The Birth of Martin Zaharuiko (Lorraine's Inverted T Cesarean)

Born 21/7/07

A couple weeks prior to Martin’s birth my Ob had been to a yearly conference where it was recommended that women with prior tear/big baby should be offered a caesarean.   Seeing as I had torn with a 9lb13oz baby he asked what I would like.  I laughed at the idea of ever having a caesarean after all the only problem this whole pregnancy had been that Martin was transverse until about 37wks.  As my first bubs came out with the perfect round ‘caesarean head’ and the tear hadn’t been that bad we both agreed that vaginal birth would be fine.  I asked what he thought this bubs would be sizewise and he thought average to a little larger than average.  Fast forward to my due date.  My sister happened to be staying with us that weekend as well as a friend who was staying with us for a few weeks to look after my 12 ½ month old when new baby came.  That Sat night I was so tired so I went and had a bath while the others watched a movie.  Fell asleep in the bath for about 1 ½ hrs.  Went to bed and didn’t get to sleep until about 12.  Probably around 1:30 the contractions started just like period cramps.  Not sure exactly what time as I was going back to sleep between them, gradually they got worse and closer together and about 3AM my husband woke to me clutching the hot water bottle.  He asked if we should go straight away and I said that I was fine, insisted that I ring the hospital and eventually decided we were going whatever I thought about it!  After a 40ish minute drive we got to the hospital at 4:30.  I was contracting every couple minutes by then but providing I was upright and could lean my head against something cool I was coping fine.  I was put in a normal hospital room to labour and they wanted to do a strip straight up but I wouldn’t sit on the bed or let them put the monitor on as I couldn’t stand the constriction.  As soon as I wouldn’t let them do that they decided that I actually needed to be in the L&D room so I shuffled off there and was stripped off…..Lesson 1… Don’t go into the hospital in labour in a full length long sleeve nightie!  After attempting to labour on the toilet(was wonderful with the first baby) and it just wasn’t comfortable I got on the bed for the strip and got some gas and air.  They did a VE with unknown dilation and bulging waters at 5AM.  I wanted to be upright but was so tired that I stayed on the bed using the gas and air on my left side. By 5:30 I was at a 7, -2 station contractions ever 1-2 minutes.  By 6:30 I was 10, -1 station with contractions same.  At 6:50 I ‘let’ the OB break my waters to try to hurry things along, after all it worked the first time.  He pushed Martin down from -1 to +1 at the same time as breaking my waters. At 7AM they decided that I should start pushing.  It didn’t relieve the pain like it had last time and in some ways actually caused pain but I did it anyway. So I attempted to push and push and push, and another lady who had come in after me pushed her baby out in what seemed like 2 seconds and I pushed some more, on my back, on my side, on the broken down bed squat position. At 9:15 the OB gave me another 30 minutes chatted for a few minutes but on the way back out the door I had my first decal so he promptly turned around and at 9:30 said c section now.  Being a Sunday in a small country hospital everyone had to be called in theatre nurses, anaesthetist, another Dr/OB to assist, etc.  9:35 was being shaved, IV inserted, revolting drink given.  9:45 the anaesthetist arrived and started prepping me and all I really remember is floating on the ceiling trying to keep track of what he was saying, what the OB was saying, and signing consent forms.  Gas is wonderful but they didn’t have any in the theatre when the put the spinal in.  By 10:30(I personally think earlier but am going on records here) everything was done and they had started the cutting.  After all the usual cutting they got down to the uterus and did the normal LUCS.  They had to extend it then had to go vertically upwards a small way and then Martin’s head was pulled out with relative ease and his shoulders became impacted, they tugged, pulled, swore(according to hubby) and what felt like jumped on my chest to attempt to get him out the rest of the way to no avail so the OB extended the vertically upwards cut.  I also tore downwards a little way towards my cervix but was never told about it, it is drawn in the picture my Ob drew of what happened on my uterus.  At 10:43 my 10lb, 54.5cm(21.5inch) long, HC 38cm(15in) baby was out and had Apgars of 7 and 10 although I thought they said 5 and 7.  According to the assistant Dr his face/head had ‘considerable congestion’.  He also had a very distinct cone shaped head once again according to hubby.  After delivery and the usual checks he was given to hubby who brought him over so I could meet him.  I remember briefly seeing my little boy but the drs then rolled me flat and I don’t remember them telling me they were going to and so I panicked and seeing I’d been on the verge of panicking the whole time they asked hubby’s permission and then sedated me.  I remember waking up in recovery at about 12PM so it must have taken them close to an hour to stitch me up.  I thought I fed Martin in recovery and had him in my bed as they wheeled me back to my room but hubby says that wasn’t the case so I was obviously conscious but out of it.  I really don’t have much memory at all of that afternoon except after hubby had gone home to pick up our daughter I remember laying in bed holding my little man and feeling utterly defeated.  At some stage my OB came and told me that he’d done an inverted T and that I’d had a constriction ring/Bandl’s ring and that he’d only seen it once before and had done an ‘inverted T’ on that lady as well.  He also told me that I had to lie pretty much flat on my back for a couple days or I might haemorrhage and then he’d have to do a hysterectomy if they couldn’t stop it.  I was to wait at least 4 yrs before I had another baby and of course the usual always caesarean and not more than 4.  Thankfully the nurses quietly suggested that I could go get a 2nd opinion.  After two lots of blood, two days flat on my back and 6 ½ days in hospital I came home, sore, exhausted and my plan of a large family was well and truly out the window.  According to my local child and health nurse I looked a little like death warmed up and that it took several months to get back to normal.  Looking back I should never have let the OB break my waters as I’m 90% sure that when he did that and pushed Martin down he caused asynclitic head on an already large head.  That day was probably the worst day to have had my son, after all in a hospital that only delivers maybe 150 babies a year and then the time I go in 3 other women go in as well so 2 midwives running around like mad.  I’m just thankful I wasn’t the one sent 2 hrs drive to the next hospital due to no more beds!  If the nurses hadn’t been so busy and if I’d had some support in keeping upright maybe none of this would have happened. Thankfully after all that Martin was healthy and no damage done to him and at age 5 ½ he is reading, writing and being the perfectly normal little boy. I never got PND or bad memories going to that hospital so really in the long run I only have a physical scar.  All in all we both came out of it very well, thankfully.

My notes state that my abdominal contour looked abnormal, noted both by my Ob and the assisting Dr.  Nobody in the hospital had heard of or seen a constriction ring or inverted T done, nor had they delivered a 10lber in a long time so I was the talk of the hospital for a while and 2 ½ yrs later one of the nurses still remembered my son.  To this day I still cannot understand why after such a short labour this happened when usually it only happens in long labour or excessively long pushing stages.  The best possible reason that I’ve been told by a midwife friend is that maybe my body knew he wasn’t going to come out and so was pulling him back off my pelvis to protect his head.