Birth story - Keeley and baby Arlo

*Trigger warning* - Very long early labour stage, very slow dilation, meconium in the amniotic fluid, unplanned interventions including unplanned C section, scary sounding medical risks, problems breastfeeding, mention of surgery for the baby, use of the word contractions (not negative to me).

Well, this is a weird story to describe as ‘positive’ because mostly things didn’t go to plan.

I really wanted a midwife-led water birth with as little intervention as possible. I ended up having my waters broken, being transferred to consultant led care and then eventually having an unplanned c section, so not the plan at all!

However, overall I still genuinely feel that the birth was positive. I felt in control, I felt powerful, my partner was incredible, the staff were excellent and now we have a beautiful baby boy and we are receiving excellent care.

This is a long post, so buckle up!

PREGNANCY:

The first and second trimesters were fairly straightforward. Some early nausea, an increase in headaches and allergies, but mostly not too bad.

At 38 weeks, I started to get severe lower back pain and pelvic girdle pain. This was really quite disabling. I had been quite active throughout pregnancy (swimming, walking and yoga) but I ended up on crutches. I had to stop swimming, driving, and going for walks as they all exacerbated the pain so much. It made me feel quite worried about labour, as it became very difficult to walk around or move position easily without getting sudden and extreme shooting pains and twinges. I was concerned this would make labour significantly more difficult.

CLEFT LIP AND PALATE DIAGNOSIS:

At the 20 week scan, we found out our baby had a cleft lip and palate. This was a big shock (no family history and no risk factors), and was a bit of an emotional rollercoaster. Mostly I was concerned about the baby’s feeding, the surgeries and the possible longer-term complications like speech and language problems. I also felt tense about other people’s possible negative reactions to our baby, as we knew he would look very different from other babies (especially pre-surgery).

Over time, we adjusted to the news and prepared as best we could. I started expressing colostrum at 36 weeks so that we could syringe or cup feed him breast milk when he was born if he had trouble latching and sucking (which we knew was extremely likely!)

FALSE LABOUR:

At 38 weeks, I woke up with dull aches that felt like period pains in my tummy and lower back. That day, I also had a huge increase in contractions.

At about 8pm, I started timing the contractions using the Freya app. They were happening every 2-3 minutes and this continued for about 4 hours. Initially, I had assumed the contractions were Braxton Hicks, but as they got more frequent and more intense, I started to think ‘this is it - I’m in labour!’ However, the contractions were not as powerful as I was expecting (I was still able to talk while they were happening).

I went back and forth about whether or not we should head to the birthing unit. Triage were a little vague on the phone, implying I should probably stay home for longer as the contractions were not too intense, but then also saying maybe I should come and get examined to see if I was starting to dilate, but warning me I may well be sent home again.

In the end, I decided to stay home and try to sleep. And in fact, I did sleep relatively well. I woke up every couple of hours with a few contractions here and there, but it became clear they were definitely fading away. By mid-morning the next day, the contractions had fully stopped.

I had an appointment scheduled with my community midwife that afternoon. She noted that the baby’s head was starting to engage, but was not fully engaged just yet. She seemed very disappointed that the contractions had stopped!

REAL LABOUR (FIRST VISIT TO MLU):

At 39 weeks + 4, real labour started. This was on a Thursday.

It was similar to the false labour, but the contractions were significantly more intense.

We went into the midwife led unit (MLU) at around 10.30pm. I had tried to stay home for as long as possible, and according to the Freya app, my surges suggested I had been in established labour for around 8 hours by the time we got to the MLU.

The midwife at the MLU said she was pretty sure from the frequency, length and strength of contractions this was the real thing this time round and she was also fairly sure I was in established labour.

She examined me and discovered I was only 2cm dilated, so I wasn’t in established labour yet. She said she was sure this would increase soon so I may as well stay, but I was also welcome to go home if I preferred. I opted to stay as I really felt like things were going to start moving along quickly and we were able to stay in the private room which (to my joy!) had a birth pool.

I had really wanted a water birth from the outset, but had tried to keep in mind that a pool might not be available - I didn’t want to have my heart set on something and end up disappointed.

I was trying to keep eating where possible but was extremely nauseous. At one point, I vomited a large amount, but didn’t really mind as then I actually felt quite a bit better!

They monitored the baby for about half an hour and all was well with him. They wanted to do extra monitoring because of his cleft lip and palate.

Several hours later, she examined me again and I was still 2cm dilated. This was hugely disappointing as I’d been having very strong and very regular contractions the whole time.

After a few more hours, the contractions then slowed down a bit (more like 1-2 every 10 minutes instead of 3-4) and I was still only 2cm dilated so we decided to head home and try to get some sleep if possible. This was around 6am the following day (the Saturday).

We went back, had a bath and tried to eat and sleep. Unfortunately, I was completely unable to sleep as the contractions were still too regular and intense. And I couldn’t really eat because of the extreme nausea and also dry mouth. I kept sipping as much water and Lucozade as I could manage, and tried to stay in a calm and positive frame of mind.

SECOND VISIT TO MLU:

The contractions ramped up again as Saturday continued and we went back to the MLU in the early afternoon.

On examination, I was now 3cm dilated. I was glad it had increased at all, but it was super disappointing that I STILL wasn’t in established labour.

They monitored the baby for about half an hour or so, then said I could go home again if I liked. By this point, I was really struggling. I was so tired and hungry and psychologically I was starting to find the contractions really difficult. I started to get really shaky and feel quite stressed. Even in between contractions when I was in no pain at all, I just couldn’t stop myself from shaking violently. I think I was having an adrenaline surge perhaps, and it was so overwhelming. I said to my partner I just wanted to have a day off where I could sleep a bunch and eat normally and then try again. I started to panic about how I would cope if things didn’t start to speed up.

My partner was incredibly helpful at this time, and said and did all of the right things to keep me as calm as possible.

We went home, and actually the contractions did calm down a lot so I got my wish for more food and more sleep.

I got a solid 2 hours of sleep, which made a really big difference to me psychologically. Then I managed to get into a cycle of dozing for 10 minutes or so, waking up for a contraction, eating 1-2 bites of cold pasta and dozing for 10 minutes again. That lasted the whole night. And although it sounds kind of rough, it was so much better than the previous night that honestly, it was enough to give me some energy back.

The next morning, I also managed to eat a piece of toast and peanut butter, and a tangerine. I also had some plain bread and hula hoops for lunch. I felt great having some more fuel on board.

And then I was back on track, thinking ‘let’s do this!’

THIRD VISIT TO MLU:

Day 3 of labour. We went back to the MLU in the early afternoon on Sunday.

On examination, I was now 5cm dilated and I was over the moon!

I was able to get into the birth pool, which was soooo much more comfortable. They offered me gas and air, but I felt like I was managing fine at this point and would prefer to save that for when things inevitably ramped up. I kept telling myself things like ‘this surge is powerful, but I am powerful too’ and reminding myself that each surge was bringing me closer to my baby.

A few hours later, they examined me again and I was still at 5cm. So no change. Gah! They also monitored the baby and had uncertain results. Maybe his heart rate was a little high at times, but maybe he was just being very active? Then maybe it was getting a bit low, but maybe it was just his sleep cycles. The monitoring devices were also not staying on very well, so there was lots of ‘loss of contact’. I wasn’t feeling worried, and was sure things would be ok. But they were also getting concerned about how long I had been labouring for and how I would continue to cope. The midwife suggested an epidural a couple of times, but wasn’t pushy when I kept on saying no.

The midwife then suggested breaking my waters. I was concerned about interventions leading to more interventions, so I asked about the risks and benefits and what would happen if we waited a bit longer.

She gave me a good breakdown and I opted to wait a bit longer. She said if I was no more dilated when we got to 9.30pm, she would need to involve the midwifery lead.

There was no change by 9.30pm, and after a discussion with the midwifery lead, I agreed to have my waters broken.

TRANSFER TO CONSULTANT LED CARE:

When my waters were broken, there was meconium in the water so they become increasingly concerned that the baby might be getting distressed. I was now on continuous fetal monitoring and the heart rate information was still inconclusive with lots of loss of contact. They explained they really wanted to transfer me to consultant led care. We had a discussion about it and I reluctantly agreed this would be the best plan. I clearly wasn’t getting back in the birth pool anyway, and I would get to keep the same midwife. It just meant moving across the corridor and involving a consultant in the care too.

I started to try some gas and air at this point. I was cautious about taking too much as I didn’t want to feel sick or dizzy.

Because there was so much loss of contact with the over-the-belly fetal monitoring, they asked to attach a monitor directly to the baby’s head. I agreed to this, getting increasingly disheartened by my ‘natural birth’ getting so full of wires and medical equipment. By this point, I was also on a saline drip too and had had a catheter inserted.

The midwife was there consistently. There were also two doctors in the room inconsistently - the more senior one often rushed in and out to attend urgent cases, but would quickly pass on jargony information to the midwife to discuss with me directly.

I was really pleased with how much time the midwife took to explain things to me clearly. And she frequently asked me to explain my thoughts and feelings and said she would advocate for the things I was asking for. She made it clear I had a choice and that they needed my consent.

By this stage, they wanted to give me syntocin to push the labour along more quickly. As this is essentially a synthetic form of oxytocin, I wanted to try and get more oxytocin flowing more naturally instead. It was sort of clear to me the midwife thought this was a bad idea, that I had already been in labour for too long and that I should just crack on with the syntocin, but she respected my wishes to delay.

But after quite some time, I was still no more dilated. They warned me that if I had syntocin, it may make the contractions significantly more intense. At this point, I felt I was only just coping, so I agreed that I would go for both the syntocin and the epidural together. However, I asked to be examined once more just to check I wasn’t more dilated yet before making a final decision. At the last check, I had been 5cm dilated.

They were not keen to re-examine me as it had been done quite recently, and they said it was risking infection to keep on examining so regularly.

Shortly after this, whilst waiting for the epidural and syntocin to be organised, I suddenly had the urge to push. They then agreed they would examine me to check if I was ready for this.

They told me to resist the urge to push in the meantime. This was extremely difficult. I’d been working so hard on keeping my pelvic floor relaxed - how to avoid squeezing my pelvic floor together whilst also avoiding pushing? It was so hard!

The lead doctor was the one who examined me and it wasn’t good news. She disagreed that I was 5cm dilated, saying this was generous and I was still 3-4cm. She also said the baby was back to back, in a bad position and that she was extremely worried I would get significant damage such as uterine rupture if I continued with a vaginal birth. She mentioned that there may already be some cervical swelling. Therefore the syntocin now seemed a bad idea, and she wanted me to have a c section instead. She noted that actually the strength and frequency of my contractions should definitely have caused significantly more dilation by now and there had to be something else wrong.

I agreed to go ahead with a c section. It sounded like the sensible option. By this point, I was also completely exhausted and struggling with the contractions and tiredness so much that I was just happy to have a faster solution without too much of a discussion about it. I was ready to meet my baby.

C SECTION

Initially they said we could go into theatre pretty much straight away, but then someone else who was more of an emergency took priority.

This meant we had to wait an extra hour with me still having (now pointless!) contractions. This was really tough psychologically. I couldn’t truthfully say each contraction was bringing me closer to my baby anymore, and it made them much harder to tolerate. I toughed it out though, with copious amounts of gas and air. And actually, I did still feel a sense of power. I was still going. I was proud of myself.

When we were ready to transfer to theatre, I was wheeled across with temporary loss of access to gas and air. That was difficult! But they did have some accessible once I was positioned on the bed in theatre.

My partner had to go and change into scrubs and then wait in a different room initially. Once in theatre, there were lots of people, lots of overlapping questions and voices.

By this point, I just really wanted them to hurry up with the anaesthetic so that I would stop experiencing the contractions.

Once the spinal anaesthetic was done, I started to feel pins and needles in the lower half of my body. I had been reclined in a strange position, with higher feet than head so that the anaesthetic could work its way up my body. My arms were very locked into place, with blood pressure monitor on one arm and a drip on the other.

The biggest surprise about the c section was how quickly they got the baby out. I could feel a strange rummaging sensation behind the screen (honestly it felt like someone was grabbing my whole belly and shaking it all about very roughly but with no pain at all) then someone shouted ‘congratulations!’

They brought baby to a paediatrician first of all, and it was so weird because I could barely see the baby at all! They then asked my partner if he wanted to cut the cord (which happened quite far away from where I was lying) and then handed him over to my partner to bring near me.

At this point, I realised I had not really discussed my birth preferences in case of a c section. I had it written down, but had not discussed it with anyone. I didn’t know if I would get to have skin to skin whilst in theatre, and hadn’t noticed or checked whether they delayed cord clamping. (His dad was very caught up in the moment and so didn’t ask / check about this either!) I was a bit annoyed at myself for not having these discussions earlier, but decided to let it go. This was a precious moment, and in the grand scheme of things, it would all be ok.

I ended up having skin to skin afterwards, in a transitionary place between the theatre and the ward. It was so lovely to hold him (even though my body was still mostly paralysed!)

AFTERWARDS:

We ended up staying in hospital together for 5 days. His dad has been able to stay over too in a private room. We’ve had the most amazing support. There were initially some concerns about baby’s rapid breathing rate and a possible infection.

Baby was put on IV antibiotics for 5 days, but this seemed to be precautionary more than anything. The rapid breathing issue resolved itself very quickly and he seemed perfectly well within himself.

He was tube fed briefly, but did very well learning to use his specially adapted bottle. I had to top up the colostrum supplies with formula initially, but by day 4, I was pumping enough milk to feed him solely breast milk.

We’re over the moon with our little guy. He has come on so well with his feeding, and is just absolutely gorgeous. And, as I said, despite lots of challenges, I would still consider this to be a very positive birth story. It could have felt traumatic and I could have felt powerless. Instead, I feel powerful and proud, and closer than ever to my wonderful partner. We are going to make a great team.