After two spontaneous vaginal births, William, my third baby came as a bit of a surprise in the form of an emergency caesarean (C-Section).
I had numerous scans during the pregnancy as my previous babies were on smaller side, so my GP wanted to keep an eye on things, however all scans came back with no concerns.
At 40 weeks my Obstetrician carried out a stretch and sweep (membrane sweep) of the cervix.
"During a vaginal examination, the midwife or doctor makes circular movements around your cervix with their finger. This action should release a hormone called prostaglandins. You do not need to be admitted to hospital for this procedure and it is often done in the doctor's room. This can be enough to get labour started, meaning you will not need any other methods.
Risks: This is a simple and easy procedure; however, it does not always work. It can be a bit uncomfortable, but it does not hurt."
At this time I was presenting approx. 1cm dilated which sounded promising, and I was quietly confident as this method previously worked with Georgia, my second child at 40.5 and I was in active labour two hours prior.
However, this time, after a few cramps & some spotting that night nothing progressed.
At 40+6, again the stretch & sweep (membrane sweep) procedure was carried out & the Obstetrician advised there had been no progress in dilation since the previous week (he believed I was not even 1cm dilated). He suggested that it was time to bring the induction forward as baby's heart rate kept rising. Due to the increase in baby numbers (covid babies!) I had initially been booked in for induction at 41.5 (as a backup if I didn't go into labour spontaneously), however luck must have been on my side as a last-minute opening became available for the following day, being 41 weeks (apparently someone had accidentally deleted a booking line - oops).
I still assumed up until this point that I would go into labour spontaneously, like my first two births and when the Obstetrician advised of his revised way forward it broke my heart - I sat in the consulting room sobbing.
My birth plan was now to proceed with Prostaglandin gel and Oxytocin drip.
"Prostaglandin is a hormone that prepares your body for labour. A synthetic version can be inserted into your vagina, either in the form of a gel or a pessary. When the prostaglandin is in place, it’s a good idea to lie down and rest for at least 30 minutes. Once the prostaglandin has been inserted you will need to remain in hospital.
When the prostaglandin takes effect, your cervix will soften and open. If you have the gel, you may need one, two, or three doses (given every six to eight hours). The pessary slowly releases the prostaglandin over 12 to 24 hours. When the cervix is soft and open, your body is prepared for labour. The next steps will vary from woman to woman – some might need an ARM to break their waters, and some women might need oxytocin to stimulate the contractions."
After agreeing to this revised birth plan, my husband, Rick and I went home to prepare for the following day. My parents had arrived to look after the kids, and we told everyone the plan. I used words relevant to the kids ages to advise them what was happening & answered all their questions to ensure they were comfortable, however looking back, I was feeling quite anxious by this stage myself. The biggest fear for me was knowing the pain that was ahead & having heard that induction contractions can feel a lot stronger a lot sooner this freaked me out a little, knowing from experience how contractions feel. I also thought the process seemed quite unnatural and I was concerned about that too.
At one stage Harrison, my first-born son looked at me from across the kitchen bench and said “mummy, are you ok?” I told him I was ok and thanked him for asking but I then had to walk away to release some of those built-up emotions, sobbing in the hallway.
We arrived at hospital around lunch time on the 5th May and were taken to our room in the maternity ward, thankfully securing a private room!
Part of the induction process is to meet specific monitoring requirements before you can progress through to the prostaglandin. Between Rick & I we were feeling quite calm, chatting about the future and laughing at each other whilst baby's heart rate was being monitored, then the next minute the midwife returned, looked at the chart & left the room very quickly. She returned moments later & the room was flooded with medical professionals. All of a sudden the room was chaos – someone was taking bloods, another was inserting a cannula, I was signing risk declarations & consent to an emergency caesarean (C-Section). I asked what was going on and we were advised that baby's heart rate was dropping below 60bpm & he was in distress, he needed to enter to world quickly. I asked if we could continue with the induction as I really wanted to attempt another vaginal birth and they advised against it, they said it could potentially place him at risk of harm as he may not be strong enough to deal with the contractions & delivery. It would cause too much distress for him & we would more than likely end up in surgery anyway – this was the best option for him.
I was already quite anxious over the thought of induction & with this information, instantly my body went into shock - shaking profusely. There was no time to process what was about to happen and I sat there, in bed with tears streaming down my cheeks at the thought of the unknown. I knew nothing, nil, about caesareans. I was completely naïve. How did I not know anything??
Rick was given scrubs and I was rushed around to theatre be prepped for surgery. We waited for a good 15 minutes as theatre was prepared and I felt like my body was starting contractions as I was laying there. It hurt. However the midwife advised nothing was registering as a contraction on the monitor.
The theatre room was freezing cold, Rick had to wait in the waiting room whilst the spinal was administered. The tears would not stop as I sat on the edge of the bed hugging a pillow into my chest. Once administered a hot rush fell over my body from the breasts down and I remember asking “will I feel anything?” I was petrified that I would be able to feel an incision.
The worst part was being alone in such a cold environment, with a blue sheet in front of my face. Rick was only allowed in a few minutes before baby was born. I remember hearing the Obstetrician's tone as she said 'get the father in here quickly' and someone brought Rick in immediately.
There was an intense feeling of tugging & pulling in my belly during the last few minutes which made me feel quite sick, and within a few minutes of Rick entering the room we had a baby; a 2.94kg baby boy.
Someone held him over the blue curtain for a second then whisked him away to be checked as he had respiratory issues and was covered in meconium. It had stained his little nails brown, it was throughout his mouth, up his nose – everywhere, and he seemed to be choking on it (days afterwards he was still spewing meconium).
Rick & I waited to hear his first cry, it felt like forever waiting to hear that beautiful noise & we sighed with relief when we finally heard it.
Our first cuddle was a strange feeling. I didn’t feel the attachment to him instantly like I had with my first two babies, but I knew I loved him dearly. He was placed on my chest, his little hand rubbed on my mouth as it was so awkward holding him so high; almost squashing my face as the blue curtain was so close to us.
With no real concept of time, it felt like forever until I would see Rick & William again. After our brief cuddle, Rick & William were taken to the nurse’s station for weighing & further assessment whilst I was being stitched back together (that felt like forever, and I felt like I cried a river of tears as I lay there alone.) It seemed like everyone just disappeared once William left theatre. I felt violated, I felt alone, I felt so scared of what now was ahead of me with recovery, I wondered if my baby was ok, and it terrified me that I could not hold him in my arms. There was minimal skin on skin time for us. It was all completely overwhelming.
In recovery, my body was again violently shaking, a shock blanket was placed over me & it was pumped with hot air to calm my body. It is so hard in that instance to not have any control over your body, and not have a baby to hold.
When I was finally wheeled back to the maternity ward, the midwife carried out a handover with another midwife and she apologised as she told the midwife I was 'completely overwhelmed' and needed a bit of TLC.
By this stage, I felt like I had been hit by a truck and reversed over again to say the least.
In the maternity room, I couldn’t look at William for some time. Rick welcomed me with a warm smile & William in his arms, but also a sense of ‘I am so sorry you had to go through that’ kind of look. I could see it in his eyes. I was so happy to see Rick holding him, I felt relieved that he was ok & that they had that time together but I was not ready to look at William. Rick asked if I wanted to hold him and I just shook my head no as I cried some more – maybe a feeling of guilt, I am not sure of the best word to describe the feeling but it all felt so foreign & scary.
Once I was ready to hold him it felt amazing & all of those attachment feelings came through thick & strong.
The hospital stay was amazing, the midwives were incredible and kind. William and I stayed for three nights and then we began our journey together in the outside world.
On the first night the midwives tell you to call them when baby needs feeding & William kept crying so they offered to take him so I could get some sleep. I tried to sleep but I could hear him crying from wherever he was and I could not sleep so I told them to bring him back to me. Once he was back in my arms we cuddled for the rest of the night, it felt so right to have him in my arms. Nothing else mattered.
The next morning a nurse came in and placed an informative sign on the wall about avoiding 'co-sleeping'. Whoops.
Night two of the hospital stay was horrible. The midwives told me to call when I needed to feed however I tried that and as the ward was full, and you are dealt with by priority, so the wait for me was forever. William was now screaming and I couldn't get out of bed due to the pain but he needed me so I leant over the crib and grabbed him with one hand around the middle section of the swaddle and picked him up, bringing him to me to feed.
I had worked myself up so much that the first time I got out of bed & up to have a shower was not easy. Every 'first' was hard for me. The midwife helped me into the seat in the shower and I washed all the blood away, cleaned myself up and was escorted back to bed. I felt better after a shower but it was hard.
We left hospital on day four and from there recovery at home began. The recovery since then has been brutal, physically & mentally and there's still work ahead to remove the traumatic story I created in my head around William's birth but I now understand after talking it through over & over that it's ok to grieve the birth you didn't receive. William is here safe & healthy, but we are all human & need a safe space to feel these emotions.
Every birth story matters.
Written by Sarah Cremona.