Birth story - Megan and baby Corrado

**Trigger** Induction, use of word contractions and episiotomy

I found the positive birth company online after trying a few different hypnobirthing methods that I just couldn’t get on with. I watched a couple of the videos available on YouTube and knew immediately that Siobhan’s more practical approach would work for me, and bought the online course that same day! My husband and I watched all the videos in one weekend and I found it really helpful to be able to go back and re-watch bits, especially when my birth plans changed at the last minute!

I had been being monitored on the maternity day unit every week from 30 weeks due to itching and suspected cholestasis but had never had a high bile acid result come back, so was continuing with my midwife’s support with my original plan of a low risk, low intervention water birth at home. However, when I went in for my weekly monitoring at 40+5 they reported that my bile acids had finally come back high giving me an official ICP diagnosis, and meaning that I would now need to be induced ASAP. I was given the chance to speak to both a midwife and a consultant and used my BRAIN to ask as many questions as I could to help me make the right choice for both me and baby. I was happy to accept the induction based on these conversations but felt really in control, listened to, and supported the whole time.

Originally they weren’t going to let me leave and would be inducing me that same day, so cue a few frantic phone calls to my husband to throw the last few bits in the hospital bag and make us both some sandwiches!! In the end they agreed to let me go home that day and return the next day (Friday) for further monitoring of baby and to be induced, which calmed me down and gave me some time to prepare. I spent the day checking and repacking my hospital bag and watching the PBC videos on inductions, and my husband and I made the most of our last night at home as just two with a nice dinner and a film.

I arrived at 8pm for my induction on the Friday night to be warned that the delivery suite was really busy and we might be in for a long wait. We ended up waiting until 10pm and then being sent home to try again tomorrow as there wasn’t a midwife available to do both the induction and the monitoring that would be necessary. I had a little cry when we got home as I was so frustrated and ready to meet our baby by then, but we both tried to look on the bright side and spent our day on Saturday having a nice long walk and a couple of naps, since I wasn’t expecting much sleep on the ward!

Finally on Saturday night they admitted me to the delivery suite for the first stage of induction at 8pm. I had a lovely midwife come in and explain the induction process again for us both and to warn me that I could be in for the long haul - something I was already mentally preparing for! She then put in my first gel pessary and left me on the monitor for a further hour. Luckily my husband could be with me this whole time, and I started to feel some very minor aches in my lower back which I took as a sign it was starting to work! Once the hour’s monitoring was up I was moved up to the ward for the night and my husband was sent home for a good night’s sleep.

I spent the night on the ward and the tightenings in my back continued but weren’t really getting any stronger - I was able to manage them with just a hot water bottle. At 4am they popped me back on the monitor to see how me and baby were doing and to check on any contractions. They were consistent but weak and I was offered a cervical check at this point which I accepted. I was not really dilated and my cervix was still closed but softening, but because the contractions were coming regularly they decided against giving me a second pessary at that point and to just wait and see how I got on over the next few hours.

My next check was around 10.30am, when the consultant came to do her rounds. My contractions were feeling stronger by this point and she offered me another cervical check. I’d made it to 2cm and it was decided they could skip the second pessary and would go straight to breaking my waters. Again I was told the delivery suite was quite busy so it might be a few hours wait before they could do this, so I began to settle in and unpack my TENS machine ready for when things started to ramp up - mine had only arrived the day before and I still had no idea how to use it!!

However, over the next half hour or so I was on my feet as my contractions were feeling much stronger and I found being upright and walking around the bed really helpful. At 11am exactly a contraction started and I heard a pop! Before my waters broke all over me and the floor - it truly was like something out of a film in my case! I hit the call button and a midwife checked me over and confirmed that I was heading straight back down to the delivery suite. I phoned my husband as he could join me at this point and started to get excited that things were finally happening!

By 11.30 I was back on delivery suite and met my midwife. She said she would leave me to it for now and come and check on me in four hours unless we needed her before then. I was still expecting to be in for the long haul as a first time mum at this point and didn’t think anything of it when she mentioned that she had her lunch break from 12.30 - 1.30...

Over the next couple of hours things really ramped up, with the contractions feeling very powerful and becoming much closer together. My husband was amazing at this point and worked out the TENS machine, getting into a rhythm of hitting the boost button for me, timing my contractions, keeping me hydrated, and talking me through my up breathing. He didn’t tell me how close together the surges were until I started panicking and saying I couldn’t do it any more and that I needed pain relief. I felt I wasn’t coping well as it had only been around an hour and a half at this point, so I assumed I was still in the very early stages of active labour. In hindsight, this was definitely the transition stage, as not long afterwards I was adamant I needed a poo and went waddling off half naked to the toilet across the hall!

Just after 1pm I was back in our room and had calmed myself down and realised that with the pressure I was feeling that I may be further along than I thought. We pressed the call button and the midwife in charge came in, as my named midwife was on her lunch break. She could see I was in a very different place to when I arrived and was happy to oblige when I asked for a cervical check. I was still not really expecting to be too far along, so was shocked when she said I was already at 10cm and was ready to go! She had checked my birth preferences and told me that the high risk birth pool was available if I wanted it, but again I used my BRAIN and decided that I was comfortable where I was and didn’t want to wait too much longer to get started as the pressure to push was really building! She went to fetch my midwife who returned in minutes with a student midwife (I had already consented to this), and asked if a doctor could be present too to see a ‘normal’ birth rather than the theatre births she was usually present for. Again I consented to this and I felt reassured that I had a good team if anything were to go wrong! They hooked me up to the monitoring machine again, as due to my cholestasis both me and baby needed to be monitored for any signs of distress throughout the birth. I had been worried about this restricting my movement but in the end I barely noticed it was there!

I started pushing at around 1.30, and Mandy my midwife was amazing with coaching me in exactly what to do, how and when to push and when to wait. Having the three medical staff plus my husband isn’t something I’d planned for but they were brilliant at cheering me on and giving me the energy to keep going, and I’m so pleased they were all there in the end! I had been pushing for around 35 minutes when Mandy told me she wanted to do an episiotomy, as baby’s head was struggling to push through. I agreed and on the next contraction she made the cut and his head immediately came out, with his body coming on the next one. Mandy scooped him up and showed him to my husband who announced that we had a baby boy! He gave one big shout and was popped onto my chest for skin to skin. We had delayed cord clamping and the team were shocked to see that he was a big baby with a very chunky cord - it took forever to stop pulsing and then needed two clamps!! I accepted the injection to help my placenta out which I delivered soon after baby. We had more skin to skin while Mandy stitched me up and while me and my husband marvelled at what had just happened! From my waters breaking at 2cm to his arrival was only 3 hours 20 minutes, so not quite the three day slog I’d been expecting - I didn’t even realise until afterwards that we completely forgot to use the fairy lights and room sprays I’d brought with me!

We were able to stay in our own room all afternoon, and Mandy confirmed that we would be able to be discharged straight from the delivery suite since we were both doing well, and which meant my husband could be with us the whole time. We were visited during this time by the midwife in charge who had seen me earlier and was keen to meet our little man, and by the midwife who had done the original pessary for me the night before. It was so lovely to get to show him off a bit! We were finally discharged at 9.30pm and it felt so surreal to be at home, showered and in our own bed with our new baby less than 12 hours after my waters broke.

I had the most incredible birth partner and team I could have asked for, but I also really do credit the PBC with giving us both the tools we needed to navigate so many last minute changes to our plan, and to enable us to ask the questions we needed to to feel like we were making the best decisions at every step. It’s also given me so much confidence in what my body is capable of, and I wouldn’t hesitate to do it all over again in a heartbeat - which is something I never in a million years thought I’d be saying about giving birth!