Thursday, 15 August 2013

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 2nd 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 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.


  1. crying reading this, what an amazing story, thank you so much for sharing. You and Ben are an amazing couple, Its an honour to know you and witness your strength in your togetherness. xxxx