Interview 06

Age at interview: 37

Brief Outline:

Had planned CS with 1st child due to his expected size. Felt CS was unnecessary, but stress-free way of having baby. Difficult decision with 2nd child, felt both anxious and curious about labour. Now pleased to have had vaginal birth with ventouse.

Background:

Married with one son aged two and a half. Husband is company director. Ethnic background: White British (English).

More about me...

First pregnancy and birth

After many years of trying and a previous miscarriage, her firstborn child was conceived through IVF. She didn't enjoy being pregnant but attended antenatal classes and felt well-informed at the time. She was disappointed to have several different midwives and not to have an opportunity to have questions answered in between appointments. She expected to give birth vaginally. But at her 36 week scan she was advised to have a planned caesarean as the baby seemed very large. She felt involved in the decision-making process and trusted the medical team's expertise. Her son turned out to be normal size, so she wonders whether the medical team took extra precautions because he was conceived by IVF. At first, she felt angry that the doctors 'got it wrong' and put her through a major operation that might not have been necessary. However, looking back now, she concedes that giving birth by planned caesarean was a relatively stress-free way of having a baby. Both her and her son recovered without complications and she was able to breastfeed him. 

Second pregnancy and birth

Her second pregnancy was conceived naturally and came as a surprise. She decided early on that she wanted to attempt vaginal birth but felt quite anxious about labour pains and complications. Having read several 'horror stories' about vaginal birth, she changed her mind about how to give birth back and forth several times during her pregnancy. Eventually, the advice of an experienced midwife about the risks of caesarean convinced her to attempt vaginal birth. Her desire to be able lift and drive again as soon as possible after birth also were important factors. Living in a rural area, she thinks that being confined to the house for a long period after her first birth might have been responsible for the postnatal depression she experienced. 

Her contractions started 4 days past her due date and, feeling uncertain, came to hospital early. She experienced contractions for several hours without dilating and was offered Pethidine to allow her some rest. She was reluctant at first, but felt it really helped her to persevere, as did the gas and air and epidural she received subsequently. After 20 hours of labour her daughter was born with the assistance of a ventouse. The epidural was so effective that this did not cause her any discomfort at the time.

After the birth, she experienced excruciating back pain, though she ascribes this to IBS and not the delivery, as she had similar symptoms previously. She also had a tear and was quite swollen and bruised, so it took her a few weeks to feel comfortable again. However, being able to pick up her two-year old son when she returned from hospital meant a lot. She had been worried that he would not understand if she could not lift and cuddle him after a caesarean.

Looking back, she feels her anxieties about vaginal birth were unfounded, though she admits that having effective pain relief throughout played an important part in making it such a positive experience for her. She would advise other women to use the full spectrum of pain relief and at least attempt vaginal birth, as caesarean is always available as a fallback option. She thinks women should be fully involved in decision-making but personally found it helpful to have health professionals who guided her with advice instead of just telling her that the decision was up to her.

With her first birth, she went along with whatever the medical team recommended. In her second pregnancy, she felt more prepared to question things.

Yeah, I was I just wanted to do what was best for me and the baby at the end of the day. And I would have gone and that's exactly what I did. I went along with the advice because they're the experts and, you know, I was happy at the time because they're in charge. It's after that you think 'gorr'. 

How involved in the decision would you have liked to have been the first time?

Well, I was involved enough. Because it was my first I was probably quite na've and just took what they said was right. I mean now, second time round, obviously, I'm a lot more, I question what they say more.

Do you feel that you were able to discuss your fears and anxieties. Mmm, or maybe you didn't have any?

I'm trying to remember, it seems a long time ago' No, I, I did, you know, it was fine, I had enough people to talk to. But again, as I say as it was my first, you don't really think to, you don't know, don't know what to ask, you know, it's all new to you. 

Doctors advised her to have a planned caesarean because her baby was big. When he turned out to be normal size, she felt angry initially.

It was just the final decision, you know, in hindsight, he wasn't a big baby and it's just - if they, they knew that the method of measuring wasn't accurate then' I found that difficult to understand, if they know it wasn't accurate but, you know, they sort of put me down to have an op, a major operation. It seemed' I'm trying to make myself clear' it was sort of a bit of a risky decision really. I don't know, it just seemed a bit odd, that they weren't that- they weren't more accurate. I mean there's quite a difference between seven-ten and a good ten-pounder really.

Actually, you know, I felt angry at the beginning in the first sort of eight weeks after [Son] was born, I felt, I felt quite angry. Because they got it wrong, but then I thought, well, they're in a very difficult position. If they hadn't have done what they did and things had gone wrong and he was big and he did get stuck and whatever, then I'd be saying well, why didn't you-, you know. So I sort of calmed down after a while and thought oh, well, you know, that's the way it is and it's, they did the best they did for, for me and that's fine. And actually, if I'm honest, it's quite a stress-free way of having a baby [laughs]. You know, now I'm faced with the- having a natural birth, you know, it's pretty stress-free really, you go in, you're booked in, you lie there, you wait to go down to theatre, I mean it's nothing. And after, I was fine. I had no problems.

And you were concerned about being awake?

Yeah that sort of, as soon as I was numb, that all went really. When it was all happening I forgot about that.

Her questions changed throughout her pregnancy. She would have liked to talk to a midwife outside of formal appointments. Having web-based information to revisit was helpful.

I think you do need- well, I felt through my pregnancy, and all the decisions that I had to make, I felt like I needed someone at the end of the line or, to go onto say, a website and have a look at, at information, because every day you might have different questions, and you can't keep phoning your health visitor every day. So, yeah, I thought it was quite good.

And what did you feel about the information on the website compared to the information that you got from other sources?

'Yes, good, I'm just trying to think. It's probably in a way, better because you've got more time, you've got your own time to sit and read it and digest it and 'and you can do it as and when you need to. Whereas often you go to see, you have your appointment to see a health professional and you forget what you want to ask them or, you might be having a very good week and there's no problems. 

'I think it would be probably useful to have more' options to speak to people and to phone' midwives or to be able to see your midwife more often than you do, maybe towards the end. Or even just throughout the whole pregnancy. I did sometimes feel, you know, you have all these questions but you can't really see anybody or talk to anybody' until your next appointment. And by that time you've probably found out the answer or you've got past that stage, you know, so I think I'd like, almost like to have a hotline [slight laugh] that you could phone and get advice, or'

That makes sense, because I think there's a tendency also to forget, isn't there, because it's a burning question, but by the time you get there it's kind of gone out of your mind?

That's it, and nine out of ten times, when you have your midwife appointment, you're having a good week and everything seems rosy. And it can, it can just turn the next day into the most awful pregnancy ever.
 

She decided to attempt VBAC after talking to an experienced midwife She found it helpful to get advice rather than just be told the decision was up to her.

I think it was one particular conversation with a midwife that really cemented my thought that I was definitely going to go for natural. I think I'd probably gone in thinking, 'Oh, I don't know, I might go for C-section', and it was just a conversation I had with her, and she was an older midwife, actually. And I just thought, 'Yeah, she's speaking a lot of sense there, I'll stick with it'.

And was that about confidence, or about reassuring you, or?

Yeah, she just, she had, yeah, she seemed to know, because she was slightly older, I think she had a lot more experience and had probably seen a lot more mums and she just filled me with confidence actually, a lot more. And she was quite, you know, sure about it, whereas a lot of people say, 'Well, the decision's up to you at the end of the day', and I thought, 'Yes, I know, but I want...', so she was almost telling me and it was quite nice to be actually told.
 

She had a lengthy and painful labour and was glad to have all the pain relief that was available. The thought of having another caesarean spurred her on to push harder.

I started labour at roughly three o'clock on the Thursday. 

I went in, straight into [Hospital], because I'd obviously had a C-section before, and I wasn't sure what stage of labour I was in. The contractions were about eight minutes apart and I thought that was quite close. Not terribly painful, but they were coming quite often. I went in, fully expecting to be sent home' but when I got in and they put me on the monitor, they were sort of about four, five minutes apart, and I think because I'd had a C-section before, they wanted to keep an eye on me. 

So then, I think it was probably about six, seven o'clock that I was admitted in and they were, the contractions were just getting stronger by now, and still about four minutes apart' and then I think at about ten o'clock, I had an internal, but I hadn't dilated at all, which was quite upsetting, because I'd been going since three o'clock and now it was ten o'clock and I was in quite a lot of pain at ten o'clock, so they advised me to have a pethidine injection because I probably wouldn't have had the energy to carry on. Because I hadn't even started to dilate, so in their words, 'Proper labour hadn't even started' [slight laugh], which was quite upsetting. 

But anyway, so I had the Pethidine, and that really helped, and glad I had that. I didn't want it to start with, but they did persuade me that it was the best thing. So, but I was glad because it gave me a chance to have a rest and the contractions didn't seem so bad then. And then, I think I was examined at about twelve, oh no, about two o'clock and I'd actually dilated to three centimetres by then, so that was excellent. They did send my husband home at midnight, which was a bit, again, upsetting, but I was' because I'd had the Pethidine, I wasn't really aware of what was going off, but I knew he was going home, but they called him as soon as I dilated to three centimetres. He came back about five o'clock in the morning. And then at three o'clock they wheeled me down to the delivery suite' and gave me gas and air, which was brilliant, I got on really well with that. 

'and then at about, I think seven o'clock in the morning, I actually ended up having an epidural. I think they thought I was getting a bit distressed and I think I was very tired, because obviously I'd been up all night' with the in labour and I had the epidural at seven and that was just fantastic, that just took all the pain away' and you know, I was really glad I had that because it gave, obviously then I slept for a couple of hours, which was, you know, what I needed to do. And the good thing with the epidural is that you could decide how much of the drug you had, they'd come back and say, 'Do you want a top-up', and I'd, you either say, 'Yes' or 'No', and I think I had less of a top-up towards the end, so I could feel the contractions more and so I knew when to push and, and that. And then I think by twelve o'clock, midday, I was fully dilated to ten centimetres and then you had to wait an hour, and then at one o'clock I was told I could start pushing, and she was born at eleven minutes past one, so it was sort of' it all seemed to go quite smoothly really. 

I think I had a text book' labour, as in I dilated every hour on the hour and it all went very well. [Daughter's name] heartbeat, heart rate raised towards the end and that's when they got a little bit concerned, and did the ventouse, which was again, because I'd had the epidural, was no problem, I didn't feel anything. And within minutes of them putting on the ventouse, she was born. I think they only needed to do sort of one attempt with it, and she was born, so, absolutely fine.

Thank yo

She felt uncomfortable after her VBAC, but it was minor compared to the pain she experienced after her planned caesarean. It was great to come home and be able to pick up her older son.

I think the natural birth was better. 'Because after the C-section, you have got quite a lot of pain, obviously. And I can remember the next morning after the C-section, I had excruciating pain. At one point, they had to give me morphine 'whereas you don't get any of that, after, after you've actually had the baby, that's it. All the terrible pain has gone. And you know this is it now and you can just go forward. Okay, you're a bit uncomfortable down below but it's not pain as in excruciating pain at all, it's just you're a bit uncomfortable. And you have pain relief for that, anyway, so, you know, that's controlled. But no'

And you hinted before we started recording about the fact that you could do more, because after a section, you're restricted, aren't you in terms of what you can do'?

Yeah, no, it was great to come home and actually see [son's name], my eldest and pick him up and hug him and that was brilliant, because I knew, obviously having a C-section, I wouldn't have been able to have done any of that, and he wouldn't have understood why he couldn't jump on mummy or why mummy couldn't pick him up. So that was brilliant, because I did go through the first week, of being quite upset that suddenly I couldn't spend so much time with [son's name] and I found that really difficult. So it would have been worse, even worse if I couldn't even have held him. No, it was great.