Today is Freddie’s birthday. This time 3 years ago I was lying in the postnatal ward, breastfeeding a newborn of two hours old. (Three years later he’s still as boob obsessed, but that’s for another blog post…).
There has been a lot in the media today about birth trauma as today has been the Birth Trauma 2018 Conference with some very necessary discussion about birth and how we can move forward towards a more positive cultural expectation of the birthing experience.
Three years ago today I had a redemptive second birth after my traumatic first experience 6 years ago with the birth of my first son. The reason it felt redemptive was that every aspect that had been traumatic about my first birth was overturned. Second time round I felt:
Confident and knowledgeable about the processes
In control (as much as you can be where birth is concerned…)
Listened to, and effectively communicated to at every stage, by the medical staff supporting my birth
This, sadly, means that for my first birth almost none of these above factors was present as overall in my experience.
First time round, I wanted a home birth or to be in a midwife led birthing centre which emulated where possible the cocooned ambience of a home, with soft lighting and birth pools…but was stymied early on in this desire by a random urine test at 16 weeks showing that I tested positive for Group B strep (which is nor routinely tested for generally), which would mean that I needed antibiotics administered during my labour and possibly to my newborn after birth. This immediately placed me in the “must be in hospital” category to give birth as I was now officially higher risk. I was a bit crushed, but armed myself with lots of reading about natural birth and how I could create the right birthing environment even if I was in the bright lights of a birthing ward rather than in a home softer less medicalised environment of my own home or a birthing centre.
At my 39 week appointment my midwife suggested that my baby was small for dates…but she dithered about whether to refer me for a hospital scan to check everything was ok. So she placed a seed of fear and doubt in my mind about the health of my baby, but without following through with any reassurance about whether this was well-founded. I went beyond my “due date” – which I’ve always said should be rebranded as a “due window” as only 5% of babies arrive on this date which we cherish and hold so close, and may as well have tatooed to our foreheads for the amount of time we’re asked about it during our pregnancy. As I went over, I had to have more hospital appointment to check all was well…at this point in the process it always feels like there is a Countdown clock ticking ominously before you have to be INDUCED. Why is there so much fear around this? Why are we so bullied about it? Induction 6 and a half years ago was slightly different to the process now, and there is no doubt that I was pressured to acquiesced when I said that I was reluctant to be induced and would rather see whether I went into labour naturally.
I had read about the “cascade of intervention”, and I had a family midwife friend telling me – supportively yet equally powerfully from the other side – that induction was unnecessary and not to be bullied, to stand my ground. In this respect pregnant women can feel pushed and pulled around by opposite “birth camps”, which is intimidating and scary.
I had an appointment with a consultant. I had been told to call to see when I was able to be seen by her, and informed that they would let me know of a spot. I was called, on a hot day in July, and told urgently that I needed to get to her office within the next half hour or I would miss her. I power walked over Denmark Hill in south east London, at 40 weeks pregnant, in the 30 degree heat, only to arrive and be placed in a waiting room and had to wait for over an hour. When I was finally seen, she was unfriendly, unreceptive, unsympathetic and barely listened to my thoughts or allowed me any time to ask questions, and told me in no uncertain terms that refusing or delaying induction was risking still birth. She wrote STILLBIRTH in capitals in my notes, underlining in a bad tempered flourish. It was not a soothing experience.
At 41 + 3 weeks I had a growth scan to check all was well after having a sweep (why does a sweep sound so pleasant, when it’s really not…), with my midwife’s words lingering in the back of my mind. I was told, “your baby is a very healthy looking 8lb, he’ll come when he’s ready” (I didn’t know whether I was having a boy until this point). When Maurice finally arrived, he was 5lb 12…
That afternoon I was told after the growth scan to “pop up” to the Maternal Assessment Unit. Another lengthy wait in a hot waiting room. I was there for over 2 hours without being seen, and my husband called and told me I should just go home as he was cooking dinner, but something about the STILLBIRTH swoosh in my notes kept me there. I was finally seen, my blood pressure monitored and my baby’s heart rate checked. I was flustered, hot and tired. My blood pressure was through the roof. The Dr decided this was a red flag, and sure enough I also had protein in my urine, a sign of pre-eclampsia. My baby’s heartbeat was also slightly unusual and kept dipping. The Dr said to me, “I think that it’s best that you don’t remain pregnant”…which is still one of the most obtuse things that anyone has ever said to me. “Erm….what do you mean?” was my reply. “It’s likely that you’ll be induced this evening to get your baby out safely”….In my mind all I could think was that Ben had cooked dinner and I was planning to watch the Apprentice final, I certainly wasn’t planning to stay in hospital and have my baby, I didn’t even have my hospital bag….
What followed was two nights on the induction ward….I havent heard of anyone else who hasn’t been offered a private room for induction once they were in actual labour, so maybe I was just massively unrelentingly exhaustingly unlucky… Two nights on the induction ward in a bed which was right next to the labour triage room, listening to woman after woman in labour being processed while screeching in pain and demanding epidurals. My baby’s heartrate kept dipping and I was strapped to a heart rate monitor listening (and other women in labour), I think I got exactly nil minutes sleep over two nights. The first night I wasn’t in active labour. The second I was.
Trying not to moo like a cow and wake or disturb anyone else in the ward….contractions every 10 minutes and really effing intense. But then dawn chased it away. My contractions basically ceased like rain had stopped play and everyone had gone home. I was left in my blue-curtained room, wishing for action, hoping for positive movement, sleep-deprived-torture playing with my emotions and mind. My husband went home in the early hours after having slept on the floor, to get a change of clothes and a shower. At 8am the doctor came to do the rounds. The lights were turned on suddenly and the dividing curtain pulled back to reveal 12 people staring at me in my bed, vulnerable and exhausted – it’s a teaching hosptial and the doctor had his student doctors on the rounds with him, plus some hangers on, the porter maybe, who the eff knows. No one told me who anyone was, or introduced themselves, or – the most important perhaps? – smiled at me in reassurance and shared humanity. The doctor proceeded to talk about me to his crew, referring to me as if I wasn’t actually there. About how they would break my waters within the next hour to make sure my labour started progressing. At that point I stuttered meekly, “errr…have you seen my birth plan, I didn’t want to have my waters broken artificially”. The doctor tutted impatiently and said “well, you can stay on the natural bandwagon if you really want, but we need to speed this up”. No one smiled at me or, it felt, even saw me as a human. They left. I called Ben and started sobbing and asked him to get back immediately.
The details are hazy from that point on. I did eventually have my waters broken. It all goes a bit blotchy from that point. I was pushed down a corridor on a trolley to a birthing room, mooing like a cow myself now, finally, FINALLY some private space. There was a lot of sickness, vomiting is my birthing modus operandum. I finally had an epidural as I’d been labouring for 36 hours and I was only 4 cm dilated, and quite frankly losing the will to live. But…the epidural coincided with my baby’s heart rate taking a rapid downturn. Whenever I was lying or sitting up (I couldn’t move from the bed due to the continuous monitor), his heart rate descended terrifyingly. If I rolled onto my left side, it picked up. Three times consultants were called to review the heart rate dip. Three different consultants. I often feel that if it had been the same one, action would have been taken sooner. My epidural wore off completely on my right side, so I was experiencing the full pain of each contraction but without being able to move from my left side.
Maurice’s heart rate dipped ever more as if in slow motion, my blood chills remembering the sound…Who knows how many different opinions and prevarications finally ended with the consultant calmly telling me that the heart rate slow was serious and I should consider giving the go ahead for a caesarean. It felt at this point that the power was entirely relinquished to me making the decision, whereas at every point up to now I had been bullied and pushed. This, I feel, was a crucial point where the medical authority should have asserted their authority and increased my confidence in the situation, rather than placing a life-changing decision in my hands – on my head be it. As soon as I gave the nod, the room was rushed by staff and I was raced down the corridor for surgery, to have my baby out within 10 minutes. A category 1 crash caesarean.
Maurice was pulled out of my belly – my grisly scar a testament to how quickly they had to open me up to get him out – and there was no sound, no hearty newborn cry. There was an eerie silence as the resuscitation team set about their job. The consultant calmly came to me lying paralysed, and told me that I’d had a boy, but that he wasn’t breathing. I remember at that point feeling like a truck was sitting on my chest, and I tried to talk myself out of what I thought was a panic attack by counting slowly to ten, then down to one, then up to ten once more.
He was revived, and he is now a feisty 6 year old with abundant life in him. My immediate postnatal experience added to the trauma of the preceding 3 days, he was teeny tiny like a premmie, there had been placental problems that weren’t picked up when they could have been. I had no skin to skin and wasn’t even allowed to touch him for over 8 hours, followed by the exhausted start of an agonising breastfeeding journey. But that is for another post.
Traumatic birth indeed – but the trauma of my experience was, in part, related to the shock and pain and fear of the events themselves. It’s not pleasant to hear your baby’s heart rate descend to nearly nothing, while you feel powerless to protect them and they are still inside you.
But, I have no doubt that it is the way that I was treated by my fellow humans that brought the trauma to me. Had I been treated with compassion, sympathy, patience, understanding and respect, the events such as they were may not have left me feeling so traumatised. Kindness is everything. Trauma is not a normal part of birth. Traumatic birth shouldn’t be something that we simply accept. Birth should not be dreaded.
If you feel you are experiencing post traumatic stress disorder (PTSD) related to your birth experience, talk to someone, read up about it if you can, notice and care for your mental state: there are many resources out there: Mind, Birth Trauma Association, Babycentre are just a few. Try not to suppress and ignore your feeling of trauma related to your birth: trauma that is frozen inside doesn’t just release. It stays there, like a DVD stuck in pause, replaying that scene in your emotions and bodily fibres until you are able to kickstart the natural healing process.
You’re not alone.