Birth story - Dee and baby girl

*Trigger warning* - PROM, Contractions (not a TW for me), induction.

Pregnancy -

I was very fortunate to have a straight forward, healthy pregnancy where I felt supported by my midwife, partner and circle of pregnant friends. However, I did struggle with knowing the adverse statistics associated with maternal mortality rates for black women in the U.K. I found myself not able to to fully enjoy my pregnancy due to worries about the “what if’s.”

Things that helped change these worries were following/supporting the FiveXMore campaign and taking on board the hypnobirthing principles.

I went from being terrified of being another sad statistic to feeling empowered - together with my husband we decided that from conception to delivery we’d play an active role in the birthing of our daughter instead of just being participants.

Final week of our pregnancy -

At 37+4 weeks after a textbook uneventful pregnancy (strong and regular foetal movements, baby head down in optimal birthing position since 30 weeks, confirmed as being 2/5th engaged at 36 weeks, healthy maternal BMI etc) I started vomiting while watching TV. After running to the bathroom to cleanup I returned to the living room where I noticed a wet patch on my sofa. As I couldn’t be certain if the patch was amniotic fluid, urine or water I decided to monitor overnight.

The next morning I was still none the wiser so attended triage where I asked them to complete an internal exam to confirm either way. To both mine and the midwifes surprise my exam returned a faint positive- my hind waters had began leaking latest the previous evening. The midwife also confirmed my cervix remained posterior, closed and long ie not ready for a vaginal delivery.

Labour -

The midwife and doctor recommended admitting me there and then for an induction. But using my BRAIN I pushed to return home and attempt spontaneous labour with my husband/birthing partner in my safe space. I was told the higher infection risks had if I didn’t commence labour within 24hrs of the leak. I compromised and offered an alternative of returning at 24hrs post PROM for a gel to be applied to soften my cervix. In that moment I felt very empowered to advocate not only for myself but also my baby.

That evening I returned to have the gel applied and due to higher priority emergencies this took place at 30hrs post PROM. On the the insertion of the gel the Dr mentioned I was now on the induction route and as such the MLU was now out of the question. My husband and I challenged this stating that the birthing centre offered telemetric (mobile) monitoring and that as such, as long as my cervix opened baby could still be monitored effectively in the calm environment of the birthing centre. Though seemingly shocked at my challenging her she recognised and agreed.

Overnight I received a message from a friend stating the MLU birthing centre was to be closed for at least a month due to staffing issues. I knew that given my EDD I was unlikely to birth there so started discussing how best to pivot my birthing preferences. The following morning (37+6) I was clear that my cervix hadn’t softened (I just felt that the contractions I felt overnight post gel insertion weren’t enough). I agreed to starting synthetic oxytocin but declined further internal exams, my basis being I had found them extremely uncomfortable. The midwife was surprised but ultimately understood it was my choice. She then suggested possible pain relief options (gas and air, epidural, pethidine) to use along side the oxytocin drip. I declined them all saying if my contractions became powerful I’d re-asses. For me my contractions weren’t powerful enough to warrant pain relief so instead I used affirmations and breathing techniques.

I commenced a 10hr drip from a low dose of 3ml/hr getting to 48ml/hr at 6hrs. During this time my uterus began contracting. I used my breathing techniques (in for 4 out for 8, moved on a birthing ball, moved around my room into various positions, affirmations, music etc) and though the contractions were strong I moved through them with ease. The machine registered that for 2hrs I was contracting approx 3 in 10mins. I felt nothing but minor discomfort. The medical staff including my mother (via phone) were surprised I was so engaged, able to eat without prompting and generally happy through all of this. At 6hrs I was asked if I consented to an internal exam - though I had reservations I ignored them and instead focused on the fact I was (I thought) in active labour and a step closer to meeting my little girl. Unfortunately, the exam revealed neither the gel or oxytocin had caused any significant changes to my cervix since the day before. I was so deflated.

Post exam I met with the consultant who recommended an epidural be combined with the oxytocin then manually break my forewaters or a c-section. Once again my husband and I used our BRAIN when discussing these options alongside remaining on synthetic oxytocin w/o pain relief. Ultimately, my biggest concern was that my waters had broken over 50hrs prior with no sign of cervical movements and though me and my baby girl’s BP/HR/movements were strong there was a high chance this could change at any moment. Add to that the risk of baby becoming too sleepy to make the journey though the birth canal might result in a stressful emergency c-section. I decided that given the circumstances an elective gentle c-section was the best option for me.

In my birthing preferences I had specified if it got to this option (a c-section) I wanted a gentle section, to be spoken with throughout , delayed cord clamping, skin to skin and my husband to cut the cord. The consultant was respectful of this.

After a series of delays due to emergency sections taking priority and my having had dinner before the cervical exam that led to the c- section selection my husband and I were escorted to theatre with a midwife, baby’s hat and a nappy. I was re- introduced to the core team, talked through all the steps with my consent sought at each point. All the requests of my section were met in addition to lots of photos (me, baby, family) throughout.

Our daughter was delivered a healthy 7lbs 9oz with strong vitals and a long cord.

Post birth -

I had 4mins of delayed clamping where baby remained skin to skin with me. My husband cut the cord and while the placenta was delivered and my tummy stitched back up my daughter remained skin to skin and used her reflexes to locate my nipple and latch on immediately. At which point both me and my husband cried as breast feeding was always my desire and the potential inability to do so was part of the reason I was so reluctant to have an induction or a c- section.

Post section I returned to my labour ward (NHS single/private) room for recovery where my husband, baby and I spent alone time as a family. Mine and baby’s vitals were monitored regularly and remained stable. Within 6hrs we were transferred to postnatal ward where I was given a private side room. My husband unpacked while I had lunch then breastfed baby.

As I didn’t like the feeling of being confined to bed or not being able to effectively look after baby independently once visiting hours ended I started to move around my room catheter in hand. My doctor had initially suggested 24hrs post section to remove catheter but because I felt strong and demonstrated being able to shower independently etc they removed it within hours.

Our baby is 36hrs old as I type this and we are being discharged with a full bill of health . My recovery has been straightforward, section scar healing nicely, baby feeding/urine normally, as am I.

I think my biggest lesson was being able to pivot when circumstances change and remain positive about these pivots. Making informed decisions with available information (question everyone and everything).