A question for the Birthing Warriors!!!

[alicesmum]

I have a question for JanetF, or Felicity, or any of our other lovely birthing experts.

I am not sure if this post should be in VBAC or the natural birthing section or the c/s section, but anyways....

I have a close friend who had her 1st baby last week. She was all set for a natural active birth and we had talked at length about having a positive birthing experience in a hospital (as I had had). She was on a midwife-based program and had developed a detailed birthplan with her DH and MWs and was very determined and excited about her birth.

She was young and fit and slim, but had gestational diabetes in the final month of her pregnancy which she managed well, exercising and eating well, and putting on only ~ 12 kg. She also did OFP which i gave her links to!!! To cut a long story short, she went in to labour naturally 1 day before her EDD, and stayed at home as long as she could, being active and relaxing. She was 5cm when she got to hospital, and upon measuring the baby's heart-rate, the MW found it was dropping during contractions but picking up in between. So she wasn't too worried and my friend remained active for a while. A bit later though the heart rate was staying low in btw contractions, so they wanted to constantly monitor the HR making my friend confined to the bed. Shortly after this, the MW was getting worried about the heart rate as well as the position of his head. SHe was 8-9 cm by this stage. The MW felt it appropriate to call an OB who decided, due to the baby's position and heart rate, they should go to theatre.

The c/s went well, and DS was fine (after 2 days in Special Care) and my friend has recovered well. They are happily b'feeding too !! However, she is rather disappointed about not having the birth she had planned and is still traumatised by the experience of them trying to get the spinal block in while she was in transition (she had had no pain relief whatsoever til then, at her request).

She just wonders if she could have done something differently, but she really feels she did everything she could. Was this c/s inevitable? What causes this to happen? Was it anything to do with the diabetes? What would have happened to her in a home birth situation or centuries ago!!!????

Not surprisingly, she wants to go VBAC next time, so i was wondering if you could post your fave 2-3 VBAC sites, so i can send them to her? Also, do you have names/contacts for any support groups in Brisbane for women who have had traumatic birthing experiences???

Thanks in advance.

Rachel

[bubhub]

I've leave it to others to answer your questions about c/s and birth, but in the meantime, I thought I'd let you know that there is a Birth Trauma group who have regular group meetings in Brisbane.

If you click on this link: http://www.bubhub.com.au/serviceshel...html#pregnancy

it will take you to the Helplines & Support Organisations page on the main Bub Hub site for Queensland. If you scroll down, you'll find the Birth Trauma group and their contact details. There are other organisations listed there too who may be able to help (which is why I've included a link rather than quoting all the contact details here).

Hope this helps
Hilary

[JanetF]

I'm going to pick out the most relevant groups from that LOOOOOOOOONG list. I know the women who run all these.

Home Midwifery Assocation (Qld) Inc
ph: (07) 3839 5883
"A consumer-based organisation which offers information, education and support to women and families considering maternity care options and, in particular, to those who are considering or are planning a birth at home"

Birthtalk - Sharing, Empowering, Celebrating Birth
ph: (07) 3379 6414 or (07) 3379 7424
"Birthtalk presents two Groups for women - Birthtalk Forum & Healing From Birth Support Group, meeting at Toowong in Brisbane on a monthly basis. We hope to empower women by providing access to current literature & information about birth, as well as birthing options in the Brisbane, Sunshine Coast and Gold Coast area."

Birth Trauma & Stress Support Group
ph: Ursula: (07) 3809 0196
email: birtrasup@yahoo.com.au
Voluntary support group for mothers who have had traumatic birth experiences. Support offered through email and phone Australia-wide. Regular group meetings in Brisbane area.

[alicesmum]

thanks for that hilary and janet! I will pass that info onto her.

janet, what do you make of my friend's story? in particular, was this c/s inevitable? What causes this to happen? Was it anything to do with her diabetes?

[JanetF]

It's really hard to know without knowing the exact details, yk? Some things come to mind though.

Babies heartbeats are harder to detect and a bit wonky as they get lower in the pelvis - nothing unusual there. Lying on the bed with a monitor usually means lying on your back and since we get told to avoid this in late pregnancy for good reason, I don't know what it's acceptable in labour. Babies hr often go weird if you lie on your back as a result and a quick position change can fix it. At 8-9Cm dilation most women have some pretty intense stuff happening and this can often be when a misaligned baby is able to move about (they move themselves if they're undrugged and mum is in a position to allow it ie not lying on her back generally speaking). It's also the time when hospies start panicking and thinking it's not going to work. If she was in transition she obviously wasn't having any dilation issues so leaving her alone may well have been what was actually needed. If she started pushing and despite position changes her baby wasn't moving then there *may* have been a discussion about surgery. Before then, it's an unknown IMO. However, the best thing she can do to answer these questions is get her medical record and take it to someone not connected with the hospy to help her understand it. I recommend HMA first and foremost as a place to find an appropriate carer who can do this.

I'll PM you some other VBAC stuff but have a look in the VBAC forum here too for other things I've posted there

[DoulaFelicity]

Hi Rachel ,

I agree with Janet's post above on the babe's heartrate, the positioning, and the subsequent C Section. Sadly, some C Secs do occur somewhat unnecessarily in the later stages of labour due to routine Hospital protocols concerning time limits (ie: "failure to progress" ), a pathological fear/panic regarding the normal heartrate fluctuations (ie: bradycardia etc) that occur as dilation is ending and the babe is beginning to move down the vagina, a lack of skill and/or will to understand and deal with any actual issues with the way the babe is presenting, a compulsion to step in and "save" the woman as labour reaches it's most intense during transition...etc. It's impossible to really conclusively suggest whether any of this had anything to do with your friend, without better understanding her particular case; as Janet suggested, if your friend is interested in processing what occurred, then obtaining her medical records is definitely a necessary step.

In terms of the possible impact of the GD, again, it's hard to say without knowing the specifics of your friend's case; however I can't think of any indications of foetal heart abnormalities (although GD can sometimes carry with it an increased likelihood of malpresentation; it's still not necessarily a factor in what happened; in fact, being confined to a bed with a foetal heartrate monitor strapped on would be a higher risk factor in encouraging non-cephalic presentation. Looking into the actual presentation the Hospital noted in the records would help in investigating this). There are also generally many ways to get around most ways that babes present before a C Sec would become the only option.

It sounds like your friend did everything she possibly could have with all the tools she had available to her; and that, with support and research on her side, she can enjoy the VBAC she desires next time. It's also wonderful to hear that her breastfeeding is going well! If she's looking to start debriefing and processing any trauma she may have (and I'm sorry to hear she has any), and also looking to begin to study what happened during her birth and consider ways to change these things next time if that is what she wants; well, she's in a positive frame of mind and is once again doing her absolute best. I'm amazed she's so conscientious so soon after the birth; I know I was in lala land for quite some time!

My absolute favourite VBAC site is www.birthrites.org. It's got everything your friend could possibly need to get support, information and advice, both with processing her C Sec and planning for a VBAC next time around.

Another fantastic one is http://www.cares-sa.org.au/. It's SA based, but it's relevant and available to all Australians.

I will PM you with some trauma related sites and groups.

Hope this helps; blessings to your friend. Processing her experience will not be a quick journey; but it will be infinitely rewarding. I hope she's enjoying her babymoon!