Teaching Hospital Needs a Lesson in Waterbirth

AIMS Journal, Summer 2000, Volume 12 No. 2

DV
Richmond, Surrey

When I was first asked to write about my birthing experience I had no idea how traumatic that would prove to be as Irecounted the events for the first time since my babys birth on the 20th March 2000. From the moment my husband and I received confirmation of my pregnancy in July 1999. I had made a conscious decision to have a natural pregnancy and birth. Being a vegan and very much into alternative health practices I was determined to have as little conventional medical intervention as possible. Early on in my pregnancy I explored the various options for the type of birth 1 wanted. My first choice was to opt for a home birth however, as this was my first pregnancy I was persuaded to have a hospital birth in the belief (an undertaking given by Queen Charlotte and Chelsea hospital) that I would get a natural birth if that's what I wanted.

Midway into my antenatal I discoved that I had developed hypenension (high blood pressure). I was advised to rest but warned that raised blood was an early indicator Of pre-eclampsia, consequently I would have to be monitored very closely. I was also informed that I would be prescribed medication if the raised blood pressure persisted. I came away from this appointment resolved to find a way of lowering my blood pres- sure without the use of drugs.

My quest led me ZW to a practising midwife who uses acupuncture to treat high blood pressure as well as a number of other pregnancy related conditions. I amazed at the effects of acupuncture, almost immediately I felt as though my internal temperature gauge had been turned down because immediately after treatment I felt a cool sensation flow from my head to my toes. ZW would always take a blood pressure reading before and after treatment and there would always be a drop in my blood pressure. I informed the midwives and doctors lesponsible for my care, must dismissed my claims.

The success of this treatment encouraged me to plan the remainder of my pregnancy and impending birth with a renewed determination to have a drug-free birth. I began to explore the use of birthing pools as I had heard that this method of childbirth was not only an effective means of pain relief but an excellent method of lowering blood pressure. My research led me to the work of Michel Odent and his pioneering work on water births. Quite by chance I saw a television interview with Dr Odent in which he stated that he would be giving a lecture on the use and benefits of water births the following day. I contacted the organisers of the event and booked two places for my husband and myself.

Attending the lecture by Dr Odent confirmed what I had already thought that the use of a birthing pool was one of the best things available to any pregnant woman with high blood pressure. At my next antenatal appointment I informed the hospital that I wanted to use a birthing pool. I was initially very encouraged to learn that the hospital had a bilthing pool, but very disappointed at the response to my request. The midwife sent in to speak to me seemed quite cold and anti-water birthing. She briefly glanced at my medical file and said "Oh you won't be allowed to the pool because you have a history of high blood pressure and you have had protein in your urine, both signs of pre- eclampsia.

I explained to her that if she looked at my file in more detail she would see that my blood pressure had lowered and stabilised and the protein levels in my urine had dropped to a level that the senior registrar that I had just seen was happy with. In fact the registrar was happy for me to use the pool as long as there were no noticeable changes in my condition.

I informed the midwife about the merits of the birthing pool in relation to high blood pressure. She said that she did not believe that the pool would have any effect on lowering blood pressure and that in any case she believed my blood pressure would be high during delivery and therefore I would not be able to use the pool. She then went on to say that I would subsequently be treated as a medical case whereby I would be given an epidural to lower my blood pressure. I informed her that I did not want an epidural, at which point her whole body language changed. She sat back in her chair, folded her arms and legs and looked at me in a way which made me feæl very uncomfortable.

Despite her reaction I asked for and received the information on water births. I was also asked to contact the attending midwife at the hospital responsible for water births. To my surprise I was informed that although the pool was available there was no guarantee that I would be able to use the pool if the midwife responsible for my care did not feel comfortable with it. When I asked about the likelihood of this being the case I was told that there was a high probability that I would not get a midwife who was trained and comfortable with using the pool, however it was probable that I could use the pool to help with the labour pains but would have to leave the pool at the point of delivery.

This did not totally disappoint me as I had already decided that I was not going to deliver in the pool, but it did make me wonder about other women who wanted to give birth underwater. How many of them realise that because of a lack of suitably qualified midwives their request for a waterbirth would probably be denied. The leaflet I was given by the midwife mentioned a company called [name removed] which would supply me with the pool liner. When I contacted the company I was greeted by the owner of the commany [name removed], who reassured me that the pool would be an ideal tool to use to help lower high blood pressure.

By the 40th week of my pregnancy I was all set to give bilth using natural methods, I had hired an acupuncturist to work with me on the day, I had hired the birthing pool and had purchased herbs designed to give pain relief and generally assist with the birth. My contractions started a day after my actual due date, I contaced the hospital when the contractions were seven minutes apart. I informed them that I had booked the birthing pool and asked that it be prepared for me. I was informed that this would be taken care of. I arrived at the hospital on Sunday 19th March at approximately 12.30pm. I was taken to a delivery room and within a short space of time I was examined and told that I was 3cms dilated.

I told the midwife that I had booked the pool and would like to use it when my cervix had reached 5cms. The midwife told me that she was not aware that I had wanted to use the pool as no-one had informed her, had she known she would have placed me in the room with the pool in it. I would have to change rooms once things progressed. I did not think that this was a good sign but resolved to concentrate on getting through the contactions. Shortly after having informed the midwife of my intention to use the pool, two female doctors entered the room, they introduced themselves and proceeded to tell me that they were not happy with my request to use the pool.

They pointed out that they were not happy with the fact that I had had a history of high blood pressure during the pregnancy and protein had been found in my urine. I stated that my blood pressure had stabilised towards the latter half of my pregnancy and the current readings were very similar to my previous readings. I also informed them that the protein levels in my urine had dropped. One of the doctors who identified herself as a senior registrar told me that I should never had been led to believe that I could use the pool as it wasn't safe in her opinion. Using the pool would not enable them to monitor the baby.

I told her that I would leave the pool whenever they needed to do that and that I vas sure the water would help to keep my blood pressure down. Again she made it clear that this was not acceptable. I stressed that this was what I wanted, she refused. I asked her whose responsibility it was to make such as decision. I wanted to know if ultimatelv the decision was mine to make. The doctor said that she would have to speak to my consultant.

The two doctors left the room and as they did so it suddenly occurred to me that in this particular hospital the doctors were not on the whole working towards ensuring the woman gets the type of care she desires, the reverse is true if it happens to conflict with what they want. The only üme you see a doctor is if some complication or problem emerges, other than that they don't have a role to play.

When the doctors returned, the senior of the two explained that the consultant had agreed with her, but if I insisted on using it I would have to sign a disclaimer form absolving the hospital of any responsibility should a problem arise. They pointed out to me that their concern was that I would have a fit and collapse in the water. I stated that that could happen outside of the pool and that it was a risk I was willing to take. They both left the room.

I tried to put the memory of the last half hour to one side while I concentrated on the contractions, they seemed to be speeding up but to my dismay my cervix was not managing to dilate any further than 3cms. The midwife suggested that she break my waters to speed things up. Initially I refused as I wanted to let nature take its course. However, after several hours it became clear to me and the others in the room that things were not progressing. I eventually agreed to have my waters broken.

It was extremely painful, but I felt I had no choice as the midwife explained to me that if the dodors saw that was not being made they would intervene. The whole process increasingly began to feel like a battle between myself and the midwives on one side who wanted a natural birth experience and the doctors on the opposing side who didn't care what methods they used in order to deliver the baby.

Some sixteen hours had passed and still no progres. The doctors informed me that although the baby's head was very low down it was tilted at an angle that was preventing it from moving any further down the birth canal. They recommended the use Of the drug syntocinon, which they said would move things along. They told me that they were for the baby especially as I had already spent almost twenty hours in labour with little progress.

With my concerns growing for the baby I reluctantly agreed. Once administered I had no idea how painful the contractions would become as a result of using this drug. My plans for a natural birth were slowly ebbing away as time passed and I found I could no longer cope with the drug-induced contractions without stronger pain relief. An epidural was administered and almost twenty-four hours since I first entered the room I gave birth to a baby weighing 6 lbs 7ozs.

Ultimately I took solace from the fact that I had given birth to a healthy baby girl. But for the mast pan this birthing experience was not what I had planned. With hindsight I wish I had asked the doctors to stop administering the syntocinon once I had got to 5cms dilation because it is at this point that would have used the birthing pool, but the whole incident with the senior registrar and my sheer exhaustion prevented me from doing so.