(by Kay)
Warning: VBAC is the acronym for Vaginal Delivery After Caesarean. True to the title, this post is about my vaginal delivery and is graphic at some places.
It’s almost 22 months since I delivered my baby and it still feels surreal.
I had my first baby in 2014. I had gone for a regular checkup with my gynaecologist in my 37th week. She observed that the amniotic fluid (a naturally occurring swimming pool for the baby) had reduced and I was asked to get an emergency caesarean. My mum is a doctor and when she said it would be better to go for a caesarean, I didn’t think twice. It was much later that I came to know fluids can increase or decrease during the course of the pregnancy and I need not have had the surgery. Although it was a c-sec, I didn’t face much difficulty in recovering post partum and I buried the incident in a little corner in my heart and forgot about it. Over the years whenever I heard of a relative or a friend delivering vaginally I would feel a slight twinge of regret, which would again be buried in the corner.
Delivering a baby vaginally – a normal delivery as it is commonly known (as if other deliveries are abnormal) – is the holy grail of pregnancy. There is this sympathy, and veiled disapproval, for women who undergo surgery, as if we haven’t gone through the rite of passage to become mothers. I faced this too, especially from the women around me.
Fast forward to 2017/18 and when my husband and I started discussing about a second baby, the memories of my first delivery came rushing back. I was not ready to go through it again and I tried delaying tactics like I want to go on a solo trip, I’m due for a promotion, etc. before finally taking the plunge. This time I decided I’ll educate myself and joined a few Facebook groups for birthing.
The VBAC stories in the groups gave me a little bit of hope. I was still not confident, knowing my fear of pain. But I read story after story of how women like me conquered the fear. I also narrowed down a list of VBAC friendly hospitals in Chennai and other services like doula/midwife.
When I found out I was pregnant, I chose a VBAC friendly hospital that was right behind my office so that I could go for my check ups comfortably. I was one gulab jamun away from gestational diabetes and so I was put on a strict carb and sugar free diet, which meant I had to survive on millets, vegetables and proteins. I also had to monitor my sugar with a glucometer every day and get a blood test done every fortnight and report to my diabetologist. Amidst all this I had to manage a household of 5 adults and a 5 year old, in addition to working full time. So I had to remind myself to not run, take a deep breath and eat something at regular intervals.
I had read good things about the hospital that I chose, and during every check up I was excited to discuss my birth plan or the possibilities for VBAC, but each visit to the doctor went by with a mandatory few questions, Doppler check for heartbeat and assurance that all was well. I was told VBAC possibilities would be looked at once I have progressed a bit. In between I managed to communicate to the doctor that I wanted delayed cord clamping (DCC, which is allowing the cord blood to pass to the baby before clamping and cutting the cord) – which was agreed – and I didn’t want episiotomy (a cut made in the vagina to facilitate easy delivery), which was politely refused. My due date was given somewhere between 2nd Aug 19 and 10th Aug 19. I had decided to work till 31st of July to the great horror of my manager.
Last week of July rolled in, and except for occasional tightening of stomach or a heaviness and the usual back pain or pain in lower abdomen, the pregnancy was uneventful.
On July 30th, my lower abdomen pain felt slightly different, coupled with a tightening of stomach. I went to work as usual, but I timed the pain. The frequency was irregular, but steadily intensifying over the course of the day. I was also running to complete something before deadline. By afternoon I couldn’t ignore it any longer and I went for an emergency consultation. For the first time, my doctor said she needed to do an internal examination to see if the cervix has dilated. Images of membrane sweep (process of breaking the membrane of the amniotic sac to induce labour), blood and emergency c-sections rushed though my mind and I refused. However, I also trusted my doctor and finally gave in. I felt a sharp pain when she put her finger inside; I quickly checked for blood at her fingertips, I didn’t find any, so I breathed a sigh of relief. She also told me I was not in labour and it might take a week.
I went back to work and then went home by 8pm. The pain was still there. Irregular, but now lasting for longer intervals. My mum realised something was happening and kept asking what’s up. I said it’s nothing since I knew my mum would insist to go to the hospital if she came to know. To give a background, I delayed going to the hospital because I had read it’s better to go when the contractions are at 5 minute intervals.
By 11pm, I was visibly writhing in pain. I also hurriedly applied marudhani/mehndi since I had got the leaves with much difficulty. My mum was baffled why I would do that. At one point she decided enough is enough, overruled me and with my husband’s collaboration convinced me to get into the car. I told my in laws over phone that I’m going for a regular check up and I’ll be back home soon.
When I went to the hospital I was again taken for an internal examination. This time there was a male duty doctor whom I had never seen before and who also snapped at me impatiently to either allow him to check or pack my bags and go home. Reluctantly, I agreed. This time the pain was unbearable. Then and there I decided I’m not letting him come near me again. I was given a room since I was not dilated yet. I was told if I don’t dilate by morning I’ll have to be taken for a c-sec.
While I was trying to walk and squat to hasten the dilation, my mum and husband said we could go for a c sec. I refused and said come what may I’m trying for VBAC. I went through all this for nothing. When that male doctor came again I refused to get an internal check from him. I said I’d rather go to a different hospital. Around 3am another doctor checked and said I was dilated 1cm.
I was taken to the labour room. I also asked for an epidural which I got around 5am. The next one hour was bliss. I slept holding my husband’s hand. By 6, the effects of epidural started wearing off and it felt like my pelvic bones got a mind of their own and started rearranging themselves every few minutes. I also started feeling the strong urge to push. From then onwards things seemed to progress really fast. I begged for more epidural but they refused. It was around this time I also realised movies have got the delivery scenes all wrong.
Around 7, the chief doctor floated in. I thought I saw a halo around her head, but it reality it was the early morning sunlight streaming into the room. I felt much better when I saw her. After that, with the help of my husband who was there for ornamental purpose and saying inane things like push and don’t worry (I know, dude), I pushed the baby out at 8.15am, and I heard the sweet, sweet sound of his crying. DCC – check, skin to skin – check, immediate breast feeding – check, juice for mummy – check.
My labour lasted close to 24 hours. At the end of it I was completely drained of all my energy and felt like a cloth that was taken through a 1200rpm spin cycle and left to dry. The peace that came after it lasted about 3 hours. Because, after that the anaesthesia wore off and the pain from my episiotomy stitches gave me enough stuff to write another post.
Having gone through both a caesarean and a vaginal birth, I can say both are life altering experiences. Be it lying naked on a cold, metal operating table feeling a knife slicing through the belly (sans the pain, of course) or reclining on a bed with legs wide open, feeling the bones giving way to bring a life out of your body, the vulnerability and the fear combined with the wonder of childbirth remains the same.
brangan
May 26, 2021
Thank you for this amazing and very personal post, Kay.
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krishikari
May 26, 2021
Congrats Kay. I had a vbac too, such fun. 🙂
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Kay
May 26, 2021
Thanks for posting, BR!
Krishikari – thanks. Good to meet another VBAC mum. I think the western countries are more open to VBAC and vaginal births in general. The idea is still catching up here and not many hospitals support it. It’s also a bit shocking but not surprising to read that India has a very high rate of caesarean deliveries compared to many countries.
https://www.livemint.com/science/health/unnecessary-c-sections-quite-prevalent-in-india/amp-11612406248139.html
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Kay
May 26, 2021
https://www.hindustantimes.com/india-news/significant-rise-in-hospital-deliveries/story-kJBaAwYQo6Gc6rWz6RxZsM_amp.html
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hari
May 26, 2021
Thanks for the personal post Kay.
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hari
May 26, 2021
When my wife was in the delivery room for our first one, I asked the Dr If I can stay, she said this is not a movie and NO you cannot stay, leave the hell out. My wife gave that “told you so” look :).
I tried the same for the second one as well, same response.
And then I underwent Vasectomy, so no chance for asking that question again :). I encourage husbands in this blogspace to do it and not ask your wife to do it, if there is even a minute chance that you can undergo the procedure.
Probably I should write a blog entry of that experience here.
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Kay
May 26, 2021
Hari – Thank you for sharing that. When it was my turn I refused to go through another surgical procedure and my husband got a vasectomy instead, although with great reluctance. I think it has to be normalised and the first step is for more men to talk about it. 🙂
Child birth is a terrifying experience. More so when one has to go through it alone. During my first delivery, my gynaec refused to allow even my mum into the operation theatre. So during my second I made sure I selected a hospital that would permit family in the labour room.
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krishikari
May 27, 2021
@hari When my wife was in the delivery room for our first one, I asked the Dr If I can stay, she said this is not a movie and NO you cannot stay, leave the hell out.
My mother was a doctor and in a small town in TN delivered a lot of babies. Right from the 70s and 80s she allowed husbands in the delivery room, she found they were handy to take care of the emotional needs of women in labour and she could get on with her job! So I am really surprised to hear of it being forbidden in this day and age! Sometimes, hearing the stories on this blog, I think India has truly regressed but every year when I visit or when I read discussions in other spaces, I feel there is quite a lot of social progress. I guess both are true.
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Anu Warrier
May 27, 2021
Such an intensely personal post. Thank you for sharing, Kay. I had the reverse procedure, with a ‘normal’ delivery the first time and an emergency C-section the second. (And that, because my lazy son refused to push after a little while, sat on his umbilical cord and promptly went into foetal distress.)
When my son was taken into NICU, I groggily told the doctor about the tubal ligation I’d discussed with my ob-gyn and she turned to my husband and said, ‘Are you sure?” I had the operating room staff in splits when I snapped, “It’s my bloody body, damn it! Do it!” She did. 🙂
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hari
May 27, 2021
Kay, most definitely more men need to talk about it. We are completely oblivious that there is an option for us as well. My dad did it right after I was born (I was third child) long time back, even before Sanjay Gandhi did it forcibly. I was shocked when the Dr and the hospital staff said % of male who come for the procedure is way too less.
So yeah guys please please take some pain away from your wife. This will NOT diminish your masculinity in anyway :
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Madan
May 28, 2021
Thanks for sharing Kay. Very personal and very well written as others have said.
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krishikari
May 29, 2021
@Anu Warrier I’m told it is a legal requirement in India to have written consent from the husband for both tubal ligations and abortions. Maybe it varies state to state.
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Anu Warrier
May 29, 2021
I’m in the US, krishikari. At least in my state, we don’t need it.
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Jeyashree
May 30, 2021
Thank you for the post Kay and wishing you and your little ones all health and joy…totally agree with you on the condescending look when it is a c section you’ve been through.. like you don’t know the pain it takes to become a mother or like you are a princess who can’t take pain and all that bs.. I’ve had it all…I’ve had a silly co-worker who bragged about how she pulled through fever and drowsiness for 30 hours and still adamantly got a normal delivery done only to have pelvic weakness and prolapse due to prolonged labour…I wonder what her doctor was thinking
As for vbac, it is a tricky road for any doctor to walk as scar dehiscence is an almost always fatal complication for the mother if things go wrong and that they do sometimes very quickly..so when you are in a place that is not prepped for an emergency c section or enough blood or specialists on call, some take the planned c section route… here I am talking about the not so privileged sections of the population also some of whom are either challenged by terrain or lack of facilities or manpower or even social support..And it is never safe to ignore or hide a pain around the delivery time if you have a c section scar on your uterus… usually the second is born earlier than the due date almost always as the uterus knows the trick this time…so riskng stress until the due date for people who don’t have help immediately available may also be not advisable.
As for the rising hospital deliveries we need to take it with a pinch of salt given the rising number of comorbidities that our women are diagnosed with during their pregnancy..the rising diabetes, hypertension, hormonal issues, number of precious pregnancies after previous fetal losses, number of medically assisted pregnancies and so forth…all of which are textbook indications for c section…curse the few asking for kundali conducive timings and the exceptions looking to do it for easy money which no sane person asks for or no honest to his soul doctor should perform…
@anu ethically and legally you can’t take consent from a person under anaesthetic medication or under the stress of any procedure…gets the doctor in deep soup if sued afterwards…I wonder if s/he had taken consent earlier itself..that said totally agree with the annoyance at trying to have the spouse’s opinion..
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Anu Warrier
May 30, 2021
@Jeyashree – great post. And yes, my ob-gyn, who was a high risk specialist (long story) and a total sweetheart, already had my consent form signed and in my medical records. We had discussed this through my very troubled pregnancy, and while we were aiming for a normal delivery (Sorry, Kay! 🙂 ) we also had a contingency plan for a C-section. And the idea was that if they were going to cut me up anyway, they might as well do the tubal ligation right then and there.
So there wasn’t any reason for this doctor to ask my husband for his permission. It just rubbed me the wrong way. 🙂
(And if it hadn’t been for my lazy brat :), I wouldn’t have needed to be cut up either. Ah, well.)
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Eswar
May 31, 2021
Thanks, Kay for sharing this. I thought C-section is avoided for its post-surgical complications. I wasn’t aware of its veiled disapproval. Reminded me of the saying: Ability is merely a tyranny of the majority. If everybody could fly the inability to fly would become a disability.
On a related note, a Neeya Naana episode discussed the challenges faced by unusually short people. One of them is that these women cannot give birth normally because of their height and weight. So there only hope is delivering the baby through surgery.
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