Avianne’s VBAC Birth Story

Our first son was born via an “emergency c-section” at a private hospital in Pretoria, for reasons that remained questionable to us. My husband and I were marginalised from the process leading up to his birth, and left questioning whether things could have been done differently, or whether our practitioner was even competent to deliver naturally. Four hours after arriving at the labour ward, and being 7cm dilated, the gynae declared “failure to progress” and “fetal distress” and indicated that I would need to have a c-section. We joked that the gynae probably wanted to get home in time for dinner, but in retrospect, we realized she was never actually committed to a natural birth despite 9 months of reassurance otherwise. In any event, our baby was born one hour after the decision to do the c-section and my husband and I were elated. He was healthy and strong!.

We resolved to be better informed about the birthing process and options available to us in subsequent pregnancies, and most importantly, we wanted an honest and open medical practitioner to guide us. As we started researching VBACs and VBAC options in Pretoria, my husband and I came across Midwives Exclusive and we attended their informational session.

We decided with the second pregnancy that we wanted to at least have the opportunity to try a natural birth, but finding support for a VBAC was proving to be difficult. The gynae that we interacted with during the first few months of the pregnancy was pushing me to have an elective c-section and attempting to scare me away from a natural birth by focusing on all the things that could possibly go wrong. I started to become anxious about the pregnancy and the delivery until one day my husband and I just stopped and said, ‘wait…this is exactly what we did not want!’

We were checking out the facilities at Femina Women’s Hospital one afternoon, when we decided to stop by the Midwives Exclusive birthing unit attached to the hospital. From our conversation with Marsha at the reception, to our initial consultation with Esti, we were confident that Midwives Exclusive would allow us to be active participants in the birthing process, and reclaim what we felt was excluded in the process of having our first child. After our VBAC assessment with Esti, the team of midwives there decided that I was a good candidate, and our journey with Midwives Exclusive began. Heather was my midwife, but over the course of the pregnancy we interacted with all of the midwives at the practice. Midwives Exclusive boasts an incredible and caring team; the experience was cathartic and empowering, which was such a welcomed shift following our previous experience.

We also did the Antenatal Class with Midwives Exclusive which was a huge benefit (especially as it concerned the stages of labour and natural birthing process, birthing positions, relaxation and pain management techniques, addressing fears and anxieties, and the role of adrenaline, oxytocin and endorphins in the labour process and working with your body’s natural processes). Under the care of the midwives there, I began to get psychologically, emotionally and physically prepared for a vaginal birth. I was excited and at ease. I could contact them about any issue, any concern or worry, day or night. They were always accessible, responsive and ready to assist. My husband and I appreciated the holistic approach to childbirth and embracing the notion that birthing is a natural process. At the same time, we trusted that if Heather thought some level of medical intervention was necessary, that it was truly necessary, and in the best interest of both mummy and baby. The prenatal appointments were relaxed and honest. Heather was like my advocate; she truly listened to our birth preferences and was committed to allowing us to have the birth we wanted. We openly discussed the full range of options, expectations, anxieties, possible complications and the course of action in the event of any complication. The appointments didn’t feel rushed or evasive. (With my first pregnancy, the appointments with the gynae felt rushed and major anxieties and concerns were glossed over or oversimplified).

I went into early labour at 39 weeks, and laboured at home for about 24 hours, until contractions were consistently 4 minutes apart and at least 60 seconds long. When this went on for one hour, after discussing it with Heather, we agreed that I would proceed to the hospital. As we arrived at the hospital entrance, Heather had also just arrived. She checked me first to see if there was enough progress to admit me and she said I would be having this baby today. Yay!

With this pregnancy, I planned to manage the pain naturally. I used the different techniques learned during the antenatal class. The one that worked wonders was my husband applying pressure to my lower back. We played music to create a relaxing environment. To help the baby’s movement into place, I moved around, rocked, bounced on the stability ball, did squats, etc. l ate snacks and stayed hydrated to keep up my energy levels, and later on Heather put in a drip with electrolytes because she was concerned about my energy levels. (By this time, I had had very little sleep in the past 24 hours).

The back-up gynae, Dr. Kruger, was also fantastic, and a supporter of V-BACs. She visited me once while in labour, but did not intervene in the process.

As contractions intensified and I went into the transition phase, I got into the bath as one of the pain management techniques and it was a relief. I used the different breathing techniques to manage pain, also imagining that with each contraction I was closer to seeing our little baby. My husband was a great labour partner. There were occasions when it became so painful, that I wanted to scream, and he reminded me to breathe through it. He was behind me in the bath the entire time, providing sips of water and rehydration fluid and supporting me through the contractions. I took advantage of the opportunities to rest between contractions and throughout the process Heather reassured me that I was doing well and monitored the baby intermittently.

When it was time to start pushing, which was about 2 hours after getting into the bath, Heather guided me well through this final phase, communicating calmly, clearly but firmly. She told me when to give it my all, even when I felt like resting; when to push hard and when to slow down. As the head was crowning, she encouraged me to touch the baby’s head, I knew I was almost there. I pushed for a little under one hour and the baby was born in the bath, 6 hours after I arrived at the hospital. I did not intend to have a waterbirth, but it was a beautiful experience.

Labour was an absolutely surreal experience. It was nothing I could have expected. The sensations were all strange and sometimes counter intuitive. Heather did such an excellent job guiding me through the process and working with my body.

Immediately after birth, my baby boy was placed on my chest. We delayed the cord clamping and my husband cut the umbilical cord. Baby boy stayed skin to skin with me in the bath for about 5-10 mins, then subsequently, skin-to-skin with my husband. Once I was out of the bath, the baby was immediately allowed to latch and breastfeeding continued for the next hour. After this process, Christelle, the second midwife who was supporting Heather, weighed the baby and did length checks and reflex texts for the Apgar score. She did footprints on a card as well.

I took a bath about 1.5 hours after giving birth. It was so refreshing to be able to move around so quickly after the birth. Heather and the gynae were comfortable to discharge me the same day, so I left the hospital that same evening and headed home. I was elated that the recovery went well and very thankful for the wonderful support provided by the team at Midwives Exclusive. Once I was discharged, Heather came to visit me at home the following day. Christelle came 4 days after that, and again, about one week later. I had 3 home visits in total, during which they monitored my recovery and the baby.

The labour, delivery and aftercare was everything I could have hoped for and more. I cannot thank Heather and the Midwives Exclusive team enough. My husband and I are grateful to have found Midwives Exclusive, a practice that empowers women and families and provides support to every stage of the pregnancy, delivery and post-partum process. It is a practice that loves women and is attentive to the concerns of families during this very special process.

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