E's birth story

My birth went:

day 0 spontaneous rupture of membranes at 41+0/40

day 1 latent labour at home, contractions 4-5 minutes long, intermittent

day 2 latent at home again, contractions ramped up overnight and then reduced in the morning

On the evening of day 2 I went into the unit to get a ctg to check all was well. My blood pressure was high. A blood pressure series showed hypertension. I took 1x labetalol tablet, and was found to be 3cm dilated, almost fully effaced.

I chose to stay in at that point, because I didn't think my body would have a baby quick enough to be okay with high blood pressure. (Of course, this was not an easy decision)

I had my waters broken, then had an epidural and we started syntocinon

Why did I give in to an emergency section when there were no fetal heart concerns? it was a matter of not quite getting to fully.

The time I had at home means everything to me. I would not have got that time, would not have been calm enough to enjoy it, without, Beth my independent midwife.

By day 3, (41+3) I was 9cm, then had an anterior lip. By lunchtime on day 3 I had blood on my urine and the senior coordinator midwife examined me and found cervix at the back as well, so I was back to 9cm dilated. The senior midwife and consultant felt it was time to ‘bail out’. After some time to cry I agreed.

We had an emergency section, time of birth 1410, 8lb 6, apgars 9 and 10Reason for section documented as 'cephalopelvic disproportion'.

The longer story…

At the time of the decision to go to section I didn't see it coming. I figured I'd made such good progress over the course of things that I'd get to fully and at least would be able to try to push. I felt I was in stasis, like waiting at the airport. I felt drugged by the oxytocin, actually; my epidural was really heavy and I had a deep feeling of wellbeing, almost opiate-like. I don't know whether this was my own labour hormones or whether synthetic synto kicked it up a notch.

The coordinator who examined me told me my baby was occipito posterior and said 'it's time to bail out'. I asked for a second opinion. The consultant found M was left occipito anterior but asynclitic. She also found cervix. I don't know how much time we had given it at that point but I was discouraged from trying for one more hour as they thought the fetal heart would go awry.

The fetal heart to that point had been very reassuring. I cried, a lot, and I remember someone saying 'no don't cry'. But I needed to feel what was happening. In fact if Beth hadn't have stepped forward and hugged me and said 'just feel it' I think I would have done the good old gallows humour. NHS style jollying along 'high ho high ho off to theatre one we go' which was not a true estimation of what I was feeling. I needed to fall apart. I also needed to follow the bit of my birth plan that said if there was time, I needed to be completely on my own for five minutes to come to terms with what was happening. Everyone - including J - went out of the room and I sobbed so hard. Then I put on the meditation I'd recorded for myself for exactly that moment. And after that, I was ready.

Maybe if I'd continued I would have had a baby on my own instead of having her surgically removed from me. There's a lot of me that thinks a non augmented labour would have gone better for us. I firmly believe that most of us can give birth without too many problems.

The fact my waters had gone for 85+ hours did not concern me. Perhaps it should have done, but I was convinced it was a hind water leak and that she was still very well protected. And indeed neither of us got an infection.

If it had just been that one risk factor (plus being post dates I guess is a rush factor to), I would have gone home again and laboured in my living room.

But my BP being high was a little concerning. I had very slightly raised ALT, and though in retrospect I had pregnancy induced hypertesion rather than pre eclampsia, it was on my mind that even the most experienced and faciliatory independent midwives I know do not 'fuck about’ with high BP. It can impact the placenta and you never know how a fetus is going to cope with contractions if the placenta is compromised.

M was in perfect shape as she arrived and screamed her head off as she enjoyed her three minues of delayed cord clamping. She was a really, really big baby for me. Other women in my family tend to have six pounders. My partner has babies in his family that are 13 pounds at birth, he is of hefty Dutch stock. So maybe I would have got stuck anyway.

My gut instinct is that everything would have been fine eventually but it might have got into alarming territory. But I'm a midwife who works in the mainstream; I am an agnostic who believes in science first and foremost; I had a partner and a baby to think about and I didn't want to put them through too hard of a process. If it had just been my own health and wellbeing at stake I would have laboured on my own in a cupboard with no-one there at all.

Was I co-erced into the decison I made? No - but I was so aware that the recommended path was one largely carved out by our modern maternity culture.

Here is the nuanced thing about modern maternity care: women and birthing people need to be given so much grace for the decisions they make because even if you are aware of the sociology, it doesn't mean you are immune to it. I knew from my experience as a midwife and particularly from working in Birth Afterthoughts that being in the mainstream system would mean being told my body was not working, over and over again. And I knew that wiser women than me have not found a good way to navigate out of that. I will never not be sad and disappointed not to have given birth vaginally but I am not traumatised.

I have the best baby in the world. Last night as me and my partner made dinner, he was belting out 'Isn't She Lovely' which if you didn't know, is about a newborn baby rather than a woman. I love her neck fat and her 'yummy yummy I'm a pterodactyl' noises as she feeds. We are besotted by her and call her Mollycoddles.

I wonder though how much of my euphoria is because Beth protected my late pregnancy. I did not go in to get induced at 41 weeks, instead hanging with my friends and walking around Cambridge in the summer heat. In latent labour I napped, watched Orange is the New Black, and I am so proud of how I coped with contractions, which were 4 or 5 minutes long. Everything knocked off for a bit during the afternoon of day 2 and J and I went for a walk and to pick some wild flowers, which is one of my favourite memories of all time. Those flowers are dried and in an old takeaway container along with her red woollen hat, her cord stump and her hospital wristband.

I deeply considered each aspect of my care and though there is no perfect decision making in birth care as it's too complicated, we had a really positive birth. She fed in the theatre. She was mine immediately. She was sacred on my skin.