epidural | Motherworldly

18 Oct

Maggie’s Birth Story

Maggie’s daughter turns 13 next week; here’s the story of her birth:

I had quite a traumatic birth experience with my son, so when I found out that I was expecting my second baby I was pleased, but partly worried that we would have to go through a similar experience again. My son’s birth had been a planned home water birth, but my blood pressure had become high in the last month of pregnancy and at the onset of labour he had become distressed, leading to an augmented labour, followed by a failed ventouse and then forceps delivery. I had the same community midwife with this second pregnancy, and at my booking-in appointment, she told me that I would have to be checked by the consultant, and strongly advised against having a home birth, given what had happened previously.

This second pregnancy went very well, until six weeks before my due date when my blood pressure went up to 130/90. At this point I started to worry about history repeating itself. Over the next six weeks, however, it stayed more or less constant at 130/90, which although high, was what it had been at my booking-in appointment, so the midwife and consultant weren’t unduly worried.

On the day after my due date I went to bed at 10pm and fell asleep very quickly. Two hours later I woke up as I realised that my waters had broken. My first labour had started the same way, but this time the fluid was clear – so far so good. An hour later we arrived at the Royal Berks Hospital. In the car, the contractions had been pretty mild, but coming about every 5 minutes. The midwife on duty gave me all the routine checks, told me I was about 1cm dilated and that everything seemed to be going normally. She just had to check on my contractions and the baby’s heartbeat and then I could go home and wait for the contractions to start in earnest.

On went the monitoring belts for the obligatory 20 minutes. At the end of this time the midwife looked worried, and told me that she wanted to leave the belts on for a bit longer and get the registrar to look at the trace. The baby’s heartbeat was apparently too steady – not enough variability, which meant that the baby was either asleep or distressed. At the end of 50 minutes the trace hadn’t changed much and the registrar was also worried. She told me that it was very likely that I would have to have a caesarean if the baby was distressed this early in labour, and even if not, they would have to speed things up with a drip. When we were asked what our feelings were about this my husband said angrily “I’m just afraid of the whole bloody thing going balls-up like it did last time”

In the meantime we were moved to a delivery room in order that they could attach a scalp electrode to the baby’s head to give a better indication of the heart rate. By now it was about 2.30am and my contractions were slowly gaining in strength and still coming regularly. Once the readings started coming through the scalp electrode the output from the monitor was faxed through to the on-duty consultant to determine whether the caesarean was required or not. The trace had improved somewhat, but was still considered suspicious. In the meantime my midwife took some blood samples from me as there was some concern regarding my blood pressure and the anaesthetic for the caesarean.

The reply from the consultant came back – no need to do a caesarean yet, but certainly augment the labour with a drip. When I was told this, I asked for an epidural to coincide with the drip going up, as I knew from my first labour that I didn’t want to have to deal with the more painful contractions that would result. However, it wasn’t possible to have either the drip or the epidural until the blood test results came back. By this time the contractions were beginning to get stronger and I was using the breathing technique to get through them, standing next to the bed and leaning on the monitoring machine. They were lasting about 45 seconds and coming every three minutes. I was beginning to think that I should have put my TENS machine on, but under the circumstances I hadn’t bothered as I’d thought I’d probably be on the operating table by now! I debated whether to use gas and air, but somehow I didn’t think I wanted it just yet as the breathing on its own was making a difference.

Eventually the blood test results came back just after 6am, they were fine, and by that time everything was set up ready for the drip to go in and the anaesthetist to do his work. Just before though, I asked for an internal examination to see how things were progressing on their own. I was 3cm dilated by this time, and having been up all night was glad to lie down on the bed for a while.

I had the epidural and up went the drip. Down went my blood pressure to about 70/40 as I reacted to the anaesthetic, felt extremely light headed and debated whether or not to be sick. This reaction passed fairly quickly, and I was pleased to discover that the anaesthetist had got the dose on the epidural spot on. It dulled the pain of the contractions, but I was able to stand up next to the bed and move around to a limited extent. My real fear was that I would end up having to lie still on the bed and give birth in that position. The midwife who had been with me all night went off duty shortly afterwards at 7.30 and another midwife took over.

After another hour and a half the registrar returned and at the same time I realised that the epidural was beginning to wear off, so I asked for a top-up. This was administered just before the registrar announced that they wanted to take blood samples from the baby’s scalp to gauge how distressed it might be. So, back on the bed I went and the registrar started to try and take the blood samples. In passing she told me that I was now 4cm dilated. In the end she had to take three samples as there wasn’t enough in the first two samples to do an accurate blood test. Once she had taken the third she told me I was now dilated to 7cm. At this point I was beginning to suspect that the top-up epidural wasn’t working as not only was I feeling uncomfortable from the internal examinations, but the contractions were getting more painful rather than less. Whilst waiting for the blood results to come back (normal again) the registrar performed a stretch and sweep and told me I was 9cm dilated – quarter of an hour after I’d been 4cm!

The registrar then left my husband and I alone with the midwife. By this time the initial epidural had completely worn off and the top-up hadn’t done anything so I could turn round on the bed so I was kneeling and leaning against the head of the bed, and very shortly I started getting the urge to push. My new midwife was great at this point, she stood back and told me to go with my body, and do whatever felt right.

As the urge to push got stronger I went with it and started pushing. Four minutes and four contractions later at 9.30am the baby’s head appeared, followed at the next contraction by the rest of her body – a little girl! After an eleven minute third stage and some oxygen for the baby she was put to the breast to feed and stayed there for half an hour! After everything that had gone before it was an extremely positive birth experience in the end.

Three and a half hours after the birth we left hospital and brought our daughter home to meet her brother. My mum, who had been babysitting, was amazed to see us – the last update she’d had from my husband had been when we were preparing to have a c-section!

15 May

Helen’s Birth Story

Helen has really benefited from all the support from Karen and would like to share her story with readers to prove that difficult starts don’t mean difficult babies

Every story has a background so here is ours. Lynn and I met in 2001 and had a shotgun wedding in December 2011 when I was 30 weeks pregnant. Marriage had always been in the plan but on finding out just how important it was to the future of our unborn child that we were married, we quickly planned a small wedding with immediate family and very close friends, which meant that Lynn would be named as a parent on the birth certificate rather than having to adopt the baby. Lynn hates it when I say we got married for the legal reasons, of course we didn’t, we are very much in love but other things had always been a priority, however, once we were made aware of this important factor marriage somewhat became the priority.

So you have probably realised that our baby was not conceived in a traditional man + woman + good times = baby, kind of way! Our baby too has been born out of love but with the additional help of an amazing selfless anonymous donor. We chose home insemination, and you can imagine the happiness, excitement and shock when it worked in the second month of trying when we had been told it was so much harder to conceive a child in this way.

So the baby was growing, and the due date was set, 24th February 2012.
Except our baby had no intention of making it to the due date!

On the 30th January 2012, I was just finishing getting ready for bed, pregnancy had been uncomfortable now for a couple of weeks and although I loved every moment of being pregnant, bed and night times weren’t my favourite times of the day, no longer able to turn over in my sleep, throughout every night I also endured the discomfort of having to wake to a fully conscious state to turn over and regular bouts of night cramps in my legs which were excruciating (these were however the only pregnancy symptoms I suffered so I am not really in a position to complain). So in reality I had not slept well at night for a couple of weeks and was getting used to napping in the day to catch up on those missed z’s. However this Monday, I had spent with my parents and had not had the regular nap that I was used to so I was exhausted.

I finished brushing my teeth and in my nightie stood by the bed ready to take on the challenge of removing my socks, I leant over and I heard a pop, my mind suddenly flashed back to our 34 week appointment with the midwife who had said ‘sometimes you hear a pop and then you have a few seconds to get to somewhere that you are comfortable with you waters breaking’! I rushed to the bathroom, made it on to the loo and then they went! My mind then flashed back to an NCT class, ‘most women’s waters don’t gush, many just trickle or seep and some don’t go at all’ Well mine certainly went, with a whoosh, I was blown away by the amount of water I was losing, in fact a little concerned, I checked the toilet for blood, but it was clear. Relieved, I called to a sleepy Lynn, ‘babe, my waters have definitely broken, you better call the hospital and your parents’.

Oh, I forgot to mention, I did have one other complication in pregnancy, gestational diabetes, we had been warned that this would have some consequences on labour, I couldn’t use the birthing pool and would be constantly monitored throughout labour as my blood sugars would be unpredictable so we were going to write our birth plan around this. I also had been informed I was likely to have a large baby possibly over 10lbs and that they would recommend an induction on the due date if the baby hadn’t come due to the risk of being oversized.

Yes, you read correctly, we hadn’t written a birth plan, we had an appointment to do this with the specialist midwife on the 1st February 2012.
So here I was, pretty unprepared, sat on the toilet, wondering what was going to happen over the next few hours and when I would get to hold the baby we had both longed for so many years. We had chosen at our 20 week scan to not find out the sex, so that too was on my mind, would we be meeting our son or daughter? I was excited, terrified, happy, sad, concerned, anxious, and overwhelmed all at the same time, thank goodness I had Lynn there to support me through the next 30 hours!

Lynn’s parents arrived to look after the dog and I was bundled in to the car sat on several towels as I was still leaking lots of waters and we had been told that the smell of the waters is hard to get rid of. A ten minute ride that I barely remember got us to the hospital and I was taken into an assessment room.

Still leaking waters I stood ashamed in the middle of this baron room while my waters dripped all over the floor, however this was met by some very friendly faces, who clearly were used to this kind of behaviour on a daily basis and reassured me it was ok and sat me on the bed.

I was strapped to a machine which quickly gauged the babies heart beat, had my blood pressure, pulse, and temperature taken and was told they thought I had some kind of infection which meant that although I wasn’t in established labour they wanted to keep me in. Then I was scanned which they struggled to get a decent picture from as I had lost so much of the fluids from the baby. I was experiencing very mild period like pains, which the Doctor informed me were moderate contractions so I felt confident that I would be able to cope with labour with little pain relief.

Lynn and I had discussed the labour on many occasions, I was adamant that I did not want an epidural, diamorphine or pethadine, I was going to do this naturally with gas and air and maybe a Tens machine. I had downloaded and had been practising hypo-birthing for a few days and was confident that this would get me through the worst, whilst Lynn supported me emotionally. We had learnt massage and breathing techniques at our NCT classes as well as some tips on good birthing positions and I was an astute birthing ball user. This was all going to help me, and the baby would be out in no time I reassured myself.

Sat there excitedly waiting for the Doctor to come back and give me an examination, I imagined being told I was three or four centimetres and that things were progressing nicely, however I couldn’t have been more wrong. After the most painful horrendous experience of my life so far the Doctor looked at me and said, ‘your cervix is still high, hard and not open at all’ to say I was disappointed was an understatement, I had assumed that as the baby had broken the waters my body would have naturally responded to this by getting ready to have this baby.

By 4am I turned to a shattered Lynn and told her to go home and get some sleep, things weren’t moving quickly and she looked exhausted, the midwife agreed that it would be best for Lynn to go get some sleep so she trundled off into the cold night.

Although I tried hard to also get some sleep this was very difficult, not least because the nurses were in and out every hour checking me and the baby because of the infection. I was also far too excited to sleep, we were finally going to meet the little person that had been growing inside me for 36 weeks, who I had felt wiggle and squirm, experienced every single hiccup with them and already loved them more than anything else in the world. Although I was worried that they were coming early the midwives were not and reassured me that at 36 weeks everything would be developed and that the baby would be fine.

At 8am a familiar face appeared back at the door, I had missed Lynn so much over the last 4 hours, not being able to share every thought I was having was hard, but she was back, and she wouldn’t now leave me again until the evening after the babies birth (38 hours away!)

Nothing much happened over the next 5 hours, I had a wash, sat on my bed, bounced on my ball, Lynn and I talked excitedly of all the dreams we had for our baby. By 1pm the midwives and consultants decided to induce the labour as it was not progressing in the way that it needed to considering the infection and lack of waters. A pessary containing inducing hormones was inserted and I was told to sit tight for 24 hours as that is how long it is likely to take.

Well 30 minutes later I was experiencing ‘proper’ contractions, to say they are painful is an understatement but they are a special kind of pain, knowing that each one is bringing your baby closer to being born makes them somehow more tolerable.

Over the next 8 hours I had many many examinations, Dr’s came and went with and without teams of students, I cant tell you how many different professionals had a look, a squeeze and a feel of me inside and out! By my 3rd examination I was an experienced user of gas and air which made them slightly more comfortable.

At 4pm the pain had become unbearable and I found myself taking the advice of the midwife and having a shot of diamorphine the first thing on my list of ‘nevers!’
Diamorphine actually turned out to be a very good decision, they gave it with anti sickness medication so I didn’t feel sick at all, it gave me a chance to relax and even have a few minutes sleep, the only negative side effect to me was that it made my skin super sensitive and I couldn’t bear being touched by anyone which was upsetting for Lynn and my sister Lauren who had by this point turned up with some lifesaving pants and nighties for me.

Lauren stayed for the duration of my labour, offering the emotional support to Lynn that I couldn’t give and allowing Lynn to take time away from me just to grab food and drinks etc. Although Lynn and I had decided that the birth was going to be something that we would experience alone, Lauren was fantastic and like many pre-birth decisions that change when you are actually in the middle of labour we are both eternally grateful for her support throughout the birth of the baby.

The monitoring of the baby was pretty much constant throughout the labour, and twice during my labour I was prepped for surgery to have a c-section as the babies heartbeat was dropping throughout my contractions, however just as I was about to be wheeled down, an ‘emergency ‘ took priority over me the first time and the baby suddenly showed signs of recovery the second time making the consultant change his mind.

Finally at 1am on Wednesday 1st February 2012 I was 10cm dilated, to say I was elated was an understatement, I was exhausted by now but so excited knowing that the baby was very nearly here. Oh did I mention that I also had an epidural at 5cm dilation, another one of my ‘nevers!’

Epidural actually was no where near as bad as I thought it was going to be and actually when you are experiencing such a drawn out labour it was a god send, I wouldn’t recommend it if things are moving along swiftly but as pain relief goes I went from agonising contractions to total calmness through a mild tightening. I had always assumed that epidurals numb you from your neck down but the one they gave me only numbed me around the tummy and I could still walk about with it in. The biggest downside was the catheter that I had to have put in due to the epidural.

At 2am I started pushing, I had received a top up on the epidural so it was hard for me to feel the contractions and I was relying on the midwife telling me when to push as she was feeling my tummy. After 2 hours and many more visits from consultants the baby had decided that they actually didn’t want to come out after all and yet again I was prepped for theatre, they were going to try forceps but if these didn’t work after 3 attempts then they would give me a c-section to get the baby out.

Leaving Lauren in the delivery suite Lynn got all dressed up for theatre (again) and I was wheeled a short distance down the corridor, I was transferred onto a theatre bed which was agony as the epidural had worn off and I was mid contraction as they moved me. They then topped up the epidural and this time numbed me from the boobs down in case they had to perform a c-section.

Before I knew it my legs had been strapped behind my ears and I was surrounded by a huge team of medics. I looked down to see the Doctor who had completed my first examination back on shift and about to deliver our baby.
I remember being told to push as the midwife was feeling a contraction and then our baby was born, so quickly and with only minimal force from the forceps, the baby was lifted over and a member of the team said to Lynn ‘tell her what it is then’ all Lynn at this time could reply was ‘it’s a baby!’ she was so overcome by emotion it hadn’t registered that it was a little boy. ‘It’s a boy’ she exclaimed several moments later, tears flowing down her face.

A side effect of full epidural is full body shakes and it was as a result of these that I didn’t feel comfortable holding our son straight away, this was probably my biggest regret as what happened next will haunt me for ever.
Lynn was cuddling our son, we named him Sebastian later on, but he was nameless at this point. I was delivering the placenta and being sewn up as I had to be cut due to the forceps. The paediatrician came over and said she needed to check him over as he was ‘grunting’. Not thinking anything of it I agreed to be wheeled to recovery while Lynn waited with Sebastian.

I was lying in recovery when suddenly this little bundle came my way, he was placed on my chest and I took in the biggest breath and smelt him for the first time, he smelt amazing, the NCT class leader had said that your baby would smell amazing but until you experience it you will never understand. As soon as I had taken this first breath and placed a gentle kiss on his forehead the Dr whipped him away saying he needed to receive some oxygen in special care, and just like that he was gone!

Lynn and Lauren went up to special care and took some photos for me but nothing was filling the hole in my heart that needed to hold my baby boy, I was sobbing uncontrollably that I just wanted my baby but no-one would bring him back to me.

I was transferred to the ward and immediately requested that I was wheeled up to the special care unit. Lynn grabbed a wheel chair and we wet up to Buscot ward. I had been told that Sebastian just needed some oxygen so imagine how I felt when we got up there to find him covered in tubes and monitors with tubes going in his mouth and nose.

I burst into tears and a Dr came over who told us that Sebastian was actually quite poorly, he had respiratory distress syndrome and they were giving him antibiotics because of the infection that I had. He was struggling to maintain his blood sugars and wasn’t able at this point to maintain his own body temperature due to everything else going on for him. They thought that they may have to ventilate him later on as he was struggling to breathe so much, but they were monitoring this.

We couldn’t cuddle our son at this point, just place our hands in his incubator which was upsetting as he flinched every time we touched him. We were taught to do a ‘containment cuddle’ where you cup his head and bottom in each of your hands and gently push in, this mimics the womb and he didn’t flinch away from this kind of touch.

After around an hour we went back up to the ward, feelings of concern, despair, worry and fear filled what should be the best time of our lives. We were on a ward with another lady who had a baby in special care which was nice for me as it was hard to see other ladies with their babies when ours was in special care, it also gave us someone to talk to who was going through exactly the same thing and feelings.

We went back up a couple of hours later dreading the worst, but we were delighted to find that he had not been ventilated and infact they had reduced the levels of oxygen he was receiving as he was doing so well, although we were still unable to have a proper cuddle we left that visit feeling much happier.

The midwives in the special care unit had suggested that I hand express my colostrum for him as he would really benefit from this as he was only on a glucose drip in the incubator.
Hand expressing is an interesting task, and with all the will in the world I just couldn’t do it, even allowing a midwife to ‘milk me’ at one stage in an attempt to get some nourishing goodness for our son. Lynn pooped home and brought back our electric pump which worked a treat. It was still hard work and the stuff is so sticky its hard to actually collect but I did well and was regularly expressing about 0.4ml which I eagerly ran up to Sebastian and left it on his incubator for them to feed through his nose later.
This continued for a couple of days and my milk came in on day 3.

Sebastian was getting better and better each day, day two came our first cuddles which were amazing and my first few attempts at breast feeding. Something I knew I wasn’t going to give up on (and did succeed with a little help from a special breast feeding counsellor a few days later, a different story!)

And by day 4, I was lying on my bed, expressing milk preparing to go and see Sebastian when he was delivered down to me. The best moment of my life so far! Although again overwhelmed as I just stared at him for about an hour in total silence wondering how on earth I was going to look after something so little (he weighed around 5lb 9oz) I knew that the baby shaped gap in my heart had just been filled and it was time to be a proper mummy.

Sebastian is now a healthy 9lb, 12 week old baby who is thriving in everything he does, he brings joy to everyone that meets him and has a smile that could melt an ice cap.

03 May

Helen’s birth story

Helen is a former client of Double Helping Doulas, and kindly agreed to share her story.

About a week before my due date (10th October) I’d had ‘the show’ and
experienced some Braxton Hicks contractions. I woke on the morning of the 10th noticing my maternity pad was wet but no gushing waters. I went to the hospital to get checked out and was told it could be the hind waters had gone, but only in a trickle. They sent me home to give me 24 hours to see if my waters would break fully on their own.

By the next morning I had two soaked maternity pads but still no full breakage of my waters. So I returned to the hospital and was booked in to the delivery suite.

They advised me that, due to the risk of infection to the baby, the next step would be to break my waters for me. Although I had hoped for a natural birth and knew initial intervention may well lead to more, the risk to my unborn baby was not worth taking. They broke my waters at midday and sent me to walk around for an hour. Very soon the contractions came on thick and fast but there was also some meconium in the waters, so I was then strapped to a monitor to keep an eye on baby’s heartbeat.

I used my TENS machine for the first few hours and then went on to gas and air. About 5 hours later I was examined and told I was 5cm and my cervix was paper-thin and soft which was very good progress. Although I was mainly focusing on coping with the contractions, I did start wondering if our baby would be born that evening. My husband and I also felt pleased things were now progressing naturally.

At 9pm I was examined again and was dealing with intense contractions
and barely aware of my surroundings, but I clearly heard the midwife
say, “Unfortunately, you’re still at 5cm.” I could tell by her face this wasn’t good and my stomach sank. She checked the position of the baby’s head and although it was facing the right way, the midwife could feel the anterior fontanelle (soft-spot), which meant baby was chin-up, and not chin tucked in. So baby was in an awkward position and was slowing progress.

The midwife was great and went through all our options with us. She said it was going to be quite a while longer now and although I had noted in my birth-plan I would prefer no intervention and drugs, perhaps I should consider it now as I’d probably need syntocinon to continue dilating. I was absolutely shattered and if I’d only had a couple of hours left I think I’d have got through. But I was in for the long haul now and decided to have an epidural. The midwife said I’d done really well so far on just TENS and gas and air, and not to feel bad. Births rarely always go to plan! She went off to get the anaesthetist while my husband continued helping me through the contractions.

It wasn’t long before the midwife returned with the anaesthetist but I don’t remember much other that being sat on the side of the bed and leaning with my arms around my husband’s neck. He said afterwards that had been one of the hardest moments for him, reading all the potential dangers of an epidural and having to sign the consent form on my behalf because I wasn’t in a fit state to sign it myself. The midwife said, “In a few minutes you’ll feel like a new woman!” She was right; the pain eased and I could start to think clearly again. It took another 9-10 hours for me to become fully dilated and for the midwife to say I was ready to start pushing.

About 8am I was put on my side and was told when I had a contraction as the epidural meant I couldn’t feel it. We had a student midwife in with us and she was helping hold my leg while my husband held the other leg and watched the graph for the contractions, to tell me when to push. After some time pushing, the student midwife suddenly fainted and fell over knocking her head on the side cupboard! The midwife came running over to hold my leg again, whilst saying over her shoulder, “Are you ok?” to the student who was coming round rubbing her head. I was also trying to ask her if she was ok but was told to concentrate on pushing. The student went off to sit down, apologising all the way, and we said not to worry about it whilst also trying to deliver our baby!

But the pushing wasn’t working so a doctor was brought in to examine me further and she said, “I hear you’ve been very good so I will give you some help now.” She went to prepare and they took the end off the bed and put my legs in stirrups. What followed were two failed attempts at the ventouse, then an episiotomy and forceps to finally bring our beautiful baby girl in to the world.

At 11:43am on 12th October she was delivered and put on to my tummy. I felt relieved the 24-hour labour was over and completely overjoyed at holding my gorgeous little bundle.

The pediatrician in the room then took her and she scored 9 out of 10 on her Apgar tests so she was fine after the epic labour. My husband was also able to cut the cord while I was given an injection to help the third stage along. I was given my daughter again all wrapped in a blanket and was enjoying cuddles when the doctor said, “This placenta is not coming out.” I had a retained placenta; I couldn’t believe it and started to feel really upset. I was tired and felt we’d already been through enough and this was the last thing I expected. So I was rushed off to theatre while my husband was left in the delivery room holding our baby girl. It was an extremely anxious time for him holding our baby and not knowing what was happening to me. I was given a spinal block and then pretty
much passed out while the doctor removed the placenta and sewed me back up.

I was taken to recovery ward where my husband met me with our baby. He’d dressed her in a white hat and sleepsuit, and she was tucked in under a blanket in the little hospital cot. The nurse put her next to me in my bed and tucked some pillows around us. I had tubes coming out of my hands but that didn’t matter as I held my baby again. My husband was pleased it was all over and that I was going
to be ok. It had been quite an ordeal and a bit traumatic at times, and we both had a few tears as we finally realised what we’d been through. But the main thing was I was ok and our daughter was here safe and sound. Ultimately, that’s all that really matters.