C-sections and the pressure to have a “perfect” birth

Last week at my 32 week scan (yes I can’t quite believe we’ve got this far), I found out my little girl is healthy and happy, but that my stubborn low-lying placenta has refused to budge and is completely covering my cervix. This is called major or complete placenta praevia.

It is now very unlikely to move between now and the birth (baby has done a full 180 since the 20 week scan in the meantime) so that means a scheduled C-section for around 38-39 weeks as natural birth is just not possible. Baby would have to push through the placenta and you’d haemorrhage. There’s just no choice about it.

And the main thing – of course – is that baby will get out safely this way. But I was truly gutted not to be able to have the natural pool birth I was hoping for. And because the chances of this happening are something like 1/200, I figured we’d had enough bad luck in this whole department, thank you very much.

In my head, I’ve been envisaging a calm, beautiful water birth with her popping out into my arms, cathartically healing the pain of what came before – the traumatic shoulder dystocia birth with my son and then all the losses.

But is that so realistic?

I have been so taken in by the natural birth movement and its ideals of a birth “experience” that brings out the earth mother in us all. But how common are these ideal births? And why do I feel such a failure not to have experienced this sort of birth?

A straw poll of a group of girlfriends and it seems I’m not alone. If we were in medieval times, we’d have all pretty much died in childbirth. Between us we had a ruptured placenta, shoulder dystocia, infections, sudden haemorrhaging and a myriad of conditions and problems leading to emergency C-sections, drips, inductions, forceps and ventouse.

In fact, amongst the more straightforward births my friends have had, the most common comments I’ve heard have been how great the epidurals were because you couldn’t feel a thing, or just that it was “bloody painful”.

That said, I do know at least two friends who did have amazing sounding births. One roared like a tiger and became some sort of primal powerful animal. The other had some sort of spiritual connection with her partner and gave birth in the pool.

But the only other time I’ve heard about great births have been in natural birth yoga classes, books and workshops. Where birth stories talk of women breathing out the baby, golden breaths through the surges, and how lavender oil totally helped. But is this a realistic image to give women, and does this not add extra stress and judgement to women who have other sorts of births – the frantic and the traumatic and the drug-filled?

I mean, my son wasn’t breathed out so much as forcibly yanked, and I cried all that night feeling I’d failed as a woman and let him down (and that was even after having refused an epidural and managing largely without pain relief – a mistaken belief at the time that I should endure the pain and move through it rather than wash it away). That was why I was hoping to somehow prove myself this time – I’ve been like a woman training for a marathon, all pelvic exercises and yoga classes – just so I had the chance to do it again “properly”.

So my disappointment on hearing I would likely have to have a C-section was very real. But then I got sent this  Hadley Freeman article in the Guardian about not judging women who have C-sections, saying “if you want an experience, go to Disneyland” but otherwise when it comes to birth, go with whatever works.

I do think we put far too much pressure on ourselves to have this magical (and possibly mythical) birth experience. There is a competitive streak to it – to refuse pain relief like I did with my son (why?! In all likelihood he was bouncing on my sciatic nerve – pethidine was a warm and fuzzy relief) and push through the pain to some sort of spiritual plane. Some women may be able to summon the spirit of Mother Earth and breathe out a baby, but in the majority of cases, mine included, it was a hard tough slog with complications and problems and urgent medical care needed.

The world exerts so much pressure on women to be the best wife, best mother, best employee, to keep ourselves young and beautiful and healthy and fit, do we really need to have the perfect birth too?

The fact is, when my son was handed to me, the first thing I thought was “oh fucking hell I’m knackered, what do I do with this then” rather than anything more profound, but soon we had the loveliest happiest bond between us that grew through time, in spite of, and not because of, the birthing experience we had (bloody awful – read about it here if you must).

And so I’m slowly accepting that this will be our little birth story, me and hers. One which isn’t really what I’d planned but which will be ours. I’m hoping she can be pulled out to a song by Deacon Blue maybe, or Stevie Wonder (“Isn’t She Lovely”?), and later, I can show her and my son the scar where she entered the world into our arms.

And anyway, The Chef still gags at the smell of lavender oil following our first attempt at a perfect birth. A small reminder that you can’t always get what you want.

 

 

A medical update & thoughts on dealing with obstetricians

As some of you may know, I was recently sent to an obstetrician to see whether I might have obstetric cholestatis (OC), in which case they may have induced me early (around now actually!) due to possible harm to my baby. This led to a dramatic turnaround in my original birth plan and was a real eye-opener in terms of learning to expect the unexpected.

Well, the good news is that it is very unlikely I have OC as my bile salts are fine and my symptoms aren’t very suggestive of it. But the original tests still show a high ALT (liver function) test which is abnormal, and the weight of medical science suggests that this is a bit odd. That’s pretty much all I know, but I’m beginning to think its just a wierd symptom of pregnancy, of baby causing all sorts of problems. But in terms of hard, cold facts (which, as a risk-averse control freak I always like to be in possession of), I’m yet to know why I have this or what it means to me or my baby, so until we know more I am in a state of limbo, not knowing whether I will be able to have the natural birth I want, and worrying that things will get worse.

Note I have nothing against induction for medical reasons, I know how common they are, and I know that many inductions can lead to wonderful, natural births. Although I also know that something like 70% of inductions lead to epidurals (many are done at the same time) due to the sudden, quick contractions that don’t build up gradually as they do in natural labour, making you work super hard to cope. I also know you need to be monitored in hospital so my prefence for privacy at home for as long as possible, for active movement, would be reduced. Although as I say, I’ve heard some wonderful stories about brilliant induced births where mums managed to move around and have lovely, natural (and blessedly very quick!) births.

The obstetrician started by telling me: “Its my job to worry; and I get worried about heavily pregnant women with abnormal liver functions walking around in late pregnancy.”  Which hinted to me that he was thinking about induction. At this, I burst into tears, and when he asked me why I was so against induction (he seemed genuinely surprised), I explained I’d just rather things happened naturally, given all I’d read about the body’s natural production of oxytocin, and my hypno-birth/active birth preparation, although of course if there was any chance my baby could be harmed I’d induce at the drop of a hat.

I also asked him what was causing the dodgy liver function, and what harm it could do to me or my baby, and it transpires that he didn’t have a clue. It was an anomaly. It could be anything, possibly a virus that I’d picked up, but it was unlikely that we’d find out what it was. I suggested a liver scan (thanks to some great advice, as always, from twitter mums) to see if it was something as simple as the baby kicking my liver, and he proposed a raft of blood tests to check for things like hepatitis.

So, subject to the tests showing up something specific (unlikely), or the ALT levels increasing to a worrying level (fingers crossed), or me starting to feel ill (I feel great), or the baby stopping moving (baby appears to be doing a daily marathon inside me so no worries there), then I suppose I can carry on happily until labour starts naturally. Which is great news. The consultant isn’t seeing me again for another 2 weeks which shows he can’t be that worried. And I’m doing all the natural things to induce in the meantime – long walks, gardening on hands and knees, raspberry leaf tea.

However, I’m not sure we would be here in this relaxed “lets wait and see” situation if I hadn’t made it clear that I was against induction, and hadn’t asked a raft of questions about why my wierd liver results were a problem. So my tips if you find yourself in a similar predicament are:

1. Find out as much as you can before you see the consultant. Ask your GP for information, speak to your midwife, ask twitter and find out what you can from the internet (although don’t panic if you read anything bad).
2. Be clear about your personal choices for birth – you shouldn’t be pushed into something you don’t want to do if it isn’t necessary. If you’d rather only induce if absolutely necessary, make this clear as it won’t be assumed. I’m amazed at how many women I’ve seen on mummy forums saying they actively want to be induced even if its not clear that there’s anything specifically wrong.
3. Ask lots of questions – if they want to induce then WHY – why are you or your baby at harm? What is wrong? If they don’t know, the next stage should surely be more tests – blood tests, ultrasound scans of your organs.. If you don’t know what you’re dealing with, how can you properly evaluate the risk?
4. If you do find out you might need an induction, don’t panic or get upset, speak to other women in your NCT group, or email Natalie at Tell Me A Good Birth Story, to put you in touch with other women who have had happy, successful inductions, to hear some positive birth stories. It may not be what you planned, but with a little mind-change and some planning you can still have the birth you want.