Jackson's Birth Story (Ruth's VBAC after a preterm Classical)

Baby's name: Jackson Lucas
Born at 5:08am, September 26th 2011 at 39+4 weeks

The birth of our third baby has been so healing, in ways that words cannot fully describe. The heartache and pain of our losses, of our preemie experience and of the surgery that brought our prem into the world had been with me daily. Since delivering our third baby, those pains and the distress they brought have gone. This birth has been such a blessing, and I am amazed and overjoyed at what my body has accomplished. It is such a natural act, yet that is too often taken from us during our experiences of labour and birth. Delivering our son was the most empowering and awesome experience, more than I could have asked for. God has given us such a gift!

I am looking at our precious baby boy and all I can do is smile. The birth was perfect, absolutely amazing and unlike anything I could have imagined! To know just how beautiful this birth was, you have to know about my previous pregnancies and births.

Our daughter Caitlin Rose was delivered 5:09am 30th March 2009. The pregnancy was tough, I needed progesterone injections the whole way to maintain the pregnancy, I had hyperemesis gravidarum and I felt movement super early. We had not planned to have a baby, so it was a great adjustment for us after only 3 months of being together. (And me being told I was infertile…ha!). I had antenatal depression sparked by the shots, and an irritable uterus causing daily painful contractions. There were episodes of bleeding and mucous plug loss, and the whole pregnancy was rather less than enjoyable. I felt overwhelmed at being pregnant and the prospect of being a mum. But that changed the instant I held her in my arms! The labour was 2 days, she was a posterior baby. Thankfully I laboured mainly at home (well, at the beach, even hosting dinner for my sisters'-in-law at home) as I wasn't convinced I was really in labour. Eventually my husband had to demand that I get into the car to drive me to hospital as I wanted to stay home longer. We allowed a student midwife that I had met previously to come to the hospital for the birth, and we had a midwife taking care of us. That was great! We did wind up with a lot of people in the room as our baby girl became distressed and she was stuck for a long time. The staff were being prepped to take me to theatre, thankfully with some hands on assistance (manual dilatation) my student midwife and midwife delivered her. I had been labouring to my comfort, in the shower, hands and knees, swaying, squatting, however I felt I needed. And we had planned to deliver her in a good position. Unfortunately I was not in a favourable position for the delivery, but we avoided the caesarean so it was a small price to pay. Only 6 hours after arriving and she was in my arms. And she melted my heart! I finally felt right about being a mum, it was such a breathtaking moment having her handed to me. Despite emergency surgery a week following her birth (due to retained placenta) I thought I had experienced a wonderful natural delivery. She was birthed without drugs, and it was a spontaneous vaginal delivery at 37 weeks.

We then conceived a baby shortly after her birth, but the pregnancy was lost. We conceived fraternal twins when our daughter was 5 months old. Sadly we also lost one of our twins, and had a lot of complications during the pregnancy. On top of the daily injections, there was severe haemorrhaging with large clots caused by subchorionic hematomas, PPROM at 18+5 (when we were assured we would lose our surviving baby. Thank the Lord that He kept our son safe!), infection and placental abruption. Our boy Jacob Kenneth was delivered via emergency classical (vertical) caesarean at 6:10am on March 2nd 2010. He was just 25 weeks + 2 days. I was in hospital on bedrest from 23+6 until his delivery, as 24 weeks is considered viable here. There was just 3cm of fluid surrounding our son, and as he was breech, we opted for the caesarean. The labour was horrible thanks to hospital staff, and also being strapped to monitors, catheter in place and unable to move with IV lines. When I knew I would be delivering him I called my husband. (I knew as the contractions were quite surprisingly as painful as those of my first labour. The pressure was centred on the cervix but the intensity was the same). As he slept next to me, the doctors on call loudly discussed my situation and the fact that I had refused narcotics to stop the labour. I had already been informed that such drugs would not prevent birth when the mother was already labouring, but could prevent a labour from beginning. I knew I was in labour, so I declined. They insisted that I would cause an unnecessary caesarean and potentially the death of our baby by refusing the drugs. It was very distressing. Another doctor examined me soon after and I was rushed for the caesarean, as I was indeed in labour at 6cm dilated. (She initially thought that the baby was presenting head down, but ultrasound showed otherwise). Because our baby had not flipped, we knew the chance for survival was slightly higher with the caesarean. The surgery was awful, I felt a lot of pain throughout and we did not know if we would be welcoming a live baby or not. He was delivered, we were told he was a boy, then I was left alone as my husband went with our son (where he was promptly asked to leave NICU, so our baby and myself were both alone. Hubby didn't know his rights as a parent to stay with our son at that time). A further 15 weeks and a lot of preemie issues elapsed before I was able to finally take our son home to our family.

So I had now experienced two very different labours and deliveries, and was quite convinced I did not want surgery again. What I did not realise is how different spontaneous vaginal labours could be. When we found out I was pregnant again, I began researching vaginal deliveries after classical caesareans. We also hired a beautiful doula who we were hopeful would guide us through this birth. Months of studying went into this, and many discussions with medical staff. I found Jessica Tiderman's site Special Scars which prompted us into further research. Between Jessica and another special scar mum Katie Perez, I was given a lot of support and encouragement. My husband and I decided to try for a vaginal delivery, and conferred with our obstetrician to make this as safe as possible. Our obstetrician was fantastic, he took on our care against hospital policy, and had us sign a waiver after explaining the risks and benefits of a vaginal delivery in our situation. He was always respectful and encouraging while stating his concerns and helping us to create a birth plan. A great change from the experiences we had until he took us on! So we now had a birth plan in place for a vaginal delivery following a classical caesarean section.

At 1am on September 26th 2011 I was up walking around the house again with contractions. They had been there for over a month, the same pain as my previous labours and could be timed 1-2 minutes apart, lasting 2 minutes. The joys of an irritable uterus! Our baby was beyond engaged and had been for a long time. I was getting around an hour sleep per night, and thought this pattern may continue for a while longer. And then my water broke. I had a quick panic when I thought I had peed myself, and then realised my waters had ruptured. So I called my Mum and asked her to come over to watch the kids. We knew they would be fine waking up to Mum without us being there. Then I woke my husband to let him know it was time to head in. I would have laboured longer at home, but we had decided to head in early in the labour to have the cannula placed in case of complications. We called our doula to let her know we would be heading into hospital as my contractions were steady. At 3am we left the house and arrived at about 3:30am. A midwife took us through to the maternal and foetal assessment unit. I had to laugh when she insisted that a vaginal exam (which we declined) was necessary for her to let me know if I were in labour or not. I let her know that I would be birthing that day. She asked us about continual foetal monitoring, which we also declined, and a male staff member came in to insert the cannula. He was unable to get it in between the wrist and elbow, so the midwife sent us through to the labour suite where we would try again. I had dropped into a hands and knees position by now to deal with the contractions, and our doula set up the ground for me to be more comfortable. I was asked to get onto the bed to let the man attempt the cannula insertion again, and I agreed. So the bed was set up reclining and I was on my knees leaning against the bedhead. The contractions were lasting only 45-60 seconds, but they were coming on top of each other. There was a great deal of pressure, which I had only experienced with our other babies when they were descending. I was dropping my body with each one, starting on my knees and bringing my bum down to my feet over and over. I was breathing deeply and consciously through each contraction. This was so different, very intense and more painful, but it was also much more natural and therefore more comforting than my other labours. I extended my arm between each one and gave permission for him to position the cannula wherever he could find a good vein, as he looked rather panicked about not being able to insert it! The midwife we were assigned bandaged it for me and bloods were taken. The midwife then asked to check the baby with a doppler, and I was happy to consent. On the next contraction, I needed to make my way to the shower to cope with the pain. I was surprised at just how painful I was feeling them, it felt like the end of my first labour in comparison and I looked to my doula and told her I wasn't sure that I could actually get through it this time. I wasn't stressed, or losing control, just quite aware of how painful they already were and I thought I would need some form of pain relief to get through the rest of the labour. She smiled and said I would do just fine.

Our doula continued with her encouragement and gentle reminders to relax my pelvis and breathe into my belly. Once we were in the shower I was able to focus on the contractions knowing our doula was between the medical staff and my husband and I. That was so important to us, it felt like our birth space was protected by a woman we trusted and felt comfortable with. Very soon I thought I felt the need to empty my bowels, so I asked everyone to leave. The midwife went to get a doppler and my doula asked if I were sure I needed the loo, or if the baby was coming. Both my husband and I thought we had many hours of labour to go, but she insisted I keep my hand close just in case. And she was right! Once I realised my bowels were empty and it was indeed our baby, I made my way back to the shower immediately after the contraction. I called my husband into the bathroom and knelt down on my knees, one hand waiting for our baby, one hand on the floor supporting my weight. The force of the contractions was unbelievable, I finally know what the ejection reflex is! With our other babies, I could not control the pushing, but I could choose whether or not to bear down with them. This time, I had no control at all over the force. I was aware of how quickly the baby was descending yet I could not lessen the pushing. It was amazing! I delivered the head, which was rather blue just as my daughter's had been, and I watched our baby turn slightly. I checked the cord and remained kneeling. It had taken a few pushes to get the head out, but with one more forceful contraction while still guiding the head, I delivered the body with my other hand. I was able to bring our baby straight up onto my chest, and discovered that we had another son! Our doula had notified our midwife of the imminent birth, and two midwives arrived after I had delivered him. One of them was a bit too quick to cut the cord (we had hoped for the benefits of delayed cord clamping) as our son was not yet breathing, despite being attached to the placenta and without any compromise. He cried within seconds of being pulled away from me and was promptly handed back. It was such a beautiful delivery, bringing our own baby up to my chest with my husband by my side. This was the first birth he had actually witnessed, although he was present for all of them. That was just amazing and still brings tears to my eyes that he was able to watch his wife deliver his baby. It was also lovely to have our doula with us. She gave us both a lot of confidence and I believe having her present allowed my body to relax fully and experience labour the way it is meant to be. What a wonderful difference to my previous labours and deliveries!

Our son Jackson Lucas was born at 5:08am, September 26th 2011. I was 39+4 weeks into the pregnancy, far further than anyone had expected us to make. We have been abundantly blessed with this birth. The Lord Jesus had such mercy to give us this perfect birth, which has been so healing for me. This pregnancy had begun with specialists being hesitant to prescribe progesterone as they believed I was miscarrying. To remain pregnant not just to viability, but to term, was such a relief and a fantastic experience for us. There had been complications with the pregnancy, and I was very sick again, but I cannot find a single thing that I would choose to change about the labour. It is surely how I was meant to birth! I needed manual extraction following the delivery due to retained products that were vascular. We tried administering Syntocinon via IV to stem the bleeding and I had IV fluids to counteract the blood loss. The haemorrhaging was heavy, one blood clot alone was 500mL. The drip failed to stop the bleeding so I was sent for surgery. I had lost 1600mL by the time I was done in theatre. There was talk of a blood transfusion, and iron infusions. But thankfully the Lord saw us through without either as we had chosen to decline them unless I had another large loss. God blessed us greatly with the surgery, as we had our obstetrician take over my care and perform the surgery himself. My husband had requested him when I became upset with needing surgery, and I am so thankful! Our obstetrician did a wonderful job, and the theatre team were just lovely with me. They had me laughing despite the situation, with the anaesthetist even playing music for me on his phone. The spinal worked to provide me with pain relief, and ensured I could breastfeed immediately once out of recovery. When I came out of surgery I was taken to the ward, where I was met with my midwife. She happened to be our student midwife with my first birth, now fully qualified. It was an absolute pleasure to find this beautiful young woman as my nurse. She was also on call the following morning, so she was there to book us out of hospital. It was great to see her and for her to see our other children again. Given that the surgery was necessary, I could not have asked for better than to have both our obstetrician and our (ex student) midwife caring for me. And I was able to leave the morning following the birth.

It was awesome to walk out of the hospital with my husband and all three of our children. And with my health. My scar was very thin, we saw this on the ultrasound that was performed to confirm the retained products. And my endometrium was presenting unusually. We know we are not willing to try for any more children now, as we believe the risks are too high after discussion with our obstetrician. Which makes it so much more meaningful that I was able to experience such a perfect birth. I had asked the Lord for a positive birthing experience for my husband and I. There could have been nothing better than the experience He gave us! No unwanted interventions, no foetal monitoring, no invasive vaginal exams, no managed third stage, and the joy of discovering we had another son for ourselves. Just a birth, completely natural and unassisted. Despite the surgery, and initially needing to express breastmilk again until our son's tongue tie was snipped (I had to pump exclusively for both our other children due to tongue tie and prematurity), I am still so thrilled with the delivery. It was painful, it was intense, and it was perfect. There is not a moment of the whole labour I would change. It felt so natural, and to deliver our son into my arms the way I was able to was so beautiful, I wish that every woman could have this kind of experience in childbirth. I am sitting here with my son right now, our other children are in our room sleeping, and the way I feel is amazing. I have no signs of post natal depression, which I developed very quickly after delivering our other babies. Our son feeds well now and actually sleeps well too, which is a first for us. A nice first! I love wearing him in the sling and sleeping next to him (as we all sleep in our room). He loves it too. I finally understand the term 'babymoon' now. I was very scared becoming a mum to our daughter, and the NICU experience was extremely challenging with our son. To have another baby at term, healthy, and thriving is just lovely. And the birth, I will never forget how amazing that felt. The Lord certainly blessed us with His great mercy and kindness!