13 May 2014
VBAC with epidural (39w 5d)
Baby 2.47kg
21 June 2012
First birth with emergency C-section (37w 4d)
Baby 2.985kg
My first birth was a C-section not because there was a
life-threatening situation but because, according to my gynae, I would be too
tired after waiting for so many hours. Being inexperienced, I went to hospital
soon after my water bag burst, despite having read that I could wait, because I
had called the hospital and the staff asked me to go in. My contractions
started on the way to the hospital, where I spent the night.
The following morning, my gynae came and suggested epidural
to relax my cervix so that it could dilate faster. I trusted her judgement and
agreed even though I had wanted a drug-free birth. 18 hours after admission, I
had dilated 6cm. It was around 8pm then and there were probably around 5 people
including my gynae in my delivery room. She advised me to get a C-section so
that I wouldn’t become too tired. One of the nurses said, “You should listen to
your doctor.” Today, I know I might have had a natural birth had I waited
longer and not blindly trusted my gynae.
After the birth, my gynae said that my future births would
have to be C-section. I was not told this beforehand! It took me a while to
come to terms with what had happened.
At the beginning of my second pregnancy, I went online to
research about having a normal birth after a C-section. To my relief, it was
possible and I was a good candidate for a VBAC. However, I could no longer go
back to the gynae who delivered my first child. I searched online for a gynae
who would be supportive of VBAC and discovered to my disappointment that there
are very few. In fact, I found only one. So I went to this gynae. It was
uneventful except near full term when he mentioned a scan to see the thickness
of the C-section scar to determine if I could still try for a VBAC. He had
never mentioned this scan before. Fortunately, from the scan I was still
suitable for VBAC.
I read as much as I could about the labour process, and positions
to adopt during contractions. I also joined a VBAC support group on Facebook. There
are many stories of doctors who say that they are open to the idea of VBAC at
the beginning of a pregnancy, but start to discourage mothers from trying for
one in the third trimester. This is true even in Singapore . It really helped to read
VBAC stories regardless of whether they were successful, as they prepared me to
keep an open mind and gave me tips on how to avoid another C-section. My plan
was to labour at home for as long as possible, not take epidural, and keep
mobile the whole time. However, things did not turn out entirely the way I
wanted.
My second labour lasted 22 hours, starting with my amniotic
sac leaking at 2.30pm. I spent 17 hours labouring at home. When I reached the
hospital at around 8am the next day, I was 4cm dilated. The nurses kept telling
me that I had to inform them early if I wanted epidural. Because my baby’s
heart rate dipped every time I had a contraction, I was not allowed to take the
monitor off. I was confined to the bed lying on my side. My husband had to
massage my lower back to relieve the pain with every contraction.
The pain increased in intensity and I took to shouting! Then
I found that pushing relieved the pain. A nurse came to give me entonox to try
to give the baby oxygen as his heart rate still dipped with contractions. The
gas helped me to follow the urge to push. By then I was 6-7cm dilated, and from
previous experience I thought I still had a long time to go before the baby
came out, so I wanted to give in and take epidural. But the senior nurse,
seeing that I could still cope, said to wait till my gynae arrived.
When the gynae arrived I was 8cm dilated. He said my baby’s
heart rate dipped due to head compression during contractions, and that was
normal. I don’t know if he knew that I mentioned taking epidural, but he told
the nurses to give me epidural and left the room. The anaesthetist pressed
something on my entonox mask to increase the speed of the gas, which was a great
relief! I had spent the whole night working through contractions and eaten very
little for breakfast so the gas was a great refresher. After administration of
the epidural, two nurses came in with the gynae and they began setting up to
prepare for delivery. The gynae said something that sounded very strange: “I am
going to help you.”
The pain had reduced and was replaced by a strong urge to
push. The baby crowned with the first push. Vacuum was used during the third
push. It was painful; the epidural had not fully set in yet. And the baby was
out. He had meconium on him. Gynae injected oxytocin to induce delivery of the
placenta, and stitched up some tears.
