Midwifery Part Three....Do It Yourself! (Birthing Methods in general)

Member Name: jusophine

Product:	Birthing Methods in general
Date:	15/11/01 (1356 review reads)
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Introduction
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I have resisted the urge to write about my own birthing experiences for some time now. I?ve read quite a few of the accounts written by other members though, and have found them really interesting, firstly because I?m a midwife, and it?s good to get feed back in general about how women viewed their own birth experiences, their care, the analgesia they opted for, what helped them, what certainly didn?t help them, and just get an idea of how the ?consumer?s? of maternity care rated the care they received.

From a personal point of view, as any women who has given birth will know, it?s great to talk about your own experiences, whether good or bad. Giving birth is such a humongous event in a women?s life, that I feel it?s something that needs to be talked about, even written down, sorted into some kind of mental order, and in some cases, come to terms with. The arrival of a healthy baby is such a wonderful thing, and brings great joy, but in most cases, also physical pain greater than many have previously experienced, and this in itself needs to be come to terms with.

Those months of being pregnant, were a time of feeling special, of feeling great pride in one?s own body, fulfilling a uniquely feminine role. There were weeks and months of anticipation, longing, apprehension, joy, fear, uncertainty, physical discomfort, pleasure at the sight of one's tummy growing by the week, for some displeasure, at the sight of one?s bottom and thighs also jumping on the band wagon, and it swirled round in a great ever growing mental and physical build up to that big day when labour started, and when the baby finally arrived.

So there you have it, is it any wonder that we women want to share our experiences, after all, no two women?s experiences are the same, and it was all new for us, even if we were having our second, third or fourth child, each time it was different.

So, I?ve decided to share my experience
s, because I too feel it will help me to put them in some kind of mental order, although I am aware that it may not necessarily be of help to anyone reading this. My main reason for not writing up to now, was because I have feared worrying or frightening any women reading the piece who is expecting her first child. I?ve led far too many antenatal classes where a well intentioned mum, expecting her second child, has felt it necessary to share her birth experiences in technicoloured goriness, with the rest of the group all expecting their first. It?s not that I agree with a ?conspiracy of silence?, where we don?t share things we think will create fear, it?s just that there are ways of broaching topics related to labour. For instance, if we talk about the severity of labour pain, because we don?t want women to be unprepared and think it a walk in the park, we also discuss pain relief, positions for labour, and coping mechanisms such as relaxation techniques.

As I share my own experiences with you, I?ll try to add some factual information too, so that rather than it just being my own story, it will hopefully also be helpful too.

Blimey, that?s the introduction over with, I?d better get on with the actual content. Hang in there, it?s coming up now!


Fergus? Story
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I had had a reasonable pregnancy, well reasonable compared to some. A couple of hiccups had occurred, an early vaginal bleed, which luckily was a one off. I think this was down to one of two things, either it was an ?implantation bleed?, caused as a result of the fertilized egg?s damage to the lining on the womb as it attached itself, the resulting bleeding later being revealed, or it was a light ?period? as a result of early hormonal confusion, as it was about the time a period would have been due. An abnormal scan at 12 weeks then resulted in a trip to the Harris Birthrite Trust at Kings College Hospital, where Professor Nicolaides was able to reassure
me that the problem( herniated fetal bowel, normal in very early pregnancy, but later an indication of possible Chromosomal abnormality, or Exomphalos, where the baby is born with bowel outside the abdomen), was now resolved. Phew, take a deep breath, and?relax!

Of course there was the matter of my admission at 28 weeks with threatened premature labour. This meant steroid injections to mature Fergus? lungs should he have decided to put in an early appearance, and being put on a drip containing a drug called Ritodrine, to suppress the contractions I was getting. It?s a particularly nasty drug, with unpleasant side effects to say the least; nausea, vomiting, palpitations, breathlessness and shaking and tremors to mention just a few. The good news is that it?s usually used just long enough to allow the steroids to work, and then it is stopped and if you labour, then you labour!

In my case, the drip had to be switched off early, because I had a particularly bad reaction to the Ritodrine. Apart from being very shakey, I managed to keep dropping my blood pressure, vomit, faint, sit up to vomit again, faint and so on. Through out this, I was being continually monitored, and I could hear Fergus? heart beat. This can be very reassuring, although for me, it resulted in me detecting a problem. This was the first of the almost Schizophrenic experiences of being a midwife and being a patient myself.

My colleagues were handing over to the late staff nearby. I remember sitting up to vomit, and almost passing out once again. The transducer, picking up Fergus? heart beat became misplaced as I moved, and so I repositioned it. What I heard I knew couldn?t be my own pulse, because the Ritodrine was making it race along at around 130 beats a minute. Fergus? heart rate was plodding along at 60(the norm being 110-160, although higher at 28 weeks gestation). The blood pressure machine was registering my blood pressure as 75 over 30(low!). I called over the mid
wives,
?I?ve got a fetal bradycardia, get the registrar!? In other words, this is very bad, get help now. Then I put an oxygen mask over my mouth, and breathed deeply, in a hope of getting some extra oxygen through to Fergus.

My poor husband was standing by the bed, and all he could do was watch. My poor colleagues, it was their friend it was happening too, and there was nothing they could say to reassure me, I knew exactly what was happening. If Fergus? heart rate didn?t pick up soon, he would be moribund.

The registrar arrived, and examined me internally. My cervix was closed, I was not in labour, but his heart rate was not picking up. Meanwhile, other colleagues were preparing theatre for my ?crash? caesarean. I remember thinking to myself; ?I?m not scared of going in to theatre, I?m terrified of losing my baby.?

My consultant arrived within minutes. She was cool as a cucumber, and had the confidence to sit patiently and not rush in. The drip had been switched off, and Fergus? heart rate slowly started to pick up, although initially in an abnormal rhythm. After about 20 minutes (it seemed a lot longer I can tell you), things were getting back to normal. The caesarean was off, I was thankfully not going to be put back on the drip, I stopped shaking, my heart rate began to slow down, my blood pressure came back up to normal, and I was seriously thanking God for sparing the life of my unborn child. I realised afterwards that I had thought that even I might die, as I had laid flat, breathing in that oxygen, hearing bits of conversation around me, at times semi-conscious. At the time I had no way of knowing whether it was all due to a massive abruption, the placenta coming away, and a resulting haemorrhage. As they say, a little bit of knowledge can be a dangerous thing.

What I will say, is that I had 100% confidence in my colleagues abilities, I knew they would have done what ever they could have done to save Fergus had they ne
eded to, and this is what I want to say to you. If you find yourself in a drastic situation, have faith in your carer?s abilities. After all this, a couple of friends that had been there on duty had told me how worried they had been, but they never showed me one ioter of this at the time, just confidence and reassurance.

I was discharged a few days later. The sudden drop in Fergus? heart rate was put down to a reaction to my sudden fall in blood pressure, and as it turned out months later, he was none the worse for wear!

After that admission, I continued to contract for several hours on and off each and every day. I suppose my uterus could be classed as being ?irritable?. I never really new if the contractions, that were more than Braxton Hicks(practice contractions that take place from early on in pregnancy which increase the blood flow to the womb, and get it ?shaped up? for labour), would tip over into true labour, and of course I had to give up work early. It was quite a tense time for me, and it stopped me from doing a lot of the things I had planned to do when I gave up work, but the main thing was that we were both healthy!

With all these contractions, friends joked that my labour would be really quick, because my cervix was probably soft and effaced from all those tightening?s, in other words, it was ?ripe? for labour. Of course the rule is, you are a midwife, things ain?t gonna run that smoothly kiddo!

An evening of particularly strong tightenings, led to a gush of fresh blood when I went to have a final pee before bed. I knew I had to get to the hospital in case this was due to the placenta beginning to come away. Of course I didn?t tell my husband this, I just said I needed to go in.

Any significant blood loss(ante-partum haemorrhage), before or during labour means you need to stay in hospital to be kept an eye on. What this meant for me, was losing the opportunity to stay at home for as long as possible,
have a bath, lie in my own bed, and do all the other things that women want to do when they are in early labour, but, being sensible, I stayed for my own good.

I went in about eleven o?clock on the 29th April, a day after my due date. Throughout that night, my contraction became much stronger, and I needed to use some Entanox gas. A mixture of Nitrous Oxide(laughing gas), and oxygen, Entanox doesn?t really get rid of all your labour pain, but it does help to relax you, regulate your breathing and give you something to focus on, and makes you feel detached from the pain. Personally, I think it really helps, but often it just isn?t enough.

For hours, I seemed to be 1 cm, then 1-2 cm, then 2-3cm. Fergus had managed to get himself into a position with his back against my back(so called Occipital Posterior Position or ?O.P?). If you want a long labour, this is how to achieve it!

In a good fetal position, the baby has the back of it?s head at the front, in other words, when it pops out, it?s looking down. If an ?O.P? positioned baby remained in it?s position throughout the delivery, it would be born looking up, so called ?face to pubes? position. Labour takes longer because the part of the head that pushes down on the cervix during a contraction, is not as rounded as that in a favourable position, because it?s the top of the front of the head, instead of the nice round top back of the head, that exerts a nice uniform, even pressure, the pressure is uneven, and therefore the cervix takes longer to open and the contractions are not as effective.

If you have laboured with an ?O.P? positioned baby, you will know that the contractions are just as painful, with the addition of plenty of back ache. Being a midwife, I had a plan in my head, because I knew I was in for a long labour. I must state though, that you have to do what is right for you, take advice from your midwife, and get through labour hopefully still able to incorporate your own b
irth plan.

My plan was for an epidural, as soon as I got to 3cm. Because this took such a long time, I had some Pethidine in the mean time. If you have this to early, it can knock off your contractions, but if you need it go for it. Some women worry that it will effect the baby. It can make the baby a little sleepy after the delivery, but I?ve never seen it have a detrimental effect. This wasn?t an issue for me as I still had a long way to go, and quite frankly, I was getting to the point where I?d take anything going.

A down side to being a midwife in the hospital you decide to give birth in, is that you feel you have to be brave. When you discover that this labour business actually hurts though, you just have to throw that notion out of the window, there are no medals for bravery, and you just have to get through it as best you can.

Finally, and I?m talking finally(at about 1 in the morning, the following night, so now it was the 1st May), I got my epidural, and not a minute to soon. After that, I relaxed, lay back on my pillow, and actually got to start thinking about this lovely baby I was going to have. I had done everything I could to help Fergus to turn to a better position, I had walked up stairs, paced around the room, kneeled on all fours, but he just wasn?t budging. I knew the next step would be to have a drip of a drug called Syntocinon(synthetic Oxytocin, the hormone that makes your uterus contact), to strengthen and speed up the contractions. Now that I had a fully effective epidural, I was all for getting on with things, and it wasn?t long before I was back on track and making progress.

A little about my epidural, I know a lot of women worry about having a needle put into their back, but these days epidurals are very safe, very common, and the anaesthetic practitioner gets an awful lot of practice. There can be side effects, and there are cases when serious problems do occur, but these are really very rare. Very oc
casionally, the anaesthetist can go a little too far putting the needle not just into the epidural space, but also puncturing the dura beyond the epidural space. This causes a leakage of cerebral spinal fluid, which results in a severe headache and is corrected by the anaesthetist taking a small amount of blood from the arm, and using it as a patch to cover the puncture site between the epidural and dural space. As soon as this has been done, the headache suddenly goes. This again is rare, but it can happen. The most common side effects of an epidural, are backache, which is actually more likely to do with poor positioning of mum during labour, because she is unaware that her posture needs correcting, labour being delayed, because you are unable to move about so freely, although less so with modern mobile epidurals where the legs can remain unaffected, and an increased chance of instrumental delivery. This is probably due to a combination of not being as mobile and therefore an unfavourable fetal position and slow progress, and physically being unable to push as effectively because of lack of feeling.

Some cope very well with a mobile epidural, in which a milder anaesthetic is constantly infused, remain mobile and are able to push, other?s find that the epidural is not totally effective, and need ?top ups? of stronger anaesthetic solution. In time, this causes a dense epidural block and lack of sensation. Bliss when you really can?t take any more pain, or if you need a Syntocinon drip, but not so great when it comes to the pushing bit. Still, I knew what I would rather have had, and I really couldn?t feel a thing!

Finally, at about 4.30 in the morning, I was fully dilated, or fully delighted should I say. Fergus? head was nice and low, and it was time for me to start pushing. Well I pushed as hard as I could, and managed to get his big head to move at least a whole centimetre! I was so numb by this stage, from a midwifery point of view, I just kne
w that I wasn?t go to do it on my own. The decision was finally made for me when Fergus heart rate started showing signs of distress.

At long last, at precisely 5.08 on the 1st May, Fergus Henry was delivered by Ventouse, a suction cup attached to the head that looks not unlike a sink plunger. I was tired and exhausted, but when that bundle of wriggly, warm, wet flesh was placed in my arms, an involuntary ?Oh? escaped my lips, and tears of relief and joy welled in my eyes. In that instant, as I gazed with awe at this little human being, multicoloured, green meconium stained hair, almost alien like blue eyes staring up at me, and funny shaped head, complete with suction cup shape at the back, I knew it was all so worth it!



Kitty?s Story
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Well, one just wasn?t enough for me, and despite all the ?hiccups? of my first pregnancy, and with Fergus just 9 months old, I was pregnant again and ready to do it all over.

My first real shock was learning to cope with Fergus whilst feeling like death warmed up! Although I had been working full time when I was pregnant with Fergus, my time off was at least mine to spend as I wished, and if that meant lying in bed when ever I wished, then great, I stopped when ever I wanted. Now I had Fergus to chase after, I felt totally drained and exhausted, and could vomit on demand. I clearly remember lying on the nursery floor, while Fergus trashed the place around me, thinking to myself; ?You?ve really gone and done it this time!?

I was so busy with Fergus, that the pregnancy seemed to go alarmingly quickly, and in my heart, I felt I wasn?t ready for another baby just yet. I was happy for the pregnancy to match the gestation of an elephant!

At 29 weeks, my irritable uterus came back to haunt me however, and once again, I found myself up on the labour ward, having more steroid injections, but luckily, no Ritodrine infusion. The rest of the pregnancy was much like m
y first. I contracted every day, was never sure if that day would be the day that labour started, but this time, I just had the feeling that Kitty wasn?t going to be early.

What did occupy my thoughts however, was the fact that having had one baby already, my labour was bound to be quicker. I am the first to admit that I am a coward when it comes to pain, and I regularly gave my friend, who was set to deliver Kitty, a right old ear bashing about how I dreaded a quick ?Multip? delivery(Multip meaning multiparous, has had more than one baby, primip, primparous, meaning first).

I dreaded not getting to the hospital in time for pain relief, I even dreaded delivering Kitty on the bathroom floor with no-one there to help me. This time I knew all those tightenings must have prepared my cervix for labour, and I could tell Kitty was a smaller baby!

Finally, my day of doom arrived. Hubby was on a late shift, and I got on with getting Fergus his tea, bathing him, and getting him to bed. All the time I was aware that the tightening?s were behaving unmistakably like contractions. The thing is though, there was this Eastenders special on, and being a huge fan, I simply couldn?t miss it! Was it the one where Babs and Pat had a punch up? Oh well anyway, I got myself comfortable leaning over the arm of the sofa, but when Eastenders was over, I suddenly refocused on what was happening to me, and decided I ought to do something.

First I phoned my friend, she would call in on her way home from the hospital to see if anything was happening, although I apologised in advance if it meant wasting her time. Then hubby returned from work, and I told him that I thought something was happening. Of course his only experience of labour was being bored out of his brain for 48 hours whilst I laboured with Fergus. The only thing for it was for him to get on the computer and play a bit of ?Quake Three?, followed then by a leisurely call to his mother to let her kno
w what was happening, and to expect a call possibly the next day.

My midwife friend arrived at 9.35, and did a quick examination, to my disbelief, I was already 4cm dilated. My friend, well into natural childbirth, suggested I got into the bath, while hubby phoned my mum to come across to look after Fergus.

I found myself in this old familiar situation, where I try to be brave, but where I?m really thinking, ouch, that really does hurt, and I think I?m going to shout obscenities at anyone who?ll listen. By the time my mum arrived, I was out of the bath, and bopping up and down round the dining room like an Ostrich looking for a good place to lay an egg.

All I wanted was to get to the hospital where my epidural, no cancel that, my general anaesthetic awaited. There was a brief delay while I waited in the car, whilst hubby searched for his computer magazines, which as you can imagine did not go down well at all. The next thing I knew was we were on the way to the hospital, and 25 minute drive away, and we were shouting at it other. ?I?m in labour you know!?, I shouted at him, cursing him for making me wait. I?m sure he enjoyed throwing the car round that mini roundabout, not to mention all those bumps. Meanwhile I kept one hand firmly against the roof to brace myself, it felt like I had a huge cannon ball rolling around inside me, gaining momentum through every curve.

At last we reached the hospital, and I remember pausing by the night entrance to catch my breath and asking my friend? ?Does my bum look big in this?? Not terribly funny, but what do you expect. My friend later told me that she relaxed at this point because she knew that if I was joking then I must have had plenty of time to go.

Once in the delivery suite, I even waited five minutes to have a nice pink delivery room cleaned from the previous poor soul, before barging in, grabbing the nearest Entanox cylinder, and sucking like my life depended on it.


It was now 11.00pm, and things were progressing. The contractions seemed to be coming with little or no gap between them, and I realised I was approaching the second stage. In some kind of out of body experience, I thought I could hear some poor woman mooing like a cow, just one of the involuntary noises women can make during the final stages of labour. Then it dawned on me that it was actually me, and I screamed at my friend to shut the door so my colleagues couldn?t hear me!

Suddenly, the cannon ball that had seemed so happy to be rolling around in my uterus, seemed to be making a bid for freedom through my bottom. I thought to myself; ?It?s the wrong hole, there?s definitely been a mistake here.? At that point, I thought to myself, it?s too late for any more pain relief, my nightmare of a rapid delivery was coming to fruition.

?Lignocaine, put some Lignocaine in.? I screamed at my friend.
?Jules you know it?s too late for that now, it will soon be over.? and she was right, but it was the longest few minutes of my life. I can still remember that lonely feeling, that I was all alone, and that nobody else was going to do this for me. It was just down to me now, and the harder I pushed against all that pain, the quicker it was all going to be over.

Then I was lying there, Katherine Darcy Louisa, safe and well in my arms, and this time no distress, no meconium, and no sink plunger marks. I felt shocked, I had given birth just 29 minutes after arriving at the hospital, it had all been just too quick, but at least I was able to breast feed Kitty(as soon as my stitches were done, although that?s another story altogether, perhaps I?ll tell you later), and get up and take a shower straight away.

I guess most women would love to have a quick, normal delivery, and to get away with using just a bit of pain relief, me, I?ll take a long labour and an epidural any day. As I lay there recovering from Kitty?s assault on my ?bits?, I said to
hubby, ?I?m not doing that again!?, and I meant it too.

Anyway, back to the matter of my stitches, which I needed on both occasions. Maybe I will have one more baby after all. It all started when I saw that poor little laboratory mice on T.V that was growing a human ear on it?s back. I?ve spoken to one of my Guinea Pigs, and he has kindly agreed to grow me a new labia on his tummy. He would have grown it for me on his back, but it could turn out with black, ginger and white fur growing from it, any way, we?ll see.

On a more serious note, any worries, any traumas, even the memory of pain, do begin to fade with time, although some memories may linger a while longer than you?d like them too. At the end of the day, for me, it?s the happiness and joy that?s there all the time, the fact that I am lucky enough to have not just 1, but 2 beautiful healthy children, and it?s all worth it in the end.

Juliet.

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