Cat

                                                      Dotty

Cat Dartnell, a tellmeagoodbirthstory buddy had two very different births with her first child Arthur, and then her daughter Dotty . But she placed herself at the centre of both - the key, without doubt, to a positive birth. What her lovely tale shows too, is how a sense of humour changes everything. Being able to laugh in labour is one of the most powerful coping tools of all.

My first pregnancy was an enlightenment – I had no idea how you had a baby. I was one of the millions of women who had fairly overwhelming doubts about how one of those could come out of there. 

I happened across an active birth yoga group - it had a discussion element. I was amazed! Still scared, but intrigued that there could possibly be a way through this.

During my months spent there I came to believe that 

a) people could have babies

b) it didn’t have to be a medical emergency, 

and very importantly 

c) the bonds of friendship you make whilst pregnant with other ladies in the same state as you will get you through almost anything.

Alongside this wonderful process, my completely adept, yet stubborn placenta appeared low on every scan. It stayed so low that I was admitted to hospital at 37 weeks to be observed. 

I was so frustrated. I felt so well, and I wanted to know what birth felt like. Couldn’t they see how far I’d come? I’d gone from utterly ignorant to wanting this, in the space of just a few months. And now…

My section was scheduled for 39 weeks. I found the countdown unbearable – the thought of major surgery  coming my way. No stopping it. Yet it was the only way to have this baby without us both perishing. 

The operation was what it was – easy, quick, alarming, productive. Arthur was born in a procedure that took 15 minutes. It was fourteen hours since I had eaten or drunk and someone had just given me a baby. It could have been a hallucination, it was all so strange. 

From then on, my recovery was textbook. It didn’t hurt. The epidural wore off, my legs came back to life, and off I went. 

My experience taught me some useful things. The surgery saved our lives. It was done brilliantly and the same can be said of the midwives and nurses who cared for me. This is not, however, how to have a baby. 

Not for me anyway. I now know that I never want another epidural unless I have another section. I know that a perceived emergency can wait longer than you thought. I know that being able to eat and drink is not considered essential in hospital. I also know from watching others on the recovery ward that going through a section is a piece of cake if you haven’t been through a long, hard labour first. In one way I am very lucky to be armed with all this information. It helped me approach my second birth with some sense of what I wanted.

On my son’s first birthday I discovered I was pregnant again. I returned to my yoga and started enjoying the process again. Except this time round, I was classed as high-risk. All of my choices for birth were taken away from me.

I was faced with a midwife who I liked very much, but who thought hospital birth was the safest option for everyone, low and high risk alike. She also thought that epidurals were amazing, having had two herself.

I had two consultant appointments where a registrar asked me if I wanted to try for a vbac. I said yes, but I wasn’t happy about being stuck on a monitor, and I wanted to use water in labour. The first time I was brushed aside. They only wanted to know if wanted to attempt a vaginal birth, and give me some statistics about rupture and a leaflet, nothing else. At a second meeting, I asked again - same stats, same leaflet, and when he went to ask if vbacs could go in water, 

we heard laughter in the halls. 

I could see myself being sucked into a highly managed, highly interventionist birth. I was stubborn, but didn’t feel brave enough to labour through that. I couldn’t understand why, as a person who had a risk factor, I didn’t qualify for a more supportive attitude to help me birth successfully. I was beginning to see why people ditch the system and go independent. 

After much soul searching (and spitting furiously), I consented to labour on the delivery ward with mobile monitoring and use of the birth pool if it was available. The consultant midwife helped me to write a birth plan, and my yoga teacher kindly consented to be my doula. 

Even so, I felt that everything was a battle. I was a petulant child, stamping my foot.  And no matter how I felt, or what I said or did, I was powerless against the argument that if I was the one rare case of rupture, I would have sacrified my baby’s life if I did not do as I was told. 

The doula and I worked out a good plan of action. I would labour at home and when I felt I needed her I would call. She would tell us when she thought it was time to transfer and we would leave it as late as we could so as to get a good proportion of my labour done where I was happiest. 

My Braxton Hicks became strong and visible in the latter stages of my pregnancy, just as they had before, but I knew they were nothing. I enjoyed them. On the Saturday before my EDD the feelings began to change. They had a more period pain like discomfort to them. They were a shock to begin with, but my body accustomed itself to them and after a few hours they tailed off. The next Saturday the same thing happened! And the next!! Was this my uterus’ version of a night out? 

Each time they began, they were uncomfortable but my body got used to them. I figured my body was teaching me something – that if I waited and let my body do what it knew to do, it would cope and the feelings would become more bearable. 

I was now a few days over my due date and wondering if I was going to take months to give birth if I kept having a week off in between bouts.  In answer to my question the contractions began again the next day, in the same way as they had done before - except this time they kept going.

My body did its thing and each time they stepped up a gear, I would move around and they became bearable again. Such a magical feeling! Was it painful? I suppose there was pain but there was so much else too! 

Knowing that I was actually fortunate to experience this and that I wanted it helped me along. The contractions were now beginning to direct me. I was unable to ignore them, but I could happily talk between them. Henry called Nicole, the doula, as I had taken up residence on my knees with my head in the corner of the sofa. 

Nicole arrived at about seven or eight in the evening. She came and lay her head next to mine, put her hand on my back and told me I was doing a really good job and coping well. 

Like magic, the pain lessened immediately and time lost any meaning. I knew suddenly that I could cope, for hours and hours if need be, and importantly - for as long as this process meant me to. 

Had we not had that sense of knowledgable support we would have probably gone to hospital soon after that point, but Nicole said that for now we were fine where we were. 

We listened to music and I hummed and waggled through the contractions. And then it was time to go in.

They heaped cushions into the back of the car and I clambered in, face down with Nicole beside me. The music was transferred to the car stereo and we all sang our way into the hospital. 

I remember the car clock said 11.40. Nicole stayed with me as Henry had to park and we made our way to the delivery suite, stopping to huff and puff now and then. The place was practically empty. We were shown into a room and I laboured there for another hour before a midwife came and introduced herself. 

She gave me one VE. She was quick and managed it between contractions and it was completely painless. She announced that I was 8cm and we’d better get the monitor on. 

At one point I forgot how to use my breath, but I looked at Nicole and she simply breathed for me. I joined in and was back in charge. I had had a few puffs on the gas and air by this time, but then the feelings began to change. 

My body was wanting me to push. Now I had a job! It felt better to push than anything else. I don’t remember feeling any of the things that people say are common in transition. I didn’t think I couldn’t do it, I didn’t think I was going to die, and the sensations had spaced out and become bearable again. 

I could even sway to the music again between contractions. I remember the midwife and Nicole telling me I was doing really well and I looked at Nicole again. Again she directed her breath, differently now, and I followed suit.

I think I had been happily making progress for about forty-five minutes when a male doctor came in unannounced to let me know that I was only allowed to push for an hour. If the baby hadn't arrived by then,  he would use a ventouse. 

Had I not been completely otherwise engaged, and on all fours, I would have kicked him as hard as I could. Everyone who was not labouring away, made him feel deeply unwelcome. The midwife said I was close. She whispered that he said that to everyone. But by now, I was feeling the stinging sensation of Dotty’s head.

I presume no one was expecting her just yet as they were all up my end. Then her head appeared and I could feel her shoulders and  I remember thinking ‘bugger this!’ and pushed the rest of her out too. 

I was almost surprised that I had delivered a baby. It was just past three in the morning and we decided that Dorothy Betsy should have the name Cariad too – a welsh word meaning love or darling – it was Valentine’s Day after all! 

I learned so much from her birth – that my body could cope with this other-wordly process as long as I went with it,; that the right support is priceless; that my scar was as strong as the rest of me.

I also learnt that a birth plan has to be watertight (I had asked for my third stage to be managed as the midwife considered appropriate – meaning that if all was well they could wait for me to deliver the placenta, not Do What You Like), and that as informed as you think you are, there may be pitfalls – why did no one think it important to tell me that I, as a vbac, would only be ‘allowed’ an hour for my second stage? 

I’ve learnt that some people think it’s acceptable for a doctor to barge in and scare women when they are at their most vulnerable (and yet powerful). I am not one of those people, and feel that behaviour of that kind is a trespass against me and all the other women that are subject to it. 

What did you imagine when you went to hospital in labour? Whether you went voluntarily, or were transferred, I bet you thought you’d get appropriate care. Truth is you get the care that’s available, which may or may not be appropriate to you. I did ok – I got my vbac, but it happened because of who I took with me. 

It could easily have been very different and is for so many women. You may be lucky and get staff that truly support your wishes and use evidence based practices. I don’t intend to gamble. I want to KNOW that my interests are top of the list of my care givers and that there’s a damn good reason for doing what they do. I’m pregnant again now. Despite all that I’ve learned and all that I know, I’m facing exactly the same barrage of statistics and hospital policies as before. I’m not fighting this time. This time I’m staying at home.

Juliette

                                                                         

                                                                                                          

Juliette's daughter Annabelle arrived on New Year's Day.

Here she shares her good birth story…

Annabelle started making her move at 3.30 in the morning, on what would become New Year's Day. It was two weeks after her due date.

I felt pretty strong stomach pains, like really bad period pains, but since I'd been getting those on and off most nights for a few weeks I didn't get particularly interested. 

Then I went to the loo and had the start of a show, so I guessed that this time might be different. 

I was excited and relieved as my husband Rhodri and I had decided that 14 days over was our cut off point, and that was the next day.

The period-like pains got stronger as daylight arrived, but with no pattern or rhythm until that afternoon.  Even so, they were intense and I was glad I'd been prepared for that otherwise I would have taken them much too seriously. 

As it was, I just moved from bedroom, to living room, to bathroom, and tried different distractions and ways to get comfortable.

The breathing was absolutely essential, with all my attention on making my out-breaths really really long. As well as the slow deep breathing, I had been told by my active birth yoga teacher to sprinkle a few drops of lavender on a handkerchief, and breathe it deeply in and out during the contraction. It really worked, and offered a great deal of soothing and comfort when the contractions were happening. The ritual of it - having that thing to do when it came - was just really reassuring. 

I used a birthing ball which was good for resting my upper body on and swaying while kneeling and I did something similar leaning on the bed supported by pillows.  I also spent quite a time on my side in bed, my legs propped with a pillow, and with one to hug and one down my back too. Being able to give way to the support was really helpful - it meant I really  made use of the rests.

At about 3.30 in the afternoon my waters broke.  It really was a gush, following a particularly strong contraction.  From then on the contractions really picked up in strength and pace.  Rhodri called the hospital to let them know, and they aid to stay at home for a couple more hours.

I'd been told to expect this and was ready - by now the contractions were really strong, and I was having to moan. But I knew to follow what they'd said, as that was the way to be sure I was in established labour. 

In any case, it felt good to stay where I was - I retreated to the bathroom,almost instinctively. It felt safe and private, and I just closed my eyes. The more inward I went, the more in control I felt. I  could almost feel how each contraction was changing things around inside me - the baby moving down I guess, and that gave me confidence, stamina in a sense to carry on and trust my body. 

By now, I felt a pretty constant urge to go the the loo, which was another reason I loved the bathroom, and Rhodri just went with that - keeping out of my way, delivering drinks and checking I was comfortable, without disturbing me or making me aware. 

By 5pm things had become incredibly intense and I couldn't focus on anything other than the contractions.  They had picked up pace and there wasn't much of a pause between them.  Plus the pressure in my bottom was getting more and more impossible to ignore.  I'd felt a real urge to have a bath, but by the time we'd run it and I'd got in the contractions were so full on that Rhodri said we had to go.

For a split second I hesitated as I quite wanted to stay put and have the baby there with paramedics. But in the end we went.

We arrived at the hospital at 5.30pm and thankfully it was very quiet. I was so in the zone anyway, breathing and concentrating on what was going on inside me, that  I didn't care.  I was calm in fact, and just remember feeling that I just needed to get on and have my baby.  

We went through to triage, to be assessed, and by this point my legs were shaking so much it was hard to stand. Rhodri told the triage lady that we really needed to go through as I felt the baby was coming any minute.

To our great shock, the woman put down her pen, turned slowly to him and said 'I'll see to her when I've finished her paperwork'.

When I look back now, on what she did, I feel outrage. I was vulnerable, in great need - and her callousness was breathtaking. Given she is the first person, labouring women meet, it seems incredible that a person such as that can even be in such a job. 

If I hadn't felt more confident, I would have felt totally dismissed by her treatment, like I shouldn't trust what I was feeling. Fortunately, she was forced to take notice, when a minute later, a load more water gushed out onto her floor, and she agreed to check.

I was 9cm dilated. We were taken straight to a room with a birthing pool and I got in. Now everything felt back on track, as the midwife we had was lovely and unintrusive. 

After a good hour or so in the pool, trying different positions and feeling relatively relieved from the pressure of each contraction by the water, we decided that I should get out as things weren't really progressing - the baby was as low as could be without crowning but not going further.

As I got out of the pool it became apparent that the baby had done a poo. I briefly knelt resting on a birthing ball but within a few minutes lots of new people were in the room. I was examined and then told that I had to get on the bed as they were worried about her heart rate. 

I did't want to lie back on the bed but was kind of led there. I could feel they were anxious about the baby's heart rate and said they would need to use a suction cup. I said no at first, and then another doctor came in and basically said I had no choice. The midwife more kindly explained that the baby's heart rate was dropping to 90 during contractions, and so we agreed. 

Looking back now, I feel that I was a bit bulldozed. I've since spoken to another obstetrician and they confirmed that the heart rate wasn't extreme and I now find myself wondering whether they could have helped me another way - for example by suggesting another position and at least trying for another few minutes or so. I would recommend to other women, to actually find out what the heart rate could and should be at the point of pushing, as in that situation, when you don't know what you need to, you are very vulnerable. 

We went ahead anyway, had an episiotomy  and with three hard pushes our baby was out.  The feeling when she was arriving was amazing, literally a sensation of pure life. It turned out that she'd had her arm over her face which was probably what stopped things progressing so well.

Overall, my labour and birth felt very positive,  even pleasure. I felt confident and in control - and the only thing I'm left wondering about is to what degree that woman being horrible, and then being told how dilated I was, disturbed that. It's true that you have to be ready for a change of plan - but I do think that continuity, trusting your body's flow and keeping your brain out of it, is the key to it going easily. 

Many women go into hospital from the point where contractions start coming every three minutes, due to misinformation from books and birth education classes.  But counting contractions is not a reliable way of knowing you are in labour. Labour is a state - NOT the amount of contractions you are having.

It is true that contractions need to be coming strongly and regularly every 2 to 3 minutes, but for most women, these need to stay at this rhythm for another couple of hours, which is what the hospital advised Juliette to do, and which is very reliable advice. 

Occasionally, and it really is occasionally, women are in established labour with the first 3 minute interval, but the reason they would and do trust this, is because other things are in evidence too - physical changes, a noticeably altered state.

When a woman is in true labour - that is the state where her body has agreed to open up - she will feel changes over and above the regularity of very strong contractions - something different happening - and partners will see and feel it too:

.  she will instinctively want to retreat from light, open space, any stimulation or disturbance. 
.  she will need to be on all fours or leaning
.  it will feel helpful/even unavoidable to make noise. 
.  she will find herself having to concentrate during the contractions, and also in-between. 
.  she will feel a heaviness in her bottom, like when you need a poo

All these things are an indication that the woman's thinking, rational brain has stepped back, and the deeper, automatic part of her brain responsible for labour is now running the show.  Oxytocin, the petrol that drives labour, is flowing well. 

Juliette paced herself brilliantly - because she knew what to expect. She had no fear, only confidence. She knew that until all the above was in place, she should think of it simply as 

                                                 HER BABY HAVING IDEAS

This phase can be anything from a few hours to a few days.

Once her waters had broken and she'd retreated to the bathroom, only then was she 

                                                              IN LABOUR  

If more women were helped to understand what established labour feels, looks and sounds like, they could set their expectations accordingly. It can feel a tall order to stay at home until labour is established, but if a woman is ready for it, and has in place the right support and a range of comfort measures, most women, regardless of temperament, pain threshold or strength will cope well and labour has an optimal chance of progressing smoothly. 

Sarah

                                                                 

                                                                             
                                                                           

Sarah's baby girl Imogen arrived towards the end of 2012. Despite lots of unexpected twists and turns, it turned out to be a very good birth story…..

I was always fairly confident in my body - and about birth, so when I passed the 41 week mark in pregnancy, it was a bit unsettling. I felt normal, but the hospital started to make me feel like I was not. 

At first I kept a handle on it, but at the end of week 41, the midwives told me that I was putting my baby in danger and that my risk of stillbirth would double after 42 weeks. One midwife just shook her head at me and said: 'You do realise you placenta could pack up in labour?

I'm not one to cry - but when I phoned my husband and my doula, I was properly sobbing, completely shaken up. I was so confused. At this point, I could feel some faint cramping, and deep inside felt I needed to trust my body. But now I also felt frightened - and started questioning whether I should.

I pushed for more information, and later that day, a consultant doctor  quantified the risk - it turned out it went from 1 in 3000 to 2 in 3000.  I was amazed. Why hadn't they just explained that instead of employing such terror tactics? I'm sure like me, many women would happily tolerate such a risk, set against the much higher risks involved with induction. Why hadn't they balanced the information, so that I could make a decision as an adult, rather than scare me, and make me feel helpless?

I went home anyway, and that weekend was hard. Every evening, contractions would start - but go nowhere. My doula visited, and we tried to be positive but by Monday evening, we both felt sure the problem was the position of the baby - that it was in my back as I was having quite a bit of back-ache.

By Monday evening, I felt ready and happy to go into hospital, as it was my decision. I'd given my body a proper chance and now it did feel like time to draw a line in the sand.

It made all the difference making that decision myself, rather than being bossed and frightened into it by the midwife two days before. I now felt ready, in control - and though I was about to agree to some intervention, I also felt completely linked to my unborn child. When I'd been told off, like a child, it was like my connection to my baby was cut - like I was nothing to do with it all anymore. Now I was linked again. And it gave me confidence.

They broke my waters, and the contractions started at once, around 10pm. I progressed quickly and I could feel changes, so we got settled into our room and I started moving around, rocking on all fours, breathing well. Best of all, we were given lots of privacy - completely left alone. I don't know whether it was intentional, but it worked. 

At midnight, a consultant came in and ominously drew up a chair . 'The situation wasn't good,' she said, there being a meconium stain in the waters, me being so late, and that I was only 2cm, and they wanted to augment the labour with a syntocinon drip. 

I knew she was just doing their job, but I also was surprised at the way she didn't consider the bigger picture.  For example, I was feeling really different, like everything was much more intense and that labour was ramping up. But it was like what my body was doing was irrelevant. On paper I wasn't progressing, and that was that. If I hadn't known I had a choice, it would have felt non-negotiable. And yet wasn't there good argument for waiting and seeing - given my baby's trace was perfect and I felt so well?

'What do YOU want to do?' my doula asked, bringing me back into the picture and it took me less than a second to know the answer -  if I continued in the direction I was going in, all well and good - if things stalled then I'd reconsider. It felt good to have made that choice, to feel firmly in the driving seat and I remember feeling this incredible calmness. 

So we were left alone again, but shortly after, the cracking backache I'd been feeling returned - and now it was unbearable. I couldn't respond to the contractions at all, and could only hold my breath and resist. It was like I was fighting it. We tried every position, words of encouragement, but it wouldn't go. The midwife just thought I wasn't coping, but my doula could see how I had been, and that this was different - the baby in my back. 

I decided I wanted an epidural. It felt like the only way - but I intended to use it wisely. Once administered, I made sure I was on my side, had all the lights switched off, and closed my eyes. There were no artificial hormones in me, so this way, I knew I was giving my body, and the oxytocin, the best chance to do their thing. Two hours later, the midwife came in to rouse me, and said I might start feeling some pressure soon. But I already was. By the time I sat up, I could feel an incredibly strong sensation and when she returned, I already had my leg on my doula's shoulder and the head was coming. It was all so quick - another midwife ran in, just in time to catch my baby on the bed. 

There were many moments in my labour, where the outcome could have been different if I hadn't been able to feel confident in my own instincts. My birth experience really enforced for me the importance of having good support. I am American, and live in the UK - but loads of contact with my sister who'd had a wonderful normal birth and always encouraged me to do the same, was very powerful. If ever I was in need of a boost, or worried about something (like being overdue), we'd speak and I'd always regain my perspective and end up laughing. I also had the support of a great doula. 

My birth story ended up being very different from the one in my mind, I didn't have the surprise baby born at home in the bathtub; I had to wait a long time for her;I felt a lot of pressure to be induced; I had to have my waters broken; there was meconium; I had to be monitored; I had an epidural. But then there was the best twist - despite the interventions, it was just one night. An experience I was completely in control of. 

Sarah's experience is a great example of how important it is to remain open and flexible about labour and birth. At every twist and turn, she re-positioned her thinking, kept her humour, stayed in tune with her baby...and the result was a good birth story. She is proof that having to accept interventions, does not mean giving up control.