First time mum Charlotte used her 5,4,3,2,1 relax and surge breaths to get through a long labour, she was mobile and strong and asked for what she needed
The advice of the midwife at my 40 week appointment was to encourage the onset of labour by pretty much any means I could think of, including lots of walking. She wouldn’t be drawn on her definition of ‘lots’, but taking her at her word, Tuesday that week found me making an expedition along the A4 towards Reading in search of wild plums and blackberries.
I never ended up making the jam I was planning, although there is a delicious batch of Birthday blackberry in the cupboard made by Joe the day after Tim was born.
My labour started off slowly. ‘Long’ was one of the words about childbirth I had written on the card in my first class, and it turned out to be true.
I had suggested to my husband that he should bring his laptop home that Tuesday evening, and he ended up doing a full day’s work on Wednesday while I did 5, 4, 3, 2, 1 relax and surge breathing as the surges came. I remember having to stop and breathe when each one came in, but don’t remember them being bad beyond that.
We went for a walk at lunchtime, which took twice as long as usual, and ended up taking a call from the community midwife team part way round (we were booked for a home birth). My surges were roughly every 3 mins and at the end of the call the midwife pointed out that we had been on the phone for 5 mins, where was the surge? He laughed when I said that there had been one point in the middle of the conversation where I had gone very quiet and concentrated on breathing.
By the end of Wednesday I still hadn’t reached the magic 1 min surges every 3 mins, but I had discovered that lying down during a surge was pretty much impossible, sitting down normally wasn’t great, and that leaning forwards (eg over a birthing ball) invariably made me throw up. My Lucozade diet began.
I spent Wednesday night sitting on the edge of a yoga block in the dining room, leaning against the wall. The surges must have helpfully died off overnight as I felt as though I had slept well, despite waking and moving to all fours for a surge a number of times. Somewhere between 3 am and 7 am my waters broke, but I was still off the target surge frequency.
Throughout Thursday things continued slowly – my waters continued to drain (with a light meconium to the concern of the midwife), the surges hadn’t reached the target, and I walked even slower than before.
I continued to drink only water and Lucozade and, by 9 pm, my body was looking forward to some overnight rest on my yoga block. This was when the community midwife rang with the recommendation to attend the Maternity Assessment Centre at Wexham Park for foetal heart rate monitoring, due to the meconium in my waters.
Leaving the house was the last thing I felt like doing – my body craved rest – but after some debate we dutifully did so. We took the hospital bags and car seat with us as we knew that once inside Wexham Park, the chances of leaving before Tim was born were low.
Continuous heart rate monitoring, with me unable to lie down for the required 30 mins was non-standard, but successfully achieved by the accommodating midwife on duty, and showed that Tim was perfectly OK.
Perhaps 2 am, after more than 48 hours of labour isn’t my strongest moment, but we eventually agreed to be admitted to the labour ward for vaginal examination to see how far labour had progressed, and for augmentation should I not be in established labour (‘right birth on the night’ was what I told myself).
The labour ward at Wexham Park lived up to many of the negative stereotypes of labour wards in general. One of the reasons I had chosen a home birth was a desire not to spend my labour pacing the stairs at Wexham in hospital dress and regulation socks, as observed when I had attended my NHS hypnobirthing session.
The first thing I was offered on entering the labour room was a hospital gown and an invitation to ‘get changed’. I declined. To her credit, the midwife put the gown away without comment, but her face showed distinct disapproval.
The next consternation came when my husband and I looked for somewhere to roll out my yoga mat. I explained that I found it impossible to lie down during surges and was much more comfortable on the floor (I was so glad we’d brought the mat).
Yes, I’m sure we could work out a way in which I could lie on the bed between surges for her to feel my tummy / other examination, but no, I wouldn’t be lying there immobile for a 30 min foetal heart rate trace. No, I wasn’t trying to be unhelpful, but I really couldn’t lie down for her – could we just move the bed out of the way of the mat a bit?
Contrary to the logic of the doctor we’d spoken to, the first thing to do was put an IV line in my hand ‘for the augmentation drip’, the next was to get another heart rate trace ‘for baseline’. Actually examining me and checking how far I was into labour was further down the list.
So 2.5 hours later, I had a line on my hand placed so that I couldn’t use that hand to support my weight (a problem when moving to all fours for surges was an otherwise comfortable option), a grumpy midwife who was sure the reason she couldn’t get a good trace was because the probes weren’t pushed into my tummy far enough (of course it would all be much easier if I lay on the bed), and a second midwife who also couldn’t get a trace and who had told my husband off for having the ‘wrong’ Lucozade sufficiently strongly that neither of us had quite dared to tell her that the fizzy stuff might not be absorbed as quickly as the flat but it was a) nicer, b) all we had and c) labour usually took some time and I would probably still be there when the sugar was absorbed, even if it wasn’t optimal.Consequently I had neither eaten nor drunk anything other than water for ~10 hours.
Finally, the second midwife decided to examine me only to discover that a) I was 6 cm dilated and so didn’t need augmenting at all (later this was reassessed as 4 cm, but I wasn’t fussed about this), and b) that my baby was much lower than she had expected – she ‘had only felt my tummy quickly before’ – so the reason they hadn’t been able to get a heart rate trace was that the probes were being put in the wrong place.
At this point I started to rebel. I had been cooperative for hours of poking, really needed some rest, and asked for the lights to be switched off and left alone. What seemed like minutes later, grumpy midwife walked in, turned on the lights and told me she was doing her routine heart rate monitoring.
I properly rebelled – I was craving my missed night’s sleep – refused the monitoring, and shortly afterwards was telling both midwives and doctor that I wanted the IV line in my hand out and that I didn’t see any reason why I should still be in Wexham Park at all. Since the exam had shown that everything was in order, why shouldn’t I go back home and give birth there? My surges had slowed down considerably while on labour ward and I was also worried they wouldn’t return while I was there.
I remember telling the puzzled second midwife that here I was on their territory and expected to comply with what they wanted, at home it was the other way round: she said that she hadn’t thought of it that way before.
It was the doctor who came up with the compromise. Perhaps she saw that my relationship with grumpy midwife was a problem and wasn’t going to improve, perhaps she had bothered to read my birth plan. Either way she suggested moving upstairs to the midwife-led unit: ‘I think you’ll like it up there’.
Suspicious, I asked to have a look first but eventually agreed. At 8:30 am, shortly after everything had been moved upstairs, lovely Claire and her student Jo walked in (‘Claire?’ said one of the community midwives later, ‘She’s the best. I want her if I ever give birth.’)
From this point onwards I remember things with a blur and remember sounds much better than feelings (timings are all from Joe). The yoga mat was no problem (‘we don’t normally have the bed so visible but we’re being rebuilt and are using an old labour ward at the moment’).
The surges came back. Jo was beautifully discreet with her 15 min heart rate obs. Claire was unfailingly patient and always had another suggestion of something else to try. I was so so tired: I couldn’t lie down, I could sit less and less, the birthing ball was uncomfortable whichever way I used it and I couldn’t find a point to relax from. I said this loudly and vociferously.
Around 2:15 pm I tried the gas and air which was wonderful. Around 3:45 Claire told me and Joe that ‘we need to get things moving’ and that she’d leave us alone for a bit. Quite what happened next I don’t know – Joe says it was the combined hormones of me, him and Tim – but by 4:15 pm I heard myself oohing and aahing like I was having great sex!
After a while, I remember realising that my breathing had changed and also remember both midwives sitting on the yoga mat looking up between my legs (apparently they were exchanging thumbs up signs).
Then Tim’s heart rate dropped. Claire became noticeably less accommodating: ‘Charlotte, I need you to get up on the bed now. Yes, on the bed. I need you to lie on your right side…’ The room got quite busy quite quickly. ‘I need someone to call an anaesthetist to put a line in, I’ve tried three times.’ ‘Last examination she was at 9 cm’, ‘Could you pass me…’, ‘I need an anaesthetist…’, ‘Now at 10 cm. Fully dilated.’. Lots of instructions about how and when to breathe. ‘Head out.’
Tim was born at 5:45 pm by ventouse suction cup and as he was placed on my chest I remember a slight sense of bewilderment: OMG, what am I supposed to do now? In the end, that was answered for me as he was breathing far too fast. Tim and Joe disappeared off to the neonatal unit while I got sewn up, and 6 days later we were all discharged, healthy and home.