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Isabell and Bradley
Fifth child, fourth vaginal birth after cesarean, natural birth, short labor (two hours)

My name is Isabell, and I am 38 years old. This was the arrival of my fifth child, and it was also my fourth VBAC (vaginal birth after cesarean). Almost twenty years ago, Sven (my first son) was born by caesarian section after a failed induction at 41 weeks.

My first VBAC in 1992 was a homebirth and I was in labour for eighteen hours. I opted for a homebirth because I was disappointed in the hospital system and its needless interventions. I believed my chances to have a natural birth would be greater at home. My second and third VBAC babies were born after about six hours, also at home. This time, with my fifth baby (fourth VBAC!) I discovered what "fast labour" means.

In the days before Bradley's birth, I felt emotional, irritable and fatigued. My hands, feet and face felt puffier than usual. I felt the baby's head pressing down, as if he were telling me he was ready to come out. I was 39 weeks pregnant, and in the night from Sunday to Monday, I went to the toilet and felt something gushing between my legs. It was only as small quantity of clear liquid, and I wasn't sure whether my waters had broken. Even after giving birth three times, labour remained a mystery to me! And you seem to forget what it feels like. You ask yourself: "Is this the real thing or is it only what they call false labour?"

That night I spent more time on the toilet than in my bed. My bowels were working overtime; something was happening. I had the best clean-out ever, as well as mild contractions. At the time I wasn't sure they were contractions, as they felt more like bowel cramps. I even wondered whether it could be food poisoning.

In the morning I told my husband about my suspicions. He was getting ready for work, and I didn't want him to leave. I started crying. I didn't know what to do, because I didn't want him to miss out on a day's work for nothing, but on the other hand, I wanted him to be with me in case labour started. I didn't have any strong contractions, just mild cramps, like period pain, so I thought it would be foolish to make him stay after all. He was only employed casually and risked losing his job if he didn't turn up.

After getting them ready, I drove my children to school. When I came back, I went to bed. I didn't want to go into labour tired and worn out, and my back was giving me trouble. Lying down seemed to help ease the back pain. I stayed in bed until lunchtime but the contractions subsided instead of getting stronger. "What's going on?" I wondered. Later on that afternoon, my husband came back from work and I told him that my waters had broken last night (I hadn't told him in the morning). He urged me to call the hospital and let them know, which I did. The midwife told me to come in as soon as possible, so they could check me out. I rang my mother-in-law, who had planned to go out that night, and asked her to come and look after the kids. When she arrived my husband and I were ready to leave.

I felt anxious, and so did my eight-year old son Michael. He cried silently and clung to me, which made it even harder for me to leave. I felt like I was going away on a long journey and my tears kept welling up. My husband told me to stop crying. I think he was nervous!

We climbed into our Toyota Camry. It was about 5.30 p.m. and the traffic was heavy. I missed my children and had to stop myself from bursting into tears. I felt very uncomfortable on my seat, as I had contractions from time to time. A car is not the best place in the world for a woman in labour (or in false labour!). Nevertheless, I urged my husband to drive carefully. I didn't want to be involved in an accident right now. "The car is getting hot," Jeff told me. "How can it be?" I asked. "I just took it to the mechanic two weeks ago, and spent 400 dollars on it!"

The hospital was a fair way from home, a good 45 minutes drive, and the Camry broke down ten minutes before we arrived at destination, right at a traffic light, in the busy traffic, on a major road. I couldn't believe it. My husband was angry with the mechanic. A taxi driver pulled over and helped him to push the car onto the side, out of the traffic. Then he gave us a lift to the hospital, wishing us all the best.

At the hospital a midwife made me lie down and took a swab from my vagina to check if my waters had broken. It was negative. I had no contractions either, so she told us to go home. Jeff rang another taxi which would take us to the train station. Then he rang for a friend to pick us up from Gosnells station and drive us home. During the train ride home I felt a bit spaced out, disappointed and relieved at the same time. Relieved about this unexpected reprieve. And most of all: I would see my kids again.

Back home we told Jeff's mum about the "false alarm." My son Michael was still awake, very hot (probably coming down with the flu). I reassured him, then we all went to bed but I didn't sleep very well. Contractions were still mild but painful enough to keep me awake and squirming between the sheets. The next day, Jeff had the day off (which he had arranged with his boss). At 5.30 am I woke him up and told him that this time, it was for real. At 6 am he rang his mum. He also asked his dad to arrange for the Camry to be towed home. Again, I had to say good-bye to my children Michael, Jayne and Sonia. I was impatient and slightly irritated because they wouldn't let me go. When we finally managed to leave, the traffic was already heavy on Tonkin Highway. We were in my husband's Toyota Hilux utility van. Oh what a feeling!

When we reached the hospital after an uneventful drive, my contractions had stopped again. Vanished! Disappeared! We saw the same midwife who welcomed me with a smile. Later another midwife came in. Her name was Sharon and she seamed very experienced. She took one look at me and said: "You're not in labour." "Well, the car ride stopped it," I answered. "When you're really in labour, nothing can stop it," she replied. "You should know that."

Of course, I should have known, after giving birth naturally three times! But one forgets what it feels like, believe it or not. Anyway, I was pretty sure that I was in labour, no matter what the nurse said, but I didn't want to argue with her. "I'm going to give you a couple of sleeping tablets and send you home," she said, "because you haven't had much sleep and a tired body cannot function. Try and get a few hours sleep and come back later."

I began to cry. I didn't want to drive all the way home again. So my husband suggested we see his grandmother, who only lives fifteen minutes away from the hospital. There I could have a sleep if I wished to.

Off we went in Jeff's "ute" again. I felt rather depressed and angry the midwife hadn't believed me. My husband though remained in good spirits. He was in a good mood, which was in sharp contrast to the night before, when he swore to kill the mechanic who had "fixed" our Camry, only so that it could break down on the way to hospital. But today he was cheerful as if looking forward to the oncoming event.

In her dressing gown and with her curlers, Jeff's grandmother opened the door for us and looked at us in surprise. She didn't expect such an early morning visit! Uncle William (who lives with her) was there too, and even more surprised. His mood matched my husband's; he was very cheerful. I was the only miserable one, so I took my sleeping tablets. I had some toast (multigrain - isn't it funny how one remember these sorts of details) with cheese slices on top (the ones that come in a plastic wrapper). I had my toast then I devoured Jeff's, as he wasn't hungry (anticipation? excitement?) Then I had a cup of tea that tasted like heaven. I was euphoric from the sleeping tablets and my head grew heavier by the minute. I had to lie down, so Jeff's Nanna took me to a guestroom. Things had taken on a dreamlike quality, and I noticed how stylish everything was in the house, the furniture and the curtains, the lovely paintings and knick-knacks everywhere.

I dozed off for a while, but didn't go to sleep in spite of the tablets. Half an hour later, I began to have strong contractions which ripped through me and took my breath away, making me jump out of bed and kneel down. I was hugging a pillow and burying my head in it. Soon I cried in my pain and called for Jeff. "That's it," I said to him. "We have to leave now. This is the real thing." Thank God he believed me. We said good-bye to Nanna and William and rushed towards the faithful ute (which hadn't let us down, unlike the Camry).

On the way to the hospital I knelt on the front seat, hugging the headrest (I didn't worry about the seatbelt). Contractions came, stronger and stronger, making me cry out in pain. My husband looked worried but I told him not to speed. The ride seemed to take forever. Midwife Sharon welcomed us and took us to the assessment room again. It was 10:00 am. Before she could make me lie down on the bed, I was rocked by a powerful contraction which made me scream (I've got no self-control). By the look on her face, I could tell she now believed me that I was in labour. "You're not going to send me home again," I pleaded. She didn't.

Instead, she ushered us into the labour suite. It was a simple room, with a big white bed in the middle. I don't know why labouring women are supposed to lie on beds. In my opinion, the supine position is the most uncomfortable when you're having contractions. But it probably makes it easier for the birth attendants. Sharon asked me if I wanted an internal examination and I agreed to it. While I was lying there, I felt a contraction coming on and jumped to my feet as soon as she finished examining me.

"You've got a nice multiple os," she exclaimed. "What does that mean?" I asked (I'm probably supposed to know, being a nurse myself). "It means that your cervix is very supple and stretchy. I just did a membrane swipe and you went from two to four cm."

Well, that was nice to know. She asked me if I wanted some pain relief, and I said I wouldn't mind some gas. She opened a cupboard ("The equipment is well concealed in this place", I thought) and extracted a long hose with a white plastic cup on the end, which I had to suck on.

Another much younger nurse came in to take over from Sharon. At first it worried me that she was so young, but I soon found out she was very competent. Her name was Nadine and she was skinny, with brown hair, brown eyes and glasses. Her manner was polite and confident. She asked me to lie down again so she could listen to the baby's heartbeat. "Can you do it while I'm standing up?" I asked. I didn't feel like hopping on the bed again. "Of course," she said. What a relief! I think that was the only time she got to listen to the heartbeat with the Doppler. "How do you intend to give birth?" Sharon asked. I understood she meant what position I wanted to be in. "On all fours," I said. I had never done it that way, having used a birthing stool with my other children. But I had heard a few women (including my sister) saying it was a helpful position. I also knew there was no birthing chair at the hospital (they do have a lot of modern high-tech equipment though). "O.K., go and get the waterproof mattress." Sharon instructed the younger Nurse. Nadine must have explored the whole hospital looking for the elusive mattress, as it took her nearly half an hour to get hold of it. And I ended up not using it anyway!

Between contractions, I sat on a white plastic hospital armchair. But then there was no "between" any more, as the contractions soon came one on top of the other, fast and furious. I was standing all the time now. My husband was sitting on a kind of footstool (which must have been uncomfortable too) in front of me and encouraged me to breathe through the contractions. It was impossible to do; I felt like being in a hurricane. I sucked on the gas when I could, which seemed to help a little, and screamed at the top of my voice the rest of the time. I hope the walls were soundproof! My screams must have put off a few women who came in that day. I've definitely got no self-control!

Then the doctor came in, wearing his best clothes: nice shirt, nice tie. I wondered why he was so dressed up, as he usually wears casual clothes, jeans and handmade jumpers. He looked so neat! Maybe he had planned to go out for lunch. My husband greeted him with a sigh of relief. When the doctor turns up for a birth, it usually means things are starting to get serious. I was still standing, leaning on my husband during contractions, alternately yelling and sucking on the gas. It didn't help much, but at least it gave me something to do. The contractions were getting more and more relentless. I needed a break. "I can't do this," I said to Jeff. "Of course you can," he said. "Stop that negative bullshit." (My husband has a very straightforward way to express himself). No, there was no way out; I had to do this, no matter what. There was no going home now.

The doctor had a feel to assess what was happening down there. "The head is still high up," he said, "and the waters haven't broken yet. I'd better break them, as it is only going to prolong the agony," he added. At that stage, I didn't really care whether he broke my waters or nor. He got something that looked like a long knitting needle and poked it up my vagina. The waters must have gushed out, but I can't remember how it felt. I was in a different world, a different dimension. Everything seemed blurred and unreal.

Then I felt something pressing down between my legs. "I feel like doing a big poo," I said (you can tell by my vocabulary that I spend a lot of time with young children). I think no one really believed I was going to give birth within the next minutes, because no one seemed to react, while I began to panic. "It's coming out, it's coming out," I shouted. "What do I have to do now?" I asked, but no one seemed to know! "Help me, help me!" I said, then I felt something pushing out of me. The doctor asked the nurse for some sterile gloves, but she said, "Sorry, it's too late. If I let go of her, she'll fall on top of you." I was still upright, holding on to her arm on my right and to Jeff's on my left.

I didn't even have time to go into a squat. I felt like my insides were falling out. As the baby made his way into the world, the doctor quickly caught him and unwrapped the umbilical cord which was tied around his neck. Blood and meconium splashed everywhere, ruining the doctor's clothes! When I saw the baby, I was astounded and elated. I couldn't believe it was all over. My baby boy was born at 11.58 a.m., after two hours of intense labour. He was 3400 g (or 7 pounds 12 ounces) and 49 cm long at birth. The second stage only lasted a few minutes. The baby didn't cry at all, which worried me at first. "Is he all right?" I asked. "Yes," the doctor said. "Just a bit dazed, because he came out so fast." They wrapped him up and gave him to me. My husband said, "He looks exactly like Michael." I sat down and cuddled him briefly. His face was bruised from the birth and he was slightly blue, so they decided to give him some oxygen and to suction him. During that time, I pushed out the placenta. It was like giving birth a second time, and I used a lot of gas to relieve the pain. I was standing again, which it made it a lot easier.

A pediatrician had a look at the baby to ensure everything was fine with him. Then I finally lay on the bed and nursed my newborn for the first time, I was so happy and relieved that he had arrived safely, despite such a speedy delivery. He looked content and alert, relaxed after his ordeal, while I felt very sore and tired. Nadine put him in his cot. I had a rest on the "delivery" bed for a while, then I got up, took a long shower (the most soothing shower in my life) and finally went to my room with my baby. I spent the rest of the day sleeping, right until dinnertime. In the evening, Jeff rang me and told me that "Bradley" would be a good name for our baby boy. I agreed that it suited him well.

I really enjoyed giving birth this time, even though the pain was excruciating, and there wasn't any time to catch my breath during contractions. But everything went so fast that there was no time to reflect, and Bradley was born healthy, which is the main thing. My only regret is that this will be my last child. Giving birth is such an amazing experience! I only spent one night in hospital and was home the next afternoon. My children were over the moon about their little baby brother.

Isabell K., Perth, Western Australia

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