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

harriet1
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.

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