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AIMS Journal, 2019, Vol 31, No 3
By Emma Mason
At the time we discovered we were having a baby we were pretty clueless about pregnancy, labour and birth. I imagine this is the same for most people about to embark on the journey towards their first child.
Early pregnancy was tough to say the least with horrific abdominal pain just a few weeks in, necessitating a very early scan to investigate the problem. The cause was unclear as there were two things seen on the scan, either or both of which may have been a fertilised egg. One was in my fallopian tube and the other in my womb. A few days were needed in order to check my blood hormone levels and rescan after further growth. Luckily, the mass in the fallopian tube turned out to be a cyst from which fluid was draining, causing me the intense abdominal pain, but no further treatment was needed as it was resolving itself. The other scan finding, situated in the womb, was an established pregnancy.
We didn't have much time to celebrate though, as it was at this time that hyperemesis gravidarum (a form of very severe and debilitating morning sickness) set in1. My symptoms worsened and worsened, with various advice of eating ginger, snacking frequently, staying hydrated etc making no difference at best, and often exacerbating the problem. I rapidly lost weight and at my worst had occasions where I couldn't stop being sick for long enough to leave the bathroom, let alone the house.
Through this time I couldn't figure out why other pregnant women were coping so much better than me and concluded that I was weak and had a lower tolerance. Feeling sick became the norm and I was uncharacteristically unreliable for weeks, cancelling whole evenings of classes with little notice, my full time job being a dance and performing arts teacher. I finally spoke to a GP who prescribed me prochlorperazine but explained that it could not be guaranteed to have no effect on my unborn baby. The tablets stayed in the packet for a few days until after a particularly bad morning my brother-in-law, a paediatric registrar at the time, told me to take them. Within an hour of taking my first tablet I felt hungry (a sensation that took me a while to identify, having not experienced it in such a long time!) and ate some toast, the best toast I have ever tasted! Although I still felt sick it was a lot more manageable and the symptoms began to ease up at around 18 weeks so I could cope without the tablets.
The rest of the pregnancy went very smoothly, and from fairly early on I decided that I wanted to give birth in the midwife led suite at Southmead Hospital in Bristol. I wanted the option of a water birth with the security of consultants just down the corridor. The choice for me at the time was a home birth, a stand-alone midwife unit at Cossham Hospital, or midwife led units at St Michaels or Southmead hospitals. However, at no point were these various options discussed with me, nor was I offered research data to illustrate the actual risks of each. As a result I felt a home birth was completely out of the question, and the midwife-led unit at Cossham was also an enormous risk to mine and baby's safety.
It was through friends and family that I heard about hypnobirthing, and after an internet search, felt it was worth investigating further. The course wasn't cheap, at £200 for 5 sessions of 2.5 hours each but I convinced my highly cynical husband that we should book in. After just one session I had done a complete U-turn, declared that I would not set foot in any hospital and had my heart set on Cossham. As the course progressed I became increasingly astonished at the skewed view of birth, doubtlessly absorbed from the media, the portrayal of birth on-screen, and horror stories from other women who ironically had perhaps suffered due to an over medicalised birth rather than been saved by it.
My husband, Rich, was also completely convinced by the hypnobirthing ethos and dutifully did all the homework required of him, vowing to be the perfect birthing partner. The physiological approach of the course really spoke to us both, giving a clear explanation of what happens to the body during labour and how the sympathetic and parasympathetic nervous system have a major effect on birthing outcome. Rich felt he had a real, defined purpose during labour and birth which was undoubtedly helpful for us both.
People we spoke to were generally not very supportive of our choice to plan for a hypnobirth. Attitudes ranged from doubtful to purely scornful, and common responses were “Just wait until you're screaming to get the baby out, you'll be asking for all the drugs they've got” and “There's no point in making a birth plan, it'll all be out the window once you go into labour”. Luckily for my wonderful family, I am a very stubborn person and had absolute faith in what our hypnobirthing teachers were telling us, so I was able to smile serenely and thank people for their unsolicited opinions.
My 36 week midwife appointment was at Cossham with one of the midwives there. I had a private tour of the facility and was able to ask any questions I had. I left that appointment even more convinced that Cossham was where I wanted to give birth. The midwife had made me feel confident of my own strength and my body's capability to give birth. At 40 weeks I had an appointment with the midwife back in Portishead where I live.
Despite my protestations she booked me in for my induction, at 40+12. I requested a sweep, as in my view I would rather start things artificially in that way and still be able to go to Cossham than have to go to hospital and be induced. When I asked for a further one if necessary, I was told that the resources weren't available. On hearing this I called Cossham, who had told me to ring if I needed any further help. They immediately booked me in for two more sweeps and also explained that I had the right to refuse the induction at 12 days ‘overdue’. They informed me of the procedure I should follow in order to maintain the safety of myself and my baby and I finished the call feeling empowered once more and still hopeful for the birth I wanted.
I went into labour at 40+7 in the morning. Rich had already left for work so I had a shower, figured out that this was the real event and gave him a call to come home. We spent most of the day walking, breathing and eating, with contractions (or surges, as we called them in hypnobirthing) mounting towards 5pm. I called Cossham who recommended I stay at home a little longer, so I settled down with my birthing ball, rocking and breathing. I was becoming concerned about the potential traffic as it was rush hour and then my waters broke, so the Birth Centre said to make our way in. The journey was fairly uneventful and the traffic not too bad, so after about 40 minutes we were walking into our private room at Cossham Birth Centre.
The atmosphere was incredibly relaxing and we'd arrived just before the midwives' shift change so we were left on our own to settle in and wait for the new midwife to start her shift and come to look after us. I was still able to breathe effectively through surges and was feeling fairly calm. Our midwife plus a student came in and introduced themselves. I got straight into the water which provided immediate relief and relaxation. Rich provided solid support, cooling my forehead with a flannel, offering a cold sports drink and coaching me through the breathing and relaxation that was necessary to maintain my focus.
I had one shock when suddenly a huge pressure built from within and something shot out with what felt like the force of a cannon firing! It turned out that in fact only my hind waters had broken at home and this was the rest. It did shake me for a while but with reassurance from the midwife I soon regained my composure!
During my time in the pool I'd been on my knees, resting my arms and head on the edge of the tub. All of a sudden I felt the most excruciating pain in my hamstring and screamed out loudly. It was interesting that this was the first pain I'd actually felt and I completely lost focus. I had bad cramp from fighting the water to stay on my knees. Rich immediately massaged the area to relieve it, but not in time for the next surge, which was significantly more intense and did hurt. Having got rid of the cramp, Rich brought me back into the necessary relaxation and the next surges were far more manageable. Even at the time I found this interesting, that my loss of focus made such a noticeable difference to the sensations I was experiencing.
Up to this point, the midwife and student had been very much in the background as I had requested, leaving me and Rich to go through our relaxation processes. They came over occasionally from their place at the other side of the room, and gently performed checks before withdrawing again. I was starting to feel as though the strength of the surges was reaching my limit and called over to ask for some gas and air. They responded with a smile and a nod and unhurriedly made their way over, at which point my baby arrived! I felt the head appear, where it stayed for one more surge and then fully emerged, at which point I remember looking straight at Rich and saying “Next one and it's coming out”. I breathed down as hard as I could, working with my body, and my baby was out in one rush.
I sat in the water, cuddling my new bundle for at least a minute before it occurred to me to ask what we'd had. The news we'd had a girl, my most secret and private wish, was the perfect end to an amazing birth. I had a physiological third stage with little drama, on a birthing stool in the drained pool. Baby Girl was taken for checks after a while and then given to Rich for skin to skin while I had my stitches, having had a second degree tear. It was at this point I had my first pain relief; I instinctively refused when offered, but then the midwife gently congratulated me on a super birth and suggested I give myself a rest!
She recommended that gas and air would help me at this stage and I took her advice. I was glad I hadn't had any during the birth, as although it was a definite help through the stitches (not to mention being helpless with laughter for most of the procedure) I'm not convinced I could have maintained the necessary focus while taking gas and air.
By the time everything was done (including a hot meal brought to us!) it was about 2am. The midwives offered to take Baby Girl so we could have our last uninterrupted sleep before taking her home. We accepted and settled down together, feeling so grateful for our double bed and private bathroom. At 6am we went to find our little girl who was safely with the midwives, and spent the rest of the day relaxing in our room and getting to know our daughter. I was struggling to get her to latch to breastfeed and received plenty of help from the staff who finally hit on the right position for us, at which point she had a lovely long feed. We went home later that afternoon.
My birth experience was such a positive, empowering one. I strongly feel this is mostly due to the hypnobirthing classes we took. The birth of our second little girl was very similar in every way and just as wonderful. Interestingly, we had an extra birthing partner who was a friend of mine training as a midwife. She said she hadn't covered anything about hypnobirthing or similar as part of her degree and despite many different placements had never before witnessed a birth like ours.
I do find it difficult sometimes to share my story as there are so many women who did not have the labour and birth they wanted; however, I do think that more of us need to share our positive experiences.
Further reading:
1. Hyperemesis Gravidarum support group: www.pregnancysicknesssupport.org.uk
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