Ending a pregnancy for fetal abnormality

Going through labour and birth

Going through labour and birth without the reward of a healthy baby at the end is likely to be a difficult experience for most women. The emotional distress that can often accompany ending a pregnancy may make labour more painful for some women, though others found their labour less difficult than they had expected. Several women said that going through labour and birth was an extraordinary experience that they valued because it had brought them together with the baby.

Her baby was born in the maternity ward and she feels glad that she had a chance to have a normal...

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Age at interview: 37

Sex: Female

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I was actually asked whether I wanted to go on to a side ward, a general ward, and do it that way, have a private room obviously. They said, 'Some ladies want to go onto maternity, some ladies don't'. And I said, 'Well, I'm having a baby, and I'm sure that [the baby] would want to be with other babies.' So I went onto the maternity ward and they gave us a room of our own with a double bed and everything - a family room they called it - so we went in there.

I had the first pessary at 10 o'clock and they, I mean they were really good, you know, plenty of sort of tea and biscuits. And then the next one was at 1, and by this time the la-, the labour was s-, quite sort of strong and you know it was moving on [coughs]. I had the next one at 10, the next one at 1, and she was born at half past seven in the nighttime. Yep.

She actually died in my arms. They did say that, this was quite strange, because they explained all this to me, they were all very very good, very thorough, and I asked all the questions that I needed to know because I didn't want to feel that at any stage that I would regret anything or wish that I had have done something but I didn't. Because I knew that living with the guilt that I was going to was going to be hard enough, but I wanted to be happy, or as happy as I could be, that things had gone exactly the way I wanted them to be, go.

So I said that I wanted her passed straight to me, that I wanted her to stay with me for the night, all these things. So when she was, when she was actually born they said, 'Some babies do actually take a first breath'. Because there is actually another way that you can do it as well. Some hospitals can actually inject the baby's heart, which will actually, the baby will die then inside the mum's tummy, and then be delivered that way, so the baby will be born dead obviously. But I didn't want that. So then she just died in my arms. Yeah, it was only, it was only a matter of seconds.

I mean I had, I remember how I felt with my eldest daughter, because I had quite a bad pregnancy and labour, and ended up going for an emergency section. And at that time I felt deprived, you know, it was just to wake up, be cut open and there's this baby. It was very very cold and, you know, and I felt, I felt really I'd not... I felt upset but I felt that I'd let myself down because I couldn't have a normal birth.

I mean I wanted so much to have a normal birth because my mum didn't have with any of us three. So although we sort of knew that I would have a section when I wanted to, you know, and I always wanted to experience a normal birth. And I know it sounds really odd but I experienced that with [the baby]. So she gave me something too, you know, and that's how I see it. So I'll always remember that you know obviously I will anyway, but you know she gave me that.

She wanted the baby to be born in a normal delivery suite with a midwife present and she found...

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She wanted the baby to be born in a normal delivery suite with a midwife present and she found...

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Age at interview: 31

Sex: Female

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And so they moved me to a normal, a normal delivery room then to have the epidural. As it happened, there was 3 others, ladies that morning that needed epidurals all at the same time, but it was quite nice, I heard my, overheard my midwife saying that, ' I want you to do my lady first,' which, I don't know, it kind of was nice that I was seen as just as much a priority as the other ladies.

But as it turned out, I didn't have time for an epidural anyway. I think I'd got, I was doing really well pain-wise and then I got a little panicky and that sort of sent all my breathing off, and I think that was because I was coming up to my second stage and whether that, you know, I knew it was getting close and I kind of started to panic a little bit.

And as it happened, as I got into that room within, I'd guess minutes our baby which, she was there, you know, I felt something had changed and, you know, and she was there, and I just needed to push her out and she came out very easily.

And then when she was born officially she was alive for 4 minutes, but it was, for us it was good because she made a few noises, she moved, they delivered her straight to me, which I'd asked for. And so those 4 minutes were just like precious 4 minutes, that it was like, I'm not getting much out of this but, you know, 4 minutes and a birth certificate, you know, that's all I'm going to get so I want it.

In terms of us feeling differently, when she was born I felt very, very relieved. I felt very calm. I felt, not happy if you like, but I was, I was happy that it had all gone straightforward and that she was here and, you know, we were there.

In contrast, that was the fact, the point that my husband found was really difficult, was when she was born because I think the reality hit him, that, because obviously before he couldn't feel the baby, and suddenly it was, it was difficult for him. And that was, I suppose, one of his moments that he would have said it was the worst time. But for me it was actually one of the relaxing calm parts when she was born.

And I felt very relieved, you know quite... So when she was born and, obviously, then 4 minutes later, the midwife just checked on her and her heartbeat had stopped. And then they just left her with us, with her for as long as we wanted.

Even though she had given birth twice before she found this labour was more physically and...

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Age at interview: 38

Sex: Female

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We were given these pessaries first thing in the morning and, and sort of told to wait. I can't remember, probably late afternoon, I started contractions, very weak. And I had, my, I had had a natural delivery with my elder child, so I knew kind of how to compare a little bit, and I've since had two other children. And I must admit it was the most physically and emotionally painful of all, of all my labours because I had violent diarrhoea as well as being sick at the same time.

And I don't whether the medication kind of made me feel a bit woozy but I really felt kind of spaced out on whatever I was taking, and I had, I didn't receive any painkilling drugs, which I requested not to have, until just before our baby was born.

But it was a very, it was very painful, and it was probably very painful because the, [baby] wasn't ready to be, to be born, and the drugs were taking effect. But I really needed, my husband was with me and very supportive. And in the early hours of the evening our, our baby was born. And it was really nice to hold her.

And she was actually breathing for a very short time and I was able to hold her while she was still breathing. And we, I could w-, I watched her as she died, which was, it sounds a bit funny, but for me it was really nice because I knew that she hadn't died in surgery, that I knew she was with me, and that was, that was very nice.

There were several key aspects of care that women and their partners particularly valued - being able to decide where to have the baby, being cared for by an experienced midwife or nurse, understanding what choices were available about pain relief, and knowing that they could chose whether or not to see and hold the baby afterwards. (See 'Deciding whether to see, hold and name the baby').

She found the birth was less demanding physically than she had expected.

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Age at interview: 40

Sex: Female

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I was talking about the labour, about my anxieties, about going through the actual birth which consumed a lot of my thinking for the, for the couple of days while we were waiting to go through it and, because I'd had quite a difficult labour with my son, quite lengthy and painful labour, so I was quite anxious about that. But in hindsight, that was just a moment in time.

The birth itself for me was not a difficult experience. It was relatively quick and relatively painless compared to the real thing, which I hadn't understood to be the case but I felt from the midwife and others I was expecting it to be more like a full-blown labour but it wasn't at all. It was a, it was a sort of mini labour and it was quite easy from a physical point of view.

Feels she was well looked after by a nurse on a gynaecology ward and was able to self-administer...

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Age at interview: 31

Sex: Female

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So I had another pessary, and I think this was about 10 o'clock. And they gave me a morphine pca which, I could press the button to give me morphine which would stop the pain when the labour did actually start.

So I got the feeling straight away that we were in a separate room, we were on the gynae ward, we had our own sister who was looking after us and she knew the full story of what had happened, and they'd given me this morphine pump. So I felt, 'well, they don't want me to be in pain, they're looking after me.' And I felt like I was in good hands.

And really throughout the morning she just kept popping in and seeing if we were alright, and she was a really really lovely woman, and she spoke to my husband. And my husband had a magazine and I had a book and we just sat there and waited. And once the pain started I used the morphine. I was a bit frightened really, I didn't know how the feeling would be. And once the pain started I said to my husband, 'Do you think I should press the button?' And he said, 'Well, I don't know'. And as it started and it got worse I thought, 'Well, I don't really want to be in pain.' I was frightened of feeling pain and I didn't really want to go through the whole procedure in agony. So I used the morphine.

And I, we explained to the sister, after reading the ARC booklet myself and my husband decided that we didn't want to see the baby because we were worried what we might see. And we both had a picture in our mind of a little baby, and we were worried that what we saw might affect what picture we had in our mind. So she said that that was fine.

And, as the day progressed she just came in and out and I was quite sleepy with the morphine. So round about 5 o'clock things had progressed and she examined me and she said, 'Right, well I don't think it will be very long now'. And she came back in and really quite easily the baby was delivered. And she took the baby away.

Many women who had experienced childbirth before said that this labour 'felt different'. Several said the labour took longer and others felt that this labour had been more painful than others because their emotions 'were wrapped up in it'. Several women felt that neither their minds nor bodies were 'ready to lose the baby'.

She attributes her painful labour to her body and mind not being ready to lose the baby.

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Age at interview: 37

Sex: Female

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So there's a tremendous amount of guilt, and yes there's upset and there's, you're worrying about your children back home, but you just know you have to do it - and as quickly as possible. And I think I was actually asking the midwife, 'Can I not have the next set of tablets now?' But you have to wait, I think its three hours, in between each set.

So that was the Wednesday we started that and thankfully labour, didn't, it was a while in starting but it didn't last excessively long. So we were fortunate in that respect, we didn't have hours and hours and hours of thinking what was going on. But it was the worst pain ever, and I've had three labours and the youngest child was over 9 pounds and I thought that was hard work. But giving birth to a baby that was only 19 weeks - he was small - but that was, there's no pain that you could describe as bad as that, and that's with all intervention, that's with morphine, with gas and air, with painkillers.

So its, possibly it's an emotional response to what's happening, because you know that you're losing a baby that you don't want to lose, and your body's not ready for it. Your body's still trying to hold on, but the drugs are making you go through labour.

She felt no one was interested in the baby and felt guilty that she had accepted an epidural.

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Age at interview: 36

Sex: Female

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They put me into a room on the labour ward, ironically. It was a room with just two beds and a window, and they just let me lie there and they n-, the midwives would come in occasionally and check on me. And the horrible thing about it is that, having had a baby before, it was such a different kind of experience. Because I didn't, I didn't have, there was no monitor to check the baby, you know. It was, there was no interest in the baby, it's just, you know, you're just there to give birth and they, you know. I know it's, that's the way it is, but that just, I found that so hard.

And then it took about, I think from about, till about 9 in the evening was when I went into labour. But unfortunately I had, I was in quite a lot of pain and I decided, they did offer me an epidural and at first I thought, 'Oh, I can't have an epidural because I should...'. I felt guilty, I thought, 'I should be suffering the pain because I'm making this deci-'. It's a very strange thing, it doesn't make sense to most people, but I just felt guilty for having to have pain relief. It's almost like I was, I don't know, I don't know how to explain it. Anyway, so I had the epidural but ironically it didn't work. So I felt all the pain anyway at the end of the day. And I felt the baby come out and everything. And he was born at 9 o'clock in the evening.

Some of the women who felt their labour and delivery did not go as they had hoped were first-time mothers who hadn't been to antenatal classes and didn't know how to cope with labour. Several women who had never given birth before said they would have liked more pro-active support - some felt they had been left to cope alone for long periods of time, and several had delivered their babies with no one except their partners present in the room.

She had never had a baby before and didn't know when she was in labour and found herself alone...

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Age at interview: 39

Sex: Female

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So it was myself and my partner. He was helping me out with the, with the drugs because I had, I think it was pethidine, and I could just press the button whenever I felt that I needed it. And so by that stage it was about 7 o'clock at night.

And, but the other thing is, because I was only 18 weeks I hadn't done the antenatal courses. So I didn't know anything about the breathing and I was doing absolutely the wrong thing. So I was breathing really fast all the time. So between the drugs and the breathing fast, I was totally light-headed. And it's funny because, you know, you're basically giving birth to a small child, but it's still the same process, but you're not, you haven't read about that stage quite yet.

So, you know, you don't know what to do to help yourself in a way, in terms of technique or massage or, you know, whatever it is. So, so basically I was just, you know, breathing really fast, trying to breathe through the pain, and I didn't know what I was supposed to feel when, when the baby was ready to come out or anything like that.

So anyway it got to the stage where I felt that the contractions were getting really strong and something was going to happen soon. So we rang the bell, but no one came for maybe ten minutes or so. And then I said to my partner, 'Just go and get someone now'. And off he went, and while he was out I had the baby, which, so I was completely on my own.

She was promised support during labour and delivery but felt that she did not receive it.

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Age at interview: 34

Sex: Female

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So I was told to just take the pills, read the paper and the bereavement midwife kept coming in occasionally to check. And apart from that I wasn't really sure what would happen. And then at about, after about 5 hours of reading the newspapers and having various pills I began to feel some pain, and I wasn't really sure what the pain was - it sounds ridiculous that we were going in to have a baby and having pain and not really knowing what it was - but I had absolutely no idea.

It was only when my husband said, “You're having, those are contractions,” because he's actually been there before that he... I suddenly thought, oh, and he said, “I'm timing them and they're happening every 12 minutes.” And he'd been doing that for sort of half an hour. I had absolutely no idea that that was happening. So we mentioned this to the midwife and then they became extremely painful. And I was told that, I was told before having the baby that I would be able to have an epi-, have painkillers, and that they advised me quite strongly, knowing the outcome of the pregnancy, to take any painkillers that I could, and not to try and tough it with a natural childbirth. Because their experience is that, in giving birth in these circumstances, the pain is much more acute than it ordinarily would be if it was a normal pregnancy with a happy outcome.

So I was strongly advised to take all of the medication, certainly gas and air and morphine. The pain got so bad I actually moved on to an epidural, which they were extremely reluctant to give me funnily enough, I don't know why. The anaesthetist was not overly keen to give me an epidural. I think the reason he wasn't keen to give me an epidural was one, that they take an awfully long time to administer, and secondly, they are quite expensive, I think. And thirdly, we knew what the outcome was and it was a small baby, and so therefore the pain can't have been too enormous.

However, my husband managed to convince him that he would be well advised to give me an epidural, so he did eventually give me an epidural. And again, I had little, no, I had no knowledge really of what an epidural was, or how it would affect me, terribly until it, until it was prescribed to me.

I was then left alone, again, for various number of hours. I was informed by the, my husband explained that I was having contractions and we were told that, actually, well... I hadn't really terribly dilated so it couldn't really be happening. I got the feeling that a lot of their... they very much felt that a lot of my pain was actually emotional rather than physical. That's how, and I felt that they were treating me based upon that. And that, you know, it was far too early to be having that sort of pain, with your cervix not dilated, and really an epidural wasn't necessary for a baby of that size. And we very much, I very much felt that at the time.

And so my expectations of, well, I had no expectations. There was no management of my expectations or my husband's at all before the birth. I didn't really know what to expect other than I'd give birth and I'd have a lot of support on the day to do it. And I was informed when making the decision that there would be a lot of support - continual support - on the day, and that we were made as comfortable and as lovely as possibly could happen. And that was not what happened at all - totally the reverse actually. Because on the day of the birth we were - everybody around us was nobody that we'd ever met before.

The doctor that we originally saw, the registrar we saw first thing in the morning because she happened to be going off duty, but nobody else was familiar to us at all. And the midwife we actually had was an agency midwife anyway, and so it was a case of, you know, ‘Let’s keep the good midwives for the good outcome’ - that’s how I felt at the time. And then you do question your decision I have to say.

Pain relief

Most women, though not all, had pain relief. Some were advised by health professionals that 'there was no point being brave' because pain relief would not affect the baby. Most women took whatever form of pain relief they were offered - sometimes women had been given a pethidine injection, others said they had taken morphine or diamorphine.

Several women took responsibility for their own pain relief and were attached to a PCA device. Some women found the drug (most said it was morphine) did not control their pain as much as making them 'feel out of it' and several had taken so much pain relief that they had passed out. Many regretted taking morphine because they felt sick and also because some women found that they lost control of what was happening to them and the baby.

She chose to take morphine not realising that her baby was about to be born and she regretted it...

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Age at interview: 40

Sex: Female

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But I think that was the only moment that was right, that would have been right because as soon as the emotions were, interestingly, I'd had morphine just about 5 minutes before she was born, the midwife had come in and said, 'How are you coping?' And had I known I was near I would have said, 'I'm coping fine,' but I thought it was more, going to be more like a typical labour and I thought I'd got 6 hours to go and I said, 'Well, I can't do this for, you know, 6 hours, give me the drugs.' So I'd had some morphine and then she was born 5 minutes later and then I was dreadfully sick, felt wretched with the morphine, it made me feel awful, awful. I was a bit cross 'cos I hadn't really needed it, not cross at anything or anybody, I was just a bit cross because I, for the next couple of hours I was really out of it and I was vomiting and I felt sleepy and it was all a bit weird.

He felt helpless as there was nothing he could do to help his wife as she gave birth.

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Age at interview: 38

Sex: Male

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It was explained to us that we would go down to where they were doing the, doing scans, so where they did scans - so we'd go down there and that's where there would be an injection into the baby. And also my wife would have an injection that would start things off.

And that was hard in itself the fact you were going on the same place you've had the scans, the same place you've been where you've been really happy in the past. And, and also sitting alongside people who are there who are pregnant, knowing that you're having to terminate the pregnancy, knowing that you're going to have to go through giving birth with it, there not being a happy ending.

So went down and the injections were given. And then we went back to up the room. And once, once things started I mean my wife was hooked up to or whatever drugs it was - one of those things where she could just give herself a boost of drugs - so she was, she was pretty much out of it for a lot of the time, sort of almost falling asleep. And that's when I felt most helpless I think, because there was nothing I could do - nothing at all apart from just be there - and no, not even talking to her because she wasn't really talking that much anyway because of the drugs.

But yeah not, just not knowing when really, not knowing how long it was going to take yeah. And not, and with our little boy being born by Caesarean, not really knowing what to expect anyway, because we, [wife] hadn't been through a natural pregnancy before so it was all a new experience, and it should have been a really joyful experience, but it was knowing that the baby that was coming out wasn't going to be coming home with us.

A few women had gone through labour and delivery with little or no pain relief - one woman who had given birth to 4 children said she 'just got on with it' - another woman had gas and air.

She found that gas and air provided enough pain relief for her on this occasion so that she was...

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Age at interview: 34

Sex: Female

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The midwife came in and said oh yes everything is dilated and it looks like, you know the birth will be imminent. And I think I'd had contractions, it was about half an hour to an hour, and [the baby] came along at ten to two. I'd felt quite uncomfortable with the contractions, and first time round the gas and air didn't do anything to take away the pain, but this time it really seemed to have a, an analgesic effect and took the pain away.

I stood up over the bed and delivered her that way. The midwife swaddled her in a lovely white cot blanket and said did we want to, to hold her which I did. And it was, it was lovely to see her and my partner and I both said the same thing - she looked so peaceful. And it's very difficult to say yes, she's poorly, she was ill, she had a severe problem that couldn't be put right, she had no chance of a normal life - when you see a perfectly normal looking baby on the outside.

A few women had asked for an epidural and found that staff were reluctant to give them. Several people didn't understand why it was difficult to get an epidural - some wondered if they cost too much. One woman thought that health professionals might be reluctant to provide epidurals because they felt that women were experiencing 'emotional' rather than genuine physical pain.

Occasionally women wanted to have - or thought they could have - a caesarean section to avoid going through any kind of labour pain, but caesarean sections are not usually performed in these circumstances.

Women who felt they should have been treated with greater sensitivity during this difficult time, or who sensed that midwives disapproved of what they were doing or who wanted to avoid caring for them, felt disappointed and let down with their care.

Describes her labour and epidural neither of which went as well as she had hoped.

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Age at interview: 37

Sex: Male

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Mother' And so we went for a meal with our family, mundane things, and then we went to the labour ward. And we were put in the SANDS room. But at the time I didn't know what SANDS (Stillbirth and Neonatal Death Society) was, and I misheard what they said and I thought they said 'the sad room'. And I can remember feeling really uncomfortable with this.

Father' Do you know I've only, I didn't know that. I've always, I've always thought it was 'the sad room'.

Mother' And so we went into this room which thankfully, and I've since met the person who was involved in getting that room done in, in that hospital and organized, and it was, it was, as far as it can be a good experience it was a good experience in that there was provision for us to be together throughout. And...

Father' I think during that time we were actually very well supported.

Mother' We were very well supported apart from the, whoever it was who just, who did the pessaries to get the labour started, which was an internal pessary. And I very strongly got the impression that they didn't really agree with what I was doing, because they were very rough with me. And, but then that was all over very quickly, apart from when we had, when it got to the point where I needed some, I was hoping to manage without too much, too much...

Father' Pain relief.

Mother' Pain relief, I couldn't think what the word was, pain relief. But I actually did need in the end to have a...

Father' Epidural.

Mother' Epidural. [laughs - sorry darling]. I did have to have something because it was getting really bad and obviously it wasn't a natural birth in the way that I'd done before. And so, because it was the middle of the night in the end by the time I needed the epidural, the person who came to do it wasn't experienced at doing an epidural. And I can remember them coming in with the trolley and the midwife saying, 'We don't normally use that needle'. And the person saying, 'Well, which needle do you use then?' And like and I remember looking at my husband thinking, 'Oh, my goodness, you know, what now, you know?' It was almost like a 'Carry On' film, you know.

Women were very sensitive about how the baby was handled during and after labour; they wanted the baby to be protected and cared for after s/he was delivered and not left alone or taken away from them for too long. (See also 'Deciding whether to see, hold and name the baby'.)

Several women expressed the view that midwives probably didn't enjoy dealing with terminations and wondered if they had any special training for this role.

Last reviewed July 2017.
Last updated June 2014.