labour and birth

The Arrival of Baby M

Despite his due date of 27th September, Baby M decided to make a dramatically late entrance to the world on 6th October 2017. A whole 9 days late, I was beginning to think he would never come out. Or worse still – the whole pregnancy was a rouse and I actually justgot really fat! But alas, after much waiting, mostly impatiently, he decided to arrive on his terms over a week late.  This is the story of his arrival, blood, guts and all. So be warned, if you’re squeamish, you should probably scroll to the next post!

Sweep sweep

As Baby M continued to be rather stubborn in his willingness (or lack of) to greet us, the midwives offered me a sweep. This is a slightly invasive examination involving a prodding experience, in order to try and bring on the motions of labour. It’s a fairly routine practice, and I was told I would be allowed up to 3 of these “sweeps” before I’d reach the 42 weeks and have to be induced.
Sweep 1 couldnt be completed as my cervix was tilted and therefore not in the right position. Then, at 8 days overdue, or 41 weeks plus a day, I was offered another sweep. The midwife this time wasn’t so forthcoming and didn’t even want to do the examination in the first place. She then told me that baby’s head wasn’t in the right position (it must have jumped back out from the previous fortnight where he was engaged) and there was no point in the sweep, as allegedly my body wasn’t ready. However,  unbeknown to her or myself, 24 hours later I would be well on the way to meeting baby M.

Contraction reaction

I woke around 2am with what can only be described as a combination of period pain and food poisoning pains. My stomach was constantly flipping and I wasn’t sure whether I was going to be sick or my bowels were about to have a serious evacuation.
I went to the loo for about the 3rd time that night and tried to get back to sleep. I got a couple of half hour naps but ultimately the pain kept coming in waves and getting stronger, not allowing me to sleep.

Around 3.45am I gave in and decided I probably wasn’t going to get much more sleep. ‘Surely this must be what contractions feel like?’ I told myself. After a quick consultation with doctor Google, my suspicions were confirmed, though there was still a slight possibility this could be Braxton Hicks. Between ante natal classes, conversations with midwives and the countless pregnancy literature provided, I knew this was only the very early stage of labour – if that. The first thing to do, I was told, is to take paracetomol, which I then duly did.

Next on the list of ‘early labour management at home’ is taking a bath. I felt ridiculous running a bath at 4am, so decided to leave that option for a little while. Instead, I started to time my contractions for frequency and length. Disappointingly, the contractions were not lasting long enough, or happening frequently enough, to bother a midwife or get my hospital bag. More disappointingly, the painkillers didn’t seem to be touching the sides. It didn’t bode well for the rest of labour for me.

Sorry, you can’t shower for work

Eventually, as the pain became stronger, I decided to run a bath. By this point it was 6am which I found to be far more reasonable than 4am, and in all honesty I was hoping for a miracle pain reliever as there was still some time to go before I could take any more ineffective painkillers. There was just one problem – the other half was due up for work within the next 15 minutes or so. He had wisely crawled off to the spare baby’s room at some point during one of my early toilet trips, so I had to creep in and wake him early.

My opening gambit wasn’t ‘I’m in labour,  we’re finally getting to meet our baby,’ but instead, ‘sorry, you can’t shower for work because I’ve ran a bath.’ The other half was undoubtedly confused by this, not knowing what time it was or what planet he was on. So I followed up with the pains I’d been having and how I hadn’t wanted to wake him up in case it wasn’t real labour, meaning he’d have to go to work exhausted.

Some advice please

After establishing that I probably should have woken baby daddy up at some point, and after a long soak in the bath (still timing my contractions), I decided to call the midwives for some advice. Mainly I was hoping here that they would tell me to come straight in and that my baby would be born within the hour,  but that wasn’t to be. As the local hospital midwives only work shifts of 8am to 8pm, with others simply on call during the other half of the day, I had to phone Royal Alexandra Hospital to let them determine whether I needed to speak to an on call midwife or not.

They were very pleasant and took note of my symptoms, contraction times and so on, letting me know the on-call midwife would call me back. By the time she did so, it was after 7am. She was again, very pleasant and explained I should take paracetomol and have a bath at this stage. She also mentioned that as she lived about 40 minutes away from the hospital, I would be better to wait on the midwives coming in at 8am, and give them a call then. It certainly made sense, but it was definitely the longest hour of my life – up until that point.

How many centimeters?

By 9am, I had spoken to the midwives at the local hospital and they had said I could come up for an examination to see how far along I was, and if it was worth keeping me in. Imagine my hormonal dismay when I was met with the midwife from the previous day – the one who didn’t even want to do a sweep. Again,  she seemed disinterested in my situation (she had been told by the other midwife so didn’t need to hear me explain again), and that she didn’t really feel I could be in labour based on the day before.

After a quick feel (I’ve been sexually harassed by strangers in bars for longer), she proceeded to tell me that not only would I be going home, but if I called again and wasn’t in established labour, that I’d have to go to the Royal Alexandra Hospital to have my baby, which shocked me. Apparently, as I’d already made 2 phonecalls which didn’t result in established labour,  this was the standard practice. By this point I’d felt cheated, as nobody had mentioned this on the phone or at any point during check ups or classes. Not only that, I’d felt that it should only have counted as a single call, as it was the on-call midwife who told me to call back purely based on the timing of my phone call. Had I phoned earlier or later, they would have invited me for an examination then!

So, without so much as a figure of dilated centimeters or any reassurance, the other half and I trundled home at 9.30am with just a painkiller to keep me going.

Time for reinforcements

Feeling deflated, hormonal and still in so much pain, it was time to call in the reinforcements, aka my mother. I had already messaged her around bathtime, along with my dad, as I knew they would be up for work. Except my mum had the day off – oops!

It was around noon by the time she had arrived, and I’d already managed another bath by that point. It helped slightly, but definitely wasn’t as effective this time round. By now, the contractions were getting longer and stronger, with myself,  other half and mum all timing them. Speaking to mum helped me cope a bit, even if just to calm me down and slightly distract from the agony running through my body every other minute. Just speaking to someone who had been there before and could sympathise and offer their story (even if the story is nearly 30 years old) helped me make it past lunchtime.

Back to hospital

Around 4 hours had passed since my deflated return from hospital,  and it was at that point I decided I couldn’t take any more and then didn’t care where baby M was born, as long as he was born soon! So I used up my cherished phonecall and made the short trip back to the hospital. Same midwife, same old story – but this time my mum was there. She made clear her grievances, particularly with regards to the midwife’s attitude towards my waters. They hadn’t broken yet, which was one of the main reasons I think I wasn’t taken seriously by her. My mum explained that her waters never broke naturally with either of her kids – the doctors had to break them both times.  In fact, my brother was born less than half an hour after my mums waters had been broken.

In that community maternity unit, their primary focus is on the most natural labour, so they don’t like to break waters. Though the second midwife conceded they would if they had to. What constitutes as serious enough to ‘have to’ eludes me. But it was decided that I could stay in that hospital, with my favourite midwife stating that they would examine me until at least half 3.

Can I get the drugs yet?

With a time frame to aim for, the other half and I settled into the room and switched on some daytime telly. Apparently I can still do maths whilst in serious pain, managing to play along with the sums on Countdown. A couple of TV shows and chocolate eclairs (the sweets, not the cakes) later, my pain and contractions were now not subsiding at all. At this point I was allowed gas and air, which at first felt like it wasn’t touching the pain, but after a while I started to feel the floatiness which helped detract from the pain if nothing else.

As promised, I was examined at half 3 to find out I was 4 centimeters dilated already.  The midwife was shocked and surprised. I wasn’t.  At this point I was advised to chill out for a little while longer. Asking if I could have pethidine, I was told to wait until 6pm when they would reexamine me and determine how far I was, as they didn’t want to give me the drug too early.

I took another bath – I have honestly never been so clean in my life – which the other half had to help me out of. Baby’s heartbeat and my blood pressure were also checked in the bath. The audience as I tried to wash/relax was odd and unnerving, but something I suppose I’ll have to get used to with a child now.

I also threw up, which is a side effect of gas and air. It wasn’t pretty but I at least managed to contain it in a sick bowl. My solution to this was to eat popcorn to line my stomach and keep my strength up,  as it was light. I blame the gas and air.

By this point I was clinging onto my dignity and my other half. My body was doing things I wasn’t entirely comfortable with, and I was still in increasing pain. It was only half 5. I couldn’t bear it, not even for another half an hour. The more sober, pain-free half called the midwives. I needed that examination pronto.

To my relief, and the midwife’s shock, I was 8cm dilated by that point. My waters still hadn’t broken, and there were a couple of centimeters to go before we were anywhere near pushing. ‘Can I have the drugs now?’ I half questioned, half stated sarcastically. ‘Yes, you can have the pethidine now,’ the midwife replied calmly, ushering the other duty midwife to retrieve the injection.

I feel like I need a poo

The pethidine took a short while to kick in but it wasn’t some miracle pain reliever. Instead, it just sort of took me back to the lesser contraction pains of a few hours previous. It was at this point I took to the floor, positioning myself on all fours on a mattress, leaning over a giant beanbag. My hips were constantly swaying and my left hand tightly gripped to the gas and air tube.

It was at this point I started to feel the overwhelming urge to poo, which I promptly declared to the midwives. Apparently all was normal and that was my body getting ready to push – but I should not push yet. After all, my waters STILL hadn’t broken. So there I was, bum in the air, head on a bean bag sooking the life out of the gas and air, trying not to move my bowels or my baby, despite my body having other feelings towards the situation.

Thinking a different position would help, I stood up to give my knees and insides a break. I managed about a whole 2 minutes on my feet before I thought I was going to wet myself. Then, before I could stop it, a rush of mucusey, bloody water flooded my feet and the surrounding floor. Finally, my waters had broken.

Do you want to delIver standing up?

By now, it was just before 8pm and the midwives were getting ready to change shifts. Before they left, my favourite midwife asked if I wanted to deliver standing up.  At the time I thought that was a ridiculous thing to ask and simply replied with a whining ‘no’ in between trying to control my urge to push.  But now I realise it was probably more to do with the fact that baby M was due to make an impending appearance,  and if I didn’t move then he would simply start coming out while I was standing,  leaving me no choice.

So I quickly hopped on the bed – well as quick as a heavily pregnant woman in severe pain can hop onto things – and the midwives positioned me properly using pillows. Still holding tightly to my gas and air with one hand, the other half came over and took my free hand. Not realising until now that this could be a pain relief/sharing option, I started to squeeze as I contracted, probably almost crushing the poor sods fingers.

In a bit of a blur, the midwives changed over and I was encouraged to push.  I wasn’t really sure what I was doing at this point, quite high from all the drugs and having tried to stop pushing for the last hour. With some encouragement from the midwife on how not to lose my voice, but rather direct my push down my body, we started to get somewhere.

This is the part where my other half could probably tell you more than I could, as I wasn’t in the most sober frame of mind and didn’t exactly have the best view (or maybe I did?). But let’s just say after a short while pushing, and a couple of worries about the size of baby M’s head, he arrived just over half an hour after my waters broke at 8.29pm. Happy, healthy and quite big, we shared some skin to skin before being moved to another room so the midwives could clean up the massacre. And his big head didn’t do too much damage either, with mum needing just one stitch – result!

labour and birth, my pregnancy

Criteria check – good to go!

So bump and I have reached week 37 which means he’s now considered full term and can arrive at any moment (help!). In order for me to be eligible to give birth at the local community maternity unit over a consultant-led unit, I had to have what’s known as a criteria check, to ensure bump and I are well enough to deliver there.

A lot of this involved going through a checklist of what’s available at the hospital and whether or not that meets my wishes, expectations and of course is suitable for my health and well-being. Most this was discussed in the tour of the hospital the other half and I had a couple of weeks ago, which prompted me to think about the choice of where to give birth. As most things remained unchanged in terms of what I wanted, how I felt and how baby was progressing, the checklist was signed off by the midwife with no problems – so far so good.

Behaving baby

Part of the check is a routine ante-natal midwife appointment, where bump is measured, felt, and heart monitored. So far so normal. Everything appeared ok, and according to the midwife his head is two-fifths into my pelvis. Apparently this is a good and normal thing. Five-fifths means he’s engaged and could literally go any minute, so it’s good to know he’s taking his time for now!

Bad blood

All routine ante-natal checks proved normal (I will never get used to peeing in a bottle no matter how many times I’m asked), including my blood pressure which has been miraculously fine the whole way throughout pregnancy. This means that the only thing that could prevent me from having a “normal” birth in a community maternity unit is my blood results. My blood type is A+ (the only A plus I’ve ever had in life!), which doesn’t mean much on its own, but as long as the blood count remains over 105 I’ll be able to (hopefully) deliver nice and naturally with minimal intervention in a hospital which I’m told I could arrive before the midwives if I go into labour in the night!

So for now, anticipation is at bay, but all is good to go. My next check is not for another 2 weeks (where I’ll be just 1 week away from due date – eek!), although the midwife did tell me to feel free to go into labour sooner. If it’s all the same I think I’ll wait till I see her next – bump permitting!

labour and birth, my pregnancy

Choosing Where to Give Birth

Being a first time mum, I was naturally a bit clueless as to how the old giving birth process works. I had (wrongly) assumed that if you went into labour, you just casually sauntered up to the closest hospital to you at the time, and by the miracle of the NHS there would be midwives on hand to deliver your baby, pronto.

Instead, where you give birth largely depends on where you’ve been booked for your ante natal appointments and checks, which is mostly based on your home location and GP practice. In this respect, some women then don’t have a choice as to where they give birth – there’s simply one labour ward in one hospital anywhere near (or sometimes not so near) where they live.

I’m fortunate enough that where I live allows a choice for where I choose to have my baby, providing my pregnancy remains normal and healthy. All being well, I have the choice between a community maternity unit literally 2 minutes from my home, or a consultant led unit in a city hospital 45 minutes away.

CMU v consultant led unit

Of course, it seems so perfectly practical that I would choose to have my baby at the hospital so close to my home. After all, it’s where both myself and my other half were born too. However, back in that day (nearly 30 years ago – ouch!) the hospital was a state of the art (for its time) fully-operational hospital, with community maternity unit, labour ward, A&E and more clinics than you could think possible. Nowadays, it’s been reduced to a shell of its former self, with a community maternity unit consisting of just 3 birth rooms.

This doesn’t bother me, and in fact, all of the suites are absolutely lovely. Truth be told, I’m not-so-secretly dying to try out one of their mega en-suite baths. What does bother me is that with such a small unit comes a couple of disadvantages in comparison with a consultant led unit, or even a community unit within a larger hospital. Firstly, if anything were to go wrong during birth, I’d be punted into an ambulance and sent to the city hospital 45 minutes away. There are no paediatricians and no emergency doctors on call in my local hospital, so if I was suddenly in need of an emergency caesarean or little baby boy needed special assistance after birth, we would have to be transported before we could be properly treated. And with health, time can make all the difference.

Secondly, and not so life-threateningly, the fact there are only 3 rooms worries me a bit. I know the number of women giving birth in that maternity unit is pretty low, but there is the possibility that I will be in and out in a flash to make way for the next woman to use the suite. It’s a bit of a selfish reason, for both my recovering body and my terrified mind, but their aim for a 6 hour (or less) turnaround is nothing short of petrifying for this first time mum-to-be.

Positives of giving birth in a CMU

Quite apart from the lovely baths mentioned, there are various positives for electing to give birth in the local CMU. Convenience plays a big factor – not only do I live within walking distance, my parents and OH’s parents are minutes away too.

As I’ve been visiting that hospital for parent education classes, and have been attending ante-natal appointments at the GP surgery which is on the hospital premises, the chances are, I’ve already met the midwife who will deliver my baby – at least once. The reassurance and comfort of a friendly face can only be a good thing in a time of infinite pain!

On top of this is the added benefit that it’s a quiet unit, which means more freedom to move around and invite visitors. More to the point, the other half won’t be turned away at 8pm because that’s when visiting hours end. At the city hospital, he would be expected to leave at 8, and be called to come back when baby is about to make his grand entrance. Which other half would likely miss, as he’d be driving 45 minutes to get to the hospital – or worse still, looking for parking in the minefield of a car park. Then he would have to leave immediately after the birth, not allowed to return until after 8am.

Which leads on to another point – at the city hospital you can only park your car for 4 hours max, before having to move it. So if little bump decided that labour would take longer than that, or if other half wanted to spend time with baby during his first minutes, he may not be able to due to the inconvenience of having to leave to find alternative parking. A very first world problem, but annoying all the same.

So where should I give birth?

To be honest, I’m still weighing up the pros and cons, but the conveniently local option is sounding the best at the moment. My next ante-natal appointment is there next week, and is a routine criteria check. So maybe they will have the final say in whether I can give birth there or not, and take the choice away from me if they feel there would be too much risk. I’m still open to feedback and advice from anyone who has either had that choice to make or who has experienced either or both CMU and consultant led births as I know this is not a decision to be taken lightly, so answers on a postcard please!