To Section or not to Section?

That really is the question.  And a very difficult question that a lot of women who have had a c-section with their first baby will face when having a subsequent baby.  I had a ‘normal’ delivery with my first baby so this was never an area I had to contemplate but a lot of my friends had emergency caesareans and found themselves debating what to do next time.  I know 2 people who have both been faced with this question, one opted for a VBAC (vaginal birth after caesarean, the other chose to have an elective section).  Here are their stories.

The birth of baby Clemmie.

Baby Clemmie moments after she was born

I was adamant from the start that I wanted to experience as natural and positive birth as I was able to with my second daughter. My first, Florence, had been born by emergency caesarean section once it was discovered that she was breech. All in all, my first birth was a stressful, disempowering experience which left me with severe baby blues and many regrets. As my husband and I only planned to have 2 children, this was my last chance as I saw it to experience what birth was all about.  I had booked back into my nearest hospital, Lewisham, for the birth and stayed with them up until my appointment (at around 25 weeks) with a consultant midwife with regards to my birth plans. I said that I wanted a VBAC and although she said that Lewisham supported these, she also just gave me a huge list of things I couldn’t do/ ways in which they would monitor/ induce and generally interfere with me as I was now an official ‘high risk’ birth.  I came out of the hospital feeling exactly as I did when I left a year and a half before after the birth of my first child. The meeting had been so negative and I realised that if I stayed with Lewisham then there was no chance of me having a positive birth – how could I if the care givers didn’t even believe in my abilities as a birthing mother, or support a non intrusive approach?  I looked into going to Kings College Hospital and was immediately heartened by their literature on VBAC on their website. In a few different places they said that they recommended certain procedures, however they did make it clear that it was a mother’s right to choose what she wanted to do.  When I went for my VBAC appointment with the consultant midwife there, things couldn’t be more different. I explained to her that I did not want to be continuously monitored during labour (as I had found that the knock on effect of this is for your midwife to concentrate on the machine and its readings as opposed to you when they come into the room – you become invisible!) and that I wanted a water birth. She was very supportive and I felt that my decision to change to Kings had been vindicated.  As my due date approached, I tried to stay active and positive. Having a small toddler certainly helped to keep me on my feet! I am a strong, physically capable woman and wanted to capitalise on that in the lead up to labour and the birth itself. I started to have quite strong twinges and Braxton Hicks from around 38 weeks and had an inkling that I might go into labour early.

On a Tuesday evening in July, the twinges finally settled down into regular and fairly strong contractions, around 3 every ten minutes. They were very bearable and I just concentrated on keeping as mobile and upright as I could throughout the night (unfortunately they were strong enough to keep me from sleeping that night!). I didn’t call the hospital as I instinctively knew that I was far from established labour but I did call my mother who on Wednesday started the journey down from Yorkshire so that she could look after my daughter. A friend arrived on Wednesday morning to take Florence for the day so I could concentrate on what was happening. As it turned out, my contractions slowed down to around 1 an hour that day, giving my husband and I the chance for last minute nesting/ cleaning/ bag packing etc! (Thank you mother nature!)

My mother arrived that evening once Florence was in bed, and once my subconscious knew that my daughter was in safe hands, my body started up labour again. Contractions became regular and painful fairly quickly, and by around midnight I decided to call the hospital. They asked me to come in just to check how everything was going (standard for a VBAC) and of course this slowed everything right down. We found out that had effaced but not dilated at all. I sometimes wonder at the relevance and usefulness of knowing about dilation as it can be quite dispiriting to find you are not as far as you thought!  We returned home and I decided not to go in again until I really felt ready. By this time I was using a TENS machine, and I set up a pacing routine in our living room. The pattern became contraction (where I would hold onto my husband) and then pacing up and down, up and down until the next one. This went on all night until I called the hospital again at about 7am on the Thursday morning, and they said I should come in. My subconscious perceived another change and slowed the contractions right down again immediately! (Really shows how feeling safe and secure is imperative for an uninterrupted labour and birth.) So we waited around another couple of hours until I felt like I was beginning to find the pain too intense to remain at home.

We arrived at hospital at around half 8 and found out I was 4cm dilated. By around 9 I was in my own lovely birthing pool room and I quickly started using gas and air which just took the edge of the contractions. I was still in the contracting/ pacing routing which really started things moving along fast. I had discussed my birth wishes with the midwife who had examined me on arrival and now had the go ahead for a water birth with no monitoring. The knowledge that this was happening as I had wished, along with being safely in our lovely room with our midwife who was very supportive, meant that my body decided to get on with things so to speak.  I was in the pool at around half 10 (I think – although my sense of time got rather hazy around this time!) and from that time until I gave birth to our little Clemmie at 12.22pm, things happened very quickly. The contractions became very intense, regular and close together and I was in survival mode really. I loved being in the water and with no clothes on and having taken off my glasses, I went very inward – I couldn’t really see anything and I don’t remember talking really either. I would cope with each contraction as it came and catch my breath in between. I was vaguely aware of my husband and my midwife talking sometimes in between but apart from that I was in my own birthing world. What was wonderful is that I wasn’t once examined or taken out of the pool, so I really was able to just be in my own world.  By around 12 my body started behaving strangely – and I felt the urge to be kneeling almost upright, bracing my body against the side of the bath and then – PUSH! What a strange feeling that was! I was aware of making quite a lot of noise, but there was nothing I could do about it, it just seemed the most natural thing to do. I knew I was suppose to stop pushing and ‘breathe’ my daughter out, but this didn’t exactly happen either as again, I just couldn’t stop my body pushing my baby out – I have never before felt the power of what my body is capable of and it still amazes me now to think about it.

And then, before I knew it, our little Clemmie was born.  What a feeling of relief although I was at first concerned about not dropping her into the water as by this time my poor legs had almost given out due to my contorted birth position.  It was a perfect birth and I wouldn’t change a thing about it.

Click here to read a fantastically written blog by a midwife, explaining all about VBAC.

Click here for more information in the UK about VBACs, your choices and all you need to know.

 

3 thoughts on “To Section or not to Section?

  1. This is really interesting! I had an elective C section the first time round (though I hate the term ‘elective’ as it was anything but, I wanted bloody lovely hypnobirthing but Elfie was breech and nothing I did could turn her) and was determined for a VBAC. Going in and out of labour for 4 days beforehand and being in hospital for monitoring meant I didn’t get the VBAC I initially wanted, but my second caesarian was just as lovely as the first. I might have pushed more to get my VBAC had I been allowed a waterbirth like baby Clemmie but it was to be a heavily monitored birth. Not ideal, and they wanted to break my waters should I have gone ahead.

    Next time (!)? If possible I’d like to think about a VBA2C (is that how you say it?!). x

    • Alice, I find it so hard when I hear women saying ‘allowed’. During the water birth of baby Clemmie, George knew all the risks associated with VBAC, she knew continuous monitoring was recommended but also knew the signs of ‘abruption’ ie break through pain, bleeding, fetal distress. But I 100% supported her decision to use the pool and have intermittent monitoring because her choice was informed choice. She researched, saw Consultant midwives and Consultant Obstetricians and believed her body could ‘do it’. If more midwives and doctors saw that VBAC’s can be achieved with the right backing and support then the wouldn’t ‘bully’ women into have a monitor strapped to them, lying on a bed with an IV drip. All these interventions lead to an increased c-section rate . I feel honoured to have supported George through her labour and it’s given me so much more courage to do for for other women. x

  2. I loved reading this, I had an emergency c section last time and I really want to try a natural birth but I am being completely discouraged, I feel much more hopeful after reading this that I will be able to have the birth I want x

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