Thursday, 17 November 2011

A birth story

At 1.15am on a windy November night, at 36 weeks gestation, our baby daughter began to make her transition from womb to world.

It was with the ice cold stab of dread I woke, paralysed while I made sense of the feeling: my waters had broken. This wasn’t supposed to happen yet, the baby was preterm. I stole out of the bedroom, packed a hospital bag and a bag for our two year old daughter, did some last minute, frantic cleaning and tidying, had a shower, then woke my husband.

‘I’m having a baby’ I told him. As he blinked to consciousness and I heard the announcement myself and the birth was in motion.

 At 5.30am, we arrived at the hospital. The welcome we received at the labour unit was less than luke-warm. Perhaps the staff could be forgiven, perhaps they were taken aback by my appearance. After all, our circumstances were far from ideal, with my headscarf and lashless face a giveaway of my failing health. But while we were anxious about all that was to come, we were also excited, full of a sense of impending event, with the expectation that others involved would share in our anticipation of a new child. But the midwives  were chatting, and we were just another customer. Eventually, someone looked our way and said 'Yes?' in the same tone a cashier at Argos might say 'Next'. I explained I'd spoken to someone on the phone, had been told to come in and a woman, whose uniform suggested she was a midwife, gave us a room number, as if directing us within a seedy hotel.

The room was cold and clinical with florescent lighting, faded curtains and some frightening medical equipment. Where were the rooms with state-of-the-art accessories I’d seen on my tour of the unit, the pools, stools and specially designed seats? There was, of course, a bed. A mean, narrow hospital bed which looked to me with my aching, swollen belly like a perch for a bird. I couldn’t contemplate climbing upon it, so lumbering and grounded was I. Above the bed was a clock, an enormous, digital display of the time, a reminder of the hospital laws of delivery, scheduled by doctors within the parameters of phased time constraints. The race against time had begun. 

A midwife came to take notes. She asked questions and wanted to examine me. Why? To see how far the labour had progressed. Why did she need to know? Um, because they liked to know. I told her I’d rather not. She left. A doctor came. He asked the same questions, suggested an examination. Without examining me, he declared I wasn’t in active labour yet. As my waters had broken preterm, he would suggest a hormone drip to induce. I declined. Against my wishes, I lay on the bed for an hour while the midwife monitored foetal movement and my contractions. Not surprisingly, the contractions relaxed, slowed, stopped. The doctor wouldn’t be pleased, she told me, my contractions weren’t good enough. Look – she showed me the print-out of the reading – these lines weren’t long enough. I’d failed the test.  

A second doctor came. He told us we had 16 hours from waters breaking to having three contractions every ten minutes, or there was a 1 in 50 chance the baby would be born with pneumonia. In order to avoid this, he’d like to start me on a drip now, first with antibiotics, then syntometrine. We glanced at the clock with the seconds progressing ominously while the baby seemed to shake her head within me and say 'I'm just warming up, not quite ready yet.' We stuck to our guns: no thank you, we’d like the chance to get things going without intervention. A walk round the grounds would be a good start. The medic left but reappeared with a drip and a needle as big as a pipe, to infuse the antibiotics I’d agreed to. Why so big? In case I needed a blood transfusion, they told me. I was scared – why would I need a blood transfusion? Blood-loss, of course. Why was blood-loss a risk? Well, it wasn’t in particular, but this was just a precaution, you know, considering my condition... Now I saw myself through their eyes: a sick, bald geriatric mother, incapable of delivering a baby. They did not know about that sunny day back in May two and a half years ago, when our first child was born and although I knew this birth would not be the same, I was capable of being in control and wanted the birth to be as positive as possible. The midwife pierced my best vein – the one so many chemotherapy drugs had flowed into many times until just six weeks earlier. I nearly hit the ceiling. Sorry, she said, I don't know why it won't go in. I could have told her there was scar tissue, I could have told her it was hardened, and that her needle was just too bloody big. She held it up for me to observe and my stomach turned. Perhaps I could have a ‘normal’ needle, a smaller one? A shrug, a warning that I may have to go through the pain again, later in labour if I needed a blood transfusion, and it was agreed. 

Shortly after, the second doctor reappeared, armed with a third doctor. He stood back, giving the third doctor centre stage to deliver his canvass. What he delivered was the same argument as the second, and the first, but when I explained for the third time that I didn’t want intervention or pain relief unless it was in the interest of my baby or myself, he laughed that they weren’t offering pain relief, only pethidine with the syntometrine drip. I didn’t bother to argue but explained, now with slightly irate interjections from my usually calm partner, that I’d given birth once without complication or intervention, in my own home, without doctors or pain relief. I knew I wasn't in the best of health but I felt strong and determined, so would they not just give us a chance, give us some time to get this thing on the road, and if we couldn’t I would give full permission for them to take over? They agreed, on one condition: we had until lunchtime. As they retreated we looked at the diminishing seconds on that watchful clock above the bed and a sense of determination boosted our broken spirit.

It took a lot of walking to get the baby moving, quite against the advice of the doctors who wanted me on the bed wearing a monitor. But the battle of wills continued. We made endless treks around the hospital grounds on that blustery November morning, up and down stairs, dropping to my knees in inappropriate places to wait for painful contractions to pass. Once we could see that things were really moving, we resigned ourselves to the labour room. The midwife wasn’t there but we went in and got on with it. As I knelt on the floor and clung to the bed with each contraction, I felt the world slipping away. I couldn’t respond to my partner who spoke to me with frightened eyes. I could hear him asking if I was alright and I thought I’d reassured him, but my answer was in my head. When I started bleeding, he went to fetch the midwife. 

The midwife had popped out for lunch, he came to report, but apparently would be back soon. Another midwife came in, asked if I’d like gas and air, set it up and deserted us. As I whirled into the private concentration of drunken pain, I could see my partner’s fear escalating while he danced between me and the door, looking for a midwife. ‘I can’t do this,’ I told him ‘I can’t have this baby.’ I remember him telling me that’s what I’d said last time, and at last I knew this must be transition. With my first push, the midwife came through the door. She’d been gone 40 minutes. I was still frantic with the pressure of timely delivery, fearful that doctors would arrive to intervene, put me on my back, blind me with bright lights, forcibly remove the baby and leave me broken and torn. I pushed too hard and fast, out of control, desperate to do this job myself. I hardly noticed the midwife, only my husband encouraging my efforts. 

When our daughter slipped onto a mat on a cold, hard hospital floor at 14.43 and 36 weeks gestation, she wailed in protest. And how could I blame her? Squeezed out by a mother who was out of tune with her body, terrified by the hospital, bullied by the doctors. When our first daughter was born, she came out making endearing, happy sounds, was brought from the water in the pool and passed into my arms. The contrast now was stark and dismal.

There is a time and a place for a hospital birth. Unfortunately our circumstances meant that this was one of those times, for the sake of our baby who was exposed to chemotherapy drugs while in utero. So why is it that giving birth in hospital was frightening rather than reassuring? Perhaps it has something to do with so many obstetricians being men, men with the kind of patronising attitudes that belong in the 19th century. 

As soon as our daughter was born healthy, we could be nothing but delighted. Not one of the three doctors who’d tried to take charge of my labour came to congratulate us, but we were too happy to notice at the time. We sat and wondered at our luck, examined our perfect little girl, kissed fingers and toes, congratulated ourselves and looked forward to taking her home to meet her sister.

We are so lucky to have a second healthy, beautiful daughter that it would be churlish to dwell on the delivery but as I say, every mother has a right to tell her birth story.

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