Alfie’s C-Section Birth Story
Having been chilled to within an inch of my life on Monday morning, I got a call from the lovely midwife I had spoken to last week asking me to come in for some monitoring so the registrar could “agree for me to postpone my induction by 24 hours”. I chuckled but I thought I might as well play the game, seeing as how I had expected to have that very conversation on Tuesday morning, anyway.
So after lunch, in we trooped to Lister and after a large dose of sitting around in what can only be described as a sweatbox, the lovely registrar came to see me about my “specific issue”. That did throw me temporarily, but I rallied and ran through all the research I had done and why I wanted to wait longer than 42 weeks before considering an induction.
We discussed NICE guidelines and RCOG guidelines (or rather I discussed them) and in the end we agreed that monitoring would happen until 43 weeks at which point we’d look and see how things were moving along.
Marv.
Oh, and while I was there, how about a baseline trace? Seemed churlish not to, so I spent a very pleasant half-hour hooked up watching Alfie get himself all excited, followed by ten minutes of the midwives flapping as the little swine fell soundly asleep and refused to move. Luckily I had a bottle of cold water with me that sorted that minor problem out while they weren’t looking.
The hospital’s push for induction
The one big downer on the otherwise very positive afternoon was the attitude of the midwife who had been so positive. Once the resident and I had agreed, a plan for monitoring her attitude changed entirely and she had a go first at Keith, and then at me, implying that we were being irresponsible by trusting my body over the miracles of modern induction.
She has even written in my notes both on Monday and today words to the effect that I have to be on Red Alert for any signs of change. Because obviously up to this point I had been using my little internal bongo drum as a mere distraction when stuck in traffic. Today I had the joy of speaking to another graduate of the Lister charm school when I went for a scan to check the placenta and fluid levels.
Her opening gambit was to ask me how far along I was, at which point she said, in all seriousness:
“So why aren’t we just starting you off then??!”
I don’t want to be induced!
I gritted my teeth and explained I didn’t want to be induced and I had agreed to be monitored instead… *blank look*… so I need you to check the placenta and fluid levels, please.
Apparently, I am breaking new ground left and right with that place because she had to leave to find out what to do next. She wasn’t finished yet though, not by a long shot. Instead, she started by measuring Alfie’s head, which apparently was off the scale (as she informed us with extreme glee). She moved on to his tum and declared that I had better hurry up because our little boy was getting close to 9lb!
Were it not because I knew already that third-trimester scans have a tolerance of 2lb I think I might have broken at that point. In reality, the printout showed that he is just growing on exactly the same curve as he had been previously and both cord and fluid are looking perfect.
Trying to move things along
So anyway, I sit here this evening bouncing on my birth ball*, looking forward to the joys of my visit tomorrow. If there were no other motivation, that alone would be more than enough to motivate me to get this baby the hell out. I do find it profoundly sad, that something as simple as delaying an induction can be met with such vitriol by certain healthcare professionals.
It’s almost as if they have taken it as a personal insult which frankly is nothing short of bizarre. Luckily I have also spoken to that wonderfully respectful registrar (who said it was “nice to meet a lady who knew her mind” which I took as a compliment), a junior midwife today who was SO interested in our plans for the birth, and most of all the community midwives, who I called yesterday to update and who, to my eternal surprise, were totally chilled about our home birth plans going ahead unchanged.
Now if only Carlsberg did home births, maybe everyone would be that positive! We had agreed to stick a date in the diary after speaking to a lovely midwife on the delivery suite who told us we could still preserve a lot of the important elements of our home birth, such as bringing in our birth pool and being very supportive of what we were trying to do.
The day before we were due to go in, I decided I needed a day of peace to centre myself, and being a chicken, I booked in with the community midwife and had Keith call the hospital to tell them we would not be seeing them until the next morning. Obviously, I could only hear one half of that conversation, but judging by Keith’s tone, the reception to our plans fell below even the usual levels of disgust. I’m not entirely sure, but I believe the point at which he rolled his eyes for the seventh time was about the time we were told once more that we were going to end up with a stillborn baby.
Awaiting the impending induction
The next morning (the 11th) we arrived at Lister for induction. It’s hard to describe where my head was at that point. I was fairly calm about the idea of being induced, I think in my head that day “off” had given me the time and space to reconcile myself knowing that we had thrown everything we could at the situation and that I had complete trust in my husband to help make this birth as positive as it could be.
On another note, I have to record for posterity the fact that we looked like a pair of nomads that morning. We moved into that hospital with everything we thought we might need for the birth–pool; hoses, stereos, CDs, food, baby equipment. It was a two-person job just to haul it around the maternity department for the next few days until someone thought to bring us a trolley.
Time for induction
After my baseline monitoring was done (and I had the chance to smugly watch our baby’s perfect heartbeat for the last time) I was taken down to the delivery suite and given my first dose of Prostin, made to lie for an hour and then sent off around the hospital to see if we could get things going.
On the seventh lap of the hospital, we spent some time in the “wild garden” which was clearly a code for random-patch of-ground-we-ran-out-of-money-to-landscape. I sat on the bench with my TENS machine, slightly concerned that the back labour that had been taunting me for the last few nights wasn’t going to miraculously turn into constructive labour.
Looking back, right there should have been the warning sign that all would not go well, if a baby is in the wrong position to trigger contractions himself, then forcing them to start with him still in the wrong position was hardly likely to improve matters. That afternoon passed slowly, first walking around and then later in the Day Room, which we had to ourselves, the lights low and me rocking and bouncing on my birth ball in a last-ditch attempt to get Alfie to turn.
My TENS machine was my best friend and despite having no appetite, I think I was well stocked up with tea and digestives by the time the evening rolled around and our progress was checked.
Nothing is happening!
Actually, it was the lack of progress because, for all that discomfort, nothing had happened. I mean not a single chuffing thing. Oh, apart from the minor matter of a swab result which showed I had Group B Strep. Ordinarily not something I would have allowed to change my plans, but then I wasn’t in Kansas anymore, and now I was being told there was no way that I could now have my water birth.
It was around this time that negotiations started around what Keith was going to do that evening because Lister is one of those enlightened hospitals where they still send dads home as soon as is decently possible. Frankly, I was having none of that, and even if I had been, Keith was having even less of it.
The home from home room
I think the fact that my notes with strewn with snotty comments about being difficult helped us so when I said I would walk if Keith were made to go home, the staff knew to take me absolutely seriously. Several calls later and the Head of Midwifery (no less) gave permission for us to use what they call a Home from Home Room.
For those of you who don’t know, the Home from Home Room is a hotel-style room the hospital uses for grieving parents who have had a stillbirth. Every last thing in the room is dedicated to the memory of a lost child, which is just perfect when you are being induced with a child you have been told for ten days is going to die because of your stupidity.
Frankly, I didn’t care by that point because my back labour had ramped up after the second dose of Prostin and the only way I could cope was if Keith put his full weight into my lower back with each contraction (or contraption as we somehow ended up naming them).
I was staring down the barrel of the second night of no sleep and I knew that wasn’t an option, so I asked for some paracetamol and codeine and got into a nice hot bath. The bliss!! The unmitigated, boundless bliss of that hot water. I floated there until my toes went wrinkly and debated whether it was physically possible to sleep a night in a bath. Deciding it wasn’t I dragged myself out, and it was then that I had my lowest point in the labour.
I was tired, I was hungry, and despite the best efforts of the midwife on duty in packing me into different positions and Keith in pressing my back, I felt out of control and railroaded by the back pains. I could see I was facing a second sleepless night, and it was the time I most wanted to sit and wail about the unfairness of it all.
The back labour!
Instead, I happened upon a solution and like a drowning man clung to it with everything I had in me. I discovered by a sheer fluke of timing that if I was sitting bolt upright at the foot of the bed when a contraction hit, I could breathe through them effectively. Obviously, this solved the backache issues, if not the sleepless night issues.
I had also made Keith hit the hay because at least one of us would need our wits about us the next day, so I couldn’t even share my newfound comfort with him. And TV is about as interesting as playing spot-the-polar-bear-in-the-snowstorm in the early hours of the morning. All of this meant that I was forced to find some way of sleeping upright, which I did just about manage after a while with the aid of the sofa and a shed load of cushions. That said, I certainly wouldn’t suggest it as an option unless all other options, including sharpened spikes, have been exhausted.
Syntocinon and c section looming
The next morning, we knocked about making the most of that little room until we were taken back into the delivery suite for The Next Step. We met another in a long line of registrars who explained the schedule of events that they were proposing, which in summary involved breaking my waters, with the threat of a Syntocinon drip to follow, and a C Section grand finale if none of the previous steps had done the trick.
Unfortunately, the idea of breaking my waters posed a bit of a conundrum for the staff because by doing so, they were increasing the risks of infection to the baby, and they already knew that I had Group B Strep… Oh what to do, what to do! Well, the obvious solution when creating a problem is to mitigate it with more medicine: In this case, IV antibiotics before during and after breaking my waters.
The amniotomy itself was painless, if an odd experience, one I suspect to be a familiar territory of the old, infirm and paralytic. Although something had gone well with my induction, there were slightly furrowed brows all-around at the sight of my waters. There was meconium, Grade 2 out of a possible 3, which it transpired was old meconium, there most likely because Alfie was post-dates, rather than green meconium which would indicate any level of distress on his part.
In an amazing turn of events, the registrar was actually pretty calm about back, as development and was apologetic about the fact that it meant my previous timetable would now have to be halved.
Alfie still in OP position but still trying for a natural birth
Strangely, I wasn’t surprised, or worried by that announcement. I think looking back I knew deep down that nothing was going to shift Alfie, and that we were essentially just going through the motions. He had been in the OP (back-to-back) position for over a week, which was the reason he hadn’t kicked off labour, and nothing we were going to throw at him was going to change the basic physiological premise of labour so if a baby isn’t pressing down on the cervix, the cervix will not dilate.
I would not stop trying for him though, not now, because he deserved every chance I could give him at as natural a birth as possible. So I got back on my beloved birth ball*, monitors attached, and rocked and bounced and wandered as far as the leads would allow. My contractions were still stubbornly unchanged though, 8-10 minutes apart and slap bang in the small of my back.
Keith had resumed back pressing duties and combined with my TENS machine, each contraction seemed quite reasonable. Part of our caravan of luggage was a folder of CDs, and it was now that I felt like I needed to be motivated by some “doing” music. There was only one CD I wanted and that was Audioslave. I’m not sure how much it helped because there came a point where I was locked in a little bubble of my own, but while I could never tell you what tracks were playing or when the vibe from that music was absolutely right for what we were trying to do.
Time for the Syntocinon
It felt like minutes later it was time for my next progress check and, as predicted, nothing much had happened. The Syntocinon was wheeled in and I was hooked up on the lowest setting, 1mg, which was to be doubled every 30 minutes until my contractions numbered 4 or 5 every 10 minutes.
The only slight problem was nobody had explained the plan to the infuser, and it insisted on malfunctioning every time I was due a dose of the drug. It was quite farcical really, the number of midwives I had trooping in and out of the room trying to make this thing work, and all of them failing to tame the miserable, temperamental machine.
I would love to say I found it amusing, but the extra attention meant that for the first time that day, I wasn’t able to buy extra time because of staff shortages and busy departments. The dose was ramped first to 2mg, then 4mg and on to 8mg and with each increase the contractions seemed to carry me off further into my own little world.
Over to dad to finish the story!
Right about now, I have to hand you over to a guest writer for the rest of the story, because my memories of everything that happened next are confused and patchy. Over to you daddio!
At this point the contractions were coming thick and fast, the monitor measuring Tash’s contractions (which had previously been told meant nothing) was going off like a seismograph in downtown San Fran, and I was trying to fold myself around the front of Tash’s bed to look her in the eye and offer words of encouragement. I must say, you do feel somewhat pathetic uttering the words “breathe, drop your shoulders” as someone is going through what looks like some kind of exploding pelvic experience.
She was then offered further pain relief and was told morphine was available. I could not work out if her reply was muted due to the intense nature of the contraction, or because she didn’t really want it. Anyway, the midwives didn’t hear anything, and so I ignored her mumblings. This went on for a few minutes until the student midwife informed her senior “she has been offered Morphine”… at which point Tash exploded:
“YES, I WANT MORPHINE!”.
We had always planned to hold off drugs as long as possible because you hear so many people with stories of “we got so far, had an epidural, and two minutes later the baby arrived–the drugs hadn’t even taken effect”.
Anyway, Tash’s mind was made up, her drug intake NEEDED to step up. Looking back, I think our error was to assume that when a patient’s request was made, then a reaction from hospital staff would shortly follow. What actually happened was Tash’s request got passed from midwife to midwife, as one either left or entered the room.
Time for morphine!
Anyway, eventually it arrived, injection injected, and Tash quickly went from hugging the ‘head’ of the bed to passed out on it. This must have been mid-late afternoon by now. This was the hardest part for me. I knew Tash didn’t want the dosage to be increased anymore and I knew the midwives were relying on me to time the contractions… yet all of a sudden I was presented with a wife who responded to very little, and a machine that wasn’t showing when contractions kicked in.
Occasionally I would ask if she was going through the same contraction, and I’d manage to make out a response saying that there had been one or two since! I had no idea when I needed to be pressing the “boost” button on the TENS machine as I had no idea when the contractions were hitting – so I kept it on more often than not, it was just great having a button with “boost” on it!
Of course, the midwives and Registrars would ask about contraction frequency and I would just tell them what they wanted to hear. Five or six in ten minutes, a minute or so apart. I didn’t have a clue, but it kept them from turning up the dosage on the drip.
No progression!?
Anyway, time passed by… we must have listened to the Audioslave album another three times through… maybe it was 8 pm… and eventually, a doctor came in to inspect Tash. Hospital timescales are shocking by the way. I remember working out at the start of the day that it would all be over by 3 pm, or else she would be in very active labour. He had a peek and declared nothing has progressed whatsoever.
So here we are, some five hours later than predicted, and still no son. This registrar, maybe the 6th or 7th we’d had the pleasure of seeing, was brilliant though. He sat down next to us, clearly feeling like he had bad news to break.
“I’m really sorry, we have tried everything, and I know it’s not what you both wanted but I don’t see any point in continuing with the Syntocinon drip.”
Tash interrupted and informed the bloke:
“The only way we are carrying on with that drip is if you’re attached to it!”
We had our plan, and it didn’t include a c section, but at every crossroads, we have faced the path we chose was always our own. We were now at a point where, for once, we agreed with what was being suggested to us. Alfie would not make an appearance without someone going in and grabbing him!
Time for a C Section
And so the registrar disappeared, and the midwives prepared Tash. A few minutes later the registrar reappeared.
“I’ve got some bad news I’m afraid.”
It appeared he’d spoken to some higher power, who had no idea about us or our situation and refused the caesarean. Tash needed to have an epidural, and the drip be cranked to 16, and then 32. If Alfie still refused to come, then we would granted our caesarean… in 2hrs time.
I don’t remember if I asked, or maybe it was the anger on my face that requested, but everyone then left the room. I checked with Tash if she was happy with a C section, that this was definitely the result we were looking for now… and prepared to fight for the birth that we wanted once more.
Note from Tash
My mind was pretty fuzzy by this point, but I remember three words going around my head like a claxon when the Registrar said we would have to try the drip for another 2 hours at the max dosage–Pit to Distress. Basically, the practice is to crank up the drip as high as it’ll go on the premise that either it’ll get things moving, or else the doctors will have to perform a C Section because of foetal distress. I was determined that there was no way this was going to happen to our child.
The midwives came in first, to which I fairly calmly pointed out that a) we had been made to feel like sh*t for 2 weeks, being told we were risking a stillborn baby and that it was imperative the baby was born ‘immediately’, b) we had been told all along that it was most likely we would have a caesarean section, and c) that we had just been offered the C section, so clearly you agreed with me. We wanted a C section, and we didn’t want to wait. I had just got into the full flow when they cut me off and said I would need to say it to the registrar. He reappeared and I went through it all again:
I want a C Section!
“We aren’t prepared to have our son on that drip any longer than needed, and now we are FINALLY agreeing with you, and it’s you guys dragging your feet, delaying what you have been saying all along was inevitable. We want the caesarean, so I ask you go away and speak to whoever you need to speak with and state our position and see what they say.”
He clearly agreed with us, and Tash said she heard the midwives say they agreed with everything I said. He reappeared a few minutes later and confirmed we were on for the caesarean. A few months earlier I remember being really worried that an incident would appear; I would have to make a decision ‘cos Tash was so drugged up, and I’d end up making the wrong call.
Now the incident had appeared, and I felt pretty good about myself knowing I’d passed that little test … then I realised the result of my actions … I was going to have to watch my wife be operated on, and my child be delivered by C section!
Now, I’m generally ok with blood, guts and pain, but when certain things are left to the imagination, I can get quite squeamish. Casualty is not always an easy watch for me! So as I entered the theatre in my ‘obese American’ size scrubs I pointed out to Jo (the BEST midwife we encountered over the whole 43 weeks!) that I had been awake for 3 days, was running on pure adrenaline, and “wasn’t really sure how I was going to be with this”.
Jo pointed me to where I needed to be and rolled a stool over to me “you wouldn’t be the first to faint Keith!” The operation was real quick. The screen went up across Tash’s chest. I was head end, so I didn’t have to see all that was going on at the business end!
Alfie is born!
They confirmed Tash couldn’t feel anything below her armpits, and we chatted complete BS to pass the five minutes we were told it was going to take for little Alfie to make his grand entrance. Suddenly I heard a quick whimper, and suddenly they whisked a very small blue baby over to a cot a few metres away to the left.
His hat was rapidly placed on his tiny head, he was wrapped in a towel, and the attending midwives began rubbing him madly. They pulled down the heat lamp. By this point, I was up on my feet, edging closer because I wanted to see what was going on, but I was also conscious not to get in the way. An oxygen mask came out and was placed over the little fella’s face… and immediately you could see him go into shock, arms and legs rigidly forced out in front of him.
I turned and walked back to Tash, telling her that everything is OK, yet I can hear “come on little fella” in the background so I had no idea how convincing my words were. The next few minutes passed very slowly, yet his temperature rose and the breathing sorted itself out. He is presented on Tash’s bed. I asked afterwards, if what I had witnessed was common, or if that’s the way C sections usually went… and was told that was a common C section delivery–why hadn’t anyone told me that in advance so I could prepare myself?
The time was confirmed at 21:34, and with the doctors’ work now done we were very quickly carted out of the theatre and whisked around the corner to a recovery area. Jo, our attending midwife at that moment, helped Alfie take his first feed, and I grabbed some photos of our gorgeous son. An hour later we were rolled back onto the ward, a further 60 minutes later I was turfed out of the hospital.
I’m disgusted that a partner is removed from his wife and newly born son so soon after birth, but having fought to stay one night it was made very clear to me that a second would not even be contemplated! My Dad – dog sitter extraordinaire throughout all this – collected me from the hospital, and I know I slept very well, and very happy that night. As it turns out, far better than Tash did!
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