CONTENT WARNING: loss, miscarriage, birth after trauma
After the sadness of a miscarriage at 11 weeks just after my son’s 2nd birthday, I was lucky enough to fall pregnant again at the beginning of 2019. The pregnancy was fraught from the outset: extreme nausea and fatigue led to time off work and limited ability to eat. Still, my scans were reassuringly normal and the baby was growing well. I felt nervous about returning to the hospital where I had delivered my son and signed up with the homebirth team for my antenatal checks so that I could receive continuity of care and avoid clinical settings that I found triggering of my past trauma.
As I approached the middle of my pregnancy I felt sure that I wanted to deliver my baby via caesarean section. The thought of labour terrified me as did the fear of another severe tear that could leave me with serious and more permanent pelvic floor damage as well as another postpartum haemorrhage. A close family member had also been recently diagnosed with pelvic organ prolapse resulting in a hysterectomy and I had read studies that indicated I would be at increased risk of the same condition due to my family history. Consequently, another vaginal birth was best avoided.
I spiralled into a panic that the public health service might not have the resources to guarantee me the type of birth I wanted. So I made the decision to sign up with a private consultant in London who would perform a caesarean on demand. For a while I felt positive and in control, until that consultant began to take frequent holidays, miss appointments and forget to administer tests. Despite my desire to gain control, I had to finally admit that I wasn’t receiving a satisfactory level of enhanced care.
It all came to a head when at 32 weeks pregnant I was diagnosed with polyhydramnios despite having never measured large for dates. My consultant was slow to investigate the causes of this condition (which can include diabetes) so I made the decision to transfer back to my local hospital and signed up with their perinatal mental health team for added support. I was lucky enough to receive care from midwives who had specialist training in supporting women with PTSD and trauma symptoms and my consultant, who confirmed my polyhydramnios was mild and inconsequential, met with me multiple times to discuss the concept of a ‘gentle’ caesarean that she hoped would be the healing birth I craved.
As the scheduled section date drew near, I became increasingly nervous and I barely slept the night before, waking up with tears in my eyes after finally managing to drift off. I was terrified of haemorrhaging, of harm coming to my baby and (melodramatically) of leaving my beautiful 3 year old son without a mother.
On the big day, my husband and I arrived at the hospital at 8am having dropped our son off at nursery. I must have been numb because I couldn’t even cry. Instead I tried to be as assertive and logical as possible. We were greeted by an experienced and friendly midwife who took us to our holding room to put on our surgical clothes. She talked me through my allergies and the implications of my past birth. Together we agreed to take the precaution of cross-matching two units of my blood type in case I suffered a repeat haemorrhage. The anaesthetist, too, listened attentively to my concerns and explained how she would manage poor contraction of my uterus, which I feared could cause further bleeding.
Then we relaxed. Our scheduled slot was given to someone else as the blood cross matching took a while to process, so I napped and my husband tinkered with his birthing Spotify playlist.
When it was time to head into the theatre I was shaking with nerves but felt overwhelming comfort when every member of the theatre team introduced themselves and explained their role. The spinal was relatively painless and when my blood pressure took a dangerous downward spiral a few minutes later, the anaesthetist calmly gave me an oxygen mask and rectified the side effects of the anaesthetic. I was able to speak to her and her student helper throughout and the supporting midwives ensured they kept me updated about what was happening. Phrases like ‘there isn’t much bleeding’, ‘your baby will come out soon’ and ‘it’s all going beautifully’ sound like pointless platitudes but were incredibly powerful in keeping me positive and feeling in control when I realistically had none.
My beautiful daughter was born with a shrill cry and bald head of vernex. She was rested on my chest with a lowered screen as the doctor observed delayed cord clamping. My husband played George Ezra on his phone and I kissed my baby’s head, relieved that she was healthy and safe.
The doctors sewed up my wound very quickly and the midwives stayed close by, reassuring me that my blood loss was minimal. It was so poignant to be wheeled out of the same theatre in which I had experienced a complex perineal tear repair 3 years previously: this time radiating a beaming smile rather than a burgeoning sense of shame and shock. Back in the recovery room, the midwife brought me a cup of tea and a muffin: to this day the best meal I’ve ever tasted!
I was then transferred to the postnatal ward where I received attentive midwifery care and was discharged home within 48 hours, achy but happy. Breastfeeding was a magical bonding experience with incredible oxytocin highs, rather than the traumatic assault it felt like last time. And most wonderfully, my perineum was in tact. I experienced no pelvic floor problems and within a few days was moving around pain free; an unthinkable feat last time around.
Experiencing such an empowering and healthy delivery has certainly helped to heal my past wounds of trauma. It’s ensured that I have begun my new parenting journey with positivity and I can focus my attention entirely on my daughter rather than having to process my own psychological and physical pain. And it is down to two things: instinct and advocacy. Following my gut and being brave enough to demand what I needed and wanted from my birthing experience.