Birth story - Naomi and baby boy

*Possible Triggers* : use of the word contractions as I am ok with it, vaginal bleeding, hyperstimulation, heart rate concerns, placental abruption, emergency c section

*a quick word to note that I am a trainee obstetrician; a doctor that works on labour ward and in antenatal clinic and delivers babies in emergencies all the time*

Pregnancy

My partner and I were very lucky to fall pregnant the month following stopping any contraception. I had very bad nausea throughout the first trimester but no actual vomiting. At times I wished I would just vomit but it never happened. I felt it was quite debilitating and was shocked at myself to feel so low during such an amazing journey. This at times made me feel guilty but by the end of week 12 /13 I was feeling much more myself. 

I had normal scans at 12 and 20 weeks but at my 31 week midwife appointment I had lots of sugar in my wee which meant I needed a blood test to check for gestational diabetes. I was very shocked at this as I am very healthy and don’t tend to eat much sugar, there was a few days of panic but thankfully the result came back negative. 

I had two episodes of reduced movements for which I was checked over in hospital and had an extra growth scan - this all came back normal apart from a slightly large head but this didn’t surprise me ( my partner also has a slightly large head 🤣).

I continued to work out with my trainer as I had done pre pregnancy up until 38 weeks when he suggested I stopped to rest. I had been having mild and irregular tightenings from about 37 weeks and I was hoping these were doing something - every little helps. I had a stretch and sweep by the midwife at 39 weeks out of choice and another when I was 40+1 weeks. I had made some progress to 1-2cm with a soft cervix, the baby’s head was low in my pelvis! One of my main worries in pregnancy was going post dates or past 40+12 as I am fully aware of the research surrounding this and the increased risk of still birth - I really didn’t want to be induced for being “post dates” so an early stretch and sweep to me was something I knew had minimal risks and possibly a small chance of preventing an induction for post dates.  

I did not write a birth plan but kept an idea in mind of what I might like, if everything were to go to smoothly and without complications, knowing all to well how quickly things can change in pregnancy. 

Delivery 

After my second stretch and sweep (which was at 9am) I had a feeling something might happen so I spent the morning writing my wedding invitations, bouncing on my ball and I made some banana muffins. During this time I began to feel period like pains coming in waves low in my pelvis. They got stronger and closer together and by 3pm I decided to use my Freya app! It said straight away I was in established labour - I had a feeling it might. I ran a bath and got in to make sure this wouldn’t send them away, it didn’t so I contacted maternity assessment and my partner drove me in. The pains at home had been very manageable with breathing exercises. The pains in the car on the way to hospital became very different - closer together and stronger - I was pleased at this to begin with. I was asked to provide a urine sample on arrival and when I went to the toilet my heart sank. My urine was red with blood and I was bleeding a little. In my head I knew this meant no birth centre, no pool birth, my baby would need to be monitored on the CTG (heart beat trace of the baby) during labour. My heart hoped the bleeding was just from some good progression in labour however the midwife examined me and I was 3cm, with some more fresh red bleeding. They provided me with gas and air and transferred me to labour ward. Baby’s CTG (heart beat trace) was very normal. 

On labour ward at around 7pm my waters broke and these were also stained with blood. My contractions were coming thick, fast and strong with barely any gap between them and I was finding it very hard to use breathing techniques. The heart beat trace began to show some episodes of decelerating  - small drops in the babies heart beat - a sign of distress. During some of the contractions I was wanting to push with a lot of back pain and occasionally I was pushing without meaning to as I couldn’t help it. I was examined again at this point as the consultant thought maybe it meant I was fully dilated but I was 6cm. In my head I knew something was not right. The consultant offered me an FBS which is a small sample of blood taken from the babies head to check how well baby is coping with labour and if it comes back normal you can continue in labour, if it is abnormal then the next step I knew was a c section. Deep down I knew already he wasn’t coping. I asked if I could skip straight to the c section to which the consultant agreed straight away. I signed the consent form and was wheeled straight around to theatres. The spinal injection to numb me from the nipples down was the greatest sense of relief from pain I have ever felt. And I knew my baby would be with me in minutes. In theatre before starting the procedure they re examined me as I was still trying to push - I was 8cm. Not enough to deliver vaginally but suspiciously quick progress. 

My baby was born happy and healthy at 21:51. My partner cut the cord on the resuscitaire and then they had immediate skin to skin as I was too shakey from the anaesthetic. During the operation they found him to be facing the wrong way and in a position that would have made delivering vaginally extremely difficult. The placenta also had some small clots behind it suggesting it was coming away before it was ready known as placental abruption. We had made the right decision with an immediate c section. 

Thoughts 

I had a debrief with the consultant the following morning to discuss my delivery, she also confirmed to me that the right decisions were made along the way. This has really helped me to put any doubts and concerns that “I did not try for vaginal delivery for long enough”. A c section can also be a very positive experience and I think this is due to the fact that I knew it needed to be done for the safe delivery of my baby. It is a perfectly acceptable way for a baby to enter this world and I am so pleased I did not persevere with a vaginal/“natural” birth: I went with my instinct and it was the right decision. 

I am unsure how much difference the fact that I am a doctor who delivers babies in emergencies made to my own delivery decisions. I am fortunate enough to have all of the knowledge I needed to prepare myself for the birth I had, however at the time, the guidance of my doctors whom I had full faith in, was indispensable. 

I did the positive birth company digital pack with my partner at about 34 weeks partly to understand more about hypnobirthing for my day job as more and more women are attending our units utilising hypnobirthing techniques and I wanted to try it out for myself. By the end of the course, It all made a lot of sense to me and I could see how hypnobirthing could be incorporated into our teaching as doctors/midwives to be used more effectively in the hospitals. I particularly enjoyed the “could you poo like this?” video. It really resonated with and made me think about some of the barriers there are to a true hypnobirthing experience in the labour ward department I work in. I will definitely be thinking about how I can change my practice / the way I work going forward and encouraging colleagues to do the same, in order to incorporate some of the ideas I’ve learnt on the positive hypnobirthing course.