Helen wanted a home birth for her first baby, Harry, but was persuaded to book a hospital birth by her midwives. She ended up with a difficult labour and forceps delivery, and post-traumatic stress. For her second baby, Jesse, she was determined to have a homebirth, and despite the fact that Jesse needed resuscitation after birth, it is clear from Helen's story that her feelings about the birth are much more positive.
My initial reaction to finding out I was pregnant was to swing very rapidly between enormous elation and complete terror. What I actually said to myself (in the loo at work - couldn't wait to do the test at home!) was "Great......oh, ****.....great, excellent....oh, ****.....and so on". I did wait until I got home to tell Pete because I wanted to tell him face to face. He was so sweet. He'd bought me a cd for no particular reason and came into the house saying 'I've got a surprise for you!' I couldn't resist stating the obvious and handed him the test as he handed me the cd! His reaction wasn't far off mine!
At this point I would like to apologise to all those couples who struggle to conceive and if and when they actually do are so made up. Pete and I had no time between deciding to 'try' and actually conceiving and the reality was very scary for us.
Pete and I discussed all the various options, and I also had a good chat with both my Mum and my Sister Jo. Jo was expecting her second baby and had booked a home birth. Every one was pro-home birth and as I was fit and healthy I didn't see why I shouldn't have one.
I can still remember the expression on the midwives' faces when I suggested a home birth. Needless to say I left that appointment having completed the paperwork to book into the local hospital!
My GP decided that she wanted to be involved in my antenatal care. It occurs to me now that this may have been more to do with the extra money than with my health (how cynical is that!).
The midwives and my GP 'nagged' me at every available opportunity until I just gave in. Some of their comments follow:
I have since discovered these comments are trotted out regardless of whether it's the first or subsequent pregnancy and are standard comments made by some health professionals when trying to dissuade someone from home birth.
The thing that concerned me more than the comments was the way in which they were said. I got the distinct feeling that I would not have 100% support from them if I didn't do things their way. Some of the issues that mattered to me most were that I would have someone with me that I knew and trusted and that I had built a good relationship with leading up to labour and delivery. I didn't feel this was going to happen if I insisted on a home birth.
I had originally booked into Winchester, but then discovered they didn't perform nuchal fold translucency scans. This was something Pete and I really wanted to have done. We needed the reassurance that everything was OK. My midwife suggested I pay something in the region of £100 and go to the Harris BirthRight Trust in London! She told me that it was not the done thing to change hospitals just to get the type of scan we wanted. I re-booked with the Royal Surrey at Guildford even though I knew that neither of the midwives I was seeing for my antenatals worked with that hospital. I'd been given so many negatives by them and my GP that I didn't see the point in persisting with any kind of relationship.
Not long after than I transferred my antenatal care to the midwife team that I had been assigned to at the Royal Surrey. They happened to be the same team that my sister had been with for her second baby. I had a good chat with the Team Leader and whilst she was happy for me to have a home birth, or possibly domino, she did not want to come as far as Alton where I lived. She suggested a compromise which was to have the baby at my sister's home. Much as I love my sister, her home is her home, not mine, and she didn't really need the disruption with two little boys on her hands. I decided to stick with the Royal Surrey as I was now happy that I could establish a good relationship with the midwife team and I would have a familiar face present on the day.
On the 12th December at about 6.30 a.m. I went into labour. Pete panicked and started painting the nursery and I just pottered about. After a couple of hours I decided to phone the midwife team just to let them know. I arranged to meet the Team Leader at my sister's house at about 2.30 p.m. so that she could check me over. She was happy with the way things were going and told me I was about 5 cm dilated. I was surprised as I hadn't really been suffering much considering. Pete was brilliant. Every time I had a contraction he massaged my back and encouraged me to do all the breathing things.
We actually stayed at my sister's for the afternoon and my Mum came up because she couldn't resist! Although they were really helpful I wish now that I'd gone home and kept busy. By 6.30 p.m. the contractions were getting quite close. They were around 2 minutes apart and I estimated that it would take us about 20 minutes to get to hospital. That meant about 10 contractions in the car!
The first thing the midwife did when we arrived was offer me pain relief. My birth plan was very basic. It said no paid relief, no intervention, no episiotomy. I'm not sure whether this midwife had actually looked at my notes, in fact I'd barely made it into the delivery room when she asked! The second thing she did was to examine me and announced that I was only 6 cm. I couldn't believe it had taken 4 hours to get 1 cm further on.
The midwife went on about pain relief so much that I conceded and tried Entonox. I'd spent the last 12 hours breathing in through my nose and out through my mouth and did not get on with the mouth piece because I had to do exactly the opposite. I had one try and gave it back.
There was a change of shift about an hour later and I met the midwives who were present when my baby was born. There was a senior midwife who was part of the hospital team, and a student midwife from the team that had been responsible for my ante natal care. She had only just joined the team and I hadn't met her before. Can you believe my luck!
Pete and I were left pretty much to our own devices with the odd request to monitor the baby using the straps that go around the top and bottom of the bump. Apart from that I tended to stay on my feet and strolled up and down the corridors reading all the posters. One in particular caught my attention about A.R.M. (artificial rupture of membranes - having the waters broken) and the potential dangers. I can't remember it very well now, but it stuck in my mind at the time.
At around 10.30 p.m. the student midwife arrived on her own and examined me. I had only managed to get another cm further on. The midwife's words were "you're only 7 cm". Only?! I only had another 3 to go is what she should have been saying! She was concerned that my contractions were not being very effective anymore and wanted to break my waters to get them going again. Pete was out of the room at the time and I was scared that it might all hurt more than I could cope with without him. I asked her to wait until he'd got back. She was happy to do this and left the room.
When Pete got back the student midwife reappeared with the senior midwife who examined me and decided that the baby was trying to turn around. I hadn't even realised the baby was posterior and no one had bothered to tell me.
She said she wanted to break my waters and put me on a drip to control my contractions. I asked if I was likely to be in more pain, which with hindsight is a stupid question because they had no idea how much pain I'd already been through. I was tired and wanted to have a rest, but they wanted to get things moving on. I opted for a mobile epidural which is a joke really because the midwives then wanted to monitor the baby continuously so I couldn't have got off the bed even if I'd wanted to!
At no point was I told that having an epidural would increase the risk of needing intervention, even though my birth plan said quite clearly that I didn't want intervention. The student midwife even commented on how much better I looked after the epidural. After 16 hours of labour I didn't know I was meant to look good!
I have a bit of a blank from around 11.00 p.m. to 1.30 a.m. I'm sure I must have got to 10 cm and had a go at pushing but because of the epidural, or perhaps because I wasn't ready, I had no urge to push. The strap monitor was not getting good readings and the senior midwife tried to attach a scalp monitor but couldn't. There must have been some kind of debate between the midwives and I don't recall being involved in it. I vaguely recall being told that they were going to call in a Dr who may have been a registrar, or a gynecologist or something.....unfortunately he brought an SHO (senior house officer - relatively junior rank of doctor, below registrar and consultant) with him.
I think they said hello, but apart from that nothing further was said to me directly. After a brief examination and discussion they made the decision to bring in the ventouse and forceps. No one told me that I would have to be strapped into stirrups. I couldn't believe it when someone else wandered into the room carrying them. I didn't have a clue who she was or what she was carrying!
At no point was I asked if it was OK with me for the SHO to perform any of the procedures. The ventouse didn't work because he'd attached it to the side of the baby's head, so they decided to go for the forceps.
All I kept saying was that I didn't want to be cut. It was the one thing on my birth plan that hadn't actually happened yet. The SHO did try without cutting me but had to in the end.
The baby was most definitely pulled rather than pushed out, even though I was being encouraged to push with all my might. He was born at 2.10 a.m. on the 13th December. He had five long bruises down each side of his head, a cut on his left cheek and the top of his right ear was folded over and bruised along with the ear lobe. He looked like he'd done 10 rounds with Mike Tyson.
The SHO must have taken an hour to sew me up during which time I was flat on my back with my legs still in the stirrups. At one point he pulled a stitch so tight he broke the thread! Four days later I couldn't walk and the midwife visiting me that day took the stitches out. Things down there are still not quite right.
The Royal Surrey operate a Listening Service where any new mums with questions about the labour and delivery can sit down with a midwife and her notes and go through things. Unfortunately my notes had gone missing by the time my appointment arrived and I was told that there was little point going ahead until they turned up. I appreciated that it would be better to have the notes and the midwife assured me that they'd turn up. I gave up ringing about 10 months later when they stopped returning my calls.
In hindsight I think there were some key areas where the health professionals failed me. Considering how strongly I felt about intervention and being cut, I would have liked the midwives to be less positive about the benefits of an epidural and more realistic about the consequences. They should also have told me Harry was posterior and trying to turn. I've been told since that this would explain why it took so long to get from 5 cm to 7 cm. We could at least have discussed the possibility that once he'd finished turning things would get going again and in the meantime I could have had the rest I needed. There was no desperate hurry for Harry to be born so the doctor and the SHO could have had a better 'bedside manner'. It would have made the world of difference to me.
It was obvious I wasn't myself after Harry's birth, but no one seemed too worried. My health visitor got me to complete a questionnaire aimed at assessing whether I had post natal depression. My score was average and did not indicate that I was a risk to my baby. I did discuss with her over the following months about not feeling right, but the only solution she or my GP seemed to have was drugs. I'm not a great pill taker at the best of times and was totally against the idea of taking something like Prozac. I refused and I'm so glad I did.
When Harry was about 18 months old somebody suggested that perhaps I was suffering with post-traumatic stress rather than depression, and put me in touch with an organisation that helps people with that problem. They sent me some info and the more I read the more I realised that was exactly what was going on. Not even my new GP, who is brill, suggested this, although she did suggest counseling which, had I been able to afford it, would have really helped.
Well, here I am pregnant for the second time and hopefully much wiser. This pregnancy, and my lovely hubby, gave me the strength to write a polite but stroppy letter to the Royal Surrey, after several further phone calls got nowhere. I now have a nice letter apologising for all the stress and trauma caused by both the delivery and subsequent lack of notes from the Head of Midwifery. She has assured me that they are still looking for them!
I have been perusing the internet for information on home births, episiotomies and how to avoid tears or further cuts with subsequent births and much much more. I've found some very interesting info on how midwifes believe now that massaging the perineum can increase the risk of tearing. Very interesting! The Internet has been a great source of information and I hope I'm not alone in saying that it's fantastic that midwives get involved and share their knowledge and experiences. It makes it all so much less scary for the expectant mum, certainly in my case anyway!
I mentioned at the end of my first story that I was pregnant again and this time I was determined to have a home birth. We had moved house since Harry was born and when I told our new GP that I wanted a home birth she and the midwife began the process of talking me out of it. No surprise there really! Fortunately, this time my husband decided to intervene and during an appointment with our GP she asked how I was. Pete was fantastic. He told her about how difficult Iíd found things after having Harry and how writing my story and the complaint letter to The Royal Surrey had helped me get over it. Most of all he stressed how important it was for me to have our next baby at home. Our GP is a lovely person, and she completely understood.
So it was that, on the date that my scan said the baby was due, I went into labour. It was 6.30 a.m. and Pete left me in bed to ring our midwife and my mum so that she could come over and look after Harry. I got up about half an hour later and my contractions immediately doubled in strength and regularity. Pete timed them and we realised that things were moving along an awful lot faster than the first time. He rang the midwife again to let them know that the contractions were now only 2 minutes apart and also called mum to chivvy here along. The first midwife arrived at around 7.30. When she examined me I was fully dilated! The only problem was I had no urge to push and I wanted Ria (the midwife Iíd had all my ante natal checks with) before I started anything.
Ria eventually got to us at around 8.15 and Jesse was born at 9.10. There were a few complications; basically he wouldnít breathe for himself for about 10 minutes. Ria and Judy were fantastic. Ria stayed with me whilst Judy and Pete worked on Jesse. After the first 5 minutes an ambulance was called along with my GP. After 10 minutes they had Jesse breathing for himself and everything was fine. The first of two ambulances arrived after 25 minutes with the second 5 minutes behind that. The first one had travelled something in the region of 45 miles from Surrey in 20 minutes and decided to make the journey because they knew the Hampshire ambulance was already on a call. What dedication! Our GP turned up after about 45 minutes, took one look at us all, realised he wasnít needed and left!
All I used to help with the pain was a TENS machine which we bought and have lent out to many friends since, and gas and air. Jesse was a beautiful baby who has always slept well and has a really sunny nature. I canít help wondering what Harry would be like if he hadnít had such a brutal start in life.
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