On May the 27th 2003 I had a son by caesarean section at Hinchinbrooke Hospital (from now on referred to as 'HH'). Up until that point, most of my ante natal care had been shared by my GP and Community Midwife as I was preparing for a home confinement. I visited HH only for obligatory ante natal clinics. The following story is written mostly by my husband as my first son's birth is a blur to me.
It all started at around 11 p.m. on bank holiday Monday as we were going to bed. I was trying to get some sleep and felt some pain so I lent up on the bed and my waters broke. I noticed they seemed to have some colour so I collected a sample in a glass. Meconium staining is common in post-term babies so I phoned the hospital for advice but was still hoping to be able to have the baby at home. We were told to come in with a sample, so began a mad dash around the house to try and think of anything that I may want to bring to hospital. I had packed a hospital bag, but it wasn't totally complete - I hadn't even included an outfit to leave hospital in.
We arrived in hospital at 12.00 p.m. and were taken immediately into a labour room as it was very quiet. We were told that the meconium sample was grade 2 (?) which meant no hope of a home birth and I had to be hooked up to monitors for 20 minutes to make sure the baby was OK. After the 20 minutes we saw a consultant who said the trace was OK but although I was in pre-labour the regular (every 2 minute) contractions I was experiencing were not sufficient in duration or in strength and he would give me an hour to start full labour before syntocinon had to be given to speed things up.
The monitors were taken off for the hour and I started to walk up and down the stairs to encourage the contractions. Unfortunately I also started to vomit. After the hour the baby had moved down further into the pelvis, but I was still only 1 cm dilated so the midwife said we would have to start the syntocinon. We asked to see the consultant again and spoke to the house doctor (no idea of the difference) who said as the baby had moved down we could have another two hours but I had to be continually monitored. I was very unhappy about this as being confined to the bed is so uncomfortable so the midwife managed to obtain a telemetric set of monitors; I was free to move and I could bounce up and down on the birthing ball.
After 2 hours and another bout of sickness I felt awful. I was totally unprepared for trying to have an active labour whilst still very sleepy and very low on energy from continuously being sick. We were then told I had only dilated a centimetre and was still not in full labour so I had to have the syntocinon. I couldn't face hours more of labour without some rest (contractions were still coming every minute or two). Also, having the syntocinon meant staying on the bed and being attached to the drip. I asked for an epidural. This wasted a lot more time as the anaesthetist was still in bed and when he came I made him explain what an epidural was and why I couldn't have a mobile epidural (not offered at HH). As it turned out labour had not really progressed much further in this time.
Having the epidural made me feel a little guilty, but Alex didn't see why. The epidural took a long time to take effect and they had to up the dose twice before I started to feel any significant pain relief and more than an hour had passed. The strength of the pain relief together with how weak and tired meant that I dozed for most of the rest of the labour. I have asked Alex to tell the rest of the story.
It must have been around half six. Kari was on her right lateral when the syntocinon was added to the saline drip. The telemetric monitors were still in place, but had been very sporadic in actually picking up Jared-to-be's heart rate. When he moved the signal would be lost for some time, returning again and stabilising at around 120 b.p.m. (which of course is pretty low, but was consistent with what Kari had remembered the Midwife measuring antenatally). A few minutes after the syntocinon was added the heart rate suddenly dipped to around 50 or 60 b.p.m. This was very alarming and the syntocinon was immediately paused, Kari was move onto her left lateral and given oxygen to breathe. The heart rate quickly came back up to the resting rate and it was assumed that the cord had been squeezed a little with Kari on her right side.
The staff replaced the telemetric monitors with the seemingly more reliable corded ones. She was then monitored for quite a while. Some time shortly after eight O'clock the consultant returned and expressed his concern about the slow progress, saying that he felt we should try the syntocinon one more time and if that had little quick effect we should go for a caesarean.
The syntocinon was restarted and within minutes the heart rate plummeted. It then disappeared altogether and the midwife was having a hard time finding it. After a few moments she asked me to pull the emergency button. What happened then was quite extraordinary - within second three extra midwives rushed in and the Consultant (who by now was a different chap), too.
The consultant attached a monitor directly to Jared's head, but could still not get a stable signal. Those numbers I did see flash up were around 5 to 15 b.p.m. The consultant asked for an ultrasound to be brought in, which arrived almost instantly. He used this to find the baby's heart beat and said that it was still going but very irregularly and that Kari needed to go into theatre immediately. He then left to scrub up while one of the midwives had Kari sign the consent form. Kari asked if she had lost the baby and the midwives gave a confident answer to this, but I felt this to be more to put her at ease than out of any certainty that we would not. Could Alex and Mum come, Kari asked, which had a firm, but retrospectively understandable, no for a reply. Kari was then rushed into the corridor and knocked into a passer-by (no injuries). A very short trip to theatre and a general anaesthetic and Kari was out for the count.
In the mean time Kari's mum and I were waiting in the labour room. The wait was unbearable, I was already thinking we had lost him and was feeling understandably tearful. After a few moments one of the midwives came in to explain the situation - though with the Caesarean still in progress there was no news. She promised to come back in as soon as she knew anything. Time was really moving slowly and after what seemed like forever, but can have been only a few more minutes we could hear a baby cry. Kari's Mum said that it might be ours. I hoped so, but was still very worried. With all the babies I figured could be around it might not mean anything. Another age (or a couple of minutes) passed and the midwife came back and said congratulations, it's a boy. The relief I felt was one of the strongest emotions I have felt in a long while. The midwife explained that the blood gas levels of the baby where a little low, but that he was otherwise very well (they seemed a little surprised at just how vocal he had been when he was pulled out). They would bring the baby in and give us a few minutes with him before he went to the special care baby unit (SCBU). He was brought in and I got to hold my son for the first time. They explained that they were still finishing up in theatre and that Kari would be out soon. The time in theatre before he was born had been only five minutes according to the notes we later read. It was only that it had felt so much longer.
They came to tell us that Kari was out of theatre and starting to come round. I was very anxious to see her and assure her that everything was fine. We wheeled the baby through to see her just as she was starting to come round. She couldn't move to see the baby, which was a particularly poignant moment. When she said he's Jared Arthur, I could only agree after what she had been through, and my slight preference for Justin vanished.
He then had to go to the SCBU for some more tests - particularly to check that the blood gas levels were OK. He spent about twenty minutes there and I spent as much time with him as I could. The fact that Kari's mum was with her greatly lessened my anxiety to see her again.
Almost exactly an hour after the birth he and Kari were re-united and we spent most of the rest of the day sitting there before being transferred to the ward opposite.
Kari's recovery was remarkable. That first night she had already been up and about. One more day and a night of recuperation (but little or no sleep for Kari, because Jared would not settle in the cot and they discharged her the next morning (Thursday) with special dispensation.
As a final thought, although the birth was not exactly what I had wanted I never felt we were forced into a position without fully understanding the consequences and all the staff had plenty of time for us. Everyone tried their best to accommodate my wishes including getting out of hospital as soon as possible and none of the staff tried to force their opinions onto us by using emotional blackmail. I was constantly asked how I felt about the experience and whether I wanted counselling and felt very well cared for.
When I first found out that I was pregnant for the second time I asked again for a home birth. I had no problem with either my doctor or midwife supporting my decision. I did have the obligatory consultant appointment where he suggested I would be better having a "trial of labour" in hospital. Ultimately however, the consultant admitted the decision was mine so I chose a home birth. To prepare for the labour the first time I did a hypnobirth course, so for this baby my mum and I repeated it. This consists basically of some relaxation exercises and breathing techniques. Unfortunately I had little opportunity to practice these with my first birth so really needed the second course.
On the 2nd of November I was woken up with mild contractions. Having little experience of labour I had no idea if this was it or not so I went downstairs for breakfast. Alex went to work as normal and Mum and I decided to spend the morning at the garden centre. I was still having contractions all the time we were there but still managed a second breakfast and Mum thought they were probably nothing.
We returned home and as this was only a few days past my due date I had arranged for some friends to come for coffee with their children. Another three hours passed fairly quickly still with slight contractions and by about 5 in the evening I was reduced to leaning over a footstall and breathing though the contractions. One of my friends suggested it was time to leave and we were by ourselves by about 5.30. Alex phoned and I suggested he brought home some fish and chips as I didn't feel up to cooking.
Sadly by around 6.00 I started to feel ill and when the fish and chips arrived the smell made it even worse. I went upstairs to hide in my room while everyone else ate. Alex rubbed my back and stayed with me till Mum had put Jared, our eldest to bed. We phoned the midwife at about 7.30 with contractions at 5 mins apart but she was reluctant to come out quickly as I was still being coherent (this is common with hypnobirths).
At about 9.30 the midwife arrived. I was very pleased to see her as I had arranged from my GP to have an injection for vomiting at home and as soon as she arrived she could give it to me. This meant I was only sick once rather than constantly as with my first labour. I had my first examination and was very disappointed to discover I was only 3 cm dilated.
There followed a fun evening of standing at the end of my bed with the hypnotherapy cd playing being monitored every 20 mins. Sadly progress continued to be slow and although contractions had felt strong and been about every 2 minutes they started to tail off as I got more tired. I tried baths which was great for pain relief but only reduced the impact of the contractions further. By 5 in the morning I was only 5 cm dilated so the midwife suggested it was time to go to the hospital. I felt very tired by then and was very reluctant so asked if I could have a couple of hours sleep. The midwife phoned the hospital who said this was O.K. if I was continually monitored.
I had a good two hours of rest and was woken by a feeling of dampness at 8.00. This panicked me as I thought it was likely there was meconium in the waters and I would end up in hospital for a second c-section. However, the waters were clear and better still I could feel strong contractions and was 9cm dilated. The midwife allowed me to stay at home and called for a replacement. By about 8.30 I could feel the babies head and was confident I would push him out by 9.00. I was never examined again so the midwife didn't know I was fully dilated as with hypnobithing you make very little sound either during the contractions or when pushing. In fact I spoke to my midwife recently and she had no idea I was pushing at all.
The hypnobirthing course suggests not pushing but I felt like pushing so I stood at the end of the bed and tried to push the baby out. By 10.00 the baby was still stuck inside and I had two midwives and a midwife in training present. It was suggested that I had a catheter inserted see if that would help but I didn't like the idea of lying down so the midwife suggested gas ad air. Sadly, I love gas and air so did nothing for the next hour and half other than lie on the bed.
Eventually the midwives got concerned and suggested they called another ambulance as the baby was stuck. I did finally move back to the end of the bed to stand up. I'm not sure I dully knew the ambulance was on its way but did start pushing and holding the push for two contractions to prevent the baby slipping back. By the time the ambulance arrived I had pushed out the top of the babies head and happily they were sent away. Niko was born at 12.30 pm 3-11-03.
I was given complete choice with the rest of the birth. My mum cut my sons cord and I was able to try to feed him to encourage the placenta to come out. Niko had breathing difficulties and was unable to feed. In fact we were nearly sent to hospital again because of his breathing but it improved while we were waiting for the placenta. After an hour it still hadn't arrived so I had some drugs to encourage it which worked fine.
I was then examined and unfortunately had a third degree tear. I was taken to the local hospital (not HH) which was a very poor experience after the excellent care received at HH.
Overall though I was so happy I had had a natural birth and could be home the next day with my eldest son it was easily worth it. I am sure if I had had a VBAC in hospital it would have resulted in a second c-section due to lack of progress and I was very fortunate with my midwives.
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