Outrunning the waves.

Grief takes many forms -  I get the impression that for many it ebbs and flows like the sea.  For a while you're walking along the shore line; you can breathe the soft salty air, the sand tickles between your bare toes and you can hear the lonely cries of gulls and the high-pitched peeping of oystercatchers.  You can bask in the sunshine, feel the breeze ruffle the hair around your face.

Sometimes your path veers off and you find yourself ankle deep in the cold waters of the ocean - you're aware of it but it's ok, it's manageable.  But then, out of the blue, a wave comes crashing over you.  It tugs at you, pulling you down, engulfing you and filling your entire existence with saltwater - blinding, suffocating, you don't think you can possibly survive it.....and then it's gone.  You can struggle to your feet and breathe again.  You might find the water is up to your neck, and you're only just keeping yourself going, or it may have receded down to your ankles and you're once more aware but managing. In the end though, no matter where the water recedes to, eventually you find your way back to the shore and can carry on your way.  The huge waves that knock you off your feet come further and further apart, the moments of wandering into the shallows happen less often, until eventually you never leave the sand.  But you know the ocean is always there, it will never go.

Most of the time everyone finds a way to cope with the waves, to stop themselves drowning,  My husband is eloquent in his grief in the moments when it catches him, he shares his pain with his friends by writing it as a Facebook status among other things - that loved and loathed modern means of communication.  I've been told that often men find it harder to communicate, to share how they feel - my husband isn't one of those men.  There is both beauty and pain in his expression, and once the wave recedes he carries on.

I try and find solace in the practical - I need to 'do', I need to find meaning, and if I can't find meaning then I'll do my best to make meaning.  In the 'doing' I hope to keep the waves at bay a little, in focusing on 'something' I hope that when the waves do come I'm kept afloat by an emotional lifejacket.  This time I'm choosing to run - literally, not metaphorically.  I've entered myself as a charity runner for Sands (the stillbirth charity) in the BUPA Great Birmingham Run - it's a half marathon and it's in five weeks and I'm raising as much money as I can.  I used to run regularly before I became pregnant with my eldest over 5 years ago, but it wasn't until she was about 18months old that I laced up my running shoes again.  Even then it was only the very occasional 2 or 3 mile plod and I hadn't been for a run for a couple of months before I became pregnant with Rowan.  So this is a challenge, a focus, meaning, something to 'do'.

My alternative is to remove myself from this reality into another, so I find solace in books, in worlds created by others - particularly books I've read before, where the outcome is always the same and the comfort is in a sense of control of events.  And that can be a dangerous place, because if I remove myself for too long it becomes more painful coming back. 

So I'm running instead of hiding. And I'm not drowning.

There are some things a birth plan can't prepare you for....

No matter how you prepare for birth, whether you choose to write a plan in detail or decide to go with the flow, whether you opt for a hospital birth, a homebirth or even a freebirth, you always make those plans under the perfectly reasonable assumption that afterwards you will be holding your beautiful baby in your arms.  That assumption doesn't tend to include the idea that the baby in your arms will never take a breath.

On the 2^nd July 2013 at 7.11pm I gave birth to my second daughter.  She was stillborn.

I started trying to write about her birth a while ago, but at the time only two weeks had past and the grief was too raw.  Now, it has been just over six weeks since her death and her birth, and the raw pain of it has faded to a dull ache.  Sometimes the rawness comes back in waves and although most of the time I can cope, there are other days, or moments in a day, where the slightest thing sets off a chain reaction of thoughts that link straight back to my baby girl.

We named her Rowan Aurelia Gwendolyn and although my heart breaks that she didn’t stay with us, the labour and birth were both empowering and positive – something that wasn’t the case with my first daughter Rhiannon.  In that regard, Rowan gave me a gift and healed the negativity of my first experience.  Rowan herself was a gift and my husband and I love her deeply.

This is our birth story.

At 37 weeks pregnant Rowan began to engage and, as she did so, she turned to a posterior (back-to-back) position.  My eldest daughter Rhiannon was also posterior (birth story here) so all through my pregnancy with Rowan I’d followed the standard advice on keeping my knees lower than my hips, not slumping when sitting, spending time on my hands and knees and other such similar things to try and prevent it happening again.  Once I realised she’d turned posterior anyway I followed more detailed advice from the Spinning Babies website – maybe I should have tried their advice sooner but as I’d already birthed Rhiannon (admittedly with ventouse assistance) I figured that I’d have no problems with a second OP birth.  I also thought I knew what to expect with labour....it was going to be long and intense and take a lot of focus and concentrated relaxation.

My due date was the 21st June - it came and went, as I thought it would; although I spent the weekend in a heightened state of anticipation as the solstice weekend also coincided with a full moon, and a part of me hoped the old wives tale about more babies being born at a full moon was true!

I had a midwife's appointment on the Thursday at 41weeks (well, 40+6) and discussed having a sweep, I'd had one around the same time with Rhiannon but this time I decided against as I was curious to see how things would go without this minor intervention, although I decided that if nothing had happened by time the following Tuesday rolled around (appointments with the community midwives are on Tuesdays or Thursdays) I'd have a sweep then.  Rhiannon was born at 41+2 and in retrospect I felt that if I'd not had the sweep then she probably would have stayed put for at least another couple of days and I wasn't anticipating baby number 2 any earlier - even though I regularly expressed my frustration and discomfort at still being pregnant!

Watching a DVD with my husband on the Friday evening I realised that I was getting Braxton Hicks every ten minutes or so and wondered if this was a sign things were starting to happen.  They continued on the Saturday morning but then petered off around lunchtime, although by that point I'd lost a small amount of my plug. I also noticed a slight leak of amniotic fluid and assumed my hindwaters had gone (as they did in advance of labour with Rhiannon), but that also petered off.  I can't remember now if I rang and spoke to the community midwife on call on the Saturday afternoon or Sunday morning, but at some point over the weekend I thought to do so just to let her know that things were probably going to kick off pretty soon and I wanted to give her plenty of warning.

The Sunday morning I lost the rest of my plug - which I found both gross and fascinating in equal measures having never lost it with Rhiannon (the world's snottiest sneeze-cross-nosebleed springs to mind).  I offered to show husband but he didn't seem overly keen ;)  Nothing else happened then and Monday rolled around with me still being pregnant and wondering whether I should take up a friend's offer of a bounce on her trampoline!

Finally, Monday evening, I started getting contractions, as with my first labour focused mainly around my back.  Unlike my first labour they didn't have a regular pattern and I'd get anywhere between 2 and 4 an hour leaving me wondering whether it really was labour or not - something I didn't need to question first time around.  Husband and I went to bed Monday night and he said to me to wake him if I needed him (he knows how stubborn I am).  We both went to sleep but the contractions were uncomfortable enough to wake me up (still 2-4 an hour), sometimes I could lie there in bed and deal with them easily, other times I'd have to get up and walk around, or kneel on the bed, and breathe through them.  At one point, in between two closely spaced contractions, Rowan shifted position and that turned out to be excruciating (I've no idea what she did!) and had me in tears.  My husband is right about  me being stubborn by the way: I felt pretty lonely on my own, having contractions in the dark, and a couple of times I may have let myself cry a few tears of self-pity but I was adamant I wasn't going to wake him up.  I'd decided it wasn't worth us both being knackered come morning.  And boy was I knackered!  I don't deal well with lack of sleep at the best of times but combine lack of sleep with contractions that still don't want to fall into a pattern and I turn into a blubbery mess.

I had a lot of tears on the Tuesday morning - I felt sorry for myself and suddenly felt that there was no way I could cope with labour if it was going to be like this. Husband suggested we ring the midwife to come out - I kept insisting no as I felt it was too soon, and in my knackered and fed-up state I was scared I'd be told I hadn't dilated at all (even though my birthplan stated no internal exams unless I wanted them!) and then I'd just collpase in a deflated heap.  It's lucky I married a man who knows me better than I often know myself however - he knew that it didn't matter if I was told I was 1cm or 6cm, I needed to mentally have a 'starting point' and then I'd be fine.  So he sent me off to have a hot shower which eased the discomfort and once I was out and more comfortable he kept pushing to ring the midwife (not in a nagging way I hasten to add!) until finally I agreed.

She arrived at about 11.30 and as soon as I saw her I burst into fresh sobs, insisted I was too tired, couldn't do it and wanted to go to hospital! She calmed me down (my midwife was lovely) and I agreed to be checked - she cheerfully informed me I was 3-4cm and 'stretchy' and it was like a switch had been flipped.  I was immediately calm, cheerful and focused - I could do this!  It was just as my husband knew it would be (I married a star, I really did!).

My midwife told me she'd pop back about 2/half past 2 to see how I was getting on and headed off, while husband and I pottered about, got the birth pool inflated and had a spot of cheese on toast for lunch, which I partly ate on hands and knees as it helped ease the discomfort in my back.  In fact, I spent a lot of time on my hands and knees, or leaning over my birthball, or resting leaning over the pouffe we have in the living room while kneeling on a cushion (we have laminate flooring, it's not comfortable on the knees!). There was the occasional toilet dash as well - seems by body was quite keen to evacuate it's contents though trying to poo mid-contraction isn't exactly easy!

Time passed, we arranged for my mum to pick Rhiannon up from school (she only lives a couple of doors away) and she asked if she could pop by at some point which was fine.  My midwife came back as agreed and my hsuband started to fill the birthpool.  The downside to this was the fact that the house we lived in when Rhiannon was born had a combi-boiler so no risk of running out of hot water. We don't have the same here so the pool was only about half full when the hot water ran out and husband had to start heating water on the stove and in the kettle to try and get the pool up to the minimum fill line before I could get in!  I was getting a little impatient to get in the water at this point (I'm not the most patient of people at the best of time) but even so I was happily managing my contractions without.

I agreed to be checked to see how I was progressing at this point and, as I was lying on the sofa being examined by my midwife, my mum chose that moment to drop by - I was shouting out "don't come in! Don't come in!" as she walked in the front door *grins* so husband went to talk to her and she said she'd come back later.

My midwife then let me know that I was 6cm (hoorah!), we listened to Rowan's heartbeat (all was fine, but she was happily kicking and wriggling between contractions so I never doubted it) and finally, the water level was high enough in the pool for me to get in.  Bliss!  Mostly I floated tummy down, legs stretched out behind me, as that was the most comfortable. For a short while I dozed, catching up a bit on missed sleep and lost in my own thoughts.  Occasionally I'd get a contraction that had me thinking "Owwww, this is too difficult!" and then I'd remember the technique from my hypnotherapy CD, so I'd envisage a dial numbered 1-10 and I'd imagine seeing myself turn the intensity down to 1 which immediately helped.  In between contractions  the three of us would chat.  (And still there was no regular pattern, sometimes there'd be ten minutes or more between contractions, at other times I'd have one immediately followed by another).  Now and again I'd get out of the pool so my midwife could check Rowan's heartbeat again (I'm pretty sure getting in and out helped shift baby's position as well) and each time it was fine.  There was one moment where one contraction immediately followed another as she was trying to listen which caused a slight delay in Rowan's heart rate returning to normal but once the second contraction had eased off, all was well.  And still I could regularly feel her doing a jig in there :)

Half past four rolled around and transition hit.  Except at the time I didn't think it was transition as so little time had passed (in my eyes) since I'd been at 6cm (I was still comparing to Rhiannon's labour).  All I knew was that I was really tired and wanted a rest, and my brain told me the only way this could happen was if I transferred to hospital and had an epidural.  The conversation with my midwife went something like this:

Me:  I'm really tired.  I've had enough now.  I think I might like to transfer.
Midwife:  Are you sure? What would you like to happen?
Me: I don't know.  Maybe an epidural?  I'd just like a rest.  If I transferred would I have to go in the car or would it be an ambulance?  I'm not sure I could manage in the car.
Midwife: We'd call an ambulance out.  You can transfer if you like, it's entirely up to you.
Me:  Um, what's the time? (I looked at the clock then).  Oh, half past four.  OK, I'll leave it until 5 and see how I feel then.

Nearly fifteen minutes passed until then next contraction hit, after I'd gone through it...

Me:  Actually, I don't want to wait, I would like to transfer.
Midwife:  OK, that's fine, it's entirely your decision.  But before I call, can I just check you after your next contraction to see how you are.
Me:  You think I'm in transition don't you?  I'm not you know, I'm not panicking or freaking out or anything, I'm just really tired and would really like a rest.

Then the next contraction arrived....

Me: Oh! I'm feeling a bit pushy! You were right, it was transition!

Everything relaxed again then - I felt suddenly full of energy, we were on our way!  The next contraction I pushed out some of Rowan's sac, which had me commenting to my midwife on how I'd read the you're more likely to have a baby born in the caul with a waterbirth (I was able to chat all the way through my labour - it didn't have the intensity of my first at all).

Over the next hour I shifted position a bit and eventually followed my midwives suggestion to get out of the pool to see if gravity would help.  I then spent a good amount of time literally hanging off my husband's belt loops on his jeans as I pushed (I'm surprised his jeans stayed up!) and he supported me.  At some point the second midwife turned up so I then had a full on cheering squad! :D

After an hour or so I still felt full of energy, but I also felt as though I wasn't making any progress and commented as such.  Knowing how things had gone so tits up with Rhiannon's birth I decided that I really would rather transfer to hospital as a precaution, in case I did need assistance, as I didn't want to end up in the situation of pushing to exhaustion and then losing the plot like last time.  We discussed it between us all, I weighed everything up, and the ambulance was called.  Just before it arrived Rowan's heartbeat was checked again, everything was still well (at no point had she shown any signs of distress) and I agreed to have the sac cut with a pair of scissors (the bit I'd pushed out still hadn't burst and it was quite unwieldy waddling around with it dangling there - we decided it wouldn't be practical to try and get in the ambulance with it intact!).  There was some meconium present but it wasn't something that anyone felt concerned about. I think cutting the sac ultimately helped with Rowan's birth as I realised just before I got in the ambulance that the back pain had stopped - it wasn't until later I made the connection that it must have meant that that was the point where she'd turned from her OP position.

As I'd hoped, and written in my birth plan, my husband was able to come in the ambulance this time, along with my midwife.  We were all smiling and chatting, the energy was all very positive.  I was lying on the bench and couldn't help grinning between contractions and keeping eye contact with husband, and he kept grinning back.  I'd stopped making any effort to push at this point as I didn't really want to speed up Rowan's birth during an ambulance journey but she had other ideas and about half way into the journey (which was only 15/20minutes) I felt her head bulge out, and told my midwife.  At the next contraction she checked, realised that Rowan was definitely planning on making an appearance sooner rather than later, and had the paramedic driving put on the lights and siren to get us to the hospital ASAP.

We pulled up in the ambulance bay just at the point Rowan made her appearance - I remember commenting as her head crowned that it stung and burned a bit - I definitely know now why it's referred to as the 'ring of fire'!  Having had a local anaesthetic, episiotomy and ventouse with Rhiannon, I never got to experience the feeling of her head crowning and I really appreciated being able to feel it this time, and in a funny way, part of me enjoyed it too.  I panted through the last couple of contractions under my midwife's directions (she had to cut off my knickers as well in the process as I'd put on knickers, slippers and dressing gown to get in the ambulance, they were a decent pair too.  Always the way!) and Rowan slipped into the world.  At that point I remember registering how floppy she was, there was no cry, husband realised too and both of us admitted to each other later that night that in that moment we both felt as though she wouldn't be coming home with us.

The ambulance doors were open that point, Rowan's cord was cut so she could be taken immediately to be resuscitated.  There was the briefest questioning of whether to wait for a trolley but they didn't, Rowan was passed to a woman (nurse? midwife?  I never found out) standing outside.  I remember seeing my daughter in her arms as she turned and moved rapidly away.  Then I was pushed out on my trolley and quickly taken up to the maternity unit to deliver the placenta as, of course with the cord having been immediately cut and Rowan having been taken away (so no breastfeeding), a physiological third stage just wasn't practical.  In the delivery room I was given a syntocinon injection and controlled cord traction was used to hep deliver the placenta, and it was at that point I started to haemorrhage. I was lying on the bed with my husband standing near the window to my right.  I know it was frightening for him to see but I never felt in any danger, maybe because I was only interested in finding out about Rowan - the obstetrician explained what she was doing at all points as she treated me, while a midwife continued to massage my uterus.  I was offered gas and air to help as the obstetrician had to have a thorough rummage to remove clots but I turned it down (it makes me feel sick) and instead squeezed my rock of a husbands hand - having the doctor rummage around in my womb with her hand was definitely more uncomfortable than most of the contractions I'd had!

And then it was done. I was hooked up to a drip and catheter and helped to move so they could provide clean sheets/bedding.  We were looked after so well.

A short while later, husband popped to the toilet adjacent to the room and while he was in there a group of people came in, including the paediatrician who'd worked on resuscitating Rowan, to let us know that although they'd tried to resuscitate her for over 30minutes they'd failed.  They didn't need to tell me, I knew, I'd known from the start; somewhere in the last 20minutes or so before she was born, Rowan had died and the words they spoke made no difference.  I was numb.  When my husband came back in he smiled and held his hand out to shake the doctors, he knew him from the badminton club he played in, I couldn't bare to see him smile because I knew something at that point that he didn't and I didn't want to see the smile go.  When I spoke up and said Rowan hadn't made it, the way his face changed will always be with me - if there was ever any way I could take back that moment of pain I would.

The worse thing of all was ringing our parents - it was like some sort of cruel joke. Later on, my mum said when I told her that she had a brief moment of thinking it was some sort of joke.  You never expect to hear news like that.  They all arranged to come to the hospital as as soon as they could.

Not long after that Rowan was brought it us, snuggled up in a knitted shawl.  She was beautiful, the absolute spit of Rhiannon when she was born.  The only difference being that Rowan was 9lb 8 to Rhiannon's 8lb 1!  And we're not talking a fat baby, she was long, with huge hands and feet (for a newborn at least!)  I wasn't able to dress her myself as I couldn't move out of bed because of the catheter and drip but we had an outfit that we passed to one of the midwives, including a beanie I'd knitted for her, the first knitting project I'd ever completed.  I was so, so proud of that hat and it fitted her perfectly.

I remember saying at the time, after our parents had arrived, that I'd never understood the phrase 'born sleeping' until that point.  But she did look as though she was sleeping, wrapped up all snuggly and warm in a shawl you can't see a newborn breathing anyway, I just wish we could have woken her.

The one thing that's made everything so much easier to bear in the weeks since, is remembering back to Rowan's labour and birth and feeling proud of myself.  I felt strong, and capable, and supported.  I was listened to, my decisions were my own.  The care we received before and after was perfect.  There is no one to blame.  Rowan's loss is a tragedy but there is no anger, no need to question why.

When it comes to labour and birth, there are those that say that what matters most at the end of the day is a healthy baby.  Those in the Positive Birth movement know that your labour and birth can have a profound impact on the aftermath, on how you bond with your baby. PTSD and postnatal depression can result with a poor birth experience.  Based on my experience I would argue that having a positive birth experience is just as important as having a healthy baby - if Rowan's labour and birth had been traumatic in any way then my ability to cope with the aftermath, to process the grief I'm feeling, would I believe, be deeply compromised.  I'm not saying that grieving the loss of my baby girl, my youngest daughter, is easy - far from it - but if I was having to cope with the aftermath of a traumatic birth as well then I doubt I'd be able to write this blog.  In fact, I very much doubt I'd be able to find the strength to get out of bed in the morning at all.

When I was pregnant with Rowan, I became fascinated with the whole process of pregnancy, labour and birth.  I've learnt a lot about myself and about what it means and her loss brought home that it's not all about happy families and babies - there is loss. Loss of the birth you wanted, loss of the child you hoped for, sometimes loss of the mother (although I'm 99% certain my life was never at risk when I haemorrhaged, it was still frightening for my husband to watch - he didn't know).  All of it has come together in my mind and I'm now hoping, in time, to re-train as a midwife.

All of these changes that Rowan's brought, even though she was stillborn, have been her gifts to me.

The Very Beginning

12 Week Scan

20 Week Scan - It's a Girl! (Probably ;) )

Proud Mum and Dad

Footprints on my heart, hands I wish I could hold.

Rowan Aurelia Gwendolyn.  Born Sleeping 2nd July 2013.

Birth Plan

I'm nearly 36 weeks pregnant and I've had a home birth planned from day 1 and have not thought of any alternatives.  However, at 28 weeks pregnant my iron levels had dropped from 12.3 (measured at my booking in appointment) to 9.9 - below the magic number 10 that my midwives were comfortable with when it came to having a home birth.  So I upped my iron intake using Spatone and paying closer attention to my diet (I'm vegetarian).

My bloods were taken again at 32 weeks and this time the midwife also requested that my B12 and folate levels were also checked (previously only my iron levels were checked). The following day my iron levels came back as having dropped further to 9.5, even with 4 weeks of supplementation.   It took slightly longer for my B12 and folate levels to come back but when they did it was discovered that my B12 levels were below the normal levels.  My GP called me into the surgery and prescribed a course of six B12 injections over a two week period.  I had my first B12 injection at 33 weeks and my last one a week ago.  I had also increased my iron supplementation further in that time.  Now, with my 36week midwife check-up looming tomorrow where I'll have a further blood test to check my iron levels again (I'm starting to feel like a pin cushion!) I'm feeling brighter, with more energy and clearer in the head - I'm hoping my iron levels have now actually been boosted over the magic number 10 and it's not just psychological!

Regardless, I've now written my birth plan for my homebirth.  I never really wrote one last time as I opted for a "go-with-the-flow" approach.  I still have the same approach this time, but it's nice to have some guidelines.......

Birth Plan

Prior to labour - Although I have planned a home birth I am willing to consider hospital if circumstances change, as long as I have been made fully aware of the reasons and/or options and am in agreement that changing location is for the best.

I generally have an open mind and all things stated below are subject to change depending on my mood and how I feel my labour is progressing!

During Labour

• My husband, Ben, will be my birth partner and will communicate my needs if I feel unable to do so myself.  Depending on the time of day my 4 year old daughter Rhiannon may also be present.  If she is uncomfortable or unhappy with being present at any point then Ben will take her next door to my parent’s house.
• I hope to keep as active as possible during labour and will choose the position/s I feel are most comfortable for me.
• I do not want vaginal/internal examinations unless I specifically request them.
• I would like the minimum amount of fetal heart-rate monitoring.
• I having been using NatalHypnotherapy through pregnancy to help me manage any pain during labour.  Based on past experience I would like minimum direct interaction with those around me to limit disturbance (total silence won’t be necessary though – feel free to have a cuppa and chat among yourselves!)
•  I would like Entonox available.  I do not want pethidine.
•  I have an inflatable birth pool available that I may wish to use for the purposes of pain relief during the first stage of labour.  I would prefer to choose the pool temperature I’m comfortable with.  However, I have no fixed ideas about where I will manage the second stage and I will decide on the day.
• I do not wish to have an internal examination to confirm whether or not I am 'ready' to push. If last time is anything to go by I will only be pushing when I physically cannot do otherwise! If there is any reason to suspect that I might have a premature pushing urge then I would like to discuss this on the day.
•  I would like to give birth wherever/whichever room feels right at the time!
• I hope to give birth in a position to allow maximum room in my pelvis (upright/kneeling/squatting/all fours).  If I feel I’m too tired to stay upright on my own I would like physical support from my birth partner and may request additional support from the midwife/s.  If I’m still too tired even with physical support then I’ll probably need some encouragement at that point to lie on my side (not on my back!).
• I would like to know when the baby’s head is crowning and would like the opportunity to feel the baby’s head. I would like guidance to allow slow delivery of the head to (hopefully) minimise tearing.  I do not wish an episiotomy unless vital or I decide I’d prefer it to a tear!

During/After the birth

• I may wish to ‘catch’ my own baby but that will be decided at the time.  Regardless, I would like my baby to be placed immediately onto my tummy/chest without cleaning up or any ‘just-in-case’ suction (obviously if suctioning the nose/mouth is totally necessary then that’s ok!).
• I would like a fully physiological third stage and do not wish the cord to be cut until the placenta has been delivered (unless the cord is too short to allow the baby to be placed on immediate skin-to-skin or to allow breastfeeding/suckling to encourage expulsion of the placenta, in which case the cord is not to be cut until after it’s finished pulsing).  Ben will cut the cord. Please do not use controlled cord traction or use fundal pressure unless there is a specific need to do so.  
•  If stitching of the perineum is required, unless a tear is severe I would like this delayed until I’ve had some time with my baby.
• I would like the placenta kept (it can be passed to my husband).

In Case of Hospital Transfer

• In the ambulance I do not wish to be strapped on my back – I wish to stay on my side.
• I want Ben (my husband) in the ambulance with me.
• Although I am willing to keep an open mind regarding pain relief options I would prefer to avoid pethidine as I have concerns regarding its effect on the baby.  In addition, I have naturally low blood pressure (e.g. it is not unusual for my diastolic pressure to be below 60mmHg) and would hope that an epidural would be a last resort due to the increased risk of hypotension and the associated negative effects.
• If a ventouse or forceps delivery is required I want immediate skin-to-skin and the cord is not to be cut until it has finished pulsing.
• If a caesarean section becomes necessary, I would prefer to remain awake with an epidural or spinal block anaesthesia (taking into account the likelihood of hypotension as mentioned above I’ll likely need a bowl to vomit into!). I would like Ben to stay with me at all times, and would like to breastfeed the baby as soon after birth as possible.  If there is likely to be a delay between my baby being born and me being able to hold him/her, then I would like the baby to be passed to my husband asap for skin-to-skin.
• If I suffer a severe PPH then I do not want a hysterectomy performed unless there is no other course of action, as I have yet to decide if I want more children.
• Please do not take my baby into the SCBU just for observation – only if there is a medical necessity or a specific reason for concern.  If there is such concern then this needs to be explained fully to myself and/or my husband.
• I am planning on breastfeeding – please do not give my baby any supplementation without my direct permission.  If I consent to supplementation then this is to be by cup, spoon or syringe and not a bottle.

Hopefully, that covers everything!  Now to see what the midwife says tomorrow :)

Eating Veg

No more chocolate! No more I say!

Oh, okay then....just a little more.......

I don't mean me by the way, I mean the daughter.  I swear that once this excess of chocolate eggs (and bunnies) is consumed then all chocolate, sweets and junk food will be relegated to a once-a-week treat.  Which somehow seems easier said than done as multiple grandparents and great grandparents like to 'treat' her (it can't be a treat if it's more than once a week surely?!) and at the moment I'm feeling too tired to argue.  But no more!  I shall by Super-Muumy The Strict, the foot shall go down, there will be spinach for breakfast and broccoli for dinner and sugar shall be banned! Oh yes!.......errmm.....

I need to do something though, I've become a tad lax in recent months with the family diet.  Not that I'd be able to persuade daughter to expand her taste for vegetables beyond the current bolognaise sauce (blended only, but I can get celery, mushrooms, lentils, peppers, carrots, onions ad carrots into that, most of which she wouldn't touch otherwise), raw carrots, tomatoes and cucumber (with the occasional small spoonful of peas....I say spoonful but it's usually 3 or 4, eaten under duress with a look of disgust on her face followed by dramatic gulping from her cup of water).  I'm relying on the theory that as she grows older she'll develop the taste for veg - husband wouldn't touch anything other than raw carrots and raw cauliflower as a child but eats pretty much anything now.  I wasn't quite so fussy but I definitely wasn't the lover of brussels sprouts that I am now (although you'd still be hard pushed to get me to eat broad beans....unless they're the roasted/fried kind you'd get in a little bowl as Tapas!).

Although I'm relying on my "she'll grow into it" theory I still sometimes wonder if there's a better way of getting her to eat veg - although definitely not the approach I remember my dad using on us as kids:

       My 4 year old brother: "I don't like sweetcorn!"

       My dad: "Yes you do!"

       Brother: "No I don't!"

       Dad: "You do and you're not leaving that table until you eat it!"

Cue three hour standoff which my brother eventually won, proving once and for all that small children are the most stubborn creatures on the planet.  

Actually, I may be exaggerating on the length of time he sat at the table staring at a plate of cold sweetcorn (I'm only three years older so the concept of time is different looking back) but knowing my dad, and knowing my brother, I suspect I'm not far off.

I think if I tried that approach with daughter the results would be similar - she also has a wonderful stubborn streak in her,  It doesn't always make for the easiest time but I hope it'll stand her in good stead as she grows to adulthood.

Funny, when I started writing this blog entry it was going to be about something else entirely.  Mostly revolving around meeting up with a friend who's about to head to Nepal for a couple of months trekking and mountain climbing.  I guess the eating-veg battle is far more exciting than discussions on tackling Anapurna and the risks of meeting a Yak Train on a mountain path............maybe.

The Fear

Today, I am 24 weeks pregnant....in my underwear I very much look pregnant whereas in my clothes, I'm half convinced I look more like I've overindulged in an all-you-can-eat buffet!

19 weeks v. 24 weeks
(also digital camera v. mobile phone camera - and apparently our house has tilted over the course of 5 weeks!)

I'm getting into the swing of pregnancy and I'm mostly feeling pretty good (except right at this second as my beloved daughter has generously shared her heavy cold with me and being a horrendous patient I am of course at death's door and letting husband know it).  The plan is also to have a homebirth and I've been looking forward to it, have dug out my Natal Hypnotherapy CD and am pondering at which point I should send husband up to the loft to dig out the birth pool and fix the puncture that it has (assuming it's even in the loft, I'm not actually 100%).

The problem is, that a week ago, while standing in the shower my mind drifting, The Fear crept over me. I didn't expect it, I thought I'd let go and resolved any underlying issues, but suddenly it was there and the tears were rolling down my face....

When I was pregnant with my daughter we lived in rural mid-Wales, not far from the border with England. I went for my booking appointment with my midwife and during it I was asked "Where would you like to have your baby? Here or at home?" with 'here' being a midwife run Birthing Centre tagged onto the side of the small community hospital.  Prior to this I'd never known that there was any other option other than giving birth in a general hospital (not having been pregnant before, or ever having had any interest in pregnancy, babies or the process of giving birth) and had assumed that's what would happened.  At the time of that booking appointment I was told the hospital wasn't suggested unless you were deemed high risk.  I know now that this isn't standard practice, I've learnt a lot over the last few years about other women's experiences and it seems mine wasn't typical - many women who want a home birth have to fight for it.  I was handed the option on a plate.  I can only assume, that with where I lived being as rural as it was (the nearest general hospital being either Hereford or Shrewbury, both nearly 40miles away, but it was the former which was linked to my birthing centre) and with pockets of 'alternative' communities scattered around from the 70s, that the idea of birthing at home had never completely been washed away by the tide of modern medical services and the accompanying medicalisation of birth (which so many women are now fighting against).

So I went away and considered my options, I read up on the potential risks of birthing at home compared to similar risks in hospital.  I read up terms such as the 'cascade of intervention', I drew conclusions on birthing in a place where you felt safe, and I educated myself as much as possible.  Being a scientist-by-training it was all about risk and natural mammalian behaviour (never mind any 'spiritual' aspects that the birth process might bring - but that's something for later).  Eventually I decided to be at home, primarily because there was nothing the Birthing Centre could offer me that I couldn't have at home - the community hospital didn't have any anaesthetists for example so an epidural was never an option, even if I wanted one, which I didn't plan to.  As part of my preparation for birth I actively avoided all birth stories, I didn't want other people's experiences to 'infect' me with fear or doubt.  And I was never afraid of what was to come, and I never doubted my ability to birth my child.  I also used the Natal Hypnotherapy CDs (I hoped to use self-hypnosis and relaxation to manage my contractions) and I acquired an inflatable birth pool.

My estimated due date came and went (as it does with most women, more often than not!) and just before the end of my 41st week, on the Friday morning, my midwife came to my house and performed a sweep and cheerfully told me that I was 1cm dilated and she wouldn't be surprised if my daughter arrived by the end of the weekend (my daughter was also still in the back-to-back or occiput posterior position which she had been for a couple of weeks - I really wish I'd researched that a bit more at the time!).  Come the Sunday I was incredible restless, couldn't settle, and had to get out right NOW! (Looking back, it was a pretty clear sign things would start happening soon).  Husband and I drove the 35 so miles to Shrewsbury for a wander around the town.  Mid-afternoon, in the shopping centre outside of Marks and Spencers (of all places) I suddenly thought that maybe baby had been pressing too hard on my bladder and I'd had a bit of a leak!  Quick pop to the toilet and I realised that it wasn't wee but some of my waters going.  All I could do at that point was unceremoniously stuff my knickers with loo roll and waddle back to husband so we could head home!

Ringing the midwife at home she said to pop into the Centre the next day if I hadn't started contracting by morning so she could give me a check-up.  I lost some more of my waters later that evening (should I admit to sniffing my knickers to check that it *definitely* wasn't wee?  I'm pretty certain I can't be only woman who's done that?!) but no contractions so next morning I went to see my midwife who examined me and confirmed I was definitely leaking amniotic fluid and if I didn't go into labour in the next 24-48hours I'd have to go to hospital for an induction due to the infection risk - which was something I really didn't want to do.  I went home and waited some more while husband went to work.

Around 5pm my lower back started to hurt, a constricting band.  A little while later, maybe 10-15minutes, the same again, and a bit of time after that.  Things were starting to happen, no fear, no worry, just relief (if somewhat discomforted!).  Husband was meant to be working until about 8 or 9pm but I rang him to let him know and he asked if I wanted him home (he was working about 20miles from where we lived) and for some reason I said "no, finish your shift!" which he pointed out was actually the wrong answer.  So by 7pm he was at home, I had dug out a TENS machine I'd been loaned which I'd hoped would help manage the contractions but I found it more uncomfortable using it than without (like bad pins and needles - I preferred to deal with the back pain!) and seeing as not long after that contractions were less than 10minutes apart it seemed a good idea to get the pool inflated and filled in the living room.  We rang the midwife to let her know and she said to call again when contractions were 3-5minutes apart.  We did and she turned up about 11pm when contractions where 3minutes apart.  By this point I'd been in the pool for a while and I felt calm, focused and relaxed and never once did I think I couldn't manage.  I was also in my own little world which I hated anyone else to intrude in - I especially hated it when my midwife had me leave the pool to go upstairs to be examined to see how far along I was, or when she made me go upstairs to use the toilet rather than let me use the downstairs one - though I know now the movement was meant to help me (really didn't appreciate the interference at the time!).  Every now and then husband would have me sip from a glass of water and honey for energy - I hadn't eaten since Monday lunchtime and this probably didn't help later on.

So it went on through the night, me calm and focused and (a bit later on) dozing between contractions, husband and midwife probably quite bored drinking tea and eating biscuits!  I remember thinking briefly late on "hmm, I can understand why women might want an epidural" although I still felt it was all manageable, I'm not sure if that was around transition, I do remember feeling pretty tired and that the contractions were starting to run one into the other - they seemed to be less than 2minutes apart for a long time but then, time really didn't have a meaning then anyway.  Around 6am and the 'bearing down' sensations started so my midwife phoned for the second midwife as two needed to be present for the birth,  It still felt good, it still felt manageable  I still felt in control.

Then a couple of hours of pushing later things began to unravel..........

I was out of the pool by then, on my hands and knees trying to get gravity involved and so, so tired.  Husband and midwives were calling encouragement but with each contraction my daughter moved down and back up and never progressed further.  I could feel her and the midwives kept saying "just one more!" and it was never 'just one more'.  And then, when they quickly listened to her heart rate they decided it would be best to transfer me - being so far from the general hospital the decision had to be made before any real problems started, and I agreed.  And then I lost control and The Fear came.  I remember being supported to stand as the ambulance arrived, dressing gown wrapped around me - I half slipped my feet into a pair of trainers as I needed something on my feet, but they were already tied (I always kicked my trainers off without undoing the laces) so I couldn't put them on properly and my heels hung out the back so I walked with a half tiptoe shuffle,  And then I was lying on my side in the ambulance, the midwife I thought of as mine was gone as she'd been with me all night and the midwife who accompanied me was the one who turned up later.  She wasn't 'mine' and I'd not met her before and I was scared.  Then there was the  paramedic in the back as well.  Only room for two so husband followed in the car and I was lost in a haze, I wasn't there any more.  That was the point I took gas and air, I was told only to breathe with each contraction but I clamped that mask to my face and barely let go - did nothing for the pain, and my focus had gone, but it took me away so I didn't care do much about the pain.  I felt every bump and rocking motion as we took the country back roads to Hereford.  At one point I realised that the strange bellowing I could hear (something like a cross between a bull moose and a distressed cow!) was me.  I didn't care.  I just wanted it over and I wanted someone I trusted to be with me.  I wanted my husband (who unbeknownst to me had got stuck behind a tractor - those perils of the rural roads! Looking back it's quite funny in one way).

Forty-five minutes the ambulance journey took.  I remember being lifted out and wheeled through A&E on the trolley and strangely remember thinking to keep quiet as I didn't want to  embarrass myself!  In the delivery room I was lost and alone, in a dark place even with the brightness of the room and the whiteness and the silver of the metal and the female doctor asking me questions.  There was no one to speak for me because husband was still someway behind and I couldn't speak for myself.  The pain, and gas and air had completely addled my thoughts, and suddenly birth wasn't something I was doing, it was something being done to me.  On my back, antibiotic drip, knees up, cut, ventouse, baby.  I don't remember her being born but at some point my husband was there, by my side.  They took her away, just for a few minutes to check her and for some reason all I kept asking was how much she weighed, my addled brain's way of asking if she was ok.

And then she was passed to me, wrapped in a blanket, and I felt nothing but shock and relief in equal measures.  I remember speaking to my mother on my mobile and telling her that her granddaughter had a conehead!  A combination of my gas-addled brain and ventouse delivery misshaping my daughters skull.  I felt no bond with this baby in my arms, no overwhelming love.  I think there was toast to eat at some point and eventually we were moved to the maternity ward.

I felt so disconnected.  There was a shower room in the corner of the room and I wandered off to shower.  I was fascinated with my reflection in the mirror, I still looked the same, I didn't look as if my whole world had just been turned upside down.  Except for my belly, all deflated with no baby inside.  I stood under the hot water just letting it pour over me, just wanting to wash everything away.  Somewhere far away I could hear a midwife asking my  husband where I was, sounding annoyed, I couldn't understand the annoyance, in my head I was irritated as it wasn't like I'd left the baby alone.  I took my time to dry off and wandered back to my bed and the plastic cot by it's side.  They wanted me kept overnight because of the delay between my waters breaking and labour starting but my husband couldn't stay so eventually I ended up alone again.

The first time my daughter cried I just stared at her in panic, no clue as to what to do and had to call the midwife on duty to help.  She seemed unimpressed by the fact I was calling her for what turned out to be a nappy change.  I didn't know.  I'd never changed a nappy before, or had a baby - in fact I'd probably only ever held a baby twice in my life and quickly passed them back in discomfort.  But the nappy got changed, and we survived our first night, my daughter and I, and the next day we went home.  Me still dazed and lost and disconnected from this baby that I'd birthed-but-hadn't.

And that is The Fear, the fear that caught me off guard as I stood in the shower a week ago.  That it will all happen again.

I probably sound excessively dramatic - I know, in that rational part of my brain, that my experience wasn't that bad, that I should be grateful for the wonderfully relaxing time I had in my own space in my own home, that sometimes things don't quite go according to plan.  It's not like I had a traumatic Caesarean, or something terrible happened to my baby.  Yet there was the darkness, and being lost, and most of all, being alone because the one person I really needed couldn't be there at that moment through no fault of his own.  And then there was the shock, and that lack of bond, everything by instinct and autopilot but no real connection to the child I'd given birth to, and eventually the postnatal depression which was, I think, mostly exhaustion from trying to do too much in the 12months after her birth, but also that disconnection and shock.

I am afraid that history will repeat itself.

More Cake!

It's my Godson's first birthday today and he's having a party tomorrow (or at least, his mum's inviting family and friends over for the afternoon).  I offered to make the cake as the birthday present.  My back and pelvis are killing me now from the time it took me hunched over the kitchen units.  I have a bit of pelvic girdle pain/posterior pelvic pain because of the pregnancy, right at the bottom of my back, deep inside on the left hand side behind that little dimple - standing for too long tends to make it worse though walking around is fine. Prepping the Christmas meal I did for the 12 of us had me barely able to move and I was limping like Long John Silver!  I got stuck on R's bed once when she wanted a cuddle at bedtime, it really wasn't funny - took me nearly 15minutes to manoeuvre myself off and as I was desperate for the loo it really didn't help (only just made it in time, how embarrassing that could have been! ).

Anyway, I digress - this should be about cake!  An Iggle Piggle birthday cake to be exact.....

I'm pretty pleased with it although admittedly I think it could be better - but you don't get better without practice, right?  I was rushing it a bit at the end because of the aching - and I cocked up one of his arms while shaping it and had to cobble another together with the bits of cake that was left (which wasn't much).  Overall though, I'm happy with it and as my Godson is only one I'm sure he won't be too critical! :-D

Today is mostly about....

....the early morning bubble-wrap disco.

1. Forgetfully leave bubble wrap from previous days package delivery in an obvious and easily accessible place.
2. Allow four year old daughter to discover said bubble wrap and spread it across the kitchen floor.
3. Four year old daughter then proceeds to the dressing-gowned, barefooted bubble wrap disco-stomp while you attempt to carefully squeeze around preparing breakfast as "you're not allowed to pop the bubbles mummy!"
4. Post breakfast persuade, blackmail or otherwise move daughter onto bedroom and bathroom for getting dressed purposes.
5. Ten minutes later express confusion at daughter's sudden disappearance.
6. Follow popping sound back to kitchen where second bubble wrap disco stomp is in full swing.  
7. Fact: Wearing school shoes makes for a better bubble popping experience.