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Posts Tagged ‘breech’

Well, i’ve been meaning to give an update on my VBAC situation for a week or so now, but unfortunately have been pretty busy with Lilly and her chicken pox - which is on the way out now, thank goodness.

Well, first off, we went to see the Supervisor of Midwives at the hospital last week. All in all it was a really helpful experience. She had had a read through my notes from the last labour and shed a bit more light on what happened and why. (My birth story – although it is an epic – is here in case you’re interested).

The main new pieces of information she gave me were as follows. Basically, re the failure to progress, I was stuck at 4cm for the best part of at least 6 hours. We went into hospital at around midnight, I was 3cm dilated. By the time I had my c-section, which was 11am the next day, I was still only 4cm. I can’t help but think the lack of mobility (because of the monitoring and the epidural) won’t have helped that, but to be fair, they can’t be the only reason.

When we went into hospital, at 3cm dilated, the monitor was showing the baby was already a little distressed – her heartrate was dipping with each contraction, but then recovering again. This could have been due to many reasons – even something as daft as her squeezing the cord with each contraction. Because they did not know why, they let me continue in the hope that I would progress quickly before the distress got any more pronounced. Unfortunately, the opposite happened, and the distress worsened at a much quicker pace than the dilation progressed. Therefore, a section was inevitable. And I suppose when the registrar was overenthusiastically breaking my waters very early on without warning me what he was going to go, and when they were hooking me up the drip to speed up my contractions, they were trying to get me to deliver before the distress got worse. Again, this is something I have never had explained to me, and makes me feel a little happier about what happened when and why.

The Supervisor of Midwives put forward a theory – which I’m not quite sure I accept to be honest – that perhaps my pelvis was too small and therefore the baby was never gonna come out naturally. She said there was swelling on the baby’s head, so she had obviously been pressing down on my cervix very hard, but it wasn’t opening enough to let her through. This again was news to us, as we were told at the time that the blood tests taken from the baby’s head at the time had come back “fine”. The first registrar I saw in this pregnancy – who had also read my notes – had suggested that this failture to progress might have been because Lilly’s head was turned slightly in the wrong direction, therefore she wasn’t pressing directly on my cervix and therefore it wasn’t dilating as it should have been. In my totally uneducated opinion, this sounds a more plausable option. I don’t think my pelvis should be particularly small – in fact, I’ll feel very ripped off if I have some kind of unnaturally small pelvis – if I did I’d expect to be a size 6 or something, but I can assure you I am anything but! Also, I kind of think that surely you’d only know if your pelvis was too small if you had dilated to 10cms but then the baby got stuck?!

I asked about how much mobility I can have with the continuous monitoring. She said I can sit on a ball, on a chair, on a stool etc, or sit upright in bed. I don’t have to be lying down. But she said I will have to make some kind of agreement as to how much, and how often, I am monitored with my consultant, who I’m yet to see.

Apparently my consultant – she is a woman (which I am pleased about) and she herself has just returned from maternity leave (which I am also pleased about – she has had a baby herself!) which is why I haven’t seen her in person yet. The Supervisor of Midwives said she is “pro-vbac” so we’ll wait to see what she says. I have another appointment on the 8th of June, and the midwife said she’d make sure I see my actual consultant, and that she’ll also try to come to the appointment as well, now that she knows my case.

The Supervisor of Midwives was positive, but she was also cautious. She really was telling me that my last c-section did happen for a reason, it was unavoidable. Yes, there were things that they could have done better, like communication with us to help us understand what was happening and why. But the outcome was probably pretty inevitable. In a way though, that helps me to come to terms with it and understand it. For a long time after Lilly was born I just couldn’t accept what had happened and why. I felt like it was all unneccessary and needn’t have happened that way. Now, after speaking to people about what actually happened, and why, and weirdly enough, watching One Born Every Minute (a scarily real-life documentary about life on a normal labour ward) I’ve come to realise that these things happen, they’re unavoidable and they happen for a reason. I feel a lot less strongly about the way Lilly was born. I’ve accepted it. I hope this one will be different, but if it isn’t, it isn’t.

One thing which came out of it was this. If I walk into the hospital in labour this time, and i’m put on that monitor, and it shows the same problem trace with the heart rate dipping with each contraction, the wisest option is to ask for a section there and then.

But I still believe that no two labours are the same, and I live in hope that this one might be a bit more straightforward and that maybe I can still achieve the vbac I really want. If I can’t do it this time, I’ll never do it.

Oh, and in other news – baby has turned! I saw the midwife at 36 weeks and she confirmed it. Great relief!

I am now stepping up the raspberry leaf tea and hoping that baby is gearing up for a successful entrance into the world!

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Well, I finished work today to start my maternity leave!

I’ve had a really lovely day, with lots of kind things said and lots of lovely presents, not only for me and the baby but also some presents for Lilly too!

It feels really great to finish. Work itself hasn’t really been so bad, it’s the getting up in the morning and getting ready, driving to and from work and then coming in after a full day, exhausted and having to look after Lilly for a few hours before bed. I must also say that I am feeling VERY “pregnant”. I can remember last time feeling like everything was loosening up and I was starting to feel a bit like my hips and everything were slightly wibbly. I think that was only in the last few weeks, but i’ve already been feeling like that for a couple of weeks this time. I’m also getting lots of Braxton Hicks contractions, but nothing that resembles “real” contractions. I feel much bigger and more cumbersome than I ever remember feeling with Lilly – I really feel like I’m dragging myself around a bit!

I’ve done some bouncing on my ball, and now I’m just hoping baby has turned and is no longer breech. If she has, I’m not aware of it, and I don’t know how I would tell. I couldn’t get to sleep straight away last night, and baby was moving lots, and I was trying to feel whether I could make out a hand or a head at the bottom of the bump… it was inconclusive! I really hope she has moved!

I have an appointment with the supervisor of midwives now – on Tuesday. I’ve written up my new VBAC birth plan (as I want it to be) and I’m going to take that along. Continous monitoring and mobility being the main issues. So I’ll see what we can agree on.

As far as Lilly goes, we have come to a sad conclusion this week: it is the end of the nap. Her sleeping has been up the wall for a few months now, and only in the last week have we enjoyed a few nights of continous sleeping. And only when she hadn’t had a daytime nap. Yesterday, she had an hour’s nap in nursery and hardly slept a wink last night. That sealed the deal! No sleep today, so lets see how well we do tonight… fingers crossed.

It’s a shame becuase I was really hoping she’d still be napping while I was on mat leave. But it wasn’t to be. RIP daytime naps, you will be missed!

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Well, 34 weeks pregnant today and only a week until I finish work.

I had my midwife appointment today and all was fine – baby is still breech though so I need to get bouncing on my birthing ball, or, as midwife suggests: “going on all fours with your bum in the air”!! I go back at 36 weeks, and if little Madame is still breech I’ll be referred for a scan at Warrington. Hopefully she can “turn it around” before then, anyway.

I’m also thinking about starting on the raspberry leaf tea. Last time I didn’t start drinking it until about a week overdue – then I decided to guzzle it by the gallon load. Don’t know if it helped or not, but labour did start two days later. I’ve read a study which says that if you have one cup a day from 32 weeks it makes the second stage of labour shorter, which can surely be no bad thing. I wasn’t brave enough to try it as early as that, but now I’m 34 weeks I think I might give it a go.

I’ve also made the call to the hospital about seeing a Supervisor of Midwives re my VBAC plans. I spoke to somebody on the labour ward just now, and get the impression that, unless I’m a bit pushy, I might get fobbed off a bit. Being pushy isn’t really in my nature so I need to pull it out of myself a bit, I think.

In order to arm myself with everything I want to know, everything I want so say and what I want them to help me with, I’ve just been looking over my VBAC research, my draft birth plan and also re-reading Lilly’s birth story to work out what it is I do and don’t want this time.

(In a nutshell – last time there was an awful lot of intervention – waters broken without warning, blood taken from baby’s head, numerous attempts to put monitors on baby’s head, continuous monitoring and not much mobility because of suspected fetal distress, failure to progress, need to have c-section, failed epidural, general anaesthetic. Phew)

So, in order to get my head straight for when and if I finally get to talk to somebody who will help me agree a birth plan that I’m comfortable with, one which might actually lead me to have as good a chance as any to achieve a VBAC, here are the outpourings of my mind…

Things I did not like about last time:

  •  Continous monitoring meaning I wasn’t very mobile, leading to failure to progress (which is what they are helpfully proposing for this time too)
  • Waters being broken early, and with no warning that they were going to be broken (scary, unpleasant, no need)
  • Gas & air not helping – perhaps I wasn’t doing it right? (Please god let it help this time!)
  • Monitor being put on baby’s head – three failed attempts!! (painful, awful)
  • All the checks for fetal distress (water’s clear, blood test from baby) came back clear, yet fetal distress was still assumed from the off. Why?
  • Having an epidural put in – didn’t like the big needle – grumpy anaesthetist didn’t help – and he carried on even though I was having a contraction – which made me cry – and might have been one of the reasons why the epidural eventually failed
  • Side effects of epidural – shivering, being sick. Will this happen again? What is the alternative, pain relief wise? Pethedine?
  • Epidural not being able to be topped up when it came to c-section – leading to general anaesthetic instead. What are the alternatives? Spinal block?
  • Being told that, once bloods have been taken from the baby’s head to check for distress, this has to be done every half an hour? (felt like a threat to make me agree to a section)

As a result of all the above, my birth plan so far reads as follows:

Birth plan for Baby No.2

  •  My last labour resulted in an emergency caesarean under general anaesthetic – something I am very keen to avoid this time.

 

  •  I want to be kept informed of what is happening at every stage, and why it is happening

 

  • I understand that labour is unpredictable but I would like as little intervention as possible in order to allow my labour to progress naturally. My aim is to achieve a VBAC and to avoid an emergency caesarean.

 

  • If possible, I would like to wait until at least 7cm dilated before my waters are broken. If it is thought necessary for my waters to be broken, I want to be told about this IN ADVANCE and be told the reasons for it.

 

  • I am open minded about having an epidural, if possible I want to wait until after 5cms dilation so as not to increase the risk of an emergency c-section

 

  • I understand that fetal monitoring will need to be carried out, but I wish to remain as mobile as possible throughout labour, so would like this monitoring to be done intermittently, not continuously. I would like to avoid having a monitor attached to the baby’s head unless this is deemed a necessity for medial reasons.

 

I feel a bit like this birth plan is all negatives – basically DON’T ANYBODY TOUCH ME!!! LEAVE ME ALONE AND I’LL HAVE THIS BABY IF YOU DON’T MIND!!! But that’s the way I feel, a little bit.

My last birth plan reads like a fantasists list to Santa. The only things on there that happened was my request for Lilly to be given vitamin K by mouth (which was hospital policy anyway) and for Tony to be given the baby in the event of my needing a section under general anaesthetic. Whoop de Whoop.

Anyway, all this could be scuppered if Little Miss stays breech. And I know Tony is secretly hoping she does, because he thinks a planned section would be easier and less stressful. He does support me but I know he can’t really understand why I want to put myself through childbirth when I don’t really “have” to.

It feels good to write it all down. I just hope I can be as clear about what I want when this Supervisor of Midwives person calls me back. I don’t really want to be fighting these battles on the day I’m in labour.

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Well, I am now totally “out of the closet” at work, in the family and with friends, which feels good!

But just as I thought the morning sickness was fading a little it seems to have reared its head again – I felt terrible all day yesterday. However, I’m starting to think it might have been connected to not drinking enough water… I usually drink water all day at work but didn’t have much to drink yesterday, and today, as I started feeling a bit peculiar again, I started drinking and it seems to have kept it at bay. So, maybe I have a bit of a strategy from now on!

It’s also worth reporting that I had my swine flu jab last week - at 13 weeks pregnant. The jab itself was fine - my arm ached like crazy that night though and if I wasn’t pregnant I would definitely have been reaching for the pain killers! It’s still a bit sore a few days later, but nothing too bad. I feel glad that I’ve had the jab now as I’m protected and don’t have to worry when I hear horror stories about women dying in labour or after having emergency sections.

Aside from that, there’s not much new to report, suppose I am just getting impatient to start feeling kicks now… although it will likely still be a few weeks yet. I have my 20 week scan at the end of January, and I think with the excitement of Christmas and Lilly’s second birthday that is going to arrive so quickly… and then I’ll be half way through the pregnancy!!!! Quite scary really, and I think time is just going to fly by…

I have an appointment with the consultant in between Christmas and New Year where hopefully we’ll be able to discuss the birth – both Lilly’s and the one I want this time. To be honest, I have a bit of a fear about this birth – and a bit of a realisation this morning that this might get worse as time goes on. I suppose the crux of the matter is I really, really want a VBAC. But I’m so scared that I won’t be able to do it – that when it comes to the crunch I won’t have the determination or resolve to birth naturally, that they’ll offer me an “easy way out” and I’ll take it. Do I really want it as much as I think I do? Can I be strong enough? Can I cope with the pain and the pushing and everything? Will i get the support I need or will I be unlucky and end up with a horrible midwife who isn’t encouraging and doesn’t help me?

And on the practical side – will they want me strapped down on a monitor, unable to move around and help things along naturally? Will they start messing with me too early on then put me on this stupid “time restriction” by which I must’ve reached a certain dilation or they threaten me with more intervention or surgery?

This time the birth feels like such an uncertainty – something that I perhaps have little or no control over. If the baby is breach, they’ll be telling me to have an elective section. If the baby is overdue, likewise.

I haven’t thought all that much about the birth yet, but as you can see, when I do, I feel a bit overwhelmed with worries. It wasn’t like this with Lilly at all – I just trusted that all would be fine, and it never crossed my mind that I’d have a section, let alone under a general anaesthetic. I really don’t want that again – I just want to be normal!

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