Monday, 25 July 2011

Birth Story Special: Emergency Caesarian

This week on the blog, I'm running a Birth Story Special. Every day I plan to publish a different birth story, with the hope that by gathering together the threads of different women's experiences, we might be able to weave a picture of what it is like to give birth in the UK today; of what is being got right, and what might need to change.

So today I faced a difficult choice, which story first? A Caesarian might seem an unlikely place to start, but in fact this honest and gripping tale speaks volumes about having a baby in the UK today. For so many women, the dream and hope of a natural experience or even a birth at home, ends in a difficult, painful or traumatic way that they were not hoping for. Approximately 15% of births end in an Emergency Caesarean, and less than half of all births proceed 'normally' ie with no medical intervention.

These traumatic experiences leave us with questions; most particularly, was there anything I or anyone else could have done to bring about a different outcome?  By bringing together these stories this week, I hope to provide a place to discuss and communicate, perhaps to find answers, and if nothing else, to find solidarity in our shared experience.


Michelle's Story

I wanted a home birth. I needed a home birth! I was 100% confident I could do it. I didn't fear anything, I was actually looking forward to it. I had read and researched everything I could could get my hands on. I had watched hundreds of videos on YouTube of women successfully giving birth at home (some even completely unassisted). My God was Ina May Gaskin and my bible was Spiritual Midwifery. I felt strong, womanly and primal, after all, giving birth is natural, this is what I was meant to do, right?

Mathilda's due date (9th May 2009) came and went. Then early on the morning of Saturday 16th May 2009 I had a show which was immediately followed by mild contractions on and off all day and pretty strong at night. I was so happy and excited! Finally something was happening and I was convinced my daughter would be arriving before the weekend was out.

On Sunday 17th May 2009 I still getting contractions and spent most of my time in and out of the bath. Trying to sleep was almost impossible as every time I laid down, it would make the contractions feel really bad. I say bad as the pain felt like an injury pain, instead of the intense 'energy' of my uterus working hard. It's difficult to describe, but it definitely didn't feel right when I was lying down. I knew then it is not natural for women to labour and give birth on their back.

So I didn't sleep much at all but I was bearing up ok, even though I was beginning to feel a bit down by this point as I was already 8 days late and just really wanted to see my baby! My husband was great, he looked after me and would hug me and rub my back every time a contraction came.

I carried on through the night and before I knew it, it was Monday 18th May 2009. I was getting really tired by then, and my contractions were getting worse, but were very irregular.

Finally a midwife came out to see me. She examined me and I was only 1cm dilated. I couldn't believe it, I felt really shattered after that, as all the pain I had been through for 2 days had only caused me to dilate by 1cm! I was beginning to feel really lonely. My poor husband was also getting exhausted and just slept all the time. His Mum rang me to see how I was doing. She was really shocked that it was taking so long as both her births were really quick (first was 8 hours, second was 4) so when I came off the phone from speaking to her I felt even worse and I think that's when the doubt in myself started to set in. I sat downstairs and cried and cried.

I carried on all day, in and out of the bath, walking, trying to sleep but couldn't, using the TENS machine, but getting annoyed with it! At 11pm I called the midwife back as pain was getting really bad by then. She brought some G&A, which helped a bit, but not much. I kept being sick.

At about 1am I asked if she could check me, so I had to lie down on the bed. And OH MY GOD... the pain was awful! I've never screamed so much in my life, I had totally lost it, I had been doing quite well with breathing/visualising/hubby rubbing my back etc... but lying on my back just killed me. She took ages to find what was going on down there. I could see panic in my husband's eyes which was not good. She eventually said I was 4cm. I couldn't believe it, I just about gave up then. I puked all over myself and the bed and said I need to go to hospital, I was so tired, just couldn't integrate the pain anymore.

So my husband drove me into the hospital which was a 20 minute drive.

I was the only woman on the ward, which was great because I had treatment straight away. I asked for an epidural (I really didn't want one before, but I just really felt like I needed a break, just to get an hours sleep, anything), I had one within 20 minutes. Oh it was lovely. At first. It only worked on my right side. So in a very concentrated area in my left hip joint I could still feel everything. So nope, still no sleep.

I dilated really quickly once in hospital. A student midwife broke my waters for me and around 6.30am I was fully dilated and felt the urge to push. The epidural had worn off on the other side too by then, so I could feel everything again. My poor husband looked exhausted, so I suggested he went home for a nap but the midwives told him to stay as they thought the baby was coming and quickly.

They let me push for 3 hours. On my back, able to feel everything but unable to move my legs. This was not how I envisioned my first birthing experience.

My baby didn't even move down an inch. I would push and push and push....nothing. By then, I was totally exhausted. They gave me something to make the contractions stronger as they seemed to be dying off. This turned the pain up to a million it seemed. And again it was like an injury pain that felt like it was doing nothing other than just hurting me!

In the end they brought in a consultant. He said he'd do a ventouse/forceps with episiotomy delivery if I wanted. I said, 'YES!! I need to have this baby now with all the help I can get!' even though this was going against everything I had previously stood for. So, they topped up my epidural with a spinal, and wheeled me off to theatre, without my husband as he was so traumatised by the whole thing he couldn't face being there with me. I can understand that, if I had had the choice, I didn't want to be there by then either.

At least I was in no pain, finally. That was nice I have to admit!

The consultant tried pulling my daughter out with the ventouse plunger thing. It popped off her head twice - she was not budging. Still way up inside, not even in the birth canal, from what I gathered. So he declared I needed an emergency C-Section and got down to prepping me straight away.

I remember lying there thinking that this wasn't happening to me. What had happened to my serene home birth dream? I was now lying there, in a cold, stark operating theatre, shaking from all the drugs, paralyzed from the waist down, needles stuck in my wrists and hands, surrounded by people I had never met before but without my husband and about to be cut open, from hip to hip.

I felt lots of tugging, and heard one big 'SHHHHLLLLLUUUURRRRPPP!'...silence...then a crying baby. They held her up above the screen that obscured my view and I could see that she was all purpley red and angry! Finally Mathilda was here. Arrived into this world via failed ventouse delivery followed by emergency cesarean at 11.05am Tuesday 19th May 2009.

They let me touch her for a brief second before whisking her off to be examined. My husband came in and it was all over. He got to hold her, she was wearing a green hat and looking around at everything, probably thinking 'where the hell am I?!'

I don't remember feeling that emotional when I first saw Mathilda, I think I was too tired and drugged up to feel anything. But 45 minutes later, I was breast feeding her, so, considering the circumstances, that was pretty amazing.



Mathilda having her first meal. Latch wasn't so good, but not bad for a first attempt!



Just out of theatre, my nose stud and earrings are still taped up.



Close up of Mathilda holding her Daddy's finger

Afterwards, the consultant told me I had lost 2 pints of blood during the cesarean so I might need a transfusion. Luckily I didn't need to in the end. He also explained that Mathilda's head had been stuck sideways in my pelvis, so I would never had been able to push her out. I didn't really know what this meant so I asked a midwife later on and she didn't really say much, just said that it's an awkward position. Mathilda had bruising around one of her eyes, I don't know if that was caused by being stuck. I later learned that this sideways/tilted head position is known as asynclitism and it explains why I had irregular contractions, severe pain in one hip and a long second stage. But it does not explain why I 'would never had been able to push her out'. I think having an epidural and lying on my back meant that I was unable to push her out.

I spent 2 nights in hospital. The first night was a haze of morphine and extreme love for my new baby. We cuddled, slept and nursed. I remember being sick a few more times, I'm guessing because of the drugs. I had to have a bed bath as I was still in my labouring top which was all sweaty so the nurses helped take that off and give me a wash and take my catheter out. I couldn't move my legs until the early hours of Weds 20th May. I remember walking very slowly to the toilet for the first time at around 4am, with a lovely nurse helping me. I remember trying to pee and it took at least 20 mins. It felt numb down there but also felt like if I pushed too had my c-section wound would explode open and my guts would fall out!

The following day I had the first set of stitches and drain removed from my scar. That wasn't pretty, but in all honesty the worst part was the surgical tape ripping out half of my pubes when in was taken off! I was finding breastfeeding quite difficult by this point, but only because of the reduced mobility I had from the pain of the cesarean scar. This would carry on for a good 3-5 weeks.

I had one more night in hospital then asked if I could go home. I hated having to say goodbye to my husband at 10pm every night when I was there, it just felt wrong that we had to be separated. I was sent off with a bag of painkillers and some anti-coagulant drugs, which I had to administer myself via an injection to the stomach. I needed to take these to stop getting a blood clot apparently. I guess another downfall of having a cesarean.

Once Mathilda and I were home, we were able to relax. Yes it was a shock to the system, and I spent some time crying on my long suffering hubby, trying to make sense of all that had happened to us.

Fast forward to the following Tuesday, a week after Mathilda was born. It was time to have my main stitch out. I have to admit, I really wasn't looking forward to it. It just seemed like more pain for pains sake. A friend of mine, who had gone through an emergency c-section due to pre-eclampsia assured me that it wouldn't hurt, it would just feel 'weird'. Well, it hurt like hell! I think I was an unlucky case as after what seemed like 10 minutes of tugging from a home-visiting midwife on the stitch, it finally, excruciatingly came out. I was sweating and shaking. The midwife examined the thread and noticed there was a tiny knot still on the end which had passed through the length of my entire scar, causing the pain and the difficulty of actually removing it.

The following day I felt a bit feverish, and I remember worrying that I was coming down with mastitis. Well it wasn't mastitis, it was actually my cesarean wound slowly becoming infected. The following morning, I was lying in bed, holding Mathilda on my chest when I felt a wet sensation on my belly. I handed her to my husband and had a look as I thought that her nappy had leaked. But no, it was bloody pus oozing from my wound. This was a serious low point for me. Not only was I struggling with feelings of guilt and failure for not giving birth naturally to Mathilda, I was exhausted, sore and verging on depression but now I had to fight off an infection. I was given antibiotics and a bunch of dressings and left to get on with it. It was horrible having to change my own dressings and see the pus leaking out of me. I was worried the infection would spread to my uterus, but luckily within 3 weeks, my wound was better and healed quite nicely.


Two years on and I'm still numb along my scar line. I also have an annoying in-growing hair which becomes infected from time to time right in the centre of the scar. I have stretch marks and the shape of my body has changed due to motherhood, but I love these changes. However, I do not love my scar, which stands out like a red line on white paper.

I'm still breastfeeding my daughter, despite the the troubles getting started, which I'm sure were mostly caused by having a cesarean. My milk took a week to come in after Mathilda was born, resulting in her losing 12% of her birth weight (which was a hefty 9lbs 11.5oz by the way!) and taking 4 weeks for it to return. I'm certain the trauma, mentally and physically and the soreness from having a major operation helped cause this.


So due to my experience, I am planning a HBAC with the support of 
a doula now that I'm pregnant again with my second child. Looking back at Mathilda's birth story, I'm sure if the chain of events had happened differently, the ending would've been very different. I am certain if i had remained strong, or somehow managed to sleep more, I would've been able to give birth to her naturally. Because of this I feel tremendous guilt and I also feel scared of any future births I might have. So with this in mind, the decision to hire a doula to help guide and support both myself and my husband through my second birth seems to be a wise one.

I'm sure time will heal the bad memories of it all. I certainly have good memories attached to it as well. Like bouncing with joy on the bed on the morning I had the show, hugging my husband every time I had a contraction (this was while I was still at home), hearing my Mathilda crying loudly and strongly behind the screen in the operating theatre for the first time and being allowed to touch her before they whisked her off to be checked out (she was all warm and slick, she felt amazing!) and of course, breastfeeding her for the first time.

So this was Mathilda's birth story and also an account of my personal cesarean experience. I'm sure not all women have bad feelings or outcomes their own c-sections (my mother being a prime example - I was a c-section baby, and she had a General Anaesthetic and loved the fact she fell asleep then woke up with a baby. She was also very pleased that I also had a c-section, but I beg to differ) but I feel most of the time cesareans are unnecessary and should only be conducted if they absolutely have to be.

For more info on VBACs and Cesarean awareness month, check out the ICAN site, I have found it very helpful and it also inspired me to write this story.

15 comments:

  1. I had an elective c section due to breached baby, I was so scared due to horror stories like the above. It was nothing like it, I got up the next day and at day 2 I was going down the stairs with the baby carrier leaving the horrible hospital. My scar healed in no time and 9 month on can't even be noticed! I would only have a second child by c section.

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  2. thank you anon. i do think it's interesting that our state of mind as we go into theatre often affects our healing process - emotional and physical.

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  3. perhaps it does, I am not sure how much medical evidence there is to back this. Natural birth could result in very bad tears too that needs stiches and might get infected. I cried when i had to sign my operational papers as I soo wanted natural birth, but since i realised I'm no hero, I see absolutely no disadvantages to c-sections, the whole birth took 20 mins, I felt for month after that i missed out on the whole going into labour experience but now I am just glad I had c-section and I no longer feel I missed out. This lady mentions giving birth is natural and that's what we meant to do, this is 100% correct, however there are a lot of things can go wrong and by c-sections the risk of death to mother and baby drastically reduced. My advise to any expecting mummy is to keep an open mind and don't set your mind 101% on natural birth as c-sections happen in you and your baby's best interest!

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  4. Just to follow on from the previous poster - Where did you get your info on C-Sections being safer out of interest? Everything I have read points to there being a greater number of risks associated with having a Section as opposed to delivering naturally... Which kind of makes sense as if Natural delivery was so dangerous I guess we would be extinct by now... Interesting article from the independent here..

    http://www.independent.co.uk/life-style/health-and-families/health-news/caesarean-risks-four-times-those-of-natural-birth-683744.html

    There are infact huge disadvantages to Sections including haemorrhage, infection and rupture of the uterus plus bad reactions to the anesthetic (including heart attacks etc). Not to mention the negitive impact it can have on breastfeeding and bonding and connection with post natal depression.

    I am not anti-section - I just feel that they should be for emergencies only. I completley respect your decision to opt for one for a Breech baby but wonder why the hospital was encouraging it when many leading midwife sand obstetricians alike agree that Breech birth is just another variation of normal and baby can be delivered naturally...

    I dont read that Michelle is saying Sections are bad - more that she knew what she was capable of but in the event she and her husband didnt have the right support around her to make the journey a more positive one. Childbirth is not a path we were designed to tred alone.

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  5. C-section is the safest delivery method for breeched baby, it is many hospital's policy that they book in a 38 weeks breech for a section. Support in London hospitals are NON existant, I was on a ward with 30 women and babies, all sections as natural delivery babies and mums were sent home. the night staff consist of 1 midwife and 2 helpers, it is a disgrace! I was begging my husband to stay after 8, when the midwife came at 11 she wanted to call security to remove him. if he hadn't been there till 11 there would have been no-one to hand me my baby for feeding. They couldnt come if buzzed as were so overworked. In my case this is the only disadvantage of c-section, having to stay in and there is no care.

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  6. re Jenski...i re-read my post and i see nowhere me saying c-sections are safer...so not sure what points you trying to prove. I said: there are a lot of things can go wrong and by c-sections the risk of death to mother and baby drastically reduced.

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  7. Anon - I think Jenski read the following ", however there are a lot of things can go wrong and by c-sections the risk of death to mother and baby drastically reduced." as saying that c-sections were safer. This too is how I read it although, having now read your last comment, I assume you meant safer in SOME situations?

    I'm pleased you healed quickly after your c-section. I know a lot of people don't. I had a laparoscopy a few years back, involving 2 tiny cuts and I was in agony for over a week afterwards. I couldn't even manage to get in and out of the shower. Thankfully I didn't have any children to look after at the time.

    I do have to disagree with Jenski though that "Childbirth is not a path we were designed to tred alone." :)

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  8. thank you all for the comments so far and for the debate. i guess this special week of birth stories is designed to generate debate and i think that it is great to discuss these issues and hopefully in some small way make progress towards positive change.
    as i said on the parallel debate on my facebook page, appropriate intervention, c-section or otherwise, is a wonderful thing, and undoubtedly saves lives...the big question is...are all interventions currently being made 'appropriate', or are some women having their hopes of an empowering experience dashed for the wrong reasons? if you look at the birth choice site you can see how rates of different interventions change over time, sometimes quite dramatically, so this would lead me to conclude that we are somewhat at the mercy of trends in obstetrics, rather than our inadequate female bodies!

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  9. Yes I did read it to mean that C-Sections are safer that natural births. I am glad you experience was a good one but am sorry you had a hard time afterwards... I spent just 24 hours on a post-natal hospital ward recently and found it soul destroying.. and I wasnt even the Mum!

    I have some wonderful friends who are Midwives and I am not blaming them as a unit - its just a shame that the money and resources arnt there to allow them to do their job - and its a shame that they are being trained to operate in the environement that currently exists.

    Pandabear - I am completly happy that we all have different opinions - thats what makes a conversation good! But just to clarify, I have complete faith and trust in the ability of a women to birth her baby, and if she choses to be on her own then that is 100% their choice. But personally I feel that humans work best when supported... Even if it is just a Mum and a clued up Dad and a friend downstairs to call on if needed. If I had another baby I would personally consider a freebirth (as my 2nd may as well have been) but I think I would still have a Doula present, even if they were sat in the corner or downstairs with a cuppa - just encase the labour was long and my husband or I needed support or rest.

    I believe we have a lot to learn from the people of ancient history and the people of primative cultures who are more intune with themselves than we are (generally speaking)... Birth is usually I time when the women would be with a few wise women of the village or sisters and aunts etc etc... And although the women needs space, quiet and often darkness I do strongly feel that the knoweldge that they are not alone adds to their security and to them being able to give birth.

    So glad the Mule is posting such provocative stories!

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  10. http://www.unassistedchildbirth.com/media/alone.html Just an interesting link about tribal cultures birthing alone. I think that for freebirth you need absolute confidence. If you don't have that then yes, the support of someone else - who does not interfere at all can be invaluable.

    I think it is a product of our society today that women do not feel they are able to birth without a medical professional of some kind (midwife/Doctor) present. Birth is portrayed as scary and dangerous, from tv accounts to the birth stories of others etc and I think that is what we need to move away from. That's why I agree with you that it is great that all these stories are being shared.

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  11. Thanks for the link Panda - have looked at the general website before but will have another good read with a cup of tea and in particular the page you highlighted.

    I am in total agreement about society and our now attachment to Doctors but I am of the belief that "Wise Women" (either a good qualified or Lay Midwife or Doula) can be of great benefit to a labouring women.

    First (and 2nd etc!) babies can often be a long time arriving and in the process you need someone to help you to sustain yourself, to provide you with food and drink and encourage you to rest... Then further on a rub of your back if your baby is pressing on an area and causing discomfort (though not contraction related) or a cold compress to your forhead or a kind word through transition... I just cannot see how any of these things are not of benefit.

    Thanks again for the link :)

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  12. It is interesting to look into the life and this case birthing of primitive/tribal cultures, however i do think that in modern society we can not really compare us to them. Women go through a very different journey during their pregnancy in modern society. We are subjected to a large amount of stress daily, travelling to work, then putting up with corp b*llsh*t for 8 hrs a day, unwelcomed late night noises in the neighbourhood etc.etc.and most commonly financial worries all these shift the focus away from the mental preparation of birth.

    I am an advocate of medical assistance, as I said it reduces the chance of fatality. My mum had a baby before me in the mid 70's, she was born with the cord around her neck and suffocated. 36 yrs on is still devastating to think about it. Medical technology was far far less advanced then.

    In this story the lady felt that she did not recieved enough support. I think in the UK we can not expect any form of support from hospitals, they simply not resourced to do anything other than the basic. We are just an item on a conveyor belt, their aim is to get that baby out safely and quickly! Once they can tick the box that mother and baby is safe, you are on your own! Perhaps that's where we should be getting our primitive tribal intuitions out.

    ladies I hope you do enjoy my writing, it has cost me a whole pan of chicken stew i was cooking for my baby that I have forgotten about...:)

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  13. thank you anon, you make some great points and it's so great to have our thinking challenged by someone who is not afraid to go against the flow. often on blogs like this everyone is in agreement and i am extremely grateful to people like you who are not afraid to shake things up a bit!
    i don't necessarily agree with you that 'medical assistance...reduces the chance of fatality' as i think this is a bit of a blanket statement.
    i'll try and address this further in a final post, meanwhile, my supper awaits, and i hope your stew was not too inedible!
    thank you again for your many valid and interesting contributions, and thanks also to jenski and pandabear for their great additions to the debate x

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  14. I recently had a baby 4 mths ago and was planning a hypno waterbirth and ended up a week late from due date, 2 days in labor to then have an emergency c-section...i can relate with this woman 100%...i could have written this as my experience and feeling do not differ very much from her own...my daughter was 9lbs 3oz at birth so big as well and the next time around i am still gonna go for a VBAC and i also plan to hire a doula...

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  15. sorry to hear that Anon, I hope you are recovering...and I also hope you have read Michelle's second birth story, a wonderful VBAC, with TWO doulas!!! http://mamamule.blogspot.com/2011/10/birth-special-from-emergency-caesarian.html
    good luck xxx

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