34 weeks pregnant

Well, 34 weeks pregnant today and only a week until I finish work.

I had my midwife appointment today and all was fine – baby is still breech though so I need to get bouncing on my birthing ball, or, as midwife suggests: “going on all fours with your bum in the air”!! I go back at 36 weeks, and if little Madame is still breech I’ll be referred for a scan at Warrington. Hopefully she can “turn it around” before then, anyway.

I’m also thinking about starting on the raspberry leaf tea. Last time I didn’t start drinking it until about a week overdue – then I decided to guzzle it by the gallon load. Don’t know if it helped or not, but labour did start two days later. I’ve read a study which says that if you have one cup a day from 32 weeks it makes the second stage of labour shorter, which can surely be no bad thing. I wasn’t brave enough to try it as early as that, but now I’m 34 weeks I think I might give it a go.

I’ve also made the call to the hospital about seeing a Supervisor of Midwives re my VBAC plans. I spoke to somebody on the labour ward just now, and get the impression that, unless I’m a bit pushy, I might get fobbed off a bit. Being pushy isn’t really in my nature so I need to pull it out of myself a bit, I think.

In order to arm myself with everything I want to know, everything I want so say and what I want them to help me with, I’ve just been looking over my VBAC research, my draft birth plan and also re-reading Lilly’s birth story to work out what it is I do and don’t want this time.

(In a nutshell – last time there was an awful lot of intervention – waters broken without warning, blood taken from baby’s head, numerous attempts to put monitors on baby’s head, continuous monitoring and not much mobility because of suspected fetal distress, failure to progress, need to have c-section, failed epidural, general anaesthetic. Phew)

So, in order to get my head straight for when and if I finally get to talk to somebody who will help me agree a birth plan that I’m comfortable with, one which might actually lead me to have as good a chance as any to achieve a VBAC, here are the outpourings of my mind…

Things I did not like about last time:

•  Continous monitoring meaning I wasn’t very mobile, leading to failure to progress (which is what they are helpfully proposing for this time too)
• Waters being broken early, and with no warning that they were going to be broken (scary, unpleasant, no need)
• Gas & air not helping – perhaps I wasn’t doing it right? (Please god let it help this time!)
• Monitor being put on baby’s head – three failed attempts!! (painful, awful)
• All the checks for fetal distress (water’s clear, blood test from baby) came back clear, yet fetal distress was still assumed from the off. Why?
• Having an epidural put in – didn’t like the big needle – grumpy anaesthetist didn’t help – and he carried on even though I was having a contraction – which made me cry – and might have been one of the reasons why the epidural eventually failed
• Side effects of epidural – shivering, being sick. Will this happen again? What is the alternative, pain relief wise? Pethedine?
• Epidural not being able to be topped up when it came to c-section – leading to general anaesthetic instead. What are the alternatives? Spinal block?
• Being told that, once bloods have been taken from the baby’s head to check for distress, this has to be done every half an hour? (felt like a threat to make me agree to a section)

As a result of all the above, my birth plan so far reads as follows:

Birth plan for Baby No.2

•  My last labour resulted in an emergency caesarean under general anaesthetic – something I am very keen to avoid this time.

 

•  I want to be kept informed of what is happening at every stage, and why it is happening

 

• I understand that labour is unpredictable but I would like as little intervention as possible in order to allow my labour to progress naturally. My aim is to achieve a VBAC and to avoid an emergency caesarean.

 

• If possible, I would like to wait until at least 7cm dilated before my waters are broken. If it is thought necessary for my waters to be broken, I want to be told about this IN ADVANCE and be told the reasons for it.

 

• I am open minded about having an epidural, if possible I want to wait until after 5cms dilation so as not to increase the risk of an emergency c-section

 

• I understand that fetal monitoring will need to be carried out, but I wish to remain as mobile as possible throughout labour, so would like this monitoring to be done intermittently, not continuously. I would like to avoid having a monitor attached to the baby’s head unless this is deemed a necessity for medial reasons.

 

I feel a bit like this birth plan is all negatives – basically DON’T ANYBODY TOUCH ME!!! LEAVE ME ALONE AND I’LL HAVE THIS BABY IF YOU DON’T MIND!!! But that’s the way I feel, a little bit.

My last birth plan reads like a fantasists list to Santa. The only things on there that happened was my request for Lilly to be given vitamin K by mouth (which was hospital policy anyway) and for Tony to be given the baby in the event of my needing a section under general anaesthetic. Whoop de Whoop.

Anyway, all this could be scuppered if Little Miss stays breech. And I know Tony is secretly hoping she does, because he thinks a planned section would be easier and less stressful. He does support me but I know he can’t really understand why I want to put myself through childbirth when I don’t really “have” to.

It feels good to write it all down. I just hope I can be as clear about what I want when this Supervisor of Midwives person calls me back. I don’t really want to be fighting these battles on the day I’m in labour.

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Back to square one in the VBAC stakes…

Well, went to see the consultant again today for 28 week bloods and general checkup. Feel like i’ve taken a massive step backwards in my quest for a VBAC.

Last time I went to see the (a) consultant, i came away feeling really positive. Because of the nature of Lilly’s birth (continuous monitoring leading meaning I had to stay lying on the bed, leading to failure to progress, fetal distress and emergency c-section), I explained to him that my main fears were not being able to remain mobile and the same thing happening again. He had thoroughly read my notes and told me that, although I would need continous monitoring, this need not start until about 5-6cm dilated, and that the hospital was hoping to have wireless monitors by June, which would allow me to remain mobile whilst being monitored.

But, oh no, when I went today that all went up in a puff of smoke.

This doctor practically laughed when I asked if they had the wireless monitors yet, and made me feel like i’d just invented something fit for Tomorrow’s World. Upshot is, no, the wireless monitors won’t be in place.

He said I’d need continous monitoring and that I’d have to stay on the bed for this. I asked whether there would be any way I could maintain a bit of mobility – even sitting on a birthing ball right next to the monitor? – he said no, not possible.

All in all total conflict to what last consultant told me three months ago.

Out of interest, i thought I’d ask him how long they’d “let” me go overdue, to see what he’d say. I know the hospital policy is supposed to be 14 days. Last consultant told me 15-20 days to give me the maximum chance of a VBAC (which i did think sounded quite long!). This one was pretty non-committal but hinted at only 10 days.

He doesn’t want me back at the hospital til 39 weeks – which, as it is on a Tuesday actually works out as two days before my due date, so pretty much full term.

I came away from it all feeling like i wanted to cry, to be honest.

Surely the quickest way to a repeat performance of failure to progress is to lie on my back waiting for things to not happen? If I’m made to stay on the bed I can’t help but feel an emergency section is once again more than likely.

What’s especially frustrating is that you get a totally different opinion depending on who you see. There is no basic hospital policy about labouring naturally after a previous c-section. So, what’s the point in seeing a consultant? In reality, it comes down to who is on shift the day you’re in labour.

It’s left me feeling pretty deflated. I feel like I’m going to have to fight a battle to get something approaching the birth I want, but I’m going to have to fight it whilst I’m in labour, rather than having the bones of a plan agreed in advance. I know birth rarely conforms to a plan (ha! Nobody knows that more than me!) and I know that a healthy mum and baby are the most important thing at the end of it all, but I don’t want to be left feeling that I’ve had another section that could have been avoided if only things had been handled differently.

I also asked him about my failed epidural top up last time, which lead to my section having to be carried out under general anaesthetic. At the VERY LEAST, this time I’d like to be actually concious when my baby comes into the world, thanks very much.

Basically, my questions were whether there was a reason for the epidural failure last time – could it happen again? How could it be avoided? If I manage to labour without an epidural (which I’m hoping to do, at least until the later stages), and then a section becomes neccessary in a hurry, what anaesthetic will they use? Can I have anything put in place (canula or whatever it’s called) just in case, so that if an epidural or spinal block is needed in a hurry, that would help? He rambled on a bit but basically said no, there’s nothing I can do to help, every emergency is different.

Now I need to try and take stock and build myself back up to positivity again. Not sure what my plan of action is really. At the least it is to hope for a helpful and sympathetic consultant on the day. And also to do some more research to try and arm myself with a few facts for the fight ahead.

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Had my first consultant appointment today

It went quite well. A lot better than it did in my dream last night, in which I went for my appointment, ended up running away from the consultant in tears and begging for a midwife lead delivery!

The doctor I saw (didn’t catch his name, think he is a registrar) seemed really nice. I hope he’s there on the day, he seemed quite jovial and reasonable.

He started off by saying he had reviewed my notes, and said there was no reason why I couldn’t go for a VBAC this time. He said he thought it sounded like with Lilly’s birth, she maybe had her head turned slightly to one side, so was not pressing as hard as she could have been on my cervix, which explains the failure to progress more quickly. He said there was no reason why this should happen a second time. I must admit, this is the first time i’ve heard this explanation, so i’ve no idea how he’s come to it, or whether its right, but I suppose it explains things. Perhaps this would also have given the impression of a distressed baby? I’m not sure, i’ll have to research that one…

I asked about fetal monitoring – this is really my main concern, as I think it was at the heart of lots of the things which went wrong last time. I asked whether I could have intermittent monitoring to allow me to be more mobile during labour. He said that, because of the risk of uterine scar rupture I will have to have continuous monitoring. However, he said that the hopsital are hoping to get wireless monitors, possibly by June, which would just stick onto my tummy and allow me to move around and stay active… that would be brilliant! I told him I really, really don’t want a monitor on the baby’s head unless it’s neccessary – last time the registrar tried FOUR times to put a monitor on her head, only to discover each time that the probe thingie didn’t work…. grrrrrrrrrrr. He was noncommittal about this, but i’d like to see them come near me on the day with that suggestion! Anyway, he then conceeded that perhaps I could be allowed to get to 5-6cm with intermittent monitoring before being hooked up (although hopefully wirelessly) for continuous monitoring in the later stages. That seems like a fair compromise, I’m going to hang on to that one for future reference I think!

I also asked about induction. Lilly was 10 days overdue and we seem to have history of overdue babies in our family, so it’s something I’m bracing myself for again. He said they would prefer me to go into labour naturally (me too!) and said they’d let me go “15 to 20 days” overdue… I was a bit shocked to hear that, as I thought they’d say 14 days then book in for an elective section. I can’t really believe that’s right, but anyway, it was good that there was no talk of elective sections at this stage.

He then tried to listen to the baby’s heartbeat – made a bit of a pig’s ear of it and couldn’t find it for ages. I wasn’t worried though, as I could feel the baby moving, and i’ve felt lots of movements over the past few days so I know he or she is in there, alive and kicking! He said he’d do an ultrasound instead – brilliant news, chance to see bubba again - but they had to send for it from the labour ward, and in the time it took to get it, he had found the heartbeat anyway. But never mind, the heartbeat sounded nice and strong, and he said all was fine.

The final thing I said to him is that I didn’t want lots of interventions this time, as last time they had been painful and contributed to an overall pretty horrible experience. He said: “We want to give you a much nicer time this time”, which has given me a bit of reassurance – just hope he’s right.

So, all went quite well. At least, until I got in the car to drive home and the stupid thing died on me in the middle lane of a busy three-lane carriageway. No hazard lights, no nothing. Got out and called the police, roadside assitance, father in law etc etc to rescue me, then tried really hard not to cry (not easy with all these hormones). It was amazing to see the amount of people (all men) who felt the need to shout obscenities at me from the comfort of their cars. Helpful comments including: “Put your hazards on, stupid b***” (yes, if I could do that, don’t you think I would?!) and, brilliantly “You’re a s*** driver” – I’m not actually trying to drive at the moment, mate, i’m standing on the side of the road freezing to death! And, for the record, I did not break down on purpose!!

Anyway, a nice policeman came and rescued me (as soon as he arrived i burst into tears!) and rolled the car out of the road. Then, a little while later father in law came and rescued me, got the car going again and we drove home.

But oh! How it restores your faith in human kind……. season of goodwill anyone?!?!?

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