December 2016 - my life was changed forever with the birth of my beautiful and healthy daughter. She was tiny, precious and a surprise red-head. As Game of Thrones fans my husband and I turned to each other and both said ‘kissed by fire’. That she certainly is. Unfortunately, that was the only thing about the birth that I could compare to a large cinematic/Hollywood experience. There was not that moment of extreme, intense, heart-imploding love that I had seen for years in the movies. I didn’t instantly feel like a ‘mum’. I felt tired and battered and ultimately deeply in shock. Here she was, this long anticipated, intensely wanted bundle of pinkness on my chest - looking up at me in the hope that I knew what I was doing, and all I wanted to do was switch off. In that moment, or maybe sometime in the hours prior to her arrival, something inside me had switched off without myself or anyone around me noticing.
The details of the birth are somewhat unimportant. Someone else could have had the exact same experience with a completely different result. Just like every baby is different, every mum is different too - something that is too often lost in the pregnancy conveyer belt. But in short; it was long, it was painful, it was confusing. For me it was the single most frightening and lonely moment of my life. Ultimately I felt unheard and completely out of control. The more I felt this the more I retreated into my own head and was unable to adopt any coping mechanisms that, to be honest, I complacently never bothered to learn.
The result? Months of nightmares. Panic attacks. Inability to breast feed. Essentially an emotional shut down which I later, with help, could recognise as PTSD. To the outside world (including my mum who is a highly trained counsellor) I was fine. My baby was happy and well looked after. I was the mum that had everything under control. Never late for appointments, the first to arrive at mummy meet ups to grab the comfy seats in the coffee shop, the first to get their baby to sleep through the night and to wean. The reality though was that I needed to control everything around me and had just lucked out with a cooperative baby!
However, no matter what I did I could not erase the complete and paralysing fear of ever having to go through the birth experience again. In fact, comparing birth stories with other mums made it worse. I didn’t go through an emergency caesarean, I didn’t need an episiotomy, my baby was born healthy. How could I complain? Still the nightmares continued. But no matter how terrified I was, I had a clear image in my head of what I wanted my family to look like. The need to give my daughter a sibling was greater than my suffering. I couldn’t imagine feeling worse.
January 2018 - I am pregnant with baby number 2. I should be excited. To some degree I am, but every night when I close my eyes I remember the harsh delivery room lights and the taste of panic. I remember the sound that echoed around the room as my baby very quickly burst from my body. I remember the feeling of being prodded while being encouraged to breast feed for the first time. Bedtime soon becomes a flash back to the night that should have been the most exciting of my life, but in reality, was one of the worst. I lie in bed and wonder what that says about me as a person; as a mother, and night after night I sink deeper until my pillow begins to feel like rock bottom.
It was sheer luck that at 24 weeks pregnant I saw a post on Facebook inviting couples to a free hypnobirthing taster evening. It ticked all the boxes - it was local, it was at a time my husband would be home, it was free. A mum friend of mine had raved about her hypnobirthing experience and highly recommended that I tried it. I wasn’t certain that it wouldn’t be my ‘thing’ but I found myself sending a message asking to reserve a place. A few days later I found myself nervously surrounded by a group of pregnant couples with an array of bump sizes. As everyone made small talk and tucked into cake I could feel my anxiety levels climbing. The only thing scrolling through my head was, ‘just get through tonight without crying’. Spoiler alert - I failed. Epically. As the session continued I could feel myself getting lost in my own head - the topics being discussed fizzing around me. I am the only one with my eyes open during a guided meditation. I’m still not sure how I feel about hypnobirthing but the woman running the session is certainly keeping me interested. She’s confident, experienced and incredibly down to earth. She reminds me of a friend but I can’t think who. I start to relax. Enough that after the session I ask to speak to her and then, just like opening Pandora’s box, everything tumbles out of me. I tearfully explain my experience. I tell her my fears going forward with this pregnancy. I tell her things that even my husband is surprised to hear. I know I must look like a mess. I know I dumping way too much on a stranger but she’s not looking at me the way the Health Visitor did when I spoke to her. She’s not just telling me to pull myself together and give it time. I still feel like I’ve hit rock bottom and am stuck in a cold, dark pit, but now, if I look carefully, there is a light and this stranger is standing in it offering a hand.
That night changed everything. I could no longer pretend to be OK. My husband could not unhear what I had said and I could no longer deny how bad things were. I would like to say that everything improved from that moment but that’s not strictly true. I cried every day for a week or two but the difference was that I didn’t hide it. I spoke more freely and with confidence to friends and family and finally started putting a name to my ‘condition’. I went to counselling sessions. I opened up to my midwife and other professionals; determined to have a different experience this time. The process felt slow and mechanical and all I could think about was the ‘stranger’ from the hypnobirthing session who after numerous Facebook messages now longer felt like a stranger. She was Charlie.
We met for coffee and a chat about how things were going, what I had been working on, how hypnobirthing could help me move forward. The whole time we were both aware that my past experience was a giant block in the way - one that needed to be chipped away bit by bit until it was small enough to overcome. However, unlike conversations with other people, Charlie didn’t make little of my experience. She acknowledged it, sympathised with me and not only said that things could be different next time - she made me believe it. Hearing her talk so adamantly about the possibility of a positive birth experience was like listening to a toddler describe their imaginary friend; it’s not something you have seen or experienced but their belief is strong enough that it starts to convince you too.
I felt conflicted. I knew the benefits of hypnobirthing. I had spoken to many people that had used it as a tool for a positive birth experience. Yet I wasn’t convinced that my overly logical, control driven brain would succumb to it and I feared that I didn’t have time to prove myself wrong. I was worried to tell Charlie this as I didn’t want her to walk away - after all she had already given me more of her time than I could reasonably expect. The more I thought about it the more I knew that I hypnobirthing wasn’t what I wanted with me while in labour - I wanted Charlie. I needed someone strong and knowledgeable. Someone able to recognise my strength and remind me of it at a time I needed it most. It dawned on me slowly; I needed a Doula. And as though all my stars aligned, Charlie was training to be a Doula and would be ready by my due date. I was so happy that for a moment I forgot my fears.
As the months passed by with increasing speed my husband and I met with Charlie on several occasions. We discussed the usual pregnancy and birth topics and started to put together a birth plan – oddly something my midwife had never raised. But more than that we got to know each other better. Charlie met our daughter, she drank tea and ate cookies on our sofa, she kept me feeling calm. While we worked on ensuring that this time around would be different from my previous experience it became clear that my son had the same plan and positioned himself firmly in a breech position. We started planning for an elective caesarean.
If I’m completely honest, which I was not at the time, I was so pleased to have a breech baby. I knew this meant, if he just stayed put, that I could have a birth experience completely different from my first without having to justifying or explain anything to anyone. I began looking up ways to make your baby turn and while I didn’t go to the extent of doing the opposite (though I was tempted), I actively avoided doing any of them. I decided to leave this decision to my unborn son. No encouragement, no intervention – just whatever he wanted to do. No pressure! Every morning when I woke up a waited to feel his little feet kick low and his head push into my rib and every morning when he woke up I could feel he had not moved.
Still we continued to plan for both eventualities (and more). My husband was given homework to watch caesarean videos online to alleviate concerns regarding surgery and I continued to discuss birthing options with Charlie. There was one evening, my daughter was in bed, the house smelt of my favourite candle and I’m pretty sure there were cookies involved. Charlie was talking about her role in a vaginal delivery. She was talking about massage, oils, support, comfort, love… everything that was missing from my previous experience. In that moment, I honestly didn’t mind if the baby moved. No matter what, Charlie was going to help make this experience not only different but also positive.
Before we knew it, the leaves began changing colour and the air grew cooler. I looked at my daughter and wondered when I had blinked and missed her growing another inch and her hair getting longer. She grew accustomed to playing in the hospital waiting area while I had scans, sat plugged into monitors, had blood tests. Though the baby had decided not to move but he had decided to be a pickle. The final few weeks were spent more in hospital than at home but I was calm. I knew the date that my son would arrive and I had my army prepped and ready. Before I knew it, I was heading into hospital to finally meet my baby.
Charlie was waiting for us just inside the hospital. As we entered the lift to head up to antenatal I felt like a celebrity with my entourage. I remembered being in this lift before; already tired, already in pain, already scared. I was none of those things this time. I was nervous yet felt completely empowered. The following hour was a blur of formalities – signing paperwork, meeting the team that would bring my baby into the world, and explaining why I had arrived with someone in addition to my husband. While faced with some confusion most people we spoke to were incredibly supportive. Yet the question still lingered – would Charlie be allowed in for the birth?
The short answer is yes – by some twist of luck, or more truthfully, thanks to my husband feeling faint and a fantastic anaesthetist that spotted this, Charlie was allowed in, playing tandem with my husband so that I had constant support. During the extended period of time it took to insert my spinal block, while lying there numb and expectant, to the moment the screen was dropped so I could witness my son’s arrival (bottom first). Charlie was there. In an everyday event for the team involved, and once in a life time for me, my son was born, healthy and gorgeous. I remember Charlie massaging my arms. I remember words of comfort and support. I remember her making me laugh (though we were told off for that). More importantly I remember the feeling of the weight of the past being expelled with the sound of my baby’s first cry.
Charlie stayed with us until the night. As feeling started coming back to my legs and my son lay on my chest, I began to commit to memory every part of him. I felt safe. I felt calm. I felt so incredibly proud. Some parts of the day are foggy in my mind but the important things will always remain. My son was long and beautiful. My husband made it through without fainting. I was so well looked after. But more than almost anything else, I will remember that Charlie was there. Supporting us in a way that seemed so natural to her. She was no longer a stranger. Far from it. She was part of the family, and in my heart always will be.
"I’m a planner. I always have been. This baby was planned down to the month, and we got pregnant first try. There was no doubt in my mind I wanted a natural, drug free, intervention free, strongly supported home birth. I organised my self a calm, caring, well informed doula named Ruth (and equally lovely backup Laura), my midwife was on board with all my decisions, I had my birth pool, my best friend to photograph the birth and we had everything ready to go.
Well. Babies do that they want! My waters broke Sunday morning 36+1, and medical professionals wanted to induce me. No thanks! I wanted to wait and see if my body would do it by itself. I went for observations each day at the hospital to make sure baby was fine, started taking antibiotics just incase, and every day was having some periods of regular contractions that were very slowly changing intensity. I was checked with speculum and told a few times I wasn’t in labour, although what they meant was active labour, I was clearly in a long latent phase. I was also given many different plans on what they wanted me to do, depending on who was on shift at the hospital, which became quite frustrating. During this time I was constantly in touch with Ruth just going over my decisions and making sure I was advocating for myself as best as I could. Tuesday night was particularly hard, the contractions changed position, and the worry about infection was taking over my mind. When we went in for that days observations I asked to start induction, while still really not wanting the artificial hormones. Went in and got examined, and was 3cm so I didn’t need the gel to soften my cervix. I went to the next stage which would have been i.v hormones to kick start active labour, and while having baby get routine monitoring first I suddenly had some contractions, so asked if I could have a bit more time, thinking they would give me an hour or so. The doctors seemed happy with my contractions so suggested 4-6hrs! I was happy with that. I went for a walk, with the contractions getting dramatically stronger and stronger, and agreed that Ruth could come up to the hospital (not thinking there would be much to do for a while, but my husband could use some support helping me with the pain). I couldn’t sit, and could feel so much pressure and within an hour and a half (or maybe less) all of a sudden I had a ridiculous urge to PUSH, so called the midwife. She was obviously surprised and suggested she check me first, and oh, yes! There’s a head there, go on! I think it was about 5/6 contractions using gas and air as something to focus on, to get out the head and out came my baby! A whirlwind of speed! 36+4 and 5lb 13, but so squishy and sweet. Ruth was arriving up the stairs as I gave birth- there was just no time! I’m so glad I didn’t follow what the doctors wanted, it worked out for me that I knew my body just needed some extra time to feel everything.
I was informed, I questioned, I didn’t accept generic advice.
What a wild ride, getting exactly what I wanted but with the exact opposite route I wanted to take.
Shared with the kind permission of the awesome parents
The first time I met Riley and Raine I felt an affinity with them; there are some interviews you leave really hoping that you get to work with the family because you just like them so much. During the long induction process and the few days we spent together in hospital, we all got to know each other well and we had some fun things in common. As Raine said today when I visited them – there is a bond that is made when you spend that intense and vulnerable time together in the birth room.
As second time mothers, they had had an incredibly difficult first birth experience under their belts and we worked together from early on to get to a place where they trusted that I would be there for them as another arm of their family. In our antenatal meetings I held space for them to talk through the birth of their twin girls five years ago and supported them in putting trauma symptoms in their place and increasing confidence in the birth that was to come. This pregnancy had already had some stresses and it naturally took some time to feel anything but fear about the birth process, but in time I saw the fear melting and belief grow.
Maybe we knew somehow that we needed to get lots of time together early, we had our 3rd meeting booked at 36 weeks…but on the eve of 35 weeks I had a call from a trembly voiced Raine saying that they were in triage for pre labour rupture of membranes. I said I would come up and see everyone and give them a hug. I popped my doula bag in the car and headed up to the hospital not knowing if I would be home that evening or not but planning to be out for the long haul. My immediate feeling was apprehension and disappointment on their behalf, of a loss of some of the options that they were hoping for this birth. A good plan – for anything in life – is not a chronological list of Stuff That Must Happen. A good plan is multi-layered and answers the question “why?” about the options and choices, it considers external influence and not only allows room for, it expects the need for flexibility. But that doesn’t mean you can always let go of the things you wanted most easily or without some time to grieve them.
I spent my journey to hospital accepting the new situation and letting go of my feelings to make sure that I did not make assumptions about how anyone else was feeling. Triage is often a difficult place, my exceptional colleague Charlotte Edun of The Good Birth Practice often says that the transitions during labour are the moments to plan the most carefully; they are the moments that can derail things and put you on a different path.
On arrival the beautiful girls, sporting superhero capes, were managing the hospital experience at 10pm like absolute champs, getting a little bored, but generally is such great spirits. Riley looked a little shaken, mostly in disbelief that she was at the start of a labour experience this early, again and Raine had a life worn “here we go again” vibe. I wanted to save them from the heavy ball of intervention rolling down the hill towards us, but it is never my place to save, even if I could. My main memory of the wait in triage where it was determined that Riley’s waters had likely not broken (a source of much back and forth, speculation and a root cause of some later drama) but that she was having regular contractions and was 3-4 cm dilated and would be admitted to the early labour ward, was of the officious and judgemental attitude towards the girls being there. The phrase presented by three separate midwives was “they need to be in their beds, it isn’t fair on them to be out of their beds” as the reason that they could not stay (asleep, on a single chair, not making a noise or hearing/seeing anything inappropriate). There were exceptionally good reasons for everyone wanting to stay together, it was not an arbitrary or lightly made decision to annoy staff. I could understand if there was a health risk, a medical risk that we did not understand – but to cite the only reason as irresponsible parenting struck me as judgemental bullshit.
However, I shall get back to the story of Riley being a bad ass baby birther. Around 2.30am we were convinced that Riley had finished being admitted and was going to get some rest and that the “appropriate childcare” would be arriving in a couple of hours so we headed back to carry the girls into bed and pack some hospital bags, pick up the car seats. I slept for an hour or so and we headed back to hospital around 5am. Riley and Raine got some sleep while I worked in the café downstairs for a few hours waiting for the doctors rounds to hear the blood test results and the advised plan of action. We spent Saturday keeping calm, talking through preferences and asking questions to form a picture of individual risk and assess Riley’s comfort level with where she wanted to be and what she would prefer to choose next. Riley chose to have steroids to speed up Willow’s lung development in case she was born in the next few days. She also wanted to stay in hospital as there were markers of a potential infection, she felt safest there. With a discussion and knowing that I was 20 minutes away – I left that evening after creating a little temporary den in the ward bay with twinkly lights and the cosy blankets we had to hand. I wanted to make Riley feel as safe and calm as possible – or at the very least like we care very much for her and had her back if she needed us. I checked with the midwives before creating the nest – they were so supportive and onboard with me dimming the lights and getting everything set up.
Sunday morning, we reconvened in the early labour ward, contractions were now minimal and very sporadic (according to the CTG machine that Riley had agreed to be monitored with every 6 hours) – not really surprising given that she had been woken in the night to be tested, monitored and given the news that she had raised protein levels in her urine and might have pre-eclampsia. I think even more than this, she was missing her girls so much and was starting to doubt her choice to stay away from them – something that can just never be known in the moment. I attempted to get everyone re-fuelled in all ways; food, hydration, positivity, control, understanding and love. As on wards across the hospital, our day was determined primarily by the anticipation of and then the arrival and fallout, of the consultant on her rounds. The registrar who had been working under the consultant and had performed her checks and observations with consideration and sympathy was sort of blown out of the water by the abrupt bedside manner and poor choice of language of the consultant who came give her verdict. I know I am being so negative about this experience, but honestly, the information that was given was done so with about as much technical language and superiority as she could muster, and it pissed me off. In hind sight, it is also frustrating that given the multiple extra ultrasound scans that were performed and the talk of risk about things that turned out not to be an issue, no one picked up the velamentous cord insertion that was actually the highest morbidity and mortality risk in the whole VBAC.
The day moved forward and I held hands and tried to lift hearts as we were rolled along the corridor of medical support and speculation. During the day I spoke with midwives, consultant and then anaesthetist to explain the previous traumatic experience and ask for an exception to be made for my presence in theatre as a second birth partner if a caesarean birth was chosen or the only option available. This request was listened to kindly and thoughtfully and granted by both the day and night shift – which was a huge relief to all involved, should we have needed it.
Just before we were going to leave from induction ward to delivery suite I mentioned to Riley and Raine that they could ask where theatre was and ask to have a look on the way passed, or alternatively avoid going near it altogether. They wanted to have a look and have a run through of the people that might be in the room and how it would work should they need to go to theatre again. I hope that doing this took some of the power away from previous memories and meant that some fear could be released for the next stage.
There was a huge shift in energy when Riley and Raine were transferred to the labour ward for the induction process; there was a medical plan in place, we weren’t waiting in the same way as before and we could claim the space and protect their bubble a little bit better. In the hour or so that we had before any more medical support, we go to work on building a nest and putting Riley in the best frame of mind possible. We restrung fairy lights and stuck up affirmations made by their daughters, we moved the furniture round and found the birth balls. I suggested we try a side lying release position to make space in the pelvis for baby to move further down and increase the intensity of contractions so we did that for a few minutes on either side.
We had a wonderful welcome from warm, thoughtful midwife who read through all the notes before she came in the room which made a big difference. I think she was the first person to call Riley by her name (as requested on the notes) and not her other names. They had time to talk through their birth plan and explain the reasons behind some of those choices. Based on this, the midwife arranged for the anaesthetist to come and consult with Riley and explain plans for theatre if it was needed. There might have been a requirement for GA over an epidural, and it was important for the couple that a GA was avoided at all costs. The anaesthetist studied Riley’s combination of medication and carefully deduced the reason behind some of her current symptoms. She spent time explaining how she would apply a spinal block and why she would change to a GA in an emergency. There was time for the couple to ask questions and to discuss the proposed plan. It was fantastic. They chose to continue working towards a VBAC with CTG unless anything changed and meant they would reconsider.
We were feeling good; Riley fresh from the shower, Raine rested (ish) and fed. I definitely let my guard down here and believed that there would be some calm for 4-6 hours in which Riley would have the space and chance (for once in the last 3 days) to listen to her body and come back to herself. There was a sudden rush at the door and the consultant from a few hours previous and her registrar were back with a very frantic air – Riley was told that she had sepsis, that the anaesthetist had lied about the medication and the option left was a caesarean section. In this moment the air rushed out of the room and we all looked at one another confused. The consultant patted Riley on the arm “OK, I know you don’t want it, but it has to be like this for the good of your baby” and left the room.
This latest surprise knocked down Riley’s last pillar of resolution and I could see her physically deflate as she told Raine, “Let’s just have the caesarean and stop this now”. They chatted back and forth with Raine reminding Riley of all the reasons she wanted to avoid that route and questioning the conflicting advice given so far and Riley building in confidence again. There was a beautiful display of a strong and loving relationship at work – years of trust and understanding were brought to the fore in that moment.
When the midwife returned, she told Riley and Raine that another woman had just been taken to theatre so there was around 2 hours before Riley would be able to go to theatre, “by that time there is another consultant on, so why don’t we see what she says when she gets here and comes to see you?”. This was all Riley needed to get back up onto her belief that she would have her baby in that room and it would be in the way she wanted until it couldn’t be any longer. She chose to have the syntocinon drip (medical oxytocin) and ARM (waters broken by the midwife) as the midwife could still feel a bag of waters between baby’s head and the cervix. I asked the midwife to not let anyone else come into the room without speaking with her first and to not speak about anything other than the positive plan now unless it was really needed. The midwife went a printed a sign for the door that read “Positive Vibes Only – please speak to my midwife before entering”.
Throughout all of this, I should add – Riley was not really feeling any contractions, with her superhuman pain threshold it meant that, like during her previous labour, there was some slight cramping, but nothing that meant she wanted any physical support or relief. After an hour or so of synto drip and some hard core emotionally charged music videos of Riley’s favourite musician, there were contractions that Riley could start to feel and I had a strong suspicion that she was on the brink of active labour.
Between 8pm and 1am, a lot happened, and my notes get hazier. There was a changeover of midwives; and we were met by another incredible midwife. She came in and detangled the room of the complex wires, rewrote Riley’s notes into a chronological order with corrected figures (which she checked with us) so that the new consultant could make a clear and quicker decision on arrival. The consultant said there appeared to be nothing indicating a need for emergency caesarean birth and a VBAC was entirely possible. She advised that Riley keep going until she gave birth, unless she didn’t want to in which case, she could choose a caesarean. It was a calm and considered chat with options. After an examination, which she wanted, it was agreed that her waters would be broken again to ensure that the drip was having the right affect; any cushion between head and cervix leads to very ineffective induction with synto drip.
Riley coped so beautifully with the ramping up of intensity, she moved as much as she could, telling us when she needed physical support. She was strong, determined and in control. As the contractions built, she found that hip squeezes were very useful so I kept that up until I could not longer reach her hips on the bed as she sat up in bed near the end.
One clear moment was Raine looking into my eyes and saying “when do we panic?” – a glimpse into her memory of last time, the midwife got in quicker than me and replied “we never panic”, I smiled at Raine and told her it was going as it was supposed to, there were no indications of anyone needing to worry – Riley was doing exactly what she was supposed to.
After a while of really intense contractions, Riley pushed with an incredible amount of power and followed the guidance of her midwife to focus her pushes to the right pace and to not lose energy or to waste a contraction. With Riley one side and me the other we provided a steady surface for her to push her hands and body against while allowing her body to move her baby down.
As little Willow was born there were more people in the room than there might have been at a totally “low risk” birth; paediatrician, SCBU nurse, consultant, head midwife and second midwife as well as the main midwife caring for Riley. Willow was quiet as she was born and took a moment to get her bearings – she was given 2 minutes before Raine cut her cord and she was transferred to the resusitaire where the paediatrician checked her over and Raine watched on. I gave Riley a running commentary on how Willow was moving and starting to squeak. The paediatrician described Willow as a “very zen” baby and was really happy with her observations.
Willow got cuddles with mummy as mama got some stiches and took a moment to get her breath back. In a short while Willow was back and had found her mama’s breast and was latching on like a pro – it felt like a magically calm moment after the hustle of the last few hours. The midwife caring for the family protected their golden hour of skin to skin while SCBU waited to check over Willow again and give her intravenous antibiotics. Riley’s infection was forgotten about until she followed up with people a few days later, possibly it wasn’t sepsis after all. After an hour or so Riley and Willow returned from SCBU and we got transferred to the postnatal ward where they settled while I went home for a sleep.