My Planned HBAC

Susannah tells of her HBAC (homebirth after caesarean) and the support she received from her doctor and midwives, allowing her to have a birth that was a such a positive experience and contrast to the induced labour that lead to the caesarean birth of her first son.

My first Baby was 10 days overdue and routinely induced. After 30 hours of "labour", a lot of intervention, and no moral support from the midwife on delivery suite, I was examined very roughly by a very horrible consultant who told the midwife to catheterise me and that I was to have a caesarean. I had been told that I was 9cm and he matter-of-factly said I was 8cm, which after so long and being so tired was a really demoralising thing to hear. He said his fingers were bigger than the midwife's. After screaming at him, he left the room and refused to come back in. When he eventually summoned up the courage, I just agreed, mainly through exhaustion I think, and Louis was born, and for a very long time I was totally miserable because I didn't feel that I'd actually given birth or that I was capable of doing so. The whole experience left me feeling inadequate and sad. I felt more and more that the whole procedure was utterly unnecessary. It was all horrible and has left me with an utter hatred of hospital's attitude towards what giving birth is. I do feel, however, that I should mention that the midwife on the ward was wonderful as was the anaesthetist.

I wish I knew then what I know now. I wouldn't have had the induction and would not have ended up with an unnecessary caesarean.

Ten months later I was pregnant again and delighted. We talked about home birth, but left it until later to make a final decision. Because of the previous section I was considered by the midwife and hospital fraternity to be high risk and was to see the consultant. So at the beginning of pregnancy, I did go and see her and the "consultant" was a 12 year old (it seemed!) assistant who was adamant that I had diabetes (because I had sugar in my urine) even though I told her I had had vitamins that morning, which, the nurse told me would have contributed considerably to the sugar trace, however the "consultant" told me I must have a glucose tolerance test and also that I was "lucky" to be able to have one. I just thought, Christ, 3 hours in a hospital bed, being monitored, worrying about Louis at home, and for what? To satisfy a load of over zealous hospital worriers who frankly only deal with "problems". I hadn't, at this stage, even mentioned home birth, but, actually, I couldn't be bothered, she was already treating my as if I was some kind of medical problem. A point I'd like to make is that, yes, I'd had a c-section, but only because of the hospital's intervention and attitude. Once they interfere, certainly in my case and many, many others, there is only ever going to be one outcome.

What with the typical unsympathetic approach from her, and the attitude of my midwife which was one of amusement at the thought of an HBAC, (she kept smiling and suggesting that I may change my mind, basically because it was some silly, irresponsible idea. She made me feel that I wasn't capable or intelligent enough or able to decide what I wanted even though I kept telling her about my research and instinct). I made the decision to have this baby at home. Therefore, I didn't attend the glucose test and didn't visit the hospital again, although my midwife kept on and on insisting that I should, she even started to ring me at home to try and convince me to go down the hospital line. I had definitely decided that I did not want to have any more to do with the hospital.

I had, by now, looked into the statistics of home birth and VBAC and spoken to a lot of people; I had made my decision; I knew that I was statistically more likely to have the natural birth that I so wanted at home and so I just said "No, I am not going to see anyone at the hospital full stop".

A friend recommended a doctor who was the only one locally who was pro home birth. We got an appointment the next week and he said he was more than happy to take me on for ante-natal care with a view to home delivery. He was great. Just what I needed, laid back, friendly and above all made it all very natural, which of course it is. My pregnancy went smoothly; there was no fuss, undue worry or concern.

Since my hospital experience, I was by now very dubious about due dates, and when mine came and went I wasn't bothered. At the back of my mind I suppose I was a bit worried about the possibility of induction again, but over-all I was filled with a huge sense of calm, positivity and determination. Not only to prove the cynical hospital lot wrong, but more to make my experience the one I wanted, and the best for baby and me.

I was fairly convinced I would be overdue this time as well, but 4 days after my due date I started to have niggling aches in my abdomen throughout the day and at about 6ish, while I was in the process of bedtime with Louis these feelings became a lot more intense and I said to my husband to get Louis into bed quick! I still thought it might all go away, but it became more and more something that I had to concentrate on, and stop what I was doing.

We had planned to be in our bedroom and all the towels etc were there, but I just went from the kitchen into my step-son's bedroom and didn't move after that. Nick brought everything downstairs into that room and called the midwife at 7:00pm and she came, I hadn't met her but she was lovely. I was 1cm and she said it probably wouldn't be until about 11:30pm that things started to become really established and to call her then. At 8:30pm the contractions were painful and Nick asked me if I'd like gas and air. My first thought was that this was still just braxton hicks and was I allowed to have entonox yet? Another contraction and I said yes please. The midwife came back at 9:30pm. I was 7cm dilated! Being told that felt like such an achievement. I had done it myself, naturally. Already it was so different from before. Things were progressing naturally and nicely.

My mum arrived as did two very nice midwives, a student midwife (who I'd met at my doctor's and who was lovely) and my doctor. From then on I just remember the determination in my head, and I seemed to find solace in having my eyes open during contractions, with the effect of the gas and air it helped to make me aware that I was OK, at home, in familiar surroundings and ultimately "here" and able to get through each contraction. I had pethadine in the fridge, but I suppose I was concentrating so much on what I was feeling that I didn't want the distraction and also I was, I think, scared that if I couldn't cope with just gas and air (I used 6 cylinders they normally give you two to start with) that I would end up in hospital

It was my hatred of that place that got me though the whole thing I think! My mum was the one I could hear, encouraging me and reminding to breathe etc; Nick was at my feet and I can remember seeing all the weird expressions on his face as, presumably, he could see changes going on down below! I was taken aback when I felt the urge to push and didn't relate that to birth. Nick helped me to feel the baby's head, but it felt so soft and didn't feel like a head, and actually I wasn't interested, I just wanted to get on with it! I could see the midwives getting things ready for a baby and I just thought, surely not - I'm not going to give birth am I? I was most aware of being scared that I was going to poo - I have been assured that I didn't.

It felt like I was suddenly being told to push hard, pant etc, all the things I'd seen on discovery birth programmes, but I couldn't make it real for me! I think I felt a certain amount of stinging but not as much as I'd imagined, I felt something uncomfortable there and then there was what looked like a huge grey thing covered in blood on my tummy!

I didn't cry or have a huge emotional outburst, but it was surreal and wonderful. Nick was crying and saying "You did it, you did it"!

I had torn and the doctor stitched me up which wasn't pleasant, and all I wanted was to be free and to be with my baby, but it wasn't all that bad and had to be done, anyway I still had some entonox which helped!

We opened the champagne, the midwives helped me to have a bath with Barnaby - I was amazed at how much swelling and blood there was. I guess I naively thought that natural birth wouldn't result in discomfort afterwards.

It took me until the next day, after some sleep, to contemplate what had happened and more and more as each day came I just felt such happiness and amazement that I'd actually done it and that he was here. I had no where near the amount of pain afterwards as I had with the section, I had a rubber ring to sit on which was the best thing ever, and began to become really fed up with feeling like an incontinent, uncomfortable boobed old woman but 2 weeks later and I was pretty much back to normal.

So from an induced 29 hour labour and a section I had a 5 hour, spontaneous labour and a natural birth. My scar didn't rupture and I feel like I've achieved what I think all maternal women want to feel. Everything feels complete now and I'm so proud of myself!

I feel a huge dept of gratitude to my doctor and the wonderful community midwives in West Norfolk who gave me such support. It is possible to have a home birth whether after a previous caesarean or not and god knows I wish there was more support for women who want to do it. I think actually that there is, you just have to believe in yourself and find it.

So now, we've had Louis and got through the difficult "new-born" crying, pooing, endless needing, to a stage where he is communicative and fun, to start all over again with Barnaby, another crying, pooing, needing baby - hurrah!!!!!

© Susannah 2005

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