Well – here it is. Isla’s birth story. Get comfy, it’s quite long…
Isla was due on Thursday, June 17. But, as we suspected, that date came and went with no appearance from our second baby. She was obviously planning to follow in the footsteps of her sister, Lilly, who was 11 days overdue when she was born two and a half years earlier.
A week after the due date, I had an appointment with the consultant, at the Antenatal Day Clinic in Warrington Hospital. The consultant performed a “sweep” in the hope of getting things going and said I was 1-2cm dilated, and that my waters were accessible if they had to break them in case of induction. My blood pressure seemed high – in the 90s where it had been consistently at 70/75 for the last few months of my pregnancy, but my consultant said she wasn’t worried. They also found traces of glucose in my urine, which they sent off for testing. We were sent home with a date for induction if nothing happened naturally – Monday June 28, at 8am.
Tony and I both felt sure that it wouldn’t come to that – I had been having on and off contractions every evening for the past two nights. They hadn’t been particularly strong, and not very close together, but there was definitely something going on, and we were both hopeful that the sweep would kick-start the whole thing.
That night, we expectantly waited for something to happen. Nothing did. Not even the irregular mild pains of the last few evenings. Very disappointing.
The following evening (Friday), those pains were back, but yet again, as soon as I went to bed they disappeared.
On Saturday I had a show and once again became hopeful that something would happen. But Saturday (9 days over) felt a bit like The Last Chance Saloon – if nothing happened that evening, it looked very unlikely that I would go into labour by myself and would have to be induced – something I didn’t really want.
The plan was to begin by breaking my waters. Not something I was looking forward to, as with Lilly’s birth having the waters broken had been a distressing experience – I wasn’t told it was going to happen and as I was under the influence of gas and air at the time I was confused, upset and scared by it. Not how I wanted to start my second labour.
Besides, this time I was determined to get a natural birth after my first ended in an emergency c-section under general anaesthetic when Lilly became distressed, I failed to progress past 4cm and the epidural wouldn’t top up for the operation. I had read a lot about how to maximise my chances of getting a VBAC – Vaginal Birth After Caesarean – and it mainly boiled down to staying upright and active during the birth, not having my waters broken too early, and no epidural until at least 5cm dilated (if at all – I was worried that if it came to a section again the same might happen with the epidural – I wanted to opt for a spinal block instead in that case),
However, by 11 days overdue I was fed up. I felt huge, uncomfortable, and everything was a huge physical effort. I had no energy to play with Lilly and wanted to feel normal again. I wanted the baby out – so I was in no mood to argue against being induced, even though I worried that being induced would mean another c-section might be inevitable.
On the Sunday, Tony and I were resigned to the idea of the induction, and started to feel excited and nervous knowing that we would soon be meeting our new daughter, and starting a new chapter in our lives as a family of four. And the induction did have one big advantage – we were able to explain to Lilly that we were going into the hospital tomorrow to get the baby and that she would be staying with Nanna while we went. We got all her stuff organised and there was no rush or panic, and, for Lilly, no waking up in the night to find we had gone.
On Monday morning, we arrived at Warrington at 8am as arranged, and were shown to a ward with only one other couple on it, having also come in for induction. Blood pressure, urine samples etc were checked by a lovely trainee midwife, and, as before, my blood pressure was still high – in the 90s. The midwife decided to take my BP every 10 minutes for a while to see if it would come down – which it slowly did, to the mid 80s, and they were satisfied with that. Once again there was glucose in my urine and more was sent off to be tested. I asked the student midwife what it might mean as all my other urine samples had been fine throughout the pregnancy. She said it was possible to develop gestational diabetes right at the end of pregnancy, but I wasn’t worried because I knew I was going to have the baby that day or the next anyway.
After that I was put on the foetal heart rate monitor for half an hour. At this point, I was aware of some of those mild contractions / tightenings that I had been feeling over the last week, and the midwife asked me to press a button whenever I felt one, which would help them interpret the trace.
With Lilly’s birth, the first indication we had of her distress was when we first came into hospital and the monitor showed that with every contraction, her heart rate was dipping, then recovering afterwards. This got more and more pronounced the longer the labour went on until the emergency c-section was needed. So our biggest concern for this labour was that the same thing would happen again. Tony and I had agreed that, if the heart rate trace was showing the same situation was likely to repeat itself, that we would not allow things to get worse and worse before the inevitable emergency section – we would ask to have that decision taken earlier before the distress became potentially serious, and we had agreed as much with our consultant.
So, left alone with the foetal monitor doing its thing, we couldn’t resist the temptation to look at those spiky lines and try and interpret it in our own very ill-informed way. And it seemed to Tony that that same dip was occurring in this baby’s heart rate when I had a mild contraction. It wasn’t a good sign, and we started to wonder if this was all heading the same way as last time.
The midwife in charge of the ward came in to tell us that Delivery was very busy this morning, and we weren’t likely to be called up in the next hour or two. So we took the opportunity to walk down to the café and have a cuppa and a cake, buy a newspaper and a few lunch items for Tony.
Back on the ward, there was no news from Delivery. We had a view from our bed out of the window onto the ambulance bay for the maternity unit, and we watched about three ambulances turning up with lights flashing. Queue jumpers!
By early evening we were a little bored, and it was all a bit of an anti climax. The midwife was apologetic and said that if they hadn’t called us by 10pm then they would be unlikely to do the induction until tomorrow morning. We were really disappointed, and getting quite tired, because we’d been up since 6am.
At about 9.30pm I was put back on a foetal heart monitor. The mild tightenings I’d been feeling all day were a little more pronounced. And yet again, the monitor showed that with each one, the baby’s heart rate was dipping – ever so slightly, but still dipping. On top of this, my blood pressure kept rising to the mid nineties again. We explained our concerns to the midwife and she said she would ask a doctor to come down and have a look at the trace. At this point I decided to get into my pyjamas for the night, and Tony decided to stay until the doctor came. At some point I asked for some pain relief as they were quite uncomfortable, I was given some co codamol, which did seem to take the edge off.
We waited quite a while for the doctor, because Delivery was still very busy. By this time, the contractions / tightenings were getting even more pronounced. If I’d been at home experiencing the same, I’d have known I was in labour.
Finally, somewhere between 11pm and midnight, the doctor – Sammy – arrived. He had a look at the trace and agreed that there was a dip in baby’s heart rate and said there was a possibility that breaking the waters would help, by relieving the pressure. He said he would let us know when there was a room free upstairs and I asked him how long that might be – I wanted to know if Tony should go home (he had already technically outstayed his welcome as partners were supposed to leave after 10pm). He said he would go and plead my case and reappeared 10 minutes later telling us there was a room and we could go up now… Yay!
We went upstairs and got settled. A nurse came in to put in a canula in my hand just in case it was needed. She made a complete hash job of it – two painful attempts and couldn’t get a vain – in the end the doctor had to do it, and even he took two attempts!)
The midwife asked me if I wanted to use gas and air when they broke my waters. I wasn’t really keen as last time the gas and air had made the procedure more traumatic, as it had must made me feel sick and confused. I told the midwife I’d have a little “test run” on the gas and air, which I did, but decided to manage without it for now.
The midwife did an examination – I was 1-2cm – but couldn’t break my waters as she said her fingers weren’t long enough and the cervix was still a little high. This news didn’t make me feel very positive as it felt like proper labour was still a while away.
The doctor came back and broke my waters. It wasn’t exactly pleasant but it was nowhere near as upsetting as last time. In fact, he had real difficulty in doing it – he said the waters were very tight around the baby’s head and when he finally managed to do it there was no gushing of water – in fact at first he couldn’t be sure if it had worked! (When Isla was born she had two huge scratch marks on her head from this procedure poor thing!)
Then the doctor told the midwife to hook my up to the dreaded Syntocinon drip to get things going. Yikes!
The drip was started on a low setting and gradually turned up. At first it wasn’t too bad although the contractions were definitely more pronounced by now – I’d say they had reached the stage where pain wise I would have been wanting to come into hospital if I had gone into labour at home. I didn’t bother with the gas & air and managed for two hours with nothing other than the co codamol from earlier.
I started to feel a bit nauseous. I didn’t want gas and air or anything else for that matter, because I feared it would make me feel worse. After a little while, sure enough, I was sick. But afterwards I felt much better and started to think about more pain relief.
Hospital policy after your waters breaking is to be examined every two hours and no more often. So, two hours later, I was examined. 3cm. I was a bit disappointed as I had hoped the pain would have helped me progress more than 1cm.
I decided to try some diamorphine after the midwife told me it was available.
The midwife gave me the diamorphine as an injection in my leg. It made me feel really sleepy and (at first) significantly took the edge off the pain. In fact, it made me pretty sleepy and I lay back on the bed and dozed on and off for an hour or so. It felt lovely…
During this time, the midwives kept coming in and out, checking the monitor for a while, then leaving. We asked the midwife to help us interpret the trace on the foetal heart rate monitor, and she reassured us that the baby’s heart rate was no longer dipping with the contractions, and that all was as it should be. Such a relief! Maybe this time would be different after all… The midwife was also turning up the syntocinon drip every half an hour to keep the contractions coming and to increase their intensity. We were left alone with the relaxing sound of the baby’s heart rate only interrupted by the occasional inflating of the blood pressure monitor. My blood pressure remained pretty high – mid nineties again. At some point – I can’t quite remember when – I was given a tablet to try to bring down the rate when it got to 100. But when they checked it again it had only gone down to 99!
After a little while though, the pain began to get stronger and stronger, and I knew that the diamorphine alone was not going to be enough to see me through. I endured half an hour or so of pretty agonising intense contractions as it was nearly examination time. I hoped I had reached five cms… which would have been a huge psychological boost as I never got past 4 last time. But when I was examined, disaster. Only 4cm. I’d only progressed 1cm in the last two hours, despite some significant pain. I was really disheartened and worried that maybe this was it; I’d be stuck at 4cm again.
It was at this point I asked for an epidural. And the midwife said she would go and sort this out with the anaesthetist, as a new one was just due to come on shift. However, it took almost two hours to get him to come to me. During this time the drip was getting turned up every half an hour and the contractions became unbearably strong. I was gripping Tony’s hand during each one and breathing but soon the pain just became too much. I started begging the midwives to turn the drip down PLEEEEASSE… and even sent Tony out into the corridor to beg them to do this for me, or to give me my epidural NOW!
Incidentally, the diamorphine was still working, even though it was not strong enough to dull the pain – I was really woozy and kept falling asleep and snoring (loudly) in between every contraction!
Eventually the anaesthetist came in – halleluiah! But wait, it was the same guy from last time – the one who had given me my ill fated epidural that gave me the shakes, made me sick, wore off, wouldn’t be topped up and ultimately lead to my c-section having to be carried out under general anaesthetic. Oh god, no!
I was still really woozy and out of it on the diamorphine. I wanted to ask the anaesthetist to NOT MESS IT UP AGAIN PLEASE, but wanted to ask him in the politest possible way, bearing in mind he was about to approach me again with a needle and I didn’t want to upset him. However, speaking coherently when you’re out of it on diamorphine isn’t easy so I ended up slurring something at him about “last time it didn’t work… please, I don’t want another general anaesthetic!”
Luckily, Mr Anaesthetist was in a much better mood than the same time two and a half years ago – I suspect he may actually have had a personality transplant in that time. He seemed jollier and actually cracked a joke… very much not like the last time we met!
Like last time, I kept totally still while he put the epidural in. Like last time, he seemed to carry on through a contraction, but I did not move a muscle! As soon as it was in, there was instant relief! That awful pain was gone… and, replacing it was a different sensation – a need to push?!
It was time to be examined again anyway. When the midwife announced I was 9cm dilated with just a tiny bit of lip left, I thought she was joking. I had gone from 4cm to 9cm in two hours – whooooooooo hooooooooo!!!! I was over the moon! But the midwife said I wasn’t “allowed” to push for another two hours, as they weren’t “allowed” to examine me again until then.
Well, for an hour, I tried not to push. Bloody hell, that was hard! The urge was so strong and I had to breathe through it when it came trying not to give in. It was amazing as I felt no pain from the contractions, just this sensation – Mr Anaesthetist had done an amazing job this time!
After an hour, the midwife took pity on me and said: “If you want to push, push.” So I did. She put my feet in stirrup type things to give me a bit more leverage and when I had the urge, I pushed with all my might. Tony was fabulous and kept reminding me to put my chin down, which I kept forgetting to do but which made the whole thing so much more successful.
After 45 minutes the midwife said those magic words: “With the next contraction, the baby’s head will be out”. “Nah,” I thought “There’s no way!” But I pushed as hard as I could and next thing I felt a scrabbling of tiny limbs as Isla shot out completely, arms and legs flying!
She was cleaned up a little and cried for a short while, a lovely, quiet, newborn baby cry. I was just in shock! I had given birth!! I didn’t even need forceps or anything! I had done it by myself!! It just didn’t feel real.
Next thing I had to do some gentle pushes to get out the placenta. I had a little cuddle with Isla – a gorgeous little thing with so much black hair, and weighing in at 8lbs exactly. The midwives were discussing the state of my down-belows… they couldn’t decide if I had a 2nd or 3rd degree tear (it was only a 2nd in the end) and decided I needed to be stitched up in theatre. So, off I went.
That ride on the trolley down the corridor to theatre brought back some memories! This time was different though as it wasn’t for an emergency c-section. I arrived in theatre and there was a very happy and jolly atmosphere – I’m sure some of those doctors were the same ones from two and half years earlier who delivered Lilly – but maybe that was just my romantic vision of the situation. My diamorphine was still doing its thing and I was STILL falling asleep and snoring!! However, when it came to the actual stitches the epidural did not mask the pain and I had a local anaesthetic injection. I mainly snored through the whole procedure. A doctor woke me up to ask me if he could put in a pessary. “What for?” I asked. “It gives you pain relief for 48 hours” was the reply. “Well, yes, of COURSE you can then!”
Afterwards I was wheeled back into the delivery room. There was Tony standing holding our new little baby. And that’s when it really hit me – so much love for our little girl, so much emotion and just so much happiness. I could not get hold of her fast enough and was sobbing looking at her perfect little face. I gave her her first feed and pretty soon afterwards we were whisked down to the ward – rooms up in delivery were still very much in demand!
So, that was it. I managed my VBAC, despite being induced and despite being put on that evil drip! Also despite not having the “active birth” I had been fighting for – when it came to the crunch I was so tired I never even considered getting out of my bed!!
Isla is completely gorgeous; I am so totally in love with my second little girl, just as I was with my first. I am so lucky.
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