Caesarean after Induction

My birth story written May 2018, Archie was born 9th November 2016.

These thoughts, feelings and experiences are my own. How I feel about my son and his birth are two separate things and should not be confused with each other.

I’ve been working with my therapist for 12 months now and one of the biggest things we have spoken about is authenticity. The ability to be authentic with friends, family and myself means that I have to bring down my walls. Walls that have been up for a very long time. It’s those walls that stopped me from speaking out after Archie was born. I couldn’t let anyone know what I’d been through, or if I did, how terrible I really was feeling. I made light of it, joked even, about how horrific some (not all) of my experience was. I hate bringing attention to myself so I kept to myself trying to navigate my new reality.

Recently I discovered a great resource online for women who have been through a traumatic birth experience. It suggested, as a way to make sense of everything, to speak with a birth consultant and review the medical notes from the birth. Understanding what happened when, how and in some circumstances why has meant that I now have a bit more clarity about my time in hospital. With that knowledge, I have been able to write my birth story, which has also helped tremendously with healing. However, writing my birth story is one thing, sharing it with you is another!

But that’s the thing, I know now that talking about my experience and the things I’ve learnt can potentially help others. Not just other mothers who have experienced traumatic births or postnatal depression. But mothers who’ve had lovely birth experiences or fathers or friends or families who want to understand what someone they know has gone through and be able to better support them. So please, grab a glass of wine and sit down somewhere comfy, read, reach out if you want and just be kind to yourself.

Throughout my pregnancy, I had always believed that my baby would be born early. However, by 38 weeks he hadn’t arrived and I was very uncomfortable so my OB booked me in for an induction at 39+6, one day before his due date.

Looking back, I wish I hadn’t booked it in, at least not so early (my OB would have let me go 10 days over). Although at the time I was so uncomfortable I just wanted to not be pregnant anymore. Hindsight is a wonderful thing.

Pregnancy had not been horrible for me, but I hadn’t been the ‘glowing goddess-with-child’ that you are led to believe from the movies! I’d had pretty awful morning sickness from about week 6 to 16, that gross hangover feeling that just doesn’t pass (and without the champagne the night before!). We also had a scare at the 12-week scan with my blood test coming back with a 1:145 chance (high risk) of Trisomy 21. We sent away for the Harmony (NIPT) Test and that was an agonising 3-week wait for results that ultimately came back fine (the odds had gone out to 1:123 million).

Additionally, I have A- blood so I had to have anti-d immunoglobulin injections at 28 and 34 weeks to prevent my body from creating antibodies. Towards the end, I had round ligament pain that flared up if I walked too much or sat too and sleeping wasn’t fun anymore (I had NO IDEA that it was about to get worse) with a big belly, sore boobs and cramping legs.

I was still hoping that I would go into labour naturally (you know, waters breaking at the most inconvenient time, the rush to get to the hospital). Nevertheless, come 6 am on the 9th November 2016, we got up to head to the hospital for our 7 am induction. When we arrived it felt like everyone on the ward was expecting us (not because we had an appointment, obviously!) but because they were all so friendly – “oh you’re here for ‘A’” (my OB), “oh, yes, Morgan, right this way”. We were lead to the birth suite. It was exciting; I was excited and nervous! The birth suite felt comfortable, I was happy to be there and (I thought) was prepared for what lay ahead.

At 8 am my Ob came and examined me; I was 1-2 cm dilated, my cervix was soft and I was having 1 contraction in 10 minutes (I was on the way!). She broke my waters, I did not expect this to hurt as much as it did and I definitely did not realise how much ‘water’ there is! At first, I had a pad in my underwear – I was trying to retain some dignity! However, after the millionth time of going to the toilet to change the pad, I took off my knickers and threw them in the bin! I waddled back to bed and apologised to my lovely midwife for leaking all over the floor (much to my husband’s disgust – he hadn’t seen anything yet!).

I was then hooked up to the syntocin drip (I hadn’t factored the IV into my active birth ‘plan’, so I felt a little restricted to the bed). I now realise that this was the first setback of many. Fearing the worst (pooing in labour), I requested an enema and that was given to me at 9 am. The rest of the morning was fairly uneventful, the contractions were strong but manageable so my husband and I just relaxed and watched the US Presidential election – Clinton v Trump.

At about lunchtime, my Ob came back to check on me. Everything looked ok except I was still only 2 cm dilated! I was so disappointed, I had been having strong and frequent contractions (although still irregular) and the midwife had been telling me I was progressing well through labour. I was sure I would have been at least halfway. My Ob advised that this was not great, but that I could still dilate and she would be back at 4 pm to check on me.

The afternoon got harder. The contractions were stronger. I practised controlled breathing, moved between bouncing on the exercise ball, walking around and positioning myself on all fours on the bed. I was keeping my energy up eating jellybeans. My husband would help me through the contractions between completing some of his CPD points online and giving a running commentary on the election. He definitely kept the nurses amused! I was sure I was dilating, the pain of the contractions was intense, there had to be movement at the station!

My Ob returned at 4 pm and yet again, I was only 2 cm dilated. I was devastated. She mentioned having a caesarean. I said no, I did not want one, never wanted one (unless of course, the baby was in distress or our lives were in danger). My husband supported my decision and we told her we wanted to keep trying. My Ob then suggested that she stretch me to see if that would help move things along. I agreed but had no idea of how painful that would be (of course, in comparison to birthing a baby vaginally I guess it’s probably mild!). Additionally, my Ob suggested that having an epidural might allow me to relax and dilate.

Ever since I can remember, I have been petrified by the idea of having an epidural. It may seem irrational to some people, but my phobia of succumbing to a spinal injury due to the epidural is severe. I desperately wanted to have a vaginal birth, and with my Ob telling me this may help, I agreed.

Within half an hour of agreeing (relinquishing) to have an epidural the anaesthetist was in the room, I had signed the paperwork and was hunched over the side of the bed. I was terrified. As I sat there, with the anaesthetist and nurses telling me I had to stay as still as I could I sobbed. Actually sobbing is too much of a gentle description. I heaved. I cried like I hadn’t cried in a very long time. There were tears flooding out of my eyes, my nose was running profusely and I think I was even dribbling.

All the while, my husband, who was sitting directly in front of me on the exercise ball, tried to calm me down. Telling me to breathe and try to relax. He knew I was scared, he knew I had not wanted an epidural. I probably looked so awful too. The anaesthetist tried two or three times to get the needle in the right place and a pool of blood began to grow behind me. I had no idea there would be any blood with an epidural, but apparently there was.

I understand why people get epidurals. The pain of the contractions was gone instantly and then I threw up. Apparently it was all the jellybeans I had eaten, but in hindsight it was probably also due to the trauma I had just endured.

Unfortunately getting the epidural didn’t help me dilate much further. When My Ob returned at 7 pm I was only 3 cm. I had been labouring for 11+ hours. Now I know that is not a long time, I know that some women have much longer labours. But I was certain I had given it a good crack. The contractions I was having were strong, they were frequent. I felt beaten. I was exhausted, emotionally and physically.

My Ob again mentioned having a caesarean. Her concern being that the baby may not be able to fit through my pelvis (I later had a MRI to measure my pelvis and it showed that I was ‘normal’ size, so it seems she was justifying her recommendation). Whilst there was nothing wrong, she was concerned that I was exhausted, the baby may be getting tired and I had lost a lot of ‘water’. I reluctantly agreed, I don’t really know why, I guess I trusted her opinion.

Within half an hour of agreeing to have a caesarean, we were in theatre. My husband had been given scrubs; I had been wheeled out of the birthing suite into an elevator and to the operating theatre. By this point, I was so over it that I didn’t even care that I was wearing just a hospital gown and flashed probably the whole surgical team as I climbed from the gurney onto the operating table. My husband had given the midwife my phone to take photos and she started snapping away.

I laid there on the table while the anaesthetist (a different one to earlier) administered the anaesthetic through the catheter in my back and my Ob ‘tested’ if I could feel any sensation by dragging (what felt like) a scalpel across my abdomen. And yes, I could feel it, most prominently on the right. The anaesthetist upped the dose. Test again. Yes, still there, on the right. The anaesthetist had the operating table sloped to the right and eventually I couldn’t feel a thing. I had been given that much anaesthetic that I had no feeling from my neck down. My arms we stretched out to the sides and I felt short of breath.

The procedure went to plan (as far as I could tell). There was a bit of tugging, people asking me if I was ok, the anaesthetist sitting on my left and my husband on my right. The curtain was up in front of me so I couldn’t see anything, in hindsight I wish I had asked to have it lowered, so I could see something. It does feel like my son’s birth happened to me, rather than me having any contribution to, or any control of it, at all – which is what I had ultimately wanted. If I knew what I know now, I would have prepared for the possibility of a c-section and explored the options regarding how I could be an active participant.

Archie was born at 8:19 pm. It was unreal. My Ob brought him around the curtain so we could see him and at the realisation he was a boy I burst into tears and my husband gave a fist pump! Archie was taken away for all the usual tests and my husband cut his umbilical cord. I remember my husband coming to check on me because I was crying but all I cared about was that he stay with our baby.

I was in recovery following the surgery for about 1 hour, while the nurses waited for my sensation to come back. There was also a bit of fussing around regarding the epidural; the nurses did not know whether they should take it out or not. This is because usually, the epidural would remain in-situ until the next day, however the anaesthetist requested it be removed due to the height of the block and the amount of anaesthetic I had been given.

Whilst I was able to have skin-to-skin time with Archie, the nurses would not ‘allow’ me to feed him. They had said to me that it was because he still needed to be weighed, however more than likely he should have already been weighed in theatre. This bothered me, but I did what I was told, believing that they knew best. All this time, Archie was crying for a feed and trying to latch on.

Once we returned to the ward and Archie had been poked and prodded for all the tests. I raised concerns about pain I could feel at my ‘wound’ site (I found it interesting that it was referred to as a ‘wound’, as in an injury). I cannot recall how long after the surgery it was, but I began feeling a burning sensation where they’d made the incision. I requested pain relief and was told that I would be given something shortly. A lot of this time is a blur, but I know I continuously asked for pain relief as the burning pain continued to get worse. I recall dozing on and off and each time I woke the pain was far worse than it had been before. However, I still had not been given anything that was making any difference.

I don’t know if the nurses didn’t believe me, or if I thought I was saying something but wasn’t, but pain relief just did not come. I remember waking in the early hours of the morning, screaming in pain and sobbing uncontrollably, that movement then causing more pain and thus more tears. Finally, at approx. 6 am my Ob was called and she ordered pethidine and I finally felt like I was on top of the pain.

Having now been through my medical record with a birth consultant I understand that it wasn’t that the nurses didn’t believe me. It was that my vital signs where not corroborating what I was saying. I scored my pain at 8 out of ten (understatement), but my pulse, blood pressure and temperature were all normal – because of the epidural.

The following days in hospital all blur into each other. Attempt to feed, sleep, pain relief, repeat. But I was struggling. Struggling with pain, sleep deprivation, not having any milk, and conflicting advice from the midwives. My medical notes have multiple entries stating how upset I was. My favourite one being “miserable, tired and teary this AM”.

I feel ripped off in many ways regarding Archie’s birth. A lot of decisions were taken away from me and therefore many opportunities to have the birth experience that I had wanted. It’s not unrealistic to have wanted a natural labour, birth and to have felt ‘well’ afterwards. After all, that is many women’s experience.

Part of the healing process is to grieve that ‘loss’ and I believe I am making good progress with that. There are many things that contributed to how I felt following Archie’s birth. However, there are two things that stand out as massive contributors to my PTSD. The experience of getting the epidural – having to endure something that I have a severe fear of; and the pain I had following the surgery – which I now know was not normal. The c-section itself was not the problem. Yes, I had not wanted one, but I am ok with the fact that that is how Archie was born.

I have had many conversations over the past 12 months with many people of varied backgrounds, qualifications and experience in regards to pregnancy, childbirth and motherhood. And there are many things that I found important, enlightening and concerning. I am still learning, I don’t know everything and I am certainly far from being ‘fixed’. Perhaps I never will be, and that’s ok. However, I feel happy that I am able to share my experience and what I have learnt with you above and maybe even in conversation one day.

Many thanks to Debby Gould from birthtalk.org for helping me to make sense of my medical notes. My therapist, beautiful husband and the few friends and family who have known what I’ve been going through for their support.

If this has brought up issues for you, please speak up. It will make a world of difference.

Morgan