Friday, 1 March 2013

The Fear

Today, I am 24 weeks 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.

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