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Oh! I'm pregnant, this is GOLD! Now I can have a VBAC...

True, first thoughts.

I am a Nurse, Midwife, Mum of 2 and soon-to-be, Mum of 3 and I'm preparing for my VB2C. 

What's that you ask?! 

Vaginal Birth (after) 2 Caesareans.

Full disclosure, I don't hold trauma after my previous 2 caesareans. I can quite objectively reflect on those experiences (which were phenomenal!) and see where I may have made different choices BUT I made the choices I did, with the information and support I had at the time.

And yes, I did get frightened into the second caesarean-more on that later perhaps.....

So being pregnant now feels EXTRA special and important for me. I'm a passionate Midwife, Hypnobirthing Australia practitioner and will launch into private Midwifery practice once le newborn allows for it.

So I mean, cummon, I'm having a vaginal birth, right… I have ZERO doubt in my ability to birth this babe vaginally. My only concern lies with WHERE I will be birthing.

I'm booked at my local public hospital... I'm daydreaming of a homebirth... Hoping a money-tree will spring up and I can employ the care of my favourite private OB...

There a lot of conflicting thoughts there BUT the one consistent one is, 'of course I can do it, can you?'.

 Preparing for birth - From a Midwife's perspective

I'm after a physiological birth. I want NO intervention and I don't want to have to explain myself 500 times and have to justify what I want...because...well...it's what I want, plain and simple. I will not be frightened into 'book(ing) the Caesar' (which I've been told numerous times already!).

For the record, a physiological birth VERY rarely comes to fruition in a hospital setting. Hospitals are brilliant for risk management, they excel in fact, at managing risk and highlighting risk factors. Risk at every corner perhaps...

For someone to trust and follow the will of birth physiology is to completely surrender and be left undisturbed. Birth is safe. The body and the baby know EXACTLY what they're doing...it's the giant invisible clock in the corner of every birth suite that disrupts that.

AND to be clear, I'm not against medical intervention WHEN medically indicated and the person is able to provide INFORMED CONSENT.

Preparing for birth - From a Midwife's perspective

 

With that backstory in mind, here's my experience so far.

  • GP appointment for hospital referral, ultrasound referral and pathology request.

Underwhelming, no 'routine' bloods tests explained, incorrect referral sent to hospital (said this was my first baby - I've been seeing her for 4 years WITH my children!).

  • First ultrasound (13ish weeks)

In person with my 2yo, lovely sonographer and efficient! Changed my 'due date' by a week! A whole week!
  • Booking appointment

Via telehealth with 2 Midwives wearing masks, unable to hear well, very uniform, very 'to the point', confirmed my original 'due date' according to my cycle, told the hospital policy is to 'book' the third caesar and very little information around support for a VBAC when asked. 'I've seen one...' was what I was told by the Midwife.
After this appointment I was chatting with my latest workshop participants who were booked at another large, public hospital and we both concluded that it feels pretty junk to be floating around in a big 'system'. I wondered how other women must feel considering I feel disconnected and I'm a Midwife-I know stuff!
Imagine how others feel, not having a clue about how it all works?!...makes me a smidge more determined in this space!
  • Endocrinologist appointment via telehealth

Referral as expected for subclinical hypothyroidism and appointment via telehealth. When asked 'what else can I do to support my stressed-out thyroid', the response from the Endo was matter of fact-nothing, just the tablets, nothing else would help.
My Natropath DOES NOT agree.
  • Second ultrasound (22ish weeks)

Attended with my partner and 5yo, all normal and friendly. Had trouble viewing the cervix, 'but that's ok, we can do an internal ultrasound'. I nearly laughed out loud. Erm are you asking or telling me...
'Oh these dates'.
Sonographer explained my dates need to be changed based on the growth of the baby ('oh and you haven't had a dating scan?!') to which I had replied, 'no we are basing the date off of my cycle'.
'Oh no no, that's not how this works' was the response, having a little chuckle.

To be honest, at this point I really wanted to leave, she was getting on my nerves a tad, so 'yes, yes, do what you need to do' and we left. (Minus the fun internal ultrasound)
  • Midwife appointment

Oh this was cute! Almost not let into the hospital as my son was with me (if it was his appointment, he was fine to go in!!). The Midwife was friendly and kindly printing my 'routine pathology' slips before I was in the room...this is in no way informed consent. Yes, she is busy and has limited time with me, I understand this having worked clinics before BUT there was no conversation, offer of tests or implications for testing. All of these factors (and more) make up the basis of making an informed decision.

In my case, I chose to decline several routine bloods, which she happily amended.

The 'due date' was confirmed as the original based on my cycle - I will now have the label 'big baby' or run the risk of 'overdue' if we changed it... either way, alert the risk management team!

Fetal heart was auscultated and explained to my son-so cute! Albeit, wrong...or perhaps we were trained differently, who knows. In my experience, it is not advised to listen to (auscultate) a fetal heart prior to 'viability' (23-24weeks depending on the organization and clinical scenario). This is purely for the fact-what if there's nothing to hear.

BUT my son appreciated the sounds. PS This babe is VERY active, so I'm able to feel a lot of movements and have no concerns about well-being based on this.

My Midwife then asked if there was anything else I'd like to add...'just birth stuff' I had replied and she got ready to type some notes.

'No continuous monitoring, no cannula, no vaginal examinations, no epidural, water/bath for labour, uninterrupted skin to skin and physiological 3rd stage. I pretty much want a Midwife to stand guard at my door so OBs don't come in.'

I had a little giggle because my preferences go against EVERY hospital policy and I KNOW it will not be 'no worries'. This is where my 'insider trading' helps (or hinders...), I just know it will be a fight to get my voice heard and my body left alone to do what it is PERFECTLY designed to do!


I may be creating a self-fulfilling prophecy here but...it's a hospital, remember they excel in risk management. And my friends, I have a risk of uterine rupture *cue dramatic music*

'What's the risk Clare?!' You ask.

'It's about the same as ANY OTHER WOMAN having their first baby', I reply

*leaving the words hang in the air*

And yet, I'm 99.95% sure I will be told of this risk more times than the first-time Mumma next door. I will have to advocate HARD-unless I chance upon a unicorn Midwife who is happy to risk 'getting in trouble' to provide support, advocacy and care congruent with my preferences.

So, Oh! I'm pregnant, this is GOLD! Now I can have a VBAC..

*It's important to note, this has been written in almost real time. My tone accurately reflects how I've been feeling about navigating my birth preparation within the hospital. It was weighing heavily on my mind, now here's the plot twist...*

THEN my unicorn Midiwfe appeared! I had a phone call from Sarah...Oh!

<sigh of relief>

'I'm wondering if you're still interested in MGP for your care?'

I nearly exploded out of the phone with excitement!

'Yes!'

We had a great chat about how the program works, who she was, a little bit about me BUT most importantly how excited we both were for a VBAC!
We made plans for next appointments, and it felt as though a weight was lifted from my shoulders!

I knew that I was thinking A LOT about this birth but I didn't realise the toll until that phone call. My 3 week-long headache lifted and I felt pure excitement! There aren't enough exclamation points to convey this feeling in words.

I feel instantly held, heard and cared for by 'my' Midwife who holds the same birth philosophy that I do and is a nice human.

Preparing for birth - From a Midwife's perspective

 

I can't wait to grow bigger and move closer to my 'hot zone' and learn just what I'm capable of as a beautiful birthing person!

Oh! And my 'welcome to the program' email was filled with glorious resources, links, information to amazing humans within the birth space who I already follow closely and have read their powerful words! Match made in heaven..

With this extensive back story in mind, I also wanted to share how I’ve been preparing for this birth, aside from merely growing.

  1. Firstly, I purchased ‘Real food for Pregnancy’ by Lily Nichols and began to understand why the body craves what it does and how to utilise fuelling the best I can. I’m not down the letter but I’m making a conscious effort to fuel in the way that suits me, my microbiome and this growing babe.
  2. Devouring my favourite birth resources (Midwife Thinking blog, Midwives Cauldron podcast, Sarah Wickham blog, Melanie the Midwife shared research, Dr Sarah Buckley on oxytocin, research shared by Hazel Keedle, absorbing the feminist power of Hannah Dahlen, constant loving on B from Core, Floor and Restore; to name a few!).
  3. As a Hypnobirthing Australia Practitioner, I’ve been refreshing my mindset around birth. Utilizing techniques such as breathing to ‘switch off’, fear release exercises, meditation for deep relaxation and movement to tune in to my body.
  4. Picked my special positive birth affirmation card to display around my space from the ah-mazing Best Birth Co. I have even tailored a few which feels even more special.
  5. I’ve been chit chatting my way into birth-related conversations and it’s safe to say, I’m obsessed! The process, the preparation, the potential for a beautiful birth and the power at my (and every birthing person’s!) fingertips!

I hope this perspective has resonated on some level and you can begin to feel the same excitement that is giving me so much energy right now.

Preparing for birth - From a Midwife's perspective

 

Since writing this excerpt, I have had a few encounters with the hospital Obstetric team associated with my Midwifery group. I was encouraged by my Midwife not to attend if I didn’t feel it necessary however, curiosity got the better of me. Not to mention, I don’t want to be viewed by OBs as ‘bad’ for not attending - I might score myself a label.

My first appointment was lovely, we chatted about waterbirth and parting words were ‘you won’t want or need to see me in birth suite, have an amazing birth’. I was genuinely so happy that an Obstetrician had that view.

My second appointment - which was requested specifically because of my ‘unconventional’ requests was a different story. This female Obstetrician was friendly, however, the conversation left my feeling deflated, worn out, upset and angry. This second appointment and attitude was what I was hoping to avoid by attending the first!

The beauty of having an amazing Midwife in my corner though was that she was able to pop in briefly and follow up with debriefing after and at our next appointment.

What bothered me the most though wasn't about me at all. I’ve mentioned it before, if I-a Midwife-can leave an appointment feeling SO sh*t from what someone has “had” to say for legal reasons, imagine the poor birthing person who has no clue, or where English is a second language, or are young, are frightened etc etc. I can get myself out of the funk because I know where to find the evidence which completely contradicts what “risk” was shared. I can Imagine the fear held by others who are just trying to birth!

What is also amazing about having and being a Midwife, I was able to read the notes the OB had documented. Needless to say they were inaccurate, we apparently spoke about a lot of other agenda items (which I must’ve completely forgotten about!).

I can acknowledge I seem cynical about birthing in a hospital, and you may have had your own challenging conversations. I’m sharing to let you know you’re not alone and it often takes some deeper work to move through frightening words and find the information that will empower you to experience birth in the powerful, magic it was designed to be!!

 

 Midwife Clare | To Birth Beautifully


Clare is a Nurse, Midwife, Mum of 2 and soon-to-be, Mum of 3. She runs her hugely popular Hypnobirthing, Positive Birth Program 'To Birth Beautifully' both face-to-face and online, is a Midwife Mentor, is the host of the Podcast, 'Your Midwife Mentor Podcast' and come 2023 (after the birth of baby) will be offering antenatal & postnatal Midwifery care. She is Yarraville, VIC.
Learn more about Clare and her inspiring businesses, To Birth Beautiful & Your Midwife Mentor, by checking out our Birth Worker & Stockist Directory.
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