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VBA3C, Triumph of Hope Over Experience

All births are a triumph in some measure. My first birth was a classic "failure to progress" yet when I awoke from general anaesthetic to find my daughter, Emma, at my breast I felt a sense of awed wonder at the creature my body had produced. In the days, weeks, months that followed I started to wonder, to regret, to blame myself for the “failure” I felt myself to be for needing a caesarean.

It was a long and rocky road, a journey of mind, body and spirit to the birth of Fergus eleven years later. Two more births came after that first one. In the preparation for Kieran’s birth I had attended NCT classes and had laid some feelings to rest but I still needed to believe that the medical profession knew better than I, still believed I was safest in their control. I slid helplessly down the cascade of intervention from induction to epidural to failed ventouse to emergency section. We joked, Raymond and I, somewhat flippantly to mask the pain, that whilst we grew beautiful babies we just couldn’t birth them. Yet somewhere inside I knew that wasn’t true and I embarked on antenatal teacher training hoping that there was an answer to the “why?” questions that plagued me.

By the time I was pregnant with Carys I had some answers and better still had managed to work through a lot of the feelings of anger and betrayal that those answers had brought. Yet still, as I planned for VBA2C (vaginal birth after 2 caesareans) I felt like a bit of a naughty child for daring to decline the consultant’s advice to “just” have another caesarean. I knew the evidence was on my side but that pregnancy seemed to be a long and painful battle with not only my fear and doubt but those of the medical profession too. I hoped but I didn’t quite dare believe that I could do this.

I was told at 40 weeks that I had all the signs of pre-eclampsia I couldn’t hold out any longer and had a calm and resigned caesarean which in many ways was a lovely experience. We decided not to have any more children and I accepted that I would never really know what it felt like to birth a baby.  I focussed my efforts on teaching antenatal classes, trying to give other women the skills and information to avoid my experience.

When I found I was pregnant for a fourth time, there was never any question of how I intended to give birth. My ongoing work as an antenatal teacher, my contacts both within the birth and the midwifery world, everything I knew about VBAC made me certain that birth after three caesareans was not only safe but possible. I also knew deeply and instinctively that I needed to be at home and I needed a wise woman to be with me.

To be fair, I didn’t reject the NHS out of hand but I know how the community midwifery system worked and I knew that whilst my local midwife might support my plans there was no guarantee that she would be available when I gave birth. My fear was never that I would have a uterine rupture, only that I would have panic stricken birth attendants who would be wanting to transfer me or inexperienced birth attendants who wouldn’t know how to spot an impending problem. Above all else this was about having a healthy baby not scoring points in some birth trial.

I knew of the independent midwife, Mary Cronk from email groups I was on and by reputation. Experienced in the more unusual types of birth at home, breech, twins, VBAC she is practical, down to earth, bolshy about uninformed medics but knowledgeable about when to use medical care and right on my doorstep. I resented having to pay for her care, not because I begrudge her one penny piece of it ,but because I believe this sort of care should be available to every women as part of our healthcare system. Raymond was horrified by the expense but accepted that only this way could we relax and get on with this pregnancy and birth, secure in the knowledge that our midwife was both experienced, confident and one hundred percent on our side.

So many times we were asked by friends and family “So what does your doctor think about this?” I realised how far I had come in my journey that I was amused rather than defensive about this. “We haven’t asked.” I would reply “We have read the evidence, our midwife is happy and we don’t require a medical opinion at present.”

Although by now convinced that I had not been truly pre-eclamptic in my last pregnancy, I was concerned to keep my weight down and avoid any possible complications so I restrained my lifelong devotion to Cadbury’s produce and tried very hard to like salads. A week after the birth I weighed only 6lbs more than my pre pregnancy weight but I was and am morbidly obese.

I hoped and I waited and I spent a lot of time on email and the phone drawing support from others all round the country who had homebirthed and VBAC’d or were planning to. I prayed a lot too. As the pregnancy reached term, and well beyond, I was conscious of so many people wishing me well, praying for me. Sometimes in the middle of the night I did wonder if I was totally mad and if I was going to die or to cause my baby’s death but these doubts were very rare. I still wasn’t sure that the damage done by the sections wouldn’t prevent this birth being straightforward but I was sure that I believed I could do it.

There are advantages to being an antenatal teacher when you are planning on giving birth. I already had a birthing ball, Tens machine, homeopathic kit, aromatherapy oils and burner and a wheat filled pillow and various bits of massage paraphenalia.

I filled our dining room with candles, I spent hours choosing music and breathed my way through every relaxation tape in my library. The birthing pool was up and ready at 37 weeks just in case baby should defy all previous experience and be early. We had chosen one with a heater and filter so that it could be left fully filled and I used it to wallow away my pregnancy aches and pains and dream about birthing in it. I ruthlessly refused all pleas from the kids to jump in and splash about – this was my space. Once a week Raymond drained, cleaned and refilled it while I paced about anxiously hoping I wasn’t going to go into sudden labour.

It was an agonising wait, I have a long menstrual cycle of around 35 days so I knew I should add a week onto the usual method of calulcating a due date.  But technically I was 18 days over my due date calculated by standard methods and 11 days over my date.  I really began to lose my nerve and spent a lot of time on the phone to Mary and to lovely Debbie and Gina from AIMS.

Both of my previous labours had been long and slow, I couldn’t believe this would be any different especially as my uterus had three scars to contend with which, Mary warned me, might take a while to get going with strong efficient contractions. So I was somewhat bemused to get up on Monday morning, after a night of mild period type pains, to find I was having quite strong contractions every five minutes. Hang on a minute…what happened to the mild, infrequent every twenty minutes or so that I tell my couples about? “Every labour is different” I told myself, hiding behind the fridge/freezer so the kids wouldn’t see me breathing through the contractions. But secretly I was more than a little miffed that I seemed to be in so much pain so fast as I fully expected this to go on for twelve hours plus.

We got the kids ready for school without revealing that I was in early labour. Emma was starting SATS that day and I didn’t want her to worry. Carys on the other hand, given one hint that baby was on its way would have point blank refused to go to school. Not that she was that bothered by the baby, she just wanted the present she knew was waiting for her on his arrival!

I slipped away to phone Mary. She was due to go to the RCM conference that day and had reluctantly handed over my care to her colleague Andrya but I knew she would want to know that it was finally happening. I then phoned Andrya and was mildly disappointed that she planned to be with me about half past ten. I wasn’t sure that I could cope another two hours with just Raymond. But I was sure that it would be many hours yet before baby arrived so just got on with breathing my way through the next contraction and willing the children to go to school soon so that I could make some noise. As they left the house I slumped over my birthing ball with a grateful “Ooooh!”

My friend Lesley, forewarned by Raymond, came and sat with me while he did the school run. By the time he came back things had kicked on a gear and I was really needing to concentrate hard on my breathing and rocking over the birth ball.

The Tesco order arrived – in retrospect I thanked God it was at the 9am end of the delivery slot and not at the 11am end or the poor man would have been greeted with a lot of noise - as it was I wonder if he was bemused by the sound of groaning female emitting from the house!

Raymond rang Mary who was making a last visit to a client before leaving for conference and she offered to come over and be with us until Andrya and second midwife Sue could get here.

It was lovely to see Mary after all, I had been feeling so sad that after all our work together during the pregnancy, she would not be at the birth.

Its such a strange experience knowing so much about birth and then actually doing it. I had by now abandoned the birthing ball and was pacing about the living room, stopping only to grab for the mantelpiece and rocking my pelvis through a contraction. I kept thinking about that teacher’s weekend in East Grinstead where we had learned to do pelvic dancing. A bit of me noted with satisfaction that it works….It distracted me from the bits of me that were saying anxiously “But it still hurts so much, so quickly!”

I now had all three midwives in attendance all quietly to hand, organising themselves unobtrusively, there if needed but not in my face. Andrya offered me an examination and, desperate to know if I was actually dilating I accepted. We trekked upstairs and I hung on the bedroom door handles while she got her kit ready. At the last moment I sank onto the bed and she was quick, gentle and encouraging “At least 3 to 4 cms dilated” Yeee ha! Erk, contraction coming…off the bed and back onto door handles quick.

How do women labour on a bed? I kept asking myself. This pain was fine if I was up and moving, the thought of being still, prostrate was agonising. Yet if I had accepted consultant care that is what I would have been advised to do in order for electronic foetal monitoring to be carried out. Andrya’s hand held monitor and frequent pulse taking seemed to be doing a splendid job of assuring us all that both baby and I were well. I knew it anyway. Despite the pain, I knew we were both just fine.

Downstairs again I wondered aloud whether to get in the pool, was it too early? Whatever you want to do, my chorus of midwives said. I decided I would get in the pool and sank into it with relief, it was like being greeted and hugged by an old friend, a lovely, comforting, safe place to be. I found a way of kneeling and leaning over the side where I could rock my way through a contraction and slump through the short intervals between. I started to retreat within myself. Not deliberately, although my teaching bit of me noted with interest that I was doing so, I just did it. I needed to have my eyes closed, to just be me with the pain and the rocking and the breathing. I was surrounded by loving voices, Raymond by one ear, Mary still there coaching me through a particularly difficult contraction. Andrya and Sue’s voices becoming more familiar. The pain racked up a notch “I can’t do this” I said. “You ARE doing it” the voices said. I could feel the presence of God in the room too, just there, just loving me and comforting me.

Mary left soon after that, withdrawing quietly without my realising it. Yet curiously I could still hear her voice afterwards, telling me to go saggy with the pain, encouraging me that soon it would get better as I started to push.

I heard myself begin to moo and bellow and again the detached part of me thought “Oooh, Gina said in her birth story that you only do a few of those before you give birth.” The rest of me thought I might be nearing the end of my tether!

At last the urge to push started, it still felt far too early in the day to be possible, and at last I was doing something other than enduring. I braced myself across the pool, rubbing my face up and down Raymond’s forearm for comfort and reassurance, remembering not to grit my teeth and push but to let the air out and go with the surges. I couldn’t feel quite what I was pushing where and made a conscious decision to push towards my bowels as I could feel something there. Sadly it was poo not baby that emerged but I was beyond caring and suddenly to my elation I could feel what I was doing, feel the baby moving down.

I didn’t need much encouragement to breathe through the stinging sensation of crowning – the antenatal teacher bit of me noted that yes it felt exactly like I had been describing for the last five years, the rest of me said “ooooooooh”! Did I want to feel the baby’s head? No I didn’t. Far too busy concentrating thank you. And then in a slither and a flurry he was out and I was sitting back, pulling my leg from under me, taking my baby from Andrya, leaning back onto the pool. We did it, we did it.

So many times I had dreamed of this in my relaxation sessions but oh the triumph of the realisation of those dreams! I had expected to be exulted, elated but it went deeper than that. A deep quiet “Yes.” An affirmation of everything I held to be true about the power of the human female body and spirit. The triumph of hope over previous experience.

The whole birth took less than six hours. I birthed the placenta in the pool twenty minutes after my boy. I cuddled him in the pool while he sorted out breathing and Raymond cut the cord – such a different experience for him too being an active participant rather than helpless spectator.

Fergus Lesley was born at 12:50pm, had his first breastfeed half an hour later and weighed in at 8lbs 60z leaving his mother with an intact perineum and a smug grin. By the time his brother and sisters came bounding back from school Andrya and Sue had tidied up and gone, leaving us to introduce the siblings.

Lovely, “ said Carys “so where’s my present?

After the birth, I discovered two cannisters in the dining room which Mary had left behind. One was oxygen, one was gas and air. “Do you mean” I said, mildly protesting to Andrya “that you had gas and air in that room and didn’t offer me any.”

She shrugged, smiling “If you had needed it, “ she said “you would have let me know.”

And she was right, I didn’t need it. The oils, the homeopathic kit, the music all were untouched too. Perhaps in a longer labour or in an alien environment I would have needed that kind of support but on the day all I wanted was my husband, my home, my pool, my God and three wonderful women who understood how birth works and how to help me make the final part of my own birth journey.

Last Updated ( Friday, 10 April 2009 )