Thursday 6 August 2020

Ettie's Birth Story: So Many Hospital Visits

Thanks for joining me for the second instalment of this long and tedious birth story (the first part is here, if you missed it). I can’t quite remember when all of the following things happened (lockdown problems), but hopefully I have the weeks correct. 

At my 38 week appointment, my midwife couldn’t determine the baby’s position, and it took a really long time to find the heartbeat. I wasn’t overly worried because the baby had been moving around as normal not long before, but also it was the first time I’d worn a face mask and I was lying on my back under a bright light for a long time and I did feel like maybe I was about to die of stress. She found a heartbeat eventually but wasn’t sure whether the baby was in an oblique lie so she rang the Antenatal Day Unit (ADU) to make me an appointment for a mini scan to check the baby’s position. She said, “I’ll make you an appointment to see me at 40 weeks on the off chance that everything is fine with the scan.” This did not fill me with confidence.

We didn’t have much time to get to the hospital so it was a bit of a rush to get the kids ready and in the car. On the way there, I made the mistake of googling ‘oblique lie’ and found posts saying ‘Take your hospital bag because they’ll want to do a section so you won’t be going home lol.’ Reader, I did not lol. I ugly cried again, but silently because the kids were in the back of the car.

A consultant came to see me and scanned my bump (with a scanner that she probably borrowed from a history museum, it was not fancy). The baby was head down and happy. Because of Ember’s size (4.7kg which translates to ABSOLUTELY MASSIVE), the consultant suggested I have a scan at 40 weeks to check the size of this baby. She said if the baby was below the 97th percentile, she wouldn’t worry because I got Ember out just fine ( she wasn’t there at the birth and I feel like 'just fine' was overselling that traumatic experience), but if the baby was over the 97th percentile then they might want to talk about intervention. I agreed to have a scan at 40 weeks and then I went on my way, relieved that the baby was head down. 

At my 40 week appointment, the midwife found static growth when measuring the fundal height measurement (this means the baby hadn’t grown since the week before). I was once again referred for a scan, though this time it was a full scan in the ultrasound department. My scan was the following Monday, so I was 40+5 by the time I was scanned. I was really worried that the scan would find polyhydramnios (this means excess fluid and was the diagnosis that stopped me having a home birth last time) or a giant baby. 

The ultrasound technician did not find a giant baby, in fact, it seemed that this baby was destined to be my smallest yet. She did, however, find that I had too much fluid (polyhydramnios). However, it was only a mild case, so it wasn’t as worrying a diagnosis as it had been last pregnancy. I was found to have a deepest pool of 9.4cm of fluid this time (with Ember, it was classed as severe which means the deepest pool was at least 16cm, I think). I wasn’t particularly worried about the fluid because it seemed borderline-ish, and I was relieved that the scan didn’t find a giant baby (although I still thought that’s what I was having because I did not trust the scan). The sonographer didn't seem too worried about the excess fluid so I was sent home after the scan.

My next appointment was with another stand-in midwife when I was 41+2. She was very pro-home birth and was talking about how lovely the birth would be. Then she touched my bump and found that the baby was ballotable (this means the head was free in my pelvis, I know this because I googled it after I left). With this and the polyhydramnios diagnosis, she felt I needed to be seen by a doctor at the hospital. “It’s such a shame, you’d have had a lovely home birth,” she said. This did not fill me with confidence. 

I am in no way medical or intelligent, but for those interested: the risk with polyhydramnios is that the excess fluid means the baby bobs about rather than becoming fixed in the pelvis. This is concerning because if your waters go when your baby isn’t head down, the cord can prolapse which can be a serious medical emergency. So a ballotable head and polyhydramnios didn’t sound like a great mix.

I went back to the ADU and waited to see a doctor. When the doctor came, he said he was offering me induction because of the polyhydramnios. I told him I’d rather not be induced, and he said: “You know we’ll be inducing you in like two days anyway, right? That’s what we do with women who go over.” As though I had no say in the matter whatsoever. When he said this, he was leaning against the wall with one knee bent and his foot flat against the wall, his mask hanging under his chin, more like one of the T-birds from Grease than a medical doctor. Obvs they didn't have face masks in Grease, but if they had, Kenickie would definitely have had his under his chin and not covering his mouth and nose).

I tried explaining that I wanted a home birth and he said that wouldn’t be safe. He said there was a risk of postpartum haemorrhage (PPH) and so I’d be better in hospital. I tried to ask about the severity of the polyhydramnios but he didn’t really answer my question. Or any of my other questions. He said if I went into labour over the weekend, I needed to head straight to the hospital and have the baby there. He told me to go back on Sunday for monitoring and to be booked in for an induction. 

It was 5pm on Friday by the time I was free to go and I felt worried that if I went into labour that weekend, I wasn’t going to get the birth I wanted. I decided to try and find a senior midwife to speak to before I left the hospital to see if we could put together a plan. What I should have done was taken ten minutes to think about what I was going to say and talk myself down from panic mode. Instead, what I did was stumbled into clinic, found a senior midwife, and immediately began to ugly cry at her. So, that was great. 

Luckily, the mask hid most of my crying face, so the midwife was only subjected to my ugly eyes. But also I made some pretty intense weeping noises that will never leave me. The midwife I found was the same midwife I had ugly cried on when I was told I couldn’t have a home birth with Ember. I don’t know if she recognised me and my ugly eyes and intense weeping noises. I didn’t tell her I recognised her, I basically didn’t tell her anything on account of all the crying. I managed to say I wanted a home birth and I think that was the only coherent thing I said. 

Luckily, midwives are very good at pretending that you aren’t being mental and they are skilled at ignoring weird crying noises, so she passed me a tissue and wrote a new plan for me. The plan was that if my contractions started, they would send a community midwife out to me to check the position of the baby and, if all was well, support the home birth. If my waters went first, however, I was to go to the hospital to check there was no cord prolapse and that baby was in a good position, and then, if all was well, I could go home. I stopped crying, thanked her a lot, and went home.

The next day, I spoke to my obstetrician friend for some advice. I recommend you all get yourselves an obstetrician friend, especially if you have stubborn babies who are trying to force you to be pregnant forever. I wanted to know whether or not a home birth was safe, and I decided that if this particular obstetrician told me it was unsafe, then I would know it really was. And I would likely take the news better from her because I already trusted her opinion. And it would be via the phone so she wouldn’t see my cry face if it was bad news.

Speaking to her was so helpful. By the end of the call, I felt reassured and informed and ready to advocate for my wishes at my next hospital appointment. I was back at Stepping Hill Hospital that Sunday, I was 40+10 and I had a CTG scan to monitor the baby. The midwife confirmed that the plan I’d put into place with the midwife on Friday was still the plan and I left feeling happy.

I didn’t have to go back to the hospital until I was 42 weeks. Going overdue isn’t fun, but I didn’t feel too stressed about it. Ember was born at 42+3 so I figured this baby was likely to be late as well. Obviously, I would have loved to have been wrong, but I wasn’t going to start panicking until I’d gotten to that point. That Wednesday, at 42 weeks, I went back to the hospital for monitoring. I met with a consultant who was lovely and nothing like Kenickie from Grease. She listened to what I wanted and respected my choices and didn't wear a leather jacket or have a car with daggers hanging out of the wheels. She was happy for me to birth at home and for me to continue down the expectant management route instead of being induced. It makes such a difference to speak to a doctor who listens to you. 

The consultant wanted me to have another scan (it had been a week since my last one) and to continue with the regular CTG monitoring, both of which I was happy to do. I headed down to the ultrasound department, admittedly a little worried that the scan would show further increased fluid levels and that I’d end up having to give birth in the hospital again. I needn’t have worried though, the fluid measurements had actually gone down (from 94mm to 89mm) and everything looked ok. I agreed to go back for further CTG monitoring that Friday. 

At each visit to the hospital, I was having examinations and my Bishop Score was very slowly climbing up which felt like a positive thing. When I went back that Friday (at 42+2), the midwife said my cervix was favourable and the CTG monitoring was fine so I left feeling positive. I was convinced the baby would be born that weekend just as Ember had been. I was, of course, wrong. The weekend came and went with no baby. I was still ok on Sunday, but by Monday morning, I was beginning to lose hope. 

I trudged back to the hospital on Monday morning at 42 weeks and 5 days pregnant. The CTG scan took a little longer than usual because the baby was in a sleep cycle for the first 20 minutes, but after that, there were plenty of accelerations and movements and the trace looked fine. The consultant came back to see me and I said I was happy to keep waiting for a few more days so she asked me to go back on Wednesday for further monitoring and a scan. I had another examination and this time my Bishop Score was 8 (things were headed in the right direction so I was feeling positive). 

While I was in the hospital, the head of the home birth team came to visit me. She was really lovely, as you might expect. She told me the midwife who examined me on Friday had been convinced it would happen over the weekend so all the on-call midwives had been ready and raring to go. I asked if they got many women going post-term and she said I was the record. This was not reassuring to hear. I knew I was in the minority but hadn’t realised I was so extreme. I asked at what point I would no longer be allowed a home birth (I was now 40+19) and she said it wasn’t about being allowed. It was my choice and they would support me. So I asked at what point they would no longer recommend home birth and she said 40+12 (so, like, a week ago) and then an awkward silence filled the room. She talked about hypnobirthing and home births and lots of other positive things, then told me she was on call that night so would see me at my home birth in a few hours. 

I went home and relaxed for the rest of the day and then I went into labour.

Just kidding.

I still did not go into labour. And how relaxed can you really be at 42 weeks and five days pregnant? Not very. It is not relaxing to know your baby is taking extra time to grow, especially when your previous baby was an actual giant. But, I tried my best. I listened to my birth playlist a lot (it was 1 hour 10 long which was optimistic considering my previous labour was 15 hours) and I watched time-lapses of flowers opening (judge me all you will, but if you’ve never been 42 weeks and 5 days pregnant you have no idea the levels of desperation it is possible to reach. If a midwife had told me voting Tory would induce labour, I would have done it).

Needless to say, the flower time-lapses did not work. The hypnobirthing visualisations did not work. My stupid massive baby was stuck or stubborn or just a terrible person. Laurie had finished work when I was 42 weeks pregnant, so he was looking after Ebony and Ember which freed me up to spend all my time wondering why the fuck I was still pregnant. Sleep had become a distant memory. I spent most nights lying in bed waiting to go into labour (this doesn’t work) and then every morning I would wake up at 4am and feel overwhelmed with misery that I was still bastard pregnant. I couldn’t ever get back to sleep so I would go downstairs and bounce on my birth ball (this also did not work) whilst listening to my birth playlist and, often, crying. It was a great week. 

I apologise for the sheer length of this post. Probably you won't read this bit because you will have died of old age before you reach this final paragraph. I promise that the next post will include a wonderful birth.

The photo is from when I was 42 weeks and 6 days pregnant, it's the last proper bump shot I have because it just got too depressing after that.

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