Elsa’s birth
Caesarean after trial of labour
Pregnancy
At the age of 36 I became pregnant with our first child after six months of trying to conceive. I had moderate morning sickness in the first trimester and some more in the third trimester. I worried about almost everything during pregnancy, but after starting childbirth classes at the hospital my rising sense of anxiety turned into a couple of panic attacks. I was overtaken by my fears of the birth, of being a bad mother, and of the enormous changes I would have to face. I sought help: I talked to my partner, saw a psychologist, and hired a doula – one of the best decisions of my life, as it turned out. She helped me to erase Hollywood images of childbirth from my mind and replace them with a notion of childbirth as a privilege, a sacred event, something to be enjoyed. I began believing in myself and my body’s abilities, believing that my baby was safe inside me and that I would be a great mum.
Finding out about the breech
We had been receiving antenatal care at the smaller of the two hospitals in our city. At the 20-week ultrasound it was found that the placenta was lying low and that another ultrasound at 34 weeks would be necessary to check that it had moved clear of the cervix. At 34 weeks the ultrasound showed that the placenta had indeed moved out of the way but that the baby was in the breech position. The doctor we saw explained that the vast majority of breech babies in Australia were delivered by elective caesarean and that there was a severe lack of clinical skills in vaginal breech birth. He (and all other care providers we talked to) cited the findings of the controversial Term Breech Trial.
I remember crying in that appointment – feeling like the likelihood of a natural birth was slipping away due to blanket policies that didn’t assess my case on its merits - everything else with my pregnancy was normal and I felt that a vaginal breech birth could very well be achieved. We asked about a trial of labour before a caesarean but this doctor didn’t agree that it was best to wait for spontaneous labour and then to have a caesarean. This was contrary to what I had been told by our doula. More importantly, it went against my gut instinct. (I understood later that this advice was related to the staffing limitations at the hospital where, if required during the night, staff would have to be called in from home to perform surgery. The doctor believed that in such a case mistakes were more likely to happen so he thought a scheduled elective caesarean was much safer than an unscheduled one that had to be done in a hurry.)
Attempts to turn the baby
After the initial shock of finding out the baby was breech and the realisation that the path ahead may involve some argy-bargy with care providers I began to get serious about turning the baby, trying some folk remedies that some people believe encourage the baby to turn head-down. I did handstands at the pool, swam, put ginger paste on my little toes before bed, tried moxibustion sticks, played music and shone a torch at the bottom of my tummy, tried to talk and think the baby around, inverted myself on a tilted ironing board propped up at one end on the sofa. Once or twice I convinced myself that the baby had moved but at the 36-week check-up we learned that she hadn’t.
We consented to an external cephalic version (ECV) later that week. An ECV is a doctor trying to manipulate the baby around from the outside. I was given ventolin intravenously to relax the uterus. It immediately made my heart race – it wouldn’t have gone any faster if I had been running away from an axe murderer. I started sweating and then I retched for a few minutes (nothing came up because I had to fast for eight hours before). The manipulation was pretty painful - like getting a Chinese burn on your belly at the same time as trigger point massage. I noticed that it upset my partner to see me in such pain. Two doctors each had a try but the baby didn't move an inch. This didn't surprise me as I felt like my uterus was rock-hard throughout.
Going with the breech
I remember feeling a bit disheartened after the ECV, but also having a feeling that my baby was doing what she knew was best for her. I began to accept that I would most likely be having a breech baby and stopped hoping so fervently that she would turn. Our doula gave me a book on breech birth by Maggie Banks and I watched the Karin Ecker movie of her footling breech birth A Breech in the System. These resources and others showed me that breech birth is a variation on normal, that it is not abnormal and that I was not alone in wanting to try for a vaginal breech birth. I joined the Breech Birth Australia Facebook group – an online community of people who’ve had breech babies or have an interest in breech birth (e.g. midwives). These women especially were a great comfort as the mind games with the healthcare system really began.
After the ECV attempt we met with another obstetrician (we got whoever was on duty that day). That doctor was very pro-caesarean for breech births, saying that he concurred with the Term Breech Trial’s conclusions that caesarean was safer than vaginal breech birth. He was honest about his and most of his colleagues’ lack of experience with vaginal breech birth, saying that he didn’t want to practice on us. It was clear that if we stayed at that hospital I had little choice but to consent to an elective caesarean the next week at 39 weeks. It all felt wrong – like a decision made out of fear.
Changing hospitals
At home I shot off emails to doctors at the larger hospital in our city and to a doctor interstate who specialises in breech births and advocates for them if the conditions are right. I considered paying for a private obstetrician in another interstate city who also specialises in breech births. Luckily a drastic late dash interstate was not required. We got an appointment at the other hospital in our city. We saw an older doctor with a kindly manner who would have been practicing long before the Term Breech Trial all but halted vaginal breech births in Australia. He was objective in setting out the risks and benefits of both vaginal birth and surgical birth for breech babies. He assessed our case on its merits, agreeing that there were no other contra-indications for vaginal birth. He also agreed that there were benefits for both me and the baby of a trial of labour before a caesarean. Most importantly he respected our right to choose which option to take. He made me feel empowered to make the right decision. A senior midwife also spent a good amount of time with us reviewing our birth preferences document. I came out of the hospital with a big smile on my face and a huge sense of relief. It was a simple decision to transfer hospitals. I could put all the negativity from the other hospital behind me and focus on getting back to envisaging a positive birth for my baby. Still, it was not an easy decision. Ultimately, it came down to a combination of gut instinct and a confidence that, having no contra-indications, I was a good candidate for a vaginal breech birth.
So we waited for labour to commence. We waited about two weeks. A couple of times during those two weeks I second-guessed myself. Was I choosing vaginal breech birth for the right reasons? Was it truly about what was best for the baby or had I been brainwashed by reading too many stories about orgasmic vaginal birth? Was I putting our doula’s image of feeling like a goddess during labour ahead of the health of my baby? My gut instinct told me that the right decision for us was to go into spontaneous labour and give a vaginal breech birth a go. My partner and I took on board the medical advice we had received, however, and agreed that if it didn’t go like clockwork we would consent to a caesarean.
Pre-labour and labour
On the evening of Friday 2 March at bedtime I began having regular light contractions. They continued throughout the night. Laying on my side made them stronger so I got on my hands and knees and waved my butt in the air for thirty seconds about every six minutes. I was amazed that I could sleep between contractions. I kept my excitement in check - I knew this was only pre-labour. At about 3am I noticed some blood when I went to the toilet. My partner rang the hospital, as we were a little unsure about when to go in – we’d been told not to stay at home too long because of the breech position. Thankfully the midwives didn’t see any reason to come in and told us to stay at home. This was just as well because by morning the contractions eased. We spoke to our doula in the morning. She said she had had cramps that night and was wondering if things were starting with me. (My mother, a former midwife, says she had cramps when her sister went into labour on the other side of the world.) The doula told us to get plenty of rest that day as contractions might start again at night. I slept for quite a few hours that day. In the evening my partner went out to a football game and I did a bit of vacuuming. Sure enough, after dinner the contractions began again. This time they were a bit stronger. My partner went to bed and I stayed up. At this point we both thought the night could be similar to the previous one. Gradually the contractions got stronger – I found a standing position with my nose and hands against the wall worked well. At 1am I felt my waters begin the break. It was like I had wet my pants a bit, not a great torrent. I was relieved that the fluid was clear. I got a towel to stand on near the wall in case there was a big gush, but the fluid continued to leak lightly into the pad I’d put on to keep an eye on the colour. I noticed by this time that the contractions were getting closer together as well. I woke up my partner. We called the hospital. They advised that it was time to come in. We called the midwife who was on-call for us, and the doula. They would both meet us at the hospital.
My partner got all the bags and me into the car. By this stage I did have to stop walking and talking during contractions – this was it! I climbed into the passenger seat of the car, kneeling and facing the rear window. My partner turned the key in the ignition. We heard the pathetic whimpering sound of a car with a flat battery! Our super-reliable Subaru that has never broken down and has always been serviced on time wouldn’t start! Thankfully we had borrowed my mum’s old ‘battle truck’, an ageing but hardy four-wheel drive, for the last few months of my pregnancy. My partner transferred all our stuff and me into that car. I got into the same kneeling position and we set off in the rain on the 20-minute drive to the hospital. I spent most of the time with my eyes shut and breathed and moaned through about 4 or 5 contractions on the way there.
At the hospital
We arrived at the hospital at about 2.30am. The doula had prepared the labour room wonderfully. The lights were dim, the aromatherapy scents were lovely (although upon entering the room was the only time I was conscious of them). It was really cosy and such a comfort to see her there, smiling at me. The only thing I remember annoying me in the room was the ticking clock above the bed. But I was quickly able to tune it out once I established my rhythm. We met the midwife who I instantly felt comfortable with. They put two foetal monitors around my belly. We had consented to this as a precaution because of the breech situation, although looking back the baby never did get distressed so they weren’t really necessary. Luckily the monitors were cordless and waterproof - I don’t recall them being a distraction. Then the doctor on duty asked if she could examine me. I lay on the bed and parted my knees. She gently felt inside me. Although I had told the midwife previously that I didn’t want to know how dilated I was, the doctor told me anyway. I preferred not to know because I wanted to get back in my trance and not think about anything to do with time and numbers. As it turned out, it was good news though – I was already at 5cm and the cervix was quite thin.
After a little while I found a pattern – between contractions I sat on a big soft chair with my eyes shut, possibly taking microsleeps, and during contractions I stood up and leaned over the bed with my forearms resting on pillows stacked on the bed. During the contractions I shifted my weight from foot to foot, like a cat kneading on a soft cushion. The doula placed a soft mat under my feet so they wouldn’t get sore. I remember taking my dressing gown on and off a few times as I got hot and cold. I drank plenty of water and went to the toilet fairly often as I had been told to. At one point I had a nice hot shower as a bit of a break and then I got back into it. I used hotpacks and massage for pain relief and didn’t even think about drugs except to a few times when I observed that, as I had hoped, I hadn’t needed to ask for any.
At 6am the doctor examined me. Again, she told me my dilation. Duh! Anyway, I was 8cm so it was good news again – I was progressing at 1cm per hour, bang on expectation. During the next period I remember feeling that I was nearly there, that soon I would be in transition. The contractions were getting stronger and I had a slight urge to poo (associated with wanting to push) but nothing I couldn’t hold back. I took this as a good sign but in hindsight I wondered whether I should have kept this to myself to buy a bit more time later.
Failure to progress
At 8am the doctor examined me again. I had no idea that two hours had elapsed since the last examination. It felt like 30 minutes to me. The doctor told me my dilation but this time it was not great news - I was still at 8cm. This was disheartening but I felt like I had lots of energy left and that I could keep going fairly easily. The doctor said she would give me another two hours. I lost my rhythm a little during this time and decided to have a shower to refresh and reset myself for the last 2cm. The doula poured a little aromatherapy clary sage essence into the shower.
While I was in the shower I could hear people talking in the labour room. I knew something was up but decided to ignore it and stay in the shower a little longer. When I’d had enough of the shower and turned the water off my partner came in. I think it was him who relayed the extra information that the doctor hadn’t told me before – the baby was not descending. The specialist on duty had been consulted and had advised a caesarean before the baby became distressed due to ‘failure to progress’. As soon as the c-word (caesarean) was in the room I felt the game was up. The faces of my partner and the doula, more than their words, told me that they believed the caesarean was justified. I didn’t question the advice. In retrospect I wonder whether I should have but by then I had already come so far out of my labour trance that I felt it would be too big an ask to re-establish myself into the zone I needed to be in to get to 10cm. It was as if my cervix began closing as soon as I heard the word ‘caesarean’. Indeed, my contractions became less intense and less frequent from that time on. I consented to the caesarean. I cried briefly with disappointment as my partner hugged me.
I summoned all the concentration I had to read and sign a consent form (I had to read it aloud to myself and follow the words with my finger like a child learning to read). The lights were flicked on and my partner and the doula hurriedly packed up their bags. A gurney was brought for me and I was wheeled down to theatre. In just a short time my contractions had weakened significantly – I was able to talk through part of them and they became spaced out. Although I was sad that I was going to have to have surgery, I was also excited – I now knew that within about half an hour I would meet our baby.
Caesarean after trial of labour
Pregnancy
At the age of 36 I became pregnant with our first child after six months of trying to conceive. I had moderate morning sickness in the first trimester and some more in the third trimester. I worried about almost everything during pregnancy, but after starting childbirth classes at the hospital my rising sense of anxiety turned into a couple of panic attacks. I was overtaken by my fears of the birth, of being a bad mother, and of the enormous changes I would have to face. I sought help: I talked to my partner, saw a psychologist, and hired a doula – one of the best decisions of my life, as it turned out. She helped me to erase Hollywood images of childbirth from my mind and replace them with a notion of childbirth as a privilege, a sacred event, something to be enjoyed. I began believing in myself and my body’s abilities, believing that my baby was safe inside me and that I would be a great mum.
Finding out about the breech
We had been receiving antenatal care at the smaller of the two hospitals in our city. At the 20-week ultrasound it was found that the placenta was lying low and that another ultrasound at 34 weeks would be necessary to check that it had moved clear of the cervix. At 34 weeks the ultrasound showed that the placenta had indeed moved out of the way but that the baby was in the breech position. The doctor we saw explained that the vast majority of breech babies in Australia were delivered by elective caesarean and that there was a severe lack of clinical skills in vaginal breech birth. He (and all other care providers we talked to) cited the findings of the controversial Term Breech Trial.
I remember crying in that appointment – feeling like the likelihood of a natural birth was slipping away due to blanket policies that didn’t assess my case on its merits - everything else with my pregnancy was normal and I felt that a vaginal breech birth could very well be achieved. We asked about a trial of labour before a caesarean but this doctor didn’t agree that it was best to wait for spontaneous labour and then to have a caesarean. This was contrary to what I had been told by our doula. More importantly, it went against my gut instinct. (I understood later that this advice was related to the staffing limitations at the hospital where, if required during the night, staff would have to be called in from home to perform surgery. The doctor believed that in such a case mistakes were more likely to happen so he thought a scheduled elective caesarean was much safer than an unscheduled one that had to be done in a hurry.)
Attempts to turn the baby
After the initial shock of finding out the baby was breech and the realisation that the path ahead may involve some argy-bargy with care providers I began to get serious about turning the baby, trying some folk remedies that some people believe encourage the baby to turn head-down. I did handstands at the pool, swam, put ginger paste on my little toes before bed, tried moxibustion sticks, played music and shone a torch at the bottom of my tummy, tried to talk and think the baby around, inverted myself on a tilted ironing board propped up at one end on the sofa. Once or twice I convinced myself that the baby had moved but at the 36-week check-up we learned that she hadn’t.
We consented to an external cephalic version (ECV) later that week. An ECV is a doctor trying to manipulate the baby around from the outside. I was given ventolin intravenously to relax the uterus. It immediately made my heart race – it wouldn’t have gone any faster if I had been running away from an axe murderer. I started sweating and then I retched for a few minutes (nothing came up because I had to fast for eight hours before). The manipulation was pretty painful - like getting a Chinese burn on your belly at the same time as trigger point massage. I noticed that it upset my partner to see me in such pain. Two doctors each had a try but the baby didn't move an inch. This didn't surprise me as I felt like my uterus was rock-hard throughout.
Going with the breech
I remember feeling a bit disheartened after the ECV, but also having a feeling that my baby was doing what she knew was best for her. I began to accept that I would most likely be having a breech baby and stopped hoping so fervently that she would turn. Our doula gave me a book on breech birth by Maggie Banks and I watched the Karin Ecker movie of her footling breech birth A Breech in the System. These resources and others showed me that breech birth is a variation on normal, that it is not abnormal and that I was not alone in wanting to try for a vaginal breech birth. I joined the Breech Birth Australia Facebook group – an online community of people who’ve had breech babies or have an interest in breech birth (e.g. midwives). These women especially were a great comfort as the mind games with the healthcare system really began.
After the ECV attempt we met with another obstetrician (we got whoever was on duty that day). That doctor was very pro-caesarean for breech births, saying that he concurred with the Term Breech Trial’s conclusions that caesarean was safer than vaginal breech birth. He was honest about his and most of his colleagues’ lack of experience with vaginal breech birth, saying that he didn’t want to practice on us. It was clear that if we stayed at that hospital I had little choice but to consent to an elective caesarean the next week at 39 weeks. It all felt wrong – like a decision made out of fear.
Changing hospitals
At home I shot off emails to doctors at the larger hospital in our city and to a doctor interstate who specialises in breech births and advocates for them if the conditions are right. I considered paying for a private obstetrician in another interstate city who also specialises in breech births. Luckily a drastic late dash interstate was not required. We got an appointment at the other hospital in our city. We saw an older doctor with a kindly manner who would have been practicing long before the Term Breech Trial all but halted vaginal breech births in Australia. He was objective in setting out the risks and benefits of both vaginal birth and surgical birth for breech babies. He assessed our case on its merits, agreeing that there were no other contra-indications for vaginal birth. He also agreed that there were benefits for both me and the baby of a trial of labour before a caesarean. Most importantly he respected our right to choose which option to take. He made me feel empowered to make the right decision. A senior midwife also spent a good amount of time with us reviewing our birth preferences document. I came out of the hospital with a big smile on my face and a huge sense of relief. It was a simple decision to transfer hospitals. I could put all the negativity from the other hospital behind me and focus on getting back to envisaging a positive birth for my baby. Still, it was not an easy decision. Ultimately, it came down to a combination of gut instinct and a confidence that, having no contra-indications, I was a good candidate for a vaginal breech birth.
So we waited for labour to commence. We waited about two weeks. A couple of times during those two weeks I second-guessed myself. Was I choosing vaginal breech birth for the right reasons? Was it truly about what was best for the baby or had I been brainwashed by reading too many stories about orgasmic vaginal birth? Was I putting our doula’s image of feeling like a goddess during labour ahead of the health of my baby? My gut instinct told me that the right decision for us was to go into spontaneous labour and give a vaginal breech birth a go. My partner and I took on board the medical advice we had received, however, and agreed that if it didn’t go like clockwork we would consent to a caesarean.
Pre-labour and labour
On the evening of Friday 2 March at bedtime I began having regular light contractions. They continued throughout the night. Laying on my side made them stronger so I got on my hands and knees and waved my butt in the air for thirty seconds about every six minutes. I was amazed that I could sleep between contractions. I kept my excitement in check - I knew this was only pre-labour. At about 3am I noticed some blood when I went to the toilet. My partner rang the hospital, as we were a little unsure about when to go in – we’d been told not to stay at home too long because of the breech position. Thankfully the midwives didn’t see any reason to come in and told us to stay at home. This was just as well because by morning the contractions eased. We spoke to our doula in the morning. She said she had had cramps that night and was wondering if things were starting with me. (My mother, a former midwife, says she had cramps when her sister went into labour on the other side of the world.) The doula told us to get plenty of rest that day as contractions might start again at night. I slept for quite a few hours that day. In the evening my partner went out to a football game and I did a bit of vacuuming. Sure enough, after dinner the contractions began again. This time they were a bit stronger. My partner went to bed and I stayed up. At this point we both thought the night could be similar to the previous one. Gradually the contractions got stronger – I found a standing position with my nose and hands against the wall worked well. At 1am I felt my waters begin the break. It was like I had wet my pants a bit, not a great torrent. I was relieved that the fluid was clear. I got a towel to stand on near the wall in case there was a big gush, but the fluid continued to leak lightly into the pad I’d put on to keep an eye on the colour. I noticed by this time that the contractions were getting closer together as well. I woke up my partner. We called the hospital. They advised that it was time to come in. We called the midwife who was on-call for us, and the doula. They would both meet us at the hospital.
My partner got all the bags and me into the car. By this stage I did have to stop walking and talking during contractions – this was it! I climbed into the passenger seat of the car, kneeling and facing the rear window. My partner turned the key in the ignition. We heard the pathetic whimpering sound of a car with a flat battery! Our super-reliable Subaru that has never broken down and has always been serviced on time wouldn’t start! Thankfully we had borrowed my mum’s old ‘battle truck’, an ageing but hardy four-wheel drive, for the last few months of my pregnancy. My partner transferred all our stuff and me into that car. I got into the same kneeling position and we set off in the rain on the 20-minute drive to the hospital. I spent most of the time with my eyes shut and breathed and moaned through about 4 or 5 contractions on the way there.
At the hospital
We arrived at the hospital at about 2.30am. The doula had prepared the labour room wonderfully. The lights were dim, the aromatherapy scents were lovely (although upon entering the room was the only time I was conscious of them). It was really cosy and such a comfort to see her there, smiling at me. The only thing I remember annoying me in the room was the ticking clock above the bed. But I was quickly able to tune it out once I established my rhythm. We met the midwife who I instantly felt comfortable with. They put two foetal monitors around my belly. We had consented to this as a precaution because of the breech situation, although looking back the baby never did get distressed so they weren’t really necessary. Luckily the monitors were cordless and waterproof - I don’t recall them being a distraction. Then the doctor on duty asked if she could examine me. I lay on the bed and parted my knees. She gently felt inside me. Although I had told the midwife previously that I didn’t want to know how dilated I was, the doctor told me anyway. I preferred not to know because I wanted to get back in my trance and not think about anything to do with time and numbers. As it turned out, it was good news though – I was already at 5cm and the cervix was quite thin.
After a little while I found a pattern – between contractions I sat on a big soft chair with my eyes shut, possibly taking microsleeps, and during contractions I stood up and leaned over the bed with my forearms resting on pillows stacked on the bed. During the contractions I shifted my weight from foot to foot, like a cat kneading on a soft cushion. The doula placed a soft mat under my feet so they wouldn’t get sore. I remember taking my dressing gown on and off a few times as I got hot and cold. I drank plenty of water and went to the toilet fairly often as I had been told to. At one point I had a nice hot shower as a bit of a break and then I got back into it. I used hotpacks and massage for pain relief and didn’t even think about drugs except to a few times when I observed that, as I had hoped, I hadn’t needed to ask for any.
At 6am the doctor examined me. Again, she told me my dilation. Duh! Anyway, I was 8cm so it was good news again – I was progressing at 1cm per hour, bang on expectation. During the next period I remember feeling that I was nearly there, that soon I would be in transition. The contractions were getting stronger and I had a slight urge to poo (associated with wanting to push) but nothing I couldn’t hold back. I took this as a good sign but in hindsight I wondered whether I should have kept this to myself to buy a bit more time later.
Failure to progress
At 8am the doctor examined me again. I had no idea that two hours had elapsed since the last examination. It felt like 30 minutes to me. The doctor told me my dilation but this time it was not great news - I was still at 8cm. This was disheartening but I felt like I had lots of energy left and that I could keep going fairly easily. The doctor said she would give me another two hours. I lost my rhythm a little during this time and decided to have a shower to refresh and reset myself for the last 2cm. The doula poured a little aromatherapy clary sage essence into the shower.
While I was in the shower I could hear people talking in the labour room. I knew something was up but decided to ignore it and stay in the shower a little longer. When I’d had enough of the shower and turned the water off my partner came in. I think it was him who relayed the extra information that the doctor hadn’t told me before – the baby was not descending. The specialist on duty had been consulted and had advised a caesarean before the baby became distressed due to ‘failure to progress’. As soon as the c-word (caesarean) was in the room I felt the game was up. The faces of my partner and the doula, more than their words, told me that they believed the caesarean was justified. I didn’t question the advice. In retrospect I wonder whether I should have but by then I had already come so far out of my labour trance that I felt it would be too big an ask to re-establish myself into the zone I needed to be in to get to 10cm. It was as if my cervix began closing as soon as I heard the word ‘caesarean’. Indeed, my contractions became less intense and less frequent from that time on. I consented to the caesarean. I cried briefly with disappointment as my partner hugged me.
I summoned all the concentration I had to read and sign a consent form (I had to read it aloud to myself and follow the words with my finger like a child learning to read). The lights were flicked on and my partner and the doula hurriedly packed up their bags. A gurney was brought for me and I was wheeled down to theatre. In just a short time my contractions had weakened significantly – I was able to talk through part of them and they became spaced out. Although I was sad that I was going to have to have surgery, I was also excited – I now knew that within about half an hour I would meet our baby.
The caesarean
When I got to theatre several staff introduced themselves. I remember telling them I was a little scared and asking that everyone be respectful of the occasion – I had visions of surgeons discussing cricket scores as they sliced me open. I needn’t have worried though – everyone was very caring and extremely professional. Nurses and the anaesthetist explained what would happen with the spinal block and asked me questions about allergies and past operations. They gave me a pillow over which to curl my body and told me to stay very still. I held a nurse’s hands. I had to wait for a mild contraction to finish and then they gave me a local anaesthetic in the lower back and inserted the spinal block. It didn’t take very long for my whole lower body to go almost completely numb.
They moved me so I was lying down and put the cloth screen up. My partner and the doula came in. I was very grateful that they let the doula come in as they often don’t allow doulas into the theatre. This meant that the doula could stay with me and my partner could go with the baby if anything went wrong with either me or the baby. There was a bit of description by various people about what was going on the other side of the screen and pretty soon I felt some rummaging around inside me. I felt some weight lift out of me and then the rummaging stopped. There were comments about her being out and I could see people on my side of the screen smiling as they looked over the screen. They lifted our baby girl over the screen and I saw her for the first time for a few seconds. I started crying with happiness – she looked complete and healthy! They quickly took her off to do her Agpar scores. I heard her crying and I knew she was breathing fine then. My partner cut the cord. They waited for the cord to stop pulsing before cutting it which is better for the baby. The doula told us later that this was the first time she had seen this happen at a caesarean – she was thrilled, telling me later I had made local history. Within a few minutes the baby was placed on my chest. I was just so amazed that she was real – pink and kicking, not the grainy black-and-white static image from our fridge door anymore. She looked perfect.
About this time I started feeling I couldn’t breathe. I started coughing and had to ask for the baby to be taken off my chest so I could breathe a bit better. My partner held her while I was given an oxygen mask and some type of anti-asthma drug to help me breathe. The operating doctor told me later that because I was coughing she put in a few extra stitches to make sure the suture would hold. I started to shake quite a lot too - a common side-effect of the drugs. The doula held my hand as all this happened. Apparently it takes about 25 minutes to stitch up the incision but it seemed quicker than that to me. Before I knew it we were in the recovery room and the baby found my breast just the way they showed us in the childbirth education classes. She took in a few drops of colostrum. I was still shaking quite a lot and they wrapped lots of blankets around me. Everyone commented on what a beautiful baby she was with her full head of hair and chubby cheeks.
When I got to theatre several staff introduced themselves. I remember telling them I was a little scared and asking that everyone be respectful of the occasion – I had visions of surgeons discussing cricket scores as they sliced me open. I needn’t have worried though – everyone was very caring and extremely professional. Nurses and the anaesthetist explained what would happen with the spinal block and asked me questions about allergies and past operations. They gave me a pillow over which to curl my body and told me to stay very still. I held a nurse’s hands. I had to wait for a mild contraction to finish and then they gave me a local anaesthetic in the lower back and inserted the spinal block. It didn’t take very long for my whole lower body to go almost completely numb.
They moved me so I was lying down and put the cloth screen up. My partner and the doula came in. I was very grateful that they let the doula come in as they often don’t allow doulas into the theatre. This meant that the doula could stay with me and my partner could go with the baby if anything went wrong with either me or the baby. There was a bit of description by various people about what was going on the other side of the screen and pretty soon I felt some rummaging around inside me. I felt some weight lift out of me and then the rummaging stopped. There were comments about her being out and I could see people on my side of the screen smiling as they looked over the screen. They lifted our baby girl over the screen and I saw her for the first time for a few seconds. I started crying with happiness – she looked complete and healthy! They quickly took her off to do her Agpar scores. I heard her crying and I knew she was breathing fine then. My partner cut the cord. They waited for the cord to stop pulsing before cutting it which is better for the baby. The doula told us later that this was the first time she had seen this happen at a caesarean – she was thrilled, telling me later I had made local history. Within a few minutes the baby was placed on my chest. I was just so amazed that she was real – pink and kicking, not the grainy black-and-white static image from our fridge door anymore. She looked perfect.
About this time I started feeling I couldn’t breathe. I started coughing and had to ask for the baby to be taken off my chest so I could breathe a bit better. My partner held her while I was given an oxygen mask and some type of anti-asthma drug to help me breathe. The operating doctor told me later that because I was coughing she put in a few extra stitches to make sure the suture would hold. I started to shake quite a lot too - a common side-effect of the drugs. The doula held my hand as all this happened. Apparently it takes about 25 minutes to stitch up the incision but it seemed quicker than that to me. Before I knew it we were in the recovery room and the baby found my breast just the way they showed us in the childbirth education classes. She took in a few drops of colostrum. I was still shaking quite a lot and they wrapped lots of blankets around me. Everyone commented on what a beautiful baby she was with her full head of hair and chubby cheeks.
Recovery and the first few days
After a brief time in the recovery room we were taken to the maternity ward. I was taking tablets for the post-surgical pain but they weren’t very effective. Someone came to examine me and when they touched the wound, the area went into a spasm. I screamed with pain – it was like a contraction and felt like the stitches were being ripped out. Before long a whole team of people surrounded my bed, trying to figure out what was going on. I was afraid that I was bleeding internally and that was what was causing the pain. After a few more contractions, through which I screamed my lungs out, they figured out that the syntocinon I was on was causing contractions. This is a drug they give to stop internal bleeding but it is also the drug they give to stimulate contractions in labour. (Note: this is my recollection but subsequent conversations indicate it is unlikely that I would have had intravenous syntocinon at this stage, so I could be mistaken.) They also gave me intravenous pain relief where I could control the dose with a click of a button. It took quite a while for the pain to recede but the intravenous pain relief was much more effective than the tablets. I had to have one of those oxygen tubes in my nose the whole time too.
It wasn’t easy recovering from the caesarean. On the second day they took the catheter out and I went back onto tablets for pain relief. Getting out of bed for the first time was very difficult. My partner helped me inch off the bed and into the bathroom. It took at least half an hour for me to walk a couple of metres. It was very painful but great to have a shower. My partner helped me do it all. I don’t know what I would have done without him. After a few trips to the bathroom with some help I was able to go by myself – dignity almost restored. It was still difficult getting in and out of bed though.
During this period Elsa was deemed to have some jaundice. To treat this they put her under bright UV lights for about 48 hours. She had to wear a little blindfold that kept coming off and she had to be naked except for a nappy. It made me a little bit sad to see her like that and I was unsure that it was necessary – my cousin told me that in the UK they just told her to put her son to sleep near a window and to let the jaundice subside over a few weeks. For her whole time under the lights Elsa did the startle reflex. Sometimes she did it every ten seconds or so. Jaundice makes babies very sleepy so we had to wake her up for feeds and keep her awake during feeds. My partner used an ice cube on her skin sometimes to do this. We also tickled her.
That time in the hospital was precious. We had two nights where Elsa grumbled and cried most of the night and two more peaceful nights. I was in a shared room for the first night and then we got a room to ourselves for the next three nights. My partner stayed the third and fourth nights on a mattress on the floor. I remember being euphoric for most of that time, marvelling at the brilliance of my body’s hormones and being utterly absorbed by Elsa.
Froggy legs
Elsa’s breech position gave her ‘froggy legs’. On our last day in hospital her hips were checked by a neonatologist and no problems were detected. Her legs gradually straightened out over the next few weeks. At six weeks she had the hip ultrasound recommended for all breech babies and was given the all-clear.
One month on
When Elsa was three weeks old our wonderful doula came to visit. It was lovely to see her again. She made childbirth something to look forward to, not something to be feared. And I now look back on the labour as something magical and enjoyable. We talked about the birth and discussed the one thing that had been playing on my mind since the birth – should I have asked for more time when the caesarean was first discussed? Did I give up on a vaginal breech birth too easily? The doula put my mind at ease, confirming that she thought the caesarean had been justified – although we don’t know what it was, there must have been some reason why the baby had not descended down enough by 8cms’ dilation. I felt a sense of closure upon hearing this. Elsa’s birth was the best birth it could have been. Now we’re setting about being the best family we can be.
After a brief time in the recovery room we were taken to the maternity ward. I was taking tablets for the post-surgical pain but they weren’t very effective. Someone came to examine me and when they touched the wound, the area went into a spasm. I screamed with pain – it was like a contraction and felt like the stitches were being ripped out. Before long a whole team of people surrounded my bed, trying to figure out what was going on. I was afraid that I was bleeding internally and that was what was causing the pain. After a few more contractions, through which I screamed my lungs out, they figured out that the syntocinon I was on was causing contractions. This is a drug they give to stop internal bleeding but it is also the drug they give to stimulate contractions in labour. (Note: this is my recollection but subsequent conversations indicate it is unlikely that I would have had intravenous syntocinon at this stage, so I could be mistaken.) They also gave me intravenous pain relief where I could control the dose with a click of a button. It took quite a while for the pain to recede but the intravenous pain relief was much more effective than the tablets. I had to have one of those oxygen tubes in my nose the whole time too.
It wasn’t easy recovering from the caesarean. On the second day they took the catheter out and I went back onto tablets for pain relief. Getting out of bed for the first time was very difficult. My partner helped me inch off the bed and into the bathroom. It took at least half an hour for me to walk a couple of metres. It was very painful but great to have a shower. My partner helped me do it all. I don’t know what I would have done without him. After a few trips to the bathroom with some help I was able to go by myself – dignity almost restored. It was still difficult getting in and out of bed though.
During this period Elsa was deemed to have some jaundice. To treat this they put her under bright UV lights for about 48 hours. She had to wear a little blindfold that kept coming off and she had to be naked except for a nappy. It made me a little bit sad to see her like that and I was unsure that it was necessary – my cousin told me that in the UK they just told her to put her son to sleep near a window and to let the jaundice subside over a few weeks. For her whole time under the lights Elsa did the startle reflex. Sometimes she did it every ten seconds or so. Jaundice makes babies very sleepy so we had to wake her up for feeds and keep her awake during feeds. My partner used an ice cube on her skin sometimes to do this. We also tickled her.
That time in the hospital was precious. We had two nights where Elsa grumbled and cried most of the night and two more peaceful nights. I was in a shared room for the first night and then we got a room to ourselves for the next three nights. My partner stayed the third and fourth nights on a mattress on the floor. I remember being euphoric for most of that time, marvelling at the brilliance of my body’s hormones and being utterly absorbed by Elsa.
Froggy legs
Elsa’s breech position gave her ‘froggy legs’. On our last day in hospital her hips were checked by a neonatologist and no problems were detected. Her legs gradually straightened out over the next few weeks. At six weeks she had the hip ultrasound recommended for all breech babies and was given the all-clear.
One month on
When Elsa was three weeks old our wonderful doula came to visit. It was lovely to see her again. She made childbirth something to look forward to, not something to be feared. And I now look back on the labour as something magical and enjoyable. We talked about the birth and discussed the one thing that had been playing on my mind since the birth – should I have asked for more time when the caesarean was first discussed? Did I give up on a vaginal breech birth too easily? The doula put my mind at ease, confirming that she thought the caesarean had been justified – although we don’t know what it was, there must have been some reason why the baby had not descended down enough by 8cms’ dilation. I felt a sense of closure upon hearing this. Elsa’s birth was the best birth it could have been. Now we’re setting about being the best family we can be.
