It’s fair to say I’m a big fan of natural birth. And having had three previous uncomplicated births, the last one at home, I really wasn’t expecting anything different this time. It’s not that I had a birth plan (I’m not that organised!), I just had confidence that my body could “do” birth. However, my experience with my 4th baby just goes to show that you can’t take anything for granted!
My pregnancy had been pretty ‘normal’. Many people had commented, as people do, on the generous size of my bump. But at 35 weeks, ironically when my midwife, Jane, had come to do my homebirth risk assessment, she looked puzzled when she palpated my tummy and measured the bump. After checking what size my previous babies had been, she said “well this one certainly isn’t a nine pounder”. She referred me to the consultant as “query small-for-dates” but at the hospital they weren’t concerned and dismissed me without any further tests.
At my next routine appointment 2 weeks later, another midwife, who was standing in for Jane, was also not happy about the lack of growth of my bump, which was still measuring the same as it had at 33 weeks. She referred me to the consultant again and this time they did a growth scan, which also suggested that the baby was measuring around 33 weeks (I was then nearly 38 weeks). The most likely cause was that my placenta was failing and not providing the baby
with enough nutrients to grow, a condition known as IUGR (Intra-Uterine Growth Restriction). To cut a long story short, it was decided to induce labour.
Now, if I had actually written a birth plan, it would have gone something like this: active birth, no drugs, no electronic fetal monitoring, no drips to speed up labour, absolutely no lying flat on my back!, delayed cord clamping, baby delivered to my chest and not disturbed for at least an hour [I had just read Suzanne Colson’s “Biological Nurturing” and was very keen to see my baby breast crawl!]. Just as well I didn’t bother writing it then, as the actual event couldn’t have been further from this plan!
So, on the Friday afternoon we went along to the Midwife Assessment Unit for induction. My cervix was apparently soft but not dilated enough to break my waters so I was given a pessary, monitored for a while and then told to walk around, get some rest, and basically wait. Apparently most people are given a prostaglandin gel to induce labour, but the idea of this pessary was that it could be removed – the consultant was concerned that the baby might be too weak to tolerate labour, and hence the need for regular CTG monitoring.
Late evening I was back on the bed and strapped to the monitor again, but now the trace occasionally showed the baby’s heart rate dropping rather low, which raised some concerns. Then on one of these instances the red emergency button was pushed and suddenly six people appeared out of nowhere, there was a sense of panic and we were hastily wheeled off down to the delivery suite in a bewildered state. The doctor explained that she had taken the pessary out and
they would monitor me for a while before continuing with the induction process.
As the trace settled down a bit, the doctor attempted to break my waters, which was incredibly uncomfortable! When that failed she decided to give the pessary another go, but this fairly quickly went the same way as before, with the baby’s heartbeat dropping every so often and the midwife and doctor reappearing, examining the trace a muttering their disapproval. After a while the pessary was removed again and we discovered that my waters had broken after all (there
was only a trickle as the fluid level was so low). At this point I would normally have been hooked up to a drip but, knowing that I didn’t want this and still being concerned that the baby wouldn’t tolerate labour, the doctor suggested we wait and watch for a couple of hours.
The trace showed that I started to have a few tightenings and with each of these the baby’s heartbeat plummeted (but then recovered fine straight afterwards). I am not sure when exactly the words c-section were first uttered, but at this point the doctor thought we might as well have a chat with the anaesthetist so we were all ready to go ‘just in case’. I think everybody knew where we were heading but the lovely doctor seemed to be giving us every chance of a natural delivery if at all possible. However, after a while, she admitted that she really did think a c-section was the best course of action. Obviously disappointed but, most importantly, wanting the best outcome for our baby, we agreed.
It was from this point onwards that things went downhill for me. For a good while afterwards, I couldn’t talk about it or think about it without welling up with tears. I have tried to work out why I feel like this – after all, hundreds of people have c-sections every day and I’ve never heard anyone say it was awful. I have come to the conclusion that it was the loss of control (which is really not good if you are a bit of a control freak!) – everything was done to me and I was unable to do anything about it. This hit home when one of the congratulatory messages we received said “Well done Karin” and I just thought “but I didn’t do anything”.
Things happened very quickly and I wasn’t even allowed to change into what I wanted to give birth in – one of John’s shirts – a small thing but it had a big impact on my mental state. The anaesthetist really didn’t help by telling me off for moving as he administered the spinal block while I was trying to hold back the sobs. On the operating table I was worried that I would feel the incision – I hadn’t realised that all the pushing and pulling I could sense was them actually performing the operation. When I asked what was happening, it turned out that they were about to lift the baby out!
Our little girl, Emma Kate, was born at 4.19am on Saturday 3rd March, weighing just 3lbs 14oz. Far from being delivered to my chest, we didn’t even see her as she was whisked off to people waiting somewhere behind my head. Fortunately she made a sound almost immediately. John tried to keep me informed by telling me what he could see but it seemed an age before she was shown to me, all wrapped up in a towel and hat and held next to my head – I could just see her tiny face. The moment was all too brief as she was quickly taken off to the Special Care Unit. John was torn between staying with me as I was stitched up and seeing his new daughter. Although he was my rock, I really wanted him to go with Emma – it didn’t seem right for her to be alone.
After the operation I started to feel sick and spent the next hour throwing up and shaking uncontrollably. The midwife put it down to a reaction to the anaesthetic but later the doctor said it could also have been shock. I was also trying to fight back a claustrophobic panicky feeling about not being able to move my legs. I remember thinking “Elective c-section – what’s that all about, why would anyone choose to go through this?!” It was lovely to see a friendly face when Jane popped in, having seen my name on the board.
John came back from SCBU with photos but it was about 4 hours before I was able to see Emma again and was finally able to cuddle her skin-to-skin; it felt so good.
Fortunately Emma doesn’t seem to have suffered from the lack of nutrients she received in utero in the last few weeks. Unlike a very premature baby, her lungs and organs were fully matured; she didn’t require assistance with breathing and very quickly could maintain her own temperature so was moved out of the incubator. She was just small and very sleepy and needed to be fed through a nasal gastric tube for the first two weeks or so. Eventually after just over three weeks of to-ing and fro-ing, we were able to take her home. By this time SCBU had become like a second home, the staff were wonderful and many felt like friends – but it was still good to be home as a proper family at last.