Assertive Birth Hypnobirthing and Mindful Breastfeeding West Lothian

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My Birth Story: a typical cascade of intervention

Why ‘winging it’ really isn’t the best plan when it comes to preparing for birth.

My sweet boy is turning 9 today, the one that gave me the greatest gift of all, to become a mummy.

Harris James Devlin was born shortly after midnight on 22 November 2013 and has brought so much joy to my life. He is the absolute sweetest, kindest and gentlest little soul. And his brain capacity is incredible, how anyone can retain so much information and facts I’ll never know. Such a lovely, pure hearted, quirky and amazing wee person. Being Harris’ mummy made all of my dreams come true.

Harris’s birth story is interesting to me when I reflect back on it, because it was really quite ‘normal’ or what I would have considered ‘normal’ - I had absolutely no risk factors throughout my pregnancy. And I did feel really positive about the birth at the time. How couldn’t I? My baby was absolutely perfect and nothing had gone wrong. He was here and he was healthy and I had managed to have a vaginal delivery and avoid having an induction or labour. All good right?

What I now know though is that some of the things that happened in Harris’ seemingly very straightforward birth might have been responsible for the issues faced afterwards, and had I made different choices things could have been very different.

So here is the story of Harris’ birth:

  • I didn’t do any real preparation for the birth, I didn’t really know I needed to being perfectly honest. I went along to the four NHS antenatal classes (which I honestly didn’t really get any benefit from) and other than that I wrote a birth plan which said something along the lines of no pain relief please and I would like to use the birth centre and in the pool if possible. Nobody ever read it by the way. I didn’t really feel fearful about the birth and I was happy to just go ahead and wing it, thinking this would be the best approach.

  • My due date with Harris was 11 November, I had already had one sweep on that date and one at 40+7, neither of which had done anything and I was booked in for induction at 9am on 21 November (40+10). I actually don’t even remember being told what the induction process would consist of it was just booked in and that was that. I really didn’t want to be induced so was just hoping I would go into labour on my own before then. But lo and behold just after midnight on 21 November I woke to some mild contractions which built a little over the next hour or so. I wasn’t really sure if I was in full blown labour but I knew something was definitely happening and I was excited to meet my baby and that I had avoided being induced. I wanted to go to the hospital soon so I called my mum and her husband to take us. I had decided on Edinburgh to the birth centre because they had pools (St John’s didn’t at the time), which honestly was a bit of a pain for everyone involved as it was a bit of a trek compared to a 10 minute drive to St John’s. What can I say I was strong willed as always, if not well informed.

  • My mum and Andy arrived to drive us through to Edinburgh and the car journey really took things to a whole new level, I felt like I was in excruciating pain and found it really difficult to stay still in the seat. I was also raging at everyone and there was even quite a comical moment when we passed the ‘Beijing Banquet’ and I started shouting at them for commenting on it - I think ‘F**king Beijing Banquet’ were the words used (I tend to be a bit sweary at the best of times). Can’t pass there now without thinking back to that car journey. When we arrived everyone was certain baby would be here really soon - little did we know. I do often look back and wonder if things would have moved on much more quickly if events had been different, as it very much felt like the transition stage with my other three.

  • We arrived into reception for triage and had a bit of a wait in the reception area before we were taken through to be checked over. I remember the reception area being really cold and bright and there was another lady there in labour too. She was freaking as much as me so I doubt we helped each other. It was then I began to feel quite scared about what was happening.

  • When we were taken into the room I was examined and found to have been 2cm dilated. This meant I was not considered to be in active labour (I’ll tell you what I think of that in my next blog), actually the lady seemed a bit cross with me that I was there and remarked that she would send me home if I lived closer. But since we had come all the way through we could stay in the triage room until 6am and if no progress we would be sent home. Those couple of hours in that room were horrendous, I felt like I couldn’t stay still I just kept going back and forward to the toilet but not doing anything and I remember there being a ball and a computer on a desk and not much else in the room. I certainly wasn’t feeling calm or chill whatsoever, I was freaking the F out if truth be told. I was losing hope and then at 5.55am my waters went with a pop, something was happening, we were getting to stay.

  • Turned out it wasn’t all of my waters so we were taken to another room and the rest were broken for me with a little hook and they basically exploded right in the midwife’s face - lovely. Then she asked if I wanted an epidural which I absolutely did by this point, so that was arranged which took around an hour or so. The experience of the epidural going in was fine, I was advised it could increase chances of an instrumental delivery but didn’t really take much notice, I would have literally agreed to anything at that point.

  • Once I had the epidural I felt great, no pain at all and just lay there chatting away to the various midwifes who looked after me. I felt relaxed by this point although nothing much was happening as it had all slowed down a bit. The next stage to get things moving was to have the drip in, a hormone drip of synthetic oxytocin which would start the contractions again. And it did and things progressed over the next few hours. I was checked regularly to see how I was dilating and things were definitely progressing.

  • It was around 10pm when I was told I was now 10cm dilated and would be ready to push soon, this was really exciting I just couldn’t wait to meet my baby. The pushing process was really weird because I couldn’t feel anything at all and was being instructed to push with all my might. Believe me I tried and tried but not much was happening and then after two hours I was told it was going on too long and we would have to try an instrumental delivery. Foreceps was the instrument of choice and shortly after midnight I was given an episiotomy and my perfect baby boy was yanked from my body (not gently guided as they had described it in the antenatal class) and placed onto my chest.

  • ‘Oh my f**king god’ were the words that came out of my mouth - he was huge! I don’t know what I had expected but I absolutely did not expect a 9lb 11 baby I couldn’t believe it. He was chunky and he was perfect and he was mine. I was walking on air and the bond was instant, which I know is not always the case, but which I was so grateful for.

  • The only issue I did have was after the birth I was in a LOT of pain from where they had cut me for the episiotomy, but again all good, just normal healing after having a baby (or so I thought). Only this went on for a loooong time, something didn’t feel right. I asked the GP to have a check over at the 6 week check which he declined and reassured me all was normal. I now know better and to trust my own instincts but at the time I just accepted what I was being told to me and tried to get on with things. Only after about six months things still didn’t feel right and I was still in a lot of pain. I was eventually referred to gynae and had a small procedure after which I began to heal properly. By this time my sweet boy was about 8-9 months old.

  • I wouldn’t say these issues ruined my postpartum period, I absolutely loved those early months with Harris, it was really such a special time. But it was certainly a lot more painful than it ought to have been. But again, I just thought these were the things that came along with having a baby and it had just been a bit unfortunate that I hadn’t healed properly.

I didn’t realise it at the time but Harris’ birth came with quite a lot of interventions, sometimes you might hear of this being called a ‘cascade of intervention’ - this refers to the fact that often one intervention leads to another if the first doesn’t work and so on. Short of having a c section I had pretty much most of the interventions going. The thing is though, I was so caught up in it I didn’t really think of them as interventions or decisions or indeed methods of induction and a lot of the time they certainly weren’t explained to me in that way. I just thought this is what I am being told happens next, so this is what happens next. Here is a list of interventions I had:

  • Sweeps

  • Induction of Labour*

  • Artificual Rupture of Membranes

  • Pharmaceutical Pain Relief (epidural)

  • Hormone Drip

  • Coached Pushing

  • Episiotomy

  • Forceps

*though at the time I thought I had escaped this, I didn’t realise all of the other things are part of the IOL process

There are probably more that I still haven’t realised. The problem with these interventions is not as such the interventions themselves - I’m not saying there is anything wrong with any of these if needed/wanted. And I wouldn’t consider my experience to have been particularly dramatic or traumatic. But the fact I had absolutely no understanding of the risks associated with them or the implications they could have and what they might then lead to (the cascade) means that I didn’t make informed decisions. And most if not all of them, in my opinion and for my specific circumstances, were not actually necessary. Do I think every single one of these interventions is unnecessary in every single case? - absolutely not. Do I think it is wrong for others to have any or all of these interventions? - absolutely not. Do I wish I had known then what I know now so I could have at the very least made informed decisions? Absolutely YES! Who knows if the choices or indeed the outcomes would have been different but I certainly would have felt much more empowered in the decision making process. This is why it is so important to me to share this message with my clients and as many other people as I can. Knowledge is power! Informed choice always.

So what are the key points I would take from my first birth experience that I want my clients to know? There are so so so many lessons learned here but here are my top five:

  1. Do not wing it - preparation is essential! Do not leave it up to chance to get the best birth for you, it’s too important! Although we are designed to do this, we are living in a highly medicalised system. Understand what physiological birth looks like and what is needed to make it happen and put things in place that give you the best possible chance. And quite frankly, in my opinion, the NHS antenatal classes just won’t cut it. This is where Hypnobirthing comes into its own.

  2. Write a birth plan, but don’t just write it actually tell your midwife to read it, get your birth partner to tell them to read it and advocate for you about your choices. What if you are faced with an emergency or an unexpected change of plan? Think about what your fundamental wants and needs are if that should happen - and write them down - and tell people about them.

  3. Think about your environment and how you can give yourself the best conditions to keep labour progressing as it should - oxytocin is your friend, adrenaline is not. Car journeys and hospital waiting rooms are not the ideal environment when it comes to oxytocin so if you are likely to encounter those things think of what you can do to make those spaces work for you.

  4. Everything is a choice. Everything that is ‘done’ to either start labour or move it along is essentially an intervention. Consider every single intervention as a choice - one that belongs to you. Understand the benefits, risks and alternatives of the common choices you might be asked to make. Understand what happens if one intervention doesn’t ‘work’ and what you might be offered next. And bearing in mind that birth can be unpredictable and its impossible to know everything, arm yourself with the tools to ask questions and make decisions in the moment, even if you’ve never thought about a given scenario previously.

  5. Relax and Breathe! Arm yourself with the tools to allow you to relax and practice practice practice. And if you feel yourself starting to freak out go back to basics and just breathe, slowly and deeply. I can’t even tell you what a difference it would have made to me if someone had just said to stop and breathe.

Some may say there is no point thinking about what could have been but I am really grateful to have had this experience as I feel it has driven me not to have the same birth experience with my girls. In turn this has led me to hypnobirthing both as a birthing mum and now as a hypnobirthing teacher and to spreading the message about physiological birth, the importance of being calm and the importance of informed decision making.

It was the beginning of a journey if you like (and if that doesn’t sound too cheesy).