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My VBAC Story - Rebecca Bell

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Thoughts & musings on midwifery related topics for the April Education Newsletter. 

Rebecca Bell, mother, consumer, VBAC advocate


In 2015, I welcomed my first born, a divine baby girl.  Throughout the pregnancy I was cared for by a team of amazing MGP midwives, we had worked through all my birth intentions, and I was buzzing for a peaceful, unmedicated birth centre birth.  The first twinges of labour hit at 11pm on a Thursday night, at 40+8 weeks – and I was onto it! I knew about resting as much as possible during early labour, but I was just so excited and ready to experience the rite of passage of labour and birth, and meet the daughter I had been talking to for the last 9 months.  I loved how powerful yet soft and relaxed my body felt in labour, we had music and candles and essential oils, it was all happening and we couldn’t wait!  If only I could have known then that she wouldn’t be born until Sunday morning, with my husband and I absolutely physically and emotionally exhausted.  

My daughter ended up being birthed by caesarean section, after failure to progress in the second stage due to brow presentation.  

My biggest fear for the birth had been that I would be pressured into interventions I didn’t want, but that was not at all the case. As I transferred from the birth centre to the hospital, the obstetrician talked to me about my birth plan, and everyone I encountered was so respectful of what I had so desperately wanted versus where this birth was heading.  My MGP midwife ensured that the points under the ‘in the unlikely case of a caesarean’ part of my birth plan were carried out, including vaginal seeding, which puzzled a few people in the operating theatre but everyone just went along with it all with no questions or judgement, for which I am so grateful.  

In the days and weeks that followed I experienced low milk supply and slow weight gain with my daughter, which I found extremely stressful.  All I could feel was that I wasn’t able to give birth to her, and now I couldn’t feed her – what was the point of me!?  I engaged an IBCLC, who was wonderful and ensured we had a plan to get on track with the feeding and weight gain.  It wasn’t long before everything smoothed out and I could settle into my new role as a mama.

Fast-forward almost three years, and I am sitting here 38 weeks pregnant with my second baby, a boy this time, ready to VBAC.  From the moment my daughter was born, I knew my birth journey wasn’t over, and that I wanted to VBAC my next baby.  I read about how to increase the chances of successful VBAC - we were beyond the ‘18 months between babies’ window, and I had even lost a bit of weight to reduce my BMI.  I am also aware of the risks of multiple caesareans, and they alarm me far more than the risks of VBAC.  Of course, alongside the medical facts is that same profoundly deep desire to experience vaginal birth I felt during my first pregnancy, to labour and work hard, to push myself well beyond my limits, to feel my baby emerge and pull him straight to my chest.  And also like my last pregnancy, my biggest fear is feeling pressured to go down a pathway I don’t want to walk, with interventions I don’t feel ready for.

My husband, daughter and I relocated to Adelaide when I was 30 weeks pregnant – I had never even visited Adelaide before this!  Before we moved, I stumbled across an online community of Adelaide women who were able to direct me to other online groups where I could gather information, ask questions, and feel welcomed and supported by some incredibly inspirational women.  As I wasn’t sure where we would be living, and I knew nothing about the hospitals and their catchment areas, I decided to engage a private obstetrician for this birth.  Through these groups I was able to find an amazing obstetrician who passionately supports VBAC.  I had heard many stories about obstetricians who seem to be supportive of VBAC at first, but become less interested in the reality of VBAC as the pregnancy progresses, and I was determined to avoid this kind of care.  I have also engaged a doula for additional support.

Throughout my pregnancy, I have managed to avoid hearing from anyone in my birth team the dreaded phrase, “well all that matters at the end of the day is that you and the baby are healthy”.  I just hate that!  Of course I want a healthy baby!  But I am also a human being with hopes, dreams and fears, and my desire for a vaginal birth is completely valid.  I am more than just a vessel in which my baby can gestate!  I think about women starting their motherhood journey feeling empowered and strong by what they just achieved during the birth of their child (whatever their birth choices), compared to those that start already feeling stripped of any of their wants and needs, made to feel selfish for even suggesting they don’t just ‘think of the baby’ and book straight into an elective caesarean.  Mothers are made to feel like they need to sacrifice so much for their children, and this mindset can so often be seen right back before the baby is even born.

My VBAC journey has been paved with a few bumps along the way, most recently discovering my placenta is still slightly low lying, not having moved even 1mm since my 20 week scan.  It is also anterior, so my brain went straight to placenta accreta, one of the risks of caesareans, and especially multiple caesareans, I had read about.  As I lay there during the ultrasound, I felt my hopes of VBAC fading.  The beautiful midwife in my obstetrician’s clinic held me emotionally as I cried and cried over everything I felt I was losing and everything I was scared of.  No placating me or diminishing how huge this was for me, just acknowledging my grief and fear.  And my obstetrician has really shown her true colours, remaining completely supportive of my VBAC.  We have discussed what tweaks we may need to make to my birth preferences to accommodate this development, and potential hurdles we could face.  She’s heard my concerns about placenta accreta, and explained the ultrasound report to me that showed there is no sign of that.  I have one more scan to check the placenta again before the birth.

Once more, my primary fears of feeling like I am not in control of my birth choices have not come to rise.  I’ve never been told, “well that’s it, you have no choice but to have this intervention or that one”.  I am working with my birth team to ensure every possible pathway to VBAC remains on the table, and while of course I wish it were a bit more straightforward, I feel supported in my decisions, and I feel respected when we discuss potential reasons for deviation from these paths.  And for me, that is hugely important.  While I remain focussed on achieving my VBAC, for both my sake and that of my son, I rest easy knowing that I have surrounded myself with people that care about how much I care about this, and know that regardless of the outcome, I have set myself up with the best support network I can. 
 

Exciting update (16th April)

Vbac is awesome! Rebecca Bell

‘My baby boy was born on 11/4/18 at 41+6, via an intense and wonderful vbac! It was everything I had hoped for. The start of the pushing phase brought to the surface a huge crisis of confidence and a lot of fear, undoubtedly as this is where my first labour went awry. But through surrendering to the experience and trusting my body, along with the support and guidance of my obstetrician, doula, husband and the midwives, my son was born! 4400g, 55cm long and 37cm head circumference.  The sense of achievement, and the understanding that my body does indeed know how to birth a child is profound. We are all very happy and adjusting to life as a family of four!’
 


Managing your CPD and linking it to learning about Caesarean birth

REFLECT: Using the ACM Reflective Activity template, take a look at your practice and current knowledge in regards to cesarean births and then birthing after a cesarean. Consider how your practice aligns with the latest research and think about what you do to support women (what questions do you ask and do you really try to find out what they want and need?).  Then use this to identify where you might need or want to learn more. 

TAKE ACTION: Once you have a base line on your knowledge then perhaps WATCH one of our webinar recordings such as Support Vaginal Birth after Cesarean by thinking outside the box, or the Working with Birth in Theatre, or READ some resources, research or articles - there are a variety that have been published in the ACM's International Peer Reviewed Journal - Women & Birth;

ASSESS & REVIEW: Then when you have completed your continuous professional development activities don’t forget to go back to wrap up your learning by REFLECTING on all that you have addressed and learnt and consider how this might change your practice.  If you are a member you can do this in your MidPLUS portfolio, or you may just want to use a template or another resource.

ACM Resources and information for your CPD

  • You can access information about ACM webinars here
  • You can check out our recordings available in our shop
  • Or you might want to book into one of our upcoming webinars for this year in Our Events
  • Information about ACM Reflective Activities (and why we think they are important) can be found here 
  • Information on MidPLUS can be found here.  If you want to record your activities you must log into your member portal first. And MidPLUS resources can be found here.

About ACM Webinars

We have a new one every month.  If you want a particular topic addressed or you know of a fabulous presenter, please let us know at education@midives.org.au and we will do our best to incorporate your suggestion into our future schedule.

AND for ACM members ALL webinars are now free to access.  That is over $3000 value for our webinar library and $300 per year for our live webinars (so over 70 hours of CPD all for the cost of your membership).  

Know someone who is not a member that might be interested?  Get them to join and they too can access all of this CPD goodness with you - Join here