Sunday 8 December 2013

The joy of a VBAC: M's birth story.

Every mum I've supported during labour and birth has been amazingly inspiring.
Every mum has taught me so much.
Every mum has reminded me of the strength a woman carries within.
Every birth has challenged my ideas of how a woman can give birth.
Every birth has challenged me as a woman, as a mum, as a doula.
The last birth I have attended and the last mum I supported, perfectly fit in what I wrote above.

M taught me that it is hard to be strong and follow your instincts, but you can do it, no matter what.
Ms and her daughters M birth story, is again a first one of because this birth has been the first VBAC I have attended, and because M has been my first last-minute mum!
Most of the mums who have contacted me so far (apart from my friend who let me know she wanted me as a doula just 4 weeks before her due date) have usually called me between 12 and 16 weeks of pregnancy, while M contacted me when she was almost 35 weeks. We met two days after I got her enquiry because I thought If Im going to be her doula we dont have too much time to get to know each other before baby arrives!

When we met we had the usual chat I have with mums, M told me about her past birth experience (not a very nice one) and what she expected from this new birth, and, since we are both Italian, we spoke about our lives in Glasgow, our bilingual kids and all the usual things two people of the same nationality might chat about when the meet and live abroad.
M told me straight away that she was more than happy to have me as her Doula also because she really liked the idea to have an Italian-speaking birth supporter with her.
So, the following week we started our antenatal meetings.
I got to know M, and met with her partner too, P.
M had a previous C-Section (4 years ago) and this time she wanted to have a VBAC. When she found out she was pregnant the second time, she thought shed go for an elective CS, but after speaking to her care providers and after reading a bit about VBAC, she changed her mind and she was now sure she wanted a natural (as much as possible) birth this time. And she read online that the support of a doula is among the things suggested to help you have a successful VBAC. Then she contacted me.
So in three weeks we tried to get to know each other as much as we could, I tried to understand Ms reasons for a VBAC, and those of her partner who, on the other hand, would have felt more comfortable if M had decided to have an elective CS. We chatted about all things related to childbirth and the perinatal period. We also met once outside of our official meeting just to have a nice cup of chocolate together. And then the time for Ms baby to be born arrived.

Her due date (which I strongly prefer to call guess date as due reminds me of an expiry date, and babies do not expire!), the 15th of November, arrived and went, but since Ms first baby was 9 days late this delay was expected. But the full moon was around the corner and I had been joking with M and her mum about the fact that this baby would be born with the full moon.
So Saturday 16th of November around lunch time I got a text from M saying that she had had some signs of impending labour, but contractions were still far apart so she would keep me updated. I told M to call me as soon as the contractions were getting 30 minutes apart (and not less) because this was a second labour, and even if her first labour lasted three days, this could be a lot quicker (and it was indeed). I was all day on my toes, checking every 5 minutes if the signal on my mobile phone was good or if I had missed a text or a call. But things were quiet, so before dinner I texted M to tell her Id go to bed early as I thought shed call me quite soon. I went to bed and read a bit and I had just switched off my bedside lamp when the phone rang. It was M: contractions were 5 minutes apart, we didnt even had time to stay home, I just called a taxi went to hers and then, together with P we went to the hospital. Excitement and thousand of emotions kicked in. I send a message to my doula circle as I feel protected and positive when my doula fellows know Im with a laboring mum. During the journey by car (a very short one) M was worried that maybe she wasnt progressing even if she had very close contractions.
We arrived at the hospital around midnight, and there I spent an hour and 15 minutes waiting to have news of M, because only 1 person is admitted with the mother in the Maternity assessment unit (I dont know if my fellow doulas feel the same, but the waiting outside Maternity assessment is for me one of the worst parts of my doula life). After an hour had passed I started thinking that maybe M had already been transferred to the labour ward and the midwife had just decided not to let her doula in, or that maybe things were not going as well as we hoped; I paced the corridor where I was waiting restlessly for an hour! Then, finally, P came out and told me that she was 1cm dilated but since the contractions were quite strong they decided to keep her in and to move her to the antenatal ward, they just wanted to monitor her for 15 minutes more and then well all move upstairs to the new ward. One of the MW told M that her friend couldnt go with them though, but when M told her that I was her doula she said shed see, and I was allowed with them. I was there to support her, so how was I suppose to do it if they allow me in the ward? The cheek of some people ;).
We have been showed to a small single room. It was, by then, already 2am, M had strong contractions, and she was doing really well! We asked for a birth ball so M could sit on it, I gave her some back massage as she felt sore, and she kept breathing through every contraction, coping really well. Between Ms contraction Id shortly chat with P, as we didnt have much chance to know each other before, but I was always worried that M might find this annoying (tricky bits of a doulas life I guess). At 2.45 Ms waters broke, so I went to call the MW who said she would come and check her. A few minutes passed and M felt as if she wanted to push, so I went out again to call the MW who said, before I could speak Yes, yes, two minutes and Ill be there so I told her, Its just that M feels like pushing, Ops! goes the MW, and there she is in the room in no time :).
The waters had definitely gone, so the MW said it was better to move to the labour suite. M was really sore, and she was feeling tired, she felt she couldnt even walk. Still in the antenatal ward M had been asked what she wanted to do about pain relief, and M was thinking of an epidural; the MW said she would have seen to it.
Once upstairs in the labour suite the monitoring started, so a few straps were placed around Ms bump to check babys heartbeat and mums contractions. M was still able to change position, not to freely move around, but she could still change position and the midwife in charge has been very helpful with this.
Once upstairs the MW checked M and told her that she was progressing really well, she was 5 cm, so she felt she might actually do without an epidural, and she also mentioned that her blood test showed she had high white cells, so an epidural was not advisable. M started then using G&A and shes been offered, diamorphine. M didnt want to have diamorphine because she reckons that during her first labour diamorphine slowed things down. So we had a chat with the MW who explained us that because she was progressing really well and she was already 5cm, diamorphine wouldnt slow down her labour. Apparently this happened the first time because she was only 2cm dilated when shed being given it. So M kept for a while just with G&A, but she said she was very sore and tired so the MW suggested again if she wanted diamorphine and M agreed.
Contractions were still strong (actually stronger) and closer, but M was asleep between contractions. P was a bit concerned because she was falling asleep, so I told him it is quite common (and quite good!) for a labouring mum to fall asleep between contractions.
M kept changing position so to help baby to move down; babys heartbeat was fine and the MW was happy with Ms progress, and so was M, even if she was really sore.
The hours were passing by, and M was really doing well: G&A (maybe just for some kind of placebo effect rather than a real one) was constantly at hand; every time P moved a few steps away, shed just call him back saying GAS GAS!
Meanwhile, in the best doula tradition, I wasnt doing a lot, I was just whispering to M how well she was doing and reassuring her. She started saying Non ce la faccio piรน” (I cant do it any) and I told her this was, albeit strange, a very positive thing, feeling you cant go on, means you are getting closer. Id ask M from time to time if she could feel a proper break from pain between contractions (just wanted to make sure that her scar was ok), and she said she was fine. Soon after 5, M was already 7 cm, so still progressing very well, and at 7 o clock she was fully dilated. The MW, had complete trust in M and told her that she would let her do what she felt like doing, so if she wanted to push just to follow her instincts; she also told her that in an hour, if the baby wasnt born yet, shed help her with pushing. But she was really positive, she kept telling M she was sure she could do it, and the baby would be born before the end of her shift.
But things dont always go as planned or hoped for. So after an hour the baby wasnt born. The MW finished her shift and another one arrived, another nice one.
She started directing Ms pushing a bit more. Telling her where to push or how she could direct all her energy inside in order to push effectively. So far every birth Ive attended has had at least one funny moment. And this one is no different. The MW told M that it was better, instead of vocalizing during her contractions, to take a deep breath in and then send all the energy and the breathing inside, with no noise. At this point P  asked me Butthe MW told M not to vocalize, sowhen is she suppose to scream?. I wish I had been a fly in the room to see my expression when I looked at him and I said Thats TV then I think I surely smiled, because I really found it funny: we are so used to see births on TV where mums scream their eyes out, that a man who sees his wife being quiet is lead to think there is something wrong.
So M started pushing with the help of the MW around 7.50am. The MW and I kept supporting M and telling her how well she was doing, the MW would call me to see the babys head to reassure M that things were moving on, and she was really really supportive. After half an hour the doctor came and checked M, she said that she was doing well but she needed her to push more efficiently, because the babys heartbeat had become quite irregular and she thought it wasnt wise to keep her pushing for much longer. Still she said M could have some more time. M was really tired at this point: she shoke her head with every push and I didnt know if she just meant that she couldnt do it any more or if she meant I cant do differently from this. The MW suggested M to put her legs on the stirrups and M accepted. Maybe it is at this point of this labour that I have my main regret. Sometimes I think I could have helped M to change position rather than let her stay on her back and in stirrups; but at the same time I knew she was tired and she had already told me she didnt feel like moving. Stillsometimes I think of it.
At 9am the baby wasnt born, so the doctor came in and said she would give M a helping hand, and she told her that at this point the best thing to do was to go for a forceps delivery. M was tired, and the doctor explained her that this would have been an easy one because the baby was quite low, but because the pushes where not working well enough and the baby didnt come down further, they couldnt just go for an episiotomy (as suggested by the MW). M agreed on using forceps and at 9.15am a wonderful baby girl was born! She started crying straightaway and for a few good minutes.
I started crying too: M had done it, she had her VBAC, things didnt go totally as planned, but she still managed to have her baby the way she wanted to, and to acknowledge the strength of her body and of her mind.
There is something truly magic about birth: and I can see it every time I observe the face of a mother soon after she has given birth. The same face that only a few minutes earlier looked in agony, was now, soon after the birth, bright and blooming.
When the MW asked M if she wanted the baby straight on her tummy for skin-to-skin, M was still so overwhelmed that she looked at her as if she was asking, Shall we go for a coffee?. She had immediate skin-to-skin, and I just couldnt help crying.
I know that 75% of women who try a VBAC will succeed, but being able to witness it, is something else. It cant be explained with a statistic


P.S: every time I read this story to proofread it, I remember something new, or I just change some words. So this is Ms birth story today. If you ask me about it in a few weeks, there will be surely something new. J