Our Birth Story: Part Two – Labour/Birth

Following on from ‘Our Birth Story: Part One – Induction,’ we’re so excited to share part 2 of our story with you all! This blog post will take you through our labour and birth, what happened and why. Then in the next blog post, we’ll introduce our little one (for those who haven’t seen our little one on our Instagram already) and what happened next. 

For now, let’s take you through our labour and birth journey! 

0300 Friday 20th August 2021

At 0300, Sarah, who was looking after us, checked my progress and excitedly announced that I was 4cm dilated and officially in labour. Considering that my cervix was still very much closed at midnight, most of the team on the labour ward couldn’t believe the quick progress. Thankfully, my epidural, which was fitted the evening before, was working brilliantly at keeping the headaches at bay, with them only resurfacing around the 10-minute mark, which was when I could press the magic button for more pain relief. 

With dad being my second birth partner, he and Alex decided to go and get some fresh air to keep themselves awake whilst I tried to get as much rest as I could whilst my body was doing its thing. Since the headaches first really kicked off in the early hours of Thursday morning, I hadn’t been able to sleep much, so I needed to get as much shut-eye as possible. With the headache resurfacing every 10 minutes, however, that wasn’t easy. We also had a problem in that little one’s heart rate dropped with every contraction, thankfully recovering each time. Dad and Alex returned, and whilst Alex managed to stay awake, it was a different story for my dad, who fell asleep bless him! 

At 0500, Sarah rechecked me to see how dilated I now was, realising I was 9cm dilated! We now knew that it would be a fast labour and that the big moment was upon us! The doctors came in to recheck the CTG, and as our little one was still dropping heart rate with each contraction, they decided that I needed to be rechecked in an hour. I decided to continue getting as much rest as I could on Sarah’s advice, although the epidural was beginning to not work as well as it had, which made resting difficult. 

0600

Finally, the magic 10cm had been reached! From here on in, things went very quickly. Half dazed, all I remember was hearing the word theatre and panicking that the doctors would switch to c-section last minute. One of the doctors came to speak with us about the plan now and decided that a trial of forceps would be done in theatre so that the doctors could quickly switch to a c-section delivery if need be. We knew the birth itself would be difficult as I wouldn’t be able to push, but with little ones CTG still showing decelerations, letting my body do its thing was no longer an option; it had done all it could. Whilst I was disappointed that I couldn’t continue letting my body do its thing, I knew that our little one needed some help getting out and making it safely into the world. 

At 0615, I was wheeled down to theatre with Alex in tow while dad stayed in our room on the labour ward. The whole time I was praying that my hips wouldn’t dislocate so that it would only be forceps and not a switch to c-section, which had my hips dislocated would have ended up being the case. We arrived in theatre and was introduced to the theatre team before they completed the various checklists. Luckily, my consultant’s extremely detailed delivery plan included suggested positions to make sure my hips stayed aligned, meaning that they didn’t dislocate! Then, with a more potent anaesthetic popped into my epidural, it was time to get this baby out! 

All I could do to assist the team was focus on my breathing and try to use my top two abs to help push down (those are the last muscles I have voluntary control over). Paige, who was taking over from Sarah, arrived and together, they told me when to take a breath in and when to breathe out, timing my breathing with the contractions. Alex later told me that the doctor pulling our little one out with the forceps had to use all their strength, so I’m not sure how much my breathing helped! 

0710 and 6 contractions later, our baby’s head was born! After some delayed cord clamping, which was one of the main things I wanted along with skin to skin as soon as possible, we got to meet our little miracle and fighter at 0714! All in all, my total labour was 4 hours and 15 minutes – pretty quick, all things considered! 

In the next blog post, you can meet our little one and find out what happened after the birth, including why our little fighter had to spend some time in NICU and later on transitional care. 

Our High Risk Pregnancy So Far: Why We’ve Accepted Induction Of Labour

The last few weeks have been stressful with no news and, as a result, no plan. Finally, at 36 weeks, we now have one, but it might not be the plan everyone was expecting us to have. If you haven’t read our previous post about our pregnancy journey so far, you can read the last one here

From the start, we always knew that I’d require some sort of medical input when it came to labour time and birth. Our biggest fears were that I’d be pressured into accepting a c-section which for me would mean a difficult recovery and relying on Alex and our families for almost everything for the first 8-12 weeks, both in terms of my care and little one’s. I’ve always been for a physiological birth, or as close to it as I can possibly get, only going for a c-section or other interventions if absolutely necessary, especially as it would very likely need to be done under general. Luckily, the result of the MDT meeting was that if I don’t want an elective c-section, then I don’t have to have one, but it’s under the condition that I’m aware we could still be heading down that route if either little one or I don’t cope well in during labour. 

How the option of induction came about and why we accepted

One of the biggest things about not going down the c-section route is unpredictability and the risks involved. For us, not only do I have a medical condition which means I can’t feel movements or contractions and have to palpate for them, but I’m also at risk of precipitous labour. Then, to top it off, we found out that I have Group B Strep at 26 weeks, and I’m also at risk of other complications. It meant that the idea of induction was proposed to us, with all the risks and benefits involved. Benefits? We’d have an idea of when my labour will begin, and with it, the option to ensure Alex is off work for a few days so that he doesn’t miss the birth. It also eliminates the risk of me giving birth at home with no help other than Alex’s Avmed training, which, whilst the scope of what Avmed covers is fantastic, where childbirth is concerned, it doesn’t equip you for a complicated labour birth. Cons? If it fails or something else happens, it’s a c-section since assisted delivery via forceps or ventose is out of the question due to dislocation risk. It also further increases my haemorrhage risk, something my consultant already factored in early on so that there’ll be medication drawn up and on standby if it’s needed. 

As my midwife talked to me about induction some weeks ago when Alex’s roster and being back at work was causing me stress around whether or not he’d even make the birth, Alex and I had actually spoken about the possibility of induction. We researched the risks and benefits before my consultant had even offered it to us to come to a decision together without feeling pressured. After those discussions with Alex and my midwife, I said that if induction was offered to me, I’d accept it to reduce the risk of that happening as him not being at the birth would be heartbreaking for us both. It also gives us some control over the situation as long as little one stays put and I don’t go into labour before induction day, something which could happen and my consultant warned us about when we accepted the offer. Alex had already made it clear that he’s scared of waking up during the night to find me still asleep whilst in advanced labour, something which we both know would affect him massively even with all of the training he’s equipped with, thanks to him being crew! 

As you can see, accepting an induction of labour was an easy decision for us once we’d weighed up all of the risks and benefits. Even with the risk of having to go down the c-section route if something goes wrong, the thought of having an unattended labour and birth with all of the dangers attached due to my complex medical history scares Alex and I more. We are also fortunate that we never felt pressured by the team looking after us to accept induction, mainly because we’d had that discussion ourselves beforehand, giving us time to fully consider everything. Not only is there information on induction of labour available to read in my handheld notes, but we also turned to Google to research the specific risks that are unique to our situation and spoke to other pregnant people who have EDS. But what if you’re enjoying a lower risk pregnancy and offered induction, or just don’t know if you want one?

Research is your best friend

Alex and I both know people who have been offered induction of labour and felt little pressure to accept, as well as plenty of people with low-risk pregnancies who felt forced into accepting an induction to keep their team happy. We started looking into our options quite early on once our consultant told me that she’d do everything possible to keep our options for labour and mode of delivery open. That kind of support from her when every other specialist outside of obstetrics had told me that c-section was the safest way forward meant the world to both of us. It also meant that we felt even more supported by the teams looking after us, both at our local hospital and the Silver Start Unit in Oxford, who we’re so thankful to have the specialist input of. 

Great places to research induction include Google (especially as you can tailor your search to your unique situation) and your handheld notes if your hospital provides information on induction of labour in these. I also highly recommend speaking to people who’ve had an induction of labour offered about their experiences, even if they didn’t accept the offer, as firsthand experiences can often help the decision making process. This same piece of advice goes for those who have medical conditions which could influence management. There are plenty of online groups on Facebook etc., which allow you to connect with others going through similar! If you can, start researching and discussing your thoughts with someone else early! This means by the time an offer of induction is given to you (if it is), you’ll have already thought about it and either decided on whether or not to accept, or you’ll have an idea of what questions to ask. It also means that whatever your decision is, you’ll be able to explain the reasoning behind your decision to whoever is looking after you knowing that you’ve given yourself time to consider all the risks and benefits. I’ve also learned to use one acronym that has helped us massively with each decision we make, called B.R.A.I.N. 

What is B.R.A.I.N?

B.R.A.I.N really is what it says it is; it’s using your brain to make an informed decision. 

B – Benefits (what are the benefits of this test or procedure for me and my baby?) 

R – Risks (what are the risks of this test or procedure for me and my baby?)

A – Alternatives (What, if any, are the alternatives?) 

I – Instinct (What is my instinct telling me? What do I think and feel about this test or procedure? Who else can I ask about it?)

N – Nothing (What could happen if I decide to do nothing or wait and see? Can this test or procedure be delayed? Can I take some time to think about it or research?)

B.R.A.I.N is something we’ve used throughout our pregnancy journey to make informed decisions and choices that we know are right for us without feeling pressured into doing something we may not necessarily want to do. It’s also something that we will continue to use and advocate that others use, especially as it is such a handy tool to have. With the NICE draft guidelines meaning that an increasing amount of people are already being offered induction at 39 weeks even if there isn’t a clear clinical need, now more than ever, birthing people and their partners must be able to make informed decisions without feeling pressured into accepting something they may not actually want. 

Have you been offered an induction of labour or had one in the past? Feel free to share your experiences in the comments with us! 

Our High-Risk Pregnancy So Far: 32 Weeks And Still No Plan!

If there were a list of posts that we hoped we wouldn’t be doing, this is one of them! I knew from the start that pregnancy wouldn’t be easy. Alex and I spoke about that fact in detail quite a few times, as well as about what we would do in set situations, but we never thought we’d get to a point where we have no plan so soon to little one’s arrival! 

Going through a high-risk pregnancy takes its toll, and with ours, we have another problem; high levels of uncertainty. Uncertainty around labour because I can’t feel movements (more on that subject here), uncertainty and worries around neonatal withdrawal and how my medication has impacted little one, and finally, uncertainty over whether or not my body will cope with physiological birth. The latter could be true for anyone. After all, no one knows for sure if they’ll get the birth experience they dream of, but we quietly hope that everything will go to plan and for our preferences to be fully respected and carried out without question. 

For me, I’ve been adamant from the beginning that when it comes to mode of delivery, I want a physiological birth if at all possible. So when I attended my first appointments with obstetrics and my midwife, I made a point of telling healthcare professionals that I want to try, even with the uncertainty around my body being able to cope. Here’s the thing with my EDS; it’s unpredictable, especially as my dislocations can happen at any given moment. I also have autonomic dysfunction, spinal involvement, and on top of that, we don’t know for sure what type of EDS I have. Although I found out in 2015 that I have EDS, until 2019, everyone assumed it was the hypermobile type. But when my thumb joints failed to the point of needing fusion and other symptoms began popping up, there were concerns that I have classic EDS and not the hypermobile type. So when I fell pregnant again and got referred to Silver Star in Oxford, doctors there decided to get me tested and find out once and for all if it is indeed classic EDS. This very bit of information will be the difference between me getting my way and getting the chance to have a physiological birth or having to go down the c-section route. 

Up until 26 weeks, the obstetric teams I’m under all agreed to keep an open mind. However, a swab I had done when I started spotting again picked up Group B Strep. It’s not an issue during pregnancy, but it’s a problem in labour or if waters go since you need to be on antibiotics as soon as possible to reduce the risk of passing the infection onto baby. It’s yet another complication we could have done without, as it’s further heightened both mine and Alex’s anxiety around labour and birth. It’s also left me worrying that even if I can have a ‘normal’ delivery, physiological birth could out of the question if the team eventually recommend that I have an induction. 

Why The Idea Of A C-Section Scares Me 

Let me start by saying that you have to do what is best for you and your baby, and no two birth experiences will ever be the same. For birthing people who choose to go down the c-section route, I fully respect your decision and know that it isn’t always easy to make. 

For me, many of the worries around c-section delivery are linked to past medical trauma, which I’m still working on processing. My EDS means that both local and regional anaesthetics are ineffective to the point that I’ve had to be put under general for surgeries where most could be awake. In one surgery last year, I had a failed regional, and my last memory before being put under was screaming in pain as the anaesthetic failed to numb my arm. I also had problems coming around from the general afterwards, which wasn’t ideal. Luckily, we’ve been able to speak to the lead obstetric anaesthetist at the hospital in-depth about this and other issues, including my long list of allergies! During our conversation, the anaesthetist we spoke to joked, ‘you’re not an anaesthetist’s best friend, are you?’ ‘No, I’m not, I’m a paperwork nightmare’ was my light-hearted reply. That conversation also highlighted other issues. However, we also had our minds put at rest over certain things. 

One of the other worries about having a c-section under general is that we were both put under the impression Alex would not be allowed into theatre for the birth. Usually, this is the case and was so even before covid. But we’ve been reassured that depending on who is the team on the day, Alex’s emotional state (good thing he’s crew) and that there are no emergencies involving myself or little one, he may be allowed into theatre for the birth. It’s something Alex is super happy about, and I’m just relieved over even if it isn’t for certain. Having my birth partner with me means having someone I know and fully trust to fight my corner and ensure my birth preferences are respected. This is especially true where delayed cord clamping and skin-to-skin contact are concerned (both of which I want regardless of delivery method). 

There’s also the worries around my recovery from a c-section. People forget that it’s major surgery with a lengthy recovery period! In my case, it means not being able to transfer myself for 6-8 weeks which means I’ll probably need to be on hoist transfers – something I heavily detest! A c-section recovery would also mean heavily relying on Alex, my dad and others since I’ll likely have to restrict how much time I can be in my wheelchair and up and about. I also take longer to heal, thanks to my EDS, so there’s the risk that the usual restrictions could last even longer. All of this makes me worry about how much I’ll be able to be involved in our baby’s care in those first weeks.

32 Weeks and still no plan

When I had my genetic blood panel done to find out what we’re dealing with in terms of my EDS, I was informed that the results would be the most significant determinating factor regarding what mode of delivery would eventually be recommended. There was hope we’d have them back at around 28-30 weeks, enabling us to get a plan in place and know what to expect. We also need to have an MDT meeting, where all the specialists involved in both mine and little ones care meet to discuss the way forward. However, we can’t have the meeting until the genetics are back, something that is starting to worry not just Alex and I, but my consultant, who is now chasing them up. 

We’re hopeful that by 34 weeks, we’ll have the results, the meeting and know what will happen. However, I feel disheartened and stuck in limbo. My birth preferences still aren’t complete because I don’t feel I can fully finish that off until we know what is going on. As we get further along, the possibility of going into preterm labour without a clear plan is not only becoming more likely as the days go by, it’s becoming more and more worrying! However, the biggest thing for me is that whilst there’s no plan in place, I’m holding out hope I’ll get the physiological birth I’m hoping for, even if others think that option is fading away.