Sunday, 31 July 2011

Birth Story Special: Every Woman Deserves a Positive Birth

This past week on the blog has been a Birth Story Special, and I've been thrilled to introduce five wonderful birth stories in five days.  We've heard about an emergency caesarian, a freebirth, a home birth with a doula, and two very different stories of induction, one that felt unnecessary, and one that saved a baby's life.  First and foremost I'd like to say a big thank you to the women who shared these stories, not just for the time they took to write them so beautifully, but also for allowing us to look in on moments in their lives that were intimate, special, or even difficult and traumatic.

My aim in all of this was to build a picture of birth in the UK today, of what is being got right, and what might need to change.  From reading these powerful stories, and your comments on each post and on the facebook page for this blog, I have really enjoyed the chance to chew over this very difficult question, and although this has only lead me to further questions as opposed to any answers or solutions, I feel that if we keep thinking and talking and feeling about this issue, then positive change will surely follow.

I'd just like to make a couple of brief points.  The first is about Choice.  Certainly as a woman and as a feminist I would argue that every woman should be able to choose where and how she gives birth.  However, we need to very carefully make the distinction between 'perceived choice' and 'informed choice'.  If a woman, for example, decides even before her labour starts that she will choose to have an epidural, then whilst it may seem to her that she is making a free choice, her decision is actually based on the perceptions of others, and even total misinformation, that she may have gleaned from family, friends, or even the television.  Rather than backing the woman who makes such a 'perceived choice', I feel upset on her behalf, that she has received such negative messages about childbirth, and is approaching birth expecting it to be unbearably awful. Somehow I would like to fight for a woman's right to make truly informed choices.

Secondly, whilst we realise that there are some situations in which we are extremely grateful for medical help, it is wrong to assume that the level of intervention in UK births today is necessary.  If you look at some of the statistics published by BirthChoiceUK you can see just how much of what happens to us while we are having our babies is at the mercy of both where we live and of current trends in obstetrics, rather than changes in our own bodies abilities to labour and birth.  Compare these statistics to those of world renowned midwife Ina May Gaskin, who in over 2000 births over 30 years has maintained a rate of over 95% normal vaginal birth at home.  Birth can be natural, birth can be normal, birth can be drug free, birth can be positive, birth can be empowering.

Somewhere, at the moment, this is not being got right.  There is too much intervention, and too much fear, and often, one begets the other.  No wonder women go into birth afraid and determined to be numbed from the waist down, when there are so many horrible stories of trauma to be told.  I'm not sure it is helpful to get angry and blame 'the system', which after all is full of doctors who wish to be helpful and who are sometimes life savers.  Perhaps as women we need to take more responsibility and change the way we approach birth, take back ownership of it, and prepare ourselves better, intellectually, emotionally, psychologically.

I don't have all the answers, but I hope that by asking the questions we can move things forward in a better direction.  I do think it matters, and that having a positive birth experience is a hugely important part of being a woman and becoming a mother.  This week I have not told the story of my own second birth, and for now I will save it for another day.  But I would like to leave you with an image which I think says so much more about why birth is important than I will ever be able to, taken just a minute or two after I delivered our second baby girl.  Every woman deserves a moment like this.  Every woman deserves a positive birth.

Apologies this photo has been temporarily removed.

Friday, 29 July 2011

Birth Story Special: A Doula's Tale

This week I'm running a Birth Story Special via this blog. So far I hope you've enjoyed the wonderful stories shared: Michelle's tale of her emergency section, my own first birth by reluctant induction, Sarah's freebirth, and yesterday's moving account of a hospital birth in which intervention was not only helpful but necessary to save a life.

There are many thoughts, feelings and questions raised by these stories, which I hope to address in a final post over the weekend. Do feel free to discuss your reactions via the comments at the bottom of each post, or on the facebook page for this blog. I will do my best to consider and address all of the points that you make.

In the meantime I'd like to introduce tonight's story, written by a trainee Doula about her first experience of witnessing birth. One of the big questions about birth in the UK today for me is - how can we maximise our chances of a natural, positive and empowering experience within the current system? There is much research to show that having a Doula present for your labour may be one way of doing so, and in this case, a first time mother had a successful home birth.

Jenn's Story

Doula - The Greek translation is Woman Servant or slave but in modern culture it refers to a
person whom assists the Mother (and family) in preparing for her new baby, supports the Mother physically and emotionally through labour and provides post-natal advice and help. Doulas are (usually) women and are (usually) a Mother or someone with knowledge or experience of natural birth – but most importantly they have an affinity with womankind and a great, deep belief in their ability to birth their babies. Midwives do not deliver babies – Mothers deliver babies. 

I have been on the road to becoming a Doula since the birth of my first child 4 years ago. Her birth was not a happy experience and although I (narrowly) avoided a C-Section I did end up with every other bit of intervention going. I felt that my body (and my soul) had failed. When I became pregnant 7 months later, I was determined that the experience was going to be a positive one – no matter how or where it ended.  It did in fact end amazingly, on my sitting room floor after a 2 hour labour 13 days past my due date… but that’s another story. Since this time I have read, researched, listened to countless birth stories, attended workshops and generally immersed myself in birth with the help and support of wise women from NCT/Midwifery and of course fellow Doulas.

Here is the story of my first experience as a Doula:

Dec 2010: My 21 year old Step Daughter Danielle calls her father and tells him she is pregnant following a whirlwind romance with Toby (now her husband). It was a very funny time – Dani didn’t have the easiest of teenage years and we had both grown distant from her. So this was a very special time.

‘Pre-Baby’: We talked, we planned her wedding and I slowly sowed the seed of what birth could be like if she wanted it to be… I say that, as I believe that as long as you end up with a healthy baby the birth can usually always be a positive experience, if you just take ownership of it from day one. That means being educated, being informed, understanding your birth ‘blueprint’ (ie what your mother, aunt, sisters have fed you about birth, together with how it is shown on Eastenders or Friends…) and letting go of all pre-conceptions and fears and learning how powerful your body truly is.

I guess without realising it I was actually doing what a Doula would do in her ante-natal visits but in a much more slow and subtle way.

Within another few months (and after quite a bit of Ina-May Gaskin) she actually asked me to be her Birth Supporter, her Doula. This was the most amazing thing ever. To have my first experience of birth (outside my own) and for it to be for someone I loved dearly.

So I continued as I had been with feeding her lots of positive links, stories, books and experiences whilst reminding her that first labours could be long and exhausting and she needed to rest and eat and to interject that with some mobility ie light walks, bouncing on ball, relaxing dancing etc etc I gave her tips on using relaxation exercises, visualisations and positions to help the early stages pass by more easily. I also suggested that the three of us (she, hubby and me) attend an antenatal day (run by Conscious Birthing) which I hoped would put us all on the same page and solidify us as a little team. The day was loved by all and had the surprising (and lovely) result of them deciding to aim for a home birth.

So the stage was set and I lent them my “magic” birth pool (it had attended 2 births and hadn’t been filled in time due to some very quick babies!).

One week before due date:

Sun 6pm
: I get call saying Dani had been having mild cramps since 2pm. I recommend paracetamol and an early night – not forgetting a nourishing tea (or in her case some Weetabix or similar!).  I say this may possibly be the start.

Sun 10pm: Still crampy.. (via Phone Call)

Mon, 1:16am: Regular Cramps (text message) – advise she try sleeping by lying over back of sofa and take a bath if that doesn’t work.  I warn her this is most likely the start, but could still be a week or so before baby comes!

Mon, 3:28am: Cramps stopping her sleeping still so she takes a bath (Text)

Mon, 6.09am: Didn’t sleep well, taking more paracetamol. (Text/Call).  I offer to come in a few hours – she agrees.

Mon, 10am: I get to Dani’s house. Contractions are uncomfortable but relatively short and pretty irregular. I distract her with chatting, make sure she eats and drinks little and often and encourage her to try and sleep which she does a little.

Mon, 2pm: Contractions pretty much off the boil now (though she has now had a show) and she is a little more rested so I suggest a short 10min stroll to see if that helps things get going without tiring her out – concerned that she hasn’t slept much and hope the walk will either pick up contractions or that the fresh air will help her sleep when she returns.

Mon, 6pm: Toby has been home from work for a while. Contractions every 15 mins or so but still on and off and not lasting long.  We discuss what to do and agree that I will go home. Dani is in good spirits and feels it will be a long time before things pick up.   I get in the car and call my husband.  I don’t think I should go but having talked it through with him decided that maybe it is for the best as I will rest better.

Mon, 7pm: I get home, put the kids to bed and eat. Glad I was home to do that but still think I should have stayed.

Mon, 10pm: Toby calls to ask about the Tens machine… Ok so I am really thinking I shouldn’t have left!  Dani is apparently in the bath and coping fine but things are picking up. I get ready for bed expecting a 3am call!

Mon, 10:30pm:  I am called! My head had literally just touched the pillow. Had hardly slept the night before and had driven 60 miles already that day.

Midnight: I reach the house. Dani is still in the bath, contractions lasting a minute every three minutes and had been that way since about 8/9pm…. I rub her back during the contraction which she appreciates. In-between contractions she leans forward and tries to doze. She is very tired. We agree that Toby should fill the pool in preparation. She breathes through the contractions and on harder ones groans – I give simple words of encouragement and occasionally remind her of visualisations to help her stay relaxed.

Tue,12:30am: She is starting to move around a lot more during contractions and doesn’t seem to be able to get comfortable, I am also aware of the fact that in her current position she cannot rest easily. I suggest we move downstairs where there is more space to lean, rest, stand or move around. Also to be ready for the pool.

Dani rests on the sofa between contractions and stands when they come on.  I often support her in a slight squat or she leans on the side of the pool. After a time her waters go followed by some regular blood drops.

Tue,1am:  I call the midwife just to let them know she is in labour and what is happening. Dani doesn’t want them to come yet and they are happy that she is most likely entering established labour (around 3cm) which had been my assumption too.

Tue,1:20am:  She vomits.  A lot.  After another 10 mins or so of contractions she says she feels like she is having to stop her self pushing. She goes to the toilet and lets out an almighty groan – small alarm bells go off in my head.. “was that more water or the baby?”  I ask in a slightly startled way… She thinks it's more show and water. I say it may be feeling weird as the head will be right on the cervix now the waters have gone. We hobble downstairs. She stands in the pool (which is about shin deep) and keeps touching her bum with every contraction… I am now getting a tad confused.   Knowledge tells me one thing… her body tells me another.  Although influenced by knowledge I override the feeling and go with her body and I call the Midwife and ask for them to come… Midwife is still thinking she is probably about 4cm… I am starting to wonder otherwise…. Still standing in the pool she says she feels she is going to pass her bowel or intestines or something (a good sign the baby is nearly there) but every time I look I can’t see anything… Her husband is with her and I walk out a few times to make sure the Midwife can find us…. She arrives within 15 mins or so.  She asks me to carry in another bottle of Gas and Air… I comment that she is handling it very well as she is… We get to the door and she is standing in the pool with her husband behind her with his hands outstretched ready to catch… head born about 4mins after (with the Midwife in prime position now) and body along 2 mins after that.
Oh my. None of us, especially Dani, expected that. The contractions never built up and never went over 1 minute long.

Post Birth: I took some pics (with the flash off), helped fetch and carry for the Midwife and began to slowly tidy up. The second Midwife appeared and the placenta was delivered physiologically. Baby was a little cold and a little slow to suck… so Mum and Baby wrapped up warm and got into bed. Toby crashed in a chair and I laid on the bed awake and encouraged her to sleep.

It was nearly dawn by this time and I had now missed my 2nd nights sleep but adrenalin kept me going (just!). I made cups of tea and toast and stayed for the morning as he was still not breastfeeding and Dani was getting a little anxious.

I left to go home at about 4pm later that day leaving both Dani and Toby happy and settled, expressing colostrum for the baby and confident that he would feed soon. I suggested it may be in the middle of the night so to try and sleep for a few hours.

Post Natal:
This is where the lines of Doula and Grandma become slightly blurry. I was awoken at midnight that night by a very distressed new Mummy who wanted her baby to eat and couldn’t understand why he wouldn’t. The story of what followed would take another few pages but in summary it included me driving back up the next day, supporting and encouraging her, driving with her to the hospital in the next town (due to slight concerns over babies blood sugar levels), a 24 hour stay in said hospital (and another missed nights sleep) and an almost constant dialogue either encouraging, explaining, calming or making her smile…. Those post pregnancy hormones take you on the roller coaster of your life – mix in an (unnecessary as it turned out) stay in hospital and a baby who was only just starting to Breastfeed and you have one stressed lady…

We all survived the hospital (though I quietly found it very upsetting) and then followed another week of Midwife appointments, expressing, cranial osteopath and finally a tongue tie snip and now I have one very happy Step-Daughter and one very happy Grandson (usually drunk on Mummies milk).

So did a Doula make any difference?
Dani has told me since that she couldn’t have done it without me, (which is quite flattering I may add!)… on asking her to explain she said that she would have had the baby in the midwife unit (which is obviously personal choice and not a bad thing) and missed out on the intimacy and comfort of her own home, bath and bed. She said that it was my confidence and education on birth that helped her cope so well during her labour, that from start to finish she knew what to expect so well that she didn’t really have a conscious awareness of what was happening, that it just progressed and she moved with it completely confidently.  When I asked how I helped during the actual labour she said what she remembered being most helpful was me physically supporting her during contractions and making her get out of the bath when it was obvious she wasn’t settled there.  What touched me the most is when I asked her if at any time she had felt fear or worry or anxiety and she said no, none at all. To top it off Dani said that if I hadn’t had been there with her during the time in hospital and on the end of the phone she would have had a melt down and the baby would be bottle fed… this I hate to think as true but statistics show this is what happens A LOT.

What I know is that Dani birthed her own baby and between them they learnt how to breastfeed. Toby supported her everyway he could and I was there, for both of them to encourage, support, give advice and keep them smiling. I was honoured to attend the birth and will never forget it. Although a Doula doesn’t usually spend quite so much time face to face post-natal (although this is all negotiable) the essence of what I was doing was 100% Doula. I didn’t take over, make decisions or pass judgement.  I simply gave facts, options and said I would support whatever she decided.

Surprisingly, with the kind of labour she had, I think I made the most difference before the birth and after... as opposed to during (although I hope I made things easier for her).  It was the birth education that I was able to pass on that gave her the knowledge and confidence to handle the labour so well and it was, I guess the same thing but for Breastfeeding that kept her going afterwards.

If you would like to contact me to talk about anything written here, to discuss birth education or what a Doula could do for you then please don’t hesitate in emailing me

I am happy to discuss attending births (in the South Somerset area) in whichever capacity is appropriate. Many Doulas support women in their communities for years without undertaking formal training (though I plan to do so myself in Spring 2012).

Further information on Doula’s can be found at
 .  Most experienced Doula’s charge between £400 and £500 (someone training may charge from FREE - £200) for their services (to cover expenses, potential loss of income or childcare costs and continued training/workshops) the cost does range depending on how experienced they are and other factors. If you think you cannot afford a Doula then do speak to them first – most charge on a case-by-case basis and there is also a hardship fund available through Doula UK.

The last thing to add is if you do decide to hire a Doula do try and meet two or three (this will be a free informal chat) before making a decision so you find the person most on your wavelength!

Thursday, 28 July 2011

Birth Story Special: When Intervention Saves Lives

This week I'm running a Birth Story Special. So far we have heard a dramatic story of a planned home birth that ended in an emergency caesarian, my own story of being induced, and yesterday an incredible tale of 'freebirth'.

All of these stories have to one degree or another been what you might describe as 'anti-intervention'. Often women feel that the doctors or midwives involved in their care are too quick to resort to drugs, instruments or even surgery, and that there should be more faith placed in a woman's natural ability to birth well and successfully.

Whilst this may be true, there are occasions in which our gratitude for medical help goes beyond words. In the following story, there are no grey areas, no question marks, and no doubts: modern obstetrics saved a life.

Anna's Story

This is without doubt the hardest thing I have had to write.

I walked in to to my local hospital feeling, sick, nervous and most of all excited. I was due to be induced with my second baby. It was an emergancy induction. I was 38 weeks pregnant and the day before I had discovered the baby was far too small, there was not enough fluid and insufficient nutrients getting through the cord. Yet I felt confident and believed everything was going to be fine.

Labour ward was busy and I remember reading trashy magazines and thinking of my daughter at my mother in laws and how much our lives were going to change.

Finally a midwife gave me some gel. I remember her as warm, comforting, mothering and being very much what I wanted. It took me a very long time to get into labour as my body just was not ready for it. By the time contractions had started it was the middle of the night and I was walking around a dark, quiet labour ward smiling at the same hideous painting I had stared at in labour with my first daughter Grace. I thought back to my lovely, perfect birth with her and silently hoped for the same again.

Unfortunately that's not how it turned out. So many things started to go wrong it's painful to look back on, memories so deeply repressed that now I want to access them I can't. Contractions were regular but weak, the midwife decided to put me on a drip to make them more intense, this was the only point I remember crying. A drip felt like such a barrier in my head, a physical line stopping the natural, drug free, active birth I wanted. It was also suggested that I should have some pethidine as the contractions would be very intense, and there was an urgency to get my baby out. The pethidine went in and boy did the contractions increase. This was the turning point in my labour, I now knew it wasnt going to be like my first one.

I was lost in my head, rolling the chosen names around, playing with the sounds like when you have your teenage crush and practise writing their surname after your name, day dreaming my way through the pain. It was safe and warm in my body but going through my head I could hear sharper words, intense words and glances. I crawled out of my drug induced brain fuzz and looked at my husbands face. He had his hand on my arm and was staring at the machines. With every contraction our babies heart rate dropped to almost nothing. The midwife couldn't put it off any longer and was just about to organise an emergany c-section when bang, my cervix went from 3 cm to fully dilated and I really HAD to push. I never had that intense feeling last time but i remember chanting I need to push, I need to push as the midwife turned on her heel to examine me. She agreed and I pushed about three times when my baby shot out. Because my bump was so small I saw her coming out and pulled her up to me, she was tiny, beautiful and blue, so very blue. The same cold sweat and sick feeling I remember then is burning back through me now. I remember the midwife cutting the cord with such haste to get her to a doctor that bright red blood covered us, the contrast between my red and her blue burned into me. Silently and without fuss the room filled with doctors. I watched them trying to get her breathing, rubbing her, bagging her, pleading with her. Watching strangers pressing their mouths to her lips to get oxygen into her tiny body and all I could do was watch. The doctor fighting for her looked up, I saw total panic in her face, that is one of the parts I will never supress. She was taken to SCBU before I knew she was ok, before she had cried, before I had seen all of her body, noted her hair colour, told her her name or kissed her. The room emptied and I was by myself getting 'cleaned up' by a midwife and throwing up. Fighting the effects of the pethidine I tried clearing my mind. My husband had gone to be with Tilly and I felt so alone. Twenty minutes and still being sick the phone rang to say my little baby girl was crying for her mummy. I made a noise of gratitude, words couldnt explain, the sound came from so far inside my body. I found her in my husbands arms in SCBU doing the same face as Grace does when she is upset. I latched her on to me and the horror seeped out of our bodies, she was here, mine and just beautiful. The following days were hard and there were many trials, we experienced even worse events with Tilly a week later but yet again she pulled through.

Whilst there are without doubt things I could fault about events during the labour, my overwhelming emotion is gratitude.

Matilda May Appleby was born at 1550 and weighed 4 lb 15.

Wednesday, 27 July 2011

Birth Story Special: Freebirth

All this week I'm running a Birth Story Special.  On Monday we heard Michelle's story of a planned home birth that ended in an emergency section.  Yesterday I shared my own story of a hospital induction.  Both of these stories have already raised some interesting questions and generated great debate, both in the comments and via the facebook page for this blog.  I hope to summarise and address some of the points raised in a final post later in the week.

In the meantime, I'd like to introduce Sarah's story. In fact, this is two birth stories in one; firstly, of her traumatic second birth in hospital, in which she felt completely violated, and 'birth raped'. The website Birth Trauma Truths
defines birth rape in this way: 

"A vulnerable woman, who is powerless to leave the situation, is at times held down against her will, has strangers looking & touching at private parts of her body, perhaps without appropriate measures being taken to acknowledge her ownership of her body or to preserve her comfort levels. Perhaps she has fingers or instruments inserted without her consent, and sometimes against her consent, invading and crossing decent boundaries. She is fearful of what is happening to her and perhaps for the wellbeing of her baby, and receives no reassurance that either she or her child are ok. That is a violation, no matter how you look at it...Even IF this treatment is given with no malice and the intent of attempting to assist her with birthing her child, there is NEVER a reason to forgo common decencies that will enable her to maintain a role in the birth, some autonomy over her body, to be involved in the decision-making, to be informed about what they want to do BEFORE they do it."

Out of this experience came the decision to 'freebirth'. Regardless of whether or not you agree with Sarah's choice, this story is gripping, touching and moving, and it also adds more to the debate about modern obstetrics.

Sarah's Story

If I tell people that my third child was a planned freebirth, I normally get one of two reactions. Either, “wow”, with every connotation that word may imply, or an incredulous look followed by a stern lecture on how dangerous it is and how I put both myself and my baby at risk. As you may imagine I don’t always tell my birth story as I don’t enjoy being lectured - if I did perhaps I wouldn’t have dropped out of college! But, I have been asked to share my (free) birth story and I have agreed to do so. Not because I think that every woman should have an unassisted birth, but because I want people to know that birth doesn’t have to be medically managed. So many of us give over control of our birthing to others. Birth can be instinctual, if we just allow ourselves to believe in ourselves and our bodies. We need to reclaim our own internal power.

My freebirth story really begins with the birth of my second son. Despite all the horror stories of tortuous labours and emergency life-saving procedures that I heard whilst I was pregnant for the first time, my first son was born easily. He was born at our local midwife-led maternity unit, where 9.5 hours after going into labour and 40 minutes after arriving, he was born into my husband’s waiting hands. I imagined my next baby would be the same, with the improvement of being born at home instead.

I booked a homebirth when I was pregnant for the second time, but towards the end I had a few high blood pressure readings, and despite an otherwise normal and healthy pregnancy my homebirth was refused. I was told that I must deliver instead at the high-risk labour ward. I was devastated. When I did go into labour, it progressed swiftly at home and we set off to the hospital with contractions that were barely a minute and a half apart. Then the fear set in. By the time we arrived my contractions had slowed to less than 5 minutes apart. My body had begun to shut down. Then followed some of the worst moments of my life. My birth plan was disregarded. I was made to feel like a freak for refusing pain relief. I was refused the right to go to the toilets down the corridor and I was finally birth-raped by the midwife and told that my baby was stuck. Humiliated and in tears I signed the consent form allowing them to give me an epidural and the right to perform an emergency c-section if my baby could not be pulled out of me. Then, in the theatre, surrounded by strangers standing by ready to cut me open, my legs in stirrups, my lower body shielded from me by a sheet, my poor baby was pulled out of me with a ventouse and then forceps. I was given my son, but he didn’t feel like mine. I hadn’t felt him come into this world, Neither me or my husband had seen him being born. I felt that my body had failed me and my baby. I blamed my husband, for not standing up for me. I blamed my baby and I blamed myself. Unsurprisingly it took me a long time before I felt any kind of bond with my baby. I would put him to my breast and wonder how on earth something so small could have given me so much pain. I had failed and people telling me “the only thing that matters is that you have a healthy baby” or “at least you were in hospital - the best place to be” only made things worse. It did matter.

Both my husband and I wanted another baby, but I also knew that I could never put myself through such an ordeal again.

My community midwife (who wasn’t at my birth) lent me a book called “The Drinks are on Me” by Veronika Sophia Robinson as she knew I was going to be tandem-feeding. At the end of this book was a small section about giving birth, and about how as mammals, humans are designed to give birth like mammals. In private essentially and that fear makes the womb shut down so that you don’t give birth in conditions that pose a threat to the baby. Reading it, it made such perfect sense and I realised that this was what had happened to me. This was the first time that I had ever come across freebirth or unassisted birth, giving birth without a midwife or medical professional present. Tentatively, I approached my husband and said that should we be blessed with another child this was what I wanted to do. His initial doubts passed quickly - he knew how much my second birth had traumatised me. I think he also felt guilty. So, long before our third son was even conceived, we had already decided how he would enter this world.

10 months later I became pregnant with Daniel. I did see a midwife for antenatal care, and I booked myself for a homebirth, with no intention of actually calling for a midwife when the time came. I told Phil that his job was to find out how to deal with any common problems that may occur at birth. I didn’t personally look into any of this, as for me the whole key was to focus on the confidence I had in my body to birth well. After all, that’s what our bodies are designed to do. Thinking of lots of ‘what-if’ scenarios would have put seeds of doubt in my mind. This is also the reason that we only confided our intentions to freebirth to just 2 of our closest friends. I mentally prepared myself for giving birth throughout my pregnancy.
Two days before my due date, at 4.30 in the morning my contractions began. Strangely enough the night before I had dreamt that I had given birth. I’d had Braxton Hicks contractions on and off throughout the day so I wanted to be sure that I was actually in labour before waking Phil up and ringing our friends to come and get our sons. I stayed in bed, trying to rest whilst my contractions got stronger and faster. I repeated to myself that I could do this. My body knew how to give birth. I tried to relax as much as possible. After an hour, I was convinced I was actually in labour and went to wake Phil and get him to ring our friends. We had decided not to have our children at home whilst I gave birth., as I wanted Phil to be able to focus on me if I needed him, and our children were only 3.5 years and 19 months old at the time. Whilst Phil sorted out things for the children and waited for our friends to arrive, I ran a bath and sank into it. It was still dark outside, the bath was warm and I closed my eyes and visualised my body getting ready to birth our baby. I breathed deeply, and tried to relax as much as possible through the contractions. I stayed in the bath for what felt like a long time, although I have no idea how long as I didn‘t want to look at a clock. The contractions were incredibly strong, and felt very close together. At times, it was more painful than I hoped it would be, but it wasn't unbearable at all. I tried to visualise my cervix opening and this made them easier to deal with. I laboured unobserved and in silence just as I had envisaged.

At some point I decided that I needed the toilet, so I got out, half dried and sat on the loo. Not long after there was a sudden gush - my waters had gone, then I was all shaky and shivery. I was probably in transition. Phil came in to see if I was OK, took one look at me and then was intent on moving me to the bedroom as quickly as possible. Apparently someone at work had been telling him about a woman who gave birth in the toilet! I definitely needed to push by then, so went in to my bedroom, and knelt on the floor leaning over my bed. I just closed my eyes and went with what my body was telling me to do. I know some people say you don’t need to push and that your body does it for you, but I definitely needed to push. There was one small moment when I thought that it seemed to be taking a long time and I thought “what if my baby is stuck”, but I pushed the thought from my mind. Not long after, I could feel the head starting to crown and reached down and felt my baby‘s soft head. I told Phil who was rubbing my back that the head was coming (I think this was pretty much the first time I had spoken to him!), and he looked and he could see him. I will never forget the sound of his voice when he told me he could see our baby’s head. It’s so hard to describe, but the excitement, love and awe in his voice was amazing. I pushed again, and his head emerged and then all of him followed in a gush. Phil caught him and lay him on the towels on the floor. Our son, Daniel, had been born into the light of a new day, in the very room in which he was conceived. We gazed at him in awe. He was perfect. His birth had been perfect. I had done it all by myself. The euphoria that came with it was amazing. Daniel didn't cry straight away, but then started to. Phil picked him up, and passed him to me and I held him straight to my breast. It was absolutely perfect. For those who like to know these things he was born at 7.33 am, 3 hours after my contractions began, weighing 8lb 2oz.

It seems rather cliché, but while I gazed adoringly at our son, stroking his silky hair, marvelling at his tiny hands, Phil went to ring the midwife and told them that our baby had just been born, but that we hadn't had time to ring before. They wanted to send an ambulance out but Phil told them we were both fine and just wanted a midwife to come out. All of our local midwives were on call so they had to send one from another area. It meant that we got about an hour and a half of just the three of us. The cord was cut and the placenta was finally delivered nearly 2 hours after Daniel was born. Although freebirth is legal in the UK, we didn’t want to deal with any issues that might have arisen from our decision to freebirth, so we said it was unplanned. If the midwives were suspicious, they didn’t say anything.

My freebirth has been classed many things by different people - most commonly ‘lucky’. I don’t see it this way. For me, it was perfect, blissful, empowering and most importantly healing. If I may, I’d like to finish with a quote from a book that helped me so much in my journey towards freebirth written by a woman whom I have never met, but who inspires me so much.  I would recommend this book to every woman, regardless of where she chooses to give birth.

“Every woman is different, and on a unique journey. Let’s celebrate women who birth from their soul and bring their babies here gently…. But, please, let us never, ever forget the women who, for whatever reason, didn’t get to experience ecstasy in birth. Sometimes, they will not want to hear our beautiful birth stories, for they are simply too painful for their wounded bodies and minds. Never doubt that by healing our own births, we’re helping to heal ALL births, and to break free of cultural conditioning and messages which scream out that birth is dangerous and deadly.” (from the foreword of “The Birthkeepers” by Veronika Sophia Robinson)

Tuesday, 26 July 2011

Birth Story Special: Induction

This week on the blog I'm running a Birth Story Special.  Yesterday I published Michelle's story, of a planned home birth that ended in an emergency caesarian. Today I have decided to share the story of my own first birth, also a planned home birth, that evolved into a hospital induction and forceps delivery.  

NICE guidelines state that induction is likely to lead to a labour that is more painful, and more likely to end in epidural, instrumental delivery or caesarian. And yet in the UK today around 20% of births are induced.  Many women find that they are coming under pressure to accept induction from around 40 weeks, and often there are confusing messages regarding the safety of continuing the pregnancy beyond their due date.  Of course, there is not a great deal of hard evidence about what happens if women are left to go into labour spontaneously beyond 
41 or even 42 weeks, as most women are not 'allowed' or encouraged to get this far.

Many women do not realise that they have a choice about induction and that they can delay or
refuse this intervention until they labour spontaneously or decide they wish to be induced.  Others like myself are aware that they have a choice but still feel under enormous pressure to comply with the status quo.  More information and evidence is needed to help women make truly informed decisions when they 'go overdue'. 

My First Birth

My baby was due just before Christmas, on the 21st December.  That much anticipated day arrived, and nothing happened.  Once you reach your due date, people start ringing and texting constantly, as if you are a cake that needs to be taken out of the oven at a precise time.  Anxiety builds.  I felt as every day went by that I was keeping a lot of people waiting.  But you also feel totally powerless.  The whole situation is completely beyond your control, and you just have to live with that.  For a few days, I didn’t feel that bothered.

A few days after my due date, I got a phonecall from my local midwife.  She said the consultants wanted to see me at the hospital.  I went to the appointment willingly, as I thought that they would examine me or scan me or something useful.  In fact, they didn’t do anything like that.  An Obstetrician looked at my notes, and worked out my due date (well done!).  He then said that I was over due and that it was policy to induce at 41+2 or 3.  He wanted me to book in for induction the following Monday or Tuesday.  I said I didn’t want to be induced until at least 42 weeks and also that I was booked for a home birth, and he went to fetch his superior.  I then had to ‘get permission’ from this next guy to wait til 42 weeks.  He explained the risks to me, not very well I might add.  He then left and the first guy came back and offered to do a ‘sweep’.  By this stage I had already had one sweep from a midwife and I really didn’t want this strange bloke poking around in my body.  I felt really vulnerable though, as I was already feeling like a naughty school girl who had not handed in her homework on time.  I thought I might cry.  Somehow I managed to find the strength to refuse a sweep from him.  I am really glad to this day that I was able to say no to his kind offer.  I’m quite proud of myself for doing this as I found it really hard and in some ways it would have been easier to comply and ‘be a good girl’.

So I was a week overdue, and already I had learnt a few new things!:
Don’t tell anyone your precise due date when you are pregnant.
Don’t bother going to meet the Obs when you go overdue.
Don’t EVER be afraid to say No to authority figures, even if this is really hard.

After this meeting it really felt like the clock was ticking.  There was something really negative about having a date in the diary for induction as well, it made it seem so inevitable that I would not go into labour naturally.

As the days went by we tried every trick in the book to get things started.  I had a few sweeps at home from various midwives.  I ate whole pineapples.  I bathed in jasmine and clary sage oil, rubbed it on my bump, and burnt it in the oil burner.  We went for bumpy car journeys, and my partner made me run up and down the stairs.  I meditated and focused on my cervix dilating.  I had acupuncture almost every day from a lovely woman called Jane who mothered me and tried to help so much and treated me for free.  We even, and this shows how desperate I was, tried sex.  And finally I drank castor oil, which made me shit through the eye of a needle, but – no baby! 

We then reached the day of 42 weeks, when I was booked for induction.  We decided not to agree to be induced that day.  It took ages and lots of talking to come to this decision and we felt really stressed about phoning the hospital and telling them we wanted to just be monitored.  Then finally when we rang up, they said, ok, that’s great, we can’t induce you today anyway as we are too busy!! 

So on the Friday evening we went in to be monitored.  I had to lie on the bed and have two ‘belts’ round my bump, one to measure the heartbeat and another to measure any contractions.  We did this on Friday, Saturday and Sunday evening.  

The first time we were monitored I could feel that I was having quite powerful ‘tightenings’ in my bump and the machine picked these up.  I was having two every ten minutes and everyone seemed to think this was very promising!  Before we left, I was given another ‘sweep’ by one of the midwives.  This was really uncomfortable and much worse than the others I had had at home (I think this was my fourth!!!).  The midwife said she had been especially ‘vigorous’ to try and get me started.  Because of this, and the tightenings they had seen on the machine, they pretty much waved us off and said, ‘Go home and have your baby’.

Looking back on it, I wish I hadn’t bothered to have that sweep.  I was having some good tightenings and I wish I had just left well alone.  It was so unpleasant that I feel it ‘frightened’ my cervix, it made that deep animal part of myself that was preparing to give birth feel unsafe, and change its mind.  I cannot prove this of course, but it feels true to me.

So over the weekend we waited and hoped, getting more and more insane and desperate.  I never got any tightenings as strong as the Friday night ones, they just fizzled out and didn’t return.

On Monday, after much talking and tears, we decided we had had enough, and that we would go to hospital. 

One of the few advantages of going in for induction is that you can take as much tat as you like to the hospital with you.  So we packed the car with cushions, a favourite pillow, rugs, essential oils, music, candles, yoga mats, birthing ball, you name it!  I took down photos I had stuck on the bedroom wall especially for my home birth and stuck them on a big piece of card.  I can remember peeling them off with a really deep sense of sadness and loss that I was not to have the birth at home that I had planned.  I had put so much thought and planning into it and it felt so desperately frustrating not to be able to do anything else to start my labour, and to have to ‘give up’ on that dream.

Nevertheless, I also felt desperate to have the baby as I was so huge and uncomfortable!  So nice to know that there was an end in sight!

We checked in to the hospital on the Monday evening, after eating supper at home.  I felt very anxious and afraid.  Firstly I was ‘monitored’ again.  We were in a small room and we stuck our photos on the wall and tried to feel positive.  At one point we heard the sounds of someone else giving birth and my partner said, ‘doesn’t that make you feel excited?’, and I said no, quite the opposite, it makes me feel terrified!

Later on the same midwife who had done the ‘vigorous’ sweep put a prostaglandin pessary inside me, this was a new induction technique that they were trialling, the drug was on a string so that, if and when you went into labour, they could remove it straight away.

I remember being quite tearful at this point as I had a real reality check and realised there was no going back.  Maybe somehow I had hoped I would suddenly go into labour at the 11th hour without their drugs!  I was asked what I was afraid of and I said, of being cut, of having a caesarean, of intervention.  I think also, though I didn’t voice it at the time, I was also full of doubt in myself, not quite convinced that I could do it, it somehow seemed impossible to me.

A new midwife came on to her shift and offered to move us to a different, and bigger room.  This new room was totally fantastic, with an en suite bathroom, lots more space, and a sofa for my partner to sleep on (although he ended up on the floor).  It was late in the evening by this stage, so we pottered around in the room for a while and had a cup of tea.  We found some ‘stirrups’, and hid them behind a curtain!

Eventually we decided to try and get some sleep, myself in the single hospital bed and my partner on the floor.  I was so glad he was able to stay, I would have been absolutely desolate on my own in that situation.  Somehow he felt like such a strong ‘anchor’ through the whole process, I felt that as long as he was there, I was safe.

I woke up at about 5am and felt that I was having some tightenings.  However, having been to this place so many times before, we decided to just go back to sleep, thinking it was probably nothing.  I slept for a few more hours, and I think it was about 7 or 8 when I woke again, and felt that there was probably something happening.  It was when I stood up to go to the loo that things suddenly felt quite strong and we fetched the midwife.  She examined me and removed the ‘teabag’ as they called it.  She said I was 3cm dilated.  This was it!

We were then on our own for a bit and I continued to have contractions.  They were quite powerful right from the start but in between I felt totally fine and my partner and I exchanged ‘ohmygodthisisit!’ words and faces.  I was on the floor with him and just moving around normally at this point.  A midwife we knew personally came, then left us alone for a bit.  We tried some different positions and at some point my partner played two Ray La Montagne albums on the ipod.   I have to be honest but after the first song I barely noticed the music!  But I guessed it must have been nice for my partner and the midwife, who by now had come back. 

I had not planned to ‘chant’ through contractions, but once I started, quite early on, I just couldn’t stop!  It felt so good to release my voice in this way, and kept me feeling steady and grounded.  If I stopped chanting I found I was liable to ‘lose my grip’ on the contraction, suddenly it would feel overwhelming and I would panic.  This only happened once or twice, the rest of the time I chanted, and stayed on top of them.  It was like trying to stay in charge of a wild horse, you had to focus every atom you had on keeping calm and keeping the horse under control; every so often the horse would explode with a burst of energy and run away with you, and you would have to work even harder to rein it in, calm it down, get back in charge.

The midwife listened to the heartbeat every 15 minutes.  I found this a bit annoying and distracting.  It seemed to pull me back to reality - when I was quite happy drifting off into a trance like state – suddenly it would remind me of time and the hospital and possible dangers, all things I did not want to have my attention drawn to.  But necessary I guess.  Certainly it seemed non negotiable.

However, after I was declared ‘in labour’ and had the induction pessary removed, I didn’t have any more vaginal exams which was great.  I believe these happen as a matter of routine unless you specifically request not to have them, so luckily I did make that request.  My labour was quite clearly cracking along at a pace anyway, so they would have been totally pointless.

I remember asking the midwife if it would get more and more painful, or if this was as painful as it got.  I think I felt at that stage that I could just about handle it but was afraid that we were just at the tip of the iceburg and I really didn’t feel I would be able to do it without drugs if it got any more intense.  I also remember that I often talked about being afraid.  Once I was in labour, my fear almost intensified.  There was no going back!  Our midwife wondered afterwards if it was this fear that had stopped me going in to labour.  I suppose it could have been.  But I also think that in these matters, we are not that powerful.  Nothing we think, consciously or unconsciously, can influence things, as it is not in our hands, not in our power, we are in the hands of fate, mother nature, or whatever you choose to name the forces of life and death.  When you are actually in labour, you feel this most intensely.  It is as if you are a paper boat being tossed on a raging sea.  You are small, insignificant, and at the mercy of something far greater than yourself.  Paradoxically, you also feel at your most powerful.  When things are going well, and you are riding the waves, it is the most exhilarating experience of your life.

Back to the story… after a while of chanting and moving on the floor, the midwife suggested I get in the bath.  To be honest I wasn’t sure if I felt like it, but said I would give it a go.  The bathroom had a really deep and wide bath, not quite a birth pool, but almost!  And actually, once I got in the water, it felt really nice, it kind of took the edge off the beginning and end of each contraction.  I just lay on my left side in the bath, and my partner rubbed my back during contractions.  That massage was wonderful.  I almost needed him to rub so hard that it hurt me, as this somehow distracted my brain from the other pain!

The contractions were still coming fast with little break between them.  I remember thinking about trying to let go of my rational brain and just go with my ‘monkey brain’, and musing to myself on how absolutely impossible this was, almost laughing at myself – Mule, you are actually in labour and STILL you are analysing everything and wondering what other people think of you!

I have no idea how long I was in the bath, but I guess it must have been quite a long time.   Maybe even hours?  Then the midwife suggested I get out.  I had no idea why but went along with it.  Once out of the water, I felt freezing cold and I remember being on all fours on a rug.  It was at this point that my waters broke.  I can only say that your waters breaking feels exactly as you imagine it would feel.

After this, I then had a contraction that felt totally different to all that had gone before.  It was as if it had another layer on top, and this layer felt like being possessed by spirits.  Let me try and explain – there was the contraction and all the usual pain and sensations etc, but then on top of this, it felt like a wave passing through me, I thought I would wet myself, poo myself and be sick, all at once.  I found it really hard and didn’t like the feeling that I might lose control of myself completely.  It was one thing being naked on the floor but another to contemplate simultaneously shitting and puking in front of an audience!  Every contraction after this was the same and I felt like I was holding on tight to my body to keep all of its atoms roughly in the right place.   I don’t suppose this can have helped me to give birth but it also felt like the only natural thing to do.  I also don’t recall ever feeling an ‘urge to push’, instead I just felt an urge to try not to be sick!  During this time, I sniffed Clary Sage oil on a tissue and when I smell it now, my body instantly recalls these amazing and intense physical sensations. 

During the contractions, I absolutely HAD to have hold of my partner’s hand, and after they were over, I absolutely HAD to have some water, as my mouth felt like a desert.  When each one was coming, I would say, ‘hand hand hand’ and then hold it as tightly as I could.  It felt like an anchor, as if I might drown if I did not clutch it. 

This went on for some time and I felt weaker and weaker.  I had not eaten much, fatal for me and my low blood sugar.  I wanted very much to get up on all fours but I just could not physically sustain it.  The only way to survive was just to lie on the floor on my blankets. 

Then I started to get pain BETWEEN the contractions!   Anyone who has ever been in labour will tell you this is NOT what you want to happen!  The time in between contractions is the golden time when you gather yourself and come up for air.  The pain between the contractions also felt like ‘bad pain’; whereas the contractions had a purposeful energetic feeling to them, this pain felt destructive.  I began to feel a bit desperate. 

The midwife then left the room.  I can’t remember exactly the order of what happened next, but I think she came back, and then a man in a suit came in.  I had no idea what he was doing in what I felt to be a very personal space.  I found his entry to be a very shocking experience in itself.  If either he or the midwife introduced him or explained why he was there, I don't remember this at all.

The next part was pretty awful and is still hard to write about.  He said he wanted to examine me and I still have a very lasting visual image of him rolling up his sleeves.  I felt utterly at his mercy and very humiliated.  Most of all I felt discomfort at the contrast between our states, he in his pristine suit, speaking calmly and quietly if at all, and me, naked, sweaty, dirty, exposed, chanting – I felt like an animal at the vets.  He examined me and it was incredibly painful and horrible.  This was an awful experience; there is no getting away from this fact.

He told me that the baby was OP and there was some discussion.  It was agreed that I could have fifteen more minutes.  For the first time I became very aware of the clock over the door.  I really started trying to push!  The time seemed to go so fast.  Then he was back.  I don’t know how the verbal side of the next bit went.  I remember protesting.  I must have been consulted in some way and I must have consented in some way, otherwise I suppose they would not have been able to continue.  I also must have refused an epidural. 

They walked me to the bed and there was some panic as they could not find the stirrups anywhere, until my partner remembered we had hidden them behind the curtain the night before!

I put on an old shirt of my partner’s that we had brought with us.  I have no idea why it was felt that I should put it on!   I sometimes feel as if at that point I was being ‘made decent’; taken from my animal state, naked exposed and groaning on the floor, and somehow ‘sanitised’ and made to fit our culture’s view of how birth should be, on a bed, on my back, my breasts covered…I was even convinced to have gas and air at this point, and I really didn’t want it!  But again I sometimes wonder if they wanted me to have it to make me quieter.  These are perhaps dark and cynical thoughts.  Nevertheless I wish to record them.

Inevitably my feet were placed in the stirrups.  Feminists and natural birth campaigners everywhere can cringe when I say this, but I have to be honest – putting my feet in those stirrups actually felt like a relief!  Something was supporting my legs and so I no longer had to.  I was so utterly exhausted.  I still kept trying to push really hard during contractions while they got things ready. 

I was given three injections in my perineum, which I felt, but which were insignificant sensations compared to those of labour.  I then must have been cut but I didn’t feel this at all.  The doctor wanted to know when a contraction was coming and so, for a few minutes, we became a team.  I did not feel the forceps go in, or if I did it was lost amongst all the other things that were happening to my body.  I gave a push, and for the first time felt that the push actually did something!  I was told, that’s the head out!  I was astounded by this piece of information and sent my poor partner to go and have a look!  This was probably the last thing he felt like doing but was hardly in a position to argue!  Then came another contraction and the most fantastic feeling of the body coming out. 

As she was born, I remember saying, ‘oh yes!’, as it felt so so SO good.   Then suddenly I heard the midwife say it was a girl and this bright red body came towards me through the air, it seemed!  I was so shocked to see a baby!  I know that I had spent the last 9 months being pregnant, and the last few hours in labour, but somehow, the last thing I expected to see in that room was a baby, particularly not my own baby!  It was 3.20pm.

They cut the cord straight away and I felt immediately disappointed that my partner did not get to do this.

I was given syntometrine (again I protested, but they could not leave me to a physiological third stage as I had been cut…the cascade of intervention I had read about was in action.)  I didn’t like this part either as the doctor was pushing on my tummy and again I had the feeling of being an animal at the vets, or, dare I say it, a piece of meat at the butchers.  The placenta came out fairly quickly but I did not get to see it, which also disappointed me.  I actually felt quite upset about this – to the point of tears - for a long time after the birth.  I had wanted to see it and possibly even keep it and plant it under a special tree, so I felt quite literally robbed that they just took it away without consulting me!  It was part of my body!  This might sound ridiculous but some people keep their kidney stones so maybe it is not so mad after all.

They set about stitching me up, which took quite a long time.  I found it very unpleasant and could feel the needle going in and out.  I told the doctor and he said something a long the lines of ‘well you should have had an epidural’.  I am so utterly glad to this day that I didn’t!  It would have only served to make me even more passive and uninvolved in the birth of my child, and even more incapacitated afterwards.  At least I got to feel that wonderful climactic rush of the moment of birth! 

I had more gas and air while he stitched me and my partner held her, as I did not want her first memories of me to be of a crying woman with a tube stuck in her mouth.  She was so alert and seemed to be looking at everything with such curiosity.  My memories of this part of the story are quite hazy, perhaps due to the gas and air.  I remember of course breastfeeding for the first time, and I guess this must have been after the stitching.  She latched on with no problem and it was a wonderful moment.  I also remember phoning a few people and I think I spoke to my parents.  After a while we got moved to a different room, a private room on the post natal ward, and I sat holding her and breastfeeding while my partner tried to gather all our stuff and load it into the car.  We were trying to decide whether to stay the night.  If I stayed, my partner could not stay with me.  To be without him that night, after sharing the most intense and mind blowing day of our entire lives, seemed unthinkable!  On the other hand I was very weak.  However, I was brought some cold roast beef, bread and butter and salad, which I wolfed down, and which almost completely fixed me!  In retrospect I think a lot of my weakness and exhaustion during and after labour was due to my low blood sugar, but it was so very hard to eat with contractions coming so close together. 

So we decided to opt for the ‘6 hour discharge’.  Everything felt so bizarre.  We had to dress our baby and get her in the car seat, and we had to ask a midwife to show us how to do this!  She seemed so tiny and fragile!  The journey home scared us both, driving along in the dark with such precious cargo. 

Back at home my partner took some photos and rushed around in a state of panic.  He was on his own adrenaline trip and could not sit still!  Eventually we went to bed although I spent most of the night sitting in the armchair breastfeeding.  I think a lot of the time she was sleeping with my nipple in her mouth, but I didn’t know this, I had no idea what I was doing.

But that I suppose is where a new story begins, the story of my birth as a mother!

Monday, 25 July 2011

Birth Story Special: Emergency Caesarian

This week on the blog, I'm running a Birth Story Special. Every day I plan to publish a different birth story, with the hope that by gathering together the threads of different women's experiences, we might be able to weave a picture of what it is like to give birth in the UK today; of what is being got right, and what might need to change.

So today I faced a difficult choice, which story first? A Caesarian might seem an unlikely place to start, but in fact this honest and gripping tale speaks volumes about having a baby in the UK today. For so many women, the dream and hope of a natural experience or even a birth at home, ends in a difficult, painful or traumatic way that they were not hoping for. Approximately 15% of births end in an Emergency Caesarean, and less than half of all births proceed 'normally' ie with no medical intervention.

These traumatic experiences leave us with questions; most particularly, was there anything I or anyone else could have done to bring about a different outcome?  By bringing together these stories this week, I hope to provide a place to discuss and communicate, perhaps to find answers, and if nothing else, to find solidarity in our shared experience.

Michelle's Story

I wanted a home birth. I needed a home birth! I was 100% confident I could do it. I didn't fear anything, I was actually looking forward to it. I had read and researched everything I could could get my hands on. I had watched hundreds of videos on YouTube of women successfully giving birth at home (some even completely unassisted). My God was Ina May Gaskin and my bible was Spiritual Midwifery. I felt strong, womanly and primal, after all, giving birth is natural, this is what I was meant to do, right?

Mathilda's due date (9th May 2009) came and went. Then early on the morning of Saturday 16th May 2009 I had a show which was immediately followed by mild contractions on and off all day and pretty strong at night. I was so happy and excited! Finally something was happening and I was convinced my daughter would be arriving before the weekend was out.

On Sunday 17th May 2009 I still getting contractions and spent most of my time in and out of the bath. Trying to sleep was almost impossible as every time I laid down, it would make the contractions feel really bad. I say bad as the pain felt like an injury pain, instead of the intense 'energy' of my uterus working hard. It's difficult to describe, but it definitely didn't feel right when I was lying down. I knew then it is not natural for women to labour and give birth on their back.

So I didn't sleep much at all but I was bearing up ok, even though I was beginning to feel a bit down by this point as I was already 8 days late and just really wanted to see my baby! My husband was great, he looked after me and would hug me and rub my back every time a contraction came.

I carried on through the night and before I knew it, it was Monday 18th May 2009. I was getting really tired by then, and my contractions were getting worse, but were very irregular.

Finally a midwife came out to see me. She examined me and I was only 1cm dilated. I couldn't believe it, I felt really shattered after that, as all the pain I had been through for 2 days had only caused me to dilate by 1cm! I was beginning to feel really lonely. My poor husband was also getting exhausted and just slept all the time. His Mum rang me to see how I was doing. She was really shocked that it was taking so long as both her births were really quick (first was 8 hours, second was 4) so when I came off the phone from speaking to her I felt even worse and I think that's when the doubt in myself started to set in. I sat downstairs and cried and cried.

I carried on all day, in and out of the bath, walking, trying to sleep but couldn't, using the TENS machine, but getting annoyed with it! At 11pm I called the midwife back as pain was getting really bad by then. She brought some G&A, which helped a bit, but not much. I kept being sick.

At about 1am I asked if she could check me, so I had to lie down on the bed. And OH MY GOD... the pain was awful! I've never screamed so much in my life, I had totally lost it, I had been doing quite well with breathing/visualising/hubby rubbing my back etc... but lying on my back just killed me. She took ages to find what was going on down there. I could see panic in my husband's eyes which was not good. She eventually said I was 4cm. I couldn't believe it, I just about gave up then. I puked all over myself and the bed and said I need to go to hospital, I was so tired, just couldn't integrate the pain anymore.

So my husband drove me into the hospital which was a 20 minute drive.

I was the only woman on the ward, which was great because I had treatment straight away. I asked for an epidural (I really didn't want one before, but I just really felt like I needed a break, just to get an hours sleep, anything), I had one within 20 minutes. Oh it was lovely. At first. It only worked on my right side. So in a very concentrated area in my left hip joint I could still feel everything. So nope, still no sleep.

I dilated really quickly once in hospital. A student midwife broke my waters for me and around 6.30am I was fully dilated and felt the urge to push. The epidural had worn off on the other side too by then, so I could feel everything again. My poor husband looked exhausted, so I suggested he went home for a nap but the midwives told him to stay as they thought the baby was coming and quickly.

They let me push for 3 hours. On my back, able to feel everything but unable to move my legs. This was not how I envisioned my first birthing experience.

My baby didn't even move down an inch. I would push and push and push....nothing. By then, I was totally exhausted. They gave me something to make the contractions stronger as they seemed to be dying off. This turned the pain up to a million it seemed. And again it was like an injury pain that felt like it was doing nothing other than just hurting me!

In the end they brought in a consultant. He said he'd do a ventouse/forceps with episiotomy delivery if I wanted. I said, 'YES!! I need to have this baby now with all the help I can get!' even though this was going against everything I had previously stood for. So, they topped up my epidural with a spinal, and wheeled me off to theatre, without my husband as he was so traumatised by the whole thing he couldn't face being there with me. I can understand that, if I had had the choice, I didn't want to be there by then either.

At least I was in no pain, finally. That was nice I have to admit!

The consultant tried pulling my daughter out with the ventouse plunger thing. It popped off her head twice - she was not budging. Still way up inside, not even in the birth canal, from what I gathered. So he declared I needed an emergency C-Section and got down to prepping me straight away.

I remember lying there thinking that this wasn't happening to me. What had happened to my serene home birth dream? I was now lying there, in a cold, stark operating theatre, shaking from all the drugs, paralyzed from the waist down, needles stuck in my wrists and hands, surrounded by people I had never met before but without my husband and about to be cut open, from hip to hip.

I felt lots of tugging, and heard one big 'SHHHHLLLLLUUUURRRRPPP!'...silence...then a crying baby. They held her up above the screen that obscured my view and I could see that she was all purpley red and angry! Finally Mathilda was here. Arrived into this world via failed ventouse delivery followed by emergency cesarean at 11.05am Tuesday 19th May 2009.

They let me touch her for a brief second before whisking her off to be examined. My husband came in and it was all over. He got to hold her, she was wearing a green hat and looking around at everything, probably thinking 'where the hell am I?!'

I don't remember feeling that emotional when I first saw Mathilda, I think I was too tired and drugged up to feel anything. But 45 minutes later, I was breast feeding her, so, considering the circumstances, that was pretty amazing.

Mathilda having her first meal. Latch wasn't so good, but not bad for a first attempt!

Just out of theatre, my nose stud and earrings are still taped up.

Close up of Mathilda holding her Daddy's finger

Afterwards, the consultant told me I had lost 2 pints of blood during the cesarean so I might need a transfusion. Luckily I didn't need to in the end. He also explained that Mathilda's head had been stuck sideways in my pelvis, so I would never had been able to push her out. I didn't really know what this meant so I asked a midwife later on and she didn't really say much, just said that it's an awkward position. Mathilda had bruising around one of her eyes, I don't know if that was caused by being stuck. I later learned that this sideways/tilted head position is known as asynclitism and it explains why I had irregular contractions, severe pain in one hip and a long second stage. But it does not explain why I 'would never had been able to push her out'. I think having an epidural and lying on my back meant that I was unable to push her out.

I spent 2 nights in hospital. The first night was a haze of morphine and extreme love for my new baby. We cuddled, slept and nursed. I remember being sick a few more times, I'm guessing because of the drugs. I had to have a bed bath as I was still in my labouring top which was all sweaty so the nurses helped take that off and give me a wash and take my catheter out. I couldn't move my legs until the early hours of Weds 20th May. I remember walking very slowly to the toilet for the first time at around 4am, with a lovely nurse helping me. I remember trying to pee and it took at least 20 mins. It felt numb down there but also felt like if I pushed too had my c-section wound would explode open and my guts would fall out!

The following day I had the first set of stitches and drain removed from my scar. That wasn't pretty, but in all honesty the worst part was the surgical tape ripping out half of my pubes when in was taken off! I was finding breastfeeding quite difficult by this point, but only because of the reduced mobility I had from the pain of the cesarean scar. This would carry on for a good 3-5 weeks.

I had one more night in hospital then asked if I could go home. I hated having to say goodbye to my husband at 10pm every night when I was there, it just felt wrong that we had to be separated. I was sent off with a bag of painkillers and some anti-coagulant drugs, which I had to administer myself via an injection to the stomach. I needed to take these to stop getting a blood clot apparently. I guess another downfall of having a cesarean.

Once Mathilda and I were home, we were able to relax. Yes it was a shock to the system, and I spent some time crying on my long suffering hubby, trying to make sense of all that had happened to us.

Fast forward to the following Tuesday, a week after Mathilda was born. It was time to have my main stitch out. I have to admit, I really wasn't looking forward to it. It just seemed like more pain for pains sake. A friend of mine, who had gone through an emergency c-section due to pre-eclampsia assured me that it wouldn't hurt, it would just feel 'weird'. Well, it hurt like hell! I think I was an unlucky case as after what seemed like 10 minutes of tugging from a home-visiting midwife on the stitch, it finally, excruciatingly came out. I was sweating and shaking. The midwife examined the thread and noticed there was a tiny knot still on the end which had passed through the length of my entire scar, causing the pain and the difficulty of actually removing it.

The following day I felt a bit feverish, and I remember worrying that I was coming down with mastitis. Well it wasn't mastitis, it was actually my cesarean wound slowly becoming infected. The following morning, I was lying in bed, holding Mathilda on my chest when I felt a wet sensation on my belly. I handed her to my husband and had a look as I thought that her nappy had leaked. But no, it was bloody pus oozing from my wound. This was a serious low point for me. Not only was I struggling with feelings of guilt and failure for not giving birth naturally to Mathilda, I was exhausted, sore and verging on depression but now I had to fight off an infection. I was given antibiotics and a bunch of dressings and left to get on with it. It was horrible having to change my own dressings and see the pus leaking out of me. I was worried the infection would spread to my uterus, but luckily within 3 weeks, my wound was better and healed quite nicely.

Two years on and I'm still numb along my scar line. I also have an annoying in-growing hair which becomes infected from time to time right in the centre of the scar. I have stretch marks and the shape of my body has changed due to motherhood, but I love these changes. However, I do not love my scar, which stands out like a red line on white paper.

I'm still breastfeeding my daughter, despite the the troubles getting started, which I'm sure were mostly caused by having a cesarean. My milk took a week to come in after Mathilda was born, resulting in her losing 12% of her birth weight (which was a hefty 9lbs 11.5oz by the way!) and taking 4 weeks for it to return. I'm certain the trauma, mentally and physically and the soreness from having a major operation helped cause this.

So due to my experience, I am planning a HBAC with the support of 
a doula now that I'm pregnant again with my second child. Looking back at Mathilda's birth story, I'm sure if the chain of events had happened differently, the ending would've been very different. I am certain if i had remained strong, or somehow managed to sleep more, I would've been able to give birth to her naturally. Because of this I feel tremendous guilt and I also feel scared of any future births I might have. So with this in mind, the decision to hire a doula to help guide and support both myself and my husband through my second birth seems to be a wise one.

I'm sure time will heal the bad memories of it all. I certainly have good memories attached to it as well. Like bouncing with joy on the bed on the morning I had the show, hugging my husband every time I had a contraction (this was while I was still at home), hearing my Mathilda crying loudly and strongly behind the screen in the operating theatre for the first time and being allowed to touch her before they whisked her off to be checked out (she was all warm and slick, she felt amazing!) and of course, breastfeeding her for the first time.

So this was Mathilda's birth story and also an account of my personal cesarean experience. I'm sure not all women have bad feelings or outcomes their own c-sections (my mother being a prime example - I was a c-section baby, and she had a General Anaesthetic and loved the fact she fell asleep then woke up with a baby. She was also very pleased that I also had a c-section, but I beg to differ) but I feel most of the time cesareans are unnecessary and should only be conducted if they absolutely have to be.

For more info on VBACs and Cesarean awareness month, check out the ICAN site, I have found it very helpful and it also inspired me to write this story.

Sunday, 17 July 2011

Pre-School: Demons and Ghosts

It's the three year old's first day to be left at Pre-School. She's never been to Nursery, or the child-minder: we've hardly ever been apart. As we cross the big playground together the sounds of school transport me back to my own childhood. Teachers' voices and the occasional scrape of chairs carry through the humidity of the July morning, my daughter grips tightly to my hand, and I can sense her taking in the loaded atmosphere of this strange new world.

We play together for a while, and I chat to the teachers. They all seem lovely and the atmosphere is warm, caring, and a bit chaotic. I tell my daughter I'm leaving and she confidently informs me that she is fine. But then there's a muddle as I'm told I have to put her shoes back on, and in the resulting faff she seems to lose a bit of confidence. She tells me she doesn't know what or who to play with.  A teacher moves in and distracts, and I slip away quick.

Back home, I make a coffee and sit on a rug with the one year old while she plays with cups. I feel quite awful in a way that I hadn't anticipated. For some reason I start thinking about lost loves. In particular I find myself remembering another hot day more than a decade ago when I took a man under whose spell I had completely fallen to Gatwick airport and put him on a flight home to JFK. I made the long drive across London back to my empty flat and sat on my living room floor, feeling too hollowed out even to cry. I wonder why I'm suddenly being visited by this ghost, and then I realise, although the story and the people are so very different, the physical feeling is the same: a sort of pulsating ache from the throat down to the belly, spreading outwards towards empty hands that cannot hold the person they most crave.

I decide to go back. On the way I remind myself not to be offended if she doesn't bat an eyelid on my return.  I'm prepared to find her not missing me in the slightest and immersed in a fun game. She isn't. As I come round the corner I catch sight of her, sat by herself under a tree in the playground. She looks worried, lonely, lost. I get another ghostly visitation as I remember so clearly that feeling of being left out of the game, and see myself as a child, sitting and watching the others play, from under a different tree. As she sees me and her sister her face lights up and she rushes towards us and we throw our arms around each other. I really feel like I'm going to cry, but I swallow it for fear of looking a total idiot.

We play for a bit longer before the session ends. I feel I'm all over the place emotionally and it's manifesting itself by an inner nitpicking and fault finding session with everything I see. Some of the girls have been playing with the dressing up box and I notice it contains a selection of high heeled shoes in little girl sizes. I know I would never have something like this at home and I don't like the idea of my daughter wearing them. A little boy does show-and-tell and has come dressed as a Devil.  I know my daughter doesn't know what a Devil is and I don't want her to know, either. Surely all these things can wait, I fume to myself.

I know what I'm doing here. By working up this angry energy I'm managing to stave off the real emotions: sadness, loss, grief. The three year old, just like her one year old sister who started walking this week, is moving away from me, and it's hard. From being nestled tight inside my body, they are both becoming more and more individual with each passing day, and it sometimes feels like a wrench even stronger than the pains of labour. And, just as when I gave birth, I know I have to let myself release them.

But I also wonder, is it really necessary, this separation, so young, so soon? The teachers tell me that sometimes the children cry at drop off time and that the staff are well practiced in the art of distraction.  But what is really going on in the heart of the 'distracted' child? Have they really forgotten their parent and their need to be near them? And what are we hoping to gain from this enforced apartness, that doesn't always seem to sit well with either parent or child? There's a cultural drive towards independence at work here, and from the cot in the nursery, to the plastic teat, to the pram at arms length, to early weaning, to sleeping through the night, we are bombarded by messages and imagery that tell us that our children should be encouraged to need us less.

I'm aware that my daughter, and her sister after her, might grab Pre-School with both hands and thoroughly love it. I'm aware that I have to allow them to do this. I'm aware that school life will bring great moments of pleasure and pride in their progress and growth. And I'm aware - before you say it - that I need to lighten the fuck up. And yet...and yet. Amidst the demons of the present and the ghosts of the past, something about it still feels at odds with my intuition.