On Halloween 2008 I gave birth to my second son, Teddy, by emergency caesarian. Having had an emergency caesarian the first time with my son Billy, I found myself the mother of two boys and yet (as one of my least tactful friends seemed pleased to point out) “never having actually given birth”. Of course I knew this was unfair – this time I endured more than 12 hours of drug-free labour, the unbelievable pain of each contraction, the mind-blowing pressure of a baby moving down the birthing canal. Yet somehow these (cruel) words resonated so clearly with me. I didn’t feel that I actually “birthed” either of my babies. I feel that I somehow failed, “copped out”; that in some way I was less of a woman, less capable, weaker.
First time round I approached the labour with my head firmly in the sand believing, whether naiively or through necessity, that I had an unusually high pain threshold. When I heard all the birth horror stories others seemed so desperate to impart (it’s amazing just how many of them there are) I simply dismissed them. My sister (a midwife) had warned “Childbirth is unpredictable; if you have very rigid ideas of how you want it to go, you will only be disappointed”. And so, armed with very little of a formalised birth plan, and filled with the unwavering belief that “it would be alright on the night” I approached D day with surprisingly few nerves.
On the eve of my Dad’s big 80th birthday bash and 2 days before my due date, sod’s law intervened and my waters broke. I was lying in bed when I heard, or felt (to this day I’m not sure which) a pop and a trickle of liquid pool between my legs. The next 10 minutes came straight out of a comedy sketch as my sister (the midwife) and me quizzically inspected my knickers like a prehistoric specimen, discussing whether this was indeed “it” or yet another example of late pregnancy bladder weakness. After some deliberation any uncertainty was finally shattered when my waters broke fully with an enormous gush. Luckily I was stood in the bath by this point. We were soon en route to St George’s Hospital in Tooting, and after a quick examination we were back home with fingers and toes crossed in the hope that contractions would start naturally. At 4pm the next day they did, and the induction appointment was happily assigned to the same bin as the dreaded vaginal sweep. After 6 hours of labour at home managed by frequent bath hopping, I arrived at hospital expecting the news that I was fully dilated and ready to push. I was 3 cm. Perhaps my ability to cope with pain wasn’t all that great after all?
The following hours were filled with desperate cries for pain relief and sarcastic comments aimed at the midwife attempting to reassure me that “everything was going to be okay”. It was 6 hours from asking (okay, demanding) until I finally received an epidural. On two occasions the anesthetist had even entered the room, poised with needle ready, before being called away to an emergency elsewhere. Hours went by. Vaginal examinations that confirmed little progress came and went. It was 12 hours after arrival, and at 6cm dilation that the consultant confirmed that a section was going to be necessary owing to signs of infection and foetal distress. At this point justification was unnecessary; if it meant that I would never have to feel the pain of a contraction again then he could get the rusty kitchen knife out for all i cared, and I merrily signed the consent form without reading a single word.
Baby William Roan was born at 13:37 on 3rd July 06 weighing 7lb 7oz by a highly efficient, and astoundingly numerous team of medical staff. After 4 days climbing the walls I was finally allowed home. In the days that followed the numb post-labour tiredness slowly gave way to feelings of disappointment quickly followed by disbelief, anger and even guilt. Ignoring all of the medical evidence I whole-heartedly believed that it was my fault that the caesarian had happened. I felt I had willed it, “copped out” when the pain had become too unbearable. Surrounded by other new mums who had all birthed their babies vaginally, I listened in disbelief at their birth stories, unable to comprehend why mine had ended as it had. Where I had failed, they had all succeeded. Where I was pathetic and weak, they were strong and heroic.
Of course these feelings dulled over time and I got on with the process of being a new mum and enjoying watching my little boy grow. Nevertheless, when I found I was pregnant the second time, I realised I still held a lot of fear from Billy’s birth, and the temptation to just “go for an elective” was strong. However, I also felt a real need to birth this baby naturally, as if settling an old score. I knew if I was going to attempt a vbac (vaginal birth after caesarian) then I needed to give myself the best chance of achieving it. After a caesarian your notes are emblazoned with the words “high risk”, clinicians talk only of a “trial of normal birth” as if there is already an expectation of failure. A list of interventions and restrictions are reeled off making the idea of anything “natural” seem at best unlikely, and at worst impossible. After much soul searching and checking of bank balances we made the bold decision to employ an independent midwife.
Aside from a few days of blind panic in the weeks before the birth I again approached the labour with surprising stoicism, surrounded by the strong support of my husband, and my independent midwife who had become a friend. After a few days of niggles and 3 days before my due date I was lying in bed ready for a good night sleep when “pop!”. “ I don’t believe it!” I muttered as i jumped out of bed and headed for the toilet. Within 15 minutes my contractions had started, and from the off were 3 minutes apart and lasting 30-40 seconds.
|The early stages were extremely smooth. I managed the contractions well using music, my birth pool and a positive frame of mind. At 3am my husband finally called the midwife and asked her to come as contractions were getting much stronger, and I was starting to feel anxious. When my midwife arrived I felt my whole body relax, reassured at the sound of a familiar voice. On examination and much to my delight we found that I was already 6-7cm dilated. “I can do this!” I thought. I started using gas and air which helped me concentrate and keep my breathing slow and controlled. I was feeling positive and empowered, happy and relaxed in my own home with all my own things around me. At about 6am the second midwife arrived and I heard hushed voices talking excitedly about my wonderful progress. They expected the baby to be born at home within a few hours.
Another vaginal exam confirmed that I was 8cm dilated and by 7am I was a teasing 9 ½ cm. All was going like a dream. Suddenly, contractions started to get “expulsive” and I remember saying that I wanted to push, believing that the end was near and feeling triumphant. However, after another examination we found that I was still millimeters away. My midwife explained that I had to resist the urge to push to stop the cervix from swelling, but it was almost impossible to resist my body’s natural urge, and on top of the pain of contractions. I could feel my confidence waning as we tried everything. Soon after 9am, and with my resolve failing I made the decision to transfer to hospital.
After another 3 hours in hospital, a failed epidural, and repeated attempts to manually push the cervical lip out the way, the consultant finally recommended surgery. Feeling exhausted, impatient, and devoid of any other options, I agreed and Baby Edward Thomas was born at 13:57 weighing a healthy 8lb 7oz. Within 30 minutes he was guzzling away happily. I felt surprisingly stoical, calm and proud of what I had achieved.
However, within days the disappointment crept in. I found myself crying endlessly as the torment of questions began. “Was it my fault?”, “Could i have done something differently?”, “How could this have happened twice?” The despair, the guilt, the disbelief all returned. To have come so close to achieving my vbac, to have coped better than i could have imagined, and only to fall at the last hurdle. The disappointment was immense.
Of course, in the months that followed Teddy’s birth, life again took over and the joy of being a new mum dominated. I can look back now with more balance, and see a birth I can be proud of. Yet I still find it difficult to hear other people’s birth stories, and rarely discuss my own. “All that matters is that your baby is healthy”. So many pieces of wisdom offered to me by well-meaning friends. All those that have given birth “naturally” listen incredulously to me harp on about the upset I still feel. To them their labours are over, unimportant in the grand scheme of things. To me they are overwhelmingly defining.
According to national statistics nearly 1 in 4 (24%) of births in the UK are by Caesarian section, whether emergency or elective. (www.drfoster.co.uk) Of the people I asked from of an online vbac group over half felt angry and disappointed after their caesarians, and almost as many admitted to feelings of depression. Some even felt suicidal. It seems the emotional after-effects of a caesarian are as real for some as the physical ones. For everyone reading this that has had a similar experience, the important thing to recognise is that you are not alone.
For further support and to share similar experiences you can visit the vbac support group at http://health.groups.yahoo.com/group/ukvbachbac/