Birth story - Polly and baby Elio

*Trigger Warning* - Heavy bleed in labour, 2nd degree tear, use of word contractions.

I really appreciated reading positive VBAC stories here, so hopefully this is of help to someone! My birth didn’t unfold exactly according to my preferences but I birthed my baby in exactly the right way for us, and feel incredibly positive about it and am still in awe 6 months later.

Brief background...

I had a planned c-section with my breech baby girl in March 2018, which wasn’t traumatic but I definitely wasn’t as prepared as I could have been and had no idea about hypnobirthing techniques or ‘gentle’ c-sections, and really struggled in the hospital environment. I came away from it feeling like I’d cheated somehow, and recovery was physically and emotionally tough for me.

We found out I was pregnant again in July 2020, against the odds as my husband had undergone aggressive chemotherapy and radiotherapy to treat blood cancer during my first pregnancy and throughout the first 6 months of our daughter’s life, and we’d been told there was a strong chance this would make conceiving again a challenge. I couldn’t quite believe it!

I read the brilliant Ina May Gaskin’s ‘Guide to Childbirth’ early on and it set me on my journey towards an empowered pregnancy and birth. It stands the test of time and really helps get you in the mindset for hypnobirthing - I highly recommend it!

I had great continuity of care seeing the same community midwife from about 8 weeks. I had some nausea and pelvic girdle pain up until 16-20 weeks and was prescribed iron for anaemia from about 16 weeks onwards. I was working from home throughout which I’m very grateful for.

When I attended a ‘Birth Choices’ appointment at 22 weeks to discuss my previous c-section the hospital midwife was very supportive of my VBAC in principle, but I was told I would ‘have to’ have my baby on the labour ward rather than MLU as I’d originally thought. I was then offered an induction appointment for 39 weeks as it was what they usually did to ‘prevent undue stress on the scar’ I was left feeling downhearted, convinced the labour ward was the wrong environment for me and I seriously considered refusing a hospital birth completely. I know some of these feelings were influenced by the past experience with my husband’s cancer during my first pregnancy and birth (being anxious and powerless, associating hospitals and medical settings with difficult times etc..) but they were so overwhelming at the time.

After some thinking time I talked things through with my community midwife, who was brilliant. She was a big advocate for hypnobirthing and her support and reassurance meant I felt in control and confident that I could still have the vaginal, low-intervention, water birth I wanted on labour ward and be fully supported, and I was assured that the setup was identical to MLU with low lighting, birth pools and medical equipment out of view etc (I did eventually spy one of the pool rooms when leaving hospital and it looked lovely!) She crossed out any reference to induction booking on my notes and told me not to worry about it.

The big day approached…

I’d been doing pregnancy fitness classes and yoga over zoom as much as I could and I think this really helped get baby into a good position and build up my core strength towards the end. I did an evening fitness class at 37+4 and felt great, then proceeded to do a lot of nesting at 37+5 while my toddler was at nursery. I was only 4 days into maternity leave and for some reason prioritised cleaning the kitchen and putting up shelves over packing my hospital bag (BIG mistake!), thinking baby would stay put until his due date at least...While moving some boxes I felt some brief pains very low in my tummy and a sort of ‘shifting’ feeling but thought nothing of it. My bump was going rock hard with tightenings occasionally but again, I just thought it was my body slowly getting ready.

At 37+6 (Saturday) after an uncomfortable nights sleep and an early start we spent all morning doing chores with an energetic toddler in tow. Again I kept feeling the tightness in my bump, along with chest pains, but thought it was just being brought on by the icy cold Welsh breeze that day

After having lunch I sat down on the sofa and suddenly felt a warm gush. Thinking I’d finally wet myself - I’d got this far without it ever happening - I waddled to the bathroom to find a lot of blood, which I continued losing into the toilet at quite an alarming rate. After a moment of shock I calmly called out to my husband and we agreed it didn’t look like it was just the mucous plug or bloody show we’d learnt about. I put my PBC hat on and tried to push negative thoughts out of my mind and make practical decisions. I told my husband to call my mum to look after our daughter and set about throwing essentials into a backpack for hospital whilst talking to the maternity assessment unit on the phone. They were very calm and advised I come straight in. The midwife asked if I’d been feeling baby move that day and my heart sank as I realised I had barely felt him at all. She reassured me by asking again if that was normal movement pattern for me and I realised it was - he was typically more active in the afternoon and night time.

I tried to focus on just getting to hospital calmly, using up breathing on the 30 min drive to focus on positive thoughts about my healthy baby and capable body, rather than the lack of movement or the blood loss that I could feel soaking through my leggings. I’d not remembered my headphones in the rush so it was a bit of a challenge!

Due to Covid I went into hospital alone while my husband sat in the car. The assessment unit was so calm and the midwives put me at ease. It did take the student midwife a while to find baby’s heartbeat but as soon as I heard it I started to relax and go with the flow a bit more. I was put on monitoring at about 2pm, little did I know those bands would stay put until I met my boy. Baby’s heart rate was perfect and the monitor was picking up mild but regular contractions. A lovely consultant came to examine me and told me I was 1cm dilated and my cervix was very short. My waters were still intact and my c-section scar was feeling fine, and although the bleeding had slowed down a bit it was still unclear why it was happening so we decided it was best to admit me now. I was walked over to labour ward and after a bit of negotiation was cannulated in case surgery was needed at short notice.

My husband was finally allowed in and it sunk in properly that this was really it and I’d be giving birth within the next 24 hours (pretty sure my mum thought it was a false alarm and kept texting my husband to check when we’d be back to relieve her of childcare duties ) By this point in time I’d agreed to at least 3 things that I’d planned to avoid according to my birth preferences (VE, cannula, continuous monitoring) and knew my much hoped-for water birth was out of the question due to the blood loss, but I still felt 100% in control and informed. I knew uterine rupture was a risk factor and that the source of the blood loss was a concern to the midwives and the consultant, but felt relaxed and excited to meet my baby - he was coping well and my body was doing exactly what it needed to be doing, just quite slowly.

A friendly student midwife had stayed with me for what felt like a long time chatting, and this was exactly what I needed, despite previously thinking I didn’t want any ‘extra’ people around. The student midwives were brilliant throughout. On a practical side note, it really helped that I’d thought to save and bring in the maternity pads I’d soaked through at home, as weighing these helped the midwives determine the volume of blood loss.

The rest of the afternoon and evening was relatively calm as labour intensified. I tried to keep upright and found that gently leaning against the radiator helped. My husband went home at some point to do bath and bedtime with our daughter and again I had a lovely student midwife to keep me company. The contractions were manageable and as they intensified I found that I wanted silence rather than counting or positive affirmations (sorry Freya!) but I was getting grumpy as I hadn’t eaten anything since lunch due to the potential need for surgery. At some point I was examined again and was at 2cm and my cervix had shortened a lot more, with baby being very low.

When shifts changed around 8pm I was given the ok to eat some toast, which was handy as things started to get quite intense later on. I was getting quite fed up with the monitor at this point and was given a wireless one without even asking. I was annoyed at having things stuck to me so didn’t get on too well with the TENS machine and pulled it off in a huff! With each contraction I was still losing a bit of blood and this was being quietly checked by my midwife. I tried to stay mobile and made many trips to the loo to keep my bladder empty.

During the night a different consultant spoke to me and strongly urged that my waters be broken to speed things up. He was quite abrupt and was quick to reference the risk factors of VBAC and mention surgery, which I tried to just let wash over me. I was absolutely determined to avoid another c-section but didn’t want baby to be distressed by unnecessary intervention either.

By around 4am I think I was approaching active labour and finally agreed to have the waters broken as the midwife could feel them bulging. They were tinged with a bit of blood but not a concerning amount so I was reassured that I could just focus and get on with letting my body birth my baby. The intensity of each contraction was making me vomit at this point, but I still felt just about in control. By dawn I had become tired and dehydrated (the cannula came in handy for the IV fluids now) and had a bit of a wobble about having left my daughter so suddenly and nothing going ‘to plan’.

I’d been awake for more than 24 hours. Contractions were now very intense with very little time to rest in between them or get comfortable in any position and I asked what my pain relief options were, accepting a diamorphine injection. Although in hindsight this was probably ‘transition’, the drugs were a great decision as I was able to get settled lying on my side dozing off for a few minutes between contractions but still able to feel baby moving down the birth canal.

Pain relief wore off completely after about 2 hours by which point I’d regained some energy. This is where the animalistic noises came in and I let my instincts take over, trying to remember not to clench my jaw (‘loose lips = loose fanny’ is what I told myself ). Visualising the down stage of labour and thinking about exactly what my body was doing all by itself really helped at this point.

I had an intense urge to pee and my new midwife and student midwife (3rd set, also absolutely brilliant!) offered to bring a commode in. I couldn’t seem to pee at all now, but she noticed how productive my contractions where while I was in that position. While I was hovering on the commode the consultant (same one as I’d seen the previous afternoon when being admitted had come back in for her next shift!) checked on me and this kind of spurred me on to prove to this room full of people that I was getting it done on my own and DID NOT need another c-section.

Shortly afterwards due to the dehydration and lack of peeing my midwife advised I get on the bed to be catheterised for a bit, which I agreed to. However before she could get started she said ‘ok, no need as I can see baby’s head’ and encouraged me to feel with my own hand how close he was. She gently asked what position I’d like to give birth in and when she saw all-fours wasn’t really working for me she quickly brought in a birthing stool, which was BRILLIANT. I immediately felt safe being so close to the ground and squatting down was exactly what my body needed. I leaned my upper body onto the lowered bed with my husband holding my hands (and a sick bowl!) from the opposite side.

By this point I was having gas and air intermittently while down breathing as mush as I could, and my body was pushing with each contraction which was such a relief. After what felt like no time at all, but was probably an hour or so, baby’s head was crowning and I visualised things stretching slowly and gently as Siobhan explained they should. As promised beforehand, the midwife protected my perineum with gentle pressure as baby’s head was born. The ‘sting’ lasted for a while but once baby’s head was out I didn’t care as I was so excited to be achieving my VBAC - it was really happening! I was told to actively push his body out but just focused on down breathing and gentle little pushes instead and Elio was born at 10:27am on Mother’s Day, crying immediately to say hello.

He was passed up to me for skin to skin and the student midwife helped me check the cord to see if I was happy for it to be clamped. Although I’d originally had a preference for a physiological 3rd stage, I accepted two injections in quick succession to deliver the placenta quickly because of the uncertainty around the blood loss. This element had been discussed with me in early labour so I could ask any questions without distractions, which was great.

I was so overjoyed to have my healthy baby on my chest that I coped quite well with the discomfort of being checked for tears and given local anaesthetic. I was laughing and chatting with the midwife and student midwife as they debated their favoured knot technique for stitches while repairing a straightforward 2nd degree tear. I finally got my tea and toast while having skin to skin

The student midwife brought the placenta over for me to have a look at as requested, and it was so amazing to see this organ I’d grown. It was intact so the bleeding remained a mystery…we’re still not sure why it happened but I’m choosing not to dwell on it.

Elio had his first couple of feeds and we were given the all clear to go home after 6 hours. In the end I relished the peace and quiet of snoozing and cuddling with my baby in the little bubble of hospital before going back home to an excited toddler!

To those of you planning a vaginal birth after c-section, you definitely have the power to do this. Even if things don’t fully go ‘to plan’ the experience can still be truly healing

Takeaways…

Don’t suffer in silence with pelvic pain, antenatal physio can work wonders

Love and trust your pregnant body, it is capable of brilliant things

Headspace & iBreathe apps are great for supporting relaxation, mindfulness & up/down breathing

Pack your birth bag early!