Birth story - Becca and baby Kit

*Trigger warning* - PCOS, IVF/Fertility struggles, 3rd degree tear, blood loss, use of word 'contraction'

Pregnancy:

We had been trying to get pregnant for over 3 years. I have PCOS but it turned out there were issues on both sides so we were referred for ICSI IVF and we finally started our first round in September 2021. I didn't respond to the treatment as expected so we only had one embryo which was transferred back to me on day 2. The odds were stacked against us & we were already planning for our 2nd and final round when the pregnancy test after the two week wait shocked us all and came back positive!

I thought I would be one of those women who loved being pregnant after trying so hard but the reality was very different! I was very anxious and struggled with alot of fatigue and PGP. Plus, I was under the care of obstetrics from early on as I have a slightly irregular heartbeat so they wanted to keep an eye on me. My consultant seemed fairly relaxed about my birth plan but she agreed we would review it as the time drew near. However, I had to cancel my review appointment with her at 29 weeks because I got covid.

When I rescheduled I saw a different doctor. He told me I would not be permitted to give birth anywhere but under obstetric care at the hospital due to my circumstances, despite the fact all my ECGs were normal. Also, I would have to be induced on or just after my due date if I hadn't gone into spontaneous labour because as an IVF mum, my placenta was at higher risk of aging early which would put my baby under life threatening risk. To say he put the fear of God into me is an understatement! I was alone at this appointment and felt very vulnerable.

Fortunately, my antenatal midwife was INCREDIBLE. She reassured me that yes the risks were higher but we were talking going from 0.1% to 0.2% risk. I couldn't be forced into anything, they would assess me and the baby and I would make the final decision. My regular consultant backed this up when I saw her but I had now been reclassified as high risk. I agreed to seeing my midwife for a potential sweep at my appointment I had booked for 2 days after my due date.

The Birth:

Fortunately, all my anxiety about having to have a sweep or induction were a moot point as I had my first contraction just after my breakfast at around 9am on the morning of my due date! They started out as a band of period type pain that went around my back and lower stomach and lasted around 30 seconds. At first I wasn't sure as I had had a few sporadic braxton hicks but they appeared to be settling into a rhythm. By 12pm I started to use my Freya app and they were around every 7 minutes. I called maternity triage and told them what was happening, I said they were pretty uncomfortable but I was coping well at which point I was told to call back when I was having 3 in 10 minutes or when I thought I would need more pain relief.

At around 1pm went for a warm bath but after around 10 minutes I had to get out as it was too uncomfortable. The contractions were now lasting around a minute to a minute and a half but their frequency fluctuated to between every 7 to 10 mins. By 5pm I was really starting to struggle through them, being on my ball and paracetamol wasnt helping much and they were around every 3 to 4 mins. My fiance was massaging my back as we had seen on the videos which did help but soon I begged him to call triage for advice. They asked to speak to me and I answered a few questions, at which point they agreed it was time for us to come in. The 20 minute car ride was the longest of my life!

Once we got to triage, the contractions were coming every 2/3 minutes and they were strong! I was given Gas and air and examined where it was found I was 4cm dilated! I was so relieved that I was being transferred to delivery suite and not being sent home!

Once on delivery suite, I was put into a room that did not have a pool as I wanted but did have a large bath. The midwife and student midwife I had been assigned read through my birth preferences in my notes thoroughly so knew what I wanted but said the doctor on duty would need to talk to me as I was high risk. Which doctor walks through the door 5 minutes later? The one who had scared the living daylights out of me and my heart sank. But this is where my midwives came into their own. The Dr unsurprisingly did not want me to go to the midwife led pool room as he said he would prefer me to have continuous monitoring on the baby to be on the safe side. He said of course the midwives would check the baby every 15 mins but alot could go wrong in those 15 mins and frequently did (!). My fiance and the midwives kept reminding me what I wanted and that I would be more relaxed in the pool environment. I asked how the baby was doing on the monitoring they had done so far and he was doing absolutely beautifully. The Dr reminded me I would not be able to have any other pain relief If I chose the pool (my contractions were really strong, even my midwife said they were stronger than she usually saw and the thought of diamorphine was tempting) and left to let me think about it. I used my BRAIN, turned to my midwife and said "pool please" she gave me a big smile and that was that!

The pool room was wonderful. There were already fairy/tea lights on and my fiance set up our Bluetooth speaker and put on my birth playlist and sprayed my favourite lavender pillow spray throughout the room. I continued with the gas and air in the pool and my fiance coached me through my up breathing and was generally amazing. He tried to get me to eat my jelly babies but at that point I was too in the zone and so he kept giving me sips of lucozade sport (highly recommended for energy in labour!). I had my bloody show whilst in the pool so knew things were going as they should. My midwife and student midwife were incredible, they stayed the whole time but were very unobtrusive and stayed out of our way as much as possible so it was as though it was just me and my fiance. I had stipulated in my notes that I wanted as little interference as possible and minimal examinations and they stuck to the letter of my preferences.

By around 10:30pm my midwife got me out to examine me and see how far I had progressed as I hadn't been checked since arriving and my contractions were still incredibly strong and taking their toll. I had a contraction mid exam and she said I was 7cm but going to 8cm during a contraction. I was a bit disheartened at this point as I was so hoping I would be fully dilated! But she reassured me that this was excellent progression so I got back in the pool.

By now, I'm not ashamed to admit I was tired and did ask a few times if I could get out and have stronger pain relief. But my midwife gently encouraged me to carry on a little longer until this 4 hour period passed and we would reassess it around 2am. If I still wanted the pain relief then I could have it.

My waters still hadn't broke and we were discussing how it wasn't unheard of for babies to be born with them still intact and this was supposed to be good luck! As if my body had heard, at around 1am I felt my waters go with a big pop! At this point, the contractions changed and my body began to push down so I changed to down breathing with them. I was pushing for around 35 minutes when I felt my baby's head rocking back and forth through my pelvis. On the next contraction I felt his head crown but it happened so fast, my body gave a mighty push and his head was out! Because of the position I was in and how fast it happened the midwife hadn't seen he had crowned and I was too in the zone to speak before it happened (the torch she had had broken and she was using the torch on her phone! ) so I had to tell them his head was out once I had composed myself. They coached me through passing his shoulders and body and my beautiful baby boy was born at 1:43am on Monday 20th June to the sound of Alanis Morrisette's 'Thank U' being played. The midwife told me to reach down and bring him up through my legs but once I saw him come out he disappeared! I had to fish around until I found a foot, then an arm and was able to lift him out to my chest. I'm going to enjoy telling him that his first action on this earth was to get lost in the birth pool .

I was able to have skin to skin in the pool for around 40 minutes. I had wanted an hour but because my placenta hadn't delivered yet the midwives wanted to get me out to see if gravity would help. The cord was cut and baby was given to daddy for skin to skin while I got out and was helped onto the bed where baby was given straight back to me (I had also stipulated I didn't want to be rushed into the baby being weighed etc which they stuck to). Once settled on the bed, the midwives helped massage my bump and the placenta eventually delivered on its own with no need for intervention. It was at this point they realised that with the head delivering so quickly that I had a 3rd degree tear (I didn’t even feel it!). Plus the amount of blood in the pool had already suggested this had happened (all in, I lost around 1 litre of blood but was fine) It was confirmed by a Dr and I was sent down to theatre to have it repaired. I was however, able to spend a couple of hours laying with my baby and managed to get him to breastfeed with the help of the midwives whilst waiting for theatre.

Because I'd had a spinal block for the tear repair, I had to stay on the postnatal ward that day. But because we were both doing so well we were able to go home at 8pm that night.

Overall, my birth was so positive. Even though the 3rd degree tear and blood loss happened, the care I received was exceptional and I've recovered really well. My experience was in no small way down to my fiancé and midwives really having my back and helping me stick to my guns. Not just my birth midwives but my antenatal midwife who I saw throughout my pregnancy. I wasn't at all surprised to discover that my birth midwife had trained my regular one. They were absolutely brilliant and really reinforced the idea that your midwife can be your biggest ally. The doctor was doing his job, I understand that. But I used my BRAIN and was able to make my own decisions that ultimately worked out for me and I'll always be forever grateful that I felt empowered to do that.