Rachel’s home VBAC -> gentle caesarean birth

RJ_CBACbirthRachel shares her second baby’s birth story – a positive, gentle caesarean birth – after her first baby’s birth by emergency caesarean left her frightened to go back to the Delivery Unit.

I had planned a homebirth for my first baby and laboured at home for 24 hours before I ran out of steam and transferred to the Rosie Delivery Unit. Due to a number of reasons I became distressed, my baby became distressed and he was born by emergency caesarean.

My second pregnancy, twelve months later, began as a rollercoaster of emotions: memories and feelings resurfaced and I was frightened to go back to the Delivery Unit. My first choice was the Rosie Birth Centre; however, women who’ve had a previous caesarean weren’t allowed to give birth there. I wanted a midwife-led birth, so homebirth seemed my only option. I researched the risks of home and hospital, and discussed everything with my husband. I knew I’d feel safer and more relaxed at home with one-to-one midwife care than in hospital. I met with the Rosie’s consultant midwife and at the end of our meeting she said: “You’re making an informed choice and we will support you.”

During the pregnancy I made time to relax and exercise. We did a hypnobirthing course and the daily practice during toddler naps was really relaxing and confidence building. I also found womanly support: my doula, Maddie McMahon, and the Cambridge VBAC Friends, whose monthly meet ups I went to, gaining support and confidence from women who’d walked this path before.

My labour began after a curry at Pipasha. My waters began leaking at 3.30am. I put my hypnobirthing CD on, texted Maddie as promised and tried to sleep. Twenty minutes later I literally leaped out of bed with the first contraction. I got settled in a chair and focused on my breath. By 7am Maddie was by my side. Nick went for a little rest (another benefit of having a doula) because he hadn’t slept since 3.30am either and suddenly the contractions accelerated, I couldn’t sit down, I had to be upright, forward. Maddie helped me find a comfortable position and did some massage. I had to really focus on my breathing, otherwise I couldn’t handle the contractions. Things seemed to be moving quite quickly. Maddie went to wake Nick (he’d only been gone about ten minutes!) and I was aware of her asking him to call the midwife and put up the pool…. and I might be in transition – I thought so too!

I went into my body and concentrated breath by breath. The next thing I was aware of was a midwife arriving. Sometime later I got into the pool. I breathed. There is a huge chunk of the afternoon missing. I remember my first wobble; Maddie was talking softly to me, reassuring me. I was being pulled out of my rhythm by the feeling of deja vu: the contractions were in my back and bottom just like my first labour. I was scared that I wasn’t dilating or the baby wasn’t descending. I was encouraged to check if I could feel the baby’s head but I couldn’t, he was still high up.

With Maddie and Nick’s kind words I pushed the negative thoughts away and regained control. I looked into their eyes and I could feel the oxytocin rush through my body. I took quick, deep breaths in and slowly breathed out. Hours later I realised that I had naturally moved to the breathing rhythm for moving baby down.

More hours passed by and I consented to an examination while I was in the pool: I was 7-8cm. With each contraction I could feel the baby slide down, and as the contraction ended, pop back up. It was so frustrating! Maddie did amazing hip compressions, with perfect timing, and I curled my pelvis against the compression and pushed. Over and over. It felt so good. I imagined two more pushes and he would be free. I visualised my baby moving down, towards light and water.

It was now early evening and the midwives were keen to check progress. I agreed and discovered I was 9.5cm dilated but the baby hadn’t descended and had twisted to face my thigh. It had been 13 hours of active labour, I had never worked so hard in my life, we had tried every trick in the book. There was no crisis, no emergency but I knew my baby was stuck. I agreed to transfer to the Rosie Delivery Unit. As the ambulance arrived (with more gas and air!) the pain became unbearable from the fear and adrenalin flowing through my body.

After the midwife checks I met the registrar, Dr Ketan Gajjar, who gently asked: “how can I help you Rachel?” I sobbed (I couldn’t speak). I was assessed: dilation now 8cm – thanks adrenalin! – baby still high. The only option was a caesarean. The registrar read my birth plan and was happy to follow my wishes for a gentle caesarean.

I was prepped, the operation began and once the screen was lowered Dr Gajjar eased my baby boy’s head out. We were transfixed. The room was completely silent, no-one touched him. He looked around, moved his eyes, then slowly his body emerged from my abdomen. It was truly magical to watch. Dr Gajjar lifted him from my body straight onto my bare skin. He was covered in buttery vernix and throughout the rest of the operation I stroked his silky skin; he rooted around, cried a little, I kissed him and held him constantly. It was so gentle and respectful, we were in tears.

The theatre staff were buzzing about the operation, I was curious, surely they did this all the time? The anaesthetist explained how he’d administered Syntometrine and along with my own natural contractions my womb had gently squeezed the baby out. Wow!

(I later read that the baby auto-resuscitates – breathing through nose and mouth – while the rest of the body is still inside the uterus, attached to the placenta, and the pressure from the uterus helps expel lung fluid, similar to what happens in a vaginal birth.)

It wasn’t anything like how I planned but it was a gentle, positive birth. I was happy to be home within 36 hours. My recovery was less painful than last time, my body has healed faster and breastfeeding was easier. I was really proud when Maddie included my story in her book “Why Doulas Matter” as an example of how surgical birth can still be parent-centred, empowering and beautiful.

Since Rachel’s birth we know that eight women have VBAC births in the Rosie Birth Centre and many more have been given permission to birth there, yet women are still told their only option for VBAC place of birth in Cambridge is the obstetric-led delivery unit or home.

Cambridge VBAC Friends’ advise all women who want a midwife-led birth at the Rosie Birth Centre or at home to contact The Rosie’s consultant midwife to discuss their options and develop an individual care plan. There’s lots of information available on The Rosie’s Hospital VBAC data page, including  guidelines and the new labour pathway for VBAC outside the Delivery Unit.

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.

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 Stir Cafe.

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