The story of my VBA2C and the birth of Courtney Skye Cassiani……
Our 1st baby was born in Jan 2005 via emergency c-section for fetal distress, no movements and poor ultrasound results at a daily stress test.. In the month leading up to his birth, I was monitored for small measurements for dates and then the week before his birth borderline high blood pressure and his heart rate not elevating high enough during movements. He was born little but healthy, he had one night stay in the nursery as his blood sugar was low but he still breastfeed as well as had formula to regulate his blood sugar. By the early morning on Day 2 he was all healthy aside from jaundice.
I felt immediate guilt and disappointment for not being able to deliver my baby naturally. I had adverse reactions to all the drugs I was on and couldn’t get out of bed as they didn’t remove my catheter for 24hrs. I went on to breastfeed (some could say successfully as I did it for a year but I would say more of a necessity to a screaming, unsettled baby) and never had post partum depression. After testing on my placenta, the results were: poor placenta but nothing that should re occur in subsequent pregnancies and I was given the all clear for natural births.
Our 2nd baby was born in Perth in 2007 but most of my antenatal care was in Canada with midwives who were focused on a natural, vaginal birth. There was never talk of a repeat c-section based on a healthy pregnancy. The pregnancy was completely normal and I was healthy. At my 1st appoint in Perth when I was 7mths pregnant with a private OB at SJOGS, I was given oodles of paperwork telling me of the risks and stats of unsuccessful VBAC’s. The OB told me that 1 in 2 VBACs end in c-sections. When I asked for his advice, he said he couldn’t give his opinion but if I were his wife, she would be having a repeat c-section. After much thought I figured if I had a strong chance of having drugs and needles, I would prefer to avoid the trauma which I went through in the 1st c-section birth so I would book in for elective c-section. The OB wouldn’t believe my dates which were a result of a dating scan in Canada at 10 weeks, rather based the EDD on an ultrasound taken in Perth at the late stage of my pregnancy. So by my dates, the c-section was booked in at 38weeks. Disgusted at myself for bowing down to pressure and the guilt at taking the easy road and not allowing my body to do what it was designed for, I kept my decision a secret. I told my husband only 2 weeks prior to birth and told my parents whom we were living with at the time, only on the day of the surgery. I had a healthy baby boy and went on to breastfeed successfully. Although never diagnosed, I am positive that I did suffer PND for at least a year.
When I turned 30, I decided that I would love to help women who have just given birth on a psychological level and so I wanted to study to be a midwife. In order to get the process started I did the Australian Doula course. Only during that course, did I realise the grief I hadn’t yet dealt with of my own births.
After much education, serious thought and many discussions with my husband, I decided (supported by my husband) to try for a 3rd, which would be my “healing birth”. We were content with 2 healthy children and no real desire for a 3rd child, but I couldn’t move on without the chance to heal from never being able to have the opportunity to birth a baby naturally. So hear is how our little Courtney arrived………
My 3rd pregnancy was similar to the 2nd aside from me being a little more active and a whole lot fitter. I taught Zumba for at least 5mths and did yoga for the last 3mths. We did hypnobirthing and I practised positive affirmations and shut down any negative or doubtful attitudes surrounding me very quickly. I was under the antenatal care of an Independent midwife. She was very supportive and positive about my success. My intention for the birth was to labour at home as long as I possibly could before delivering at KEMH. As standard practice, I had to book in at KEMH for 1 appoint in my pregnancy. Not happy about this, I went along disapprovingly and probably was a little short with the staff on the day. The OB was more concerned about drawing pictures on what would happen during a uterine scar rupture than she was on giving me any antenatal care. My file was covered in “homebirth” stickers and I was advised to have the baby in hospital following standard procedures. I was so confused by all the homebirth stickers and I didn’t really say anything, just lots of uh huh and mm hmm’s. I went home extremely angry at the OB and annoyed by this unnecessary appoint.
1 month later at my next midwife appoint, she told me that the OB I saw at KEMH had reported her to the Head of Midwifery for potentially homebirthing me. My midwife was then flagged and watch dogged for all births and was told if she attended my house whilst I went into labour, she would be de-registered. I was FURIOUS! So out of courtesy and respect to my midwife, I discontinued my antenatal care and was forced to look for alternative antenatal care.
I decided after hearing about Joondalup Public’s great VBAC success rate to birth there. My 1st antenatal appoint was much more pleasant than KEMH and I was advised all the standard VBAC stuff and just nodded and assured them I am educated in my decision and happy to VBAC. At my 2nd antenatal appoint I was told that no VBA2C’s were allowed at Joondalup hospital, public or private and I would have to deliver at KEMH. Given what happened during my last appoint, the OB at Joondalup agreed to see me antenatally.
Only 1 week prior to my EDD did I decide that when I went into labour, all going well, I would take my chances and go to Joondalup. If I felt something was not right, I would go to KEMH. So I booked in nowhere and went with the flow.
From 37weeks onwards, I was encouraged to have stretch and sweeps, all of which I turned down. I was given the opportunity to go until 41 weeks before having to make some kind of “management plan” for delivery. All along my decision was NO induction under any circumstance, at 41 weeks we could disucss a repeat c-section. I knew if it got that far and the bub was fine, I would push to wait until 41 +3.
My EDD was 12 April, which came and went. I was going to regular pre labour acupuncture appointments, had a few reflexology appointments, went for long walks etc…. but this bubba was too comfy. I was generally positive and enjoyed every moment of being pregnant and was comfortable with being overdue. I was getting a little anxious at the thought of confrontation or having to be assertive at my next Antenatal appoint if I hadn’t gone into labour. At my 40week appoint they told me to go get CTG monitoring at 40 + 3 days.
All was fine with the monitoring and the midwife was so excited that I was a VBA2C and so supportive. I went home feeling positive about my upcoming labour.
My labour started the night before my 41 week appoint. I had a few contractions on the 17th April but as I had never been in labour before, thought it was probably just the beginning of early labour or nothing at all. By that evening, the contractions became regular and closer together and made me need to focus on them. My mum came to take the kids to her house and my support partner, Tam, came over. My husband, Renz was plodding along, going about his business not really sure on what to do.
At first I wasn’t quite sure what to do with each contraction and I think maybe I read and listened to too much! So each contraction I did something different, walked, hip rolled, swayed, listened to music, burnt candles, got in the bath, listened to affirmations, asked for back rubs. I think maybe one could say an ‘ADD’ approach to early labour.
Walking was great but I was over the corridor in my house. Tam and I went for a walk while Renz went to sleep. It was much easier to get through each contraction; I closed my eyes and walked very slowly. Tam tagged teamed with Renz and this was when I discovered he was best given the role of go getter rather than support partner. He often let me walk unguided in the night, let me cross roads blindly and kept bumping into me as he was still half asleep. When we got home, I told them to both get some sleep as the contractions were fading and I would try and sleep. There was something humbling about being in labour during the night but I think I should never have made the comment that it must be so disheartening to labour all night then see the light of day and go into the night again……
By sunrise my contractions had backed right off and a new day began. No one wanted to leave me, so we hung around home chatting and laughing and wondering if this baby would ever show its face. By the afternoon, it was even less of a labour, so Tam went home to run some errands and Renz took me to the shops to get my eyebrows threaded (one still needs to look beautiful). Contractions became more regular but no closer than around 10mins apart. They did get more intense but with such long rest in between, they were completely manageable. I found my sync; I found a wall, stepped my feet and Tam massaged my lower back. I listened to my birth affirmations continuously. This went on all night and morning. Tam was amazing, I hardly had to say anything, and she would see my ritual and knew how to help me through a contraction. Renz recorded each contraction on his ipad application and became very good at Solitaire! The labour was coming along slowly but I felt like it was gentle on my body so that the baby could come at the right time and when my body was fully prepared. I had a bit of bright red bleeding in the night but after a few hours of homeopathic remedies, it stopped completely. I was getting bored between contractions but couldn’t really focus on anything, so decided it was time to wax the underarms, straighten the hair and beautify myself. Tam was perplexed as to why I had to do this stuff now, but it was a great mood breaker and distracted me from the tediousness of early labour.
By mid morning contractions had intensified but still no closer than 10mins apart. I was completely content with how things were going but had a feeling I was making more progress than it showed. Tam suggested and I agreed we should go to the hospital soon. We wanted to give ourselves time incase we got sent to KEMH or had to deal with any political complications.
We got to Joondalup just after noon. The midwife was not convinced I was in labour but as soon as I said it was my 3rd baby but 1st labour, she quickly set me up on a bed for assessment (giggles!). I was prepared to have a VE in order to have a stronger chance of delivering at Joondalup. Upon assessment she was shocked that I was 6 almost 7cm with bulging membranes. They tried desperately to monitor the fetal heart rate with the continuous monitoring but my baby was not partaking. The midwife was lovely and so excited I had come to hospital. Then an OB walked in. She was so nervy and panicky and was at this stage not wanting to transfer me as she was convinced I would deliver on the way. She said we’re going to set you up on the monitor and get an IV cannular. WHOA! I said, no cannular for me and no belts on my belly. She was shocked! She was pressuring me for an IV cannular and couldn’t comprehend why I was refusing. So then she told the midwife (Without asking me) to get a fetal scalp electrode. WHOA! Again I said, not a chance! She was again shocked, responding with we have to blah blah blah! . The OB went on to tell me if something when wrong not having enough time to get iv’s set up if I had no cannular etc.. and that they could probably save the mum but maybe not the baby. She was so nervy and sounded like she was hyperventilating as she was speaking. I told her I was happy to sign any form necessary to say I take full responsibility for any decisions I make and any consequences that may arise due to those decisions.
Then I had my 1st contraction in 2 days lying down on a bed. The baby’s heart rate flipped and the OB went bananas “Sonja, Sonja, the baby’s not liking this, it’s not happy!! Sonja see, this is really dangerous.” Tam piped up as I was unable to speak and told them the baby has never endured a contraction in this position, so it’s telling us, it doesn’t like it and doesn’t know what is going on. Yay Tam! Once my contraction was finished, I said I am not lying down for anymore contractions. I rolled over and bub was happy and back to normal. However, I needed to follow their protocol in order to deliver there, so I told them I was happy to go to KEMH.
Seeing as I was almost 7cm, they said I would need to go in an ambulance. I consented until they came back and said I would need a midwife escort, so Tam and Renz couldn’t come along. I refused ambulance transfer. The OB was practically chsing us out the hospital, begging us to stay and do it their way.
We drove happily in our car to the Hospital, making a toilet stop along the way and go figure, no baby arrived (said with sarcasm). At this point I was feeling a lot of pressure on my hoo hoo and had a feeling that I may need my waters broken, so decided that if we came across any confrontation at the hospital I would use that as a compromise on intervention.
On arrival at KEMH, everyone was lovely and I was admitted to the labour ward. We got there about 2pm. The midwife who greeted us was delightful. I was having closer contractions so while I was contracting; Tam was filling the midwife in on what had been happening and the reason for the transfer. The midwife was lovely and straight away asked for the birth plan. She told us all the legalities and knew we were going to refuse them but was very supportive of our decisions.
Then the OB came in. She didn’t believe I was that far along in my labour, she was not okay with me not following standard management practise, she gave me the run down on how I would have to be pushing in 2hrs or they would start intervention. Her reasoning was that a study showed that 90% of women fitted into the “normal” labour or progressing 1cm per hour. So I decided to keep her happy I would have another VE. She was proud to say I was only 5cm along (I thought great! That means I have more time before they start wanting to come back and interfere) and she desperately wanted to brake my waters as she had full confidence then that my VBAC would be successful. I politely told her my VBAC is going to be successful anyway and that I was doing great this far. However, fine I will meet her halfway and let her break my waters. She was so happy and chuffed, she left the room and never came back! (well, according to Renz, she tried to but the midwife had a word with her outside and she never came in).
My labour progressed very quickly after this. I went from having a great break between contractions to rolling contractions with no break at all. I got in the shower but didn’t like contracting in there at all. So got my labour Kaftan on and paced the birthing room. Renz was sent out to get me a hairdryer as both my labour support people left mine at home. I was addicted to my hairdryer as the warmth relaxed me and the sound was soothing.
The birthing affirmations got thrown a mile once the contractions got more intense and everything became kind of a blur, all I remember next was the pushing stage. Well this was like every book said it would be. I fell asleep between contractions and felt with every push that the baby was getting closer. But far out was it taking its sweet merry time! The thoughts running through my head were hilarious…. “hmm, maybe I could just shove my hand in and pull it out, I understand why people use vacumms, how the hell could anyone contemplate doing this more than once….” I even asked for a suppository (this was more of a joke which the midwife missed!), you know the theory that I could give it a nudge a long seeing as I was feeling constipated, lol! Then that lovely ring of fire…… But I knew that meant my bubba was on its way and my labour was coming to an end. The midwife told me I could feel my baby’s head if I wanted too as this helped some women get through to the end. I couldn’t think of anything more disgusting, but as I got more into the pushing, I instinctively reached down and felt it. Funny enough, it made me push harder and longer when my body said too. I always thought I could “breathe my baby out” but at that time, I couldn’t think of anything more impossible and my body said push, grunt and scream (last part out of sheer frustration for the baby to hurry on out). I found my place hanging onto the bars on the side of the bed and squatted down with every push.
Finally out she popped and I was so relieved. It was very surreal and I didn’t even have the urge to want to hold her. I was just glad I didn’t have to push anymore! The midwife was an angel and passed her up to me and I couldn’t believe it… I did it! No dramas, no medical problems, no thoughts of pain relief or worries or concerns. It just all happened how it was meant to and she came out how she wanted to and I felt so great. It wasn’t how I knew a baby to be born. I had only experienced drugs and handed a cleaned up baby. Now I was dripping in sweat, my legs were like jelly, I stayed true to everything I believed in, stood up for myself and I was dressed in my own clothes holding my own slippery little angel whom was only a few hours earlier, dancing up a storm in my uterus.
When I checked on the sex, I thought she was a boy, but after being told to check again, a couple times, I was shocked that we had a little girl! Again, surreal, I only knew what to do with boys……
I got to lie down and snuggle my little girl, the midwife never mentioned anything about third stage until what seemed like hours later. With a few pushes the placenta came out, I cleaned up and was ready to pass out with my little girl surrounded by some of the most amazing people in my life. And that is how our little Courtney Skye Cassiani arrived into this world.
A tribute owed to the midwife who was like a ghost in the room and respected my space, my goal and did her job beautifully. To my friend Tam, who took her role as my support person to another level and did her job perfectly. And my husband, who lived up to everything I thought he would be….. I couldn’t have done it without all 3 of them…..