34 Weeks pregnant with Baby#2 & an update on my hopes for a VBAC

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Well, this pregnancy sure has flown by, and yet in some ways it feels like I have been pregnant for forever. And what they say about your second pregnancy being a bit of a blur, is completely true! I’m doing my best to capture this pregnancy, and to keep up Baby Boy’s journal ( bough both Everly’s and BabyBoys journals from Typo!), but there are only so many hours in a day and when most of them are spent running after a busy toddler, it doesn’t leave much time to daydream about what life is going to be like when he arrives. In some ways I’m almost glad, as the moments I do have to sit and wonder about what life will be like, I’m left pretty much terrified (in a good kind of way haha). I have zero idea of what life is going to be like with two under two, and as Everly isn’t walking yet (she’s 16 months old now and although she’s cruising along everywhere, pulling herself up on everything, pushing her trolley around everywhere & has taken quite a few steps on her own…she is still not officially walking). While I’m not worried about this from a developmental point of view (I mean, she only started crawling just after her first birthday) it’s more of a worry for me as she is so darn heavy and I’ve already got nearly 20kg’s of baby weight on my front…and so picking up another 12 - 15kg’s in the form of a squirming toddler is not my idea of fun. I’m not up for that kind of cross fit session every time we have to go anywhere ;)

She’ll get there eventually, I just hope it’s before her brother is due to arrive in +-6 weeks time!


Today I wanted to share a bit more about my hopes & dreams for a VBAC.

A VBAC (Vaginal Birth After Caesarian…aka a natural birth after a caesar) has been my dream ever since Everly was born via emergency c-section in September 2017. I do plan on sharing her birth story (if anyone is interested in that) but to sum it up I went into labor naturally, and after 36 hours of unmedicated labor, my cervix started hardening (I was already 7cm dilated) but she just wasn’t progressing any further. I have a lot of ‘what ifs’ and ‘If onlys’ but after that amount of time, as well as my doctor and the nurses worrying about her being in distress (not to mention how exhausted I was) and so I was rushed off to theatre and my little girl was born a mere 30 minutes later. It wasn’t what I had planned, but she was born healthy & safe, and even though it was not the sort of birth I had hoped for, I don’t feel any remorse about it. I just feel a lot of determination that it will go differently this time.

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In saying that, I have come a long way in the past 7 & a half months with regards to my mindset and I’ve realised that what is most important for me, is just to go into labor naturally. I want my baby to choose his own birthday, to be ready to join the world, and for my body to be ready too. I’ve realised that in some ways a Caesar is ‘nicer’ if I can put it that way (no tearing/cutting, a longer stay in the hotel ahem I mean hospital) but the recovery time is much longer than a natural birth, and trying to recover from a second c-section, feed and care for a newborn AND look after a busy toddler is not going to be easy.

VBAC’s in South Africa

Just a little note…these are my own thoughts & perceptions from months and months of research & spending time chatting to care providers and other moms, I am in no way bashing the health system here, but rather sharing my own personal views.

South Africa, in general, is not very VBAC friendly. Most gynaes are not very keen on the idea (I say most, because up until recently I didn’t even know that it was an option to try for a natural birth after having a ceasar as it’s not something the majority of gynaes support). I am generalising, as there are some incredible VBAC pro gynaes out there, but they are few and far between, and there are lots of reasons for this.

First of all, most gynaes will tell you that the biggest risk of a VBAC is your uterus rupturing. While there is a chance of this happening, the actual statistics are soooooo tiny (it’s less than 1%), and there is only a slightly lower risk of this happening even with a regular, first time vaginal birth. Anyway, this post is not supposed to be a rant on gynaes and their choices to avoid ‘risk’, but rather to share my feeling and decisions in wanting to pursue a VBAC.

There are also lots of factors that affect a positive outcome for a VBAC, and a lot has to do with the reasons why you may have had to have a Caesarian in the first place, as well as the type of scar you have (these days its most common for a Low Transverse Incisions to be done…this is from the top left and across). If you had an elective caesar the first time around, there is no reason why you shouldn’t be able to birth naturally. If, like me, you had an emergency caesar, it can change things a bit as your doctor would worry about whatever happened to prevent a natural delivery the first time, happening again.

If you are wanting to explore the option of a VBAC further, I would HIGHLY recommend joining the VBAC in South Africa facebook group. There are loads of wonderful ladies in that group sharing their experiences, their VBAC successes and failures, as well as LOADS of information of VBAC’s here in SA.

Did you know that Government hospitals will push for a VBAC due to the immense cost & labour (ie staff required) of caesarians, preferring for the mom to rather attempt a natural delivery than have a repeat caesarian. This really should highlight just how normal the idea of a natural delivery after a c-section is.

Here in South Africa, most gyna’es have a very strict tick box list for a VBAC in hospital (these may vary slightly, and some gynaes may differ/be open to changes but these are the general guidelines:

  • Baby must weigh 3.5kg’s or less at birth

  • You must go into spontaneous labor (ie your body has to go into labor naturally) by 38/39/40 weeks

  • Labor has to progress by 1cm an hour

  • There should be at lest a 2 year gap between your last birth and your current due date

From what I have read and from the many, many ladies I have spoken to about this, the highest chance of a successful VBAC is to have a home birth with a midwife & a doula. While I love the idea of a home birth, I’m not sure it would be something I would actually pursue, and the fact that I live 1.5 hours from the nearest hospital basically rules out that option, especially for a VBAC, when most midwives wouldn’t attempt a home birth for a VBAC as if things do go wrong, you need to be able to get to a hospital as fast as possible.

Your second best chance for a successful VBAC is a hospital birth, but with a midwife as your primary caregiver, and a Gynae as backup. This is a tricky one, and unless you really strike it lucky with a Gynae who agrees to be ‘on stand by should things go wrong’ it’s not easy to make happen. It’s different if you live in Joburg or Cape Town, as then you have the option of a clinic like Genesis, which is midwife led, and whose whole focus is on a natural delivery. I visited Genesis in Joburg for my second trimester abnormally scan, and it was just the most incredible place. I even considered moving in with my family in Joburg for the last few months of my pregnancy, just so I could give birth there…but then came to my senses when I had to ask myself if would really be happy being away from my husband for those months, and also would he be happy to be away from me and his little girl during that time.

Third option, and the one I have had to settle for due to my own personal circumstances (basically, the fact that I live out in the middle of nowhere!) is to have a hospital birth with a VBAC pro gynae. There are not a lot of options for VBAC pro gynaes in Pietermaritzburg, and in my months of research, have realised there is a big difference between a VBAC pro gynae and a VBAC friendly gynae. A VBAC friendly gynae is open to the idea, but they are far more risk adverse than a VBAC pro gynae, and the chances of a successful VBAC are much lower. Anyway, beggars can’t be choosers, and I have found a VBAC friendly gynae (she was the gynae who actually delivered Everly as my doctor just so happened to be overseas when I went into labor) and so as she actually did my surgery, I decided to go with her for my second pregnancy. She was very blunt with me in the beginning, not saying no to a VBAC, but not being very hopeful either. She just told me we would have to see how my pregnancy progressed, and gave her strict list of labor protocol. I left every check up with her ( up until about 28 weeks) feeling despondent, and not at all hopeful for my VBAC. I even considered changing gynaes several times…I just wanted someone to give me the chance and to be encouraging and positive about a VBAC. I wasn’t looking for anyone to make any promises to me (after all…I have first hand experience of how things can change during labor) but she was very honest and pragmatic about the whole thing, and I really respect her for this now. She didn’t want to give me an false hope, and I’ve realised it’s not her job to feed into my birthing fantasy, when she knows there is no actual way to know what will happen during your pregnancy, never mind during the actual birth.

I think the guidelines above make it pretty much impossible (if followed 100%) to have a VBAC. First of all, the weight scans during check ups are estimates…Everly was estimated to be 3.5kg’s at birth and was born at 3.085. Not many women (generally speaking) actually go into labor naturally before 40 weeks…many are induced (something that is not recommended for a VBAC as labor can progress very quickly once induction has taken place, and this places a greater stress on your scar tissue. For labor to progress by 1cm an hour is pretty much ideal textbook stuff, and not likely that most women’s bodies would follow this ideal. The age gap stated is to give your body and scar an adequate amount of time to heal, but some women heal faster than others, some scars heal better than others, and so this is a very hard guideline to follow. I have heard most midwives prefer an 18 month gap, and no less. But then again, there are always exceptions and I have read about amazing mommies who have had successful VBAC’s with a 11/12/13 month gap. My gap will be about 17.5 months if baby arrives at 40 weeks.

It was at my 28 week scan when my Gynae told me that although she does elective caesars at 38 weeks, she was willing to make an exception and allow me to go to 39 weeks for spontaneous labor. I was happy to compromise on this, and considering Everly arrived at 38 weeks (and apparently second time labor is likely to be early too) I felt confident that my labor would begin before then. If not, I agreed to set a date for my repeat caesar. I have just gotten back from my 33 week check up, and Doctor was very happy with how things are looking and has told me, that as long as everything is else is in order (ie no complications, baby is in the right position etc) she is happy to let me go to 40 weeks. I am delighted with the news! So, according to my original due date, I’ve got until the 22nd Feb to go into labor naturally. I will be doing ALL the things to try and ensure this happens, but as I mentioned above, I am far more at peace with a repeat ceasar that I was before and now will just have to wait and see what happens in the next 6 weeks.

I’ve got my wonderful Doula, Clare, at the ready (Clare was by my side through my entire labor with Everly and I know I would not have been able to make it as far as I did without her) and was one of the first people I told I was pregnant this second time, and told her to make sure she had a note in her diary for mid/end Feb! All that I can do now is wait, stay healthy, keep active (do my kegels, bounce on my Pilates ball) and be patient.


If you’re still following along after the above very long VBAC related discussion, here are some more general thoughts and feelings on how the last 10 weeks of my second pregnancy have been. Click here to read my first post on how this second pregnancy has been.

My Body

Following on from the tummy comparison I shared above, here is a comparison of me at 33 weeks with Everly (on the right) and now with BabyBoy (pictured left).

I am also absolutely amazing at how different women gain weight in their pregnancies. I gained 18kg’s with Everly, and am already at the 18kg mark now with BabyBoy and I still have +-6 weeks to go. I was lucky in that I lost all (and then some) of my pregnancy weight within about 8 months (thanks to breastfeeding and following our regular low carb lifestyle). It’s still rather shocking when you think that baby only weighs, in my case, about +-3-3.5kgs…where does the rest of the weight come from!? I do like to remind my pregnant friends not to worry about their weight gain during or after pregnancy, because you just never know what your body is going to do, or how it will respond afterwards. Rather worry about getting back into shape once you and your baby have had a good chance to get to know each other. Don’t let it consume your thoughts, your body goes through an incredible transformation, and we need to be kinder to ourselves.

My skin started clearing up around the 6 month mark (thank goodness!) but I’ve still got cracked heels (apparantly this is from the weight gain). I’ve been lucky enough not to get any stretch marks again (holding thumbs it stays this way for the rest of my pregnancy) but have been religious with lathering BioOil on after each and every shower.

I am sleeping better, but it doesn’t help that I’m awake at 04:30 every morning when Farmboy goes to work, but I usually wake up that time to go to the loo. I have also had less round ligament pain this time, but I think that’s only because I now know to sleep with 4 pillows (one at my back, one at my tummy, one between my legs and one for my head!).

This boy is SOOOO active compared to Everly. I barely felt Everly kick, and every time she did it would be a wonderful little surprise. This guy hardly ever keeps still! He has hiccups none-stop, pushes and prods me with his legs/arms/bum and uses my poor organs as punching bags regularly. I’m hoping this is’t a sign of things to come, as Everly was the most contented baby & toddler, happy to sit around and play with her books and toys by herself for ages. I have a feeling this little guy is going to be a real busy body…who knows, maybe he will be walking before his sister haha #ImOnlyHalfJoking.

My Mind

Gosh, it’s still not real that a second little human is going to be joining our family soon. And to be very honest, I haven’t given it too much thought as my days revolve around Everly. We also moved house at the end of November (this was incredibly hectic!) and so most of the past 2 months have been spent sorting and organizing our home. Having said all of that, I am SLOWLY adjusting to the idea of being a boy mom (although I’m really struggling to come to grips with all the blue!) but I am excited and I just know Everly is going to adore her little play thing ahem, I mean brother.

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Everly

Thanks to the advice of lots of friend and family, we bought Everly a little doll and gave it to her a little while ago. Oh my goodness if this hasn’t just been her absolute favourite thing in the whole world. She calls it her Baba (she has stopped referring to everything under the sun as ‘Baba’) and now the only Baba’s she talks about are her doll, and my tummy. She will often sporadically point at my tummy and say ‘baba’ and loves to lift my shirt up to see my tummy, after which she will give it a little cuddle (or rather a headbut sort of thing which is her version of a cuddle) and then carefully pull my top back down again. It’s the cutest thing!

Her little doll came with a magnetic dummy (genius!) and is just the right size for her. I found it at PicknPay after hours of looking around all the shops and feeling totally overwhelmed by the sheer variety of dolls. So many of them were really plasticky looking, and I wanted something simple…and small enough for her to carry herself. I have also been absolutely amazed by how she has started caring for her baby. She insists on wrapping her in a little blanket (I never showed her how to do this!) and will often share her milk with it, and puts the dummy in and cuddles it while giving it bum pats. I’m amazed at her natural mothering instinct.

Do you have any tips for introducing a young toddler (Everly will be about 17 months old when her brother arrives) to their new baby sibling? Friends have suggested getting her a special present that comes especially from her brother, which I love the idea of (any ideas of things that would make good presents for her?). I’d also love to hear any tips you may have for the actual first introduction, as I have no idea if there is a ‘best way’ to go about it.

Everly is still in her cot, but we plan on taking down the sides of it this week to convert it into a toddler bed, and are holding thumbs the transition won’t be too hard on her.

Ideally she will be sleeping in the single bed that’s in her room now by the time BabyBoy is here. But we aren’t going to rush that just yet, as he won’t need the cot for a good while still.

The Nursery

While BabyBoy is going to be using most of Everly’s nursery furniture (compactum, feeding chair, bassinet) there are a few things I’m changing, the first being the general ‘theme’ of his room. We are doing a constellation theme, and as I have really struggled to find beautiful decor items that match our theme so far, I’ve been in touch with the lovely ladies behind Riley & Fox Bespoke Nursery Linen and have had some custom linen items made just for him.

Here are some photos of how the nursery is looking so far, and of course Everly has had a ball ‘helping’ me get his room ready:

Still to be added:

  • the family bassinet

  • custom prints on the wall next to the compactum

  • floating shelf of some kind in place of the bookshelf

  • a nightlight (we used and still use a beautiful pink Rose Quartz lamp in Everly’s room) and I’m planning on getting a white salt lamp that will also give off a lovely soft glow

  • and when he gets a little older, he will go into Everly’s cot (although I haven’t quite figured out where the cot will go in the room as right now there really isn’t any space. There’s still lots of time to worry about that though, and we might take the bed out when the time comes for him to go in the cot, and put the cot where the bed is now

What I AM sorted with though is all his cloth nappies! While I did try to buy mostly gender neutral nappies with Everly, I have gotten a little carried away with boy prints this time around and have a beautiful stash of both newborn and OSFM (One Size Fits Most) nappies for when he gets a bit older. I’ll share more on his nappies in another post soon.

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I hope you enjoyed this update.

Thanks for following along! Feel free to ask me anything/leave a comment below, I love hearing from you.

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