I met Kate and her husband Simon when they did my VBAC Your Way course earlier this year. Kate had two little boys, both born via Caesarean section in the UK and she was extremely keen to avoid a third Caesarean despite knowing the odds were well and truly stacked against her. Kate knew that in order to give herself any chance of having a successful VBAC, she would need to do her homework and assemble a crack team of birth support – which is exactly what she did!
Read on as Kate shares her absolutely beautiful and incredibly inspiring birth story of baby daughter Maggie.
Maggie’s Birth – 13 April 2017
I guess the story of Maggie’s birth really starts with our first baby Freddie in 2011. Freddie was breech and despite every effort to turn him, he remained bottom down. The hospital in London where he was to be born were supportive (in theory) of a breech birth but couldn’t guarantee any doctor or midwife on duty would ever have delivered a breech baby before. Given that clinician experience in breech delivery is the main criteria for successful breech birth, we reluctantly opted for an elective caesarean. It was calm and we knew and liked the obstetrician who delivered Freddie. He required a short period of resuscitation and was wrapped and placed on my chest. Either Simon or I held him until I was in recovery about half an hour later, where we then had skin to skin and I breastfed. The recovery was straightforward, but painful and mobility was limited. I felt content that I had made the right decision with the options available to me.
In 2014, I was pregnant with our second baby, Alexander. I knew I wanted a VBAC and this was considered the recommended option. No one ever queried our decision. In our local hospital in London, the VBAC guidelines were: we needed to have the baby in the labour ward (not the birth centre), we were told to come in as soon as contractions started, I had to have continuous monitoring and they wouldn’t use Syntocinon to induce or augment labour. I arranged a private class with a doula to revise the stages of labour and positions for active birth. Simon and my mum were my birth support team. As my EDD rolled around, my blood pressure was creeping up and because of this; I was scheduled for a caesarean section at 40 +9. I requested to wait until 12 days after my EDD, but the theatre schedule dictated 9 days. I had a stretch and sweep and acupuncture the day before and started having contractions the night before the scheduled Caesar. Following instructions, we went into hospital early. At 7am, I was 1 cm dilated and contractions irregular. I was admitted and had my waters broken. This was extremely painful and I then requested an epidural. No one mentioned my birth plan (which said no epidural) or suggested I try a different position. The baby was posterior and I was now lying on the bed with an epidural. By 8pm I was 7cm dilated and it was suggested to put up a Syntocinon drip or have a Caesar for failure to progress. The baby was fine throughout. I didn’t want to have Syntocinon as I was concerned this would lead to increased risk of scar rupture (in retrospect, we probably should have tried the Syntocinon, but I had been told that they wouldn’t use it – so I was very concerned and confused when they did offer it), so reluctantly consented to a Caesar. Alexander was tricky to deliver, as he was already low in my pelvis. He didn’t require any resus. He was wrapped and put on my chest, but I was exhausted and shaky from the epidural, so Simon held him until I was in recovery. We stayed there overnight and it was a lovely calm time – I remember feeling happy and safe and warm and relieved it was all over. We had skin to skin and breastfed well. In the weeks following the birth I felt very upset and disappointed. The birth was a typical cascade of interventions. I was naïve and totally unprepared for that VBAC.
So, in 2016, when we were planning to have a third baby, I did a lot of research and reading. We were living back in Melbourne by now and I had spoken to friends who were midwives, read a lot online about VBAC and what I needed to do to have the best chance of a successful VBAC. Two names kept coming up: Dr Lionel Steinberg, aka “Vaginal Lionel” and Jan Ireland – an independent midwife. I met with them both before I was pregnant and got the statistics and the risks involved. Both were supportive and encouraging. I also had a counselling session with Rhea Dempsey to debrief about Alexander’s birth and read her book “Birth with Confidence”.
I happily became pregnant a couple of months later and were cared for by Lionel and Jan throughout my pregnancy. Simon and I attended a VBAC course run by Tanya Strusberg. We also attended Rhea’s Birth Preparation course. I practised yoga with Melissa at Kundalini House and had massage and acupuncture at Fertile Ground. What a team!
I felt great until about 38 weeks – fed up with SIJ (sacroiliac joint) pain and difficulty rolling over in bed. Not sleeping comfortably. I was irritable and starting to feel anxious about the birth and uncertainty about when I would go into labour. I had been having weekly massage and acupuncture since 34 weeks which really helped me feel relaxed and focused on being ready for the baby from 37 weeks onwards.
At 39 weeks I tried to concentrate on feeling good. Arranged help with the boys, so I could have an afternoon nap, took warm baths, enjoyed our super clean and organised house – bought candles, lit flowers. Said ‘no’ to things I didn’t really want to do. Went to the beach for a day as I really felt like swimming in the ocean. Enjoyed being pregnant for possibly the last time.
On my due date, I finished making some notes and flash cards and felt “ready”. The house was as good as it was going to get, I’d read what I wanted to read and my bag was properly packed and ready to go.
That night I started having irregular contractions. I tried to stay in bed and sleep, but they became too uncomfortable. I got up and pottered around downstairs – tidying up the kitchen, pausing to breathe through contractions. I felt the contractions low and at the front but also a strong vaginal pain. At about 5am they died off and I went back to bed. We had an obstetrician appointment and a period of foetal monitoring booked for Monday morning and all was fine. I was reassured these overnight periods of early labour were common and weren’t wasted – they were contributing to my cervix dilating and my body preparing for birth. I was a little shaken at the intensity of “early labour” and started to doubt my ability to cope with the pain – this brought back my anxiety and irritability!
That afternoon I had a bloody show – so exciting! I was actually going in to labour!!!
Monday night I was prepared for another night of early labour – but I had a good sleep – well, apart from going to the toilet several times and the usual discomfort and lengthy rolling over procedures!
On Tuesday I took the boys to Mum and Dad’s and we went for a bike ride and walk around the park. Freddie spent some time climbing trees, and I hung onto low branches and swayed and rocked.
Tuesday night, I had another night of early labour. I used the ball and TENS machine, but didn’t wake Simon. Again it disappeared in the morning.
On Wednesday, my best friend came over with her two little boys and we went for a walk to the park and had a coffee. It was great to take my mind off it and have a laugh. I was wearing my TENS, in case I had any painful contractions. I was having irregular contractions and everything just felt quite heavy and low and uncomfortable.
The boys and I did some Easter craft in the afternoon and then mum came to take them for a sleep over – I just needed some space and we had an early monitoring appointment at the hospital.
Simon and I had a two hour nap together and woke just as the sun was setting. We went for a walk around St James’s Park – slow and with quite a few rests. I was feeling very uncomfortable and having lots of Braxton Hicks contractions. There was a huge amazing rising moon as we walked home – really spectacular. My bladder felt really uncomfortable and I felt like I needed to go to the toilet often, but only a dribble would come out. When we got home, I had a bath – I thought the water might take the pressure off my bladder and I could do a proper wee. It helped a little. Simon went and picked up some dinner from our favourite Malaysian restaurant and we watched a movie. I spent most of the movie on all fours – leaning onto a section of the sofa or sitting on the ball. We went to bed about midnight and then the contractions picked up. I started timing contractions – 1 minute long and anywhere from 5 to 11 minutes apart. I used the TENS machine and started vocalising as the contractions got stronger. Using knowledge from Rhea’s antenatal course, I tried different positions; on the ball, on all fours leaning over the bed. I spent some time in side lying trying to rest. Simon was helping me get into positions and heating up hot packs and snoozing in between. At about 4am I got in the shower. This gave me some good pain relief. I was a bit concerned when the contractions died down, (but also relieved) but after 20 minutes in the shower, they returned and I took the ball into the shower and leant over the ball during the contractions.
At about 5am, Simon thought we should call our midwife, Jan. I still thought I wasn’t in labour and that it was too early to call Jan, but I could see Simon was starting to feel anxious and wanted some support. The plan was for Jan to come to our house and we would labour here before going into hospital together. I spoke to Jan while I was in the shower and she suggested we meet her at the hospital. We called the hospital and told them we were on our way. We pottered around getting ready and left the house about 5.30am.
The car journey was fine, Simon and I were chatting calmly. I thought we were heading in too early and that my contractions were going to disappear. We parked in the car park and walked the 150 m to the hospital. We left the baby clothes in the car, as we really didn’t think we would be staying. I had a contraction as we walked out of the lift, but it was mild and I could easily breathe through it.
We were admitted to delivery suite at 6am and my contractions were mild and irregular. I was able to chat easily to the hospital midwife, Nicole, and to Jan when she arrived.
I had continuous telemetry monitoring, which I was very happy to have as I felt reassured that the baby was ok and that I was safe. I didn’t really even notice it and Nicole looked after it and adjusted as needed. Throughout the labour, I didn’t once worry about the monitor or think about my scar rupturing.
As the contractions gathered momentum, Jan helped me get into a rhythm using the ball and the hospital bed as props. During a contraction I was standing leaning over the hospital bed, breathing, swaying, vocalising and using the TENS. As each one ended, I would sniff essential oil I had dabbed on a tissue and tell myself “that one is finished now – rest”. I sat on the ball to rest and swayed gently side to side, trying to relax my shoulders and take an “ocean breath” (that I had practised in yoga).
Lionel did a VE at 8.45am and to my great surprise and absolute delight… I was 6cm dilated. We were given the option to rupture my membranes, which we did – a big warm rush of fluid – and from then on, things were pretty intense!
There was meconium in the water but no one seemed too concerned.
I agreed to having a cannula inserted as a precaution. Sitting on the edge of the bed for two contractions while the cannula was inserted was difficult.
I then got straight into the shower, standing up and holding onto a hand rail and the shower curtain rod (that was thankfully securely screwed into the wall)! Jan had the hot water spraying on my back, which felt wonderful. Simon was giving me sips of water and a cold face washer in between contractions.
It felt like I was only in the shower for 10 minutes before I felt huge pressure into my bottom. I felt almost out of control. My deeps “ahhhhhs” became high pitched and I remember crying out “I can’t do this”. This part is all a bit of a blur. I was so inwardly focused; I can hardly remember what the bathroom even looked like. I was completely naked except for the monitoring straps and have no idea who was in there with me and didn’t care! I feel like I had my eyes closed the whole time I was in the shower. My ‘birthing nightie’ didn’t make it out of the bag, along with the candles, oil burner, music, stress balls and key word flash cards!
Jan looked after me emotionally, psychologically and physically. She suggested positions and whispered encouragement. Nicole looked after the monitor and all of the hospital admin. Simon was there in the background – getting drinks, snoozing in the armchair and then offering me water and a cool face washer.
I got out of the shower and up onto the bed – kneeling over the raised head of bed. Contractions were really strong and I was squeezing poor Jan’s hand very tightly.
Jan suggested I try a different position after a while and I moved into left side lying. This wasn’t very comfortable, so it was suggested I try a semi reclined position. I was able to brace my feet against the bed and it felt like a better position, despite my initial reluctance to be ‘on my back’.
By now it was about 10am and apart from the afternoon nap, I had been awake for 26 hours and was feeling tired. I remember asking Jan how long she thought until the baby would be born. She said half an hour! That helped enormously and I focused all my energy and effort into pushing this baby out. Lionel had come and gone a few times (to his rooms downstairs).
I could feel the baby starting to crown and was listening to Nicole and Lionel and their instructions on pushing. After a few ineffective pushes, I got the hang of it and could feel when it was a good push and when the baby moved down and stayed down.
Once the baby’s head was delivered, I reached down and touched it, but I still didn’t believe it was happening. There was a long pause in contractions here and then her shoulders slipped out and Lionel told me to “reach down and pull out your baby”! I gently pulled the baby up onto my chest. Simon had a look and… she was a girl!!!
I did it! Until I was holding her, I really hadn’t let myself believe that it would happen. I had birthed my baby vaginally! What a mix of emotions! RELIEF! AMAZEMENT! EXHILARATION! GRATITUDE! PRIDE! SATISFACTION! HAPPINESS!
Jan later showed me a video she had taken of Maggie being born – what an incredible gift! So completely unexpected and amazing to be able to watch (about 100 times) and relive one of the most amazing moments of my life. “Oh hello darling” “I can’t believe I did it” “Thank you everyone” “Well done (to the baby)” in between some tears and snorts and a kiss from Simon! Just the most amazing moment and then to have a girl – what an incredible surprise! All a euphoric blur after this!
We cuddled skin to skin and took some photos. Nicole did all her obs and labelling of the baby on my chest, as per my birth plan. I breastfed and gazed at my daughter! Jan made us some tea and toast and we talked and enjoyed that magical time.
When I changed side to feed her from my other breast, Maggie was weighed… 4.3kg! At some stage we called my mum – who had no idea I had even been in labour. More tears and joy!
Delivery suite was busy and they needed the room, so I was asked to get in the shower. How amazing to walk to the shower 2 hours after giving birth! I felt incredible. A strange sensation in my ribs, from pushing, that disappeared that afternoon. I tried to wee in the shower but couldn’t. Success on the toilet – ouch and some stinging too. Two grazes, but no tear or episiotomy. I changed into clean pyjamas and ate some lunch, while Simon held Maggie on his chest.
At 1.30pm we walked to our room on the postnatal ward where I happily lay with my gorgeous baby for more skin to skin. I felt so tired but unable to sleep. So happy!
A wonderful few days followed – family, messages, photos, meeting her big brothers.
Looking back, I was very anxious and fearful of the unknown and the discomfort Hopefully next time (!) I can relax and be more confident in my body and enjoy the process more. I felt completely safe during labour and had total faith in my team – Jan and Lionel.
I feel so delighted and proud. So happy that I researched and found such amazing practitioners. I feel so fortunate to have had 100% positive support from everyone – family, friends, midwife, obstetrician, massage therapist, acupuncturist, yoga teacher. At no point during or before my pregnancy did anyone question my plan. We researched the risks involved in VBA2C and repeat caesarean section and decided what was right for our family.
The recovery has been so different. I could get in and out of bed with ease, roll over, bend, hug my children, I even joked that I could have gone for a jog! I had been quite uncomfortable in the last week of pregnancy; I especially found it difficult to get comfy in bed. Within an hour of birth, I felt more comfortable than I had in months!
A few thoughts about my support team –
Jan – warm, friendly, nurturing, tough, extremely wise, switched on, very perceptive, very respectful of Lionel, sensible and calm. Acknowledged there are risks involved (as there are in any pregnancy) and that a hospital birth with monitoring was appropriate and that those precautions wouldn’t detract from my birth experience. Getting to know Jan and slowly build a relationship and trust during my pregnancy was wonderful. I particularly loved her coming to visit us after the birth, once we were home. I loved being able to debrief about the birth over a cup of tea and know that I had someone at the end of the phone if I needed anything.
Lionel – direct, calm, genuinely believes in natural birth and values the joy and empowerment a woman feels when she births a baby. Extremely skilled – I knew I was in good hands if anything went wrong. I didn’t need to second guess his motives. Jan was instrumental in me trusting Lionel – she was very respectful and reassuring (to me) of his decision making and skills as an obstetrician.
Simon – my wonderful husband. Fully supported me in a VBA2C. Never doubted my decision. Attended three full days of antenatal courses (this is his 5th baby – so he could have argued he didn’t need more education). Never questioned having an independent midwife or worried that he might be pushed out of the way. Didn’t murmur when I shouted at him in labour or demanded water rudely! Shared my joy and told our birth story proudly – with me as the star!
Rhea – wonderful, calm, very knowledgeable, likeable, excellent presenter, engaging and entertaining. Experienced. We gained so much from Rhea’s book and course. She helped me get my mind in the right space and to really believe that women’s bodies are made to give birth. I felt reassured about the choices I had made in my support team and appreciated the evidence that backed up all of her teachings.
Tanya – wonderful resource and great encouragement. Hugely informative course and lovely gentle manner. I would encourage anyone considering a VBAC to go to Tanya’s course. Another brilliant reminder of how natural childbirth works and how far we have strayed from this as a society.
I always felt that my body was capable of birthing my babies and I looked forward to the experience. I love being pregnant and had problem free healthy pregnancies. I love breastfeeding and have had smooth experiences and breastfed both boys beyond two years. I am so pleased I have now experienced a natural birth. I am so proud that I achieved my VBA2C!
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