My pregnancy was a smooth ride, allowing me to work up until 38 weeks. The only complaint I had was the occasional sore back which I remedied with acupuncture and massage. My last pregnancy was similar, but it went downhill when I discovered that I needed an emergency c-section due to a non-reassuring heart rate picked up on routine monitoring (as I was 10 days overdue, this was required daily). I emotionally and physically struggled with the recovery from the c-section. While the pain of the recovery was not so terrible, the physical limitations was something I really wanted to avoid this time, particularly as I now have a very active 2.5 year old!

I was determined to have a natural birth so I made efforts so that this would be more likely. I hired a wonderful Doula, Erin who had knowledge of Spinning Babies techniques to assist with optimal foetal positioning (which I practiced regularly), and I consulted a women’s physiotherapist to assist with making sure my pelvic alignment and pelvic floor muscles were optimal. I also tried to keep active for as long as possible and was exercising 3 times a week until 30 weeks, and walking most days thereafter. I also had weekly acupuncture with one of my colleagues, Ernestina.

One of the reasons why I worked towards giving myself the best chance of an natural birth was because having had a c-section previously, the monitoring and risk of interventions would be higher, which can in some instances actually increase the risk of  a repeat c-section.

What is a VBAC?

For those who don’t know, after you have had a c-section there are some concerns about having a natural birth (a VBAC, or vaginal birth after caesarean) due to a risk of rupture of the scar where the c-section was performed. This risk is .2 to 1.5%, which is approximately 1 chance in 500. Most women who choose to have a VBAC are successful in doing so, as long as the reason for the previous c-section isn’t something recurring and there has been enough time between births. The chances of success are increased by having a good support system, such as a doula.

Support during Birth

A 2017 Cochrane review confirmed this, stating that having continuous support by another woman during the entire birth process increased positive outcomes and decreased negative outcomes during birth. While midwives and nurses are amazing, they are often not able to be with you during the entire labour and due to the spontaneous nature of birth, and the shift work of midwives, you do not know who will be working when you go into labour, or whether your labour will cross over into another midwives shift. Hospitals are also rather short staffed, and so midwives may not be able to be there with you during the entire birth. This is where a doula can be helpful. In addition to that, a doula will also have your back emotionally and will provide you with support in sticking to your birth plan when you are faced with challenges and emotional times during labour such as ‘transition’.

Given the risk of rupture it is not usually recommended for a woman having a VBAC to be artificially induced with pitocin or the like, as this increases the force and frequency of contractions, potentially making the risk of rupture greater.

My drawn out labour…

I stopped work at 38 weeks and was feeling fine, but impatient for baby to arrive. Braxton hicks were fairly constant so I thought surely this is a sign labour isn’t too far away? But that wasn’t the case. As I went longer and longer overdue, my care providers became more concerned that I was not going to go into labour naturally and would end up with another c-section. In my heart I felt like if I was given enough time I would go into labour naturally (I had a gut feeling I would be 12 days “overdue”), and knowing that so often due dates are just an arbitrary calculation meaning what is technically overdue can often still be in term.

While I wanted to just let the pregnancy take its own course, my obstetrician was concerned about this. Conversations were had about the possibilities of less intense induction methods, as well as the risks of going overdue. The other risk to consider was that of undergoing a repeat c-section, which actually has it’s own risks. Most professionals believe that a VBAC is safer than a repeat c-section, although the risks of repeat c-section are less often discussed.

I had looked at the risks and decided I wanted to wait to allow my body to go into labour naturally, and while the midwives supported me in this decision, the obstetricians wanted to induce labour using a ‘gentler’ approach to pitocin, by breaking waters and then using oxytocin. I wanted to avoid this as I knew that an induction would result in a more painful birth with increased risks of other interventions. However as the pressure from them increased I started to doubt my body, and I eventually gave in and an induction was scheduled on Wednesday morning (11 days overdue).

But… on Tuesday night I went into labour naturally – hooray! I had been having braxton hicks for over a month which were getting increasingly more frequent and intense, but they never had a pattern to them and I could never describe them as painful. When labour arrived it was a completely different feeling, so I was very excited to know that this was actually it. On top of the different sensation I also lost the mucous plug which confirmed even more that this was real. Interestingly, my doula proposed the idea that women going through a VBAC may have longer periods of braxton hicks as their uterus is preparing the scar tissue to protect itself from rupture. 

The contractions stayed at 15 minuted apart, lasting for about 30-40 seconds, and I would describe them as uncomfortable, like moderately bad period pain, but definitely something I could cope with, especially if I moved and breathed through it. That evening, like the many nights previously involved lots of walks up and down our road and through the nearby park.  The contractions stayed at that level for the night, and I called the midwives in the morning who said come in for a check later that day or earlier if things progress.

The next day contractions were still 15 minutes apart so I went into the hospital and had a CTG to make sure baby was coping (which she was), and had a discussion with the obstetrician who said that now I was in labour naturally it is better to labour at home as long as possible, unless my waters broke. Even though this was what I wanted to do, being in the hospital made me feel stressed and my labour slowed down a lot that afternoon. Tim and I went for several walks to try to speed things up some more, but it was still a bit inconsistent for that evening. The next morning my doula Erin visited, and she did some spinning babies techniques such as side lying release and rebozo sifting to make sure pelvis was good to go. She also suggested going out for the day (somewhere not too far away) to distract myself and boost the oxytocin, and to try not to think about the labour. So Tim and I went out for lunch and walked around a cute little town in the lower mountains, and wouldn’t you know labour started to pick up again. Contractions became 10 minutes apart and stayed like that, meaning that I would have to get up from lunch every now and then to discreetly breathe through the contractions around a corner.

The contractions would fluctuate between 7-15 minutes apart until 10pm that night, when they really increased in intensity and felt a lot more uncomfortable. At this point I knew I had moved from latent to active labour. I wasn’t able to sleep between these contractions and after a few hours I needed Tim to massage my back through them. At 3am Friday morning I called the hospital and Erin, and headed in to the hospital. I think I was in denial that this labour was real, possibly because I had heard so many stories of women being sent home from the hospital, being told they’re only so many centimeters dilated and still had a long time to go, and partly because I had been led to doubt my ability to go into labour at all.

The walk from the car to hospital, and through the hospital to the delivery suite took a long time as I had to pause to lean against the wall to breathe through the contractions while Tim and the hospital’s security guard patiently waited for each one to pass. Once in the maternity ward the midwives greeted us and we settled into the room. The midwife read through my birth plan which included requests such as dim lighting, to not be offered any pain relief (as I didn’t want to be tempted if it got bad), a physiological third stage and delayed cord clamping. I had a quick CTG to make sure bub was still doing well and had to have a canula inserted in case the VBAC went wrong (which I hated but understood the need for). I was worried that like the previous day my labour would stall once I was in hospital, but it kept up a steady pace. I stayed upright for the majority of the time, leaning against the bed while Tim applied pressure to my lower back. Erin arrives shortly after us and set me up with some honey water and coconut water, and was a constant source of emotional support.

At 5am the intensity of the contractions increased, they lasted much longer and were considerably closer together. I consider this bit to be the most painful part of the birth but I still wouldn’t describe it as the worst pain I’ve experienced, or even unmanageable.  I had prepared myself to go through periods of intense emotions thinking “I can’t do this” especially as I went through transition, however I never had any checking of dilation so don’t know when I was at each stage, and I don’t recall having a moment of doubt of my ability, rather I just doubted that I was in real labour – that was until my water broke at around 5.30am. Off came the pants and the labour sensations shortly changed from being like cramping in my lower belly and back, to a downward pressure in my bottom. At this point I was very relieved and excited because this was definitely real!

I don’t remember this part of the labour being painful, I found it fascinating, but also very tiring. I had had very little sleep the last two nights, and none at all on this night. The urge to push was uncontrollable and associated with some interesting guttural noises. When the midwive who had ducked out to make herself a coffee heard me making these noises she raced back in and started prepping for action.

I moved to kneeling across a pilates ball and the midwive would hold the CTG monitor to my belly after each contraction for a little while to make sure bub was coping with the contractions (which she did so beautifully). The pushing stage lasted a bit under an hour, but to me it felt like ten minutes. I vaguely remember that the contractions slowed down at this point to be a few minutes apart, much slower when compared to the last stage. In retrospect, because Lara had such a large head and I have a thick perineum this was possibly natures way of preparing the exit. I had planned to let my own breathe and the natural fetal ejection reflex control the last stages, but after a while the midwives said I needed to speed the process with more forced pushing, which I did, and Lara was born about 4-5 pushes later. The midwife who was positioned behind me caught her and passed her through to me. I scooted backwards, picked up her slippery body and was awash with a feeling of ecstasy – here was my baby girl, healthy! I had done it, a drug free VBAC birth! It wasn’t that bad! Nothing hurt anymore!

I stood up and climbed onto the bed, grinning madly about the fact that I could move about without pain (the pain I had been so afraid of from my last c-section). Lara latched on immediately and after about 15 minutes I delivered the placenta (boy was that easy compared to the baby!) Tim cut the cord, and we all marveled over the awesomeness that is a placenta, and oohed and aahed over Lara.

But then I was checked for tearing, and it was discovered that I had a third degree tear. This meant I needed to go into theater for it to be repaired which was upsetting for me as I had been able to avoid any interventions so far, and I would also have to be separated from Lara. I was also frustrated, wondering if I had just continued to let the fetal ejection reflex do it’s thing whether I would have torn, but I have since realised that there is no benefit in dwelling on this, and to be grateful, as I was with Ash, that I have a healthy baby. My high immediately dissipated, I was in shock at this news.

I didn’t feel the tear happen initially, and the pain afterwards was only mild. I was still able to move around freely, and so far have healed well and have been doing my rehab exercises.

Even though I had the tear I still consider the birth to be an awesome experience and personally I would choose that over the c-section if given the choice. I know some women who didn’t struggle recovering from the c-section as I did, but for me I am so glad I have been free to move around after the birth, to pick up my toddler, and to not be in any lasting pain. I’ve also noticed a big difference in terms of my belly going back to normal (not there yet, but definitely better than last time).

If you’re still reading my enormous birth essay than I hope that my story has been of interest or benefit to you. As I said before I loved reading other peoples stories, so I wanted to share mine as well. Do you have a story to share? Let me know in the comments below, I’d love to hear it.