Post-recurrent MC, Gestational Diabetes, VBAC - long birth story(4 Posts)
This is long, but writing it in detail is part of me processing a birth that was quite different to how I thought it might go.
My previous labour (4 years ago) was approximately 30 hours from spontaneous onset after my waters broke at 40+8. I progressed well to 8cm using entenox and water, started to feel pushy, hot and nauseous at that stage and was made to get out of the pool as I said I felt 'faint'. Neither I nor MW recognised that this might just be onset of transition. Without the pool for pain relief I asked for an epidural, and at that stage my labour stalled. Syntocin was eventually started but didn't help progress anything, a scan showed DS's head was asynclitic and we agreed to EMCS, not a crash section as no distress, DS was born at 40+10 weighing 9lb 11oz. I found the c-section absolutely fine, remarkably jolly in the theatre and no issues with recovery after the first difficult 2 days.
I went into this VBAC with every confidence that my body would labour given the chance and a well-positioned baby. I wanted to keep active, avoid an epidural, use the pool. All of this was agreed to at a VBAC clinic consultation but my gestational diabetes meant the OB wanted me to have the baby no later than 40 weeks. We agreed that I would have a series of sweeps from about 37 weeks and if that didn't work a non-chemical induction using Foley catheter and ARM.
I had an Antenatal appointment on Tuesday, 37+5, where the OB examined me and found that I was 1-2cm dilated and 1cm effaced. Baby had been scanned that day and the current estimate at that date was 7lb 12oz. We had discussed having a sweep if favourable so she did that easily. We then discussed the next steps, she wanted to book me in for induction the following Wednesday as I was so favourable. I suggested booking in for further appointments with MWs for more sweeps to give myself the best chance of going into labour spontaneously. I was quite shocked that the OB had said my cervix was so favourable - my Bishops score at that stage really was absolutely fine for induction - but in my head I had prepared to be told that nothing was happening as I'd gone late with DS. I hadn't had any cramps, but I had had quite a lot of 'downward pressure' feelings and the babies head had been 'well down' for a while.
An appointment was made for Friday, 38+1, for a further sweep and we agreed the MW would make the induction booking on that day too, so that a slot could be guaranteed for me if labour hadn't started. After the 1st sweep I had quite a lot of crampiness, nothing too uncomfortable but definitely like bad period pain. A little pinkish discharge which the OB had warned me to expect, and then the following day I lost a lot of fairly clean mucous which continued for the next day as well.
Friday's appointment the MW did another sweep as well as a session on the CTG. We could see contractions (although I wasn't feeling them as such, more as 'tightenings') and at that stage I was about 3cm dilated and so all the niggly aches and pains that happened after Tuesday's were actually doing some work as well as loosening the mucous plug. The MW asked me to call the Assessment Unit on Sunday if nothing had happened to go in for another trace just to check on baby's wellbeing post-sweep.
Same thing happened on Friday night, with aches pains and then some bloody show, I was writing up my birth notes and making sure my bags were properly packed and realised the crampy feelings were coming fairly regularly - to the point where I thought I should time them and found they were 3mins apart, and close to a minute long, but they were easy enough to cope with so I thought I should go to bed, get some rest if things were starting and when I lay down and relaxed it slowed down, although I did have a few sessions through the night where I had to get up and walk around, until gradually it all just tailed off towards Saturday morning. I had been worrying about the childcare issue, when to call, how it would work etc. so the next morning I called my mother and asked whether she would come up and stay with us for a few days 'just in case'. Knowing I was going to have another sweep the following Tuesday and that I'd had these aches was making me nervous and I wanted to have someone here rather than having to try to judge when to call and then wait for them to arrive before heading to the hospital. She agreed to come up on Sunday and stay until the induction as needed.
Saturday was much the same, few aches and pains but nothing regular or getting worse etc. At some stage on Saturday I read the leaflet my AN class had been given about quick labour and what to do, and noticed a sentence where it said that some women don't recognise a long latent stage as labour so can be taken by surprise. The MW had suggested I call the delivery suite or assessment unit to get checked on Sunday anyway, just to ensure baby was happy.
I decided to give the delivery suite a call at about 8:30pm Saturday night, just to talk through what had been happening. I'd been feeling cramps while sitting watching tv and timed them to be about 6-7mins apart, so I had a bit of info when talking to them. After going through my history, they asked me to come in, so we called some childcare to come and got the bags into the car - just in case. It probably took about 40 mins for the childcare to arrive and 10 mins for us to get to the hospital, where I was met by a lovely laid-back MW and shown straight to a room with a pool when I asked for it. The plan was that she'd monitor baby, check me and then we'd decide whether I should go home and continue as I had or stay in for further observation.
After monitoring and a check they said they didn't want me to go home, baby was perfectly happy but I'd progressed a bit further, to 4cm, so although they didn't term me as being in established labour, they thought it would happen quite soon. The MW assessed the baby's position during the VE and had suggested some positions to help deflex the head and let the body rotate a bit. She brought in a kneeling rocker and suggested some pelvic rocking movements for if I preferred to stand. Then she came in and out, read a book while feeling my contractions with her hand and being generally unobtrusive while I breathed through what seemed to me fairly low-key contractions, not particularly close together.
Four hours later, it was Sunday morning 38+3, nothing much had changed but I was getting tired - it was about 4AM and I'd been on a kneeling rocker, bouncing on the ball, standing and swaying and breathing through my contractions fairly easily. Going home wasn't an option as I was now 5cm even with these contractions that didn't need much to get through and were 6-7 mins apart. The options discussed were having some pain-relief to help me rest (pethidine was suggested), or try to move things on by breaking my waters. I couldn't see the point of pain relief when to my mind I wasn't actually in pain and had got to that point of wanting to just get on with it.
So we decided to go for breaking my waters. That was at about 4:50, I was 5cm, and then it was all on! contractions got much stronger and closer, DH filled the pool while was being monitored on the bed for 15 minutes. The MW had found a wireless monitor which was able to go into the water so I was able to have CFM as well as the pool, unfortunately like other monitors the 'pads' didn't sit very well when the baby was so far down and I had to keep getting up out of the water for her to press it down a bit more. I was vocalising (ok, I was moo-ing ), getting through each strong contraction, with a part of myself just feeling amazed at what my body was doing. I called out to the MW that I felt 'pushy' and she asked 'downward or back passage?', it was definitely downward and she said just to go with it, which was a relief sinking down into the pool and letting my body push the baby down.
The trace wasn't good and they wanted to put a scalp clip on, so pushed the bed over to the pool and I got onto it and onto my left side. I'd been in the pool only 15 mins, putting the clip on at 5:30 she said I was 8cm, at 5:40 the MW handed me the entenox and said i was fully dilated. I remember quite clearly saying: "Are you telling me I'm ready to push?" I couldn't quite believe it had happened so quickly. Or at all, really. I had to take a moment to think about what I was going to do as this was all new territory for me. I remembered something I'd read in Juju Sundin's book about pushing down with your diaphragm and the image of a coffee plunger which I found really helpful. I was still on my left-hand side, which was a position the MW had suggested as still allowing the coccyx to move out the way rather than being on your back. I was pushing well and then they noticed a couple of dips in the baby's heartrate so the OB and midwifery supervisor came in and suggested ventouse, I kept on pushing by myself and the ventouse was used just for the last two pushes to get her head out. She was born at 6:08, with 28 minutes 2nd stage.
She was passed to me and I discovered her sex and she stayed on me for a lovely long time and she breastfed immediately. I've got a few stitches for a 2nd degree tear but they seem to be healing quickly and I'm not in any pain. At 8 days postnatal I feel ok - just getting used to the breastfeeding and general newborn oddities again. I'm really pleased to have achieved the VBAC, as it confirmed my belief that my body WAS able to birth a baby it was just that my 1st labour wasn't managed well at transition stage. But I have to confess, nearly my first thought when I was breastfeeding was: "I can't believe women voluntarily choose to do this more than once!" It's unlikely we'll try to have another child, but if we did at the moment I think I'd be asking for an ELCS .
She was 7lb 8oz, so a little less than the last scan estimate, and is so far pretty contented and alert. No issues with her blood sugars or any other GD complications. She had a tongue-tie which was clipped on day 2 and then I was discharged. At the MW visit on Friday she'd made back her birthweight, and today's visit showed she'd put more on which is reassuring and the initial damage to my nipples with the short latch seems to be healing.
We've called her Rosalind Eliza. She's wonderful.
I know this was a while ago, but I wanted to thank you for posting - I've just been diagnosed with GD and a bit worried about how it will affect the birth so it's great to read a positive story and think it is still possible to have a normal birth and be reassured that the baby will be ok.
Hope you are enjoying your lovely baby and thanks again.
I have only just read this - I love reading birth stories, and this is a wonderful one! Well done, Ladybee and that's a beautiful name.