Being 40 didn’t seem to count against me. West Suffolk are very pro-VBAC and that message really came across. Great.

We reviewed their care pathway for VBAC women and discussed the risks of both VBAC and caesarean. I wasn’t happy with various parts of their protocol. Their own stats showed that VBAC women are just as likely to deliver vaginally as first time mothers, so why would I not be treated the same? Shorter time limits imposed for stages and progress, canularisation and anti-acids in case of emergency cs, being in the Labour Suite not the MLBU unit just in case and so on. This time round I was aware that one can decline any and all recommendations, as well as having a better understanding of the disadvantages of different interventions and approaches. It felt like they would be camped out with stop watches waiting for me to fail, and I knew that was hardly conducive to a good labour for me. I explained that I wouldn’t be happy with that protocol but actually it was irrelevant as we were planning a homebirth. At this point, the MLBU magically became a potential option. I said thanks but no thanks as I did want a homebirth. The midwife did her best not to look alarmed and invited me back to have a chat with a consultant.

Dr Jac Reeve

I nearly didn’t go to the appointment with the consultant as I was happy with our decision and thought it would just be undue stress and pressure. I am glad I did go. I researched my socks off and went armed with facts and figures about the risks and benefits of each element. I felt like I was preparing for battle. On the day, I was totally disarmed by the wonderful Dr Jac Reeve. In the six years she has been at WSH, the caesarean rate has gone from 29% to 20%. She is massively pro-VBAC. She herself had two homebirths. I cannot praise the care this amazing woman gave me highly enough. Jac was honest about what she would prefer me to do but I never felt pressured. At our first meeting, we respectfully disagreed on HBAC and were still able to have a productive discussion.

Breech VBAC

At 39wks, I took myself in to WSH for some monitoring as the baby’s movements had changed to pushes and stretches rather than kicks and jabs. I saw an experienced midwife who suggested the baby might have turned breech as the heartbeat was further up than expected, and a scan confirmed this. It was Friday night and I would have to wait until Monday to see Dr Reeve to talk about a new plan.

I once more dove into research, this time about breech VBAC. It was an incredibly stressful weekend but also one of overwhelming generosity from strangers. I sent out pleas for information on my Facebook groups. I spent hours on the phone to doulas and independent midwives, getting advice. I found an IM team (Andy Parker in London) who would attend me for breech HBAC or in hospital if they could get an honorary contract. My local TCM guy squeezed me in for some moxibustion, and supplied me with a kit to continue doing it at home. (I also hung upside down off the ironing board with frozen peas and a torch on my tummy…) My doula came over to show us how to do some rebozo. Teddy Brookes the osteopath in Cambridge came in specially to treat me on the Sunday. Shawn Walker, a Norfolk independent midwife, offered to come in and train the WSH staff if they felt lack of training was a barrier to a breech VBAC. I am humbled and very grateful for all the kindness I was shown over those two days.

I should also give my husband a special mention at this point. He did an incredible job of supporting me, as he had done throughout. I think a lot of people would have baulked at this point but he managed to keep his concerns contained whilst I explored all possible options. Yet another thing I am grateful for.

A home breech VBAC was probably beyond even my comfort zone at this point, so I went in to discuss what my options in hospital would be. A growth scan confirmed a frank breech but otherwise healthy and appropriately-sized baby. I met with Dr Reeve and a senior MLBU midwife. I had been discussed at the consultants’ meeting that morning and it was made clear that the consensus of opinion was to recommend a cs. But Dr Reeve was prepared to support my choice. Risks were discussed calmly and rationally, with their recommendations made clear but my decisions respected. Unbelievably, I left with an agreed plan for a frank breech birth (not a breech delivery) in the MLBU, along the lines of my previous VBAC MLBU plan. Note: in a breech birth, the mother typically delivers in a gravity-aided position and the midwives do not touch the emerging baby. In a breech delivery, the mother lies on her back with feet in stirrups, and an episiotomy is often done to aid the use of forceps to deliver the baby’s head.

Dr Reeve and I agreed that she would try to turn the baby by ECV, so I went back in the next day (40wks by their dates, 39+3 by mine). Dr Reeve’s technique is unusual – I’d liken it to a Thai massage – but her success rate is the best in the region (73%). It didn’t hurt and it did work. The woman is a genius.

Change of plan

In theory, with the baby now head down again, the HBAC was back on but my husband and I had been shaken by the past few days. Moreover, I had been utterly reassured that my wishes to be treated like any other low risk mother would be respected. Every time I attended WSH, someone from the MLBU had been present, which mean that I met many of the team. Each one took the time to ask about my past experience and try to allay my concerns about labouring in hospital. At my final appointment, the head of the MLBU herself gave me a personal guided relaxation to try and help let go of any baggage I had! They really did go above and beyond for me.

My husband and I slept on it and decided that we would opt for a hospital VBAC in the MLBU. The community midwives came and took their homebirth kit away. I was fine with the decision. We could still labour at home until it was time to head in. Whilst I would have preferred a homebirth, it was VBAC that was my priority. The home bit was mostly about maximising my chances of doing so. The baby was now back to back (having been LOA until 39wks!!) but at least I knew what kind of labour I might be in for. All would be well.

And finally…

In the end, our second daughter was born at home on the sofa after a rapid labour, a HBAC after all. I was attended by two stellar community midwives, yet another credit to the NHS.

Throughout this journey, the support I have received from the local and online birthing communities has been amazing. I am extremely grateful to live in the UK where choices are available to us. A massive thank you to all who have played their part in the birth of my second child. We did it :0)

COMING SOON! Rachel’s homebirth after caesarean (HBAC) story. Her partner has written about the birth from his perspective and her doula has too.

If you would like to connect with other local women, like Rachel did, planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s research, blogs, birth stories and hot topics on the resources page.

And there’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

FREE pregnancy & birth support in February

This month’s Cambridge Birth Choices FREE pregnancy and birth support drop-in sessions are on:

Friday 10th February 2017 from
12.30pm to 2.30pm at Cambridge Women’s Resources Centre, Hooper Street, Cambridge. CWRC is a women-only space, children welcome. Click here for full details.

Friday 24th February 2017 from 1pm-3pm at Satyam Yoga & Wellbeing Centre, 2-4 Hawthorn Way, Cambridge, CB4 1AX (next door to Stir Cafe). Partners and children welcome. Click here for full details.

Like our Facebook page or follow us on Twitter to keep up-to-date with news and views, and Cambridge Birth Choices’ community page and Twitter too.

 

Suzzy’s VBAC at Hinchingbrooke Hospital

After I had my son in 2012 by caesarean section (due to failure to progress after an induction at 40+17), Chris and I tentatively decidedly the beginning of 2016 that this would be the year to start trying for a second child. I’d suffered quite severe postnatal depression (PND) after the birth of my first baby, and so became very anxious when I discovered on Good Friday that I was pregnant- what if it all happened the same way again? What if I just was one of those mums that couldn’t give birth naturally?

After the first 18 weeks, the anxiety and low moods started to lift, and talking to friends and family helped me no end. It was reassuring to hear I wasn’t alone in feeling the way I did. I was also referred to cognitive behavioral therapy (CBT) which seemed to take the edge off of the anxiety, and helped me cope more day to day.

During my pregnancy I was under consultant-led care and saw Dr Pathak at 16 weeks who discussed the idea of being induced at 40+12, then on day 13 provided I wasn’t already in labour I would have another caesarean. However, she was keen to express that I had a strong chance of having a VBAC, around 60% or so. Fortunately, Hinchingbrooke were keen advocates for VBACs.

As the pregnancy continued, I started to feel more anxious again. Conscious that we have no family locally and my son having started school, I was increasingly worried about having another caesarean. While discussing my fears on a Facebook mummy group, someone suggested hiring a doula to ensure I would feel in control of my birth and experience no matter the outcome. It was also suggested by my community midwife Carl to be something I might find useful, to guarantee continuity of care and to have someone with me at my child’s birth who was educated in my options. After all, as lovely as I’m sure each midwife in the delivery suite would be likely to be, I worried that I would be assigned a midwife who wouldn’t know how to handle VBACs. Silly I know.

I did some research of local doulas, read up on their profiles, and made a shortlist that I showed to Chris. For me it was important that our doula would not only be, hopefully, quite spiritual and holistic, but also be logical and factual for Chris’s benefit. We saw three wonderful ladies who all had very different approaches to being a doula, but when Verity, the third and final doula left our house after coming for the initial meeting, Chris turned to me and said “well, no point in debating – she’s the one.” (See what I mean about logical and factual..?)

As my due date was looming, I’d been lent a VBAC hypnobirthing CD that I listened to every day religiously and would often fall asleep to- it definitely helped me to relax!
At 36 weeks, I went to Dr Pathak’s clinic once again for a catch-up and met with one of her registrars who granted me permission to go to 43 weeks gestation should my body not go into labour beforehand, on the condition that baby’s movements continued well and I felt physically well too. On both mine and Chris’s side of the family the women have carried until 41 or 42 weeks gestation without issue, and it so it was agreed that unless there were any concerns for either my health or baby’s health, no intervention would be done until 43 weeks. I agreed to daily CTG monitoring and weekly scans to check the fluid around the baby, the start date of which would be discussed at a follow-up appointment with Dr Pathak. This was made for 24th November, when I would be 40+5.

I made sure I remained as active as I could be, as not only did it help me to keep up with my son who is a ball of energy, but it also helped to somehow keep my SPD at bay, and kept my anxiety low.

From around 37 weeks, I got regular Braxton Hicks in the evenings. They would normally start around 8pm, and die off around 10.30pm or wherever I went to bed. Rather than feeling anxious about it, it excited me. It proved to me that this pregnancy was already so different from my last, as I’d hardly had Braxton Hicks at all with my son. My body was preparing for my cervix to contract and give birth to my baby when the time was right!

Two days after my due date, 40+2, the Brixton Hicks didn’t stop. In fact, they grew in strength and numbers, and I downloaded a contraction timer. To my amazement, I was having more than three contractions in ten minutes, and before long the app told me to “GO TO HOSPITAL”.

I went for a nice relaxing bath (as relaxing as it could get with Chris panicking in the background and packing the last few bits for the hospital bag that is!) and Verity had lent me a TENS machine that I started to use once I got back out.

Verity soon arrived and around midnight we went into the lounge as my contractions were making me increasingly vocal as I breathed through them but we didn’t want to wake my son or mum up. Soon, however, I started to feel incredibly sick and started to vomit after each contraction which was tiring me out quite quickly. At Verity’s suggestion, we headed off to hospital.

At 3am we’d arrived at the Delivery Unit and had managed to get Room 7 which was the low-risk room in the delivery unit also attached to the birthing pool. Sadly, despite my best efforts, I still couldn’t keep anything down in spite of an anti-sickness drug, baby was only 4/5ths engaged and I wasn’t dilating. After a few hours I was taken into the antenatal ward, was eventually given fluids by IV to get me rehydrated, and was CTG monitored for a while in the afternoon. The day seemed to pass in a blur as I was exhausted, still having strong vocal contractions, but Verity and Chris encouraged me to be as mobile as I could be. Once rehydrated to an extent, Chris and Verity encouraged me to go for a walk around the corridors of the hospital, and I was grateful for the large oversized radiators there as I could lean against them during a contraction while rocking back and forth.

Upon my return to the ward, I asked for pain relief as I felt that the TENS machine was reaching its limit, and the midwives asked to examine me in case I’d dilated enough to allow me back to Delivery so I could get gas and air. To my sheer relief, I was 3cms and well on my way. Baby had turned from being back to back earlier in the day, to being sideways on. A midwife was called in, and soon we were in Delivery with a lovely midwife called Kimberley. Although we’d hoped to go back to Room 7, it was already occupied but Kimberley got as many props as she could- a nice mood-light, a beanbag, and a birthing ball. I was happy as a Larry as I eventually was given access to gas and air as Kimberley could see how strong the contractions were, as well as an anti-sickness drug that seemed to keep the sickness away.

Sadly, again, I failed to progress in time, so, frustrated and nearly in tears, I was sent back to the antenatal ward, but not before Kimberley did a sweep (she claimed to have great talent when it came to giving sweeps- in hindsight I’d tend to agree!).

I sent Chris home to get some sleep and Verity was allowed to stay with me. She and I were placed in an empty bay in the ward, as the midwives were aware that I may feel self-conscious about being so vocal with my never-ending contractions. Once on the ward, I begged for more pain relief; I hadn’t slept for nearly two days, and I was conscious that in order to give myself a fighting chance of having enough strength and energy for childbirth, I needed to rest. I was eventually given oramorph and in spite of my initial cynicism, Verity was quick to point out that I had in fact been able to sleep between contractions; they were still there, but I’d been able to sleep. At 3.30am I was given a top-up, and remember asking the midwife if I should now be trying to get labour started again, or if I should carry on resting til the morning; I felt THAT well-rested! Needless to say, she strongly urged me to get the rest while I could.

Wednesday morning Chris came back, Verity was sent home, and after having had a quick conversation with Dr Pathak on her rounds, she was sympathetic but explained that the longer I stayed in hospital the more likely I would be pressured into having interventions of some kind. She explained that, as this was essentially the first time my body was in labour, the latent labour phase could take hours, days, or weeks! She wanted to respect my wishes of as few interventions as possible, so encouraged me to go home. Although I was grateful for her support and advice, I must admit that it felt weird going home while contracting as much as I was, and as strongly as I was, rather than be staying to have my baby.

Once home, Chris went to work, and my parents looked after me for the day. I remember my son coming home from school, excited to see me as I’d been away for two nights, but trying to explain to him that no, mummy wasn’t dying, she was trying to get his baby sister out of her tummy through breathing and making loud noises, wasn’t easy.

Fast-forward to the evening and the previously slightly-manageable contractions seemed to ramp up to another level again. And the sickness returned. I called Labour Ward, explaining my situation, and pleaded with the midwife to let me come in just so I could at least get another anti-sickness injection. The contractions I could just about handle, but being sick on top of it all made me anxious that it would get as bad as it did on Monday-Tuesday. Eventually we got told to come in, I called Verity to ask her to come to hospital too, and she pointed out that I’d had more than three contractions in the 6 or so minutes we’d been on the phone..!

This time, when I arrived at hospital I had to be wheeled up to labour ward in a wheelchair. There was no way I could walk even that short distance!

On the Delivery Ward, I met with our assigned midwife who said she recognised me – it was Charlotte, the midwife who I’d met in the summer during a VBAC Clinic and who had been the first to assure me I could still have a water birth if I wanted, and that VBACs were possible. I remember thinking at the time that it would be great to have her as my midwife for delivery (she just had a certain air about her that made nothing seem like a worry or stressful), and there she was! Of course, at this point i didn’t expect to be kept in as I was only expecting to have the anti-sickness drug (Chris and Verity were quick to give Charlotte the background so I was given the right drug), but Charlotte handed me gas and air in exchange for an internal examination to see how far along I was, and I’d done it – I’d got to 5 cms! FIVE! No matter what anyone said now, I was well in established labour territory! I remember punching the air with my fist, shouting “Let’s get this show on the road! Come on, FIVE CENTIMETRES!” and then the preparations went underway. This time, Room 7 was free, as was the pool, but there was a sticking point- I declined continuous monitoring, and the doctors wouldn’t give me permission to use the pool without it. Charlotte tried to convince me to have the telemetry monitors (which were waterproof and wireless) as per the doctors’ requests but I was stubborn. Doctors on delivery were equally so. In the end, Charlotte came across Dr Hamilton, explained to her that I was aware of the risks of scar rupture but only wanted to be monitored intermittently, and Dr Hamilton agreed! We’d been given the green light!

Verity disappeared to run the water for the pool, Chris helped to get our belongings together, and soon enough I was in the pool room. I remember Chris asking me where my tankini top was, and whether I wanted it now, at which point I threw my t-shirt I was wearing at him, and told him not to worry.

Completely stark naked, I was in the pool, my playlist I’d begun putting together on Spotify (but hadn’t finished – I wasn’t expecting to be in labour for weeks yet!) which included songs Chris absolutely HATED was on (he knew though that this was not the time to argue with me about it). Chris and Verity took turns to rest, get coffees, go for toilet breaks, and at no point did I feel like I was on my own. Prior to labour, I remember reading in a book that I mustn’t grab my birth partners whole hand for support, but only three fingers at most, as any more and I could break them. Both of them motioned for me to grab their thumbs only. Apparently my grip was pretty strong. Who knew?

Time flew by, and hours felt like minutes. The gas and air plus the warmth of the water, and the knowledge that I was surrounded by three amazing people who I love (Chris) or respect (Verity and Charlotte) dearly, kept me going. At no point was there talk of interventions, and although it took me a while to get to 10cm dilation the only suggestions that Charlotte and Verity came up with were changes of position and trying to handle the contractions without gas and air for a bit. Chris kept reiterating how well I was doing at regular intervals.

I had a wobble where I was convinced I couldn’t do it anymore (presumably the transition) and my Dream Team of wonderful people kept cheering me on. Before I knew it, i was beginning to bear down, and I felt immense pressure as baby’s head was beginning to crown. My waters had broken without anyone realising, but had clearly run clear. As I was bearing down with each contraction Charlotte jumped in and monitored baby after each one. I’d push, she’d monitor. Push, monitor. It went like clockwork. I moved into different positions as I listened to what my body wanted, going from squatting, to laying on my back, to standing.i remember looking down at my bump at one point while floating on my back and holding onto the handles of the pool, and noticed colostrum glowing on my nipples. My body knew the time had come to release my baby, and was starting to prepare for feeding. It was doing everything by itself, and it knew exactly what to do. It was such a deeply primal experience, no logical mindset remained. I couldn’t speak anymore, and I didn’t care.

After I’d been pushing for about 45 minutes or so, I was struggling to cope with the pressure on my perineum. Charlotte, aware that I didn’t want an episiotomy, suggested I tried to wee as I’d been drinking a lot of squash and water to keep me going and continue to rehydrate me. As I was still in my strongly primal warrior-woman mode, I couldn’t seem to engage my bladder. Charlotte got me out of the pool and onto the birthing bench, and was about to flush my bladder as meconium spurted out. Even if this meant we needed to get baby out quicker, there was no sense of panic. Charlotte asked the other midwife (who had snuck into the room quietly at this point) to go and get a paediatrician, explained to me that I now needed to be continuously monitored, and the pool was unfortunately no longer an option. As I could fully understand the reasons WHY, I agreed. Another couple of pushes and Charlotte asked if she could do an episiotomy, as my perineum just didn’t seem to want to give. I consented, she gave me some anaesthetic and did a small cut. During the next contraction I felt an absolutely blinding and indescribable pain – Her head was out! Everyone shouted at me to stop pushing, and baby’s head slowly rotated from face down to sideways on, and with the next push, her body was born.

At 5.37am I got to see my beautiful daughter Lorelei Faith for the first time as Charlotte placed her on my chest. She only had a little cry, but seemed more shocked and surprised than anything!

The paediatrician was satisfied that Lorelei was fine, and i remember feeling a sense of silence and calm. Chris cut the cord once it had stopped pulsating, and after a while, through the use of the injection, a big juicy placenta was delivered. I remember looking at it and thinking “whoa, did that really fit inside me as well as the baby?” Eventually I was moved into another room to have stitches done, and I remember feeling like such a pro as I had my legs in stirrups (my “cosmetic surgery” as I called it) and feeding Lorelei at the same time.

Charlotte kept me informed all along, and at no point did I feel out of control, or like I was having interventions I didn’t want.

We got to cuddle Lorelei for what felt like hours before she was weighed and had her newborn checks, and I felt on top of the world as I was wheeled back into the postnatal Ward. Carl, my community midwife, was in the hospital that morning so came through to congratulate us, and the midwives we saw when going from delivery to Lilac Ward cheered me and congratulated me on my successful VBAC having just used gas and air. They were all in awe. Kimberley and Oriel (who had worked on the antenatal Ward on the Tuesday afternoon/evening) came through especially to offer their congratulations too.

As Lorelei had pood on her way out, we had to stay for monitoring for twelve hours but got to go home that same night, but not before the night staff shifts began, and Charlotte came through to say goodbye. I’m so glad she did, as I got to say a massive thank you to her for keeping me going.

The next day at home I sat in a dreamy daze- we hadn’t got much sleep that night, but I couldn’t get over just how much I loved her already. My son absolutely adored his baby sister from the moment he met her. If you were to ask me if I’d do it again, hell yes. In spite of the sickness and long latent labour, nobody put pressure on me to have interventions, everyone treated me with respect, and it really felt like each and every staff member and volunteer was on my side.

A final special Thank You to Chris for having supported me throughout the pregnancy despite my moods and anxiety, to Verity my doula extraordinaire for empowering me and helping me believe my dream birth was possible and keeping me going throughout the labour and looking after Chris, and finally to Charlotte, super midwife. Words cannot express my gratitude enough. She remained calm and in my side throughout my labour.

I was so blessed to have my Dream Team.

If you would like to connect with other local women planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s information about local hospital data including VBAC guidelines and VBAC rates. Further information incl. research, blogs, birth stories and hot topics are on the resources page.

And there’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

Harriet’s speedy VBAC at 35wks at the Rosie Hospital

When planning for a VBAC with my second child, I could not have imagined how very differently things would unfold from my first labour. Our first child, Matthew, was born in March 2014. After a straightforward pregnancy, I went into labour spontaneously at 40+9 and soldiered through 36 hours of exhausting latent and first stage of labour in the Birth Centre in which something was not quite right – I had agonising and continuous heartburn-like pain in my bladder area which made it impossible for me to manage the contractions by keeping active. I dilated to 5 cm but progress then stalled and I agreed to have the waters ruptured to try and speed things up. Unluckily, the ARM provoked a sudden and sustained fall in Matthew’s heart rate and we had the frightening experience of an emergency transfer to theatre for a crash Caesarean under general anaesthetic.

When I became pregnant again I knew from the outset that I wanted to aim for a VBAC, and chose to go back to the Rosie Hospital, although we had by now moved from Cambridge to North Hertfordshire and were substantially closer to the Lister Hospital. I was reassured that I had a good chance of VBAC and the situation that led to my emergency Caesarean was unlikely to recur. I did some (fairly basic) reading up on VBACs, went to one of the Cambridge VBAC Friends meet-ups, and had an appointment with consultant midwife Jan Butler to discuss the option of using the Rosie Birth Centre rather than the Delivery Unit. I felt quite ambivalent about which option felt the right one, and left it that I could decide on the day. I assumed that I was likely to go at least to full term again (Jan Butler agreed that this baby would probably be late) and that it would not be a particularly quick labour, as I’d only got to 5 cm dilated before the Caesarean first time round. My main concern was a recurrence of the abnormal pain I’d expienced in labour with Matthew, in which case I thought an epidural would be a good idea; otherwise, I didn’t have a particular birth plan this time around.

On Sunday 14th August, at 35+1, I woke up around 7 am with soaking sheets. We called the Rosie and told them I thought my waters had broken, and they said to come in immediately. We hastily transferred a few things from the partly-packed hospital bag to a smaller bag – I had no idea if I was going in to have a baby or just for overnight monitoring. They checked the baby’s heart

Big brother meets Imogen

rate on the monitor and confirmed my waters had gone, then gave me a bed on the antenatal ward. I was told they’d check me on the CTG again that evening and the next day, then send me home with prophylactic antibiotics if there were no signs of labour. That evening, the monitor detected uterine tightenings, but I couldn’t feel these at all – I still felt totally normal, other than the leaking waters. My husband David went home as there were no signs of labour and he needed to look after Matthew.

I had a fairly disturbed night by other activity on the antenatal ward and around 04.30 am became aware of a vague crampy pain in my lower abdomen. I got some paracetamol from the midwives and went back to bed, but became very hungry and wondered whether it was unreasonable to go and make myself some toast at 5 am in the ward kitchen! I decided to compromise on orange juice, but got as far as the fridge and had the first definite contraction that I had to sway through to manage. Around 05.30, after two or three more, I thought I should let the midwives know, though wondered if I was making a fuss prematurely. They got me back on the monitor and things ramped up really quickly – suddenly I couldn’t find a comfortable position, felt a bit sick and faint, and told the midwives I was scared and wanted some gas and air. I still assumed this was early labour, though in retrospect it was a textbook though short-lived experience of transition! However, it was still much less painful and more manageable than labour with Matthew had been.

A third midwife had arrived by now and asked if she could examine me. ‘You’re fully dilated, I can feel the head, and we’re going to Delivery Unit now!’ ‘Oh – shall I call my husband?’ I said. It was 6 am. I managed a brief but fairly coherent conversation with David while the midwives hastily rounded up my stuff, then we trundled across the corridor to a delivery room. I was quickly given some gas and air, which made me feel more in control again and the pushing stage felt quite manageable. A neonatologist appeared (as a precaution because the baby was premature) and unpacked the delivery kit and the midwife said ‘This baby’s going to be out in the next few minutes’. I had three real pushing contractions and Imogen was born at 06.25 am. They checked her over quickly, weighed her – she was 5 lb 11 oz at birth, a good size for 35 weeks – and then asked if I wanted her put skin-to-skin. I’d missed out on this moment with Matthew because of the general anaesthetic, so it felt extraspecial. David arrived around 0 minutes later to meet his daughter – we live about35 minutes’ drive from the Rosie, so given the speed of my labour, he had had no chance of making it in time. Indeed, it was lucky I was already in hospital for monitoring!

My unexpectedly quick and easy VBAC then progressed to a longer saga of going to theatre for surgical removal of a retained placenta, and a ten-day postnatal stay as Imogen needed some initial help feeding because of her gestation. Looking back at the birth, I feel enormously lucky (as well as surprised!). Things I’d been concerned about in terms of maximising my chances of a successful VBAC became irrelevant in the end – I didn’t get to use the birth centre or a pool in labour, and I did have continuous monitoring and delivered on my back (and Imogen was back-to-back), but I’ve since realised that these issues are means to an end rather than the end in itself, as it was definitely a great birth. It wasn’t really down to planning – I just got thrown a totally different hand this time around.

If you would like to connect with other local women planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s information about local hospital data including VBAC guidelines and VBAC rates. Further information incl. research, blogs, birth stories and hot topics are on the resources page.

And as Harriet mentions, there’s FREE monthly face-to-face support at Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

January 2017 Cambridge Birth Choices pregnancy and birth support drop-ins

Happy new year!

This month’s Cambridge Birth Choices FREE pregnancy and birth support drop-in sessions are on:

Friday 13th January 2017 from 12.30pm to 2.30pm at Cambridge Women’s Resources Centre, Hooper Street, Cambridge. CWRC is a women-only space, children welcome. Click here for full details.

Friday 27th January 2017 from 1pm-3pm at Satyam Yoga & Wellbeing Centre, 2-4 Hawthorn Way, Cambridge, CB4 1AX (next door to Stir Cafe). Partners and children welcome. Click here for full details.

Like our Facebook page or follow us on Twitter to keep up-to-date with news and views, and Cambridge Birth Choices’ community page and Twitter too.

 

“Nothing in my life will top this experience.” Becca’s story of her homebirth after caesarean (HBAC)

“This is my tale of how our gorgeous son, Lorcan, joined our family in the wider world.

Lorcan’s birth was preceded two years ago by the arrival of our healthy little girl at Broomfield Hospital, Chelmsford. Despite a healthy and positive pregnancy, it was a truly agonising and traumatic labour: I found myself laying in fear on my back on a hospital bed, under continuous monitoring and attached to a drip to keep me hydrated. Fifty hours after regular contractions starting and at 9.5cm dilated we were advised a caesarean was the only way to birth our daughter and we were whisked into surgery. We wanted to feel more empowered for a positive birth experience with our son and decided the safest, healthiest place to do this for us was at home.

During pregnancy: a few things helped me prepare immensely: the positive support of midwives; a birth reflections appointment; the Wise Hippo hypnobirthing course alongside Zoe Tolman’s fantastic all round support; Clare Minter’s reflexology sessions; Emma Stevens’ Pregnancy Yoga; the AIMS VBAC booklet and Kate Evans’ book “Bump: how to make, grow & birth a baby”. HUGE thanks to all of these people for contributing to the best night of my life in the wonderful birth of my son; you’re all amazing for your contribution to our special gift.

Just before labour (14:00 to 17:00): So, our pregnancy was healthy and despite NICE guidelines that I should be seen by a consultant, it didn’t happen until 40 +12 when I attended the Rosie Hospital for continuous monitoring. During the 45 minutes on the machine, I was getting a few tightenings of my uterus that had started and stopped over a few of the preceding 18 hours. They weren’t strong, long or regular enough to convince me early labour was underway. The consultant agreed and an internal exam showed no progress. The doctor however was more concerned that I was following a homebirth plan and I was advised against this choice because I was past dates with a history of a previous caesarean with a macrosomic baby. I hadn’t had any additional growth scans. I waited while the doctor spoke to colleagues and another consultant came to recommend I admit myself to labour ward to have my son. I refused and on the way home I had a pep talk with my bump; we were healthy and well and would have the birth that was healthiest for us.

Early labour (17:00 to 23:00): I popped to a couple of shops on the way to collect my daughter from nursery. We got home and as I started to prep dinner my tightenings started coming in more regular waves. By the time my hubby (Chris) arrived home from work at 18:30 I was struggling to concentrate. It was difficult to juggle my daughter and impossible to relax into the surges which were as frequent as 3 or 4 in 10 minutes but lasting just 40 seconds on average. I was feeling stressed, but comfortable and at ease in my own home. Chris went on to blow up the pool and I was pacing around the house having lost the ability to keep track of the surges and decided to call the Princess Alexandra Hospital (Harlow) at 20:20. They were aware of my situation and said they would advise the community midwife to come out. Chris then took our daughter up to bed and my midwife (Lynn) called – I was lucky enough to have gotten to know her – and she said she would call back after an hour. Not long after 21:00 she called and advised she would be on her way to us.

Lynn arrived at 21:30 with Kerry another midwife I was familiar with. I was so pleased and fortunate that they were on duty because they had listened to my birth choices, understood and supported them as well as reassuring me along the way. We sat for what felt like no time at all, me bouncing on the birthing ball at first, chatting away. After about an hour I was being supported by hubby and the midwives through each wave while I squatted and focused on using my hypnobirthing techniques while looking at boards I’d made up with positive affirmations and relaxing/ positive pictures. Even now I was doubting whether the surges were productive given my history alongside the fact that they remained short – albeit frequent. At around 23:00 Lynn asked if I wanted to get in the pool. I had my first internal check before getting in, and it was good to hear that I was in established labour (4 to 5cm dilated).

Active labour (23:15 to 00:20): So, I got into the pool and it felt wonderful. It really helped ride through the surges, along with some gas and air as I found myself in transition (because of fleeting thoughts that I could not birth my son right now). I was so glad to have been aware of that phase in advance in order to manage it positively. I remained squatting while in the pool. I was aware the midwives were wanting me to increase my sugar intake with the aim of fuelling my contractions to lengthen but I was also reassured that progress was being made. Much of this time is rather a blur as on the whole I was focussed on my son, my breathing and my body. Upon reflection I wasn’t rationally experiencing what was happening around me when a couple of things distracted me: I complained that my hubby took too long to get me a towel and griped about the midwives being bossy. Focussing on my body felt incredible though; I could feel my son slowly moving down and followed instruction from the midwife to reach down and feel his head crowning: wow!! I’d like to say I wasn’t in any discomfort but it was certainly a lot of work to ride out the waves. I maintained positive thinking when focussed though and it was such a positive experience with Chris and the midwives reassuring me throughout.

The birth (00:20 to 00:39): As I felt my son make his way lower, my body told me to bear down (at 00:20) as it expanded. I soon heard Lynn say to breathe and I panted him through to the big wide world. Before I knew it our son’s head had emerged, quickly followed by his shoulders. Then, a short rest and I could feel him wiggling to progress and my body bearing down, it is 00:39 and he arrives! My husband catches our son and passes him to me, I sit back and hear Chris repeatedly saying “you did it Bec!” full of emotion, I look at our boy, holding him close and thinking “we did it” he is crying but I feel immense pride in him. It starts to rain, thrashing down heavily on the conservatory roof. It was immensely symbolic of the rush of emotion we all felt. Kerry tells us that part of the amniotic sac was completely intact around him as he was born and we should keep it because that’s lucky!

The third stage: There was no rush to get out of the pool, but we moved into the lounge. I chose to birth the placenta naturally but wasn’t feeling that my body was continuing to surge. Lynn reassured me that it was normal because it didn’t feel there was anything to bear down with compared to the sensations with the baby. It was tricky to bear down while hoping our son would latch onto my breast and stimulate more positive hormones! After a little help to drain my bladder, I birthed the placenta and phew, I felt a huge relief. So, back to lots of cuddles with our baby boy!

The happiest ending to our experience: Our daughter Lara had been upstairs asleep the whole time but around 02:00 we hear her call out from her bedroom. Obviously she would not settle given the atmosphere but I was concerned that she would be meeting her baby bro at a less than ideal time. Lynn and Kerry reassure me and Lara comes into the lounge. She looks a tad confused at first but as soon as she sees our baby she said “ahh, baby bro is here. I love baby bro! Look at his tiny hands . . . tiny ears . . .” Mumma, Daddy, big sis and baby bro all share cuddles on the sofa and I experience the most magical, happiest, wonderful moments of my life. I feel more privileged than I ever thought possible and the love in the room is immense. Nothing in my life will top this experience.”

If you would like to connect with other local women planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s information about local hospital data including VBAC guidelines and VBAC rates. Further information incl. research, blogs, birth stories and hot topics are on the resources page.

And for monthly face-to-face support, there’s the Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.