Sara planned a home birth for her twins, but ended up having a caesarean section for pre-eclampsia.
Home birth had appealed to me for some years, since reading Nicky Wesson's book of that name. During my pregnancy I practised Active Birth Yoga and took an Active Birth Course at Janet Balaskas's Active Birth Centre.
My birth experience in my own mind began when trying to induce labour. We tried everything in the book. Castor oil, acupuncture, homeopathy and herbs brought on violent pre-labour symptoms, but my body and my babies refused to budge. I began to lose faith that my pregnancy would result in actual babies. Having felt very lively, well and bouncy up to 39 weeks, I started to feel tired, heavy and less well. My blood pressure and protein urea were creeping up. Although we had been under prepared for the arrival of twins at 37 weeks, by 40 weeks everything was in place. I had read so much about childbirth, I could have passed an exam in it. Intellectually, I was ready, but my body never swung into action.
On Saturday September, at almost 42 weeks, I visited hospital for precautionary blood tests. These showed I was still OK to continue with the pregnancy. Then I spent two days in bed in induced pre-labour brought on by castor oil (2nd try) and acupuncture (4th try) and woke on Tuesday feeling better. I felt very bright until the onset of a violent visual disturbance felled me. I sat on the bed wondering if I would die. I knew the disturbance indicated pre- eclampsia. I called my partner, Alistair, and my midwife, Mary Cronk, who was coincidentally coming for a visit. Her colleague, Val Taylor, was in my house within 10 minutes. My blood pressure was racing. I felt very unwell. She got me to lie down.
Mary and Val took my blood pressure very frequently and performed an internal examination which suggested I was barely dilated at all. Val explained kindly but firmly that we would have to let go of our plans to have a homebirth. Even though the situation was alarming, this was very hard to let go of. The birthing room was prepared with birthing pool, plastic sheeting, birth ball, beanbag; the cupboard full of aromatherapy, homeopathy, raspberry leaf tea, etc.
I felt hospital would inevitably mean caesarean, because I felt too unwell to experience induced labour. The midwives encouraged me to consider both options on admission. They were eager to call an ambulance. In shock, I was trying to pack.
My experience of the ambulance ride was extremely positive. I was moved by the non- driving ambulance man's kindness. This set the tone for the operation. I consider myself very lucky that Des Holden, consultant, was on duty when I was admitted and stayed on in his own time to perform the operation. A scan showed that the presenting baby was breech, so caesarean was an inevitability. Mary talked me through every detail and helped me do the necessary shaving.
It was mercifully quick. The anaesthetist, Jez, was very kind and reassuring. I was frightened that the epidural wouldn't take. The needle was painful going into the back, the only real pain there was that night. It took very strongly and I was numb. I could feel someone stroking my hair, but couldn't see how it could be Alistair who was holding my hand. It was a good feeling (even though I thought it was the anaesthetist doing it - in fact it was Alistair reaching round with his other hand). The worst part of the caesarean was the pulling out of the babies. Feeling the pulling. Mary put the babies to my dry breasts while I was still being sewn up. It was good distraction but they were a bit too high up and I felt I was being strangled. I was very pleased to have a boy and a girl, which was hinted at earlier in the day because of the different heart rates. The operation was so quick that I was in shock and couldn't cry. But the tears did come days later.
E, my daughter, was born at 7.23pm and L, my son, at 7.26pm.
I was high afterwards on morphine and phoned my family. Late at night I was moved down to the postnatal ward, but concerns about my blood pressure meant that I was moved back up to the labour ward. I was on a drip. I wasn't producing much milk, maybe some colostrum, but the babies were content the first night. I held them and did not sleep as my blood pressure was tested every 15 minutes.
My parents and Sophy came on Wednesday afternoon. Also my cousin and her young son turned up uninvited. This had me in tears. It was particularly invasive as I was still in a labour room surrounded by equipment.
Wednesday night was nightmarish. L seemed unnaturally desperate, nervous, unwell. I raised my concerns several times over 2 days and was told to breastfeed. I fed L for 2 hours in one go on Thursday but he did not feed much that night. The milk was not 'in'. L and E were awake all night, crying and sucking our fingers.
On Friday morning we successfully cup-fed Louis supported by Val. Midday on Friday we awaited test results and agreement to depart hospital. Instead we were told that L must go to SCU for rehydration. I wanted to object; I wanted him re-tested now he had cup-fed, but Val nodded that he must go up so I agreed. He had a cannula for the drip inserted very messily while I cried but refused to leave. Young female paediatrician said she had done a good job. It had to be redone shortly after.
The Sister wanted me to leave SCU. I refused. I did not want L to be left to cry like they leave the premature babies to cry. Most of them were so small that they are barely audible, like little cats. That evening, while our doula Jayne and I sat with L in SCU, his temperature dropped. His heart rate dropped. He was put on a heart monitor, the doctors called, tests, ECG leads. Very alarming. I feared losing him. I made myself say goodbye just in case. I told him about all the toys waiting at home for him, told him I loved him, that Daddy loved him, that E loved him, that it was a privilege to know him.
He was in an incubator. I was allowed a cuddle at midnight. I had it at 1am in the end as E had the breastfeed of her life.
After the cuddle, I left Alistair in SCU cuddling L and took E to bed. I was very exhausted and tearful, thinking it could be a final goodbye. Downstairs E started crying. I had to leave her crying to go to the loo. I chanted Om Mane Padme Hum and cried. She stopped crying. I had one and a bit hour's sleep with E in the bed. Then at 3.30am relieved Alistair in SCU. He stayed with me for a while and reappeared at 4am to get E fed.
They left at 4.30am to return at 6.30.
L looked better, now warm, heart rate mostly 80s and 90s. He slept and slept. He woke in the night and sucked Alistair's finger and his heart rate improved. I wanted to get him out of SCU the next day. I thought it a place where dramas escalate. It was full of strange machines and very premature babies who are long-term inmates. There were very few parents - none at night. Some visited evenings and weekends and it looked as if they were playing with dolls. I could not bear to look at first - not at them or their babies. I did not want to correlate my experience with theirs. My baby was a real full-size baby. Both my babies were. In the end I did look. I wondered at the parents, wondered if they had any idea of the incalculable possibilities of psychological damage. Some of the nurses were kind and some were simply efficient.
They suggested I needed to get rest, partly out of genuine concern and partly to get rid of me. I worried about myself: lacking sleep, post-operative and still on medication, worrying and lots of breastfeeding and mixed diet. But could not leave L alone. I wanted to be there to provide reassurance and skin contact, but wondered how I could keep up a 24-hour vigil if this continued. Did not consider SCU a good place for a child. Since L looked as if he had a hard time in the womb, I did not want him to suffer more. Alistair was stoical and determined. E was angelic, healthy and pink. She seemed to sense the crisis and allowed us to focus more energy on L.
I prayed that we would get L back, even if still under the hospital roof. I followed my instincts closely, sure that it was important to touch him and talk to him in order to keep him alive. At 3 days old no-one knew what was significant for him.
We got L back 4 days later, a week after he was born. I breastfed him throughout this time, and he was never without one of us there for long, but I never liked him being in SCU. I battled with the staff for access to him. They tried to stop me taking E up. But the midwives on level 12 supported us and she was allowed up there for tandem feeds.
They wanted to leave him up there in an open cot on his last night. He was kept up there for not being able to maintain his temperature (in a drafty room without his parents). I insisted on an incubator. The nurse talked about intubating him and could not understand my objections.
After we got him back Dr A from SCU and the female paed with clipboard came into our room - like the Gestapo, I thought - and wanted to do more tests on L, including a brain scan. Dr A got angry when we deferred these tests on the advice of a midwife. He talked of cretinism. This upset Alistair; it was his lowest moment.
The night we got L back, I suffered the most excruciating pain of my life, which began during a feed. It was in the area of the wound but no-one established the cause. I was give intravenous antibiotics and morphine. Then I did the next feed. I continued with morphine for 24 hours and with strong oral painkillers and antibiotics for some time.
We finally got home on Friday, 10 days after the birth. I was distraught, in collapse and sat in the bath and wept. I was only glad to be home days later.
Because a post-operative complications, caused mainly by a fibroid, I bled heavily for weeks. After about 6 weeks or so, my health improved as did my competence and I started finding some pleasure in motherhood. I felt I recouped some of the sense of naturalness of the process by breastfeeding round the clock for the next three months, and then continuing with it, combined with other feeds. The trauma of the hospital experience and some twinges from the caesarean are still with me, nearly four months on. The babies, now glowing with health, are here for good.
Sara T
Independent Midwives - what they do, and where to find one.
Doulas - professional birth attendants.
Transferring to hospital - why it might be advised.
UK VBAC/HBAC (Home Birth After Caesarean/ Vaginal Birth after Caesarean}) group: http://groups.yahoo.com/group/ukvbachbac
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