Nuala’s Unplanned Cesarean

Love reading positive birth stories, you’re in the right place…. Nuala was hoping for a VBAC to welcome her second baby into the world. Nualahad a Foley Balloon induction but her labour progressed quite slowly. At this point Nuala was offered a oxytocin drip to progress the labour or an unplanned cesarean. She opted for a cesarean and had a calm experience and had the drapes lowered as her baby girl was welcomed into the world.

I’m always under consultant /midwife shared care due to a history of childhood arthritis but it’s never caused me any issues as an adult or in pregnancies. I’m starting my story at my 39+5 appointment after an uneventful and healthy pregnancy where I did more exercise and posture health management for myself than first time round. 

I’d had twingey evenings all week leading up to this appointment and hopeful that spontaneous labour was only days away from around my due date. At this last growth scan, the doctor found that baby was suddenly measuring 98th centile on growth after tracking 70-80th all along. After some discussion, I agreed we would book for induction one week over (18/04) although I declined a sweep as I didn’t feel ready.Also I didn’t really believe I had a 10lb baby on board… as I felt smaller this time and last one was only 6lb10 on 38th centile after tracking 80th too. 

I contemplated how that appointment had gone all weekend and then with no real changes to the twinges, I requested to see community midwife at 40+2 for V/E and potential sweep. She assessed that my cervix was soft (dates FTW!) but still mid position or potentially closed. She asked if I had been sent for a repeat GTT even though earlier one was negative (family history) which I hadn’t and in hindsight I wish I had.

I still didn’t believe 98th centile and started to get quite annoyed at this point. Geared myself up for a “debate” at my 40+5 appointment and also requested a female doctor as I was doubting that male doctors were sympathetic enough to understand my points, I know this shouldn’t bother me but it did and receptionist didn’t even blink when I asked. 

AT my 40+5 appointment I got quite upset as she again walked me through the potential risks of a bigger baby and not having gone into labour spontaneously yet at almost a week over and also given that I didn’t go into spontaneous labour in last pregnancy, this was putting me on the “backfoot” for this one – I had visions of exact repeat situation of hooked up to drip and stuck in a bed with an epidural and nothing working again. I accepted a sweep to try bring on labour before induction which I agreed to go ahead with – cervix was shorter and very slightly open so it was possible. In hindsight I didn’t really use EBRAN properly at this appointment, I left the appointment quite deflated and focused on the risk outcome of my decisions rather than the benefit of what I had chosen. I wish I had been more prepared as I felt under pressure to make a decision in seconds without my husband there, but the doctor reminded me I can stop the process at any point later and change my mind,

The options discussed were foley catheter Induction or book in now for elective c-section. I chose to go ahead with induction, thinking that’s closest to my original plan. I had a COVID swab and headed home to self isolate for the weekend. I came home, had a cry – rewatched Beth’s videos on Medical Induction and controlling what I can and letting go of what I can’t. Felt SO much better that I was making a decision that was keeping baby safe, she’s fully cooked, potentially big and there’s no more benefit to her staying in there, only potential increasing risks as days go on.

I made my mind up to treat the weekend like I was already in early labour whether I was or not – chill out, music, dancing, cuddles with toddler and hubby, good food, reading and enjoying the sunshine in the garden. And a bit of pampering too to set up for going into hospital. I started making notes on this story so I wouldn’t forget things along the way. 

I got quite a few regular (every 10 mins or so) contractions on the Friday night but none were very strong. Went to bed with 2 paracetamol and slept fine. These eased off on Saturday aside from lower back pain most of the day. Got a FEW big contractions on Saturday night with a bit of mucous plug coming away but not very much. Again headed to bed and they eased off. 

Induction on Sunday

Phone call at 7.04am to head in first thing that morning. I asked midwife for some time to get ready and agreed I could be there for 10am (we’re only 20 mins away). Got up, washed my hair and final wee pamper and my mum and dad came over to sit with our little boy. He understood what I was telling him about the baby coming (finally lol) and sent me off with a lovely gentle kiss – beautiful boy and a wee oxytocin boost to boot. 

With our local restrictions, hubby dropped me off at the door to the ward and I got settled. I had Foley catheter induction. I’ll not lie, I found this first examination and insertion unpleasant but cervix was actually only 1cm open and 3cm long so I really needed it to help get me going. I kept breathing through using as much of the techniques and staying as calm as I could. Once in, I spent the day bouncing, pacing the bay and standing over the bed to read. I went for a full hour walk around the hospital grounds and another once around the carpark after dinner. Foley actually fell out just before this second walk after dinner. I thought maybe I had strained it out trying to go for a no. 2, but midwife assured me it it could only have come out if it had been sitting in my vagina instead of cervix meaning it had done its job and opened me up a bit! Yay!

Time to get ready for waters being broken but was confirmed they would do this first thing the next morning so I could get a good night’s sleep in the bay and some breakfast. Got a supper of toast and tea, yum! Slept on and off for cat naps throughout the night but not too bad. It was so much more relaxed on the bay than my previous pregnancy where there were so many people about! It’s so important to get rest and sleep on induction bay if you can, the road ahead can be quite long!
Got more toast and tea for breakfast and scoffed an extra protein bar, a fruit and nut mix and some jelly babies as well as knew would likely be asked not to eat except jelly babies. Moved on round to labour ward. I asked to wait until my husband arrived before trying to break waters which was no problem at all. This was the most surreal and hilarious experience of the day! I started using the gas and air vigorously to get through this one, I get really giggly on gas and air, it’s the closest to being high (not that I’d know for real!) that I’ve ever experienced (in both pregnancies). Well…on my water breaking

I started to giggle thinking I sounded like Darth Vader on the gas n air so I kept going on it, also had Princess Leia socks on so in my head I started saying “I’m Princess Leia, I’m Princess Leia” completely spaced out and uncontrollably giggling but it must have completely relaxed my body because waters broke and it was a tsunami over the bed! Midwife said she’d never had anyone laugh their way through a water breaking and we had a good giggle about the Princess Leia visualisation after I eased off on the gas n air for a few minutes! 

The next two hours before administering the hormone drop, (standard time is one hour but I requested a bit more time which was again no problem) involved mobilising and seeing if labour would start spontaneously – bounced on ball and zoned out listening to my playlist, waters kept coming out constantly when I relaxed so figured this was all good ways to bring on contractions on their own. It didn’t, but I figured that was unlikely anyway in the short time frame so we discussed with doctor and went onto the hormone drip at a low level which is a normal recommendation VBAC anyway apparently. 

I asked if I could get a shower before syntocinon went in just to freshen up and this was amazing to have, the shower was my happy place all throughout pregnancy for pain relief at home. Midwife helped me to the shower with the wireless CTG unit.
Once in, contractions started to ramp up and I continued on gas and air and breathing techniques in between. I got regular, strong 4 in 10 contractions from 14:30 starting at 2cm dilated so I agreed to be examined at 6.30 and see how I was getting on and help me make a call on what I wanted to do next as I had wanted to avoid the drip really.

Great mixture here of all positions, on the ball, on the floor, sitting up forward on bed, resting on my left side, dancing, standing leaning over side of bed and keeping bladder empty. Kept losing more fluid and definitely felt like I was dilating and pelvis was opening up. Midwife kept praising how well I was doing with my breathing and gas and air and changing positions. Felt very proud of myself using everything I had learnt from the course!

6pm came and because contractions had been really strong and regular, doctor asked if he could examine me then to assess where we were and discuss. Agreed and found I was 3-3.5cm and just about effaced. He gave me all the options but recommended c-section as the progress rate indicated worst case I would be on the drip all night and well into the next day and if I wanted to go for a section now it could be calmer and less rushed. The main factor presented was risk was about uterine rupture continuing to increase if I needed to be on the drip for a long time. Kept being reminded by all staff that I was the boss of this birth and they would just give me the options and benefits and risks and support me.I wasn’t pressured and was given time to think and discuss as he went to review another patient. Honestly I was massively disappointed, I think I had hoped I would have been 5cm at that point given how I was feeling but in the moment I hadn’t pre thought what good progress would have felt like to me before the examination so I wobbled a bit here.

It was at this moment my already amazing midwife went on her break and and a senior midwife came in – a hypnobirthing pro herself, Nicole of The Motherhood Bubble (https://instagram.com/motherhood.bubble?igshid=kfkcav9suhvb) on Instagram (another great page to check out if you’re from Northern Ireland) – by sheer luck she was just who I needed to speak to at that moment and she helped me discuss and sound the whole thing out loud as I do normally which she picked up as my personality type immediately. She got my YesMum cards out and helped me pick out some to feel better. Hubby and I used the chat time to do our own typical logical 4 box method and came to conclusion that c-section was the right and best choice for us all. I felt I had too many unknowns at the road ahead otherwise on the induction pathway and baby was currently so happy and chilled, I wasn’t as tired as I had been with my first wee man so I knew cesarean section recovery would be more laid back at the very least. 

I updated the doctor on our choice and asked for a calm caesarean with drapes to be lowered as baby was born etc. Got all prepped to go and just then a bigger emergency happened next door with a wee distressed baby – I was so rechilled at this point after speaking with Nicole that a simple control what you can let go of what you can’t in my head kept me in check. 
Honestly the worst part was accepting that it meant my day team had to go home and I didn’t know who would be in theatre with me and then lo and behold in walks a midwife from my first baby and the lovely lady doctor I seen at 32 weeks. 

A couple of hours later and I walked down to theatre (also so much more empowering than last time!), when I met the theatre nurse, this again was the lovely person I remembered giving me a head massage the last time ? our fantastic cesarean section birth followed with all our requests and at almost 10pm, drapes were lowered to Magic Radio playing and we saw our beautiful little girl lifted up into the world ??…weighing only 80g off where the doctor predicted the week before… ? on the 96th centile so proven that they do get this right on scans too so I happily ate my own words! Got lots of pictures and cuddles and Ed Sheeran’s ‘Perfect’ was on the radio as they stitched me up which I LOVE and is giving me a lovely oxytocin boost as a memory for expressing now!

I realised at the end that it had been an all female theatre team and my hubby was the only man in the room, including my wee woman – total GIRL POWER! How amazing is that?! Doctors post op update was that she was able to reuse the same scar line from before and that I had very little scar tissue which was so amazing so when healed I’ll only have one scar line.The summary was that baby had been hanging out in an unfavourable position which wasn’t through lack of trying on my part so really c-section at that time was 100% the best choice for us all. 

Wee woman was so awake and alert afterwards which was very different to her brother and she got a feed in recovery, almost latching on immediately except for my massively large nipples that my newborns just don’t seem to like staying on. We’re now expressing at home… 

For me, our story just completely sums up “Control what you can, let go of what you can’t” and I feel so positive about all of our decisions and approaches this time where last time even though generally positive overall I struggled to accept it a bit and beat myself up that I hadn’t tried hard enough and asked myself lots of what ifs after. 
There’s NO WAY I could say that about this wee baby’s birth, I tried everything I could for a VBAC and stayed positive. It just was meant to be this way for us. 

If I ever have a third, I’ll be bossing that elective cesarean section from Day 1 and giving my consultant team way more credit along the way!

Click the link for more information about The Bump to Baby Chapter’s Hypnobirthing and Antenatal Online Course. Know what you can do to stack the odds in your favour for the birth that you want. Videos, checklists, audios & a support group all created by a midwife to get you feeling excited, prepared and confident for birth.