Some more things they don’t tell you before or during a pregnancy.

A couple of months after DD’s birth I wrote a post called Things they don’t tell you before or during a pregnancy which has been far and away my most viewed post. I still like it because I still think the things I wrote about aren’t talked about enough, and I still think knowledge is empowering! With that in mind, I thought I might write a follow up. For my second baby, I had some definite ideas about what to expect and also about what would be acceptable to me during pregnancy and birth, so this one feels a bit more serious. Here goes.

1. The professionals have your best interests at heart, but they also have their own best interests at heart. And your best interests, in the opinion of most midwives and consultants I’ve spoken to, are to have a healthy baby and be a healthy mother. Of course! You wouldn’t expect anything less. So their priority list goes: healthy baby, healthy mother, don’t get sued. Which is completely fine, but your own priority list might go: healthy baby, establish breastfeeding, look after mental health, be at home, etc etc. Or: healthy baby, be left alone. Or: healthy baby, don’t be left alone. Or whatever. Whichever way you look at it, your list of your own best interests is going to be longer and more complicated than the list your caregivers have, and sometimes that means there’s a clash of priorities, because their ‘don’t get sued’ is fighting for space with your ‘have a water birth despite being advised against it due to factors x, y and z.’ And of course, they’re professionals, and if they advise you to do something or not do something then you’d be stupid not to listen to them – but, and here’s the bit that makes me and other similarly-thinking mothers like me a giant pain in the midwife’s arse, you don’t have to take their advice. How you give birth is up to you. That means if you want an elective caesarean they cannot say no. And if you want to have a home birth, they cannot refuse to attend you. These, and any number of other things, are up to you.

Listen to the advice from your midwife and/or consultant, take it seriously, do your own research, talk to independent midwives, talk to a doula, talk to people you trust, make lists of pros and cons, decide on your own level of risk that you’re comfortable with or not, and make your own decision based on being informed and knowledgable, not scared. I was dead set on a home birth this time around. I saw a terrifying consultant who refused to go through DD’s birth notes with me but simply said no, and couldn’t or wouldn’t give me a reason other than ‘it would be dangerous’ while quoting anecdotes at me about babies that had died. I did masses of my own research and eventually my lovely community midwife got my notes from DD’s birth and went through them in her own time and explained them to me. My doula sat with me in the meeting because, frankly, I was an emotional wreck, and asked pertinent questions that I hadn’t thought of, and I asked more questions of my own. There was no pressure either way and eventually I decided, based on the facts that I wanted to go to hospital. So I came to the same conclusion as the terrifying consultant, and in terms of NHS time I’m sure she would have said I wasted it, but I felt a hell of a lot more confident in knowing that I had made an informed choice, and when I gave birth I was comfortable birthing in the place I’d chosen to be. So here’s a middle finger for Ms M the consultant. You were a cow.

2. A doula could change your life. Truly, madly, deeply. Our doula gave me confidence in my body, managed the birthing space, ensured I had the things I needed to feel comfortable, gave DH the space to do nothing but exactly what he and I wanted rather than having to worry about anything, and generally made me feel like an incredible goddess, doing a normal but wonderful, magical thing. She held my hand and said encouraging things and cried when our son swam into the world, and then she left us to our new bliss at the right time and came back a couple of days later to debrief, feed me homemade granola bars, kindly and gently support me and not judge me about how difficult I was finding breastfeeding (again), give our baby a bottle while I had a little cry and give me many hugs. I still see her occasionally and I am amazed every time at how good she makes me feel. I am convinced that my positive mental health and bonding with DS are in no small part down to how much compassion she showed me before, during and after labour. Not everyone wants a doula with them in labour and some people are horrified at the thought of a non-medical professional seeing them in such an intimate way, but if it’s something that interests you, do some research and find someone you click with. If finances are an issue then look into hiring a trainee (as we did) or apply for funding. Lots of information can be found at Doula UK.

3. Your body is strong but it is also delicate and needs to be taken care of. If you think you have any kind of prolapse, hernia or other pregnancy/birth related injury, don’t suffer in silence. There is a whole community of professionals out there who know how to help, but these are issues that people feel uncomfortable talking about and so many women are in pain as a result. Start with your GP and if they’re not helpful for any reason, look into physio, post-natal fitness specialists etc. There is so much help available. MuTu, which I’ve already written about, is one option for post-natal fitness, or a specialist personal trainer like Vanessa Barker (who is a friend of mine – there are many people like her though so look for someone local to you if she isn’t!). You would be surprised how many people have incontinence issues, pain during sex, spasms, tears that don’t heal etc etc. They’re not so common that pregnant women need to worry about them excessively, but they do happen, and if they’ve happened to you, you are not alone. I’ve been lucky with both pregnancies and births in physical terms, having a second degree tear with both that healed easily. I know several people who weren’t so lucky and getting help as early as possible is key to a swift recovery!

4. In many parts of the world the post-natal woman is positively tended to hand and foot for a significant chunk of time – up to three months in places. After DD’s birth as soon as I was released from hospital I was UP, entertaining, making cups of tea for visitors, keeping busy, keeping in charge, keeping in control. This was all despite my husband and mother both being there – I had no need to be out of bed, but I felt that somehow I must. In retrospect, this made my physical healing harder and it made my mental state more shaky. This time around one of the women leading our ante-natal Mindful Breath Birthing course said something that really resonated with me – that post-natal women who have had straightforward births need to try to spend roughly five days in bed, five days on the bed and five days near the bed. I did. It was bliss. I stretched, I did my pelvic floor exercises, I pottered a very little around the house (to the bathroom and back mostly!), but mostly I – and the baby – were in bed. If anyone wanted to see us, they came to us. I didn’t make a single cup of tea or a single meal. I just recovered, stayed mostly naked with my mostly naked baby and, as far as possible with a tiny, fragile, up all night newborn, relaxed!

5. Babies are different to each other, including to their siblings. DD arrived after an awful labour experience, screamed a LOT as a newborn and then slept through the night and self settled from 3 months. DS arrived after an amazing labour experience, doesn’t cry very much but also doesn’t sleep for longer than a couple of hours or self settle, and he’s 6 months now. If you’ve got one and you think you’ve got parenting nailed, you may be in for a shock when the next arrives! But they’re different in wonderful ways too. They have their own personalities and their own wondrous gazes and their own amazing ability to poo at 40mph. Even when you’re at the end of your tether and just. want. to. go. the. fuck. to. sleep. they will surprise you and make you laugh through your gritted teeth. Babies are hilarious, tiny dictators. And even if you’re sure you never want to go through it again and you’ve decided you’re definitely done with having children, the sight of a tiny new one will make you ache.

That’s it really. If I ever have a no. 3 I’ll write another list!

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Another birth story

So while I’m here I thought I’d put up my birth story, which I wrote recently.  It’s long.  Sorry.

When I gave birth to E it was quite traumatic: it started with my waters going, I contracted for about 3 days, was eventually induced via the drip with a failed epidural and she got stuck at the shoulders and had to be hauled out in an emergency procedure. As well as the fact that she almost died, which was completely terrifying, the more I looked back on it the more I found the whole ordeal humiliating and infantilising. I didn’t trust my body and neither did the medical professionals, rightly or wrongly, and despite learning hypnobirthing exercises while pregnant, in the event I only found them useful for the early stages of labour, before I was told I had to be induced. I was determined that with my second birth things would be different!

We attended an antenatal class called Mindful Breath Birthing which at first seemed extremely hippyish but which we ended up finding invaluable. The basic premise was that if you were mindful and in the moment, experiencing each contraction and breathing through it without engaging through thinking, things would unfold as easily as they could as all the right hormones would be present. Calm and relaxed equals oxytocin flowing and a body that does what it’s made to do, while stressed, fearful and thinking equals a body that’s hampered by too much adrenaline and less likely to work properly. Obviously none of this accounts for emergencies with the baby, but I definitely felt that with E’s birth I had felt under so much pressure to give birth within a certain time frame due to my waters having gone that I was almost certainly too stressed and frightened for it to happen. If I hadn’t been so stressed, perhaps I would have laboured more quickly, not been induced, not been on my back with an epidural and not had shoulder dystocia.

The other thing we did differently this time around was to hire a doula, M. E’s birth had been traumatic for all of us, not just me, and at one point J had ended up literally shoved into a corner by doctors and midwives where he was left to try and see what was happening, convinced our baby had died or was dying. We wanted to have someone else there who we could trust had our best interests, and only our best interests, at heart. Midwives and doctors and nurses are amazing but they’re bound by the legal interests of the hospital as well as their commitment to the patient. Doulas are there purely to offer emotional and practical support. They don’t offer medical advice or get in the way of the professionals, but they protect the birthing mother’s space in a way that it’s difficult for the parents themselves to do when under pressure, in pain, or frightened. Over the weeks before the birth M helped me as I battled the hospital’s (wrong) diagnosis of gestational diabetes, attended emotional meetings with me where I was talked out of a home birth by midwives convinced this birth too would end in shoulder dystocia, hugged me when I was upset and provided constant, gentle support.

I had awful PGP in the final weeks of my pregnancy and on the 12th I had slipped in the bathroom and done the splits, which would have been painful enough at the best of times, much less when 41 weeks pregnant and suffering pelvic girdle pain. On the morning of the 13th I had been very relieved to get E into nursery for an extra day, so I could take the day off from toddler duty and just lie down attempting to get comfy. At about 5.30pm, lying on our bed I suddenly felt the tell tale ‘pop’, stood up and felt a familiar gush of waters. I managed to waddle to the bathroom but had forgotten that once they go, they keep going! I called J to tell him that things were starting, and he was about to finish work anyway and pick up E so he did that and got home by 6.30. I also texted M to alert her as she had her own childcare to sort out, but said that I didn’t know how quickly things would progress so not to come round yet. At 6 my contractions started but they were very mild and easily breathed through, so I didn’t consider them ‘real’ labour. When J got home he put the TENS machine on for me, as it works better if it’s on from early labour, and I called A, who was going to come and look after E for us if we had to go to hospital in the night. I told her not to come yet as we didn’t know whether we’d be going in that night at all, and it was her husband’s birthday! She completely ignored me and got in the car, so was with us by about 7.15, which turned out to be a very good instinct of hers. She and J gave E tea and put her to bed and at 8 I moved into the bathroom as the contractions were coming quite regularly now, about 3 in 10 minutes, though they were still relatively mild. I wanted to kneel and lean over my ball so the bathroom seemed the easiest place to be, as well as easily wipeable! I texted M again to say they were coming quite regularly now and she was with us by 8.15.

I was using the boost button during contractions and M brought candles, rubbed my back and gave me Clary Sage and Frankincense on flannels to sniff, as they’re both supposed to encourage the body to stay in labour once it’s started. She talked when I wanted to but was otherwise a quiet, calm presence. It was really comforting for me to have her there, and it also meant J could go off and do things like eat, pack up what we needed and not have to be with me all the time. At about 8.45 she asked whether I thought I’d like to go hospital but I was convinced that I wasn’t in full blown labour, despite the now very regular contractions, purely because the pain was so manageable. I remembered with E feeling like I was going to die of pain (!) and this was nothing like that. I said that I really didn’t want to go in only to be sent home again, and that I’d rather stay at home for as long as possible. At 9, with me getting quite a lot more vocal as I was doing a sort of loud hum through the contractions by now, she said that she thought if we were going to go to hospital, we should really go soon. In retrospect I realise that she and J were trying to convince me for a little while! I agreed as the contractions were feeling more intense now, and J called to tell them we were coming and packed the car while I went to the loo (which I was relieved about as a full bladder can get in the way of labour) and rocked through the contractions.

The drive to hospital was only 10 minutes (over a million speed bumps) and we were there by about 9.30. I was slightly annoyed because they initially took us into one room and then changed their minds because the lights didn’t work well enough – which I rather thought they could have checked out before we arrived – but very quickly we were in another room and M had turned the lights out for me anyway! One of the reasons I’m so glad we had her with us is that she made our birth plan just happen. It all seemed to fall into place and I didn’t even have to say a word; I had been worried that I would have to argue for some of it but she just quietly made things happen and I didn’t have to think about them at all. So the lights were extremely low, there were candles, everybody whispered, I had no vaginal examinations (something I had been certain I’d have to have an argument with the midwife about), I wasn’t coached to push and the midwife, F, barely spoke. I was completely free to focus on my breath and be mindful and in the moment. The contractions really stepped up as soon as we were in the room (testament to how relaxed I was feeling I think) and I was leaning over the back of a sofa, beginning to feel a bit ‘pushy.’ There was one moment in particular where I felt like I was getting out of control and I shouted ‘I can’t do it!’ and M was right there, pushing down firmly on my lower back and saying quietly, ‘you are doing it.’ It was exactly what I needed to hear and I had a funny little out of body moment where I suddenly thought, ‘I am in transition!’ Which was quite encouraging really, as it meant I had to finally realise that this really was labour.

By 9.45ish the pool was ready and I asked J and M to take off my TENS pads. I didn’t realise at the time, but they actually managed to electrocute themselves while doing this as they forgot to turn it off first – and it was up at full whack by this point! Once it was off I got in the pool and was able to start using gas and air to help with the pain. I don’t think it actually dulls the pain but it does a good job of distracting from it and it made me feel a bit woozy in quite a pleasant way. I tried a few different positions in the pool, which was a bit disappointingly shallow. I wanted to be on all fours as much as possible so I leant on the edge and kneeled. The next day my chin really hurt and I realised that when I was pushing in that position I’d managed to bruise it on the tiles. M was there with cool flannels and sips of water whenever I needed them, and J held my hand and kept whispering encouragement. The midwife wanted to check the baby’s heartbeat between contractions (and in retrospect was clearly quite scared about me being in the pool, given E’s birth, but she didn’t say a word at the time which I’m very grateful for) and I got a bit irritated because it meant I kept having to move back so she could get the doppler onto my stomach, so I switched to a sort of lying on my back position, where J and M held one hand on either side and I floated, pushing and squeezing their hands for support and something to press against. Each time I pushed my whole body and head bobbed down under the water a bit and M said afterwards that at one point she and J looked at each other and shared a ‘hope she doesn’t drown’ look! I still had the gas and air at this point and after I’d been pushing for a bit the midwife suggested I stop using it as it was making my pushing less effective. I was a bit reluctant to give it up but she was absolutely right because as soon as I stopped using it I was able to be much more mindful again and really focus on pushing. Part of me wishes I hadn’t used it at all as I think he’d have been born sooner, but it was nice at the time so I don’t regret it.

My pushing got a lot stronger and, just like with E, I felt that my body was sort of doing it without me. I could feel everything moving him down and the midwife could see his head but he wasn’t actually moving out. I didn’t think about shoulder dystocia at all (thankfully, as I’m sure if I’d thought about it I’d have freaked out and it would have all gone wrong) but I think J, M and F were all thinking about it. If it had happened I’d have had to get out of the pool to attempt to deliver. A woman from the antenatal course had told us the story that when she had her second baby he wasn’t moving out and she turned onto her left side and he was born, which suddenly popped into my head and I turned onto my left. J was holding both my hands, M was holding my right knee up and F had her little torch out but wasn’t touching me when all of a sudden, with one big push and me shouting ‘it stings!’ H swam into the world at 11.07pm. I couldn’t believe it! F guided him to the surface and into my arms. At some point a second midwife had come into the room and sat quietly in a corner; I only noticed when she just as quietly got up and left. No shoulder dystocia, no trauma, no emergency at all – I don’t think I’d really believed it was possible until it happened. The whole thing took less than 6 hours.

M continued to work her magic and J, H and I were left alone in the peaceful, calm dark for a good while, just staring at each other, having skin to skin and laughing and crying, just as we’d asked to happen on our birth plan. Eventually F came over and said the cord had stopped pulsating so we could cut it now if we were ready – she did ask if J or I wanted to but neither of us could quite bring ourselves to! The lights were all left low and the atmosphere was lovely. After I guess about half an hour I wanted to get out, so she helped me out of the pool and I sat on a recliner chair with H. She was doing some paperwork, M was tidying up her bits and pieces and J was picking up my clothes from the floor when I suddenly felt a bit pushy again so I just shifted slightly to the front of the chair and all of a sudden the placenta pretty much fell out of me – absolutely perfectly into a cardboard bowl that F had left there. It was weirdly funny at the time as it was so quick and I don’t think anyone expected me to accidentally ‘aim’ so well! She was quite excited by the fact that the third stage was natural as she was newly qualified and in her whole training she’d only ever seen women birth the placenta with the injection. It was also the first birth at which she’d ever met a doula, and it was her birthday! Once the placenta was out and we’d turned the lights up she got quite chatty and was absolutely lovely. I’m so grateful to her that she was willing to go with our hippyish ways and take the lead from M in terms of the birth plan – I think we were very lucky to get someone so amenable and so kind.

After a little more cuddling and some initial attempts to get H to breastfeed F examined me where I was sitting in the chair and said I’d need some stitches, so we ‘transferred’ across the corridor to the more medicalised rooms with beds, and she said I had a second degree tear and stitched me up. As with E’s birth the local anaesthetic didn’t work so I had gas and air for the stitching, which wasn’t too bad. M held my hand and J held baby H! Then M gave me a banana and a breakfast type bar, as it was about 2am and I hadn’t eaten tea and was starving, and we had lots more skin to skin and breastfeeding attempts. We could hear a woman next door screaming in pain and F said she was having a difficult birth but had a needle aversion so wasn’t having any pain relief. I felt awful for her – I wish she’d had a doula to calm her! M went home to get some sleep after giving me a witch hazel spray for my maternity pads and some herbal stuff for the bath to promote healing, F cleaned up and weighed H in at 8lbs 15ozs (on our birth plan we’d asked for him to not be taken off for cleaning and weighing until there had been lots of opportunity for skin to skin) and I had a shower while J had more baby cuddles. Then H had his first dose of vitamin K, which we wanted him to have orally rather than by injection. The final thing on our birth plan was that we didn’t want to be in hospital for any longer than absolutely necessary, and at about 4am F came and said we could go home once she’d finished up the paperwork. By 5am we were at home and at 7am E woke up, came into our room and said, ‘that’s my baby brother!’

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