Tuesday 12 March 2013

Cat







                                                      Dotty


Cat Dartnell, a tellmeagoodbirthstory buddy had two very different births with her first child Arthur, and then her daughter Dotty . But she placed herself at the centre of both - the key, without doubt, to a positive birth. What her lovely tale shows too, is how a sense of humour changes everything. Being able to laugh in labour is one of the most powerful coping tools of all.


My first pregnancy was an enlightenment – I had no idea how you had a baby. I was one of the millions of women who had fairly overwhelming doubts about how one of those could come out of there

I happened across an active birth yoga group - it had a discussion element. I was amazed! Still scared, but intrigued that there could possibly be a way through this.

During my months spent there I came to believe that 
a) people could have babies
b) it didn’t have to be a medical emergency, 

and very importantly 

c) the bonds of friendship you make whilst pregnant with other ladies in the same state as you will get you through almost anything.

Alongside this wonderful process, my completely adept, yet stubborn placenta appeared low on every scan. It stayed so low that I was admitted to hospital at 37 weeks to be observed. 

I was so frustrated. I felt so well, and I wanted to know what birth felt like. Couldn’t they see how far I’d come? I’d gone from utterly ignorant to wanting this, in the space of just a few months. And now…

My section was scheduled for 39 weeks. I found the countdown unbearable – the thought of major surgery  coming my way. No stopping it. Yet it was the only way to have this baby without us both perishing. 

The operation was what it was – easy, quick, alarming, productive. Arthur was born in a procedure that took 15 minutes. It was fourteen hours since I had eaten or drunk and someone had just given me a baby. It could have been a hallucination, it was all so strange. 

From then on, my recovery was textbook. It didn’t hurt. The epidural wore off, my legs came back to life, and off I went. 

My experience taught me some useful things. The surgery saved our lives. It was done brilliantly and the same can be said of the midwives and nurses who cared for me. This is not, however, how to have a baby. 

Not for me anyway. I now know that I never want another epidural unless I have another section. I know that a perceived emergency can wait longer than you thought. I know that being able to eat and drink is not considered essential in hospital. I also know from watching others on the recovery ward that going through a section is a piece of cake if you haven’t been through a long, hard labour first. In one way I am very lucky to be armed with all this information. It helped me approach my second birth with some sense of what I wanted.

On my son’s first birthday I discovered I was pregnant again. I returned to my yoga and started enjoying the process again. Except this time round, I was classed as high-risk. All of my choices for birth were taken away from me.

I was faced with a midwife who I liked very much, but who thought hospital birth was the safest option for everyone, low and high risk alike. She also thought that epidurals were amazing, having had two herself.

I had two consultant appointments where a registrar asked me if I wanted to try for a vbac. I said yes, but I wasn’t happy about being stuck on a monitor, and I wanted to use water in labour. The first time I was brushed aside. They only wanted to know if wanted to attempt a vaginal birth, and give me some statistics about rupture and a leaflet, nothing else. At a second meeting, I asked again - same stats, same leaflet, and when he went to ask if vbacs could go in water, 
we heard laughter in the halls. 

I could see myself being sucked into a highly managed, highly interventionist birth. I was stubborn, but didn’t feel brave enough to labour through that. I couldn’t understand why, as a person who had a risk factor, I didn’t qualify for a more supportive attitude to help me birth successfully. I was beginning to see why people ditch the system and go independent. 

After much soul searching (and spitting furiously), I consented to labour on the delivery ward with mobile monitoring and use of the birth pool if it was available. The consultant midwife helped me to write a birth plan, and my yoga teacher kindly consented to be my doula. 

Even so, I felt that everything was a battle. I was a petulant child, stamping my foot.  And no matter how I felt, or what I said or did, I was powerless against the argument that if I was the one rare case of rupture, I would have sacrified my baby’s life if I did not do as I was told. 

The doula and I worked out a good plan of action. I would labour at home and when I felt I needed her I would call. She would tell us when she thought it was time to transfer and we would leave it as late as we could so as to get a good proportion of my labour done where I was happiest. 

My Braxton Hicks became strong and visible in the latter stages of my pregnancy, just as they had before, but I knew they were nothing. I enjoyed them. On the Saturday before my EDD the feelings began to change. They had a more period pain like discomfort to them. They were a shock to begin with, but my body accustomed itself to them and after a few hours they tailed off. The next Saturday the same thing happened! And the next!! Was this my uterus’ version of a night out? 

Each time they began, they were uncomfortable but my body got used to them. I figured my body was teaching me something – that if I waited and let my body do what it knew to do, it would cope and the feelings would become more bearable. 

I was now a few days over my due date and wondering if I was going to take months to give birth if I kept having a week off in between bouts.  In answer to my question the contractions began again the next day, in the same way as they had done before - except this time they kept going.

My body did its thing and each time they stepped up a gear, I would move around and they became bearable again. Such a magical feeling! Was it painful? I suppose there was pain but there was so much else too! 

Knowing that I was actually fortunate to experience this and that I wanted it helped me along. The contractions were now beginning to direct me. I was unable to ignore them, but I could happily talk between them. Henry called Nicole, the doula, as I had taken up residence on my knees with my head in the corner of the sofa. 

Nicole arrived at about seven or eight in the evening. She came and lay her head next to mine, put her hand on my back and told me I was doing a really good job and coping well. 

Like magic, the pain lessened immediately and time lost any meaning. I knew suddenly that I could cope, for hours and hours if need be, and importantly - for as long as this process meant me to. 

Had we not had that sense of knowledgable support we would have probably gone to hospital soon after that point, but Nicole said that for now we were fine where we were. 

We listened to music and I hummed and waggled through the contractions. And then it was time to go in.

They heaped cushions into the back of the car and I clambered in, face down with Nicole beside me. The music was transferred to the car stereo and we all sang our way into the hospital. 

I remember the car clock said 11.40. Nicole stayed with me as Henry had to park and we made our way to the delivery suite, stopping to huff and puff now and then. The place was practically empty. We were shown into a room and I laboured there for another hour before a midwife came and introduced herself. 

She gave me one VE. She was quick and managed it between contractions and it was completely painless. She announced that I was 8cm and we’d better get the monitor on. 

At one point I forgot how to use my breath, but I looked at Nicole and she simply breathed for me. I joined in and was back in charge. I had had a few puffs on the gas and air by this time, but then the feelings began to change. 

My body was wanting me to push. Now I had a job! It felt better to push than anything else. I don’t remember feeling any of the things that people say are common in transition. I didn’t think I couldn’t do it, I didn’t think I was going to die, and the sensations had spaced out and become bearable again. 

I could even sway to the music again between contractions. I remember the midwife and Nicole telling me I was doing really well and I looked at Nicole again. Again she directed her breath, differently now, and I followed suit.

I think I had been happily making progress for about forty-five minutes when a male doctor came in unannounced to let me know that I was only allowed to push for an hour. If the baby hadn't arrived by then,  he would use a ventouse. 

Had I not been completely otherwise engaged, and on all fours, I would have kicked him as hard as I could. Everyone who was not labouring away, made him feel deeply unwelcome. The midwife said I was close. She whispered that he said that to everyone. But by now, I was feeling the stinging sensation of Dotty’s head.

I presume no one was expecting her just yet as they were all up my end. Then her head appeared and I could feel her shoulders and  I remember thinking ‘bugger this!’ and pushed the rest of her out too. 

I was almost surprised that I had delivered a baby. It was just past three in the morning and we decided that Dorothy Betsy should have the name Cariad too – a welsh word meaning love or darling – it was Valentine’s Day after all! 

I learned so much from her birth – that my body could cope with this other-wordly process as long as I went with it,; that the right support is priceless; that my scar was as strong as the rest of me.

I also learnt that a birth plan has to be watertight (I had asked for my third stage to be managed as the midwife considered appropriate – meaning that if all was well they could wait for me to deliver the placenta, not Do What You Like), and that as informed as you think you are, there may be pitfalls – why did no one think it important to tell me that I, as a vbac, would only be ‘allowed’ an hour for my second stage? 

I’ve learnt that some people think it’s acceptable for a doctor to barge in and scare women when they are at their most vulnerable (and yet powerful). I am not one of those people, and feel that behaviour of that kind is a trespass against me and all the other women that are subject to it. 

What did you imagine when you went to hospital in labour? Whether you went voluntarily, or were transferred, I bet you thought you’d get appropriate care. Truth is you get the care that’s available, which may or may not be appropriate to you. I did ok – I got my vbac, but it happened because of who I took with me. 

It could easily have been very different and is for so many women. You may be lucky and get staff that truly support your wishes and use evidence based practices. I don’t intend to gamble. I want to KNOW that my interests are top of the list of my care givers and that there’s a damn good reason for doing what they do. I’m pregnant again now. Despite all that I’ve learned and all that I know, I’m facing exactly the same barrage of statistics and hospital policies as before. I’m not fighting this time. This time I’m staying at home.

Saturday 23 February 2013

Juliette




                                                                         





                                                                                                          

Juliette's daughter Annabelle arrived on New Year's Day.
Here she shares her good birth story…


Annabelle started making her move at 3.30 in the morning, on what would become New Year's Day. It was two weeks after her due date.

I felt pretty strong stomach pains, like really bad period pains, but since I'd been getting those on and off most nights for a few weeks I didn't get particularly interested. 

Then I went to the loo and had the start of a show, so I guessed that this time might be different. 

I was excited and relieved as my husband Rhodri and I had decided that 14 days over was our cut off point, and that was the next day.

The period-like pains got stronger as daylight arrived, but with no pattern or rhythm until that afternoon.  Even so, they were intense and I was glad I'd been prepared for that otherwise I would have taken them much too seriously. 

As it was, I just moved from bedroom, to living room, to bathroom, and tried different distractions and ways to get comfortable.

The breathing was absolutely essential, with all my attention on making my out-breaths really really long. As well as the slow deep breathing, I had been told by my active birth yoga teacher to sprinkle a few drops of lavender on a handkerchief, and breathe it deeply in and out during the contraction. It really worked, and offered a great deal of soothing and comfort when the contractions were happening. The ritual of it - having that thing to do when it came - was just really reassuring. 

I used a birthing ball which was good for resting my upper body on and swaying while kneeling and I did something similar leaning on the bed supported by pillows.  I also spent quite a time on my side in bed, my legs propped with a pillow, and with one to hug and one down my back too. Being able to give way to the support was really helpful - it meant I really  made use of the rests.

At about 3.30 in the afternoon my waters broke.  It really was a gush, following a particularly strong contraction.  From then on the contractions really picked up in strength and pace.  Rhodri called the hospital to let them know, and they aid to stay at home for a couple more hours.

I'd been told to expect this and was ready - by now the contractions were really strong, and I was having to moan. But I knew to follow what they'd said, as that was the way to be sure I was in established labour. 

In any case, it felt good to stay where I was - I retreated to the bathroom,almost instinctively. It felt safe and private, and I just closed my eyes. The more inward I went, the more in control I felt. I  could almost feel how each contraction was changing things around inside me - the baby moving down I guess, and that gave me confidence, stamina in a sense to carry on and trust my body. 

By now, I felt a pretty constant urge to go the the loo, which was another reason I loved the bathroom, and Rhodri just went with that - keeping out of my way, delivering drinks and checking I was comfortable, without disturbing me or making me aware. 

By 5pm things had become incredibly intense and I couldn't focus on anything other than the contractions.  They had picked up pace and there wasn't much of a pause between them.  Plus the pressure in my bottom was getting more and more impossible to ignore.  I'd felt a real urge to have a bath, but by the time we'd run it and I'd got in the contractions were so full on that Rhodri said we had to go.

For a split second I hesitated as I quite wanted to stay put and have the baby there with paramedics. But in the end we went.

We arrived at the hospital at 5.30pm and thankfully it was very quiet. I was so in the zone anyway, breathing and concentrating on what was going on inside me, that  I didn't care.  I was calm in fact, and just remember feeling that I just needed to get on and have my baby.  

We went through to triage, to be assessed, and by this point my legs were shaking so much it was hard to stand. Rhodri told the triage lady that we really needed to go through as I felt the baby was coming any minute.

To our great shock, the woman put down her pen, turned slowly to him and said 'I'll see to her when I've finished her paperwork'.

When I look back now, on what she did, I feel outrage. I was vulnerable, in great need - and her callousness was breathtaking. Given she is the first person, labouring women meet, it seems incredible that a person such as that can even be in such a job. 

If I hadn't felt more confident, I would have felt totally dismissed by her treatment, like I shouldn't trust what I was feeling. Fortunately, she was forced to take notice, when a minute later, a load more water gushed out onto her floor, and she agreed to check.

I was 9cm dilated. We were taken straight to a room with a birthing pool and I got in. Now everything felt back on track, as the midwife we had was lovely and unintrusive. 

After a good hour or so in the pool, trying different positions and feeling relatively relieved from the pressure of each contraction by the water, we decided that I should get out as things weren't really progressing - the baby was as low as could be without crowning but not going further.

As I got out of the pool it became apparent that the baby had done a poo. I briefly knelt resting on a birthing ball but within a few minutes lots of new people were in the room. I was examined and then told that I had to get on the bed as they were worried about her heart rate. 

I did't want to lie back on the bed but was kind of led there. I could feel they were anxious about the baby's heart rate and said they would need to use a suction cup. I said no at first, and then another doctor came in and basically said I had no choice. The midwife more kindly explained that the baby's heart rate was dropping to 90 during contractions, and so we agreed. 

Looking back now, I feel that I was a bit bulldozed. I've since spoken to another obstetrician and they confirmed that the heart rate wasn't extreme and I now find myself wondering whether they could have helped me another way - for example by suggesting another position and at least trying for another few minutes or so. I would recommend to other women, to actually find out what the heart rate could and should be at the point of pushing, as in that situation, when you don't know what you need to, you are very vulnerable. 

We went ahead anyway, had an episiotomy  and with three hard pushes our baby was out.  The feeling when she was arriving was amazing, literally a sensation of pure life. It turned out that she'd had her arm over her face which was probably what stopped things progressing so well.

Overall, my labour and birth felt very positive,  even pleasure. I felt confident and in control - and the only thing I'm left wondering about is to what degree that woman being horrible, and then being told how dilated I was, disturbed that. It's true that you have to be ready for a change of plan - but I do think that continuity, trusting your body's flow and keeping your brain out of it, is the key to it going easily. 



Many women go into hospital from the point where contractions start coming every three minutes, due to misinformation from books and birth education classes.  But counting contractions is not a reliable way of knowing you are in labour. Labour is a state - NOT the amount of contractions you are having.

It is true that contractions need to be coming strongly and regularly every 2 to 3 minutes, but for most women, these need to stay at this rhythm for another couple of hours, which is what the hospital advised Juliette to do, and which is very reliable advice. 

Occasionally, and it really is occasionally, women are in established labour with the first 3 minute interval, but the reason they would and do trust this, is because other things are in evidence too - physical changes, a noticeably altered state.

When a woman is in true labour - that is the state where her body has agreed to open up - she will feel changes over and above the regularity of very strong contractions - something different happening - and partners will see and feel it too:

.  she will instinctively want to retreat from light, open space, any stimulation or disturbance. 
.  she will need to be on all fours or leaning
.  it will feel helpful/even unavoidable to make noise. 
.  she will find herself having to concentrate during the contractions, and also in-between. 
.  she will feel a heaviness in her bottom, like when you need a poo

All these things are an indication that the woman's thinking, rational brain has stepped back, and the deeper, automatic part of her brain responsible for labour is now running the show.  Oxytocin, the petrol that drives labour, is flowing well. 


Juliette paced herself brilliantly - because she knew what to expect. She had no fear, only confidence. She knew that until all the above was in place, she should think of it simply as 

                                                 HER BABY HAVING IDEAS

This phase can be anything from a few hours to a few days.

Once her waters had broken and she'd retreated to the bathroom, only then was she 

                                                              IN LABOUR  

If more women were helped to understand what established labour feels, looks and sounds like, they could set their expectations accordingly. It can feel a tall order to stay at home until labour is established, but if a woman is ready for it, and has in place the right support and a range of comfort measures, most women, regardless of temperament, pain threshold or strength will cope well and labour has an optimal chance of progressing smoothly. 




Monday 21 January 2013

Sarah


                                                                 
                                                                             
                                                                           

Sarah's baby girl Imogen arrived towards the end of 2012. Despite lots of unexpected twists and turns, it turned out to be a very good birth story…..


I was always fairly confident in my body - and about birth, so when I passed the 41 week mark in pregnancy, it was a bit unsettling. I felt normal, but the hospital started to make me feel like I was not. 

At first I kept a handle on it, but at the end of week 41, the midwives told me that I was putting my baby in danger and that my risk of stillbirth would double after 42 weeks. One midwife just shook her head at me and said: 'You do realise you placenta could pack up in labour?


I'm not one to cry - but when I phoned my husband and my doula, I was properly sobbing, completely shaken up. I was so confused. At this point, I could feel some faint cramping, and deep inside felt I needed to trust my body. But now I also felt frightened - and started questioning whether I should.

I pushed for more information, and later that day, a consultant doctor  quantified the risk - it turned out it went from 1 in 3000 to 2 in 3000.  I was amazed. Why hadn't they just explained that instead of employing such terror tactics? I'm sure like me, many women would happily tolerate such a risk, set against the much higher risks involved with induction. Why hadn't they balanced the information, so that I could make a decision as an adult, rather than scare me, and make me feel helpless?

I went home anyway, and that weekend was hard. Every evening, contractions would start - but go nowhere. My doula visited, and we tried to be positive but by Monday evening, we both felt sure the problem was the position of the baby - that it was in my back as I was having quite a bit of back-ache.

By Monday evening, I felt ready and happy to go into hospital, as it was my decision. I'd given my body a proper chance and now it did feel like time to draw a line in the sand.

It made all the difference making that decision myself, rather than being bossed and frightened into it by the midwife two days before. I now felt ready, in control - and though I was about to agree to some intervention, I also felt completely linked to my unborn child. When I'd been told off, like a child, it was like my connection to my baby was cut - like I was nothing to do with it all anymore. Now I was linked again. And it gave me confidence.

They broke my waters, and the contractions started at once, around 10pm. I progressed quickly and I could feel changes, so we got settled into our room and I started moving around, rocking on all fours, breathing well. Best of all, we were given lots of privacy - completely left alone. I don't know whether it was intentional, but it worked. 

At midnight, a consultant came in and ominously drew up a chair . 'The situation wasn't good,' she said, there being a meconium stain in the waters, me being so late, and that I was only 2cm, and they wanted to augment the labour with a syntocinon drip. 


I knew she was just doing their job, but I also was surprised at the way she didn't consider the bigger picture.  For example, I was feeling really different, like everything was much more intense and that labour was ramping up. But it was like what my body was doing was irrelevant. On paper I wasn't progressing, and that was that. If I hadn't known I had a choice, it would have felt non-negotiable. And yet wasn't there good argument for waiting and seeing - given my baby's trace was perfect and I felt so well?


'What do YOU want to do?' my doula asked, bringing me back into the picture and it took me less than a second to know the answer -  if I continued in the direction I was going in, all well and good - if things stalled then I'd reconsider. It felt good to have made that choice, to feel firmly in the driving seat and I remember feeling this incredible calmness. 

So we were left alone again, but shortly after, the cracking backache I'd been feeling returned - and now it was unbearable. I couldn't respond to the contractions at all, and could only hold my breath and resist. It was like I was fighting it. We tried every position, words of encouragement, but it wouldn't go. The midwife just thought I wasn't coping, but my doula could see how I had been, and that this was different - the baby in my back. 

I decided I wanted an epidural. It felt like the only way - but I intended to use it wisely. Once administered, I made sure I was on my side, had all the lights switched off, and closed my eyes. There were no artificial hormones in me, so this way, I knew I was giving my body, and the oxytocin, the best chance to do their thing. Two hours later, the midwife came in to rouse me, and said I might start feeling some pressure soon. But I already was. By the time I sat up, I could feel an incredibly strong sensation and when she returned, I already had my leg on my doula's shoulder and the head was coming. It was all so quick - another midwife ran in, just in time to catch my baby on the bed. 

There were many moments in my labour, where the outcome could have been different if I hadn't been able to feel confident in my own instincts. My birth experience really enforced for me the importance of having good support. I am American, and live in the UK - but loads of contact with my sister who'd had a wonderful normal birth and always encouraged me to do the same, was very powerful. If ever I was in need of a boost, or worried about something (like being overdue), we'd speak and I'd always regain my perspective and end up laughing. I also had the support of a great doula. 

My birth story ended up being very different from the one in my mind, I didn't have the surprise baby born at home in the bathtub; I had to wait a long time for her;I felt a lot of pressure to be induced; I had to have my waters broken; there was meconium; I had to be monitored; I had an epidural. But then there was the best twist - despite the interventions, it was just one night. An experience I was completely in control of. 



Sarah's experience is a great example of how important it is to remain open and flexible about labour and birth. At every twist and turn, she re-positioned her thinking, kept her humour, stayed in tune with her baby...and the result was a good birth story. She is proof that having to accept interventions, does not mean giving up control. 

Monday 10 December 2012

Hannah





                                                                               




Both of Hannah's babies were overdue, by NHS standards, very overdue….even so, she trusted  her first baby to give the cue and had a positive and simple birth at 42 plus 3, with labour starting spontaneously. With her second, she chose to be induced - and went on again, to have a second positive birth experience. Here she tells why - and how.....


When I was 42 weeks and 2 days, I had an assessment scan and found my baby to be perfectly healthy, with an optimally-functioning placenta. Afterwards, I had a meeting with a consultant midwife at the hospital, to talk things through. She agreed to support my plan for expectant management - I was to go in to be monitored daily, to ensure my baby's wellbeing. She also supported my wish to give birth at home should I have gone into spontaneous labour.

A plan was also made in the event that I should choose induction. I was to be supported to give birth on the midwife-led unit, in water if I should desire, with intermittent monitoring.

As it happens, I chose induction as I personally found the wait caused me anxiety (I have suffered from anxiety issues/panic attacks in the past).

This whole process was incredibly important to me. I simply was NOT happy to be induced according to anyone's timetable but my own.

I had to request this individualised care - it was not offered. It was simply assumed that I would have 1, 2, 3 sweeps, then hey-presto: be induced at 41+5 according to hospital policy. Well my policy was different. 

I was always clear that as long as baby was healthy and I was ok, I would wait.

When I did decide to go ahead and have an induction, it was my choice, not theirs.

In the event, labour took only 3.5 hours from the first contraction after they broke my waters, until he was born. It was totally manageable and much easier than my first birth, physically.

There were some concerns about my baby's heart rate during transition and it did look at one point as if a c-section would be needed for a quick delivery. I was rushed into theatre, which was not nice. However, again my wish to avoid intervention was listened to and honoured: The obstetrician halted her theatre team (who were prepping me for a spinal), and made them hold back whilst I pushed my son out into the world.

She LISTENED to me. She WATCHED me. She OBSERVED me and what my body was doing.

I believe that it was down to my determination during that scary time, and the obstetrician's sensitivity that I avoided a c-section, and subsequently will go on to birth my future children without a scar in my uterus.

My experience was positive and that is very much down to the respect I was given by my community midwives and the consultant midwife. They didn't try to bully me, or scare me into towing the line. I was supported to make an informed choice. They listened to me, and my husband, and they accepted that the decision was ours.



There is an incredible amount to be learnt from Hannah's birth stories. There is of course always a risk with going over 42 weeks, but when midwives and doctors explain this to women in this situation, they rarely if ever quantify that risk in useful percentage terms. 

More often, women are read the riot act, or bulldozed with loaded statements like, your risk 'doubles' after 42 weeks...  which of course mathematically it does. But if women knew that the doubling was from a 1% risk of placental failure, to a 2% risk, they might not feel as scared - or as irresponsible as they are so often made to feel.

I think it would be true to say, that all round the country, pregnant women who are overdue, feel pressurised into sweeps and inductions - and genuinely believe they have no choice in the matter. Certainly it doesn't feel like choice when a medical expert implies the situation is dangerous, or that you are irresponsible - and fails to balance that information with the risks an induction will also bring.

The last woman I was doula for, declined induction at 42 weeks and while being monitored, was told by a midwife, 'you do realise your placenta is likely to pack up in labour don't you?'. She was so frightened, she couldn't stop crying. 

Of course, the maternity system needs to inform women that there are certain risks in these situations. But the key word is inform.  Given our maternity service's watchword is 'choice', shouldn't it be the case that a woman advised to have an induction, is IN THE SAME CONVERSATION told the risk of a syntocinon drip - informed of the cascade of interventions a drip is likely to trigger?

Perhaps if the risks were presented in a proper and balanced way like this - in a way that treats women like adults  - more of us would, like Hannah, feel able and empowered to make an informed choice. 

For some that would be to wait - as Hannah did with her first, and for others, that risk would still be intolerable and they would agree to induction - but as Hannah did for her second birth, on their terms. 

Such an approach is absolutely KEY to getting a good birth experience. Even if an induction ends in an emergency c-section, when a woman enters into it with this mindset - with a sense of control - she almost always comes out the other side with a sense of acceptance and satisfaction. 

The difference I see as a doula when a woman draws her own boundary, as opposed to being frogmarched or even frightened into it, is immense. The three inductions I have attended in the last two years, where the woman has done the deciding, remains the agent in her birth process, and feels respected and trusted by her caregivers,  resulted in utterly normal, spontaneous deliveries. 

As well as being informed, it is absolutely crucial that women ask for meetings, as Hannah did.  Talking to a midwife or consultant, where a woman can be heard and helped to get an appropriate plan, helps her to get OFF the obstretric conveyor belt and  create a relationship with her caregivers. It is, after all, in relationships that we get the chance to communicate, where both parties' viewpoints are seen and heard. When there is a real opportunity to air feelings/fears/wishes, and trust is built. It really is just a case of picking up the phone and asking. Hannah's meetings were the key plank to her entering her induction with confidence.  So follow suit. Turn unknown territory into something more known - and you are much more likely to have a good birth experience. 





Friday 30 November 2012

Ella

                                                                           
                                                                               

                                                                               


Cloudea, Ella's second daughter was born quickly and easily, at home in her bedroom. Here Ella tells us her good birth story....


My contractions started on Monday morning, coming on quite intensely just as they did with my first daughter.  However,  I knew it wasn't established labour, as once my toddler woke up things slowed down and  I had the latent phase everyone talks about.

I spent the day doing all the things that you’re supposed to do to pass the  time... I had a bath, went for walks, I even baked a cake!  And then I went to bed.

Between midnight and 1am I had some strong contractions and then suddenly, a very big one that made me scramble on to all fours. 

I went to the bathroom and soon I was standing over the bath, gripping on to the edge with a relentless cycle of intense contractions.  

My partner was trying to time them, but since it was hard to tell when they were starting or finishing, she called the hospital.  A midwife said she'd be with us in half an hour.

I really wanted to get to our bedroom, where we’d set up a nest.  Like last time, the contractions came on quite violently and suddenly, and I was struggling to find something to hold on to – in both the physical and psychological sense.  But once I managed to get to the bedroom,  I was able to shut everything else out and focus on my breathing.  Now I was anchored. 

The midwife arrived at 2.15am and wanted to examine me and listen to the baby’s heart beat.  I was kneeling on the floor with my elbows on the bed, and she asked me to lean back on the floor.  Every time I tried to move the contractions became more violent, but I eventually managed to sit on the bed, and when the midwife found I was already 8cm, she went to the gas and air, which I'd asked for.

I was able to get back into my kneeling position and the midwife could check the baby’s heartbeat without disturbing me.  In my birth plan, I had said that I would prefer to stay in my zone, and asked that any communication be done through my partner.  I carried on riding out my contractions using my breathing and the gas and air when they were really strong, and then my partner whispered in my ear .

“The midwife is worried that the baby is getting tired, so you need to push on the next contraction”.  I sat up and said “What?!”  I couldn’t believe it was time. 

I remember reaching down and feeling the top of her head and feeling incredibly excited – so spurred on to push her out. The midwives guided her down but left her between my knees, for me to pick up.  It was so amazing and exciting reaching down for my beautiful baby.  I held her to my chest and she grabbed on to me with both hands and I thought I’M IN LOVE!

It only  took a couple of pushes and she was here, born at 3.30am!  A two hour labour! 

The midwives helped me to get comfortable, went and made me a cup of tea and then left me, my partner and our baby.  It was amazing – the middle of the night, all was still and peaceful and we were able to enjoy the first magical moments with our new daughter, in the comfort and privacy of our own bedroom. 

I thought my first daughter's birth, also at home, was amazing and I really hoped to be able to give me second daughter as good an arrival. Her birth was even better... it's not often that you hear words like 'peaceful' and 'exciting' in birth stories, but that is exactly how we describe this birth. I almost wanted to push her our again!


How I love Ella's nest. She couldn't have highlighted the most basic need of labouring women better. A private place, with utter peace and quiet to retreat to. And as soon as she got it,  now that she felt 'anchored' as she put it, her body could do it's thing. There was nothing for labour to snag on, no disturbance to derail it's flow....right on cue, with her body's needs met....the labour powered off and her baby came.  Honour the physiology, help the hormones flow, and birth can be simple. 

Thursday 8 November 2012

Melissa

     


                                                                       

Melissa's son Oliver was born at home, on September 19th.  She chose to give birth alone, with her husband and a doula to support her. 


During my second pregnancy, I opted for minimum contact with maternity services and began to consider freebirth. What appealed about the idea was the freedom and control it gave back to women and birth. I could imagine nothing more peaceful than allowing birth to take over with no interference. The more I thought about having midwives present, the more I felt it would be detrimental to my birthing experience.

I don't have a personal issue with midwives or hospitals. I think they do an amazing job under great pressure. But I don't believe that all women automatically need care in such a systematic way.  Our bodies are designed to give birth, it is a normal physical function and if the woman is healthy and the pregnancy low-risk, it's my belief that birth does not belong in a medical setting or need over-seeing by medical experts. I believe in a woman's ability to birth successfully provided she is surrounded by the right, supportive environment that she was able to make an informed decision about.  

As my pregnancy progressed and I gained more knowledge I knew I wanted to give birth alone. I did not have a specific due date as I had no ultrasound. I knew I was due sometime late September. 

On the morning of the 18th I woke up having mild contractions but by lunchtime they stopped. At 5pm I had a show and contractions started picking up again. They were very intense coming every 20 minutes or so. At 8.00pm my partner, David and I settled our daughter, Sofia,  into bed. During this time the contractions became closer together but remained erratic. I ran a bath but began to feel extremely dizzy and sick. I was feeling afraid of the pain and so decided to contact our doula, Tina. 

I followed my bodies cues and feeling the need to be on all fours I knelt on on the floor, resting against the bed, face down in the duvet. I used David's hand and leg to help me through contractions, pushing and squeezing while he held our daughter asleep on his other side. 

Time seemed to passed slowly and I didn't realise just how fast things were progressing.  I was gradually feeling as though I was losing the ability to speak and all  I could think about was water. It was now approximately 11.30 and David suggested I try the bath again.  As I tried to get up, I leaned back from all fours and the pain was intense. With David's help and a lot of concentration, I eventually made it into the bath. As soon as the water touched my skin, I felt instant relief. As I lowered myself down the water transformed the sensations. The contractions just came and went and I was completely still, silent and intently focused. 

When Tina arrived, David went to help her with the pool leaving me alone in the bath. I thought about the idea of getting up, walking down the stairs and getting into the pool and it seemed like an impossible task. Then quite suddenly I heard a loud pop and a small gush of red came from between my legs followed by a stinging sensation. I laid back as I felt my body in complete control. A familiar sensation overtook me as I instinctively seemed to seize up and bear down. I let out a loud noise that I couldn't hold back. Tina came straight up to the bathroom and sat by my side holding my hand. We both knew my baby would be here soon. I still felt afraid and holding her hand helped me feel strong. 

As I began to push my baby out I reached down to touch him. I felt the unmistakable feeling of his soft scalp and hair. With every push I could feel his whole body.  It felt as though my body was moulding  itself around his, easing him into the outside world. I felt excitement as his head appeared. I could feel our baby moving under water, half way between my body and the outside world. I began pushing again, his shoulders moved out and again a short pause before the rest of his body finally emerged in the water. I immediately lifted him up and put him to my chest. The rush of emotions and pure relief was incredible. 

I remained in the bath for around an hour and a half, chatting with Tina and eating toast.  I delivered the placenta in the toilet, then cut Oliver's cord. I rinsed and checked the placenta, keeping it to one side as I planned to encapsulate it myself.

I am now beginning to process this experience and place it's meaning  within the context of  my life. It feels like a true achievement,  I have experienced something really special, a moment of absolute clarity, control and freedom in a world that frequently limits our choices and confines us within very narrow margins. It has been a journey that has opened my eyes to new perspectives about life and birth.


Thursday 25 October 2012

The Arrival of Tommy


                                                                                                            

                                                                                   

The Arrival of Tommy Hunt..... 

At 5am or thereabouts, on a cold morning last December, I woke up with a slight discomfort. My waters broke. I was amazed/terrified/exhilarated and bewildered. I called out to my husband from the toilet ‘Andy, it’s started!’. 

I was aware it could still be a very, very long time before we met our baby so reassured Andy we should just get back into bed and sleep.  

Within 30 minutes or so mild contractions had started, but I still wanted to stay in bed and was almost in denial about what was happening. I wanted our doula to know that things might be unfolding, so sent her a text and then carried on pretending it was a usual Monday morning. 

We decided to watch a film in bed. I then remembered that keeping things normal,meant I should still eat. So we went downstairs and had porridge and tea. All the while the contractions were getting a bit more distracting but I was determined to carry on ignoring them. Frozen Planet was the next show on TV, I’ll never be able to look at polar bears in the same way! Whilst they were padding about on the ice, I was on all fours in our living room feeling like one of them...

I’m not sure what happens to time when you’re on your journey to having a baby, but I certainly have no concept of it looking back now. I remember retreating to the bedroom and kneeling by the bed with my head under the duvet. I suddenly felt the need to be alone, focus and have a word with myself. The contractions were becoming stronger and I got quite emotional, I needed a big hug and reassurance from Andy, and then I needed to be alone.

My doula arrived. I was so pleased to see her. She and lovely big inhales of lavender oil got me through another couple of intensive hours. I remember wondering when it might be good to go to hospital, and then feeling that actually I wanted to be at the hospital, so around 2pm, we left. The journey was bizarre. Initially my contractions slowed, but then once under a big blanket in the back of the car, I concentrated on keeping going, I really didn’t want to lose the momentum that was building. I felt that as long as I let it, my body would know what to do. My long, slow breathing, helped me stay on top of the waves of pressure I was feeling. 

Arriving at the hospital scared me, the contractions were getting stronger and faster, which was good but I didn’t want to be distracted. I felt that as long as I focused I could handle it. We arrived and I was on the floor, on all fours. My eyes were closed, and I was concentrating deeply so I didn’t feel remotely self-conscious. Being right inside myself, felt a safe place to be and I just wanted to be able to carry on and let it happen. 

A midwife approached and started asking questions.  I gestured that my doula and Andy should speak for me - I couldn't afford the distraction. They both knew that I wanted a natural water birth and I did not want to know how far dilated I was, just whether I was truly ‘in labour’. The midwife was astounded, but I was adamant. I had planned this as I knew that if I was given a number of centimetres dilation, I would focus on this. Too much and I may have panicked that the baby was coming too soon - too few would mean disappointment. 

Fortunately, the midwife confirmed I was staying, but there was no birthpool available. My heart sank. I had only really prepared myself for a water birth. However things were ramping up and I had no time to feel too sorry for myself. My doula assured me we could use water for pain relief and went to run a shower. I began to feel I was losing a bit of control here, I’d managed to stay calm so far, counting my breaths and knowing exactly how many breaths each contraction lasted and knowing a break was coming.

We went into the bathroom only to discover no hot water. With  cold water on my back…I lost it. I'd been holding on to the idea of hot water and now I felt helpless. I remember asking my doula for pain relief of any kind and quickly. She calmly and reassuringly suggested I try gas and air before anything else. The midwife set this up and it gave me amazing relief and the confidence boost I had needed. 

However I was still nervous of where exactly I was going to give birth. I wanted to be in a pool, I’d only ever imagined being in a pool. The room we were in felt stark, I didn’t want to be on a bed and I couldn’t get comfortable. I don’t know how long we were in this room. I was so focused on breathing, counting, the ramping up and the calming down of each contraction time just went.

I think Andy had a stern word about the lack of hot water, a new midwife started and by some small miracle she found us a birthing pool. I was so delighted. I remember asking her how we would get there, she had a wheelchair for me and when we got to the room, I couldn't believe it - the room was perfect, just what I needed. Dimly-lit, lots of space and the sound of running water as the pool filled. 

The relief of the warm water was immense. I could move more freely and got back into the rhythm of the contractions. Things ramped up, I felt scared, but it was because things were changing and I felt the need to push. My doula was amazing, just her presence reassured me that things were going ok. I felt like pushing lasted an eternity and it was harder than I could ever have been prepared for, but at the same time I knew that my body could do this, I just had to keep going. 

The moment Tommy was born will stay with me forever, there he was ‘swimming’ in the water, I picked him up and couldn’t believe my eyes. He was perfect, beautiful and our precious son.  


What's to learn?

The most important thing to learn from Gemma's great birth, is how she had a grounded and realistic expectation of what real labour was. Even though at home, her contractions were coming every three minutes (while she was on hands and knees, watching polar bears in the rests inbetween), she knew it was unlikely to be labour, from the simple fact that she could tolerate the telly.  A woman in real established labour just wouldn't want or be able to engage in that way - the stimulation would be too much.

She knew, because she'd informed herself, that true labour was more of a state, and that though the contractions demanded some attention, they didn't demand all of her.

And then that changed...quite suddenly, after a trip to the loo. Now her bedroom felt a better place to be.  Peace and quiet, darkness, privacy.  These were the things that now helped her to cope and drop deeper. 

Now something more established was taking over - technically, (though as she rightly said it's far better not to get hooked up in rational numbers and measurements) she would have been 4cm or so, which meant her body had started the work of opening up. 

This can feel intense, an acceleration, as Gemma puts it....'a ramping up.'  Certainly it's tempting to rush into hospital at this point, and even feel a little afraid. But the best thing to do is as Gemma did, 'have a word with yourself.'  Remind yourself that change almost always signifies a GOOD thing, progress....and to trust that. What is happening is right, not wrong, and to find your feet with that. 

Take one contraction at a time, go with the flow, and labour proper gets a chance to take a hold. When this happens, a physiological momentum builds and it is far less likely that labour will slow and stall.

When women stay at home for an hour or two once contractions are very strong and regular, (see the tellmeagoodbirthstory page on helping labour to happen for more 'proof' of labour) they usually arrive in hospital full of sturdy confidence - they can feel for themselves that it is working. There's no panic, no need for rescue........she trusts her body to take her to the next stage.  

And a final word about the car journey...in case you are thinking you'd rather 'get in early' fearing the journey in will be uncomfortable, note this. The advantages of the quick and efficient labour that is likely to result from waiting at home that bit longer, FAR outweigh the discomfort of the car...especially if you are on hands and knees in the backseat, leaning into a sturdy pile of pillows (never use a baby's carseat as a reason not to do this....it's a priority and sitting in the front with a seat-belt on will wreck the best of coping rhythms)