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Liz's VBAC

Liz shares her four birth stories. An emergency caesarean for failure to progress with a face presentation, followed by three hospital vbac experiences.

Harley

I had a very long labour with Harley. My contractions started at just before midnight on Friday 5th July (the hospital's summer ball was on the Saturday night) and although they were mild they were coming every 3 mins or so. I was also bleeding, although not heavily, enough to be concerned. After speaking to my local hospital I was advised to go in and they would take a look. I was 3 cms dilated and having "very mild" contractions. I was then sent up to the ward to let nature take its course. I was completely ignored throughout Saturday - I had no sort of monitoring or examinations and in fact didn't even get told when it was dinner time! At about 2 am Sunday morning a "new" midwife appeared on the ward (she had been downstairs delivering earlier) and decided that I really should be monitored/examined since I had been there so long. After monitoring me for about 10 mins she said that I didn't appear to be having any contractions (which was news to me) but did an internal anyway - during which I had a contraction which she felt - it didn't show up on the monitor! So a new monitor was found and I was strapped on again. I was still only about 3 - 3.25 cms dilated. She gave me some meptid at this point, as she thought I should relax a little since I had been there for so long without sleep. After about an hour of monitoring she said that she had noticed some slight decelerations with the baby's heart and thought it adviseable that I go down to the labour ward, just to be on the safe side.

Once on the labour ward I was strapped to another monitor and left alone for about an hour. I was then visited by another midwife and another internal was given. I hadn't dilated any further so she called in a doctor who decided to break my waters and see how things went. The midwife then stayed with me throughout. However, if I wanted to move or turn over I got moaned at because it meant she had to adjust the monitor, which she wasn't happy about. I spent the next couple of hours dozing only to be awaked by her giving me an injection of pethidine, which neither I nor my husand had requested (over the next few hours they gave me a few shots of pethidine, but but that point I couldn't really care). By about 8 am I had reached the heady heights of 5 cms but was feeling very tired and fed-up. I even remember asking the doctor whether I could have a c-section as it had gone on for so long, only to be told "you're doing really well Mrs Woods, it won't be much longer". By lunchtime I had at last fully dilated and now the problems really started. I spent the next four hours flat on my back trying to push. They decided that as the contractions had slowed I should have a drip put in to try to speed things up. They tried to attach a scalp monitor to the baby, which I found extremely painful, without success. They attempted both ventouse and forceps, without success (incidentally, they did not perform an episiotomy, for which I am very grateful). At about 3.30 pm I heard the doctor say (with what sounded like a note of panic in his voice) that they would have to do an emergency c-section as the baby was in distress (so was the mother at this point, as I'm sure you can appreciate). Since I hadn't had an epidural they arranged for me to have a general. Harley was born at 4.10pm on Sunday afternoon weighing 5lbs 13ozs. I was told by the doctor delivering her the next day that she was face first, which is what had caused so many problems with the monitor, ventouse and forceps.

Keziah

When I became pregnant with Keziah I was determined not to have another section, however during all my antenatal appointments I was told that because my first had been so small and I'd had to have a section with her the chances were I'd have another section. They were however prepared to allow me a trial of labour on condition I came to the hospital as soon as I felt the first contraction! At no time were the risks of having a VBAC explained to me - I had to find all the information out for myself.

When I eventually went into labour I spent a few hours at home first and then went to the hospital at about 1pm. As I walked into the labour room I was met by a midwife and junior doctor who both informed me that I would have to have a canula put in and have an epidural "for when you have the section". They were very firmly told that I was not going to have another section, to which I was told "well you had one last time so you'll probably have one this time". I relented on the canula aspect, but would not relent on the epidural one (we had quite an argument about it). I was also told I would be continually monitored, which I told them I didn't want as I wanted to be more mobile - "tough, you've had a section, you've got to be" was the response.

After about an hour a new midwife and her trainee came on duty and took over my care. What a change in attitude. I told her my feelings and her response was "I can't force you to be monitored if you don't want to be, as long as you let me do intermittent monitoring, that's fine by me". We agreed that she could monitor me for 15 mins every 45 mins (so I had 30 mins of freedom).

Just before 6pm I was visited by a doctor because I had not dilated any further than the 3cms I was when I first arrived. The midwife suggested that they break my waters to see if that would speed things up - she didn't want me on a drip since it could cause problems. He said no and I would have to go up on the ward to wait things out. I flatly refused since I had visions on birth no. 1 going through my head at this point, and said that I would rather go home - "well you can't do that you've had a section". The midwife then suggested that hubby and I went to the hospital restaurant for a meal for a couple of hours and then come back. At this point he decided to break my waters and told me that things should start moving by midnight! My hubby was sent home and told they would ring him if anything happened.

The contractions then hit with a vengence and things progressed rapidly. Hubby had been home about an hour when they called him back because things were going so quickly. I delivered Keziah on my knees leaning over the back of the bed at 9.50 pm with no pain relief, no stitches and a great deal of joy. She weighed 6lbs 10oz.

The midwife who looked after me was also my community midwife so I saw her quite a bit at home after the birth and she told me that she got into a lot of trouble for letting me labour without continuous monitoring, despite the fact that that was my wish.

Nerise

When I found out I was pregnant with Nerise I asked if I could have the same midwife again since I had had such a pleasant experience with her. However, she was not on the team I was under and to get on her team I would have had to change GPs - which I was not prepared to do. I was also told that the reason on my notes for the section with my first baby was DTA (deep transverse arrest). This was the first time I had ever been told this. I then asked about home birth and a meeting was arranged with my Consultant. She advised that although she could not stop me having a home birth, she would not recommend it because of the risks (which by this point I had looked into further and knew only too well). However, in view of the treatment I had received previously she would speak to the Head of Midwifery and see if I could go on the GP/Midwife Led Unit - that way I could have a birth with no medical intervention but if there was a problem they would be on hand to deal with it. I agreed to this as it seemed a fair option to me and was told a couple of weeks later that the Head of Midwifery had agreed too. I was again told to come in fairly early on, just to be on the safe side.

When I eventually went into labour (on my due date, surprisingly), I called the GP Unit and was told to go in (about 7.30 am). However, when I arrived I was told by a very rude midwife that she was not prepared to deal with me on the GP Unit as I was "high risk". She was then told, in no uncertain terms, that if that was the case I would go home again and they could send two midwives experienced in dealing with a Home VBAC out to me at home. She then decided to monitor me to see how things were going. Unfortunately for me (but very conveniently for her), the baby had a very flat heartbeat, so there was no going home. Straight down to the labour ward, where miraculously, the baby's heartbeat was normal! However, I still wasn't allowed home. My consultant came to see me and apologised profusely for me not being allowed on the GP Unit, it seemed that the Head of Midwifery had forgotten to put anything in writing on my file! I was only about 2 1/2 cms dilated, but in view of the flat trace the Consultant wanted me monitored for a couple of hours and if things were fine, I could go home until everything started moving. So I was sent up to the ward (about 11 am).

I spent the next several hours pacing, hoping to speed things up, since no- one would give the go ahead for me to go home, they didn't even monitor me as they had been requested to do by the Consultant. At about 10pm that night my hubby was told by the midwife in charge of the ward that he couldn't stay. We then had quite an argument with her because I hadn't been put on a monitor or examined since I had been up there and my hubby wouldn't leave until I had been! She then reluctantly put me on a monitor examined me and said that I wasn't in labour as I was only just 3 cms dilated (that dreaded 3 cms) and that it would be hours yet. So hubby was forced to leave at about 11pm and was told that they would phone him when my waters broke. I and a girl who was in for observation went to see him out. On the way back my contractions suddenly intensified, so much so that I could no longer walk through them but had to stand still and hold on for dear life.

We told the midwife what had happened when I got back to the ward and was told not to be silly as I wasn't in labour yet and to go to bed and rest. By about 12.15 I was having difficulty coping on my own so called the midwife, who was more than a little annoyed. I got told not to be silly and to call me the next time I had a contraction. She had barely left the room when I called her - I had had two contractions in that time! So she examined me (at 12.25) and declared I was only 4 cms and had hours to go yet. At this point I was so fed up I asked for an epidural (which I have always sworn never to have), by this point I was starting to think I'd have the baby on my own in the ward. So she arranged for me to be transferred down to the labour ward and telephoned my hubby. They got me into a labour room and I told the midwife there that I felt like pushing, "don't be silly, let's have a look". The following is virtually her exact words: "Shit, midwife, trolley now" at which point all hell broke loose. My hubby arrived on my 2nd push, the doctor arrived to put in a canula, my waters broke on the 3rd push and Nerise (weighing 5lbs 12oz) was born with my 4th (at 1.03 am) - the canula never got in, since the doctor had seen what was happening and vacated! My notes state that I had a 35 min first stage and an 8 min second stage. (Incidentally, when one of the girls on my ward commented that I would be back in a couple of hours with a baby, the midwife on the ward said that I would be lucky to be back by lunchtime the next day!) I was back on the ward by 2 am! Her comment to me the next morning (after avoiding me for the rest of the night) was "you multips are so unpredictable". If we're so "unpredictable" then why the hell didn't she listen to me!

I bumped into the midwife who delivered Nerise when I was going for my dating scan with no. 4. She asked whether I was going for my homebirth this time (she had been one of the community midwives who visited me after I transferred home and we had joked that I'd better have a homebirth next time because I probably wouldn't make it to the hospital). I said that if she would do it, then yes I was. She was quite happy but obviously has to get her team leader's permission as well as the Head of Midwifery's and the Consultant's - so I think I may have a bit of a fight on my hands. However, I am not to be swayed this time - even my hubby is adamant for a homebirth (he was not too keen before Nerise, but considering my treatment says I'll be better off at home).

I have since spoken to her on the phone and she said that her team leader went white when she told her about me and said that we (ie me, my midwife, her team leader, the Head of Midwifery and the Consultant) would have to have a meeting to discuss things! However my midwife is still quite happy to do a homebirth (although she has been told to persuade me to have it on the GP Unit - fat chance).

I think that's everything. If there's anything you want to know, don't hesitate to ask!

Questa Marie

Just to let you know that no. 4 arrived very quickly at 05.42 this morning weighing 6lbs exactly and is another Girl (making 4 of them my poor dh has to deal with), we have named her Questa Marie!

Moderate contractions started at about 3 am yesterday morning but would die off for half an hour or so if I lay down - so knew latent phase was going strong (as per all my births). By about 10.30 pm last night things had started to progress and having had a long Instant Message chat with Gail (for which thanks by the way), we made our way to the MLU. However, baby's trace was awful, so m/w went to get Reg who wanted me on the LW being continuously monitored. After the Reg was told no (I think my exact word was "b******s") I got the usual speil about not being forced to do anything etc but that I couldn't remain on the MLU and I would have to go to the LW and be continously monitored, but when I tried to explain my reasons for not wanting continuous monitoring she walked out of the room without listening - so I discharged myself and went home (I was only about 2cms dilated at this point). She wrote in my notes that I was verbally abusive and obstructive (the only time I swore was the b******s about the monitoring) and that she had told me the risks of not monitoring etc (which she didn't)!

The m/w from the MLU phoned me up at home about an hour later and asked how I was doing and whether I was coping etc and said that if I wanted to come back in just let her know.

By about 3.30 am I was having trouble coping at home (had sent dh to bed by this point), so woke him up again and made our way back up to the MLU - unfortunately I was still only 2cms so they ran me a wonderful bath and put me to bed! By about 4.30 I was getting what I call my "transition wobble" - not quite an urge to push, but not a normal contraction. So back into a birthing room again, however, contractions spaced themselves apart to 5mins again and the "wobble" stayed until about 5 am. Then the grunting started! However, I was still only 3 cms - but it definitely felt like transition with a strong urge to push (albeit controllable). By about 5.20 I was struggling to control the pushing urge and asked my m/w to see how I was doing as I was worried that even the uncontrollable pushing was going to cause problems if I wasn't fully dilated - she held off doing another VE as I'd only just had one. I spent the next 15 minutes desperately trying not to push, although by the end of it I was probably pushing during half the contraction and stopping myself the other half - but I was also getting very upset, calling for any type of pain relief (including a General) etc. Anyway, she'd just said that she was going to let this contraction finish and do another VE when I just couldn't stop myself and she said she could see the head - so she ended up trying to keep out of the way of my waters exploding over her (they still hadn't gone by this point), but also trying to keep an eye on what was going on and open the delivery pack and get to the door to call in a 2nd midwife as baby catcher! Next thing I knew the head was born (with the next contraction) and we had a little lull before the next contraction and the body followed. I have no idea when my waters went - I have a feeling they and the head made an appearance at the same time!

We had planned to have a physiological 3rd stage, but she was concerned as 30 mins later there was still no sign of the placenta and the cord looked like it was going to come away, so I told her to give me the jab (I was already sitting up on a bedpan by this point hoping that would have done the trick). Jab given and about 5 mins later I gave a little push and placenta plopped out.

I think I may have a little tear (although I'm not sure and my notes haven't made it home yet) which didn't require stitches. Apart from that I'm none the worse for wear just very tired and ache to hell and back (I have yet to find a place on my body that doesn't ache). I'm also high as a kite (despite not having had any pain relief), so am now off to bed to sleep it off, but thought I'd let you all know that despite some of the horror stories you see and hear every day, you can still have a normal"ish" birth on the NHS! Oh yes, and we were home by 8.50 am!

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