· By Tiny Hearts Education
At 37 weeks pregnant with my first daughter, I was told that she was breech - an elective c-section was recommended, and I was heartbroken. I wept as I signed the consent forms and spent the next 2 weeks grieving the natural birth I had hoped for. My c-section was performed at 39 weeks, and thankfully it was a beautiful and calm experience, with a textbook recovery. However, I knew that I really wanted to avoid major surgery for my next pregnancy and try for a vaginal birth.
To my surprise, though, at around 20 weeks pregnant with my second, I started feeling anxious about it. I felt fear of the unknown and began focusing on how much more 'painful' going natural could be and was tempted to book a repeat c-section. Thankfully though, I had a wonderful MGP midwife who gently encouraged me to reconsider.
I began thinking back to how empowered I felt after taking hypnobirthing classes during my last pregnancy, so I decided to re-enrol. Thirty minutes in, and I was once again a convert. Being reminded of the beauty of childbirth, my body's ability to do it, and the control I could have over the pain I experienced, was just what I needed to make up my mind - I was going to try for a VBAC!
Having heard horror stories from other c-section mums, though, I knew from the outset that I could be in for a fight with the hospital obstetrics team about my birthing preferences. I had a high BMI and gestational diabetes, which placed me in the 'high risk' category. This meant that statistically, I was much more likely to have a very medicalised birth experience.
Unsurprisingly, I was told at my first appointment that they wanted to induce me between 38-39 weeks due to my gestational diabetes and that I wouldn't be allowed a water birth because of my BMI and previous c-section. If labour didn't progress fast enough, they would intervene with Pitocin or by breaking my waters. A cannula would be placed in my arm upon admission 'just in case,' and I would need constant monitoring. Little did the obstetrician know, but I had been preparing for this appointment for weeks and came armed with a mountain of statistics, studies and a 4-page birth plan!
My baby was measuring perfectly, and my sugars were well controlled, so there was no need to induce labour before my body and baby were ready for birth; I was happy to wait until 42 weeks. Contrary to what the obstetrician tried to tell me, the latest QLD guidelines advise that a water birth is not a contraindication for VBAC. I refused to be discriminated against based on my size - if I wanted to birth in water, I would be birthing in water. Unless baby or I were in distress, I wouldn't be consenting to unnecessary interventions or being put on a clock to birth within their prescribed timeframe.
We agreed to continuous fetal monitoring, but I didn't want a cannula - 'who wants to labour with a needle in their arm?' I thought. I trusted that if necessary, medical professionals could place one in pretty quickly. Needless to say, the obstetrician was a bit flabbergasted. I dont believe they're often told 'no,' as most women, myself included, are subtly led to believe that they don't really have a say in their birth. But I knew better; ultimately, it's my consent that's needed, and these are my decisions to make - not the midwives, not the obstetricians, and not the hospitals. I knew how I wanted to birth, and now it was just a matter of waiting for it to happen.
I had quietly hoped that baby would come prior to my due date to avoid the inevitable chats about induction, but 40 weeks came and went as it does for most, and my midwife recommended we start doing regular stretch and sweeps. I was tempted, but decided to decline and trust that my baby and body would know when it was time for birth.
I got to 41 weeks and started to feel a bit anxious about when our girl would make her appearance. I had already decided that, no matter what, I didn't want to be induced and would book a repeat c-section after 42 weeks - I was really hoping that things would kick off soon! And thankfully, just a day later, at 41 + 1, it was [bloody] showtime!
I soon started feeling menstrual type cramps intermittently. I decided to spend the day doing flat packs and cleaning the house, hoping the work would bring on labour. Contractions started later that afternoon, and by 11.30 pm, they were 3 minutes apart, so I headed into the hospital to meet my midwife. When we arrived, I was disappointed to find out that I was only 1cm dilated, and my midwife suggested that I head home. I decided instead to walk around the hospital for the next hour, willing things to ramp up. To my excitement, contractions shortened to 2 minutes apart and became stronger. Still, after a second exam, I was told I had only dilated to 2cm despite being at the hospital for 4 hours. We ended up agreeing to go home, and in hindsight, while I was disheartened at the time, I'm also thankful to have had a midwife who was honest and willing to give me the advice to leave. The hospital's policy is for women attempting a VBAC to stay once admitted, but she knew I had a lot longer to go in my labour, and would likely be encouraged to rush things along if I stayed.
It turned out to be the right call, as I spent the next 20 hours at home in early labour. Although I was tired, I managed pretty well - bouncing on my exercise ball or in the shower, listening to music and reciting my affirmations. We returned to the hospital the following night at 8.30 pm, when my contractions were intense and at 1-2 minutes intervals. During the car ride there, though, I began to lose my composure - I started panicking as my contractions were ramping up fast! But in the midst of me screaming like a banshee, my husband reminded me, "Grace, you need to calm yourself. This fear is flooding you with adrenaline, and it's going to make your labour longer and more painful." Wow, I guess he was listening during those hypnobirthing classes after all! I let his words sink in, pulled myself together and went inward, focusing on my breathing and squeezing the door handle like my life depended on it. The drive felt like an eternity, and each speed bump through the parking lot nearly broke me, but we got there! And upon arrival, it was confirmed that I was 6cm dilated - after 24 hours, I was finally in active labour!
My husband got to work setting the mood as soon as we entered the birth suite; dim lights, music, printed affirmations and aromatherapy. Everything and anything to get my oxytocin flowing! I laboured first in the shower on an inflatable CUB birthing stool - AMAZING! The relief and distraction of the water was perfect. I managed through most of my contractions with the 'up' breathing technique I learned in the hypnobirthing class, which allowed me to stay focused and in control. 'Everything is going just as I had hoped!' I thought, until my husband started running the bath for me.
The midwife advised me that the obstetrician on duty didn't feel comfortable with me having a waterbirth. I, quite strongly, said something along the lines of, "her feeling comfortable is irrelevant, it's my choice and I'm willing to sign an AMA to take responsibility for it." My Mum was quietly cheering for me from the corner as I, between contractions, stood my ground. I prepared myself for the full onslaught of scare tactics as the obstetrician entered the room for a 'chat.' Thankfully, though, she had actually had 2 waterbirths herself [a rare choice for an OB], and after a brief conversation to make sure I was informed of the risks, left me to continue as planned. Crisis averted!
As I hopped into the warm bath, I felt instant relief; my whole body relaxed - a little too much, actually. I began falling asleep between contractions [literally snoring on my husband's chest], and the momentum of labour started to slow. My midwife suggested that I get out of the bath, sit on the toilet, and then come back to get things going again. There was nothing I wanted to do less than get out of the bath at that point, but I knew that if things didn't continue to progress, I might be faced with pressure to consent to interventions. So I shakily walked myself to the bathroom, and as soon as I sat down on the toilet, it all started happening!
By the time I returned to the bath, I was instinctively pushing. Bearing down with deep breaths and guttural groans, I felt my baby start to descend. My midwife encouraged me to trust my body and do whatever I felt I needed to. I was pushing for close 2 hours and knew I was progressing, but at the end of each contraction, my baby's head would go back up, and it began to feel like two steps forward, one step back.
After 32 hours of labour, exhaustion and doubt started to creep in, and I cried to my midwife, "I can't do this!" but she reassured me, "you are doing this!" I decided to reach down, hopeful I would be able to feel something, and sure enough, my girl's head was right there. Knowing she was so close gave me the strength I needed to push past the pain and fear and completely surrender myself to birthing her.
Our daughter entered the world minutes later, shooting out through the water and straight into her Daddy's arms. As she was placed on my chest, my first words were a triumphant, and genuinely shocked, "I DID IT!" With a little bit of encouragement, our girl soon let out a big cry, and we all breathed a sigh of relief. She was here; she was okay; I was okay - we did it.
I later found out from my midwife that there was a whole team of medical staff waiting in the wings during my birth, all fearing the worst would happen because my birthing choices weren't in line with their standardised policies. But as it turned out, we thankfully didn't need them. Against all the odds and biases, I, a woman with a high BMI, gestational diabetes, and a previous c-section, had a successful unmedicated VBAC in water. I credit so much of my achievement to the support I received from my husband, my Mum and my midwife. They kept me on track to have the birth I had hoped for by reminding me to breathe, stay focused and trust that my body could and would birth our baby.
Photos + video by Sarah of Little Hands Media [https://www.littlehandsmedia.com.au/]
Well done Grace, you did so well