The story of Rhys and Clay; the VBAC that took place in the bath AND the theatre?!

sarah1WEDNESDAY

At 3am on Wednesday, 3 June 2010, I had my nightly toilet visit, however, this time I returned to bed and felt a slightly weird pain in my lower tummy, then a “clunk” and — to my absolute surprise — my waters broke! I quickly jumped out of bed (not wanting to dirty the sheets!) and allowed it to all trickle down my pyjama pant legs and onto the floor, before waking my husband. I could not believe that my body had naturally started off the birthing process; I was so happy and excited, and eagerly tried to wake my husband:

“Steve…?” (He’s a deep sleeper.) “Steve!”

“Hmmmm?” was the reply.

“My waters just broke.”

He jumped out of bed so quick whilst exclaiming, “Really?”

“Yeah!” I replied. He said he would go get a towel, then — for some weird reason — he disappeared out the room and didn’t come back. A few minutes later, I went out and found him getting out of the shower. He decided that he needed to be clean and ready, for who knows what was to come!

At 3.30am, our 23 month old son, Rhys, woke up, came into our room and Steven warmed him some ‘yum yum’ (milk). I put some clary sage in the burner, made a cup of raspberry leaf tea and had some Weetbix to eat. Then we thought, “What do we do now?” I took my temperature at 3.50am (to keep check I wasn’t getting an infection after my waters breaking) and it was 37.0 degrees.  Lastly, I put on some washing — maybe this was the nesting instinct kicking in?!

At 4.15am, I had not experienced any more contractions, so we went back to bed.  However, at about 4.30am, I started experiencing some infrequent, irregular contractions.  It was very exciting!

At 7am, I rang my mother, my sister, sister-in-law, our doula, Helen, and the WCH. I had a muesli bar at 8am, my temperature was 36.5 at 8.15am, 36.8 at 10am, and 36.8 at noon.

At 10 or 11am, we decided to go for a walk to try to encourage things to get going. We walked to the bank and, to our local cafe owners’ astonishment (they had already heard from our parents that my waters had broken!), we walked into their cafe to have a quiet, relaxed breakfast.

By about 12.30pm, I was having contractions every two minutes and they were starting to hurt, so I quickly had some yoghurt (a good low GI food to hopefully help keep me energised during labour!), but then by about 2ish, my contractions were only every thirty minutes. So, I decided to have a toasted sandwich. (Are you starting to sense that my life revolves around food…?)

At about 4.30pm, our back-up midwife, Kathy, visited and we talked about the possibility of having antibiotics due to my waters breaking.  Despite my plan of wanting an active labour, I had found during the day that when I was upright, my contractions slowed and when I lay down, they kicked back in, so I tried to rest as much as I could and Steven made some nice chicken wraps for dinner. At 6pm, I rang Kathy and informed her that we would come to the hospital at 9-9.30pm to have some antibiotics, but I did not want to be admitted in case things slowed right down, so we agreed I would come home again, and then return to hospital in the morning for another dose. I managed to have a brief nap for an hour from 6.45pm, then at 8pm I burnt some more clary sage and expressed some milk (for the nipple stimulation) using my breast pump and my temperature check was 36.5; all was looking good.

At the hospital, I had some monitoring which indicated that the baby was very happy and healthy and, whilst in the hospital toilet, my mucus plug came out – I was, once again, very excited. I had my antibiotics at about 10pm and was continuing to have mild, ten second contractions, but they were very irregular.

 

THURSDAY

Temperature check at 1.37am was 36.8.
3.39am 36.9 degrees and pulse 74 beats per minute.
5.55am 37.2 degrees and pulse 90 beats per minute.

The following day, at about 6am, I burnt MORE clary sage and expressed some more milk, then we dropped Rhys off to my parents’ house and went back to the WCH for some more antibiotics. We were meant to return four hours after the first dose, but, oh well!

We picked up Rhys at about 9am.  Mum was very worried about me and was being quite pessimistic, so we quickly headed off to the acupuncturist for a 10.15am appointment in the hope of bringing on the labour and turning the baby from the posterior position.  After the needles falling out a couple of times and only one or two contractions, we headed back to the WCH at about 12.45 for some more antibiotics.  To our relief, it was agreed that I could take the antibiotics orally rather than having another jab in my arm (by this time, I was looking like quite a drug addict with all the marks up my arms!). However, this meant that we needed to have a ‘chat’ with the Head of Obstetrics, who was very enthused to tell us all about how he presented at the recent Coronial Inquest into the death of a baby from Group B strep. So, when he questioned us on what we knew about breaking waters and obstetric research, we responded that a lot of the policies and protocols of the hospital around the state were related to minimising risk, rather than on what the research evidence says; at least he agreed with that!

Anyway, we got our little antibiotics prescription and we were off again – this time to the naturopath at 2pm for a consult and a very relaxing reflexology foot massage, but it didn’t do much for the contractions which by this time were virtually non-existent! Then, last of all, we headed to the chiropractor at 3.15pm for a treatment using the Webster technique – I had this the night before my waters broke, so thought it was definitely worth another shot!

Thursday arvo was quiet and it was nice to finally rest. Steven the Saviour made dinner, cleaned up and looked after Rhys and the contractions returned.

Steven went out to the shops for a while, so I sat down and rested and read and wrote down my positive affirmations on little cards to use during labour.  I was feeling good.  It was at this time that I foolishly phoned my mother.  Although she was only worried about me, she was full of negativity and said she was worried about the health of the baby. I was so upset and so disappointed in her attitude — I should never have phoned her. I ended up telling her that, believe it or not, I was actually worried about the baby too, but the Doppler had continuously shown that the baby was happy and healthy. I also told her that waiting and being patient was the plan with which Steven and I felt most comfortable (little did I know that Steven, too, was VERY worried and nervous, but he didn’t dare tell me until after the birth!).  I told Mum I could not talk to her any longer and hung up, and jumped in the bath (forgetting that I shouldn’t have done that with my waters now broken and labour not yet in full swing, but I wasn’t thinking straight!). Steven came home to find me crying and upset in the bath.  My sister came over some time later at about 8.30 for ‘damage control’ – she was sent by my mother to check on me and ensure that she had not upset me too much. My sister was reassuring and left when she felt I was okay. Surprise, surprise, the rest of the night was uneventful apart from my great disappointment that the contractions had stopped and my thoughts began to turn to, “I’m failing to progress – noooooooo!”  It brought back memories of my first pregnancy where I failed to go into labour thirteen days past my due dates. Back then I had had an ultrasound which predicted an 11 pound baby who had not yet engaged and was posterior, so we agreed to have him by Caesarean. I now wondered if this next birth was also going to result in another C-section which I was so against!

 

FRIDAY

Thursday night I had a great night’s sleep — from about 10pm until 7am — then got up, took my antibiotics and had some brekkie.  I also received a text message from my brother-in-law at about 8am telling me to stay strong and true to my beliefs, do what I feel comfortable with and enjoy this amazing time; it was so true and such great and timely reassurance! At 10am, Helen and my primary midwife, Tania, came over. The baby’s heart continued to sound good with many fluctuations and it appeared that the baby might now be lying transverse. Towards the end of my pregnancy, my baby’s position had changed from head down, to bottom breech, to head down, to footling breech, and lastly, to head down again.  By this time, I wasn’t even worried about the baby being posterior, as I felt that it would turn before or during labour anyway. Helen, Tania and Steven were great in providing support and giving me renewed hope that my body knew what it was doing, and that I should try and relax and surrender to the process.  The previous day we had discussed being induced on Saturday if nothing had progressed by then, but this chat filled me with positivity and we decided that we would delay being induced until Sunday, which would be about 96 hours after my waters had broken – a decision which I had written in my birth plan and with which I was comfortable.  Tania and Helen encouraged me to try not to get too excited, to relax and rest, but also suggested a long walk.

At 12.30pm, Steven, Rhys and I took the new toddler stroller for a walk and we had some lunch (whilst Rhys slept in the pram — bonus!), then, when he woke, we went to the playground and Rhys had a good play on the swings and the slide.  On the walk home, I was very excited that my contractions had begun to kick in again and, by the time we got home, I was definitely having 15-20 second contractions again (yippee — progress!), so I tried to distract myself by watching Judge Judy and There’s Something About Raymond!

Rhys and I went for a couple of walks around the block and the contractions continued for another 90 minutes before they started to die down again; this meant bringing out the big guns – the castor oil! I took 25mls at 4.30pm with 25mls of orange juice, but NOTHING happened (not even the much dreaded runs!). So, I took the same dose again at 6pm when we had a nice dinner. I then had a shower at 7pm, and headed back to the Chiropractor again at 7.30pm.

Between 8 and 8.30pm, I rang Tania and from then until about 11pm, I experienced 2-3 REGULAR contractions of about 30 seconds’ duration every 10 minutes.  Tania came over at 11pm and listened to the baby again and all was still okay.  Unfortunately, after this, the contractions slowed again. I found it hard to sleep, so I was up at 1am and 2am to go to the toilet, but then at about 2.30am my contractions returned, and stronger this time; talk about an emotional and painful rollercoaster! The contractions worsened such that I needed to stand for each one. So, at 4.45am, I ate some more yoghurt (didn’t I learn from last time?!) My temperature obs at 5am were 37.3 degrees with pulse 100 beats per minute, and at 5.35am 37.3 degrees with 100 beats per minute.

 

SATURDAY

At 6.30am, Tania returned and suggested an internal. I was reluctant in case there was nothing to report and this would set me back psychologically. However, Tania reassured me that the hardest part for the body is the lengthening and softening of the cervix and the first few centimetres of dilation, so even if that was all that had occurred, then that would be enough.  I agreed and she discovered that my cervix had started to soften and I was 1-2 cms dilated, so I was very pleased.  Rhys woke shortly thereafter, and at 8.30am we again returned to the WCH and I was given a saline drip (the castor oil had finally kicked in, so I needed some rehydration!) and monitoring.  At about 10.30am, we returned home once again.  For the rest of the day, I had minor, regular contractions and I spent a lot of the time rocking on my fit ball, listening to my hypnosis tracks, pacing up and down or stomping up the hallway, and thinking that perhaps I needed to go to the hospital for some pain relief! My sister also came over again for some support and company – but it was all getting a bit monotonous!

From 3.30pm until 5pm I had a nice sleep and woke to very few contractions — d’oh! My mother delivered us a beautiful roast lamb dinner, and after this we rang the hospital and booked in for an induction that night; I felt like I had given my body and the baby plenty of time to prepare but it was time to get this show on the road!

At 7.30pm, we went to the Women’s Assessment Service. Our midwife, Kathy, met us soon after and took us straight up to Room 10 of the Labour Ward. Although I was disappointed that I wasn’t able to labour in the birthing centre, when I saw the big, spacious room with its fantastic corner bath I was excited all over again.  We waited for staff handover at 8pm, and then I was given a drip for more antibiotics and the dreaded Syntocinon.  Our doula, Helen, was with us by now, and she commented on how lucky we were to have such good staff that night: Kathy, the Clinical Nurse Practitioner and a Consultant.  However, in my anxious and apprehensive state, I expressed reluctance when the consultant suggested a vaginal examination, asking him inappropriately, “Have you ever had one? They hurt!”  Anyway, I agreed that Kathy could perform one later — but maintained that I did not want one right now, thank you very much!

The drip fluid started trickling in by about 9pm, set at the lowest level of 12, and I started to have contractions again a couple of hours later; who would have ever thought I’d be so glad to experience contractions!  My mother, sister, niece and sister-in-law had arrived at the hospital, but Steven sent them home stating it might be a long night! I was still feeling really good although I was tired from the lack of sleep during the previous few days.  I had been watching the monitor and my baby’s heart beat, but decided that I needed to stop looking both at this and the clock and to instead focus on the task at hand.

Gradually, the drip was turned up and the contractions increased in intensity and frequency although there was always a welcome break between most of them during which I tried different active birth positions, like leaning on the bean bag up on the bed and walking around the room. However, the most comfortable position which I maintained for most of my labour was standing up near a big table, leaning forward and rocking my pelvis whilst reading positive labour affirmations such as ‘my body knows how to birth safely and comfortably’ and ‘my baby will come when it is ready’. We also listened to my old wedding music on my MP3 player, I sat on a chair and rested my shaking legs in between contractions and my support team encouraged me after EVERY contraction. Helen gave me great tips on relaxation and breathing techniques to cope with each contraction. We tried the “pelvic clock” to open up and relax the pelvis and cervix, and breathing in for 4 seconds and breathing out for 6 seconds. This worked a treat! Also fresh in my mind was my recent private psychology work with clients doing deep muscle relaxation; this also helped me to further focus and relax.  My support team continued to inform me how much progress I was making, however, as I was tiring near the end of the first stage, I asked them, “How much longer?”, my support team suddenly went quiet and no one replied! I think I asked again, but I received the same non-committal response: silence! Looking back, I am glad that no one responded; this made me focus on the pain being for a purpose/reason and my goal of a natural water birth free of time limits. I continued to try to distract myself whilst my husband ate smarties and chocolate muffins from the ‘labour goody bag’ my sister-in-law gave me – something she had prepared to help celebrate the birth and the end of my gestational diabetes and chocolate abstinence.  Luckily for him, he made up for his behaviour by giving me good back rubs and allowing me to brace against him during some powerful contractions!

 

SUNDAY

At approximately 1am Kathy, suggested a VE to check my progress. Again, I was initially reluctant in case there had been little of the “P” word, and I feared that I would only be 1-2cm dilated.  My support team reminded me that the stretching and thinning of the cervix and the first couple of centimetres dilation was the hardest part, and Kathy also promised me that my cervix would not have closed shut since my last VE Saturday morning. Kathy announced that, indeed, my cervix was soft and had thinned out to about 2-3cm, however, she could easily stretch it to approximately 4cm. Thank God; this was fantastic news and it gave me the extra motivation that I needed. Kathy also said that it had only been my hindwaters that had broken Wednesday morning (hence the delay in the contractions really kicking in!), therefore if she broke the forewaters this would progress things further. As she had mentioned that magic “P” word, I agreed immediately.  So, out came the ‘knitting needle’ followed by the floods of Noah’s Ark for what seemed like hours afterwards. The water, though, was so warm, and nice and relaxing, although it presented somewhat of a OH&S slipping hazard for my support team — it trickled out wherever I moved in the birthing room.

At this point, someone suggested I try the birthing bar, so I alternated between standing, kneeling and just flopping over the top of the bar.  At about 3.30am, Steven filled up the bath and we had a joke about him not putting it so hot that it would scald me; I was amazed that I still had a sense of humour by this point! The moment I stepped into the bath I felt such relaxation, and my support team would certainly have heard me going, “Ahhhh!” in a much more relaxed fashion at this point – something I am sure they welcomed after all my painful contraction moans and groans of the previous five or so hours! The only issue to arise from being in the bath was that I kept kinking the Syntocinon drip cord such that the machine kept beeping at me, however, even this was somewhat usefully distracting from the powerful contractions.

I heard Kathy trying to whisper to Steven that it would take approximately another hour for me to push the baby out. I couldn’t believe it – that LONG?! However, I tried to re-focus telling myself that it was only another hour out of my life, that my baby would be here soon and I instead tried to concentrate on each contraction, taking each one at a time.  Whilst the contractions became very painful, I felt like I was making a lot of progress. Helen reassured me by telling me to go with the pain and not to be afraid, which was really useful as I had never experienced labour before and this definitely reduced my fear and allowed me to further relax.  I again surrendered to the contractions and the birthing process.  Kathy was exhausted and took a break, and Steven and Helen continued their great support and reassuring comments and back rubs.  I was encouraged to try to feel for the baby’s head, but at this point I was in a bit of a daze and wasn’t sure what the heck I was feeling. I tried again and thought I felt something, so then after another couple of contractions I asked Steve if he could feel the head.  He said he could and the excitement in his voice was very motivating, despite the fact that he was fumbling around and being a bit rough right whilst I was having a powerful contraction!

I could feel the baby coming down and the head kept coming out and then slipping back in at the end of the contraction, but eventually it didn’t go back. Then the baby’s head actually came right out! The excitement of my support team was overwhelming. I could hear comments like, “Amazing!” and, “Look at it looking around under the water!” Kathy said that the baby would come out with the next contraction.  What then followed was a very LONG, LONG break until my next contraction.  I am sure my support team were feeling very impatient waiting for that last one, but I was enjoying the rest and the break, and was surprisingly not feeling nervous or worried at all;  it felt exactly right. The much-awaited contraction came and the baby came out. Steven announced that it was another boy and, when Kathy suggested I take the baby, I looked down and could not see anything, pleading, “Where is it?” Kathy brought Clay — our little 8lb 13oz baby (his older brother, Rhys, was 11lb 1.5oz!)  — to the surface at 4.32am, ninety-seven and a half hours after my membranes first ruptured.  I couldn’t stop saying, “Oh my God! Oh my God!” I gave him a cuddle; he was so calm and still and just perfect – a contrast to Rhys who had come out screaming at the top of his lungs and covered in meconium! I could not believe that we had done it, and Steven, too, was overcome with emotion and awe.   I had delivered a baby naturally without any drugs! It really was amazing!

Kathy suggested I get out the bath to deliver the placenta, at which point I was brought back to reality and feeling very unimpressed that, after all that, I still had to push more! I’d forgotten that a placenta had to come out too! They all helped me slowly and carefully out of the bath whilst I held Clay and then lay on the bed. Kathy told me to push but I was so excited and tired that my pushing was abysmal. I asked, “I’m not doing, it am I?” and she gave a laugh and responded, “No.”  So, I focused again, pushing out the placenta with the next contraction.

I gave Clay a breastfeed on my chest at 4.45am; it was just like I had always hoped for and more. I fed him on the other side at 5am and he had the hang of it already; there was none of the sleepiness and lack of attachment with which  Rhys and I struggled after both being pumped full of drugs with the Caesarean.   Steven cut the cord and lastly there was the nasty stitching up of my third degree tears which seemed to take forever!

Eventually, at about 6am, my sister, mother and niece came back to the hospital and had a little cuddle with Clay. My sister and I had a good cry when she told me how proud she was of me.  I was proud of myself, too. It was such a lovely time.  They all had experienced very little sleep — apparently they were halfway back to the hospital at about 1am when Steven had texted them saying to go back home as the baby still a long time away! – so they had all headed back off home again.

An hour or so later, Steven, Helen and I were eating toast and drinking hot chocolate and reflecting on the whole amazing process and discussing the option of perhaps going home.  However, I had been experiencing some blood loss and decided that I would have a shower and clean up a bit. As I walked to the shower, I felt slightly dizzy and quite breathless, so I sat on a chair and had a nice hot shower.  However, due to the blood loss, by the time I turned off the water and called Steve to come in with my clothes, blood was again dripping down my legs and onto the floor.  Steven and the midwife, Ann, assisted me back to the bed as I was feeling quite dizzy and shaky, and Helen cleaned down my legs with a warm flannel.  However, I had another gush and more blood, then yet another gush. Helen – God bless her – again wiped me down with a warm flannel, and it was at about this time, perhaps 8.30am, that three doctors entered the room on their ward rounds.  We discussed the gushes and blood loss, and one of them asked if she could have a look at my stitches and palpate my belly.   My belly was very soft and as she palpated quite a few blood clots came out.  My Syntocinon drip had been removed, so I was given some oral tablets to help my uterus contract and to control the bleeding.  My uterus hardened, but after a few minutes it became soft again and lots more clots emerged after another palpation.  I tried to feed Clay in the hope that breastfeeding would help my uterus contract further. Suddenly, more and more hospital staff began entering the room — it was like a scary scene from ER. I was given a drip with Syntocinon, but experienced still more blood loss — approximately one litre by that time — and I was informed that I needed to go to theatre to find out why I was losing all this blood. The Registrar and the Consultant explained that it could be my cervix, but that if it was something in my uterus, they would have to investigate and they could only do this by cutting into my Caesarean scar. My first thought was, “Nooooooooo! Not after all that work I have done to achieve a non-surgical birth!” Anyway, I realised the seriousness of the situation and, of course, agreed.  I asked if Steven could be present, but this was not allowed. Steven was telling me everything was okay, but I was really scared and worried that I actually might not survive the ordeal.

I gave Clay a kiss, then Helen and Steven took him, and I went off to theatre. In shock, my body was shaking uncontrollably; I kept asking what was happening.  Ann gave me regular updates and a lovely theatre attendant tried to distract me by talking about my boys and even holding my hand! There were three attempts at the spinal with me being held by staff, curled up into a ball, my head held down to my chest and me arching my back. Eventually, after what seemed an eternity, my body slowly went numb.  I never thought it would be such relief. The theatre staff had tried covering me with warm blankets but I was still shaking a great deal until they brought out the puffy blanket which blew hot air onto me — what a difference! — and the shaking eventually stopped. The Registrar later informed me that she had to further cut my exterior third degree tears to get to my cervix, however, the good news at the time was that she had discovered (bilateral) cervical tearing which she stitched up and the blood loss stopped. By this time I had dangerously lost 1500ml — apparently only about 500ml more and I actually could have died! It turns out that the blood clots that started to come out just after my shower had been holding up the bleeding, thus the issue had not been immediately apparent.  I was given two units of blood in a transfusion and I felt a warm, sleepy feeling in theatre.  I felt so relaxed and warm and my eyes were slowly closing, and even though I was exhausted, for some reason I made myself stay awake, thinking that even though the bleeding had stopped, if I closed my eyes I might not ever wake up again.

After the surgery, I was taken to recovery and, just like when I had Rhys, I was continuously trying to move my toes (I was told that if I regained feeling in my toes that I could be taken to the nursery to see Rhys – a big motivator as I only got to briefly see him after the birth before he was whisked away). However, this time it was a bit trickier as my ‘shock shakes’ had returned with even greater intensity.  Another big difference this time was that I had a nice Icy Pole and, soon after Steven, Helen and Clay came to recovery and I got to hold and feed my little Clay again for quite some time.  When Rhys was born via Caesarean, I only got to see him very briefly and I didn’t get to hold him until six hours after his birth as he had been placed in an incubator, still covered in meconium and having respiratory difficulties.  This was something that I didn’t want happening again!

After a little while longer, we all went back up to the labour ward  and we were TOGETHER AGAIN. Eventually, my shaking stopped sarah2and I finally got some sleep.  With Rhys’ birth, I was bedridden for two days in pain, spent a total of seven days in hospital and experienced feeding and sleeping difficulties.  Two days after Clay’s birth, Rhys, Steven, Clay and I all left the hospital together – I walked out the door in little pain, my milk was coming in already and I felt fantastic. Even though I had a scary and serious hiccup after Clay’s birth, my labour had certainly been empowering and everything I had wished and hoped for!