After a traumatic first birth, Yolande decided on an elective caesar for her second baby. But then it was time for her third baby and her heart was set on a natural...
Yolande’s first baby (a boy) was born in December 2004. “It was a very traumatic birth,” recalls Yolande. “My waters broke when I was 37 weeks. When I went to the hospital, labour was induced because although I was dilating slowly, my baby’s head was not engaging. The induction made me feel really sick and when the pain became unbearable, I was given an epidural.”
Yolande was monitored and dripped, and was frustrated because she felt strapped to the bed and couldn’t move around freely. “By the time I was fully dilated I was so exhausted and nauseous that I was unable to push properly so the suction cup was used, and when this failed the high forceps were used and I ended up with a third degree tear,” says Yolande. Her baby was admitted to NICU due to respiratory distress and she was only able to hold and breastfeed him 24 hours later.
Understandably this birthing experience influenced Yolande’s decision (17 months later) to have an elective caesarean for her daughter’s birth. “I’ve never regretted this decision,” Yolande says candidly. “I was honestly not in the right place either physically or mentally to even consider natural birth at the time.”
In the second half of 2008, Yolande found herself pregnant again, but this time she felt very differently about giving birth. “Somehow, I was at peace within myself, and from the start, I wanted to make this a positive birthing experience. My doctor was against VBAC, but I persevered and researched my options. At 26 weeks, I visited the Midwives Obstetric Unit in Linksfield (Growth Spurt Midwives at Linkwood) where I discussed the possibility of a VBAC with them. They were so positive and reassuring; I knew that I had made the right decision.”
Yolande was assessed by a gynaecologist at 32 weeks and again at 37 weeks who gave her the green light for a VBAC. She lives in Pretoria and the drive to Linksfield is almost an hour in flowing traffic. From 36 weeks she had strong Braxton Hicks contractions, but Yolande was unperturbed when she went beyond her due date.
At a routine check-up, the expectant mom was surprised to find that she was already five centimetres dilated (she thought they were particularly strong Braxton Hicks contractions!). Because the labour was progressing very slowly, Yolande went home to see to her children and returned to the birthing unit at three in the afternoon.
“My waters then broke at five o’ clock and from then on, it was hard work for all of us. But this time was different. I felt empowered and in control – even towards the end when the midwives had to encourage me to keep going, when I thought I didn’t have it in me to see this through,” recalls Yolande. The birthing ball and walking around were useful distractions from the pain, and a small dose of Pethidine was given at about 9pm. Then Yolande stepped into the bath for her water birth and after spending half an hour in the water, her baby girl (weighing 3.95 kgs) was born.
“The bonding with my daughter, skin-to-skin with my body in the water, fulfilled the wish I had for this baby, and I would certainly encourage all women who can, not to give up on their dreams to have a natural birth,” says Yolande. “The experience was definitely worth every minute of labour.”
Advice to moms
“My biggest joy with this birth was feeling empowered as a woman. I did not feel sidelined as the patient who is uninformed and unable to make decisions about her body and her birth,” relates Yolande.
Her advice to women wishing to have a VBAC is:
- Explore your options thoroughly.
- Speak to the right people.
- Research and ask the right questions.
- Get support (“My husband was amazing!” says Yolande.)
- Trust your instincts.
- Don’t feel intimidated – equip yourself with answers by reading up everything you can about VBAC.
- Sometimes even doctors aren’t informed enough. They will almost always only recommend what they feel comfortable with.
- Be prepared for the unexpected.
- Always try to keep an open mind and know that at any time during the labour, circumstances for a successful VBAC could change.
- Understand and come to terms with this possibility.
A special thank you to midwife Henny de Beer for her extensive research and literature study: “Maternal and neonatal outcomes of women who attempted a vaginal birth after caesarean section” (M.Cur 2009) that was used to compile this article.