Tuesday, 10 December 2013
What is a VBAC? Why would I post about having a VBAC?
Recently I have been asked by two of my friends to give them some information on my experiences having a VBAC? I thought there might be quite a few ladies out there who want some first hand information. So what is a VBAC? Vaginal Birth After Caesarean.
I have had 3 VBACs. Every birth after a caesarean is called a VBAC. My first was a natural delivery, my second was an emergency caesarean and my last 3 were VBACS. Yes, I’m one of those crazy people who have a thousand kids. My first VBAC I researched and researched. I lived in a rural community and was not permitted to have the VBAC in the local hospital. The Royal Flying Doctors could only guarantee they would be there in 4 hours and if there was a rupture of the scar tissue that is not soon enough. I believe I was very lucky to have a doctor who was from Africa. He had delivered thousands of babies, yes, thousands, I’m not making that up. He had delivered many VBACs in very unsavoury conditions. His belief was that in Australia with our class of surgeons even our GPs and our sterile environments that everyone should be delivering vaginally after a caesarean if it was medically possible. I was lucky that he told me what a ruptured scar felt like, as much as a man can tell a woman anything about labour, and was able to put my mind at rest. He had delivered quite a number of babies in Africa in slums and villages where the scar had ruptured and both mother and child had survived. He did tell me though that the more babies I had after the caesarean the more chances I had of the scar rupturing.
I am not basing my whole belief about VBACs on his words but he did give me confidence to make a go of a VBAC. In my research I found that the Australian heart rate norms, those that they use to see if the baby is in distress or in danger, is quite a bit outside of the World Health Organisation (WHO) acceptable rates meaning in Australia we are more conservative variations of foetal heart rate. Why are they so concerned about foetal heart rate? It gives an indication if the scar has ruptured and if the baby is in distress.
I found that the greater the amount of medical intervention the greater the risk of caesarean and repeat caesarean. In most instances woman naturally have a period in their labour where their labour stalls for a short time. Some woman the length is longer but more often than not this period will occur at the same time every labour. For me it was 5 cm. Some women stalled at 8 etc, etc. Women who chose to only be monitored intermittently had a higher chance of having a successful VBAC compared to those who were hooked up to machines the whole time. The studies surmised two reasons for this. Firstly, the labouring woman wasn’t free to move about and thus the labour was stalled because the woman was more often on a bed or sitting in a chair and not moving around the birthing room. Secondly, hospital staff saw any increase or decrease in heart rate or contraction intensity and were quick to insist on another caesarean.
According to medical teams I spoke to the longer you are in labour the greater the risk of a rupture to the scar. In my first VBAC I was very aware of my long labours. My waters had broken with Hollie (my first) at 12am and I started having contractions 6 mins apart from then, slowly increasing in frequency until she was born at 4pm that day. That is a long time to be in labour with contractions that strong and that close together. I knew I had long labours so I didn’t tell the hospital when they admitted me how long I had been in labour. I was in labour for 18 hours before Hannah, my first VBAC, was born.
Hannah, the first VBAC
During Hannah’s labour I arrived at the hospital and all the 6 birth suites were full. I had to pace outside in the corridor while they cleaned a room for me. I was lucky in a sense because they left us be. I asked not to be continuously monitored and they were fine with that. At 5 cm they let me in the bath, which technically I wasn’t supposed to do but in my first labour it was something that calmed me down. They would come in regularly and check on me and put the monitors on my belly. I was able to walk around and operate like any normal labour. I also asked not to have a canula in because when I labour I like to grab things and I didn’t want the needle thing shoving into my hand as I gripped. I know people are thinking how many risks I was taking but I remember when I had my caesarean that the surgeon said she could get a baby out 30 seconds after the anaesthetics were administered. To me that means baby will survive. Hannah was born in the sack and it was probably the most rewarding birth I have had. She was born 7 minutes before midnight, I cut her cord and hugged her and hugged her because we had done it. Against all the risks and all the people who put doubt in my mind, we did it. Her poor Dad didn’t get to hug her on her birth day. She’s the only one of his kids that he didn’t but there wasn’t much time left in that day and the day was all for us.
This is probably one of my favourite photos ever. The is just the proudest and most wonderful Dad. I am a very lucky wife.
Lovely Lisa, my 2nd VBAC.
When I had Lisa, my 2nd VBAC, I was in my rural community and because I’d had my scar tested with Hannah’s birth I was able to deliver Lisa in the local hospital, however I had to agree to be constantly hooked up to machines or they wouldn’t allow me to birth there. Lisa was 15 days late. Yes, 15 days! Can you imagine how I felt for those last 15 days? All of my children have been late except my caesarean. She was three weeks early. Lisa was due on the 16th of December and the doctors were going to induce me on Christmas Eve and I said, “Do you want to spend your Christmas here with me or at home with your family?” They decided that at home was the best option so I was monitored every day for 1-1.5hours. I really didn’t want them to break my waters or to intervene in any way. All the research I had read said that was a bad idea. In the end they ended up breaking my waters, which did nothing, and eventually they put the oxytocin drip in me. Normally they don’t do that for VBACs but they believed they had a greater control over that than anything else and they could turn the drip off if they needed to. The drip worked straight away and I started having contractions. It wasn’t very pleasant because I was hooked up to all the monitors and the clip off the baby’s head came off about 40 mins before she was born and the second clip didn’t clip on so the doc had to go up there again to stick the clip on. Not fun at that time of the labour. In the end it was a fabulous labour because it was so quick. Over and done with in 2.5 hours. I felt like I could run around the block after that.
If you want a VBAC I say go for it. If you think, like I did, the recovery after a natural birth is a lot easier give a VBAC a go. Post natal depression increases with caesareans. A VBAC give you the chance to be less dependent on people. When I had Jessica and the nurses said to me not to pick up anything heavier than the baby, I thought, “ Which one?” Hollie was still a baby at the time. She was 13 months old. I had to pick her up when she needed me. If you think you can have a natural birth do some research. I admit it was very difficult to find a balanced or an alternative view. Most of what comes up in google searches are by American doctors who seem so scared of the worst possible thing happening. I know I would have not forgiven myself if something terrible had happened to Hannah but I also knew I had enough facts to do it and do it with confidence.
Kevin, my 3rd VBAC
I wrote out a birth plan specifying under what conditions I would have another caesarean and at what points I would have medical intervention. This is something I encourage any one thinking about having a VBAC do. If nothing else it clarifies in your mind what you believe and what you want.
Do some research and if you have any more questions please let me know how I can help.
Tuesday, 3 December 2013
There are a few things about parenting that I am a firm believer in and it would take a lot, and I mean a lot, to persuade me to alter my view. One of the issues is toilet training. This is a hugely controversial issue. It seems that most people don’t hold my view and I’m ok with that. I stand from the point of having toilet trained 4 kids and am about to attempt to train the 5th. I therefore feel I have at least some basis for my viewpoint.
So what is your view Amity? My view on toilet training is easier the younger you do it the easier it is. What? How can that be? I don’t view toilet training as a difficult thing. It is an essential part of parenting. My opponents, if that’s a word in parenting, advocate toilet training when a child is ready. Normally people feel like a child is “ready” when they are around 3.5 years old (from my 7 years of being involved in playgroups and music programs and chatting with many, many parents over these days). My belief is that parents have missed the first signs of being ready. My son is 15 months old and he is currently showing signs of being ready to toilet train. Are you serious? Yes I am. My second daughter was completely toilet trained by 15 months and dry through the night by about 19 months. I can’t actually remember when it was because she just did it but it was just after my third daughter was born.
How can I tell that Kevin, aged 15 months, is ready for toilet training? There are many signs but here are a few of the most common.
He is very curious about any of us going to the toilet. He comes into the toilet and watches. I know that some of you are cringing right now but I have pretty much had an open door policy on the toilet because otherwise I would never get to go or there would be huge tantrums and break downs outside the toilet door.
Kevin has started to pull his nappy off. Luckily I have not had him pull it off when it has been soiled. He has pulled it off many times though when the nappy has been full of wee. When he is wearing modern cloth nappies (MCN) he will pull them off as soon as he has done a wee.
He comes to me as soon as he’s done a number 2 in his nappy. In the last few days if I don’t jump up straight away to change him he will toddle off and get the packet of wipes and bring those back to me. He is showing signs that he doesn’t like the sensation in his nappy. Probably a month ago he started to pull at the crotch of his nappy when he thought his nappy was full. He wasn’t walking at all at this stage so I wasn’t prepared to toilet train him then because I wanted him to be able to make his way to the toilet.
I think a large part of the problem with parents saying their children aren’t ready is that they are missing all the signs. I know with Hannah, number 3 child, I missed the window. She used to come to me when she was about 15 months with a nappy in her hand and she would say, “Pappy, pappy” and she was wanting me to change her nappy. I was pregnant with number 4 at the time and I was so ill with morning sickness I couldn’t face toilet training her at that time so I would just change the nappy. She was my most difficult to toilet train when we started at 18 months. She is a very determine young lady though and I think part of her problem was someone was telling her to do something and she wanted to be the one making the decisions about her self and her body. Once I stopped talking to her about going to the toilet and ignoring her she decided to go by herself.
I think another problems parents in the Western world face is the propaganda the nappy companies have dished out over the last 15 years. Of course they want parents to toilet train their children later because it means more money in their pockets. In 3rd world countries children are toilet trained at a very young age. They begin the process very early on. I know in China they start as soon as the baby is born and they will make a noise while the baby is toileting. This then creates a Pavlov’s Dog response when the noise is made later on. It stands to reason. These people don’t have the money or the time to have kids in nappies.
Look out for the signs and you will see how easy it is to toilet train your toddler.