One of the most recurring questions I get in my every day practice is: ‘Sue how should I deliver my first baby?’, but more often it’s..‘I had a shocking first vaginal delivery and I have significant birth damage- should I have a Caesar? My answer to patients is that they must consult with their O & G, their midwife, their GP and do plenty of research themselves. I lay out the evidence, the pros and cons (as unfortunately there are pros and cons for both), but when they press for a definitive answer, most importantly I say:’ I don’t have to have the Caesar and I don’t have to do it! Ultimately you (in consultation with your partner) must make that decision’.
I was recently seeing a patient, Claire, who had returned after her second baby and was ecstatic with her second birth experience. She reported a delivery via C-section that mimicked some elements of a natural birth and I asked her would she mind writing me a blog- which she did. My Xmas present (from Claire) arrived today and as I have been busy playing Grandma I was very pleased to be able to send this into cyberspace as my Xmas blog. Here is her story……
In late 2013, I was pregnant and preparing for my baby’s birth. I read a lot of books about giving birth and wanted a wonderful “birth experience”. I was accepted into a Brisbane hospital Birth Centre and was over the moon about my midwives supporting my desire to have a water birth with no drugs. Unfortunately, the birth was not the smooth experience I wanted it to be and I ended up with a third degree tear after a prolonged pushing phase and perhaps some mismanagement during the birth process. The four days I spent in hospital after the birth were the worst of my life. I had very little assistance during my stay, I was in a lot of pain, and I had a baby who had a huge bruise on his head and screamed almost constantly. We had a lot of trouble breastfeeding and I found the first three months extremely stressful, definitely exacerbated by the pain of my tear and my slow recovery from the tear.
When I fell pregnant again in 2015, I wanted to avoid a repeat experience that would cause even further damage, especially considering I still have ongoing issues from my tear. I talked to every midwife and obstetrician I could about my experience and asked each one what they would do if it were them. The overwhelming answer was to have an elective caesarean. I agreed.
In the weeks leading up to the caesarean, I wondered if I had made the right decision because of all of the drawbacks of caesareans I’d heard of and a desire to still somehow have that wonderful “birth experience” that would make up for my first birth. I stuck to my decision though and felt surer about it as my due date grew closer and I was told I was carrying a large baby. I know my anxiety would have been huge if I were to have a natural birth and was relieved that I knew what was coming.
My caesarean was carried out by Dr Matt S. at the same hospital and was absolutely wonderful. Oddly enough it felt like exactly the natural, calm and joyous event that I had wanted my first birth to be – yet since it was a C-section it was a very ‘medical’ birth! Once the incision had been made, Dr S lowered the drapes so I could see my baby emerge from my belly. The midwife moved my gown and my beautiful girl was lowered onto my chest, with my husband cutting the cord. We had skin to skin contact for a long time until she was briefly taken away to be weighed and measured while my operation was completed. She was with me again in recovery where I breastfed her and she slept on my chest. This time my time in hospital was great and restorative. The midwives knew exactly what I needed and helped me with everything. My pain was managed perfectly and after the first couple of days, my recovery was easier and quicker than with my tear. My baby has been a happy baby from day one, we have had no problems feeding, and I have genuinely enjoyed the newborn phase with her. I have absolutely no regrets about having a caesarean and would recommend it to anyone who has damage from childbirth.
Now I am not advocating that everyone must follow Claire’s path, but I do think her wonderful story may be reassuring for those girls who are anxious and reluctant to have a C-section because of the medicalization of the birth, but for many reasons the Caesar may be the best, and sometimes only, course of action.
And as the clock is fast approaching midnight and another Xmas Day will commence, I would like to wish you all a very Merry Xmas. I am looking forward to my first Xmas with my grandson and his family; I am missing my intrepid travelers but am inspired by their fabulous trip to South America and am thinking lovingly of all those who are no longer here, but are never far from our thoughts.
Sophie and Mike, 23/12/15 Machu Picchu