Birth story - Hannah and baby Mia

*Trigger warnings* - use of words such as contractions, sepsis, emergency and fatality. Discussion talks about induction, and emergency c section (hopefully in a positive way!)

Positive pregnancy bar bleeding for first 10 weeks and morning sickness until 15 weeks. No complications post this, except low iron levels in 3rd trimester and baby breech until 38 weeks.

My waters broke at 8pm on the 23rd Dec. I had spent the day laughing hysterically and I swear this set me off. I rang the triage centre and they insisted I came in to check me over but when I got there they agreed that I didn’t need to have an examination or swab as no one can wee that much (changed the pull ups twice in the car park). I understood that research shows that from that moment, the risk of infection goes up should you not deliver in 24 hours so we were sent home happily to get things going in home environment with lots of oxytocin, walking, resting and visualising baby and birth.

Luckily on my way back from the hospital my contractions started from period like pain, ramping up to irregular noticeable surges that needed my full attention and breathing. I timed one or two but didn’t focus on being too obsessed with them and they were lasting around 30 seconds and every 9 minutes. This pattern lasted from until 5 am Christmas Eve and I felt positive and in control that they were progressing well in time and length. However at 5 am, I changed positions to try and ramp them up and they stopped completely. I was so frustrated and started to unhelpfully blame my body. My husband and I stayed calm and we tried everything to get them back going, but because of the looming deadline I think my body felt too much pressure and we just couldn’t get anything moving. As such we decided to have ‘Christmas’ at home. I cooked a full Xmas dinner and we sat down to eat, watched Christmas films and played with the dogs etc.

When we attended the hospital on the 23rd they said they’d book me in for an induction but I was adamant I didn’t want this so said I would decide on the day using BRAIN. It came to 6 pm on the 24th Dec and I was due for my induction spot at 8pm so we called them to discuss our options. They again asked me to consider induction, and I used the brain model/tool to assess. The nice midwife on the phone said I could go in and discuss it with them and they would examine me ‘externally’ and pop me on a monitor so we could hear baby and see if I was having any contractions to help with my decision making. I agreed this was acceptable and so we went in with bags but with the intention of having a discussion before decisions were made.

I went ahead and accepted induction as I was already having very small contractions that I couldn’t feel and due to my previous infections, and baby gestation, overall I felt it was too much of a risk (especially over Christmas and bank holidays) to leave nature a few more days to see if anything happens and to be honest I was fairly desperate to stop my body feeling like it was letting me down which I now realise I should have challenged at the time with kindness and compassion, I was doing my best to remain in control and I can understand why. As I was contracting slightly without feeling it/knowing and was already 1cm dilated, they took my bloods and gave me a pessary behind my cervix and sent my husband home to get some sleep and let the dogs out incase he was needed the next day. The plan would then be for me to go onto a drip to continue the induction.

However, just as my husband left for the night, I started contracting heavily and within an hour of him being at home, they were strong enough to ask for pain management options to support my up breathing. I asked for some one to come and walk with me as I was struggling with using my breathing exercises on my own and wanted some positive affirmations/support. I opted for paracetamol only at this point. I was tearful and pacing - I just kept feeling I needed to go for a poo and so I tried to just distract myself by dancing around, using the toilet (constantly- mainly to relieve wind) and trying to do a cross word. I couldn’t even hold a pen so this was pointless but it was something to distract. I just felt like I was emotional and excited but tired rather than in active labour. This is when I thought I was starting to not be in control of my breathing and needed someone to remind me and help count to nip it in the bud. A kind lady offered to walk me around the ward but by the time she had told another member of staff where we were going I was having contraction on top of contraction without any gap and I just couldn’t catch my breath between. The midwife noticed this and tried to use various methods of distraction to test out what was going on but she quickly felt it necessary to prepare me for delivery and asked for my husband to return quickly.

Fairly soon though it was obvious I couldn’t talk or get any relief as they were back to back contractions. I was offered stronger pain killers in form or co-codamol and opted for the gas and air. As I kept insisting I needed to poo instead and my midwife kept asking me if I needed to push but I didn’t feel it was that, more that I was just reacting strongly to the pessary (and the Christmas dinner I’d eaten that day!!) so she asked if she could examine me internally again. I agreed and she was shocked I was 3cm dilated. Pessary was quickly removed (it was in for less than an hour) and a call to the delivery team was put in. Although I was not yet in established labour/4cm dilated, due to the intensity and rate of acceleration the delivery ward accepted me and collected me within minutes.

They asked me to walk to the ward but soon realised I couldn’t get a break to do it! So they wheeled me across really quickly in a chair and hooked me straight up to a drip and on to the machines, my first disappointment of having an active birth and not laying on my back was starting to take over my thoughts and I was chanting between gasps that I couldn’t do it and that no one was helping me/listening to me. As my husband arrived I was saying that I felt like I was going to die. I was not in the green zone and I was getting stressed. As such, my new midwife got really firm and reminded me of my breathing and that I was not helping myself by not using my gas and air alongside breathing techniques . She then asked about an epidural as they felt I was going to need something to cope with the intensity and pain together if I was to progress at this rate. I kept saying no but I was clearly unable to do anything productive let alone stay in control/use breathing exercises when I was so overwhelmed by the back to back contractions. Again, she firmly said to me ‘what are you afraid of, we need to ramp them up further and you haven’t given me a good reason why you won’t consider this?’ She used my own language and the model and was really good at forward planning about ‘if things change you’ll have to wait for an anaesthetist and there may not be one available’ so I accepted reluctantly… but boy did I need it, basically it allowed me to be present when my baby was born and it allowed me to dilate to 9cm in the next 3 hours.

Looking back, with the way things played out, I would have had to have been put under a general anaesthetic to have my baby if I hadn’t relented, and it would have meant I wouldn’t have been able to have skin to skin contact to calm me as I was being stitched. I also wanted to see my husband cut the cord and weigh the baby and breast fed her on the way back to the ward so I see this ‘change’ to my wishes as a blessing in disguise!

To continue the story, I woke from a nap - joys of epidural is you can do that (despite that it didn’t block all of my contractions that were lower down my vagina by now!) and I was greeted by a doctor and nurse looking at my observations. They explained who they were and that I was having too many contractions on top of of each other and that they were squeezing the baby too tight and causing their heart rate to increase to a level they considered too high. They also said I was showing markers of sepsis and were concerned about my health (my heart rate rocketed and so did my temperature as well as my body showing signs of infection) so they gave me an injection to loosen my uterus and slow contractions down as well as iv antibiotics and iv paracetamol to try and get everything under control explaining they would give me 20 minutes to see if I was able to continue to labour.

However, my health continued to deteriorate and I became very confused. The doctor explained that we would likely need to think about forceps delivery in surgery if I was ready for the baby to be born or a c-section within next half hour. However within 20 minutes they felt it was unsafe to continue to wait and as such, needed to deliver the baby sooner and all other options bar c section were no longer considered safe.

My midwife examined me at this point, I was 9cm but still a thin rim of cervix remained and as I had been given injections to slow my labour, I was advised I didn’t really have a choice of waiting at this point. I again used the brain model of assessment with the doctor. He explained there were no benefits of waiting as we now had two lives at risk of fatality and it could take up to 3 hours for me to deliver vaginally and by then I might be too unwell to do so. He explained from his perspective why he felt it necessary and I explained from mine what I would consider. He was very patient with me considering by this point I was quite clearly delirious and unwell, so he said (as far as I can recollect!) we could meet in the middle, he would try and facilitate a gentle birth via cesarean by keeping the wound as small as he can and making it calm and following my preferences, but for that to happen we needed to do it now and asked my husband to get into scrubs. He allowed me to have as much autonomy of the situation as possible and briefed the team as such with me in the room.

When we got in to theatre they all made a fuss of us, sang along to Christmas carols (it was Xmas day after all!) and had presents waiting for us. They showed us around and explained that we now couldn’t wait for the epidural top up to work so instead in order to have my more gentle and present birth, I’d need to have a new spinal block put in and I agreed this was appropriate and the team quite literally ran off to scrub up while I was prepped and signed the consent forms. The team were lovely and really kind, calm and excited with us. They normalised a very surreal situation and they all guessed the sex of the baby and talked about getting back to the ward for Christmas Day to have the second Christmas Day baby of 2022! I was so thrilled by the way they treated us, I felt really empowered and respected despite being vulnerable and numb from breasts down and strapped to a table naked with 20 people around me.

Then it happened, a kind lady asked to take our phones and took photos of baby leaving my womb. And with that; Baby arrived! The room was silent and the team started laughing around us as they held her up- everyone predicted boy in the room and throughout pregnancy we called Mia a him as we had ‘a feeling’. The screen between the surgeon and myself was lowered and there she was! Perfect, with eyes open and her chonky cheeks, legs and arms stretched out- no idea how she fitted as she was so long, no wonder the pain I had in my groin and ribs for so long!! Absolutely the best moment of our lives! They took her to the table to give her a little suction before putting her on me to crawl across me. Mike (husband) and I were so in love and besotted, we just laughed and held hands giggling at her cheeks! The oxytocin was flowing and although Mia didn’t cry, we knew she was safe and healthy.

Mike was called to help out with cutting the cord and everyone round the room guessed her weight. Mike helped weigh her and rub her to stimulate her skin as well as watched them give her vitamin K and check her over. I could hear him chatting to the nurse and I’ve never felt love like it towards him. He then carried her back with the nurse to me, ready for me to put her on my naked chest where she latched nearly instantly. This is where she stayed until I was wheeled from the recovery bay to the trauma ward. The rest they say… is history!

Perfectly imperfect birth and despite all changes above, I feel really positive by it. It’s true that your mamma bear instincts are super strong and you just find a power to do it for them, and once they’re here you literally forget any pain of some aspects of the journey. I’ve always been an advocate that your body and baby really do know best, but I really felt it was proved it in this situation. Sometimes letting go of a plan creates new options and that is ok!