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Interview 13

Age at interview: 33
Brief Outline: 1st child was breech, so had planned CS. Various complications made her keen to avoid repeat CS. Asserted herself against doctors' recommendations. 2nd child born after 12 hour labour with help of ventouse. Pleased with experience, recovered much better.
Background: Retail assistant with one daughter aged seventeen months. Husband is a design engineer. Ethnic background: White British (English).

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First pregnancy and birth

Her first pregnancy was long-awaited and achieved with the help of ovulation induction. Her pregnancy was largely without complications, though she experienced sacroiliitis (an inflammation of the joints connecting the lower spine and the pelvis). She had attended antenatal classes but did not find them very informative. The information she got from mother and baby magazines and from watching birthing programmes on TV was more useful. She had hoped to give birth vaginally, but found out at a growth scan at 34 weeks that her baby was in a foot breech position. She felt that vaginal delivery would be impossible under these circumstances and booked a planned caesarean. She prepared a birth plan for the caesarean and at 38 weeks it was confirmed that the baby had not turned.  

She felt quite scared about having a caesarean. While she was keen to witness her baby being born, she felt fearful of having an epidural and of being conscious during the operation. On the day, her husband accompanied her into the operating theatre. Setting the epidural was more painful than she had expected compared to what she had seen on TV. The caesarean itself went smoothly and her daughter was born healthily. However, immediately after the birth, she had unexplained pain in her right shoulder. She felt very sore and found managing with a newborn after surgery more difficult than she had anticipated. In the weeks after the birth, she also experienced recurring heart palpitations and wondered whether they had been triggered by the stress of the operation. She was referred to a heart specialist, who was unable to determine a cause. The palpitations eventually subsided after five months without medication. She initially breastfed her daughter, but switched to formula milk when the baby developed reflux. Looking back, she would have liked to receive more detailed information about recovery after caesarean. It might have helped her to prepare better for the time after the birth.

Second pregnancy and birth

Her and her husband wanted more children and had made another appointment at the fertility clinic, but she got pregnant spontaneously with her second child. Her second baby was also in breech position but she was very keen to avoid another caesarean and refused to book one ahead of time. She was relieved when the baby turned at 36 weeks. Her doctors were not particularly encouraging about VBAC and told her that she would be monitored closely, bu she felt very strong-minded about having a vaginal birth. Her main reasons were a quicker recovery and being able to return home sooner. She gained confidence in her ability to have a vaginal birth from watching births on TV and also from chatting to other women on the internet.

She came into hospital with contractions in the early hours of the morning and laboured relatively comfortably up to 8cms. She then had an epidural, which slowed down her labour for a while and made it more difficult to feel movements at the pushing stage. Her son was eventually born after 12 hours of labour with the assistance of a ventouse. 

She had been worried throughout labour that she would be forced to have another caesarean but managed to stay in control of the decision-making process throughout. Even though she felt tired and bruised after the birth and had a third degree tear, she rated the soreness a lot less painful than what she experienced with her caesarean. She is glad to have experienced vaginal birth and found it a very emotional experience. The feeling of her body 'doing its job' felt empowering compared to the loss of control and clinical feel of having a caesarean. Being able to pick up and cuddle her toddler ddaughter when she returned home was also very important.

She has been told that due to her tear and the size of her two babies she would not be allowed to have another trial of labour with a future pregnancy, but had already decided independently that she did not want any more children. She thinks making the decision about how to deliver after a previous caesarean is difficult for women, especially if they do not have a lot of information. She counts herself lucky to have had friends with similar experiences who she could talk to. She would advise other women to seek out information early on and to give natural delivery a go if there are no strong reasons against it.
 

The information she received on planned caesarean did not prepare her for the difficult recovery...

The information she received on planned caesarean did not prepare her for the difficult recovery...

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And what were the antenatal classes, what were they like? 

They weren't very informative to be quite honest with you. I didn't really learn anything.

Right. So where did you get better information from?

Probably off of the tele, watching birthing programmes. 

Okay.

And reading magazines of course, Pregnancy and Birth, Mother and Baby. 

And what about the obstetrician when you had the growth scan and found out about the breech, did they explain to you about the section at all then?

Yeah. 

What kind of things did they tell you?

They basically just said what the procedure was, and that I would have another scan at thirty-eight weeks just to see whether the baby had moved or not, and also explained that I would need to go to the hospital the day before [the section] to have a scan and then where I had to go for the actual section etcetera.

And with hindsight did they prepare you for how you were going to be after the section?

Probably not as much as one would expect really. That was a bit of a shock for me I think. Although I realised it was surgery, I didn't realise just how difficult it would be to cope with a newborn baby and be so sore as well.

I think maybe it would have been nice to have known about the risks with the second pregnancy, and about what it was like after having the section.

 

After the caesarean, she developed heart palpitations that lasted for several months and which...

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After the caesarean, she developed heart palpitations that lasted for several months and which...

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When my daughter was delivered I had quite a lot of pain in my right shoulder and no-one could really tell me at the time why that happened, and it lasted a few days and I was given painkillers for it. And also I had quite a few problems with my heart after as well; whether it was due to the stress of the delivery I don't know or if it was just' I really don't understand why it happened, but I ended up having to see a heart specialist because of it because it went on for about four or five months.

And what kind of problem was that?

It was, it just felt like my heart was thumping really hard in my chest all the time, almost like palpitations I suppose.

And how did that resolve, did that do it by itself or '?

It resolved itself in the end. They said that if it didn't I would have to take medication, but luckily it did, it did go eventually.
 
 

She made friends with other women who were keen to attempt vaginal birth through an internet...

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She made friends with other women who were keen to attempt vaginal birth through an internet...

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And what other information sources have you used this time?

Erm, again, watching programmes on the tele [laughs]. I'm a bit addicted to like the baby channel [laughing].

Do you find them scary at all though?

I do, some of them are a bit scary, but it's really nice when a woman's had a previous section and she then goes on and has a natural delivery because it really makes you think, 'Well I can do this, if she can do it I can do it,' you know, 'I can do that as well.' I've discussed, I've' I gone on the internet, I've been on to a website on the internet and I've made friends on there and I've discussed it with them as well. 

Do you think it's a common dilemma for women then, being in your situation?

I would say so, yeah, yeah.

And is that the kind of thing that you've been getting from the other women you talk to?

Yeah, yeah.

They've had sections and they're making decisions?

Yeah, yeah, mm.

I've not seen them, so what kind of things do they say?

Erm, well they're basically in the same situation as me where, you know, they want to have a natural delivery but they don't really know throughout the whole of their pregnancy how it's going to end up, so they feel like everything's up in the air because you don't know what sort of delivery you're going to have. Even if you want a natural birth and it's actually planned to have a natural birth, you don't know really if that's going to happen, because obviously with a previous section, you know, you really are closely monitored and you can get told at any point, 'No, I'm sorry, but you've got to have a section now,' so'
 
 

She felt anxious when a growth scan at 34 weeks showed her baby to be breech as she did not want...

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She felt anxious when a growth scan at 34 weeks showed her baby to be breech as she did not want...

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Yeah, I mean, I actually went for a growth scan at thirty-four weeks and the baby was breech [right] at that stage, and I was actually booked in for a Caesarean, which was really upsetting for me. But luckily obviously the baby's turned and the section has now been cancelled, because I was due to have it next week.

Did that cause you anxiety?

It did, yeah, I didn't' because again I felt like everything was out of my control and I had no choice in the matter, it did cause a bit of upset.
 
 

Being able to talk to friends who had faced the same decision was helpful in making up her mind....

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Being able to talk to friends who had faced the same decision was helpful in making up her mind....

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I think perhaps when you've had a caesarean and to then have a natural labour, I mean, you're always going to have something on your mind like is this really the best decision to make, or it would be really nice to talk to a woman that's actually gone through this already. Because when you actually go to the hospital and they're saying, 'Oh, I'm not sure if you should have the caesarean', and then you're think well am I making the right decision, you know, what's going to happen to me, you know, is it really that bad a decision to make? And to speak to other women that have actually been through it I think can really help ease all your worries and put your mind at rest, and think well I can go for it then. I was lucky enough that I had a couple of friends that had been in a similar situation to me so I managed to talk to them. But it would be really nice I think.
 
 

She was determined not to have another caesarean. The doctor said she could only push for an hour...

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She was determined not to have another caesarean. The doctor said she could only push for an hour...

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I woke up at half past four in the morning and realised I was getting contractions and they were five minutes apart and lasted about forty seconds. So I rung up the delivery suite and they said to come on in straight away. I had to wait about an hour and a half for my parents to turn up to look after my daughter, and then we got into hospital and we taken into a room straight away, and the midwife at the time said not to suffer and if I wanted gas and air to go ahead and use it, but I used my TENS machine for quite some time. I wasn't actually examined straight away, I think I was at the hospital for about two or three hours before they examined me, so I was quite anxious to find out how far along I was. And then when I was about six centimetres dilated I went on the gas and air, and I said to the midwife at the time I don't know if I would like an epidural, I don't know how far along I can go. I didn't want to feel out of control. And she said, 'Well, you're doing fine as you are, just let me know once you feel like you need one,' and I got to eight centimetres and I decided that it was just too much and I had an epidural. But unfortunately with that my labour slowed down a bit so' but by positioning myself on my left side it soon sped back up again. I think I was fully dilated about one o'clock in the afternoon, but I wasn't allowed to push for I think it was about an hour and a half because they wanted my son to come down as far as possible. And he was delivered at half past four by ventouse. Because of the epidural I obviously lost quite a lot of the sensation so I couldn't really tell if I was pushing in the right place or not, so I needed a little help in the end. But that was fine by me because I'd rather have that than a caesarean. 

'You've told me a lot there. At any time was there a concern that you might need a section at all?

Once I was fully dilated, a doctor came in and said, 'We'll let you push on your own for an hour, but that's all you're allowed is an hour because of your previous section.' And then we would have to, then we would have to go ahead and use some other method to get the baby out. And so at that point I started thinking please don't let it be a caesarean. I think I probably even said, 'I don't want a...,' you know, 'I don't want a C section.' But obviously once I'd been pushing for an hour they then had to come in and help me out, so'

And were you worried that you only had an hour, did that concern you?

I think it did a little bit at the time, but I suppose you're so concentrating on getting this baby out you don't really sort of take much notice of the time, but once the doctor comes back in and you know she's going to say something, you think, oh please, I don't want a caesarean, I'll try anything but I don't want a caesarean right now, just give me a chance. But luckily they said, 'We'll try the ventouse and see how we get on with that.' I think they were going to take me to theatre by they decided not to and I delivered in the room that I was in at the time.

And having had the ventouse, was that something you felt prepared for to have assistance?

I knew there was a possibility it could happen, and one of the reasons why I held off so long having the epidural, because I knew if I had one quite early on there was a greater chance of me having a caesarean, so I left it as long as possible, and in fact I was absolutely amazed that they gave me one at eight centimetres because I do believe they don't normally so late on, but because the anaesthetist was available I could have one. But' 

But do you think it was something you were prepared enough to have?
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