I had a difficult birth last time – an emergency caesarean due to pre-eclampsia, and a difficult start to this pregnancy – a threatened miscarriage on Christmas day and weeks of bleeding. But the baby kept growing, and the pre-eclampsia didn’t recur.
I really didn’t want another caesarean, and I really wanted an undrugged alert baby, so despite a decision to have a hospital rather than a home birth, we booked an independent midwife, Debs Purdue, to ensure we didn’t get on a conveyor belt to a repeat section.
At 4 am on the due date, after two weeks of frustrating on-off labour, I was rolling playdough on the kitchen table to relax between contractions. Debs arrived, confirmed I was at last in established labour, and we called my mum to look after Mary, my 2½ year old daughter.
I was coping fine in the house through the night, but I didn’t want to be in labour with my mum and Mary about – I didn’t want to distress them, or lose my focus. So once mum arrives, and Mary has had her breakfast, we leave, probably too early for my labour, but at the right time for my peace of mind. Contractions in the car were much harder, as I felt trapped, and labour slowed down once we got to hospital. I take a homeopathic remedy (not to get labour going, but to deal with my emotional state) and do some serious walking.
I had negotiated with the consultant that I didn’t have to have continuous foetal monitoring, nor a IV drip in my hand, so I was free to move around. However the labour rooms at the new Simpsons have nothing to hold on to while standing or squatting, so Debs and I rigged up a hand hold using my spare trousers and the bed rails. With a bit of ingenuity you can have an active birth anywhere.
I was shouting now and needed Debs and James to push my lower back during contractions. I coped at home by being shut into myself, but in hospital I needed a lot of hands on support. When I wanted to get in the bath, I needed an internal first to see how dilated I was. I have a history of pelvic pain caused by an internal procedure, and I panicked at the thought of an internal. We asked for some privacy so I could compose myself, and I took an appropriate remedy. It calmed me down, I gritted my teeth and had the internal, and then got in the bath – which I got immediately manky, having been barefoot for hours (later I had to clean my nipples before feeding the baby!). As I was getting in, the midwife stretched the entonox tube over to the bath. I said “Don’t bother, I don’t want to miss a minute of this”. It never occurred to me to ask for pain relief, not because I was being a martyr, but because I wasn’t feeling ‘pain’. It was a very strong sensation, I was having to work very hard, but it wasn’t pain. And I still wanted that alert baby.
I thought the bath would ease the contractions, but they got more intense. However it was lovely floating in between (though I had to flounder back to my supporters whenever I felt a contraction coming). I got out of the pool eventually, and was told I was 10cm dilated – officially in second stage. I was delighted, but I was feeling no urge to push. We had been at the hospital for 10 hours now, and doctors were starting to hang about ominously, so I started to push anyway. Let’s get this baby out.
I pushed on the loo (where my waters broke). I pushed on James’s knee, just once, as it felt like a bad Benny Hill sketch, and got his shoes a bit messy. I pushed leaning on a chair. I felt in tune with the first stage of labour, but a bit divorced from what was going on now, and had to be told what positions might work.
I hadn’t persuaded my consultant to waive a ½ hour time limit on second stages in VBAC (vaginal birth after caesarean). Now that I was officially pushing, I wasn’t going to be left to do it in my own time. Now this is only bit I am not really happy about: at the urging of the midwives, I sat on the bed, with my feet on their hips, being coached to push. It went against everything I believe about birth; I was pushing uphill, I wasn’t listening to my body. But they were hearing the doctors at the door, rattling their forceps, and gambled this was the fastest way to get the baby out ‘naturally’. It’s the best position for them to coach in, because they can see what is happening. This was when James came into his own. He was totally supportive when I was pushing, but he was assertive when the doctor was interfering. I was aware of this damn doctor appearing every so often with threats if I didn’t have a baby within the next ten minutes. James would then go out into the corridor in nine minutes and stop her coming back in. He managed to turn a ½ hour limit into a 4 hour second stage.
My three supporters were getting me through contractions as a team: Diane coaching me through it, James calming me down afterwards, and Debs telling me how we were doing. They had to take it in turns to talk, I couldn’t hear more than one voice at a time. I got angry with James for trying to tell me how to breathe. I couldn’t remember which breath was in and which was out. I kept saying “I don’t know what to do!” But I did feel that we were a team. But the doctor wasn’t part of the team, and we lost it a bit every time she came in.
My bit of the teamwork (apart from pushing) was to say when a contraction was coming. And every time one finished, I toyed with the idea of not announcing the next one, so I wouldn’t have to push. In fact I always did admit to them, and always did push, like a good girl. But I’d still rather be upright, and I finally persuade the midwives to let me kneel up. And it is GREAT! I feel the head moving down when I push.
But here comes that doctor again. I am being moved onto my back, and I have another contraction while I am sprauchled over the bed, and the baby really moves. Really turns that artificial corner we have created by having me on my back. The doctor is serious about interventions, even though foetal monitoring is shows that the baby is coping fine. Debs and Diane recommend that I have an episiotomy, to get the baby out fast. We don’t have the time to take it slowly (this sudden rush is not for my benefit, nor the baby’s, but for the sake of the doctor and her clock.) As I am being threatened with forceps, which would need a cut anyway, I say yes.
I have an episiotomy. At the next contraction a head comes out. At the next, a body, feeling very small after the head, slithers out and there is a wee wet bloody person laid on my chest. Alert. Looking at me. With a squished manky beautiful face. Prompted, I look under the towel. A girl. Hello Evelyn!
Evelyn was born just after 11 pm on her due date, 8 lbs and 3 oz. She spent her first hour gazing at me and her daddy. She was feeding within 15 minutes; I expressed a wee drop, she licked it, she liked it, she sucked. We have had no problems since. A far cry from the days it took to establish feeding with her caesarean sister.
At least I got to stand up to deliver the placenta, and then I was sewn up, which was excruciating. Then I had a bath, James had some toast, and we were away. Home within five hours of her birth. Mary woke up the next morning, to a new wee sister. We all sat on the bed, Mary with the hugest grin I have ever seen.
Reviewing the birth, Debs and I speculated that Evelyn, who had been perfectly positioned, turned during labour (a peculiarity in my womb shape?) and wasn’t presenting correctly in the second stage, and wasn’t giving me the urge to push. Given more time, she would probably have turned again.
I regret not feeling that overwhelming urge to push, and I regret not pushing her out in a more natural position, without a cut. But she came out the right way, without drugs, and it was a truly amazing feeling to give birth for the first time.
I think my supporters gave the right advice under the circumstances, and I got my healthy alert baby. Maybe next time that doctor will have a bit more faith in the power of a woman’s body, with or without scar, and will leave well alone.