When birth doesn’t go to plan…again (Part 1)

Abbe Bates - 30 Jun 17

He’s finally here. Gus Neil Whittle born at 7.27am on Saturday 10th June.

After quite a traumatic birth with my first son, I had hoped that this birth experience could be more positive.

Here’s what happened (it’s quite a long story so this is Part 1):

LABOUR AND DELIVERY

I had always planned to try for a VBAC so if labour did not start naturally, I was due to be induced at 11 days overdue by having my waters broken and then if labour did not progress within 4-6 hours, another c-section would take place, or if my waters could not be broken, it would be straight to a c-section.

At two days overdue, I had an obstetrician’s appointment where it was discovered that my blood pressure was high so I had a sweep and we talked about bringing the induction date forward to that Friday.

I returned the following day, which was the Tuesday, for another check and my blood pressure had gone down a bit but I was starting to get anxious about everything being ok so we agreed to stick with an induction date of that Friday.

During the week, I had a few mild contractions but they were very irregular.

On the Thursday, it was my pre-clerking day for the original c-section date, which had always been planned and I was told it was best to keep that appointment.

This is where it all started to get a bit confusing. The set up for an elective caesarean is actually very good and that is the procedure you follow on pre-clerking day. There is a dedicated caesarean midwife that has recently been introduced who makes sure procedures are followed such as delayed cord clamping. But the midwife unfortunately had the day off on the Friday I was due to be induced and there is no other caesarean midwife so the careful procedures she has put in place sometimes become patchy when she is away.

If you are trying for a VBAC, it all gets a bit muddled because you are processed as if you are having an elective caesarean when you will be trying for a normal labour first. So I was given anti-sickness pre-meds to take the night before, which means you can’t eat past 2am. Therefore, if you are trying for a VBAC, you are setting yourself up for labouring on an empty stomach.

I was able to look around the wards and the theatre though, which was a really nice thing to be able to do as it made everything seem more familiar.

Then I was asked to come back in on the Friday morning to have my waters broken. Friday morning came and we arrived at the ward. It became clear that continuity of care was a problem as staff seemed unsure whether I could now eat or drink as I’d taken the pre-meds. It was decided I would be checked to see if I was dilated enough to have my waters broken and if so then I would be able to have refreshments, which kind of made the taking of the pre-meds a bit of a pointless exercise.

It was decided my waters could be broken but the delivery suite was very busy that day and so from expecting to go straight in and be able to be admitted to the labour ward, we had to wait on the antenatal ward, where it got to lunchtime and it was not looking likely that there would be space for the next few hours. With an increasingly busy ward with women in some discomfort waiting for delivery rooms to free up and one twat of a partner listening to a film on his iPad at full volume next to us, I asked if we could go home and wait there as it would be a bit calmer. That was fine and the staff said they would just ring me as soon as there was a room available and if we didn’t hear from them, then to come back again in the morning.

At 5pm, I got a call to say that I could come back in and this time we were able to go straight to the delivery suite, where we had a lovely midwife who got everything ready for the induction and the consultant came and broke my waters. It was quite difficult as I was only 1cm dilated so pretty painful and it took a couple of attempts and I had to have my legs in stirrups. But at this point I just wanted to get on with things, having had quite a stressful build up, even if perhaps my body wasn’t quite ready. There was a mention that it was seen as a challenge to break a woman’s waters at this stage, which did leave me with an image of some sort of obstetricians’ scoreboard as they high-fived themselves behind the scenes on succeeding in particularly difficult cases.

I had always stressed that although I would accept ARM as an induction technique (artificial rupture of membranes), I did not want the syntocinon drip, which mimics the hormone oxytocin that encourages contractions, as with my first son, this had not worked but labour had been long and painful, and baby had got into some distress, leading to a Cat 1 emergency c-section.

So the consultant on at the time respected this.

Then there was a shift change and it all started to go wrong.
The midwife who I had felt so comfortable with came in and apologetically said that she was finishing now and would have to pass me over to a different member of staff.

I immediately had a bad feeling. The midwife taking over from the offset was uncommunicative, closed off and under confident. I later discovered she was an agency midwife, but more of that later.

She offered hardly any direction or reassurance and just sat in the corner most of the time, with either a slightly worried look or her head in reams of paperwork. She made no attempt to develop any kind of rapport or relationship with us.

Labour started off ok and gas and air was fine. I’d brought in a birthing ball as it was important that although I was being monitored I could move around. l was promised that this would be possible but, in fact, I was told off for trying to sit up and as the labour pains got more and more excruciating, I was virtually pinned to the bed. All I could do was grab the back of the bed for support, which meant I damaged all the muscles in my right shoulder. There was no encouragement or direction on how to make things more comfortable.

At this point, I thought it time for an epidural. I had to ask for it – nothing was forthcoming or suggested. Unfortunately, there was an emergency c-section taking place and so no anaesthetists were available, so I had to wait about 2 hours for one.

At this point, I realised I was pretty much on my own with all this, which meant I was panicking quite a bit. The only thing I could do to deal with the pain was to scream at the top of my lungs – “help me”, “I can’t do this”, “I’m going to die”, and “fuck me” (I really didn’t give a shit about my dignity at this point) – all met with a slightly panicked look from the midwife but not much else.

By this point I had dilated to about 7cm and I felt I needed to both push and poo myself, to which the midwife merely grunted so it was unclear which I was supposed to be doing, so I ended up doing neither.

A new consultant had come on shift at the same time as the midwife – it was like the worst tag team possible – and had made it his main aim to ignore everything I had asked to be followed. He kept trying to convince me to have the drip so amidst crippling labour pains I was having to have an ongoing battle with him not to use it.

I can only describe him as like Stephen Merchant playing a comedy doctor but in no way funny. Amongst some of his gems that night were:

“You’ve been screaming for six hours already, it would be a bit of a waste if you didn’t try and continue for a natural birth” once I had had the epidural.

And once I was at 7cm dilated, “Ha, I knew that would happen. The threat of the drip always makes women dilate quickly.”

At this point we were past the point of six hours after my waters had been broken. Pah – well that promise was meaningless too. The consultant decided to leave me to labour through the night as he was convinced I would further dilate. By 6am, I hadn’t progressed and he dropped into the mix that I looked like I was on the verge of a septic infection so we’d better do a c-section, 6 hours after it was supposed to happen. Funny that – feeling like I was in a prison rather that a hospital with rubbish support from medical staff meant my cervix didn’t want to play ball. Can’t think why.

When we did arrive in theatre, it was a much better experience. Everyone was very professional and kind, they were clear about what they were doing and my husband was able to come in with me, whereas I had been on my own with my previous c-section.

Adhesions which had formed from the previous operation were fixed and Gus came out healthy and alert, and we were able to take photos and enjoy the moment.

I appreciated the chance to have a better caesarean experience but it left me angry with myself for trusting the system to support a VBAC when in reality, it is so stretched at present that it really isn’t capable of that, and I would have been better off opting for an elective c-section in the first place.

I then went into the recovery bay and was looked after really well and treated like a human being. It was only once I was on the post natal ward that I became known as ‘B4’…

Abbe Bates

I'm an editor and writer. Blogging about the elations and frustrations of life, from parenting to pregnancy loss with some travel in between. Consultant Editor at Landor Travel Publications, including GTO magazine and regional group travel guides.

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