Was a planned cesarean the best decision…
My second birth story.
I write this post with less than a week to go until Pud turns 1. I know everybody says it, but wow thats gone fast!
Early in 2015 and we had decided it would be a lovely for a brother or sister for Pops. I’m not sure how nature does it. If you had asked me 6 months earlier if baby number 2 was on the cards I would have told you no way! I felt like we were just about finding our way in life as a family. I felt settled as a mum and was starting to enjoy being able to take my daughter out and have the sort of spontaneous fun that didn’t require a bag of nappies, bottles, baby food, spare clothes etc!
However at some point, for some reason I got broody. Really broody. I could start to visualise a fourth member of our family, a little brother or sister for Pops. I could do this without getting anxious or recoiling in horror but instead I smiled at the thought.
Luckily a few months down the line and we were happily expecting our second baby. It seemed different this time. Of course I had the same worries as first time. Would I miscarry? Would the baby be ok? I had all the usual concerns along the way. This time though, I just felt more relaxed about it all. I also had a distraction – Pops!
Thankfully my pregnancy progressed well, with no serious complications. I just had to decide which mode of delivery I would go for. A Vaginal Birth After Cesarean (VBAC) or an elective cesarean. Now, if you have read my post ‘The feeling of failure as a struggling new mum’ you will know how much I struggled with the fact I ended up with a cesarean. So you might find my final decision a little surprising.
Being a midwife I have to say I did feel the pressure to go for a VBAC. VBAC is a completely viable and prime choice for most. It is completely safe with most women going on to have a completely normal, uncomplicated birth. It just didn’t feel right for me. I worried that I would have a long drawn out labour again resulting in an emergency cesarean. It was the recovery period that was key for me. Recovering from surgery first time round was horrendous. I felt like a cripple for weeks. I only felt like I stood up straight after about 6 weeks.
I know with hindsight that most of my feelings postnatally were as a result of crazy hormones, sleeeeeep deprivation and attempting to kid myself that I had adjusted to motherhood immediately (because that’s what everyone does, right?). I did however feel that the recovery from my emergency cesarean and having to put aside my independent streak, somewhat contributed to those dark days of feeling like a failure. I also feel it had a massive impact on my inability to breastfeed Pops.
I did not want to feel like that again. I knew there were no guarantees but if I could minimise the risk then I would. I knew from friends, colleagues and women I looked after that the recovery from an elective cesarean was much more straightforward than after an emergency. This makes sense. After a long labour, tired, and having not eaten properly for a couple of days my body was mentally and physically exhausted. It had little reserve for the recovery period. Before an elective cesarean I anticipated I would be in reasonably good health, fed and watered and ready to take on the world…well my new baby at least. My chances of a successful VBAC were slightly reduced as I had never given birth vaginally before and my BMI was over 30.
I want to reiterate that most people will go on to have a very normal vaginal birth after a previous cesarean and that each individual has to consider their own feelings about each outcome, various factors and what is right for them. The rationale I discuss above was from my own experiences and feelings. Surgery carries with it it’s own risks. There is a risk of infection and haemorrhage and it impacts on the mode of delivery for any future pregnancies. After two cesareans, although it is now supported to have a VBAC the success rate of VBAC is slightly reduced and the risk of complications is slightly higher than after one cesarean. Once you have had a third cesarean the risks of infection, major haemorrhage an other complications increase further.
For us, we’ve always said that two children would make our family complete. I know, I know, I might want a third and that would be ok although a little risky. However I’ve no desire to be Britain’s largest family!
So we decided that an elective cesarean would be our choice.
Later in pregnancy we arranged a date for surgery. It was 2 days before the official due date. In low risk situations elective cesareans are about a week before the due date, however due to the doctors strike they weren’t booking as many women in as usual. This was ok though. There was still a small part of me that hoped I would go into labour, have a comparatively fast labour and avoid surgery. The overwhelming fear of a repeat of last time though confirmed for me that we had made the right decision for us.
The night before the big day my daughter went off to her nana’s for a sleepover. I gave her a huge kiss and a cuddle that I wished could have lasted forever. I missed her straight away. My other half and I went out for a meal at one of our favourite restaurants, my last meal possibly for 24 hrs! I don’t think I slept much that evening. I was nervous, excited, missing Pops, thinking about those moments of finally getting to meet our new son or daughter and running over checklists in mind.
The morning came too quick, we had to be at the hospital bright and early. We arrived on time and shown to the waiting area where we waited and waited and waited! One other mum to be waited with us too. My other half decided to investigate the delay. A midwife promptly rushed in, told us they were extremely busy, the elective surgery was on hold and she would be back later. She left as promptly as she arrived. Just what you want to hear as you can smell bacon butties through the open window!
A couple of hours passed and still no news. So again we asked for an update. We were told that they were hoping to commence the elective surgery soon. Another hour passed and finally someone came saying they were going to get the first person ready. That wasn’t me. Oh well, at least our turn is in sight now or so I thought. Another couple of hours passed until finally we were called into a room to get ready.
My midwife was lovely. She soon learned I was also a midwife from my notes. After the long wait the rest of the journey was seamless. I had most of the theatre team introduce themselves prior to entering theatre (which actually makes a big difference). I’m used to theatres but for somebody who isn’t, it can be quite scary going into a room full of strangers and scary looking equipment.
Into theatre I walked, calm(ish) and excited and also trying my best not to flash my bottom through the large gap in my gown in the corridor. I had my spinal anaesthetic, a urinary catheter inserted, drapes…draped and then they did the usual tests to ensure the anaesthetic was doing it’s intended job. Minutes later laughter erupted as my son had a wee all over me. Yes, it was a little boy, our little boy, crying loudly and looking so beautiful. He was wrapped up and handed over to us. The tears rolled down our cheeks, a moment reminiscent from when our daughter was born.
Over in recovery, Pud was unwrapped and I was helped to initiate some gorgeous skin to skin time. His little body all warm snug next to mine. Bliss. My pain was minimal, I felt well, and I was given a bru and some toast (the most amazing toast ever). He had his first breastfeed without complications and all was well.
The worst part of the day was the fact that due to the delay, visiting time on the ward had finished by the time I got there. This meant I couldn’t see my little girl till the following day. I simply couldn’t wait to see her beautiful little face and the reaction when she met her little brother. I spoke to her on the phone and she sounded so excited but upset she couldn’t come to see us. I cried when I put the phone down. I missed her so much.
The next day she came in at the earliest time visiting hours would allow with daddy, she bounded in straight to her new baby brother cooing at him with a smile from ear to ear. It was a scene to melt hearts, well mine anyway.
I stayed in hospital two nights and went home to begin our life as a family of 4. This time, thankfully my recovery was great. The first 5 or 6 days I took pretty easy. My very attentive partner had everything under control. We went out for a short walk on day 4. After day 6 I realised I wasn’t taking regular pain relief. Thereafter I only took pain relief on an odd occasion. First time round I watched the clock in anticipation for the next dose!
I’m glad I made the decision for an elective cesarean. It was right for me. Yes it was a gamble, yes I could have had a vaginal birth and yes I could have had complications from the surgery. In the end all was good and this time I didn’t feel a failure. I felt like the proud mummy I should.
If you are wondering which path to take yourself, please note that there are numerous individual factors to consider. Please discuss them with your midwife and obstetrician. Here are the RCOG green top guidelines for you to peruse.