This is the story of my pregnancy and birth experience with my first baby. Although it's not an especially traumatic journey, it's also not a particularly positive one. There may be parts of my story that could be triggering for some, please keep in mind. It's also not a brief story, so by all means - make a cup of tea and get comfy.
My husband and I had been talking about kids for a while. I had not long started working in a corporate job in my qualified field after a while of freelancing and then working in a heavily commission reliant retail role. I had a couple of holidays planned and we had decided that after I got home from the last big overseas trip, we'd start trying.
I'd been on a pretty good health kick over the prior few years in an effort to improve endometriosis symptoms (which had worked quite well for me) but after a few weeks in the US where I'd basically just eaten whatever I wanted and consumed my fair share of booze, I returned home and went straight into a solid detox, wanting to feel less sluggish and also just generally healthier to hopefully improve our chances of conceiving. I'd only just ovulated as I got home, so we had about a month before we could start trying and in that time I'd cut out alcohol, caffeine and processed foods, basically just eating whole plant foods. To our surprise, and relief, we fell pregnant that first month trying. I don't know how much my health kick had helped, but nevertheless, it provided me with great cover for continuing not to drink alcohol or coffee in the short term, before we told our families and friends.
I had done a little bit of reading and research around what kind of care I wanted in pregnancy but a lot of what I had been reading was American based info. I could tell that midwife care was more aligned with what I wanted and my approach to pregnancy, but I didn't know much about the benefits of continuity of care midwifery models or even where or how to access that until too late. I briefly considered homebirth, but I was one of those people who said things like "Oh, I'd love a homebirth but I would just prefer to be in a hospital in case something went wrong". I wish I'd known about the midwifery group practice at my local hospital, but by the time we were told about that, it was too late. It's not a huge MGP program at my local and the demand significantly outweighs the number of midwives available. We had increased our private health insurance for pregnancy cover a year or so prior, and in the end I opted to go for a private obstetrician. Literally the deciding factor in my decision was that I knew I would have more time in hospital after birth which appealed to me because breastfeeding was incredibly important to me and I wanted to make sure I had access to help with that in the early days. I so wish I had spent more time before becoming pregnant understanding what support there was for breastfeeding and what care models there were available to me (as an example, I know now that I would've been much better off trying to get into the MGP and also lining up an IBCLC to help where I needed it).
I met with my GP to get a referral and I asked her whether she knew who in our area would be best to see for someone who was very keen for a natural birth and she promised she would ask around to find me the best option. By the time I was looking for a referral, I was about 8 or 9 weeks and had no idea how late in the game that made me already. The top recommended doctor didn't have availability to take me on, but the second did. I booked in with her without hesitation and had my first appointment set for around 10wks.
We were late to our first appointment, and unfortunately we were the first appointment of the day, and that pretty much set the tone for our whole journey with her. The appointment was brief, she asked us a list of questions one after the other, barely looked up from her paper the whole time, took my BP and got me on the scales to get my weight. She had asked for my LMP and declared my due date to be 27th August. I told her that I had longer cycles so I'd calculated my EDD to be 29th Aug and I can remember so clearly her saying (without looking up) "Oh, it doesn't really matter, we'll just leave it as the 27th." I wish I'd pushed harder about that, because let me tell you, it definitely bloody mattered by the time we got to the 27th of August.
My pregnancy was pretty easy, but I gained weight quickly between 10 and 30 weeks. I literally put on a kilo a week, and hit a surprising depression around 17-18weeks - that stage where you are gaining weight but don't look pregnant? With a history of body image issues, and my OB exclaiming each time she put me on the scales "What are you feeding this woman?!" to my husband, I was not coping. It was after my third day of lying on the couch without even having showered and not showing up to work that I realised what was happening. I got in to see a psychologist pretty quickly, as well as having my B12 levels checked and rectified (they were quite low, which I also had a history of and knew it was something in the past that had made a big difference to mood) and was on the up again.
About the same time, I'd started getting some mild sciatica in my right hip but by about 20/21 weeks I was finding it constantly painful to walk on. I also had some significant and sudden swelling in my feet and ankles pretty much overnight at 20wks. I was checked and cleared for other preeclampsia symptoms and the swelling remained, not getting any worse thankfully, until after I'd had my daughter when it all disappeared.
The sciatica, however, was getting increasingly worse and I asked my OB at one appointment whether there was anything I could do about it. She said it was just one of those things in pregnancy and there wasn't anything that could really help. Such a shame. At 27weeks, I'd been sent to Melbourne for work for a week and I completely wrecked myself putting weight on the wrong side while lifting my luggage off the train. I cried out and nearly collapsed in pain and no one helped or offered to help. I limped my way through the airport, on the flight, nearly collapsed again trying to get my luggage off the carousel and eventually made it onto the skybus into town. I was a disaster by the time I made it into the Melbourne office, where the team (who thankfully, I had met before) were a bit concerned and asking if I needed to take some time and get into a physio or something. It wasn't until the following day when I stepped badly off the curb, nearly collapsed and almost got run over by a taxi as a result, as well as spending the rest of the day fighting back tears with every step, that I thought this was getting beyond manageable and I decided I would try and get an appointment with my physio when I got home.
My physio was brilliant and said he could help to a degree but that he would give me the name of a chiro I should follow up with as that would be the most help. I felt a million times better after his treatment, and I soon got to see the chiro and it was like getting a whole new lease on life. Suddenly I felt like I could make it through the pregnancy! I'd been really stressing about how much worse it was going to get and how I would survive. It would still creep up, but the chiro kept it mostly under control and allowed me to be able to walk far more comfortably.
My husband and I did the calm birth course at around 32 weeks pregnant and I got so much out of it, and my hubby was surprised to find that he did too. Of the two day course, the first day focused mostly on birth physiology and mindfulness techniques, where the second day looked a lot more at decision making and interventions and what you can do to maintain a sense of control, as well as what things you can ask for if you do need intervention. Turns out that was the most useful part of the course for us, in the end. We were also taught a little bit about where to find evidence based information, which was also very useful.
I had all the usual tests and procedures done along the way, of course, mostly out of an assumption that they had to be done and without an awareness for the implications of the results of those tests. I was lucky, anyway, that I came back negative for GDM (and lucky that my OB didn't make me retest given my weight gain), negative for GBS and that my bedside scans weren't giving her anything to worry about from a "big baby" perspective. My appointments were always brief, after waiting a long time in the waiting room for them, and always impersonal. I was offered stretch and sweeps from 38 weeks and it was the first (and last, now I think about it) thing that was offered to me as "it's your choice". I declined at 38 weeks as I was taken by surprise but I accepted at 39 weeks. I hated it. My OB told me I was 1-2cms, which I thought was great.
At no stage had we discussed anything to do with a birth plan, and I'm ashamed to say I never brought anything up because I was so anxious about the confrontation we would likely have in disagreeing on multiple counts that I simply avoided it. It would have been much smarter to bring things up in advance, but I was afraid. I was also feeling hopeful (despite knowing how foolish I was being) that I left my 39 week appointment and the topic of induction had never come up. Although I have learned much, much more since having my first child, even then I instinctively knew that for the physiologically normal birth I wanted, avoiding interventions - particularly induction - was crucial.
But surprise, unsurprise - at my 40 week appointment, the word induction was one of the first out of her mouth. She asked me straight up when I'd like to book in my induction, despite the topic never having come up before. I said let's just book in another appointment for next week and we'll revisit the conversation then. I don't think she was surprised by my push back, but she still wasn't thrilled about it. When she was doing my physical exam, she mentioned baby was less engaged than she had been the previous week and that "it might not even be safe to induce, we might have to go straight to a caesarean". At this offhand comment, I absolutely spiraled internally. When I got home, I called my mum in a panic. She suggested we chat to a couple of midwife friends she had and ask whether they had an opinion on this (one of these friends was the woman I would hire as my private midwife for my second birth, the other a long time family friend). We did that, and I also called my chiro and asked about whether they could do anything to assist with getting baby to engage, which they said they could certainly try to help with and booked me in. Finally, I called a local acupuncture clinic and booked in with them as I'd read that acupuncture could also assist.
Both midwives had come back to us saying that the level of engagement my baby was currently at was definitely not something to be worried about and could change at any moment. Both also said I was well within my rights to push back on being induced, and Jo (my future midwife) particularly warned us about the cascade of interventions that can follow an induction. I started researching about the real risks of being “overdue” and felt a lot more secure about my decision not to accept induction yet. The compromise with my OB when I declined booking an induction was that I had to present to hospital every second day for monitoring and also undergo a foetal wellbeing scan. The scan came back fine, and all the monitoring was looking good.
Being a first time mum, the research I was reading was only giving me so much relief. I was entirely patient enough to wait for my baby - I had never assumed I would be going into labour on or by my due date and I was okay to wait. But the anxiety of some of my family who were checking in near constantly and asking "what my plan was" as well as my doctor who clearly didn't have patients go beyond 41 weeks very often, if ever, was rubbing off on me and I was constantly second guessing myself. Particularly when it came to baby's movements, and one morning I got myself convinced that I hadn't felt enough or any movement and so we called the birth suite and they said to come on in. It was the Sunday before my 41 week appointment, so I would have been 40+5 and I was in-between my agreed monitoring days. As soon as I actually arrived to be monitored, I started getting plenty of movement and we had a perfectly good trace to follow. My blood pressure was a bit high (which looking back, I'd say was almost definitely the stress of wanting to avoid an induction and feeling like I wasn't going to be able to) but I was checked and cleared for proteins in the urine and other pre-e symptoms.
However, unluckily for me, my OB happened to be on call that weekend at the hospital and was in for another patient, so she dropped in on me as well. She asked me when I was booking my induction. I was taken off-guard, as I was preparing myself for this conversation on Tuesday, I hadn't readied myself for it on that day. I had spent a lot of time thinking (and stressing) about it though, and had decided I would suggest the Monday in a week's time, which would make me 41+6. I had hoped that would give me enough time to go into labour spontaneously, but I also didn't feel I could comfortably keep waiting after that given the fear and anxiety from others that I was struggling not to be overwhelmed by myself. So, I suggested that day. She shrieked "Monday week?!" And then proceeded to explain that she has a policy of inducing by 41 weeks (which I had previously never been informed of) and it's a policy for a reason but if I was refusing to be induced so be it "just so long as you understand, the risk increases with every week". About as well as I'd expected it to go, but I was pleased with myself for standing my ground.
I'd been having prodromal labour in the evenings since I was 39+6 so I was really hopeful that I would go into labour before the induction date. My 41 week appointment came and baby was back to ⅘ engaged and no more was said about that. I was told I was about 3cms and I was given another stretch and sweep. My OB was pretty standoffish, and I knew she was going to be pleased to finally be done with me in another week's time. She said she’d see me at the hospital at 7am on the Monday. I replied saying unless, of course, I went into labour in the meantime. Her response was, and this seems more insane to me every time I think of it: “Well, you haven’t gone into labour by now, so you’re probably not going to.”
I had two sessions of acupuncture and a chiro appointment over that week. The acupuncture was actually giving me some mild contractions which I was really hoping would turn into something, but it never did. I went to bed on Sunday night with a last desperate thought that I might wake up to spontaneous labour through the night, but when my alarm went off at 5.30 the next morning, I had just accepted that it was an induction we were having. A big part of me really wanted to beg for just a few more days because I felt so sure I was almost there, but after the reaction to setting the induction date so "late" to begin with, I just didn't feel up to the fight.
We arrived at the hospital, and as I walked through the front doors, I had a very strong feeling in my soul that I wouldn't be leaving there without surgery. We met my mum at the desk and were shown to our birth suite. The midwife we had had the previous day during our monitoring session had been so lovely and probably the first one I had met who seemed to have some sense of faith in physiological birth and she had written us down to be in the room with the wireless CTG for the induction, to give me the best chance at keeping active and upright. I'd asked her whether she thought it would be reasonable for me to request holding off the syntocinon for a few hours after having waters broken and she had said it's the kind of thing she would have whispered in my ear if she'd been the midwife on with me. It was a real shame she wasn't the midwife on with us - instead, we were met with the one midwife I'd seen across my time spent in birth suite on monitoring who I really hadn’t gelled with. Awesome. They got me on the CTG all set up while we waited for my OB to turn up, apparently she had called to say she was running late. The midwife who I didn't like hung around and made awkward small talk and I really just wanted her to leave so I could get my mind right. I'd made a comment about postdates induction that I can't exactly remember but made my feelings about it clear enough, and this midwife had jumped on me with all the "well you know, the placenta starts dying and we want to make sure your baby gets here alive and well" rubbish which had confirmed my initial thoughts about her.
My doctor eventually got there at 9am, two hours later than we had. I asked her whether she could give me a few hours after breaking waters to see if I would start to labour without the drip and she threw her arms up and exclaimed "You're 42 weeks!" although her expression while I was asking the question told me she had expected me to ask. I said exactly, so what's a couple more hours, and she sighed and said I could have two hours. I took that as a win and graciously accepted. She got me up on the bed and broke my waters. I swear there was slight meconium in there but all my notes say liquor was clear, so maybe not. Then she spent nearly half an hour making a mess of my hand trying to get a cannula in before eventually deciding to send an anaethetist up to do it instead. She said at 11am she'd have the midwife start the synto and she'd see me later, and off she went.
I walked around the room, I bounced a bit on the ball, but mostly I just hung about aimlessly willing my contractions to start, not really knowing what I should do to help my body. I felt very uncomfortable being in the birth suite, I didn't want to bother people by asking for help or anything and I wasn't really sure what was appropriate to ask for, anyway. Time ticked away and eventually, 11am rolled around and by 11.30, I was hooked up to the synto. I had a birth plan, and had printed a few copies which were still sitting in our hospital bag as not once did anyone ask us about our plan and again, I felt uncomfortable to bring it up because I could tell I was already being a less than ideal patient by throwing out everyone's schedules demanding extra time before the drip was started. I was feeling very self-conscious and not at all comfortable.
They told me they would boost the level on the drip every 15mins until I was having regular and strong contractions. Now… I don't know what their technical guideline for judging "regular and strong" was, but by 3pm, I well and truly felt we were there. For the first hour or so, nothing much happened, contractions began but were not painful, mostly just noticeable. Into the second hour or so and they were on the scale of painful but only just and so they still weren't really bothering me, just needing my focus when they came. Then sometime around 3pm there was a very sudden and significant shift and they became very painful and intense. I ended up stuck standing by the bed, leaning onto it, and swaying my hips back and forth with the contractions, vocalising strongly. They were thick and fast, with very little break in between, and what break there was wasn't complete relief either. My hips and lower back felt like they were on fire, burning ferociously, and that pain remained between contractions. My contractions I barely felt in my abdomen, as I was utterly overwhelmed by the sensation of being ripped apart from the hips and set alight with each one. My sense of time distorted - sometimes I'd look at the clock thinking it had been half an hour and it'd been five minutes, other times fifteen minutes had really been an hour. I couldn't think, I couldn't focus, it was all I could do to simply survive the pain.
I asked to try the gas and absolutely hated it. I threw it away as soon as I'd put my mouth over it because I realised it was preventing me from vocalising as I had been and the vocalising was all I had to make me feel I was somewhat in control. A little while after the failed gas experiment, I asked for something else and agreed to pethidine. I didn't feel like I could possibly keep going but I knew instinctively I was not anywhere near the end. The pethidine did very little for the actual contractions but relieved the burning and fire sensation between the contractions, and so it gave me a bit of a second wind being able to relax a bit between them. I believe this was about 4-5pm and I was about 5cm dliated, having started the day around 2/3cms.
This whole time, the synto was continuing to be turned up every fifteen minutes. Every time the midwife (who was a different person by this stage, with shift changeover) came in to turn it up, I was internally screaming at them not to do it, thinking desperately "can't you see it's killing me?!" And that's not an exaggeration. It seems dramatic, but I honestly started to think I might die.
As the synto continued to increase, the pain began to break through the pethidine again and with each contraction I would think to myself "this is it, this is the absolute limit of pain a person can handle, I'm just going to die" and then when it would pass I'd think, well the next one will have to kill me if that didn't. I couldn't speak, I couldn't function except to sway my hips and moo and moan into the bed. I felt I was barely surviving.
Around 7pm, I reached a new limit and demanded a VE to determine whether I get an epidural. I just couldn't do it much longer and I had hoped (although deep in my soul I knew I wasn't) that they'd tell me I was at least 8cm and then I would feel like I could make it. For some reason, 8cm was what I wanted to hear, and I thought if I was 8, I probably only had to keep it up for another hour or two and if I knew that was all that was left, I could muster the strength. I was told I was 6cm. And so I asked for the epi, knowing it could still be many hours.
The anaethetist was on call, as we'd hit out of hours time, but he was there within about 45mins and somehow - I still genuinely don't know how I managed - I kept still enough through my near-constant contractions for him to place the epidural. The relief was almost instant, the first contraction after it was placed was slightly less painful, and then the one after that was far less, and then I couldn't feel them at all. It felt like a fog had lifted from my brain, suddenly I could think, I could see, I could analyse what was happening around me. And I was pissed too, because I'd heard the anaethetist say to the midwife right after he had placed the epidural, "she's not LOP, is she?" and the midwife’s reply "Yes, she is". I was so mad that no one had mentioned that to me earlier, and mad at myself for not realising it personally (but I had been way too far into the pain cave to be able to think at all). I felt like I might've been able to make some sense of all that pain if I'd known I was battling posterior labour.
I suddenly felt hungry and asked my hubby to pass me some food and the midwife quickly interrupted saying "oh no, you can't eat now" which got some cogs moving in my head. As I watched her for a little while after that comment, checking the trace, turning me from side to side, I realised that we were heading down fetal distress territory. It was shift changeover again by this stage, and the midwife taking over asked the other whether my doctor was on her way in and she said she was. I knew it wasn't because I was about to push a baby out. They did another VE and found I was still at 6cm, an hour after the epi had been done.
When my doctor showed up not long after, she came in clearly expecting a fight but I had been watching and I could tell what was going on. I wasn't willing to take any risks at that point - given how much I was struggling with my contractions, I thought of course this baby is struggling! Just because I can't feel them anymore doesn't mean they can't. The OB said baby is getting too tired now and we need to go to surgery, and I just accepted. She looked surprised that I wasn't fighting her, so I jumped at the opportunity and said "but I want delayed cord clamping and immediate skin to skin" and I remember so vividly her sighing and saying "Katelyn, if that baby comes out okay, you can have whatever you want".
We rolled down to theatre, my epidural got dosed up, a little too much to the point that I was starting to feel numb at the base of my neck and almost in my throat and had to keep consciously focusing on swallowing and breathing. I didn't want to let it take over though, because I knew they'd just put me under general and I wasn't having that.
Surgery got underway, I was very numb but I could feel a bit of pushing and tugging. It eased and not long after we heard a little cry, but it was all still happening on the other side of the drape. I heard my OB say "they don't know the sex, so don't say anything" to the rest of the surgical team and then she called out to me "Baby's here, we're just waiting for the cord to stop pulsing." Another few minutes went by and they presented our baby girl to us around the drape. I was sooooo sure I was having a boy that I had to do a bit of a double take and then said to my husband "that's a girl, right?!"
She was put on my chest, although she was partially wrapped up, and after a little while, she started rooting around for a nipple. I got the midwife to help me help her latch, and she had her first feed right there in theatre. Unfortunately, once the surgery was finished, they didn't have a proper recovery at that time of night (she was born 10.45pm) so Florence and my husband were taken up to the ward with the midwife and I was moved to the side in the theatre while it was cleaned up and set up for the next surgery. It was a long time that I was stuck there, shaking from the epidural and wondering what was happening with my baby. It was almost 2am when I made it back up to the ward where my exhausted husband and precious baby were.
My recovery went about the best you could expect from major abdominal surgery. I was up and walking around that first day, only very slightly, and we were discharged after four nights and was only taking Panadol after the first couple of days. Our breastfeeding journey was pretty great, with some minor bumps in the early few days. I had some grazes on my nipples that were excruciating to feed with. The horrible irony of my choice to go private OB for the extra time in hospital for breastfeeding support was (which probably comes as no surprise to anyone who has birthed in a hospital) that every midwife and nurse had different and conflicting advice for me. Some of it we were simply lucky didn't derail our breastfeeding journey, like "Oh, your nipples are sore because she's using you like a dummy you should just give her a dummy and then they'll be fine". Flo, luckily, was a major boobie monster, but she is also a massive dummy addict (thanks, that midwife - any tips on how to now wrestle it back from her three years later? 🙄)
I was weirdly calm about the whole experience and having had the caesarean despite having the old belief of "once a caesarean, always a caesarean". I didn't know many people who had had caesareans, but I also didn't know many people who had given birth at all. My step mum had a caesarean with her second (and last) child, and I knew my grandmother had had them for both my mother and aunty, back in the days of the classical vertical incision. I had certainly never heard of the term VBAC, and as much as I was feeling okay about having had Flo cut out of me, my VBAC research began before I'd even left the hospital as I googled the question "Can you have a vaginal birth after a caesarean?" and discovered a whole world of maternal health care that I had previously known nothing about.
At my six week check up, my OB pulled the classic "I know it's not the outcome you wanted, but at least you have a healthy baby" line and I just blindly agreed. I asked her about future birth options and she practically rolled her eyes as she said "Yes, you can try for a VBAC but you need to wait at least a year before becoming pregnant again".
She wanted to do a pap smear, as I was overdue, and as she was prepping for it she said "although honestly, you are so tight down there I don't know if you'd be able to birth a baby vaginally" which I was guttered to hear but knew enough by this stage to at least be slightly dubious. In response, I asked her about how vaginismus affects vaginal deliveries. Vaginismus wasn't something that I'd mentioned in my medical history or in my file or anything because it wasn't something I'd had a problem with since I was a much younger adult when I was experiencing significant pain and generally difficulty with sex. I'd seen an gyne, gone through some treatments and eventually gotten through it, only experiencing discomfort intermittently from then on. But it had occurred to me that the tightness and pain I had from VEs was a similar sensation to the vaginismus, so I thought it was worth asking. Oddly, my OB's tone and demeanour changed at the mention of vaginismus - she softened completely and spoke very gently and kindly to me saying it could impact a vaginal delivery, and then when she proceeded to do the pap smear, she very slowly talked me through the whole experience and was far gentler and more respectful than she had been at literally any point of my pregnancy and labour. It was very peculiar. In any case, I knew it would be the last time I'd ever see her as I knew I wouldn't go back for any future children or to see her for gynaecology.
And here ends the story of Florence's birth, but never fear - Stella's birth story is coming. And it's a ripper.
My name is Katelyn Commerford and I am a doula and next birth after caesarean guide who has completed comprehensive doula education. If you want to know more about what I do and how I can help you, please visit my website where you can get your free cheat sheet of my favourite VBAC resources, or find me on instagram @thenbacguide where I answer commonly asked questions about planning the next birth after caesarean and share loads pregnancy, birth, postpartum and parenting content.
Business Name: Katelyn Commerford - Doula and NBAC Guide
Phone: 0431 369 352