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Carol's story
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First pregnancy and birth
She had an easy first pregnancy without complications and did not feel worried about giving birth. While she was hoping for an unassisted birth, she was reconciled that things might not go as planned. During the pregnancy she developed a hernia, but it did not cause her any problems. Her and her husband moved to another town so she had to change midwife but she did not feel this was a problem. She had attended six antenatal classes, made a birth plan and felt generally well-informed.
She came to the hospital in the evening after contractions had started and laboured through the night. Her husband helped her manage the labour and in the morning, she had dilated to 8cm. She felt she was coping well with just breathing techniques and gas and air for pain relief. When her son's heartbeat started dropping during contractions, she was offered a caesarean. She felt well looked after by the hospital staff and trusted their recommendations. Initially, an epidural caesarean was discussed but the cord had wrapped itself round the baby's neck and eventually her son was delivered by caesarean under general anaesthetic.
She recovered very well and was back up on her feet within a day of the operation, though she probably should have rested a little longer. Her son had no complications and she was able to breastfeed him without problems.
Second pregnancy and birth
Her second pregnancy 18 months later progressed almost as easily as the first one, though she experienced a bit more nausea and also developed another hernia. At first, she assumed that she would have to have another caesarean as the baby was in breech position and she thought the hernia might cause complications. Her consultant reassured her that the hernia did not present a problem but that a caesarean might be advisable if there were problems with the baby's growth. When the baby turned again and was found to be growing well at a scan two weeks before her due date, she decided to attempt vaginal birth as she was keen to be mobile again quickly. Her consultant was supportive of her decision and told her that she would be monitored closely.
Talking to other women had made her slightly worried about the pain associated with any stitches required after a vaginal delivery. But the very speedy arrival of her second child meant she did not have to endure a long labour. She was woken by pains at night, arrived at hospital, was met by her consultant, had her waters broken and delivered her baby with the aid of a ventouse - all within the space of two and a half hours. Unfortunately, her placenta became stuck on her previous caesarean scar, so after delivering the baby she was given an epidural and taken into theatre to have the placenta removed. The epidural assisted with the few stitches required. She recovered well and was able to return home the next day.
She has a very practical attitude to birth and her decision to have a vaginal birth after caesarean (VBAC) was mainly because of the shorter recovery time. In making the decision, her conversations with her consultant and midwife were more influential than other sources of information. The fact that they thought she could do it and that she had managed to labour to 8cms with her first child gave her confidence. She thinks it is important that women seek information to understand why they had a first caesarean, as this knowledge will help them to make the decision about how to give birth next time. |
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The antenatal classes provided her with all the information she felt she needed. The breathing techniques she had learned turned out to be very helpful during her labour.
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And what kind of information did you want with it being your first pregnancy, what kind of things did you feel that you'd want to know about?
Can't really remember now whether I… because we had the antenatal classes which provided probably the wealth of information that I needed and they thought of spoke through… talked you through breathing, the epidurals and the breathing was something that I was very conscious of and I sort of was practising that and I think that's what helped my labour. Because I seemed to cope just with the breathing and the TENS machine, but it probably also helps I found out I have a high pain threshold as well, so [laughs]…
And how many classes did you attend?
About half a dozen.
And was that local?
Yes.
Okay, and now thinking back, what kind of information did you want to receive?
Probably what they provided us with, yeah, because…
There wasn't anything that you feel that you could have really done with knowing?
I don't think so, no, no. |
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Her family expected her to need extra support, but she felt so well that she went shopping the day after her caesarean and was told by her midwife to slow down.
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I had quite a good experience, although it… although it was an emergency Caesarean, I recovered very well, because I know when…When they decided we were going for emergency Caesarean, my husband had actually phoned his mother to say, “Oh, [wife's] going in for Caesarean,” and she must have then phoned her other daughter who'd had a Caesarean before and said, “Oh Mum, you're going to have to get down there, [husband's] not going to know what to do.” Because she… it took her quite a long time to recover, she couldn't get out of bed, but I was completely different, I was… I had the Caesarean on the Monday, and they advise you to sort of stay in bed really on the Monday, but on the Tuesday they like you to start walking about a little bit, and that was absolutely fine, fine for me, yeah.
In fact, I probably was on my feet probably a little too quickly, I was walking out to the shops and found… I was getting a bit tired and when the midwife came to see me she said, “That's far too far for you to be walking,” because I hadn't actually been advised about… that was probably something about after a Caesarean, so I'm probably one of these people if I can manage it I'll go and do it, but probably wasn't aware that I probably shouldn't have been walking that far. |
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She had considered a caesarean but changed her mind when doctors encouraged her that there was no medical reason she could not give birth vaginally.
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I had my mind made up for some time and then I… at one point I had decided I would quite like a Caesarean because at least we can plan, can sort [son] out with childcare. And I had it in my mind that the hernia must have caused me complications before so therefore I'm going to have to go Caesarean, and the baby was also breech. But it's now turned and I've been advised that the hernia didn't cause the complications last time so I'd quite like to try for the natural just for the fact that you can be more mobile afterwards.
Because I got to eight centimetres last time fairly comfortably, and apparently it's quite a common thing for your first labour for your cervix not to move completely, but eight centimetres is quite a good result to get to, and the fact that I can be more mobile afterwards so that's why I've chosen to sort of go that way now. But sort of still been quite open-minded, if I have to be Caesarean at the end of it, then that's fine. |
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Her main concern in making the decision for a VBAC was to recover as quickly as possible rather than a great urge to do it 'naturally'.
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I think I was always sort of a bit afraid of like the pain that people sort of tell you about, but I think as I said before, I've got quite a high pain threshold, what did I have? In fact, I just had gas and air, that's all I had but… but I didn't have any sort of… some people I think have a, a great urge that they want to do natural and I, I didn't have that great urge, that I was desperate to do it natural. I think the, the main reason I wanted to try natural was, as I say for the recovery rate afterwards. |
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Talking to a consultant about why her previous caesarean had been necessary and learning that similar complications were unlikely to happen again encouraged her to try for a vaginal birth.
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I had decided to try, try natural. Initially, I was undecided but having read the leaflets the- I can't remember whether it was the hospital or the midwife gave me, about caesarean or natural birth, I had a consultation with the consultant and I had various questions to ask then, and she answered my questions and put my mind at ease about trying for a natural.
She'd gone over sort of what had happened in my previous birth and she said well there obviously weren't any medical complications there, I think it was due to the fact that the cord had got wrapped round the baby and they were concerned about his heart rate, but she said that it may not go that way again, and I would be monitored throughout.
And did you feel confident that you, you would have a fair chance of a natural delivery?
Yeah, she, she seemed very confident as well. So that was quite reassuring. |
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She thinks in reaching a decision it is important to understand why the previous caesarean was necessary.
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If you were to give a message to other women facing this decision, what would you say to them?
Well I think, understand what your complications were before, why you had to go to caesarean, and I think ultimately that will define as to whether you can try natural for your second birth. |
