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Helen's story
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First pregnancy and birth
She had an easy first pregnancy. She had attended antenatal classes and made a birth plan. She was keen to have an unassisted birth and to stay mobile during labour. Around her due date her waters broke but she did not have any contractions. She came to hospital to be induced, but did not dilate. Further checks revealed that the baby's head was outside the pelvis. She was advised to have a caesarean and received a spinal block.
She had been emotionally prepared that she might need to be induced as it had also happened to her sister. However, she did not expect to have a caesarean and felt her antenatal care had not prepared her for the experience. She was disappointed to have missed out on labour and felt slightly odd to have a child without having experienced contractions. However, looking back, she did not feel there was any choice for her and she trusted the decisions made by the medical team. She was told that the shape of her pelvis might have prevented the baby's head from engaging and that this problem could repeat itself in future pregnancies. She would have liked to gain certainty about the reasons for her first caesarean at the time, but was told that such issues would be taken up as and when she was to have another baby.
After she had returned home, her caesarean scar got infected and she had to take antibiotics. However, this did not interfere with breastfeeding her son and she managed to feed him for 11 months. He was quite a sickly baby and she wondered whether this might be due to how he was born. Nevertheless, she thinks her caesarean was a 'good caesarean' in that neither her or her baby had any long-term complications.
Second pregnancy and birth
Her second pregnancy was planned and progressed as easily as the first one. She found it very difficult to decide about how to give birth to her second child. While part of her felt keen to attempt a vaginal birth after caesarean (VBAC), she felt pessimistic about her chances of having one and was afraid to end up with another emergency caesarean after a long labour. Her doctor and midwives told her to 'think positively' and pushed her to attempt vaginal birth, while her friends thought a planned caesarean would be less risky. Her main considerations were the length of recovery and having to look after her toddler. She changed her mind back and forth during pregnancy but eventually decided to 'give in' to the expertise of the professionals, though she would have changed her mind again if her 36 week growth scan had indicated a very large baby.
She went 10 days past her due date but eventually started contractions without induction. She came into hospital when she was 3cms dilated and was monitored closely because of her previous caesarean. When the baby's heart rate dipped, her doctor decided to break her waters and found meconium. As she did not progress much and the baby's head was disengaged, she was transferred to the operating theatre for an emergency caesarean. Receiving an epidural came as a relief to her and she subsequently dilated to 7cm. At that point, she was offered to continue with labour. But as she felt very exhausted, she chose to have the emergency caesarean instead.
Looking back, she felt her second caesarean was 'better and quicker', although she had more pain afterwards. She feels proud to have attempted vaginal birth but overall, the experience was traumatic and scary, as it took such a long time to make the decision about whether to have an emergency caesarean or not. Her baby had no complications but she had a very slow recovery, which she thinks is due to having gone through labour before the operation. She struggled to move around for the first few weeks and felt so uncomfortable lying down that she had to sleep in a chair rather than in a bed.
Overall, she is glad to have attempted vaginal birth but thinks doctors and midwives could have been more forthcoming in discussing the risks of different ways of giving birth. She thinks women might benefit more from talking to other women with similar experiences and would find it helpful to have support groups. |
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She has decided to attempt VBAC even though she does not feel overly optimistic and is worried about the possibility of uterine rupture. Played by an actor.
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And how do you want to deliver this time? What's your preference?
Well, obviously, just pop it out and my husband will catch it [slight laugh]. I, yeah, I obviously I would love for it to be natural and be no problem, but I think I'm kind of… I've been told off for being too negative, and you sort of tend to think that everything's going to happen that happened the first time. And you think, oh, I'm probably going to end up having a caesarean anyway. You know, so… it did sort of cross my mind to go for the, the planned option, but I've kind of decided to give it a go and see what happens.
Did you have any particular worries this time? I mean, obviously work out the way that you were going to deliver, but what are your concerns?
Well that… the chances of it… the wound rupturing… was one thing. I guess, my, with what I've chosen, my worry is that I'll give it a go and it'll have a long traumatic labour and then still have to have an emergency caesarean. So you end up feeling a hell of a lot worse than I did last time.
Yeah. And, and have you talked about that with the midwife or the obstetrician, these worries?
Yeah, yeah.
And has that helped at all?
They just kind of say, “Don't be so negative”, which… and, “Everybody's different”, you know, “Every pregnancy's different”,… dah, dah, dah.
So how involved do you feel in the decision this time?
Well, I know it's my choice, but because I'm so indecisive and I find it so hard I guess I've gone with, I've just gone with what they've advised really. So… obviously, it's my decision, but I've, yeah, I've gone along with what they've advised. |
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After her previous caesarean, she was told that the shape of her pelvis might cause her problems in future pregnancies but at the time she had no plans of ever getting pregnant again. Played by an actor.
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Were you given any information at the time, after you'd had a section about the fact that it might have implications for a future delivery? Did anybody kind of debrief you afterwards that because you'd had a section, that you might have to deliver by section again the next time around?
Only one thing was said to me, and then it wasn't ever followed up. One thing was… who… I think it was my midwife, my local midwife that I know, said to me that it was unusual, the reason why I had a caesarean, that his positioning, that was quite unusual and that I may have to… it could have been because he had a big head, and the shape of his head, or it could have been me, it could have been the shape of my pelvis and that, if I was ever to get pregnant again, they would probably scan or x-ray or something, my pelvis to see. Because obviously if it was my shape, that it would have to be another caesarean. And, I remember her saying that, but at the time you think, “Oh, I'm never getting pregnant again!” But then I remember saying to my doctor at some point about it, when obviously it did come into my mind that I might get pregnant again, and he said… sort of dismissed it and said, “Oh, well, that's something we'd think about if you got pregnant again.” And then once I was pregnant, I did mention it to, either him or my midwife, and they said, “Oh well, we wouldn't scan you now you're pregnant” or something. So it was… that has remained, has remained something a bit strange really, that that was said and then… nothing after. It never seemed to be the right time. |
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She struggled to make up her mind about how to give birth and almost wished the decision would be taken out of her hands. Played by an actor.
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And what kind of information have you wanted with this pregnancy? Have you thought about different things this time?
Well, obviously the, the main different thing has been obviously I've known that I'm going to have to have this decision at the end of what option to go for, whether, you know, the planned or the natural. And it's sort of been at the back of my mind, but I've been very indecisive all through really, which is me, I guess. I am an indecisive person, and because it's something so important, it's just really horrible actually, I'd rather… My sister's second delivery, she… her baby was breech so, you know, the option, it was sort of- the decision was taken away and I, I kind of almost wished that, that this baby was breech, you know. So I wouldn't have to decide and it wouldn't be, you know, if it was the wrong decision, that it wouldn't be my decision… which is really silly. |
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Her husband thought a caesarean would be safer, but he left the decision up to her. Once she had decided to attempt VBAC, he was supportive of that choice. Played by an actor.
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He was kind of… at the beginning he was kind of like, “Well, it's up to you, but I think you should probably have a planned caesarean.” Because I think he was quite worried about what happened to me before, and that it could have been potentially quite dangerous if they hadn't, if the midwife hadn't have been as vigilant as she was and kept checking his head position. If they'd have kept inducing me, he could have sort of come out like superman. It could have been quite… so I think he was, he was thinking that might be the safer option and maybe, you know, we've done it before, kind of thing, it's, you know.
And I was kind of agreeing with him, but then as it's gone on, he's like, “Oh, it's your decision, I, you know, I can't say”, you know… which is not that helpful really.
So how does he feel now that you've decided to have a trial labour?
I think he also is relieved the decision's been made, because I think he was completely fed up with me and as soon as I said, “Okay then, I'll give it a go” to the doctor And he said, “Oh, you've made the right decision”. |
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She thinks women who don't have a strong preference about how to give birth might find it difficult to make up their own mind and be swayed by the views of health professionals. Played by an actor.
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I think it is completely your choice, it is completely your decision, but it depends I suppose what kind of person you are; how swayed you are by the professionals. Because somebody like me, I think, being really indecisive, it's, it's going to affect me a lot. But I have known of people that have been like, “No, I'm having a, a planned caesarean, I'm not messing around with all that.” And you know, they know exactly. And I kind of in a way wish I were like that, or like, “No, I really want to go natural, you know, because of the achievement and that's what I want to do.” So ultimately, obviously it is completely your decision but I think if you're kind of indecisive and you're not really sure, you are going to be affected by the doctors and the midwives, because they are really, “You should give it a go and.” |
