Saturday, 26 October 2019

she's here! our labour story...

hey all! our daughter has arrived, and we are so thrilled with our gorgeous girl.

today i want to share our labour story with you all, because firstly this blog is somewhat of a diary for me, and i want to remember all the details, and secondly, because i know that i like to read other peoples stories, so perhaps you'd like to know mine... i will hold nothing back, so if you don't like all the gross, gory bits, stop reading now!!

firstly, let's talk about why i had an induced labour. if you're new here, you may not know that i have type 1 diabetes, which although it was very well controlled throughout the pregnancy, they still like to induce early due to the likelihood of a larger baby and need for a c-section if the baby went to 40 weeks. but, for my good sugar level control they scheduled me in for 39 weeks as she wasn't measuring as too big on the scan.

so the day came when i was to be induced, they had actually called a couple of days early to say that the ward was less busy than normal, could i come in earlier than planned? and of course, i said yes...

We arrived for the induction at the labour ward. The induction room at our hospital had 4 beds in it, each with a separate curtain for privacy. However each space was pretty small, just about enough space to sit on a ball if you wanted, and enough space for your bags and a chair for the birthing partner to sit in. One of the hardest parts about induction is being confined in this space waiting for something to happen.

After a little intro into what induction would entail, and what options/routes it could take, i was put on monitoring to check my baby's heartbeat and my contractions. it turned out that i was already having some small contractions, but nothing major. they also did an internal exam to see if i was dilated already, and i was about 1-2cm.

because of the mild dilation and contractions, they decided to give me a 6hr pessary instead of the 24hr. so that was put in at about midday - quite an uncomfortable process as it has to go in a very exact place in your cervix... so for me there was quite a bit of wiggling and shoving and manoeuvring around to get it in the right place. but it was worth the discomfort to make sure it did its job properly.

then i was immediately placed on more monitoring to check it started to do something straight away. when that was confirmed i was allowed off the monitoring, and they told me to get up and about and go for a walk to "get things going".

i walked with Pete over to the hospital shop to get sandwiches and ate them outside on a bench. on the way over there i wasn't really feeling anything, but then by the time we sat to eat the sandwiches i was feeling regular pains, not too strong, but definitely present.

by this time the contractions were fairly thick and fast - it's a strange sort of muscle memory, and it made me feel really emotional, recalling the last time, thinking of the pain to come, as well as the joy, and really feeling like "ok, we're gonna have this baby soon!"

i needed to go back to my bed, and sit, so we found a ball and sat on that - the ball was lovely in those early stage pains, because you can change your position easily to relieve pressure, and it's easy to sit on and lean on the bed too. i loved the ball and was so grateful there was one available.

i was put on more monitoring, and the contractions were already at 4 every 10 minutes. the midwives were impressed!

we waited. waited on monitoring for half the time to check the frequency didn't get too strong too fast. and then we ate some dinner. the thing about induction is that it brings on the contractions, but that doesn't always mean something is happening... so you can contract without any dilation, without any shortening/ripening of the cervix. at least that's my understanding, as well as my experience.

i had an internal exam,. they concluded that there was some small thinning of the cervix but not more dilation, eg not enough to break the waters (which was the next step). but as i was contracting still 4/5 in 10 i was told to wait longer,. the midwife suggested i do a sidewards wiggle walk up the hospital stairwell. which i did, another 3/4hrs seemed daunting in that tiny space, and any distraction was welcome.

i felt really low for half an hour - the idea of more contractions without progress was frustrating - i wanted to meet my girl! and i knew that every hour of contractions was tiring me out for the main event. i had so badly wanted to do this labour faster and without any pain relief... i cried. and then realised that my mood was affecting my contractions, and decided to be determined and positive again. it's crazy how quickly my attitude change affected my contractions.

i was put on more monitoring, which showed that the contractions were getting stronger. i was really having to breathe through them at this point.

i had another internal exam, and they decided that i was just about dilated enough (about 3cm) to break my waters.

my waters were broken. perhaps the most uncomfortable thing ever! it takes a while to find and hook cervix with finger first, and the first student midwife's fingers were too little for my long body, so i had to have it done twice. i was also refusing any sort of pain relief at this point, although it had been offered to me. but oh my goodness, it was a horrid feeling, on top of breathing through the contractions. but after many minutes of wiggling around the midwife hooked it, then used the giant crochet hook to break it. my water came leaking out everywhere, lots and lots.

i was moved straight to the delivery room.

which was good, because the contractions got wayyyyy worse!

i decided that an epidural was needed, as my body was too tired from all the contractions and lack of progression earlier in the labour. and i knew that if it was going to take much longer that i would need some intervention. also, my legs were starting to shake, and i could barely hold myself up on the ball or on my feet. the only other option was the bed, and i know that lying down was far more uncomfortable. i also knew that it would take an hour or so for the anaesthetist to be available, so i wanted to get ahead.

whilst i waited for the anaesthetist, the midwives put a canula in my wrist - i still have bruising from a couple of failed attempts. i tried also to eat some toast, because you aren't allowed to eat with an epidural in.

the anaesthetist arrived to administer the epidural. it's a really tricky procedure, requiring exact position for placement, so i had to sit on the edge of the bed, squeezing my husband's hands whilst i stayed as still as i could during contractions whilst she administered it. i kept repeating "the pain will be over soon" and then finally by about 3:15am it started to work and i felt that warming numbness pass down my legs, not quite to the end of my toes.

i had another internal check, and i was declared 4cm dilated, and officially in active labour. i was still having the same amount of contractions, but i wasn't able to feel them!!

i had on and off sleep, realisitcally i was dozing, and probably only slept for about 10 minutes at a time. i was having checks done every 30minutes, on my sugar levels, my blood pressure and to check the epidural wasn't spreading with a cold spray. i could also top up the epidural every half an hour, so i did that when i needed to.

one thing that really surprised me about the hospital was the permanent 1to1 midwife care during active labour. literally no-one left my side. and then every hour my midwife would get another midwife to double check the baby heartbeats, to make sure they weren't missing anything.

we were both so happy to be able to sleep a little. it had been quite an intense day.

the thing is, last time with my son, i had an epidural because it was the only form of pain relief my Belgian hospital offered, so i knew i could trust that it would work, and i knew how it worked. and even though i'd really wanted to labour naturally, i knew with the facilities available to me and the fact that the induction had been relatively slow, that i just didn't have the stamina or strength.

another internal exam - and this time i was fully dilated! they said it so casually, i was like hold on what?! then standard practice with an epidural is to wait for another hour before you begin the pushing, just to make sure your body is ready, as you can't usually feel that pushing urge.

handover to new shift staff and meet new midwives that will birth our girl. we were also asked if a 1st year Junior doctor could watch the birth, and we agreed - it was his second week of the course and he needed to tick the box 'watch a baby being born', and so it was really cool to be the first birth he would ever witness.

we commenced pushing. it is so weird pushing with an epidural, as you can easily put all the force into the wrong place, and so you really need guidance as to if you're doing it right. they did keep saying that i was doing really well, but it went on for a long time...

as pushing gets stronger, babies heart rate is dropping with contractions as my O2 levels drop, this is usual but midwife decides to review with a doctor.

reviewed by Junior doctor who passes case to obstetrician. they consider the positioning of the head might not be where it needs to be to crown. they have a feel for where babies head lies. apparently i kept almost crowning and then she would slip straight back up.

the obstetrician says to keep going for half an hour and we will review then, as i was pushing so well.

obstetrician asks for review from consultant as baby is not birthing as quickly as expected (later our diabetic consultant suggested that the labour could/should have been allowed to continue naturally and this might be as a result of diabetic bias amongst the team at the time).

the consultant reviews and determines exact baby positioning, suggests an episiotomy and forceps in the labour room will be enough to deliver baby imminently.

obstetrician prepares for this by wearing scrubs and cleaning herself. a baby resuscitation cart is wheeled into the room in place of the cot in case of complications, along with a neonatal paediatrician. i was feeling overwhelmed by all the movements around me, without anyone really asking permission, or feeling like things had been explained adequately. i cried the second i saw the resus cart arrive, it felt all too similar to the birth of my son.

pulled with forceps, quite easily, and had the midwives pull my legs back to get the shoulders out, she arrives! she was immediately placed on my chest, vernex, blood and all. thankfully she needs no help from the paediatrician, she cries a little, seems to be very well and also very large! the cord was left for a time to drain, as the placenta was born, and then we breastfed pretty much straight away (whilst i was being stitched back up).

i was kept on a drip for 4 hours in the room - oxytocin (to stop further bleeding - i'd lost 500ml in the process, which is on the border of concern - and contract my uterus further) and sodium lactate (keep my fluids and electrolytes up). during which time she was weighed - a glorious 9lb 1oz, or 4150g - the midwife wrote up my notes, we called our family to tell them the good news, and we took lots of pictures of her cute little cheeks...

then i was moved to another ward for recovery, blood pressure checks and catheter removal checks (pee twice) post-epidural.

checks on our girl the following day, we discovered a broken collar bone (clavicle), and severe tongue tie, otherwise all well. we went for an X-ray to confirm the clavicle. and the physio was booked for the following week. apparently should heal itself within a week! newborns have really quick healing rates usually. we went home that evening, 36 hrs after she was born.

however, when my milk came in, i got a low grade flu/fever, i was shakey, had a high blood pressure, and my temperature elevated. it went away with breastfeeding. i was sent in to the hospital for review, and they sent me home with antibiotics as a precaution (the blood test results showed i had an infection). i felt better about 36 hrs later after starting the antibiotics.

then, a couple days later, at our next midwife appointment, we spotted she was getting jaundiced, and so we ended up spending two nights in the hospital having blue light phototherapy, and now we are finally home and i'm sat here again, engorged breasts, slightly yellow baby, still with a tongue tie (that hopefully will be fixed next Tuesday) and needing much more sleep than i got at my second stay in the hospital...

birth is different for everyone, but that's my story. please ask questions if  you have them, either here in the comments, or via DM on my Insta (@thealissaevelyn). i hope you found that interesting!