Lewis's Birth Story - What not to do!

Lewis was due 23.03.20 - the date the UK Locked down! It was my first experience of birth and it didn't go to plan!

Warning - this isn't really a POSITIVE birth story but it is a COMMON birth story. I don't feel it was traumatic, it was the day I became a mother and incredibly special - but it isn't the birth I had hoped for.

We had my 12 week scan the day before our wedding! And from that moment on, this baby was full of surprises!

On my due date, I sat in the bath, hoping for a twinge or a sign that baby was on the way. My husband was night shift and the COVID pandemic had been ramping up across the UK, that night Boris was due to make a statement about it. I will never forget sitting in the bath with my iPad, watching that news briefing that the UK was going to go into lock down and wondering what that now meant for me and my baby! I called my husband in tears from the bath. I wasn't scared or worried just sad he might not be able to be there - I think I was in denial still about the seriousness of COVID. The lockdown was only going to be for three weeks so I figured that if baby was a little late it would be ok - my parents wouldn't miss out on too much if we were in lock down at the start. They could meet baby when it ended.

So I went from wishing my baby would arrive, to hoping he would stay in a little longer! My midwife offered me a sweep but I declined it. At 41 weeks - a week after we had been in lock down, she offered me it again. I didn't know what to expect - I assumed it would be like a smeer and decided to agree this time - I was so fed up of being pregnant by this point. The sweep however was not like a smeer - it was incredibly uncomfortable. She told me my cervix was really far back so I had to place my hands under the small of my back to help her. So I balled my hands into fists and tried to focus at a point on the ceiling until it was over.

Once home I had some spotting and cramps and got excited - perhaps baby was on the way. But after 24hours, nothing further happened. My induction was booked for the Saturday 12 days after my due date and I started looking forward to that - I didn't know at this point really what an induction meant or how it would completely change my birth experience! I had been along to the hospital antenatal education - learned how to bath baby, change a nappy, about the stages of labour and what to pack in my birth bag and I thought that was all I needed to know. I watched a lot of 'One born every minute' as another form of 'education' and felt confident that worst case - the doctors would be able to help if something went wrong - in every episode something seemed to happen and the baby was always ok in the end. In hindsight I did every thing you shouldn't do to prepare for birth!

Thursday 2nd April

On the Thursday I started to get back pain - it was a constant dull ache in the small of my back and wouldn't shift. I tried various yoga positions on the floor throughout the day to get comfortable and also used my TENS machine, but by 9pm it was really starting to get to me and although it wasn't any more painful, I found I couldn't ignore it to sleep. I knew this was because my baby was lying back to back - my mum had warned me that this would probably happen so I called NHS 24 instead of triage as I didn't know who to call. Eventually NHS 24 phoned back and explained I should call the hospital.

The midwife asked over the phone a couple of questions and asked about the babies movements - he had been moving fine but I said on the phone that the movements might be slightly reduced as my aunt had told me this was a sure fire way to be seen. The midwife told me to come in so they could check what was going on. So we made the drive to Forth Valley Hospital at 11:30pm. My husband had to remain in the car due to the pandemic and I wondered the corridors slightly lost until I found someone who could help me. I was shown into a room and strapped to a CTG monitor.

Friday 3rd April, 1am, CTG Monitoring

The midwife strapped the monitor to my tummy and explained she would be back in half an hour to check it. Half an hour came and went - I didn't have signal on my phone to let my husband know what was happening or to entertain me, so I lay watching the monitor and the print out, trying to work out what all the lines meant. I took pictures on my phone to show my husband when I got out. I guessed that I was beginning to have contractions from the peaks I could see at the bottom, and gathered the top was baby's heartbeat. Eventually the midwife returned, she wasn't happy and said she would continue the monitoring for another half hour.

I was beginning to feel uncomfortable, on top of the back ache I now needed the toilet because the straps were both pressing on my bladder, but continued to lie there for the monitor. This scenario repeated two more times with her returning but not being happy with the read out. Apparently once in every half hour or so, the baby's heartbeat was dipping. She recommended I stay in and be induced that day - a day ahead of schedule.

This was the first time I panicked - not about being induced - that I was happy with - I was so ready to get this baby out! But I wasn't ready to stay in the hospital! We had come to the hospital without even my hospital bag as I was so sure baby wasn't arriving - I just wanted the back pain dealt with! My husband wasn't with me and I needed him to help make the decision! I asked what time would they be inducing me and she went away to find out. Another 20minutes or so went by before she returned and said 4pm. It was now about 4am. I made the decision there and then I was leaving! I was not going to hang around by myself without my hospital bag for 12hours. I told them I would return at 4pm and I went to find my husband asleep in the car park.

Friday 3rd April, 4pm, Induction begins

I did manage to get back to sleep once home and woke at about 10am. I continued to have twinges throughout the day and made myself comfortable on my birth ball or in various positions on the floor. We got the hospital bags ready, and at 3:30pm we headed to the hospital. My husband dropped me off and I made my way to the antenatal ward.

Fortunately my friend had told me what to expect with an induction - and that was a lot of hanging around and not to be impatient! So I sat in the waiting room upstairs for over an hour. The nurse came by to take my order for dinner and eventually about 5:30pm I was shown to a bed in a 4 bed ward. I got myself comfortable on the bed as there wasn't much space behind the curtains. I wondered about the other 3 women behind their curtains - it would have been nice if we could have chatted as we were all alone. I wondered how long they had been there before me? If they were having contractions and just being silent. How they were feeling?

My dinner arrived and was cleared and at 7pm the midwife came to strap me back onto the CTG monitors. At least this time I knew what to expect and took some comfort watching the little graphs print out. I also had my iPad with some downloaded programs to watch. After 7:30pm they came to review the monitor and began the induction process with a pessary - 3 hours after I had arrived! At about 10pm I was quite uncomfortable - I knew I was having contractions now and the graph confirmed it - but due to the mixed ward, I kept quiet behind the curtains - I didn't want to be the one making noise and keeping people up! At 11pm a midwife offered me a bath and I agreed! Anything to get off that ward!

During the walk to the bathroom the contractions kicked up a notch but once I was in the bathroom I was in heaven! A dark, private room and the bath was huge and deep! I sank into the bath and relaxed - and my waters broke! It felt like a plug had popped inside of me and I felt this huge rush of fluid between my legs. The waters were dark and stained and I wasn't sure what to do, so I decided to just pull the red emergency cord in the bathroom.

Straight away two midwives arrived and I explained (from naked in the bath) that I thought my waters had broken. They agreed and said that there was meconium in the waters - baby's bowels had opened - and that is why they were darker. The midwives helped me out my short lived bath and I got myself dressed. Whilst I should have been worried about the meconium, I was happy - it meant I would be transferred to the labour ward right away and my husband would be able to join me. I used the hospital phone to call him and explain, that even though I wasn't in established labour yet he could come in because I was now 'high risk' - imagine being happy for now being 'high risk'! But I was just so glad not to be alone! I went back to the mixed ward to gather my bags and the midwife wheeled me through on my bed at 12:30am. I was the first to leave that mixed ward and it felt like a win!

Saturday 4th April, 1am, Labour Ward

Finally my husband could join me. He found me bouncing on a birth ball at the end of the bed in the labour ward, breathing through contractions. I was asked to get on the bed so they could reattach the CTG monitors. I really didn't want this again - I'd had it constantly in the mixed ward and was finally enjoying bouncing on the birth ball! I found the CTG too restrictive. I asked if they could do something else and they suggested a clip for the babies head - I agreed to this, again not really knowing what I was agreeing to. Now I still had to get onto the bed for them to do this procedure!

They had to attach the clip to the babies head through a vaginal exam. I found this intervention - like the sweep - incredibly painful and I used the gas and air to help - this was the first I had needed any pain relief.

Even though I had requested the clip so that I had freedom to move, I don't think I got back off the bed after it was attached as very soon after they wanted to examine me again. The midwife tried but couldn't reach my cervix with her fingers - it was too far back. Her attempt to reach had been agony! She tried again and failed. She explained this had never happened and decided to try a third time. This time I did make a noise - I screamed and asked her to stop - the examination was too painful. She went to find a doctor to do it for her. The doctor managed and was able to manipulate my cervix closer to the front, but the pain caused by these examinations was enough for me to ask for more pain relief. I requested diamorphine.

The diamorphine was administered along with an anti-sickness injection but both were ineffective for me. Instead of pain free I felt drunk but not in a good way. I was lightheaded, dizzy and clammy and immediately started being sick. I could still feel the contractions every so often, and when I was able I drank some lucozade, but this was followed by the most spectacular projectile vomiting you have ever seen! I was clearing the end of the bed. My poor husband was there each time with the cardboard sick catcher! I remember lying there, sweating and shaking violently whilst the room spun around me. The midwives managed to find me a decent fan to try to help cool me down, I used wet facecloths on my forehead and neck, and I was re-injected with the anti-sickness medicine, but nothing helped. Hilariously in the midst of all this, at one point I cried out that I had gone blind - and was politely reminded that I needed to open my eyes!

At about 7am I remember throwing up a huge amount, and all of a sudden felt better. A bit like a bad hangover than can only be cured by being sick - the diamorphine had finally left my system!

Saturday 4th April, 7am, Epidural

At this point they wanted to re-examine me. I was only 4cm dilated. They said it was now time to try the drip to speed things along and I requested the epidural. My friend had told me as soon as they mention the drip just to get the epidural and I went with it. The anaesthetist came and gave me the epidural and a catheter was attached - I was now stuck on the bed - not that I had moved in the last 6 hours anyway. As soon as the epidural was attached I relaxed. They advised I just try and sleep and that is what I did. I could hear my husband chatting somewhere to the midwives but I just zoned out and tried to rest.

They woke me 4 hours later for another examination. I was 8cm! Finally I was getting somewhere! But they were not happy with the baby - his heart rate was dipping when I was having contractions. They suggested a c-section but I was really against this. Instead they decided to do a foetal blood sample. This was via another examination but fortunately thanks to the epidural completley pain free. They cut my baby's head and took a sample of blood to check the blood oxygen level. Thankfully It was high enough for me to continue my labour.

They repeated this when I reached 9cm. It was still high enough for me to continue. Finally I reached 10cm dilated.

Saturday 4th April, 1pm, Pushing

The doctor explained, due to the meconium in the waters and the baby's heart rate dipping on the monitor, they would only give me half an hour to push baby out before they would have to try and help. The beauty of the epidural was that I was very comfortable and was well rested for pushing. With my legs in the stirrups and my husband helping I gave it my best go every time I had a contraction. It felt strange to bear down but not know if I was doing it correctly as I couldn't feel anything.

After half an hour they explained they would need to help things along. We were going to go through to theatre and would try a forceps delivery - if that wasn't successful it would be straight into a c-section.

I knew my baby was not going to be born via c-secton. I couldn't even imagine it. I would have to give my best with the forceps as I knew that would mean an episotomy and I did not want stitches in two places!

Saturday 4th April, 2pm, Theatre

My husband was given some scrubs and I was wheeled through to theatre. The epidural was topped up in case I needed a c-section - although I still didn't believe I would. They got the forceps organised and asked me to push. I knew I would only get 3 chances before they went to c-section and I gave it my all.

On my second push my baby's head was born! I couldn't believe it because I couldn't feel it! I listened to the doctors and when they told me to push again out came my baby! I listened intently for a cry but couldn't hear anything. I remember staring at the ceiling and just hoping for a sound. Apparently he had cried straight away and I had missed it! I'm not sure what was going on at this point - I imagine my placenta was being birthed but I was completely unaware of that, and I guess checks were being done on Lewis - I think Craig had gone over to see him. I just lay and focused on a point on the ceiling and waited.

After some time, Lewis was placed on my chest and I burst into tears. It was relief that it was all over, relief that he was here, pride that I had done it and pushed him out, and joy that I had a baby all in one. Lewis Arthur was born 2:40pm on 4.4.20 weighing 9lbs 3oz. He had a little mark to his head from the forceps but was perfect.

When we returned to the ward, our midwife apologised to us. She had just been to a staff briefing on COVID and from now on had to wear full PPE and a mask and could not hug us to congratulate us! This was just the start of social distancing and lock down life with a new baby!

Night One

Because there had been meconium in my waters when they had broken, Lewis had to stay in for 24 hours to be monitored and have his temperature checked. And I was numb from the waist down and still had a catheter in so I would need to stay in anyway. My husband slept as he felt he needed to before driving home and I held Lewis. I managed to breastfeed him for about 45minutes and simultaneously eat the best toast I've ever had.

At 7pm we said goodbye to my husband and were left by ourselves. At 9pm I was wheeled through to another mixed ward with 3 other new mums and their babies and began another very long night! There was no signal to use my phone which was frustrating but I still had some sweets left which I ate. I had to ring the buzzer for midwives to change Lewis's nappy as I still could not move from the epidural and felt a little strange not to be taking care of him straight away.

It wasn't until 11pm that the midwives came to remove the catheter and help me up and out the bed so that I could shower. I waddled to the bathroom on the ward with the help of two midwives holding a large maternity sheet beneath me and had a wonderful wash. I walked back and finally felt I could relax. Lewis was asleep although a midwife told me I should wake him to feed him, which I did. Later another told me to let him sleep and sleep myself. I realised all midwives give you conflicting advice at this point!

All through the night someone's baby cried, I was still awake at 3am, hyper and unable to settle. I guess I did sleep and at 10am my husband arrived to take us home. We dressed Lewis in his going home outfit and after his checks were complete were discharged at lunchtime... we didn't leave for another 45minutes as we couldn't work out how to lengthen the straps on the car seat!

Finally, after 3 days, we left the hospital and began our journey as a family of 3!

What I learned from my first birth experience

I hadn't obviously planned a forceps birth - I don't think anyone does! I had hoped for a water birth but as soon as I agreed to the induction I knew that I wouldn't be able to have one. But looking back, knowing what I know now - there are so many incidents that stand out for me as learning points.

• My waters broke spontaneously - and my labour progressed itself the only time I truly felt safe and relaxed - in the bath! The environment was so important for birth and I didn't realise it.

• There was meconium in the waters - later a midwife said 'Well, of course there was, he was well cooked!' What she meant and what I have since learned is that it is not necessarily a sign of distress - just a mature digestive system - very common in babies overdue - about 20% will have meconium stained waters.

• A lot of other people's birth stories influenced my decision making and perception of labour - from my mum telling me a back-to-back baby would be agony, to my aunt telling me to just say movements have reduced to jump the induction queue, to my friend telling me to take an epidural if they offer the drip. Perhaps I shouldn't have listened to these quite so much.

• I did not like the CTG monitoring - the pressure on my stomach and bladder was uncomfortable and I couldn't get off the bed. I have since learned that the evidence for CTG monitoring is questionable and I wouldn't have this again.

• The contractions and labour never pushed me to request pain relief - it was always the examinations and interventions - I could have declined examinations at any point but did not realise this and thought that the midwives and doctors needed to do them. I don't even know if I truly consented to this, I just thought it was part and parcel for birth and necessary. I have now learned far more about my rights in birth.

• Finding out I was only 4cm was not helpful information - I felt disheartened and at this point I think I gave up when I requested the epidural.

• Diamorphine was not for me and nor was gas and air - both meant that I lost control mentally and I did not like that vulnerability. I much preferred the epidural where I was able to talk calmly with the doctors and be taken seriously. I decided I would never have gas and air or diamorphine again.

• I believe Lewis may have been born by c-section if I had not been so against this. I could not envision my stomach being cut and him being born that way and I was so determined I would push him out one way or another, but the doctors were suggesting a c-section when I was 8cm.

• I learned later that 47% of women whose labour is induced ask for an epidural - compared to 19% who have a spontaneous birth. And that of these 47% of women who have an epidural, they then have a 40% increased chance of then having an assisted delivery such as forceps. This is known as the cascade of interventions and this is what happened to me and many others like me. I wonder what would have happened if I had not had an induction at all?

The final thought I have on my birth experience is this - perhaps there were occasions where I should have spoken up a bit more. Maybe my husband could have? It was the start of a pandemic and I didn't want to be seen to be creating a fuss or being a nuisance, but I'm not sure just going along with everything in order to be a 'good patient' was really in my own best interests. But this birth experience was important, as from it I learned 'what not to do' for my next one! And Lewis was born, healthy and happy and so in some ways, it was still one of the best days of my life.