Louise's Caesarean

Following induction at 12 days overdue, Louise tells of her repeat emergency caesarean due to caesarean scar rupture.


After carefully considering the consequences I decided that I would accept the recommendation of the midwives/doctors at the hospital re induction at 12 days "overdue".

I knew that with induction there is an increased risk of uterine rupture, but as they were not going to use prostaglandins I thought that the increased risk was still acceptable. (Based on some tables that I had found on the homebirth website.)

My cervix was closed & posterior on examination at the hospital although soft so they commenced the induction with the Foley's catheter method.

This took about an hour to open my cervix to about 2cm dilation, whereupon I had my membranes ruptured.

I then was advised at this point that they usually commence syntocynon intravenously but I declined & we agreed that I would be checked in four hours - in four hours the cervix had partially effaced but not dilated any further, I was getting weak irregular contractions. (I'd never experienced a contraction before so this was exciting!!)

Being on a trial of scar & time ticking now I agreed to the synto drip. So far I had avoided the continuous monitoring & needles but for no longer. The monitoring was as if I was low risk i.e. at this hospital it was 1/2 hour on 1/2 hour off. After 1 &1/5 hours they stopped racking the synto up.

My baby was also posterior so I tried several positions that are considered helpful to encourage the baby to turn and although I was stuck at 3 cm for four hours, when they next checked me lo & behold he had turned nearly completely in the right direction. Much heartened I had one of those isotopic energy drinks & the contractions seemed to ramp up a notch. My lovely co-operative baby was responsive & happy throughout, unlike me. The contractions gradually got more regular, three close together followed by a rest (thank god) I'd been using gas & air and relaxation & breathing so far. An hour later the pain was much increased, the contractions relentless & I started to panic, as did my poor husband who had no idea how much his back massage was helping me to cope. At this point we both thought an epidural might be a good idea as the gas & air was not making any dent in the pain.

They set it up about 20 mins later & as they were doing the test dose I got the urge to push. If only I had known that I was fully dilated I might have had the courage to ride out what was transition, never mind. The epidural was in by that point.

It was here that things started to go pear shaped. The pushing urge , which I could not have ignored if I tried, really hurt, even with the epidural & the pain continued after the contraction had passed. After about three contractions I was in agony & the baby's heart rate was all over the place but gradually diminishing (I think I remember someone shouting its at fifty) ... loads of people in the room & the registrar says delivery in theatre now.

I was given a general anesthetic & my baby was delivered 10 mins later with an apgar of 4 rising to 7 at five minutes. He was transferred to the neonatal unit at the district hospital about seven miles away before I'd come round from the anesthetic.

They found that the scar had separated & torn either side, & the baby was in my abdomen, from where they delivered him. I lost about 800 ml of blood. It was fortunate that they were able to operate without any delay.

I was shocked when I came round & couldn't stop shivering for about three hours. I had pictures taken of my son but did not see him until the evening (he was born at 1 am).

This was the worst part of the whole experience; until I saw him I did not believe anyone who told me he was fine, thinking they were bound to say that anyway.

I was prepared for the possibility of a section this time, especially as being induced put my risk factor up. I'm glad that I had the opportunity to labour and the staff on the labour ward were brilliant at implementing the bits of my birth plan that were relevant to my situation. I felt fully supported in achieving my objective of a vaginal delivery & the outcome was as much a shock to them as me.

I managed to labour using gas & air to 10 cm dilation whilst on the syntocinon drip which was an achievement in itself and I'm glad to have experienced labour, which if I'd had an elective c-sect I would never have experienced.

At the end of the day it is I that will live with the choices that were made and I feel that they were realistic & I & my husband are of the opinion that the choices that we made given the facts available at the time were appropriate for us. I am going back to see a midwife counselor to go though my notes when things have calmed down at home, but this time around I fell much better about the whole process. I think that having researched VBAC extensively & taking a précis of relevant info in with me enabled me to really give what was informed consent this time, rather than having things done to me. It was this ultimately, which has enabled me to come away with a positive feeling after what was a very traumatic delivery. Of course with hindsight we would have done things differently.

I would not want this experience to put anyone else off trying for VBAC or hbac, it's the person who comes home with the baby who lives with the consequences of the choices that are made in labour & if more health professionals bore this in mind we may have a more woman- centered approach to childbirth.

Baby Peter is now doing fine & so am I

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