Meimango's Pregnancy Journey, STEPS, Sharing

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Meimango’s pregnancy journey

Week 29

It seems strange after having experienced almost three years of motherhood, that natural childbirth is still an untried experience.  And although it would be an exaggeration to say that I was afraid, the sense of unchartered territory is very real.  I’m in the throes of formulating a birth plan and if all goes well, I’m headed for a VBAC (vaginal birth after caesarean).

In a sense, it would be easier to have another caesarean section.   The last time, when my son was discovered to be breech at 38 weeks, he arrived safe via elective caesarean section and I recovered as well as can be expected from major abdominal surgery.   I was disappointed that the birth was medicalised, but knew I didn’t want to take any further risks, with only a handful of midwives in the UK trained to deliver natural breech births.   In my limited experience, the outcome was positive.

So why try for a natural birth this time?  A repeat caesarean was one of the first options my local midwife presented to me.  She said that I was “within my rights” to try for a VBAC; a seemingly odd turn of phrase.   I had always imagined that midwives would be eager to champion unmedicalised labour.   Why didn’t she immediately draft me into the ranks of the initiated? What was wrong with me?  I know, at 37, I’m no spring chook and I’m considered ‘high-risk’.  (Not a comforting label.) Though, as I understand it, the greatest age-related risks are to do with conception and pregnancy, rather than childbirth.    And the evidence stands that VBACs have less associated risks than repeat caesareans.   The only greater risk a VBAC poses is a slightly greater chance of uterine rupture.   It’s a serious risk and potentially devastating, should it occur.  But whenever I read information like this, a vivid memory flashes before me.  I’m lying on the operating table after my son has been delivered, I’m bewildered but happy, and the consultant congratulates me and then says, very directly and unprompted, “There is no reason why your next child cannot be delivered vaginally.” I hold onto that utterance. So different to my midwife’s cold admission.

So I’m going to try for a VBAC.  A VBAC is more natural than a caesarean, but to what degree do I want my birth preferences to state natural birthing?  Pain relief?  Environment?  Birthing methods?

I have a TENS (Transcutaneous electrical nerve stimulation) machine floating around somewhere.  It stimulates the nerves in the back to relieve pain during the early stages of labour. I’ve lent it to friends who I’m glad have had the opportunity to use it.   Some of them said it worked brilliantly for them, and others said it was just annoying.  So, fingers crossed, I’ll have a chance to see how it works for me.  First stage of pregnancy – sorted!

About a week ago, I bought a hypnotherapy cd specifically for VBACS to give me some visualisation techniques to help with the birth.   During my son’s pregnancy, I watched several clips on YouTube showing women giving birth with great focus and self-managing their labour using hypnotherapy.   I was in awe of their concentration and strength, and promptly bought a hypnotherapy cd.    I remember using it religiously around this time in my pregnancy and gaining confidence in my ability to birth.  And although I didn’t have occasion to use the technique, it did make me feel more in control of my own process and comfortable with the decisions I had to make in the lead up to my son’s birth.   I’ve listened to the new cd once now, and would love to be able to use the techniques for myself. So, second stage of pregnancy – sorted!

But if only it were that simple…  I don’t know what my pain tolerance will be like in labour.   I remember being frightened and unable to move in severe pain, several hours after my caesarean.  No one told me I would experience contractions post-surgery.   Likewise, during my miscarriage, the pain was unexpected.  The gas and air (etonox) supplied by the ambulance crew was gratefully received.  And I can only imagine that the pain of labour will be much greater than either of these experiences.  So I can’t rule out using the drugs, especially if labour doesn’t seem to be progressing.   Though, I know some drugs increase the likelihood of labour slowing down.  The last thing anyone wants is a cascade of medical interventions.

It all seems to be about weighing up the odds.   How does one create as close to a perfect environment for giving birth, without sacrificing the health of your baby and yourself?   In order to give myself a good chance of a successful natural birth, it would be best to be in a relaxed environment.   The ideal conditions being low lights, familiar sounds and smells, unwatched… almost the opposite of a hospital environment.  I think I’m going to need all the visualisation techniques I can muster.   However, I would be a fool to refuse medical intervention if it proves to be the only  means to a safe birth.    Unfortunately, with chronic shortages of hospital staff, leading to tired and overworked medical teams, some very poor decisions have been made by employees at my particular maternity hospital.   I’ve heard and read in the media of several tragic incidents over the past few years, which would cause any prospective patient to be wary.   I need to have my faith restored in my hospital to know that they have addressed the issues which contributed to medical negligence.

I would love to have a look around the hospital beforehand and become acquainted with the wards, but due to mrsa, swine flus, etc., tours are no longer permitted.   I have so many questions about my preparation and choices during each stage of labour.  Each hospital is very different in what it will permit, and what is expected of its staff.  I hope I will be able to meet with a consultant and have my concerns about the hospital addressed.  I’m due to see my midwife in a fortnight and I’m hoping she will have some of the answers.