Tuesday 6 September 2016

A Birth Story Part I: Expectant Management & Polyhydramnios

I’ve been a mother of two for ten days now, so I guess I should write about the birth. When Ebony was born, I spent the first two weeks telling anyone who’d listen just how wonderful her birth was, recounting the details with dramatic finesse and beaming each time Laurie mentioned how well I’d done. I wrote her birth story down two weeks after she was born because I didn’t want to forget a single detail.

This time is a little different. I’m using writing as a form of therapy because I really need to process what happened. It feels like my head is filled with the unraveling threads of my birth story and it’s difficult to make sense of. So I’m writing this down as a way of unpicking that tangle of thoughts, of trying to work out how I feel and hopefully of letting myself accept what happened.

I didn’t get the calm, beautiful home birth I did the first time around. I didn’t get to welcome my new baby into my living room. I didn’t get to give birth in the hot tub I bought specially. And, most devastatingly of all, Ebony didn’t get to be there to welcome the new baby into the world. She didn’t get to pass me cold flannels or tell me what a great job I was doing during contractions. Instead, I gave birth in a hospital while Ebony slept at home with my mum.

The problem was this baby just didn’t want to come out. I was expecting to have to wait a few days after my due date, but I thought the baby would arrive within a few days just like Ebony. Every night, I went to bed hopeful that tonight would be the night. I would do a quick tidy up of the living room, make sure the hot water was switched on and that I had everything I might need, and then I would go to bed excited. And then I would wake up the next morning. Still pregnant and with not a niggle insight. It became quite ridiculous, really.

I went to see my midwife when I was 40+9. She looked at me sadly as I entered the room and said she had been checking for my name every morning, wondering if it had happened in the night. In Stockport, it’s standard practice to induce at 40+12. Instead, I chose to have expectant management. This was due to start on the Monday with a trip to Stepping Hill Hospital for a scan and monitoring. I agreed because I was convinced it wouldn’t come to that, of course, my baby would arrive over the weekend.

Only it didn’t. Friday we watched a documentary about Ina May Gaskin in the hope that might get me in the mood for labour. Saturday I had acupuncture and reflexology in the hope that might tempt the baby out. Sunday I bounced on my birth ball. None of it worked. Monday morning I woke up still pregnant and dreading going to the hospital. Laurie decided to start his leave early on the assumption that, surely, the baby would arrive soon.

Early on Monday morning, my mum arrived to look after Ebony whilst Laurie and I headed to the hospital. We were sent for a scan first. They check the placenta, the cord and the levels of amniotic fluid. The sonographer explained that the fluid levels were unusually high and though he initially said this as though it was no big deal, he soon appeared with a yellow alert note stapled to the front of the maternity notes. When we got back to the maternity unit, it was clear things had changed. The midwife spoke about my home birth in the past tense, as though it had slipped out of my hands since she last saw me 30 minutes ago.

A consultant was called. She wanted to induce. She explained that there was an increased risk of cord prolapse. Cord prolapse can be fatal for the baby, is difficult to be predict and means a crash section is necessary. It’s also incredibly rare, even with polyhydramnios (the medical term for holy shit that’s a lot of amniotic fluid), but the consultant didn’t seem too bothered about that. We asked how much the risk had increased by (the risk of cord prolapse is always there even in a low-risk pregnancy) but she didn’t say. She just said she would strongly advise induction and that she felt a home birth would be a big risk. She told me if I chose to go home and my waters broke, I would have to immediately get into a face down position on the floor and call 999 to await an ambulance ride to the hospital so I could be checked for cord prolapse.

Then we were left to make a decision. The problem is, it was very difficult to make a decision based on the information given by the consultant. She went through worst case scenarios but didn’t bother explaining how unlikely each scenario was. She wanted to induce, explaining that sometimes birth doesn’t go to plan, but not really understanding why I wanted to avoid unnecessary induction. And so, Laurie and I spent the day at the hospital not really knowing what the fuck to do. I wanted to go home, I didn’t want to be induced and I wanted to have a home birth. But I also didn’t want to suffer cord prolapse or have to take an ass-up ride in an ambulance. I spent a lot of the day crying and the rest of the day googling on my phone. There just didn’t seem to be a right answer.

In the end, a kindly midwife took pity on me and offered me a bed. That way, I could avoid induction and wait for labour to happen naturally without straying too far from the safety of medical help. This really felt like my only option. They sent a Supervisor of Midwives to speak to me and we discussed the possibility of still having a home birth. She wasn’t sure it was a great idea but explained they would make an exception and allow Ebony into the birth centre should I choose to give birth there. It was all a lot of unknowns and didn’t feel massively reassuring but I did at least feel supported by the midwife team.

They showed me around the birth centre in the hope of convincing me it was a nice place to have a baby. Whilst I’m sure it’s a step up from the hospital environment on the delivery suite, it simply couldn’t compete with the tranquility of my previous home birth and I spent most of the tour trying not to cry. All I kept thinking about was how disappointed Ebony would be to miss the birth and how stupid I had been for not preparing her for this eventuality. I’d spent the whole pregnancy preparing her for the birth without even considering the possibility that I might not get a home birth.

I was shown onto the ward and Laurie went home to get some things together. He came back a couple of hours later with plenty of clothes, food and my beautiful daughter. I spent the two hours he was gone preparing myself for seeing Ebony. I didn’t want to cry in front of her and upset her. Her first words when she walked nervously onto the ward were, “Mummy, why are you crying?” because, of course, I had immediately burst into tears as soon as I saw her. I just wanted to be at home with my family.

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