By Isabel Hitchings
Before my first son was born in 2001 I believed that homebirth was an option for second births, once a woman had proven herself as a “good birther” in a more managed environment. For this reason I chose a hospital-based midwife, but planned to have a natural birth and thereby qualify myself to have any subsequent births at home.
Throughout my pregnancy I was plagued by high blood pressure, which was mostly caused by the fact that I hate to have my blood pressure taken. If I could persuade my carers to wait twenty minutes and retest (something they were often unwilling to do) it almost invariably resolved to normal. After a borderline result on the glucose tolerance test at the start of my third trimester I was also diagnosed with gestational diabetes. Because of these two things I was subjected to a lot of extra blood tests and ultra sounds – which were fortunately always normal.
Because of my diabetes and high blood pressure it was considered likely that labour would be induced on or before my due date so I was half pleased when my waters broke in the early hours of the morning when I was 37 weeks pregnant. I called my midwife and my mother and went back to bed in a futile attempt to get some more sleep.
Twelve hours later I met my midwife at hospital for “monitoring”. I had assumed that if labour wasn’t established and baby looked OK then I would be free to leave. However, to my surprise, I was automatically admitted for prophylactic antibiotics and was offered induction, which I refused. My contractions were nearly non-existent, disappearing when I lay down and I was dilated a whole one centimetre. I was admitted to a ward and spent the next several hours pacing the corridor trying to get things moving.
My contractions picked up and became quite frequent and very painful but always disappeared when I lay down to be monitored. My instinct was always to adopt forward leaning positions but the cannula in the back of my hand (for the antibiotics) hurt whenever I tried to put my weight on my hands. The afternoon passed and I was still pacing the corridor at dinner time though, between the contractions and the hospital kitchen’s inability to feed someone who was both diabetic and vegetarian, I didn’t manage to eat much at all. As the evening progressed I became increasingly worried and tearful because, if labour wasn’t advanced enough for me to be admitted to the labour and delivery ward by the end of visiting hours, my partner Jamie would be asked to leave. Fortunately I made the three-centimetre mark just in time.
I was getting very tired at this point and still had a long journey ahead of me so my midwife suggested a shot of pethidine to help me rest. I had planned a drug-free birth but tiredness got the better of me and I agreed. After a couple of hazy hours, which I didn’t enjoy, the pethidine wore off and I used the gas instead. I liked that much better as I could control my dose and my head cleared quickly, but it meant I had to stay in pretty much the same place which was not very useful.
Although increasingly painful, my contractions never looked very good on the monitor and I stalled at four centimetres for several hours. I was repeatedly told that my contractions were irregular and uncoordinated which always felt a bit like a personal insult. Twenty-eight hours after my waters broke I was put onto a syntocinon drip to augment my labour and given an epidural because, in my midwife’s words, I wasn’t “handling” the contractions and they were going to get a lot worse with the syntocinon.
My epidural had to be topped up several times before I got a complete block but once it was working properly I was able to get some rest. Jamie was very tired and overwhelmed by this stage and I think it was a great relief to him that I was no longer in pain. Once I was resting heas able to doze in a chair for a while. I greatly regret only having the one person there for support. When Jamie ran out of energy and needed to rest I resented him. When he left the room to eat or use the toilet I felt utterly alone. I suspect I accepted pain medication as readily as I did in part because I felt like I was being a bother to everyone.
The baby’s heart rate on the monitor became quite flat and unreactive and I was moved onto my left side. His heart rate improved somewhat but was never massively reactive. Around this time my midwife got tired and called in her back up so she could go home and sleep. I heartily wished I had some back up to call in too! As she left I overheard her tell someone else that my baby was posterior which was why everything was so slow and painful – I really wish someone had told me that before I accepted medication that left me lying on my back.
Even with the syntocinon my contractions continued to be irregular and uncoordinated so everyone was surprised when, less than four hours later, I was complete and ready to push. I have to say that the second stage of labour was the good part as this was something I was in control of and something I could do well (though, in hindsight, the spontaneous and uncoached pushing in my second birth was a lot more satisfying).
After I had been pushing for a while the monitor stopped picking up my contractions and my syntocinon dose was increased (again) with little effect. Around this stage a doctor came in and seemed quite keen to use a venteuse to get Crispin out. We asked to try for another half hour and he left. I noticed that I was feeling an intense pain right on my pubic bone. The pain came and went and seemed to improve when I pushed, so I pushed with the pain and soon my baby was crowning. The doctor came back with his venteuse and it was great to be able to tell him he wasn’t needed. The midwife held up a mirror for me and I was able to watch my son being born. With the epidural masking any pain, I pushed really fast for the last bit which caused a second degree tear. Crispin was born crying lustily and looking very healthy. He was placed on my chest and the first thing he did was pee all over me! My first thought when I saw him was “this kid has character”.
Within twenty minutes my baby had been taken from me to be weighed, examined and wrapped. About an hour after he was born he started rooting around but I found latching him difficult. The midwife wasn’t in the room to help so we fumbled about for quite some time before he fed.
Because I had gestational diabetes, Crispin’s blood glucose levels were tested and found to be quite low. Even though he was asymptomatic and his glucose levels were slowly improving with breastfeeding, I was strongly advised to offer him some formula via syringe to “get him going”. This was presented to me as hospital policy and I felt I had very little choice.
For the first few days of Crispin’s life he was very sleepy, due to being almost three weeks early and having a mild case of jaundice, which made breastfeeding challenging. I hand expressed colostrum and fed it to him with a syringe, but he also (at the insistence of the nurses) got syringes of formula. After a few days I allowed myself to be persuaded to offer Crispin’s supplemental feeds via a bottle. He would have worryingly long periods of unwakeable sleep that almost always followed a large formula feed.
I hated being in hospital, especially at night when Crispin was fussy and Jamie wasn’t allowed to be with us, but they were reluctant to discharge me while we were still having feeding difficulties. I was in a four-bed room and had very little privacy for breastfeeding, pumping or sleeping. Every evening I was told that I could go home the next day and every morning I was told we would need to spend another day.
Eventually, on the fifth day after Crispin was born, we were discharged. Unfortunately my long hospital stay meant that my parents (who had come down from Nelson) had to leave the day I was discharged so we had no help or support at home. But still, it was wonderful to be home where I had privacy, comfort and a loving partner who was there all the time.
I’d thought that having a good hospital birth would prepare me to birth my next baby at home but, in fact, it was having a bad hospital birth that made me determined to do things differently the next time. I call my second son’s birth my “redemption birth” as it proved to me that there was nothing inherently wrong with either my body or my willpower, but that I had been failed by a system that makes giving birth and learning to be a mother much harder than it needs to be.