When you sit down to write a birth plan, regardless of whether or
not you have done so before, all you can do is hope for the best. Of course you
add in 'epidural if I feel I need it' or 'complete silence and being left
entirely alone by absolutely everyone if I feel I need it', but you also write
aspirational things like 'empowering music', 'a dark and peaceful space', and
'aromatherapy massage'. Needless to say, there is a reason why some midwives
are advocating for referring to these as birth 'preferences' and not birth
'plans' - as anyone who studied Robert Burns, or even Steinbeck at GCSE, will
know, the best laid plans gang aft agley, and this seem as (if not more) true for
birth as it is for everything else.
One of the things I most
definitely did not write in my birth plan for Seb was
'three different catheters please' or 'such a painful urethra I need an
epidural more for that than for the contractions'. In fact, everything that
went 'wrong' with his birth had been previously entirely unconsidered by me,
despite re-reading all the books in the weeks before to get in the mood. When
it comes down to it, there is in one sense absolutely nothing significant to
complain about: we are all here, we are all fine, and one of us is off the
chart in terms of weight, height, head circumference and general all-round
flourishing baby status. Nevertheless, we shed more tears and had to call upon
the services of more hospital staff than I would have liked or intended, and I
left hospital later, tireder, and more traumatised than I expected.
The beginnings of the journey
were not all that auspicious: the hospital where I had my booking appointment
somehow lost track of me, meaning I saw no midwives for the first twenty weeks
of the pregnancy, and then my 'latent labour' began at 37 weeks even though I
didn't give birth until 41 weeks. For the uninitiated, latent labour is very
early labour when your body is gearing up for birth, and until recently I had
no idea it could go on for several weeks. For me it included bouts of
contractions (a little more intense than Braxton Hicks, not as significant as
'real' labour) as well as heavy period-type cramps and a general feeling of
nerves and disorientation. When it began I went into hospital for a positional
scan as I genuinely thought labour was kicking off for real - even making C
take a day off work to come with me. After all, I had been in labour before, so
I knew what to expect - right? (Wrong...) In any case, once we had established
that, unlike my first baby, this one was cephalic (head down) I headed home,
confidently expecting to be back within 24 hours or so, when in fact I didn't
return for another month.
Throughout those four weeks I
behaved a bit irrationally (getting my mum to come and stay twice because I thought
the baby was going to come any moment) and at times quite horribly (having a go
at a man on the phone for the fact a home intruder alarm I didn't even know we
owned had gone off, and he had the temerity to not know the code) but in
general it just led to a sense of enormous tiredness even before the baby
actually came. I was massive, uncomfortable, and fretful, plus I was waking
every two hours in order to pee. To top it off, despite trying to line up
childcare plans for any eventuality, inevitably when the contractions did start
it was 1am, we hadn't got anyone local to contact, and things seemed to ramp up
fast. Cue C calling his mum at 3am and her driving 2.5 hours to save the day -
and me labouring away from the comfort of my own bedroom because I had allowed
Maggie to sleep in there with me in a moment of weakness, and then couldn't
turn the light and risk waking her up. It was a scrappy start, and not nearly
as serene as I had hoped, although I did manage a bath and an episode of Mrs Maisel, which is
highly recommended for emotional times as, unlike seemingly most TV dramas of
late, you won't suddenly find yourself faced with the threat of a dead baby
storyline (thanks, Ozark).
Once C's mum had arrived and he
had managed to extricate the hospital bags from the bedroom without disturbing
Maggie, we were on our way to Royal Sussex. My contractions were about three in
ten minutes and feeling pretty intense: all I wanted to do was be on my feet
and pacing, so sitting in the car even for twenty minutes felt tough. We
arrived at about 7am to be greeted by a midwife who we had seen when Maggie was
born. I find her hugely reassuring insofar as she has had eight (!) children
herself, and exudes an aura of someone who has seen it all before. She met us
in the maternal assessment unit, where they decide if you're ready to be
admitted up to the antenatal ward. After a vaginal exam (makes you feel more
bovine than you would wish) it was established I was only at 2cm and so the
midwife gently suggested we could go home if we wanted. I didn't really want
to, mainly because I didn't want Maggie to see me in labour, and the midwife
agreed we could stay for a bit. Her main concern was that I couldn't pee even
though I'd been up overnight and drunk two cups of tea and two pints of water
in that time. This was to become a theme of the labour, and in fact no pee
would be forthcoming until around 20 hours later, once Seb had
been born. The midwife I saw afterwards reckoned his head was pressing against
the lower half of my bladder and preventing even a catheter from doing its job,
but at the time I was advised I was dehydrated and to drink more water all day,
leading to Seb being
born with a salts deficit because in fact both of use were wildly
over-hydrated. Again - not something I had considered when reading all those
birth stories.
But back to the morning: as a
result of the pee issue the midwife tried an in/out (or 'solid') catheter and
it hurt significantly more than either of us expected: I nearly broke C's
fingers gripping his hand while she tried to push it past the obstruction
caused by the baby's gigantic head. In retrospect I think the fact he was so
enormous and heavy had caused everything to become very tender and sore even
before the big moment arrived, and I hadn't realised this until someone came at
me with a big plastic stick. In any case it didn't work, and by the time I got
to the antenatal ward a couple of hours later the midwife there insisted I have
a proper 'soft' catheter which would stay in. And so there I lay, prone and
tearful, arguing with a medical professional about whether or not I needed to
have another one as the first had hurt so much. In the end she pulled a trump
card by wheeling out the gas and air, and I submitted (pretty unwillingly). Again,
nothing happened, and again I was told to drink more water.
The upshot of this, however,
was that I was now labouring lying flat on my back as I was too nervous to move
around with the catheter in, and oh my god people aren't exaggerating when they
tell you it's the worst position. It's the worst. I was tearful, losing my grip
on my breathing, and not allowed any more gas and air until I got to labour
ward proper at 4cm. It was at this time that a very nice woman arrived to
apologetically explain there were no hot meals but would I like a cheese salad?
Bizarrely I said yes, even though it was probably the last thing I wanted
(other than another poke in the urethra) and so the next thirty minutes were
spent with C and I staring mournfully at a plate of lettuce, tomato and grated
cheese and a clingfilmed bread
roll: me not eating it because I didn't want to, him not eating it because he
couldn't bring himself to take NHS food off a legitimate patient / a
woman in labour.
Not long after lunch, the antenatal
midwife came along with another gloved hand and established I had reached the
magic 4cm and could go off to the labour ward. I wasn't feeling as chipper as
she clearly expected when she told me triumphantly that my labour had
officially kicked off, and just before we set off she told me I was going to
have to give in to the process of the labour and try and let go a bit. I didn't
say anything, but I gave her a look which I hope communicated the sentiment
that I would love to but I was being depressed by the presence of an invasive
rubber tube. After this rather one-sided exchange I was put onto a chair facing
backwards (as in, arms on the back, knees on the seat and bum in the air)
grasping onto the gas and air tube as the catheter and my gown trailed behind
me, and we set off to the lift up to labour ward. Some people waiting at the
lift were ushered aside by the midwife saying "Can we go first please,
this woman is in labour!" which was pretty cool, and reminded me of
'coming through, coming through, lady with a baby!" from Grease, and then
we were up at the 13th floor in a lovely private room with a midwife who
reassuringly shared a name with my youngest sister. She was unperturbed by me
standing in the middle of the room crying about a catheter, and very sweetly
told me she would take it out, which she duly did. She may have been a bit
surprised by my announcement about twenty minutes later that I'd probably like
an epidural, please, since A) this requires a catheter anyway and B) once I'd
had the epidural I
wouldn't be able to feel it, but there we go. Labour does funny things to your
communication skills.
The midwife explained that the
epidural would depend on the availability of the anaesthetist, and that there
were emergency and planned C sections to work around, so we decided I would
have one as soon as someone was available which turned out to be very soon
after. The epidural needle was initially put in the wrong place and had to be
relocated, which was a bit of a bummer for my spine, but when it hit it was as
good as you'd expected and was genuinely the first time all day I hadn't
thought about my urethra. Thankfully the labour itself was progressing well, C
had done an amazing job with lower back massage and helping my head off the
contractions through movement, and although my waters hadn't broken everything
was very 'soft' in the cervix department (yes I know, bleurgh...sometimes
it is referred to as RIPE! Haha).
What I hadn't appreciated was
that midwives from this point stay with you all the time, which is amazing, but
also a bit weird when you have had an epidural as there isn't all that much for
them to do: I just sat and chatted, which to be honest I didn't really feel
like (I think I probably could have slept for a bit if I had tried) but even in
the throes of labour I was too polite to ask not to to talk (a bit like when
you're at the hairdresser and you just want to read your goddamn book). I heard
recently that midwives used to knit in order to keep busy, since so much of
their job is observation and listening rather than doing, which makes perfect
sense. Anyway, darkness fell over Brighton and I was reminded by how
spectacular the views are from the top of the hospital tower as we saw the sun
set and the city lights start to twinkle. I even got presented with another
plate of hospital food - vegetarian cottage pie with green beans - which the
midwife took one look at and advised me not to eat considering how far along
the labour was. I had one green bean and realised she was right (I realised it
again when I threw the bean up again an hour later).
Shift change came along at 8pm
and our midwife was replaced by a team of another plus a student. I was getting
really tired by this point and there was a bit less chat, although being observed
by two rather than one was a little weird. The student told me she had to be
present at 40 births to complete her training and was already on 38, so there
was a chance I could be her final - about an hour later we heard a woman next
door very clearly about to give birth and she rushed next door to witness and
rack up her 39th, so things were looking good for me being the Big 4-0.
By this time I was 8cm and not
long after this was established my waters broke - I was feeling really good
that progress was being made, and I was loving the epidural. It was
pump-operated and could be dispensed every 20 minutes or so, but I had been
really frugal with it so I could still tell when the contractions happened and
even how strong they were, whilst watching them on the monitor at the same
time. It was a brilliant combination of having a sense of control but without
the pain, and I was also insisting on sitting so upright I was practically 90
degrees from the floor as I was convinced gravity was going to help speed
things along. All told I was feeling pretty on top of things.
Then 11:30 rolled around and it
was time for another vaginal exam (my fifth by this point, by a fourth midwife)
and things took a bit of a nose-dive. I was still 8cm and, quite swiftly, the mood
in the room changed. Firstly the student midwife asked her colleague to confirm
her suspicions that things hadn't moved along by performing another exam
(making it 6 by 5 gloved hands). Previously I had been told the contractions
were so regular and strong it practically looked like I'd had the hormone drip,
they were so textbook, but now I was being told that labour wasn't progressing
quickly enough and I should consider having the hormone drip for real. I don't
think this would have happened had this been my first baby, but since this was
a VBAC (Vaginal
Birth after Caesarian)
they were more nervous about a long labour, with the tiny associated risk of
uterine rupture. I had never wanted an induction and the hormone drip sounded
dreadful to me: I was worried about it feeling too 'nought to sixty' and out of
control. The midwives explained this concern didn't really make sense given the
situation - unlike a full induction I was already way into labour, I had had an
epidural anyway, and it should just speed things along. Nevertheless, I stuck
to my guns and said if I couldn't labour by myself I would rather have an
emergency section. This made me really tearful as it was exactly what happened
with my first baby - I laboured for 24 hours and had a section anyway (she was
breech) meaning I went into the operation already totally exhausted. It was
even the same time of day, approaching midnight, and the same surgeon appeared
to talk me through the procedure. She was, however, exactly as kind and
professional as she had been the first time, as was the nurse who ran the show,
and I quite quickly calmed down enough to be undressed and wheeled
through.
All of a sudden a team of about
twelve people were amassed and a very nice anaesthetist used the line-in from the
epidural to 'top up' the drugs ready for the operation. This was an odd
feeling, cold in the veins and a bit of a shock, and it also led to me
immediately vomiting into a cardboard bowl being held by the ever-patient C.
The operation happened quickly, just as I remembered from the first time, the
only delay being a pause for a bit of muff-shaving (the least of my worries in
the last few weeks of labour). And then things went dramatically down hill. The
baby was pulled out and held aloft, I had the briefest impression of a big head
and an umbilical cord, and then...nothing. I couldn't hear crying at first, and
my heart was pounding before I finally heard a squawk and a bit of a gurgle.
But he wasn't wrapped and brought straight to me, as I knew to expect from my
daughter's birth. Instead, and without me realising it at the time, he was
being given oxygen via a tiny mask because he had been born with meconium aspiration
and was struggling to breathe. Meconium is the name for baby poop in utero, and
sometimes it can be passed by the baby during labour and
end up in the amniotic fluid. Because the baby had been so big only my forewaters had
broken - again, he was a giant plug holding everything back - and the hindwaters where
the meconium had
been present had therefore not come out or been seen by the midwife. Poor C had
to witness his emergence from the womb, blue and breathing raggedly, as well as
the swift arrival of a consultant from the baby unit upstairs, all the while
not knowing what on earth was happening. Meanwhile, I understood even less,
since I couldn't see past the curtain shielding me from a close-up view of my
own organs, but the adrenaline and drugs had started to make me shake really
violently. To distract me from this, and presumably to keep me from worrying
what was happening on the other side of the curtain, the very sweet
anaesthetist attempted to talk to me about a breakup he had been through that
meant he had gone years being unable to listen to Bon Iver.
It was a horrible, surreal time (testament to my excellent upbringing that I
was polite about the breakup despite the gnawing dread I was attempting to
suppress, or the fact that the shock made me want to close my eyes as well as
shake like a leaf).
After some time, maybe ten or
fifteen minutes, it was established the baby could only breathe with some
assistance and so he was wheeled upstairs to the Baby Unit. I saw him as he
went past but we didn't cuddle, and that was the hardest thing - you read over
and over how important the initial skin-to-skin contact is, and to be deprived
of it, even for incontrovertibly sensible reasons, was tough to handle. Soon
after I was completely stitched up and wheeled to recovery, where C and I had
to wait for news for a long time. This was worse for him than for me, as I
simply couldn't stop myself dropping in and out of sleep, but he was wide awake
and thinking the worst. Finally, around 4.30am, he was taken upstairs to meet
baby Seb for
the first time. He came back down with a video of a gorgeous, pink, squishy
baby with those wide open eyes that newborns sometimes have, looking as old and
wise as a little Psammead.
Shortly after, once my drip had finished, I was de-wired and
taken up in the bed to have our first cuddle. Seb was
born at 1:02am and I got to hold him at around 5.30am. It was a long four
hours, and we were both full of tubes, but it was so worth the wait.
(There would be a lot more
waiting over the days that came after ~ but that's a blog for
another day).
Cuddle #1
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