This is going to be long, but just as it felt important to me to get Little Miss’ birth story out, I feel the need to do it again with Little Mister’s. (Yes, we had a Little Mister! I’ll call him “Peanut” and “It” a fair bit here though, as we didn’t know the sex until birth.) As with Little Miss’ story, this isn’t all sunshine and roses, but about things not going to plan, and dealing with the emotional and physical aspects of such a complex issue as birth.
Again, I don’t want to name the hospitals involved. As with most, some of the staff are incredibly lovely and helpful, some not; some procedures can be helpful and life-saving, others traumatic and unnecessary. I don’t want to publically bad-mouth any hospital or person when my experience could just happen to be an isolated one, and many of the midwives and nurses turned out to actually be pretty great.
Part 1 – The Lead-Up
Little Miss was born in Hospital A, but I had moved to another area and so began going through Hospital B. They generally prefer you to wait 18-24 months before trying birth after a previous C-section, however, accidents happen, such as Peanut – there would be 15 months between births. My GP felt that since I’d healed so well and was healthy and strong, the hospital should be willing to let me start labour naturally, but would be quicker to rush me into theatre if things started going wrong, which sounded reasonable to me at the time. However, Hospital B didn’t agree, and wanted to book me in for a caesar. I did a lot of research and found many women who’d had natural, even home, births after caesarean, much earlier than 15 months. I discovered that the risk of uterine rupture is actually only minimally higher than a woman who hasn’t had a caesarean, however, the hospitals of course have to take any risk into consideration.
But the pressure to book a caesar made me feel miserable. Every time I went into the hospital, I felt tense anyway – I couldn’t explain it. The midwives had all been pretty lovely. I think it was just remembering going through those last weeks of pregnancy when Miss B went overdue, and the constant pressure at Hospital A for procedures and induction, the lectures on stillbirths, guilt trips … I felt unable to cope with that if it were going to happen again. I couldn’t concentrate on anything birth-related. I felt like emotionally, I was running away. And yet Peanut was growing, and was going to come out at the end of nine months (give or take).
The more I researched HBAC’s (home birth after caesarean) and spoke to women who’d had them, the more I wanted the birth I’d planned to have (and didn’t) with Miss B. I wanted the birth pool, the quiet, the candles in the dark, the meditations / music playing. Only I didn’t want that interrupted by midwives coming in and turning lights on and announcing loudly that it was time for a vaginal examination (I heard so many stories of women’s labour coming to a halt because of this), or telling me I hadn’t progressed far enough since they’d last checked, putting me on a clock because of when my waters had broken, pressuring myself and my partner that it was time to have a caesarean. I wasn’t being stupidly stubborn – I knew there was a chance I’d go to theatre again; it wasn’t “home birth at ALL COSTS!” I wasn’t anti-medical system. Just, I wanted the chance to birth the way I wanted to first.
I went on feeling miserable, but with the added stress of being about to move house whilst heavily pregnant and with toddler in tow. (I’d already moved when pregnant the last time!) I spoke to Hospital C – where we’d be moving – on the phone a few times to check what I needed to do to transfer, and each time was assured there was nothing I needed to do except just simply show up once I’d moved.
Once we moved, Hospital C told me I needed to physically come in to make an appointment. When I organised babysitting and duly went in, I was told they couldn’t make an appointment after all as they were so busy that it was likely no-one would be able to see me until after my due date. The impression I got was that it was my own fault for moving when pregnant. I wondered if I was supposed to show up when actually in labour, and hope for the best. Though I since found out that two other hospitals in the area had closed their maternity wards over the recent years, which meant Hospital C was overflowing. So I can understand the stress that the midwives at the desk were under; unfortunately, it doesn’t help when it’s taken out on pregnant women.
Then the hospital rang with an appointment at such short notice that I couldn’t make it, whereupon I was told that since I’d “cancelled”, they didn’t know when they could fit me in again. They did ring with another appointment at short notice, which I was able to make – but as I was walking in, they called to cancel themselves. Since I was already there, they decided to take my history, but I was reminded constantly how much of a favour it was as they were so busy, and that it wouldn’t be thorough. I was also told I’d be expected to test my own urine in future (but not now, as they were so busy) and interpret the results to a nurse, which to me sounded the wrong way around.
I was expected to see a GP, so having just moved, I went to the first one I could get into. I didn’t get past telling her that Little Miss had gone overdue, before she was shuddering dramatically and telling me she didn’t like that at all, and that women shouldn’t be allowed to do that. She also told me that I already had a term fundus, with a baby that was basically ready to come out now (six weeks early). I had to ask a couple of times what the measurement actually was, whereupon she reluctantly admitted I was measuring on target. She also told me that my urine showed I was ketonic and that I needed to eat some sugar immediately – whereas another doctor a few days later, interpreting the same sample, told me there was too much sugar in my urine (I had already been tested three times as negative for gestational diabetes). That second doctor also bombarded me with the risks of bleeding to death during birth, possibly even needing a hysterectomy – that is, if the baby and I didn’t die in childbirth first.
It was about that point that my partner agreed to seeing an independent midwife. The hospital was notified, agreed to send the midwife my records, and somehow sent them neither to the midwife nor to me, but to my old address, where I managed to get them before they were thrown out.
It was rather late in the pregnancy to get a private midwife, but it was the best thing we did. It really took the stress out of things. The very personable Rachele (from With Woman) took the place of both hospital and GP visits, being able to come to our home at times that suited everyone and meant I didn’t have to organise a sitter. Instead of being bombarded with doom and gloom statistics, I was reassured calmly of Peanut’s health and growth. I felt able to relax for the first time about the whole thing. Peanut appeared to be in a good position, too – anterior. We thought I’d have to be very unlucky to have two babies that were posterior and deflexed.
I had an emotional moment one night, though. I’d thought I was at peace with the fact that Little Miss’ birth had turned into a caesarean – otherwise we may have both died in childbirth, so why be upset? But my partner was YouTubing a video of a woman giving birth in a pool at home, surrounded by candles, and I surprised myself by bursting into uncontrollable sobs, saying that was the birth I was meant to have given Miss B. I felt heartbroken and in mourning. I was jealous of the woman on the screen – and I had never before, and never since, felt jealous of anyone achieving their ideal birth just because I hadn’t. I was just overwrought from the whole process.
Part 2 – The Birth
Peanut was due roughly a week into September, but since Little Miss had been three weeks over, we told people the baby was coming anywhere between the 1st and the 30th. I had been having back cramps for quite a few weeks, but knew not to put any emphasis on them. With the first pregnancy, you think anything is a sign of impending labour; the second was more, “Meh, teasing me again, are ya, Peanut?”
Miss B had come on a full moon. At the very end of August, there was a big super-moon, and I got the weird feeling that Peanut would be coming in the next few days. The next day, I began losing bits of mucous plug. With Miss B, the mucous plug loss, waters breaking, and labour beginning all happened on the same night – but I knew that wasn’t necessarily the case for every birth.
A few days later, on the 2nd September, early morning, the back pains were so intense they woke me up. They became regular contractions perhaps ten minutes apart. I couldn’t lie down, but had to walk around to ease them.
I had a sleep mid-morning (Miss B had gone to her Nana’s), remembering to conserve energy early on in case of a long labour. When I woke up, the contractions were gone. They came back more strongly in the afternoon, and my waters broke as well.
My partner was caught up in bad traffic, so it seemed an interminable amount of time before he got home. I stayed calm and got in a warm bath. I was happy that these weren’t at all like the “contractions” I’d had with Little Miss – the waves of pain just blending and crashing into each other non-stop as she turned posterior and got wedged, until I was begging for an epidural. I felt confident and was managing. I seemed to keep losing more water in gushes – there must be an incredible amount in there.
Rachele came when the contractions got closer and closer (my partner was home by then). I remembered to do things that I’d forgotten to with Miss B’s birth, such as drink lots of water and keep peeing (so the bladder didn’t get in the way of the baby’s head). I lay on the bed in the dark, listening to meditations, drifting off in between contractions, for some of it. Sometimes I walked around. Other times I was in the birthing pool, again listening to meditations whilst surrounded by candles. (I’ve never been very good at meditations, but somehow in labour I found it helped centre me and take my mind off thoughts of “pain”.) Some contractions were easier to deal with than others. Occasionally I’d get an urge to push, but it would go away again. I drank Endura (magnesium drink) and coconut water and just plain water. I got into a good rhythm sometimes, even when it hurt – managing to drift off in between with the help of the meditations. But sometimes the contractions were so intense I didn’t know how I’d cope, trying to ride them through to the end. I began to wonder how long this was going to take.
We were into the small hours of Thursday 3rd, and the contractions became … well, not quite right. It began to have a bit of a feel of Miss B’s birth about it, where they got irregular. The feeling of wanting to push being only spasmodic bothered me. Then the contractions began coming thick and fast on top of each other, but not in a regular way – it was again like Miss B’s birth – it was agony ripping up my spine relentlessly, sending me out of my mind. I saw dawn breaking through the blinds, and knew it was the next day. I was exhausted and spent; I could feel my body giving up, much as I tried to go within myself and will it to continue. I knew the baby had turned posterior at some stage. None of my partner’s tricks, that had worked earlier in the night, now did – the counter-pressure on the back, the squeezing the top of the hips to open the pelvis. I don’t want to focus on the pain, but I have to, to explain why I gave up on the natural birth I’d wanted so badly. Rachele couldn’t even manage an internal examination until I was able to lie on my back instead of writhing on my side. The baby’s head was now not engaged in my pelvis, when it had been. And I was not as dilated as I’d expected – 5 cm. I couldn’t go through more of this to wait for the other 5 cm.
It’s not actually that hard a call to make, to give up on everything you’ve worked towards, when you’re in so much pain you feel like you’re going to go insane or die. I had to go to hospital, the place I’d been trying to avoid.
But it’s a long process when you can’t even dress yourself, and everything has to wait for rare lulls in the pain. I could barely get to the car and get in. Every bump and bend on the road was agony, feeling like it was grinding Peanut’s spine against mine more. Then it was a long walk from the parking lot to the hospital. I made it up one lift and along a walkway to another, where the pain got too intense again; to try to hide it from the people waiting, including a family with small children, I managed to get into an alcove and lean moaning against the wall. It was right over a rubbish bin, but I was beyond caring. I was aware of a woman asking if I needed a wheelchair. I can’t remember what Rachele or my partner said, or if I yelled “YES!” or that was just in my head, but she went to find someone. It seemed to take ages (probably didn’t), and then I was being sat down and wheeled. We still weren’t inside the hospital yet, so had to cross a section of pavement with non-slip bumps, which made me want to scream at the orderly (I didn’t). Then inside and waiting for another lift. Other people joined the queue. I have no idea why they felt it was so important to get in the lift with the moaning woman instead of waiting for the next one, and I would have liked to have yelled at them, but I didn’t have the energy.
In the birthing suite finally, lying on a bed, a drip in, begging for an epidural, just like last time. My partner trying to convince me to try other pain relief methods first, same as last time. I kept saying, “I can’t go through that again. I just can’t.” Not the stuffing around with trying things that didn’t work, and I didn’t want to load my system up with other drugs first. As it was, I was sucking back on the gas like a leech. I was biting the damn nozzle. I was hyperventilating. I was getting pretty stoned. Again, it didn’t really take the pain away, but it was something to cling onto.
They had to wait for the anaesthetist and to get blood test results, but it was done pretty urgently, so it wasn’t that long until I got my epi, catheter put in, etc. They didn’t manage to get the epidural needle in the first time, but had to do it twice. I went through the déjà vu of Miss B’s birth, sitting on the bed hunched over a pillow, trying to stick my spine out, in between contractions – really not fun when you have no regular contractions and no real break in them. Somehow I managed to stay still, biting the gas nozzle harder and vowing my partner would get a vasectomy if I had to give it to him myself.
An examination before the epi had found I was now 7 cm, which was promising – there was the hope that with pain relief, my body would relax and the baby would come out. Unfortunately, it can also go the other way, where your body stops labouring. The baby was indeed posterior and deflexed (chin up rather than down), just like my first.
I will say that although I hadn’t been impressed with Hospital C up to this point, actually being in the Birthing Unit was different. The vast majority of midwives were amazing and caring, and had worked to get me the epidural as quickly as possible, and to let us know what was going on, and kept optimistic and upbeat. There is always “that one”, though, and we did experience “That Doctor” who was obviously very pro-caesarean and seemed to just want to get me into theatre and out of the way, before properly assessing and giving things a reasonable amount of time. It had to wait, though, as she’d been sending others into theatre before me.
After a few hours, things still hadn’t progressed. By this stage I knew a C-section was likely to happen. The epidural had taken away the pain but not the “pressure” feeling of contractions, and I could feel that they’d almost disappeared. Every now and again they’d make a token effort, but nowhere near enough. And I couldn’t even try to go inside and will them, because I kept drifting off to sleep, exhausted. They couldn’t put me on Syntocinon (artificial oxytocin) to stimulate the contractions, because of the risk of uterine rupture after the previous caesarean.
Now and again I looked at the clock and thought, “Today is the 3rd. Wouldn’t it be funny if Peanut was born at 3.33?” Miss B had had such an impressive birth date and time – Friday the 13th, full moon, at 23.23 – and I kind-of wanted Peanut to have a go at an impressive date and time as well, for fairness’ sake.
Meanwhile, the traces on Peanut showed that bubs was still going strong, seemingly unaffected and not in distress. Tough little bugger. I had the feeling that its head hadn’t been fitting through my pelvis, so it had gone up and turned around to keep trying, but had been unable to find anywhere to fit. That could be totally medically inaccurate, but that’s the way it felt to me.
Strangely, they didn’t want to do an internal examination until I was in theatre to see if things were progressing, which sounded odd because if it turned out I had dilated further and Peanut was going to come out vaginally, they would have to take me back up to the ward again. A surgeon later told me I had been closing up and was down to 4 cm when they checked on the table. I was taken to theatre and prepped, more cannulas put in, and epidural topped up. They warned me that it would give me the shakes, but I remembered that from last time. The shakes started while I was still waiting for my partner to be allowed in, and some nausea, so they put something extra in the drip for that. By the time my partner came in, my arms were shaking so hard and uncontrollably that my muscles ached from the shoulders down.
The caesar itself happens quickly. The screen was up so I couldn’t see anything. Unlike with Miss B’s birth, they didn’t whisk the baby straight off for routine checks while I waited and wondered what it was and what it looked like and when I would finally get to hold it after everyone else in the room had. My partner peered over the screen as it emerged. Funny, with Little Miss he had been kind-of hoping for a boy and then was enraptured with her from the moment he saw her; this time, he had been hoping for another girl, but I could hear the same rapture in his voice when he came back to my head and grinned excitedly, “It’s a boy!” I didn’t know what to think. I think that’s part of the problem with caesareans (for me, anyway – and could also be the result of long labours, epi, etc.) – I’m left feeling drugged and wiped out instead of present in the moment.
They held him up over the screen for me to see before they cut the cord. I remember wanting to say, “Leave the cord pulsing!” but somehow couldn’t get the words out – so a good reminder to bring a Birth Plan with you to the hospital. Miss B had been fairly quiet when she came out and then proved to be loud later, but this one was the opposite. I had an impression of a tiny screaming baby not too happy at being dragged out into the bright lights of a theatre – I don’t blame him.
Apparently he wasn’t so tiny, though to me he looked it. It made me feel better when I was told later that he weighed 4.32 kg (9 pounds 8 ounces) with a head circumference of 37 cm – some people do manage posterior births though it’s rough going, so I’d felt miserable that I couldn’t; but then add a large baby to that, and the deflexion meant that the largest part of the head was trying to push through – kind-of like a battering ram to the pelvis.
“I changed my mind on the name!” I said urgently to my partner, realising for the first time what people meant when they said they had a name picked but it didn’t “suit” when they saw the baby. My partner agreed on the new name on the spot – a name we’d toyed with earlier but discarded.
I asked what time he’d been born. Someone replied from the other side of the room. “Did he say 3.30?” I asked my partner.
“3.33,” he replied.
Ha!!!!!! I started laughing. I couldn’t believe it. A birthdate with lots of numbers divisible by three, born on the 3rd at 3.33. I had actually managed to have two babies with impressive dates and times.
Anyway, unlike with Miss B’s birth at Hospital A, although Hospital C had quickly done Apgar testing – my little man scored nine out of ten both times as well – they left the other tests till after my partner and I had had a hold of him, which I appreciated. Though they didn’t do skin-to-skin – he was all wrapped up already – and then they left with him and my partner in tow to do the other tests, weighing, etc.
After they finished stitching me back up, I was taken to Recovery. That’s where I found the most upsetting difference in hospital policy. Hospital A had allowed my partner and baby to come with me; here, they didn’t. I hadn’t seen either of them since they’d left the theatre, and neither of us had been told that that would happen. We were separated since the hold I’d had of a sleeping Mister A not long after his birth until around 8.00 p.m., so roughly four-and-a-half hours without my newborn. I know that’s nothing compared to olden days, but in this day and age, with knowledge and research around immediate skin-to-skin contact and offering an immediate breastfeed and the importance of bonding, that seemed archaic. And “That Doctor” seemed to find reasons to keep me down in Recovery. At first it was genuine – my blood pressure and oxygen kept dipping and setting off alarms whenever I drifted off to sleep (which was pretty often – I tried to stay awake, but couldn’t – it was like I was just passing out), but they were going to take me back up to the ward at 6.00, which stretched to 6.30, and then kept getting longer and longer. One nurse said I’d lost less than 500 mL of blood during the surgery (anything over that is considered a postpartum haemorrhage), and she in fact thought it was probably no more than 400 mL. But “That Doctor” discovered I had had a small PPH in my previous birth, and then it was all dramatic from there. She kept changing the amount until finally, on my discharge papers, it shows 1,000 mL, which is a big difference to 400 mL. Extra drips were organised, injections to stop clotting (I still have bruising two weeks on), suppositories, all sorts of things I wasn’t in a clear enough mind to question.
One thing I kept asking everyone constantly was about my baby. Why on earth was I separated from him?! What if he got hungry? That was a bloody long time without a feed. I kept asking, but kept being told babies couldn’t come down to recovery unless a midwife was available to come with them, and none were available. I asked why my partner couldn’t come down, but was repeatedly told they couldn’t be responsible for a baby in recovery without a midwife there. I constantly asked about feeding, and was told they had formula upstairs they could give him if he got hungry. I got distressed as I had perfectly good colostrum that I would rather be his first feed, so a midwife finally came down and expressed some from me. I wondered why if a midwife were finally free, they didn’t just bring my baby to the colostrum instead of the colostrum to the baby. I was getting more and more anxious, as visiting hours at the hospital ended at 8.00 p.m. and I had no idea if they would try to send my partner home before I even got back to the ward, leaving my baby alone without either one of us (not that he would have agreed to that).
He was upstairs also anxious, with no news of me, and nobody giving him satisfactory answers or seeming to understand that a partner might want to know why the mother of his newborn had disappeared for hours and whether she was alright!
Luckily, when they brought me back up, it was to the Birthing Unit, so instead of my partner going home, we all stayed in the one room (which we wouldn’t be able to do in the shared rooms of Maternity). I was unhappy to find that Mister A seemed not keen to feed, and also to prefer my partner to me, and wondered if that was because of the separation and being fed his first meal via a syringe – though it may not have been. (Both things improved slowly over the next few days.)
Overall, though, despite that I sound anti-Hospital C, there were many lovely midwives who were just doing their job within the confines of hospital policy. Some even came to check up on me on a personal level when they had other patients waiting and didn’t have to, and were really kind to me despite how busy they were.
As for my feelings about a caesarean again – well, I just tried to be pragmatic, as with last time. It appears I have just grown big babies with a pelvis that can’t accommodate them, and they turn posterior and deflexed. Though there are women out there who have managed natural or home births after two or more caesareans, which shows that no-one necessarily has a “pattern” – just bad luck.
What helped greatly was my partner’s support, assuring me that I’d done my best and that it was okay to end up in hospital even after booking a private midwife. And I felt good overall about how much of the labour I’d managed to get through at home – I felt like I almost made it this time and had experienced more of “real” labour. But I was also grateful that there is intervention available when it becomes necessary, that can help to save women and babies from dying in childbirth. There is no shame to bringing two beautiful babies into the world, however they arrived.