Back to the start…2008 I had my first child born by emergency Caesarean, something that I struggled with as it was happening and unfortunately I was one of the many women who didn’t think it would happen to them! I had had a healthy pregnancy, attended a hypno-birthing course and was pretty confident I’d have the birth I had imagined. As a first time mum and at the end of my pregnancy I just wanted to ensure delivery of a happy baby so I never questioned the doctor’s reasons for Caesarean. Knowing what I know now I feel that this birth has a high chance of ending in Caesarean anyway but my baby’s apgar scores show he wasn’t in as much distress as thought.
Maybe, just maybe if we had been given more time this birth could have resulted in a non-surgical birth?
However, once I laid eyes on my baby I forgot all of the emotions associated with the surgery and was delighted to have him to hold in my arms as is what most mums experience! I recovered well with just a minor issue of my scar separating slightly but a day or two of rest resolved that. I knew no different and because he was my first child I didn’t have the worry of taking care of and lifting a toddler or older child. I was able to sleep when he did and this helped my recovery. Having this experience though, I still remember a lot of comments or situations that arose that opened a trail of questions and thoughts internally within me.
Some that stand out was meeting a midwife from New Zealand working in the hospital and as I’m from New Zealand myself we had a lot to chat about. She said to me that I was a brave woman to have a baby in this country!! She also said when her time was here, she was definitely returning to New Zealand to deliver her baby. I feel that this speaks volumes from someone working within the maternity system! Another midwife was cross with me for ringing the buzzer because my baby was crying, but the reason I was ringing the buzzer was because I wasn’t allowed to get out of my bed and couldn’t reach him so I was hardly going to lie there and listen to him cry at a few hours old was I?? Once home I was lucky to have a lot of family support around me and to live in a location where it was easy for me to walk a close distance to the local shops for daily basics.
But it did make me think of how many women living in Ireland, and not just rural Ireland, are isolated after having a Caesarean with very little or no family support around them and many I’m sure don’t live in an area where it is so easy to walk to the shops and not being able to drive for a few weeks can add to this isolation which I feel could then contribute to issues such as post-natal depression. This could sound like I’m against Caesareans, I’m not, I feel they have their place, but I am now against the misuse of this surgical procedure without a true medical need. Personally I feel that this surgery is sometimes done without too much thought by the medical staff as to the women’s recovery or the effects it may have on her life immediately after or in her future.
Onto pregnancy no 2. My second child was born in 2010. Again all went well with this pregnancy and throughout at all of my antenatal appointments I made it clear I wanted a vaginal birth after Caesarean (VBAC). I was always met with support and it was written in my notes as my preference. The only thing I came across that I now know is they quoted out of date stats regarding scar rupture, but this did nothing to deter me. I was confident that this baby would be born vaginally but naively I thought it would just happen if I was given the chance. I went term + 10 days and as per hospital policy was admitted for observation, being told as I arrived you won’t be going home without a baby! I was excited about this when really if I had informed myself more I should have had the check up and, as all was well, negotiated more time….hindsight is a wonderful thing. I had read a little bit of literature regarding VBAC and had been experiencing some warm-up contractions so again thought a little nudge would put me in the right direction.
So the monitoring and the induction process was started with lots of explaining as to what the doctors were willing to do and again, because of what I know now, I would not be consenting to this as the procedures they used are actually contradicted in VBAC but at the time I was none the wiser and thought they were to my benefit. The staff and consultant were very friendly to me and were telling me what I wanted to hear regarding VBAC is a great choice and every woman should be given the opportunity but in the same breath listing off the conditions attached. Hence at the end of the day when not enough progress has happened to keep them happy, a C-section was decided on for failed induction, telling me that they couldn’t do anymore and that because the process had been started they had no choice but to perform the Caesarean.Throughout the whole day and night and right until the Caesarean was performed my daughter showed no signs of distress at all. This to me was most definitely a case of failure to wait!
Obviously I was very upset and emotional and ended up spending a night alone in the ward crying for most of the night. Due to scheduling, first thing the next morning my second child was born via Caesarean. The procedure itself I coped better with in comparison to the first time because I knew what to expect. Recovery was again good with only another minor issue of a stitch not dissolving but it was definitely a slower recovery I think due to having a toddler at home and it being my second Caesarean.
Prior to having my second baby I stumbled across the title of Tracy Donegan’s book The Irish Caesarean and VBAC Guide online, however it wasn’t published until after my daughter was born!! Once it was available I purchased it and absorbed every bit of info in it and could see where both of my children’s births could have been different if I had been more informed. In saying that I could easily recite information and stats to my friends while they were pregnant but when it came to my own pregnancy and labours my brain seemed to forget this information at the necessary time!! This opened the floodgate and google definitely got hit with every search term related to VBAC and now VBA2C!! Once I had read some success stories I was hooked!
Online there is such a large volume of information relating to everything VBAC but I was very much interested in the possibility of VBA2C, I found some great groups online and the information they provided for me is so positive.
Most of the information they provide is pretty well balanced which I find refreshing in comparison to most of the medical profession in Ireland who seem to only focus on the negatives related to VBAC….mainly scar rupture. One site provided the risks associated with a 3rd Caesarean and this definitely made me feel I was making the right decision in trying to pursue the idea of a VBA2C.
For me personally the reasons I would like to VBA2C are mainly no surgery!! I still really don’t like the idea of a Caesarean but if necessary obviously I would consent, I feel passionate about babies deciding their own birth date and planned Caesareans generally don’t allow for this. I am reassured by the research that has shown how important the hormones that start labour are to the baby. The risk of complications obviously goes up for every additional C-section a woman has and if at all possible I would like to avoid this.
Fertility issues…I don’t think I want any more than 3 children but who knows and I want to make that decision, not have it made for me! RECOVERY…..Although I have had good recoveries from both of my Caesareans I would love to be able to come home and lift my other children without the fear of doing damage to myself. I am aware that there can be complications from a vaginal delivery but I am willing to take the chance provided my baby and I are healthy. I would like to experience a vaginal birth for all the positive reasons such as my baby benefiting from being birthed through the birth canal, the surge of hormones we would both receive, immediately holding my own baby, immediate skin to skin, the feeling of accomplishment that I had birthed my baby! And even for my older children to truly understand that not all babies are cut out of mummies tummy by the doctor! Another factor would hopefully be a shorter hospital stay.
Because I get so emotional in regard to VBAC and now VBA2C while pregnant I decided to gather as much research as I can to educate myself and support my decision to VBA2C prior to having to negotiate with any doctors or consultants when the time comes. Through my research I have seen that while the Irish maternity system is generally very supportive of VBAC, they are very slow to support VBA2C. Upon reading the Irish maternity guidelines and the booklet produced by AIMS Ireland I felt that I had some back-up in approaching the two maternity hospitals I have the choice of attending.
So I set about writing a letter to each hospital addressing it to the Head of the Labour Wards and asking for some correspondence from them regarding VBA2c.
Prior to this I had met with a consultant for a separate gynaecological issue and had approached the subject of VBA2C…I was told that nowhere in this country would they allow it and really I’d find it hard to find anyone in the world to support VBA2C!! I had to stop myself from laughing and was shocked at how out of touch some consultants can be! I have always known that it will take some negotiating which I don’t believe is fair for a pregnant woman to have to do when research and evidence show it is a viable and safe option for MOST women. Hence the reason for me trying to do the bulk of the negotiating prior to becoming pregnant! And I’m hoping that the more we speak up about it and make the hospitals and consultants aware that woman once educated on the subject can decide for themselves that eventually it won’t be a battle with the system to be given the opportunity to have the births that are the most beneficial for our babies and our own bodies.
In my letters I outlined my two previous births and my interest in VBA2C and was wanting to know each individual hospitals policy and procedures relating to VBA2C. I very quickly got a response from one hospital, a phone call from a lovely supportive midwife who knew the latest research herself and suggested setting up a meeting with one of the consultants, I agreed and felt very positive. The next day however I received a call back from the midwife after speaking to the consultant whose words were “NO WAY, NOT AT THIS HOSPITAL” The midwife was disappointed but said that the consultant was pretty definite but still offered a meeting which I declined at that point until I heard from the other hospital. I didn’t see the point in wasting time and energy with a consultant that was so closed minded if I didn’t have to.
Then the anxiously awaited contact from the other hospital came and I had a very long chat once again to a lovely midwife who was relatively up to date with the latest research, but was very open to discuss options and while she explained to me that herself and the consultants wouldn’t welcome a VBA2C with open arms they most definitely would be open to discussion that would be conducted in a polite and dignified manner. She also told me that VBA2Cs have occurred at the hospital (unplanned) but all has been fine. I felt that at least the staff were aware that it can happen and the fact that they are open to discussion was definitely a step above the other hospital.
Another positive from this hospital was that the midwife told me that I would still be considered a low-risk patient and could attend the midwives clinic ante-natally, another step up from the other hospital whose policy is that once you have had one Caesarean you are considered high-risk!
So that is my story so far, here’s hoping to a positive outcome not only for me but for all the woman in Ireland to have more options!!!