How To Advocate For Yourself When It Comes To Birth Choices: My 2nd Birth Story
So I now have a one year old, The Littlest’s birthday was last week and today we had a Naming Day Ceremony / 1st Birthday Party for all our family and friends, so I thought now would be a good time to talk about my birth story with him, and how you shouldnt be afraid to advocate for birth you want.
Because my birth with The Biggest was so horrific, I really didn’t want to see a repeat performance – but – as a plus size mum, I was already up against it. In case you are not aware, most trusts will not offer women above a certain BMI the option to give birth anywhere other than in a consultant led unit, they want you to be constantly monitored, they advise an early epidural etc. However, this series of events can often lead to needing intervention, as I had experienced with my first birth. There are a lot of statistics which will tell you plus-size women are more likely to have complicated births, however, how much of this is it ending up a self-fulfilling prophecy, when the intervention slows your body down?
Anyway, I really did not want to see myself anywhere near a consultant led unit for The Littlest, but I was consultant led, having to attend the ‘Health & Wellbeing in Pregnancy’ clinic, which I affectionately named what is was – Fat Clinic. My awesome community midwife, Debbie, who served me wonderfully through both of my pregnancies, suggested I speak to the Supervisor of Midwives, as I had done a ton of research and had decided I wanted a water birth and was considering have one at home, as I knew that my local trust would not offer them to anyone with a BMI over 30. Here is the thing; so many women assume they have to do as they are told when it comes to giving birth. It’s alien territory, you want to do the best by your baby and you want them to arrive safely. So you listen to the experts (and I don’t want to do down our NHS at all, as it does the absolute best it can under the circumstances) but sometimes, you feel like you’re a tick in a box. If I wanted to give birth at home, my local trust is legally obliged to provide me with the care I need, which would mean sending a midwife. However, given the situation I found myself in with my eldest (I ended up with a forceps delivery in theatre with an episiotomy, but there was some issues with the cord around his neck so he needed consultant care immediately), I wanted the security of giving birth in a hospital, I just wanted to be able to give my body a chance to do what it needed to do.
So towards the end of my pregnancy, I asked to attend a birth choices clinic, where we could discuss my birth plan. Now, other than being a fatty-bum-bum, I had a text-book pregnancy. No sign of gestational diabetes, (despite 4 tests!), blood pressure was always fine, no issues with babies movement etc, so it really was just my weight stopping me from being able to try to birth my baby how I wanted. I just wanted as little intervention as possible. My consultant got the Head of Midwifery, Joan, to come and speak to me. She was AMAZING. She read my notes, listened to what I had to say and agreed I had been let down a bit with my first birth. My point remained, I would never do anything to jeopardise the safe arrive of my baby, but I had done lots of research which proved water was great for pain relief for plus-size women as the water helps with buoyancy too. Joan advised me not to go with a home birth, but said she was happy for me to go to the birth centre and took me on a tour of it, introduced me to the midwives on the unit (which was literally next door to delivery suite). We discussed at length what I was happy with and what wasn’t, I said I would rather not have continuous monitoring unless they had any concerns, I would be allowed in the pool, but would be willing to come out before the pushing stage if again, there were any concerns. We both agreed it was about informed consent, which I definitely didn’t have the first time round. She wrote on my notes I was cleared for the birth centre and would also email them so they were aware. If in the final weeks there were any issues arise with blood pressure, baby size or movement, they would need to re-evaluate. Happy days!
I spent the next 6 weeks listening to some hypnobirthing cd’s to try to prepare and relax me for the birth. I really struggle to meditate or relax enough to get myself in a hypnotised state, but I definitely think they helped with the positive re-enforcement of my body knowing what it should do.
Skip forward to 39+6. I had been trying the usual tricks to coax baby out and went to bed in the spare room the night before his due date, as I just couldn’t get comfy in our bed as at that time, the toddler was very much co-sleeping with us still. I woke up around 2am to use the toilet and had some pains lower down but I had been having braxton hicks on and off for weeks. I went back to sleep and then woke up at around 4am, stood up to go to the toilet and felt a gush. I hobbled to the toilet, sat down and felt another gush. I quickly pulled a pad out to see what colour they were – as I had meconium in my waters with my first – but they were the right colour – huzzah – so I went and woke up my husband.
Mr Raucous is a panicker. He flew out of bed, grabbed the phone, tried to rouse the toddler but I hissed at him to chill out as my waters were fine and it would probably be ages yet, but he called my in-laws as they are retired so could drive over to have The Biggest (they live 2 hours away!) and then called our friend down the road to let them know depending on how things panned out, we might need to drop The Biggest off with them until they arrived, as was the plan. At this stage, I was bouncing on my ball and my waters were still going. My contractions were fairly painful, but the first time round I had been on the dreaded drip so had no idea what natural contractions felt like. Mr R said we should probably call the birth unit as my waters had gone, they said to come in so they could check and see how I was progressing. Mr R woke up The Biggest and he was half asleep, but I sat and had a cuddle with him and got quite emotional, that was the last time we would ever be a three; he would no longer be an only child, when he saw us again, he would be a big brother. My contractions seemed a bit closer together, so Mr R carried him down the road to our friends then came back for me and we put the bags in the car.
When we arrived at the hospital at about 4:45am, it was a bit crappy to be honest. I hobbled down to the birth unit and we waited for the midwife to come out. A quite snotty midwife, looked me up and down and said quite bluntly “I don’t think you’re supposed to be here” When we explained, yes, we were, it was in my notes, she left us in the reception area for a while, before shuffling us into an empty room. We were there for a good 30 minutes and my contractions were fairly close together at this point, I was on my upright on my knees on a comfy chair leaning forward to help with the pain. Mr R went to go out find a midwife to find out what was going on and they were in the office, trying to find the email which backed up the claims in my notes. Eventually he got them to come in and I asked if they were going to examine me. The midwife responded with “I thought you are here because you wanted low intervention”. I was a bit gobsmacked, as they had said on the phone to come in for that reason, and started to panic I was going to end up in the same situation I was in before with my care, but I tried to remember my positive visualisation and asked if I could get in the pool for the pain. One was being used and the other waiting to be cleaned, so she gave me 2 paracetamol (seriously) and said I could I have a shower while we waited for it, whilst Mr R moved the car, as it was outside in the drop off bay still. He went to do that and I sat down in the shower grunting and groaning. By the time Mr R got back, I was in a right state, I was in so much pain I couldn’t even get my bra back on so was starkers whilst the midwives tried to cover my modesty and asked if they could put cannula in. I had wanted to avoid this, but at this stage I didn’t care, so they tried to do that whilst I begged for some gas & air to be told by snotty midwife I should probably save it for when I really needed it! I STILL HADN’T BEEN EXAMINED AT THIS POINT.
At this stage it was about 7ish, when they begin to swap shifts. The pain now was really intense and I started freaking out about how I couldn’t cope and I needed to go to the delivery suite and how I thought I could do it drug free but I wanted an epidural immediately. I remember crying that I was all too much, I had flashbacks to when I had my first and being in the same amount of pain and I was barely 2cm and I was devastated that I felt I was back in the same place and history was about to repeat itself.
I remember Mr R asking the midwife if I could be moved so I could have an epidural and they found me a room on the Delivery Suite next door and were preparing to do this, when I remember some midwife stroll in and say “Has anyone actually examined this lady yet, because it sounds to me like she is ready to push. She isn’t going anywhere until we have”. So she told me to lie back and then as she was examining me said “Do you feel like pushing?” And I could only reply “I think so?” as with my first I was epiduralled up to the eyeballs and had to be told when to do it. Then she said “Well, that’s because you’re fully dilated, there is a little lip there but if you feel like pushing, you go for it. I don’t think you need to go next door, there isn’t really time for an epidural now anyway. Ahh! So this was the transitional period I was told about many moons ago in my NCT classes. Good to know the course content came in useful eventually!
After I knew I was 10cms, it was like calmness washing over me. I was fully dilated – I could do this! I then asked for some gas and air and my new midwife, Erica, was shocked I hadn’t been offered any before and sorted it out, whilst she got ready for me to start to push. At this stage, another midwife said that there was a male student paramedic in reception who needed to see 3 live births before he could get signed off on that part of his training and would I be willing to let him come in and help? At that stage, the whole of Leicester could have come in and I wouldn’t have cared, so I said yes and in came the paramedic called Craig. The pushing stage is a bit hazy, I remember shouting about how I think I had pooed (although Mr R informs me he didn’t see any evidence of this!) and then Mr R shouting he could see his head. At this stage, Erica told me to stop pushing and pant, but Mr R had a moment of panic, where he forgot how biology works and thought “HOW IS MY SON BREATHING IF HE IS STUCK THERE?” and kept encouraging me to keep pushing so I think at that stage the baby practically flew out and the paramedic caught him. He was put directly on my chest and I just remember sobbing in disbelief as it was such a different experience. He stayed on my chest for a few minutes then Dan cut the cord. My chunky boy was just shy of 9 lb at 8lb 15.5 oz and was born at 8.27am, around 4 1/2 hours after my waters went. I put him to my boob and he latched on straight away (again, not something I experienced with my first. We did end up with having a tongue-tie issue though, but that first feed was magical)
I had opted for a managed 3rd stage as apparently this is safer in plus-size women, so had the injection and my placenta literally came out in minutes too, Erica couldn’t believe how quick, she wasn’t even ready! I had a small 2nd degree tear (probably due to Mr R’s enthusiastic encouragement), so waited to be stitched up as I held my precious boy. Erica my midwife, had 3 children of her own and had only been qualified for 6 months, but she had avoided doing stitches. She told me this was because she had a traumatic experience after one of her births being stitched up and she hated doing it, as it made her remember that and didn’t like to think she could be inflicting pain on anyone, but the senior midwife was amazing and we both were like, come on, you can do this! She had been so amazing and encouraging with me, it felt nice to be able to help her get through something which was obviously a hurdle for her. It was uncomfortable but – hey, I had just given birth. I had to wait around for my prescription of Fragmin (blood thinner I needed to inject myself with for 10 days due to my BMI) to be sent over from the pharmacy and then we were free to go. No overnight stay needed, yay!
After being stitched I had a shower and I was literally stomping around the room in my Tena lady nappy (sexy) and a vest shouting about how I felt like a warrior and could probably run a marathon. Spoiler: Ain’t no way I could run a marathon! But after my first birth, it was an amazing, healing experience and I felt invincible.
Look, all birth is natural, be it drug-free, drugged up, forceps or a c-section. There are no prizes for how your baby arrives, but as someone who had experienced a traumatic birth the first time round, it was everything I needed it to be to help erase some of those memories. If the birth had been another difficult one, I would have felt more prepared as I wouldn’t be going in blind to what may happen, but I was fortunate that wasn’t the case. Despite the perceived risk from my BMI, I was able to give birth safely in a birth centre, knowing all the big guns were next door should I have needed them.
Basically, don’t be afraid to question your consultants, do your research and ensure you think their plan is the best one for you, don’t let yourself be reduced to a tick in a box. But really do your research, if there are significant risks, ask yourself if you are willing to take them. I knew I had the security of the delivery suite and its myriad of consultants nearby. And if you have experienced a traumatic birth, talk to someone, debrief with a midwife and know just because it happened once, doesn’t mean it will necessarily happen again. I’m proof it doesn’t!