Birth story - Charlotte and baby Aneurin

*Trigger warning* - use of the word contractions, difficult discussions with obstetricians, reduced fetal heart rate during labour, second degree tear.

I wanted to give something back to this group by posting my birth story, as in the final weeks of my pregnancy I found myself searching out positive stories of induction and birth beyond 42 weeks. The amazing posts on this group gave me the confidence and knowledge to fight for what I wanted, and I hope my post will help those who find themselves in a similar situation.

A bit of background… My first was born by elective c-section in 2019, as he was footling breech. I hadn’t done much antenatal education, so was underprepared, and the communication in the run up to the operation, and during, was very poorly managed. Consequently, I suffered a very difficult postnatal recovery. Fast forward to my second pregnancy and I realised that knowledge is power, hence completing the PBC pack.

I had a very healthy pregnancy and my only risk factor was aiming for a VBAC. I decided that I wanted a relaxed birth in my own environment and planned for a home birth. I am used to reading and critiquing medical research for my job, so I scrutinised the evidence base associated with VBACs, and based upon my personal circumstances, perceived the risks to be low. I had discussions with two obstetricians and the consultant midwife, and at 36 weeks was stepped down to midwifery led care, and booked for a home birth. If I’m honest the discussions with the obstetricians were particularly challenging, but I found listening to the positive affirmations helpful in regaining my confidence afterwards.

I naively thought that my baby might make an early appearance, as he engaged very early and I was struggling to walk by 35 weeks, as he had dropped so low. Instead my due date came and went. My bump had been measuring small throughout the third trimester, but towards the end of the pregnancy the growth scans revealed that this was a big baby. By 41 weeks I was beginning to get anxious that there were no signs that labour was imminent. My routine antenatal appointments were delayed due to the perfect storm of post Christmas, bank holiday backlog, and omicron staff sickness. Consequently towards the end of 41 weeks, I had only just been offered a sweep (which I accepted), and had no further plan of care in place for going post-dates. I had a growth scan that day, which estimated baby to be 9lb 6oz, with normal placenta function and fluid levels. I was aware that I was likely to be offered an induction immediately given that I was already 11 days overdue, but empowered by the findings of the scan, I asked for a discussion with the consultant midwife. She kindly made time to see me that afternoon and we put in place a plan for extra monitoring at 42 weeks. At 42+0 I had CTG monitoring, which showed everything was normal, and a second sweep. I booked induction for 42+2, to give the sweep 48 hours to work.

At 42+1 (the night before my induction) I went into early labour naturally at home. I spent the night weighing up my options and decided that the balance of risk had now shifted in favour of a hospital birth, given the gestation and size of my baby. I attended my induction as planned the next day.

I had spent the night before my induction rewriting my birth preferences. I had specified that I would like to try and avoid IV syntocinon if possible, as I knew that it would increase the likelihood of requiring an epidural, and potentially an assisted delivery. Upon initial examination in the induction ward, despite being in early labour and slightly dilated, it was not quite enough to break my waters. The midwife recommended that I have the pessary for cervical dilation, as it might also help ramp up my contractions and avoid the drip. Sure enough after a few hours my contractions intensified and the pessary fell out. As it hadn’t been in for long, another pessary was inserted, which again fell out shortly afterwards. At this point I was starting to struggle and asked about pain relief options. The midwife suggested a VE and upon examination found that I was 4cm dilated and in established labour. I was transferred to the delivery suite (consultant led unit) and I called my husband to come in.

In my birth preferences I had requested the pool room and wireless monitoring. There is only one pool room on the delivery suite, in which someone had just delivered, so I spent a few hours in another room initially, bouncing on my ball and managing the contractions with up breathing and gas and air.

The shift changed and my new midwife, having read my birth preferences, suggested breaking my waters to speed things up, to give me every chance of avoiding the drip. I accepted this. At this point the obstetrician did her morning ward round. She told me that she had every faith in me and that she would leave me with the midwives, and congratulate me after the baby was delivered. This hands off approach was very empowering, as I had desperately wanted midwifery led care.

Shortly after breaking my waters the pool room became available, and after an agonising walk between rooms, I finally made it into the pool. Unfortunately, it didn’t bring the relief I’d hoped for and after a lot of thrashing around trying to get comfortable, I decided to get back out and onto the birth ball. 2 hours had passed since breaking my waters and I was offered another VE, which showed that I was still only 4cm. Rather than get disheartened, I decided I needed to change tactic. I’d been in labour for about 40 hours by this point (including at home), and I needed a rest. I requested pethidine, which had not been in my initial birth preferences. The pethidine did not take away the pain, but did allow me to rest between contractions.

Suddenly I woke up with a bang. I began mooing and realised that I wanted to push! The midwife quickly examined me and I’d gone from 4cm, to fully dilated in just a couple of hours. Despite being very calm throughout early and established labour, at this point it all got a bit primal. I struggled to coordinate my breathing with the gas and air, so abandoned it, and forgot all about down breathing. I requested coached pushing (not in the birth preferences), as I just couldn’t think straight and listen to my body. This turned out to be really helpful. I tried initially on all fours and then flipped onto my back pushing my feet against some foot plates on the bed.

The next bit is a bit of a blur, but I think this is what happened…

Things were progressing well, but my baby’s heart rate began to dip once the head was delivered. My midwife calmly called in a senior midwife, who told me to try one more push, and then they would have to lie me flat to help baby out. I think they were worried that his shoulders might be stuck due to his size. This spurred me on and I put my chin on my chest and pushed. Aneurin was born without intervention.

I requested the injection for the third stage (another deviation from my birth preferences), as I couldn’t handle anymore pushing by that point and I actually needed a second dose, due to a bit of a bleed from a second degree tear. I enjoyed delayed cord clamping and skin to skin, and was efficiently stitched up. My husband was able to stay with me for several hours after delivery, until I was transferred to the postnatal ward overnight for baby observations, due to light meconium in my waters. We were discharged the next day with no issues.

I have only positive memories of my birth experience. Despite not being the home birth I’d planned, the knowledge gained from the course and this group allowed me to navigate my change in circumstances and make informed choices throughout. I firmly believe that trusting my body to go beyond 42 weeks, empowered by the reassurance of extra monitoring, facilitated such a smooth induction process, as my body and my baby were ready. I also had fantastic care from the consultant midwife, who communicated my birth preferences in advance to the induction unit and the delivery suite. I was cared for by experienced, women-centred midwives, as well as the student midwives accompanying them. They all respected my birth preferences and double checked with me, when I wanted to deviate from them. I was also particularly grateful to the obstetrician on shift, who trusted the midwives and quietly observed from the sidelines. This experience has completely changed my perspective on hospital birth, and I have learnt that any birth can be positive, provided you are fully informed and empowered to make your own choices.