Kara was planning a vaginal birth after a
caesarean (VBAC) for the birth of her second baby, but experienced
complications during labour and had a repeat caesarean birth. To hear
more of Kara's story,
click here to read the
story of her third birth.
After nearly a month of prodromal labour, on Thursday morning 4am I felt
a gush of liquid. My shorts, 2 towels and bed sheets were soaked
through. Thank goodness for the plastic sheet! I went to the loo to
check that it wasn't pee. There still wasn't any change in pattern of
contractions which occurred only at night. Doc says since I decided to
stay home, I was to monitor my temperature every 2 hours, and if it went
above 38C, I was to call him immediately. OK, I thought, piece of cake.
So long as I get to stay home. Bub still giving his karate kicks to my
ribs. I've got a champion kick boxer! During the day, there were still
no contractions. So I continued mucking around with my stuff and resting
up for the labour ahead.
Friday (Due date): Running a slight temperature 38.6C. Still trickling
fluid on and off, just enough to be annoying. Doc said to come in and
let him have a look. He didn't want to promise me that it will be ok to
go home to labour. I was so close to tears in the clinic where I had my
CTG tracing done [checking the baby's heart rate]. It looked ok, but I
was definitely reacting to something that was causing my raised
temperature. He did a speculum check, the gush was a hind water leak.
(Didn't know it could be that much.) [This means that the bag of waters
surrounding Kara's baby was still intact.] I
didn't want an induction. I knew that if that happened, I wouldn't have
the conviction that my labour would be drug-free. Doc advises starting
antibiotics if I don't want to be induced to fight off any infection.
OK. Agreed. Prefer antibiotics to another failed induction. It'll be
soon. I was so thankful that he was supportive of no induction. He said
he was confident that I would go into labour before the weekend was
over. At this point, I was ready to try anything to get my contractions
up to the next level, i.e., for it not to ease off when morning came.
Nikki suggested that some women find a brew of cumin, cloves, ginger and
something else (I forget) and a cube of raw potato helpful. It was too
vile, I couldn't bring myself to drink it. Stuck to my raspberry leaf
tea instead and tried to rest up as much as possible during the day.
Saturday: Still nothing. Only the mild contractions at night that
tapered off in the morning. At least my fever is gone. Continued to
drink lots of water. Went to the zoo for a walk.
Sunday: Some contractions started in the early morning at 4am, 4 minutes
apart about 30-40 seconds long. They were different from the ones I've
been having. I thought this was it, but figured if I stuck to my plans,
labour might just decide to stymie them. I could still walk and talk
during the contractions, so decided to continue with my plans to go
visit my friend whose son was born the day before. This was the first
time I was having contractions while it was daylight. After visiting my
friend, hubby and I decided to go shopping. Last chance to pick up last
minute buys together. Besides, contractions were still just 4 minutes
apart 40-45 seconds long, and not too heavy that I had to stop doing
what I was doing. Updated Nikki and asked her if there was anything I
could do to help things move along a little faster. Nope, she just
advised me to let my body takes its time and enjoy what could be my last
day of having Bub inside me and just continue as normal. Hubby and I
decided to go for a drink. I scan the menu and was delighted to find
white Zinfandel! Can't find that everywhere.
To hell with the antibiotics. I decided to have a glass of wine. It
might be the last one I can have in a long while. Towards evening, my
contractions were becoming lighter and easier to handle. Contractions
stopped abruptly at midnight. Decided to get some rest. I hate prodromal
labour! It's so draining and discouraging. Fell asleep pretty quickly.
Guess I was a little worn out.
Monday: 4am (again! Things always seem to happen at this time for me)
Had another small gush accompanied by an intense contraction. This time
they were even stronger than yesterday. Still 4 minutes apart, 40-45
seconds long. After 4-5 contractions, I stopped timing them. These were
"going-somewhere" contractions. I wake hubby up to tell him I needed to
change the bed sheets and that he could go back to sleep after that. It
turns out that he wouldn't be going back to sleep. After the sheets were
changed, my contractions got stronger and were lasting about 60 seconds.
It was still an unearthly hour to wake Nikki. [Your doula will remind
you that it is ok to call at any time – even 4am!] Decided to wait as
long as possible before rousing her. These contractions were nothing
like I remembered from my first labour. I was optimistic that hey, today
is the day!! YAY!!! Hubby started preparing eats and drinks that we'd
bring with us to the hospital. He figured he might as well get them done
while I could still handle the contractions alone.
6am: I couldn't be my yappity-yap yap self anymore during the
contractions. It was still dark outside. Told hubby maybe wait another
hour before waking Nikki. Contractions were now every 3-4 minutes,
slightly more than a minute long. The leak was back to a trickle. Was
pacing a lot to try to ease my backache.
6.40am: Thought I needed some help to get through the contractions.
Decided to ring Nikki after all. She'll be right over. So I concentrated
on riding the contractions while waiting for her. Decided to use my TENS
machine. Had read that using it from the start would help. It does! I
was pleased as punch. I put it on the lowest setting. Didn't want to use
up all my ammunition before the marathon even got half-way! Found being
on the floor leaning over the bed to be the most comfortable position
for now. Prior to that had tried all fours, but floor was too hard on my
wrists.
7.30am: Nikki arrives. What a relief to have a companion who can focus
her attention on me. Back hurting like hell. She gets a heat pack to
help with the back pain. Changing positions a lot. Contractions now
lasting about 80 seconds. Deep breathing to get past the peak. Saw my
little show while in the loo. Yippee! We're rock and rolling. Kept my
window curtains closed. Preferred the low yellow lighting to bright
daylight. Contractions got more intense. Hubby lowered the air-con
temperature and I up my TENS machine setting. Start making some noise to
get through the contractions. If this was early labour, I can't imagine
what the end of first stage would be like, let alone second stage!
Wondering where I was now and how much progress I was making. Wondering
how long I would be in labour before I got to meet Bub. This can't last
forever, right?
9am: Had some pushing feeling during contractions. Hubby stays in
background quietly supporting me and doing a great job of providing
counter-pressure to my back. Still making frequent trips to the loo.
10am: Now I was mostly on all fours on the bed over a beanbag. Nikki
suggests I get some rest in between contractions. They pick up again
shortly and I get on the bouncing gym ball and lean forwards. After a
couple of contractions, I'm latching on to the idea of using the bath in
the hospital. Nikki suggests I try the shower at home. OK. Lug the gym
ball into shower stall and got the hot water running. It provided some
relief, but there wasn't much room for me to maneuver into positions I
was comfortable with. Gave up after 20 minutes. Was just getting
frustrated by the narrow space and decided I didn't need to accept this
kind of frustration. So I get out of the shower stall and we headed to
the hospital.
11am: I was helped downstairs out to the car. Nikki followed behind in
her car. At the hospital, I remember her asking people to take the next
lift coz I was in labour. She was helping to keep me up, but after
coming out of the lift, I just moved down onto the floor. Somehow I get
to room 6 but didn't want to get on the bed. Stayed on the side furthest
from the monitor. The wires were just long enough for the midwife to
strap the monitor around me. Was monitored for 20 minutes on arrival.
12pm: Midwife (Grace) does a VE to see if I wasn't too far along to be
able to use the bath. I was fully effaced but only 2-3cm. I was so
disappointed. Nikki got the bath running, and I got in. The relief was
amazing. I started to believe that I could do this once again. Doc came
to see how I was doing and said he'd be back in 3 hours to check my
progress. Had my favourite Sting CD put on. Then everyone left the room
to hubby and me. Grace came to check on Bub's heartbeat every half hour
using a hand-held Doppler.
2.30pm: My contractions were slowing down again to about 6 minutes
apart. I asked if there was something we could do to bring them closer
together and Nikki suggests homeopathy and nipple stimulation. It starts
to work and contractions back at 3-4 minutes apart. She left us alone
for some privacy. But 1 hour later the contractions start to space out
again. Was starting to feel very tired. By this time I was sitting in
tailor position and not walking around so much anymore except to go to
the loo.
4pm: Doc back. Bub's in direct posterior and -1 station, I was 4cm
dilated. No wonder this was such hard work. I felt like giving up there
and then and told Nikki so. She encouraged me that there was a good
chance to rotate Bub since my membranes were still intact. She showed
hubby how to do some tummy massage from left to right to prod Bub to
rotate we talk about homeopathic options to encourage rotation. She goes
off to fetch an obstetric TENS machine to help me through the
contractions and back pain. There is a shift change and I have a new
midwife (Sue). She was very encouraging and said usually the first 5cm
is the slowest. But when Bub turns, the last 5cm would be very fast.
5pm: Nikki's back with the super TENS machine. Wow, my teenie weenie
little one is nothing compared to this. Very tired now so the TENS
machine helps. Contractions have spaced out again to 6-7 minutes and
double peaked for some of them. I tell hubby that I want a carat for
every centimetre. Nikki retorts that it should be 1 carat for every
hour. Had a good laugh. Told hubby to start saving!
6pm: Sudden migraine onset. I asked if I could take my codeine tablets
to relieve my headache. Doc said anything taken orally wouldn't work.
It'd have to be pethidine. Decided against it. Meanwhile hopped on the
loo. I still had that pushing sensation. Tried to rest and relax in the
bath again. I couldn't even tolerate the low lights, so the room was
plunged into complete darkness except for a torchlight. Sue lent me her
sunglasses as the torchlight was still very sharp. My headache settled a
little after a while and I got into a rhythm of "deal with headache" and
"deal with contractions and blow away headache" pattern. It helped for a
while and hubby could support me while Nikki went for a dinner break.
Not having any drugs for pain relief kept me alert and aware of when
something was wrong later on.
6.30pm: While in the bath I felt this excruciating pain in my upper left
tummy as if someone had stuck me with a knife and left it there. The
pain wasn't going away when the contractions ended. Hubby rang for Sue
and helped me out of the bath. Sue got me onto the bed and she put the
monitor back on. During the contractions I felt like I was being pulled
apart in opposite directions. Hubby rings Nikki's handphone and asks her
to come back. Sue did another VE, still 4cm. The pain was moving lower
on my tummy and I'm turned to lie on my right side to take the pressure
off my left side. By that time, the lights were switched back on and I
just lost it and started hyperventilating. I wasn't able to focus on
anything anyone was saying. Hubby says I was struggling and there was
still no sign of doc. Sue paged for him again. He's stuck in traffic!
8pm: Doc arrives and checks me, still 4cm, Bub higher up, contractions
on CTG tracing spaced out and Bub had some tachycardia (just a little
bit) [tachycardia is a fast heart rate].
That's it, he says. I said, NO, not again. Nikki asked if there was time
for an epidural. Hubby says doc hesitated a little before saying OK, but
to not waste any more time and get me prepped for a Caesarean
immediately. She also went through the rest of our birth plan with him.
Hubby asked doc if he could bring my spectacles into the operating
theatre for me to put on immediately after Bub was born so I could see.
Doc OKs it. Hubby was glad that at least this time he could be with me.
8.30pm: Anaesthetist arrives and Nikki helps me with the Entonox gas
mask while he got the IV and epidural going. Soon I was wheeled to the
operating theatre and transferred to the operating table. The lights
felt extra piercing. I asked where hubby was and was told he was still
changing into his scrubs. I scrunched my eyes shut as my arms had to be
taken away from my face for the BP cuff, pulse monitor and IV hookup.
The anaesthetist puts a piece of cloth over my eyes to help some. It's
the only time I've ever been alone.
Doc pinches me to test if the epidural is working fully. It wasn't, so
he said to wait a while more. Hubby still wasn't in the theatre. I
begged him not to start without hubby. After a while I don't feel any
pain from the pinch any more (just pressure) and doc starts the
operation. Where's hubby? I opened my eyes to look for him. That was
when I realised the epidural was not fully working and I let out an
exclamation of surprised pain. The anaesthetist quickly put a gas mask
over my face. No. Not GA. I struggle to get my face away from the mask.
But it was strange. I think hubby was in the theatre at this point coz I
heard him protest against GA. I could hear the anaesthetist explain to
hubby that it was just Entonox to tide me over until Bub was born and he
could give me something stronger through the IV which would also help
with my migraine. Everything was black.
When I could open my eyes, hubby slipped my spectacles on for me and I
see him holding Bub all wrapped up in a towel in his arms. Bub had given
a short shriek when he was born and was now asleep again. Hubby brought
Bub to my face for us to smell each other. My headache was gone. I was
so tired. I could feel doc finishing up the stitching and putting on the
pressure bandage. When he was done, he reached over my chest to shake
hubby's hand in congratulations. Hubby and Bub followed me to Recovery.
There I tried to breastfeed Bub. The two nurses there were surprised. No
one had ever done this before and hubby was stubborn enough to insist
that we were never separated. My arms were still rather useless, so I
asked for help to be propped up with lots of supporting pillows. I
didn't want to wait to get to my room to try breastfeeding. Bub nursed
strongly. A short while later I was wheeled up to the ward. Hubby
carried Bub.
Nikki was waiting for us in the ward lobby. She had packed our stuff in
the delivery room. I had forgotten about all those things. It seemed so
far away and long ago. I was settled in my room and Bub was weighed in
my presence instead of being brought to the nursery for that to be done.
Hubby took some photos. Bub was given to me to hold again – I was
getting the use of my arms back. It was then that I started shaking from
the epidural. I was so afraid of dropping Bub that I passed him back to
hubby. Nikki then squeezed the arches of my feet and the shaking reduced
considerably. Then she packed Bub snugly next to me. By this time, it
was nearly midnight. We requested that a warmer be brought into my room
since Bub was rooming in with us. Nikki bade us goodnight and went home.
It took me several hours to fall asleep though. I was overtired and was
trying to process everything that had happened. My whole body started
itching like the last time. Was given calamine lotion (again like the
last time!) which didn't help at all. But I managed to drift off
eventually. I remember forgetting to ask to see the placenta. I have
never seen one before. I was completely zonked out.
My labour did go almost exactly as I had wished for in my birth plan;
for that I was pleased. I felt I managed to cope with hubby's and
Nikki's support, especially during my down moments. My disappointment
was that once again it was a Caesarean birth due to the threat of a
uterine rupture. My Caesarean was done according to my birth plan,
although hubby had to pay attention to when things were going to be done
according to routine instead. It helped that doc backed us up when Nikki
wasn't able to be around in theatre. The best decisions I made was to
switch doctors in the middle of my pregnancy to someone who didn't place
limitations on my vbac trial and to have a doula with me for my second
birth.
What's going on
here?
Kara and Alex planned carefully for a vaginal
birth after caesarean (VBAC). Kara had contractions off and on over
many days and even weeks before labour finally did start. This is called
"prodromal" labour and is a very common scenario! This was Kara's body's
way of preparing for labour, releasing birth hormones, and starting to
get the baby into just the right position.
Coping with contractions that come and go can try a mother's patience,
however, so in ParentLink childbirth classes you'll spend time
looking at ways to minimize frustration and feel confident about what is
happening in your body.
Click here for more details
about classes and how they can make a difference for your birth.
After some hours, Kara's baby began to show signs that he was starting
to have trouble coping with labour. Kara chose a second caesarean.
Although not the birth she'd planned, she was thrilled that her labour
had gone to plan and that her caesarean birth was a far more
positive experience than before. She attributes her satisfaction
in part to having chosen a doctor whose approach to birth matched hers.
If you are considering a VBAC, it can help to meet with someone who can
answer your questions about the pros and cons of different options and
sort through the myths and realities of safety when it comes to VBAC and
caesarean birth, and can help you identify as Kara did, whether you and
your doctor are on the same page. You and your partner can meet with a
professional labour supporter (doula) for a birth plan consultation,
and get the information and support you need to help you make the
choices that are right for you and your family. You'll end up with peace
of mind, a place to discuss your concerns, and an effective
written birth plan tailored for you.
Click here for details.
If you'd like to learn more about how a doula could help you and your
partner as Kara and Alex's doula did,
click here for more information.
To talk over your particular needs or concerns, you can:
call Tania at +65 9671-8428
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