Monday, June 2, 2014

The birth story I didn't want

My birth story isn't the one I wanted. I didn't really make a birth plan, other than liking the idea of a water birth, but even so I felt let down by the reality of what happened.

A week or so before my due date, the baby started to shudder and have strange movements. After speaking to the midwife I had to go into hospital to be assessed. Monitoring of the baby's heart rate produced no evidence of a problem (other than the movements causing the monitor to disconnect during the one episode recorded), and I was sent home. I had to return two days later for further monitoring, again with no problems seen, and again in another two days to see the consultant. At this point I was told they would induce me the following day, 'just in case'.

I was given no option in the matter. With hindsight I wish I could have refused, but hindsight isn't there at the time. I felt that I had to follow a medical professional's opinion, and knew that if I refused and there was something wrong with my baby, I would never forgive myself. I did ask about increased risks etc with induction, but was told there were no real drawbacks for me, and I could still have a water birth if I wanted. I went home, repacked my bags, and spent a last quiet evening with the other-half-of-us. I didn't do any research into induction, for which on one hand I'm grateful I didn't know what was coming, and on the other hand wish I'd been prepared for the reality of induction.

The following morning, after a delayed start due to the number of women already giving birth, we headed to the hospital. In a way it was nice to travel calmly with no rush, but looking back now I realise I expected and almost wanted that middle-of-the-night hospital dash of excitement and fear, just one of the many parts of my 'expected' labour that didn't happen.

Once at the hospital, things were slow to start with. I had a pessary inserted, and a sweep given at the same time (with the comment that they were surprised I hadn't been given a sweep prior- another thing I regret not having happened). For a few hours not much happened, and the other-half-of-us and I whiled away the time chatting together (with a walk to M&S to get some food!) until he had to return home. As night approached, contractions started with a vengeance. By 1am they were under 3 minutes apart and lasting over a minute each, and there was no chance of sleep. With my TENS machine going I, paced the corridors for most of the night, something I apparently became known for by the staff: various midwives later commented on how they'd seen me wearing a groove in the floor that night. I think I coped pretty well at this stage, thinking that things were surely progressing.

In the light of day, with an internal examination, a hard reality hit: nothing had happened. The cervix was still in pretty much the same state as before I had had a single contraction. I felt defeated, as if all those hours had been for nothing. I now know that induced labours tend to have more painful contractions for longer than non-induced labours, a fact I wasn't aware of at the time. I simply felt I had let myself down in some way. To make matters worse for my mentality, I was also informed that induced labours have to be monitored throughout, and therefore I was not allowed a water birth. At around 6am I was encouraged to have a bath to see if that helped. I sat in it and cried my eyes out.

As the contractions continued to build I was moved into a private room. The other-half-of-us soon arrived; my rock and support back with me. I finally accepted painkillers (paracetamol), and as the pain increased, tried gas and air. It did not agree with me. As soon as I started breathing it in, I felt dizzy. I had to stop breathing it as soon as I reached the peak of the contraction to prevent myself passing out, but this meant half of each contraction with no pain relief. The midwife commented she never wanted to see me take recreational drugs as I reacted so strongly to gas and air! A trip to the (ensuite) toilet was a mission, supported by the other-half-of-us, and those contractions made me miss the gas and air even with the effect it had on me.

After what seemed like eternity and an infinite number of contractions, an internal examination at around midday revealed I was at 3-4 cm dilated. Again I simply felt defeated, as if all this pain was achieving so little. I told the other-half-of-us I was done, that I couldn't go on. I was moved to a delivery room, now labour counted as 'established', involving a slow stagger along the hall, basically held upright by the other-half-of-us, gown hanging open for all to see! Once in the delivery room, an epidural was suggested. At first I held back, having decided previously I wanted to avoid one, but soon gave in as I realised I was in no fit state to carry on otherwise. It turns out the midwife had already ordered the epidural before I consented, knowing that it was the best plan of action for me, but she did an amazing job of still making me feel I had made the decision myself, that I still had some kind of control over my labour. My mentality had hit a new low, and I needed a new plan.

I am led to believe that the epidural had to be placed twice as the first did not work very well. All I remember is the torment of having to keep still while contraction after contraction raged. I clung onto the other-half-of-us for dear life! But what a difference once it started to work. I could have kissed the anesthetist. With each trickle of icy water on my thighs feeling less and less cold, the pain of each contraction began to ease. I felt like I had re-entered my mind again, like I could think better without the cloud of hellish pain. At this point I apparently turned back into me, and started apologising to the midwife and the other-half-of-us for my behaviour. The next few hours are the time I remember least of the labour. With the pain reduced, I watched the contractions roll past on the monitor, drank water, and calmed right down.

At 4pm, the next internal revealed I was almost fully dilated. I felt such relief. What a difference those four hours had made. I was told we would wait another hour for the last tiny bit of cervix to move out of the way, but before the hour was up the midwife said she couldn't wait any longer and checked again. Now fully dilated, I was at the pushing stage.

This bit was tricky having had an epidural. In theory I understood how I needed to push. In practice, pushing when you can't feel your bottom is hard! I had already stopped topping up my epidural, and as time went on and it began to wear off, I could feel more and more. After an hour, a doctor appeared. She told me I hadn't pushed baby far enough down the birth canal and would need to go to surgery to have a ventouse delivery, which would probably not work and then I would have no option but to have a cesarean. She gave me 20 minutes to see what progress I could make on my own. I am told as soon as she left the room I stated "do not let that woman cut me", although I have no recollection of that!

At this point, a team of amazing midwifes entered the room. My cheering squad gave me the support and guidance I needed, showing me exactly how to push. Helped by the extra feeling I had back, I got the hang of it, and soon was told they could see that my baby had lots of hair! I was encouraged to feel the head, to feel the physical progress I had made, and it really did help. Knowing that my baby was so close gave me the mental capacity to push as I had never pushed before, to really give it my all. By the time the doctor returned she stated I could have a ventouse delivery in the room, but my cheering squad encouraged me to keep at it and push baby out myself. I ended up having an episiotomy, but pushed my baby out unaided, the only part of my labour I am proud of. And what relief I felt once the head was out, knowing I had reached the peak of pain and baby was almost here!

My baby was placed on my chest, and the other-half-of-us cut the cord. He then informed me, in a somewhat bewildered way that it was a girl! We had convinced ourselves we were having a boy, even though we had kept the gender as a surprise for this moment, and so were both a little surprised. As we gazed at her, trying to take her in as she started to suckle, I could feel the placenta being pulled gently out (it felt so much bigger than I expected), and I relaxed. This would be that moment, after all the pain and hard work, where the other-half-of-us and I got to meet properly our new daughter, to bond as a family.

But this did not happen. The placenta was out two minutes after I gave birth, and seconds later, I started to haemorrhage.

Within seconds every midwife on duty plus the registrar and consultant were in the room. I am told the call button sounded like a submersing submarine siren, that everyone in the room needed clean shoes and trousers afterwards, and other gruesome details I won't share here. I lost a litre and a half of blood. I remember trying to focus on the ceiling tiles, willing myself to remain conscious, my logic being I couldn't be dead if I could still see the ceiling! A doctor put a canula in my arm, and I could feel blood running down my arm from it and dripping on the floor. Someone had their fingers in me to stop the blood flow, which eventually got packed and stitched up. I cannot fault the care I got, with one midwife stood next to my head explaining what was going on, and my midwife through labour staying and holding my hand. Throughout, the other-half-of-us was sat in the corner, holding our new baby against his bare chest.

Eventually the room emptied, crisis over. I was washed down with a flannel, and the lights were dimmed. I'm not sure whether I had the baby back at this point, or later when I was transferred to a four-bed ward. The blood loss combined with tiredness meant I felt completely out of it. There were long pauses between me being asked a question, computing it, coming up with an answer and saying it aloud. I managed to feed the baby, judging from the feeding chart of her cot, but I remember little of it. Hours later, a doctor came to remove the packing still inside, having been stuck in surgery until this point. Thankfully he declared as was well. It was now 2am or so, and I desperately needed sleep but couldn't switch off- I remember asking the other-half-of-us for sedation! In the end, after the other-half-of-us had left for the night, a wonderful midwife took our new addition away for a few hours, promising to bring her back if she needed feeding, and at last I fell asleep.

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