Birth story - Abi and baby Charlotte

*Trigger warning* - low Papp-A, extra scans, theatre delivery, suspected placental abruption.

The pregnancy

My pregnancy was discovered pretty late at 8 weeks as I had covid around the time of my missed period and blamed many of the symptoms of tiredness & funny tastes on this for a few weeks before it dawned on me I was pregnant. I had morning sickness to around 16 weeks.

After the 12 week scan we were relived to have all the screenings come back with low risk so told our parents (this is the first grandchild on both sides). A week or two later I got a letter through the post saying that these screenings had flagged and issue in my blood work and I had something called low Papp-A which could indicate that my placenta is not working as well as it should do. There was a very scary list of additional risks attached to this ranging from late term miscarriage to pre-eclampsia, premature birth & low birth weight. At this point I was told I would need additional scans every 3 weeks from 28 weeks onwards.

This news scared us and meant we delayed telling people about our pregnancy. There wasn’t seemingly much I could do, so we just continued and tried to not worry about it. However, it did mean I knew home birth was unlikely and the extra facilities at a hopsital were advisable as we may need them. This meant I never really had a very formal birth plan, I described it more as preferences. I knew things might not go to plan and I had gone from low risk to high risk.

28 weeks rolled around and we had our first scan and an appointment with the obstetrician. He was lovely & very reassuring. He said 9/10 people with low Papp-A will have totally normal pregnancies and that the extra monitoring is just a precaution to ensure baby is growing nicely. We started to think of the extra scans as another opportunity to see our baby that we wouldn’t have got otherwise. We were scanned every 3 weeks until 37 weeks and maintained growth on the 50th percentile.

29 weeks I got covid again from the office. I knew exactly what it was this time around and couldn’t believe I was pregnant with covid for a second time in my third trimester. From this point until 38 weeks when I stopped working I mostly worked from home with only 1 day at the office.

Shortly after this I did the PBC hypnobirthing course in the 40 degree heat wave. It really changed my mind set that birth would be positive, not scary and I felt well informed. We had also been on an NCT course and they complimented each other nicely.

The Birth

The week of my birth started with the Queens funeral and I remember watching bouncing on my ball and feeling a few twinges and thinking please not today. The next 2 days we had our hot water tank moved with more twinges, again I was thinking please not today. Finally we get to Thursday and now the plumber had gone I went into full nesting mode with the help of my mother and we did a lot of cleaning. I also went for a walk around our village and made a lentil dahl for dinner. I thought it was ok to have a baby now and by 8pm we were watching Paddington and I started to feel regular twinges. My mum went up to bed around 10pm and I said to my husband at this point that I didn’t want to say anything in front of my mum & over excite her but I thought that I was in labour.

Throughout the night I bounced on my ball, we watched happy films (the sound of music & Disney films) and I used the Freya app to coach me with breathing and timing contractions. By 4am I was in established labour so rang the maternity unit. They advised me to take paracetamol & run a hot bath. I did this but it really slowed things down for me. Our bath is very narrow and I was worried about not being able to get out. I quickly got out and went back downstairs to my birthing ball.

My mother came down at 7am having heard us running baths etc but stayed out of the way. She has since said to me how impressed she was with how composed I was. I had popped my hair into two French plats and looked very chilled. By 9am Freya was saying established labour again so we rang the hopsital who asked us to come into the Day Assesment Unit. Here they did a VE and I was 4cm which wasn’t enough to be admitted to the labour ward they wanted 5cm. So we went back home with some codine. I took this, jumped in the shower and then went to bed for a couple of hours as I had been awake all night and tried to get some rest for what lay ahead.

I woke up in constant pain about 2 hours later. I could not cope with this pain, there was no let up between contractions to go from amber to green. In fact I could hardly feel the contractions through the pain. I knew in my gut something wasn’t right and asked my husband to run us back to the hospital which we arrived at around 4.30pm. Again we were sent to the day assessment unit. Another VE and I was 7cm so we could finally go to the labour ward. I was in a lot of pain so this was great news. At this point I was not using the app anymore as the pain was constant so the coaching didn’t help.

We got given a pool room at 5.15 which really lifted my spirits and made me think ok I can do this. I am now here in the right place and we have a pool. My husband started to unpack the bags and get things set up. The midwife offered me gas & air which I was very happy to take and offered me pain relief. However, she quickly noticed I was breathing it all the time and not just in the contractions. I said the pain was constant and across the front of my belly. She felt me and next thing I know there are several other people in the room. A monitor was popped directly on baby’s head and by this point they could see baby’s heart rate dipping and mine increasing and we were told that baby needed to come now for both our safety. There was no time for written consent or additional pain relief. Being wheeled down to theatre I was told it would be a c-section under general anesthetic as this was the quickest way to deliver baby. My husband again was asking all the questions when I really could not, advocating having done the course with me.

When we got to theatre I was scared but everyone was lovely introducing themselves by name and saying they were here to look after us. My husband wasn’t allowed in because I was going under a general. However they checked how dilated I was and I was 9cm which meant they could try and push me to 10cm and do a forceps delivery which I immediately said Yes to. I really wanted to avoid a c section if possible and definitely a general anesthetic (I’ve never had one before). It worked and they pushed me to 10cm whilst I puffed away on the gas & air. My husband was then allowed in. He stoked my head which was the most reassuring feeling in the world.

They told me, ‘right it’s time to push this baby out. You need to push too.’ I breathed in deeply and then pictured blowing out candles on a cake and with 3 or 4 big pushed & the forceps she was born. I heard her cry immediately and they held her up so I could see she was a little girl. She was fine and immediately placed on my chest where I said her name was Charlotte. My husband was allowed to cut the cord which was white so we assume we did still get delayed cord clamping.

In the recovery room we had 2 hours of skin to skin & breast feeding.

Despite the situation becoming an emergency they did so many things we would have wanted had our birth been a more natural one.

Ultimately hypnobirthing kept me calm and got me to 7cm and I am pretty sure had things not started to go wrong with my placenta (which was always the risk with low Papp-A) we would have continued to use it.

It might not be the birth I had planned but I know when baby no 2 comes along we will definitely repeat the course.

We have both used the breathing techniques since at times when we’ve become overwhelmed so it’s really a life skill.