Finally, after nearly two years I have got round to writing my birth story for Lewis – prompted probably by having a far more positive one to share for Adam as well. Here we go…
Lewis
I had planned a home birth for my first baby. Being convinced of the benefits of natural, undisturbed birth for baby and mother, and of the importance of the emotional side of labour, I had decided that I would be most comfortable labouring in my own home, where I would be relaxed and most likely to release the hormones that would make labour and birth go smoothly.
I reached full term after an easy, healthy pregnancy, marred only in the last few weeks by what seemed like endless false labours, insomnia and night-time hip pain. At 39&6 my waters broke – an enormous, dramatic gush of fluid that I had thought happened only in films. My husband and I were thrilled; excited that finally we were going to meet our first baby. I felt well prepared for the birth, and looked forward to experiencing proper contractions as opposed to the continuous regular Braxton Hicks contractions I’d been having every evening since 34 weeks.
We called our community midwives, and one came round to see what the story was. I was 1-1.5cm dilated and contracting gently; waters nice and clear. Baby was in a posterior position (back-to-back) which meant that labour could take a while to get going, and could follow a bit of a start/stop pattern. She advised me to go to bed and get as much rest as possible; if labour was going to kick off it would wake me up, otherwise I’d be refreshed and ready for it the next day. Although this felt like ridiculous advice to an excited first-time mum, I duly went to bed and hoped things would start to happen.
24 hours later I was up at the ERI for monitoring, as I had experienced no contractions to speak of. The colour of the fluid I was passing had changed overnight and was now lightly stained with green – something I had questioned with the midwife who had returned that morning to check up on me and take a swab to check for infection. She had told me “no traces of meconium” as she took the swab, so I was feeling confused.
At the end of a 20 minute monitoring session in Triage, no signs of distress were observed in baby and the nurse had just said it was fine for us to go home and wait for labour to start in earnest. I was feeling a bit funny about the stained waters, so queried them with her; she instantly recognised meconium and went into red alert mode. I was told that I couldn’t go home, that I was to go upstairs to labour ward immediately for a syntocinon drip and that we needed to “get this baby out”.
I was offered no choice, no discussion of the implications of the meconium took place despite the reassuring monitoring that had been recorded, and no account was taken of the fact that my baby was at term dates and just as likely to have passed meconium because his gut was mature, as to have passed through distress.
I was dazed, confused and felt completely disempowered. All I could think about was my home birth slipping away and being replaced with frightening medical procedures that I knew I didn’t want but seemed to be obliged to accept.
The next 17 hours fade into a blur; only random images really remain with me – me sobbing with frustration as I tried to cope with fierce synthetic contractions whilst disabled and feeling utterly trapped by the monitoring machine – I had asked for intermittent monitoring but was told it “wasn’t allowed”. Me telling the doctor in tears that I didn’t want an epidural, and being told with rolled eyes that it was “recommended” because a syntocinon induction was going to be so painful. And finally, me at a disappointing 4-5cm dilated, finally breaking and asking for the epidural when the words “slow progress” were bandied about once too often – I had become so demoralised and disempowered that in my despair I decided that if a C section was going to be inevitable, that I might as well get the epidural out of the way before it was too late, so they wouldn’t have to knock me out altogether.
Had I known at the time that posterior babies tended to turn with strong contractions and mum adopting forward-leaning positions, leading to an easier more progressive labour, I may have thought twice about asking for that epidural. However nobody thought to discuss my options with me, or to suggest trying the gas and air first in order to keep me mobile.
All this time I had the “dedicated attention” of one midwife; she never left us for a moment. Of course, the reality of this was in fact that it was the continuous monitoring machine that had her dedicated attention, and she barely spoke to or looked at me or my husband throughout the whole first stage – only responding to our anxious questions about baby’s wellbeing, as we had been told that his heart rate was dipping with every contraction.
Eventually, at 6-7cm dilated the doctor who was popping in and out every few hours to examine me told me that if I hadn’t made better progress (at least 2cm) by the next examination, that we were going to have to discuss our options. I knew this meant the seemingly inevitable C section talk, and by this time I was so miserable that I would almost have welcomed it. My epidural hadn’t worked down the left hand side of my body, so I was still in enormous pain – and now immobilised in bed; exactly the birthing position I had been most keen to avoid, knowing that it would compromise baby’s blood and oxygen supply (not good news when the syntocinon contractions were already causing his heart rate to dip) and make pushing more difficult, as he would effectively have to come out uphill and round a corner.
Luckily for us, there was a shift change, and the doctor who took over my care had a more relaxed “wait and see” attitude to my progress. His positivity must have been infectious, because although I hadn’t achieved the 2cm “target” dilation stipulated by the previous doctor, I felt a bit more hopeful – I had been told that progress was being made, it was slow but it was definitely happening. This gave me the hope and encouragement I so desperately needed to really make a go of giving birth vaginally. I started to remember my yoga breathing and relaxation techniques, and with every contraction repeated inside my head “I am opening up and this baby is coming OUT!”
My progress seemed to speed up, and very suddenly the contractions down my left hand side became utterly unbearable. I was thrashing around in agony, and remember screaming “for the love of God will somebody DO something for me!” at which point somebody handed me the gas and air nozzle and I started drawing on it frantically, desperate for some relief.
I remember drifting away and feeling very sleepy and peaceful , so grateful to have left the nightmarish hospital behind me. Very rudely (I thought) one of the midwives grabbed the nozzle back and gave me a row for taking too much, which made me start to concentrate on my breathing more. Quickly I learned that I could take two or three deep breaths on the gas and air as I approached the peak of a contraction, and it would carry me over the top and down the other side in complete comfort – to this day I have no idea if the pain relief was actually that effective, or if it was just the case that I was learning to manage the sensations by paying attention to my breathing.
I reached full dilation in what seemed like no time at all, finally enjoying myself and singing along happily to Paolo Nutini who was playing on my iPod. When the time came to push, I had half an hour or so to relax, snooze and prepare myself while the midwives made all the necessary arrangements for delivering a meconium baby. Some sadistic and unkind person wrestled the gas and air from me (about which I was most unimpressed) and I assumed the “traditional” position for giving birth. I was semi-reclined on the bed, with my feet braced against my husband’s hip on one side, and the midwife’s hip on the other (incidentally, pushing in this position is probably what lead to me suffering from postnatal pelvic girdle pain). I was still exhilarated from the sudden turn for the better that events had taken, and was determined to take full advantage of the unexpected opportunity to avoid a C section.
So I pushed frantically, with the midwife shouting “Push! Push!” at me with every contraction – I had no urge to push at all and was only doing what I was told. Thankfully Lewis was a petite baby at 6lb 13oz, and I was able to birth him with relative ease – second stage lasting about half an hour, and my perineum sustaining only a small tear which required no stitches.
I was euphoric and so thrilled that against seemingly all the odds we had managed to have a “normal” delivery and escape injury. I barely noticed as I was injected with syntometrine and my placenta was managed out of my body, and I was allowed about half an hour of skin-to-skin contact with Lewis before he was taken away from me, cleaned and swaddled. This was despite clear instructions in my birth plan that stated I wanted uninterrupted skin-to-skin until we’d had our first breastfeed. Of course, I was in no fit state to question my treatment at the time, so docilely accepted what was going on and continued to gaze in wonder at my baby as he lay wrapped up in his hospital cot.
10 hours later, I had received no further medical attention. I had asked twice – once on the way to my room and once by ringing the buzzer (which brought an angry nurse to the door to snap “what’s wrong with you?”) for some help to get breastfeeding established, but had seen nobody. In my irrational state of mind, I started to think that I would be better off comfortable at home than uncomfortable and ignored in a hospital room, so when my husband came to see me I asked him to go and see about having me discharged – which it seemed they were happy to do.
Only when the midwife came to go through the discharge papers did she realised that I hadn’t seen anybody, Lewis hadn’t been fed, and none of the newborn checks had been done. Tactfully she suggested that I should stay in overnight, and I agreed, asking again for some help to feed Lewis.
According to my notes, I received help with breastfeeding four times that night – although the only memory I have is of the hospital midwife “plugging” Lewis on to my left breast for me, which resulted in the only successful feed we had for another four days. With hindsight I realised that there is a big difference between a baby who’s attached to a nipple and sucking, and a baby who’s latched on and feeding. Sadly I didn’t know this then, and the first I knew that feeding wasn’t working was when urate crystals showed up in Lewis’ nappy two days later, showing that he was becoming dehydrated. My discharge letter from the hospital reads “managing breastfeeding well” which just goes to show how much attention they were paying.
Lack of support, and poor advice from my community midwifery team on discharge led to me offering Lewis formula top-ups in fear of him failing to thrive. This undermined my already shaky milk supply (I didn’t understand the importance of expressing every 3 hours from birth to establish supply in the absence of baby latching, and nobody noticed that I wasn’t doing it) and eventually Lewis developed a very assertive flow preference for bottles at 11 weeks, at which point I gave up combination feeding him and moved fully onto formula. I was very sad, and still struggle with feelings of guilt for not finding myself able to give him the best start of exclusive breastfeeding.
For a long time after Lewis’ birth I found myself feeling upset when thinking of the experience. Never before have I felt so powerless, trapped, undermined and fearful. I struggled with feelings of anger at how unnecessary all that suffering was, and regularly found myself welling up with tears of frustration when I heard another person telling me “as long as baby arrived safely, that’s all that matters.” Why did it have to be that my safe baby came at the expense of my emotional health and the replacement of a positive birth experience with a traumatic one? I was completely ill-equipped to tackle the challenge of taking care of a newborn after the birth; traumatised and exhausted – actually shivering with fatigue for 10-15 minutes every time I woke from another too-brief sleep.
Eventually things settled down and I was able to start enjoying Lewis properly and make my peace with our rotten start. I learned to congratulate myself on breastfeeding at all given the challenges we faced, instead of beating myself up for giving up early. I learned to feel proud of myself for achieving a relatively intervention-free vaginal birth despite the odds being stacked against us.
I also learned to feel angry that the difficulties we faced were a direct result of misinformation and defensive practice at the hospital. I decided very shortly after the initial birth euphoria had worn off and I realised how poor our care had been; never again.
