Interview 23

Age at interview: 26

Brief Outline:

Had lengthy labour with 1st child after being induced, taken for emergency CS after baby's heart beat dropped. Explored options early in 2nd pregnancy, decided on VBAC. 2nd child born after 10 hours, painful labour but great sense of achievement.

Background:

Shop supervisor with one son aged two. Living with fiance, who works as a risk assessor. Ethnic background: White British (English).

More about me...

First pregnancy and birth

She had a complication free first pregnancy. She was keen to be as informed as possible and attended antenatal classes as well as gathering information from family, friends and television programmes. She had made a birth plan and hoped to have an unassisted water birth, but was conscious that she didn't really know what to expect in terms of labour pains. She kept an open mind about possible interventions. 

When she went past her due date, the hospital booked her in to have an induction for the 12th day after. However, as she felt quite anxious, she contacted the midwife and asked her to do a sweep, which was successful in triggering her labour. When her waters broke the following night, she went into hospital. She laboured to 9' cm, but her baby was in a back to back position and was pushing against a swollen part of her cervix, causing his heartbeat to drop during contractions. After a failed attempt at pushing him into a more comfortable position, the midwife raised the alarm and she had an epidural caesarean. Being rushed to the operating theatre was very traumatic for her and her partner but she trusted the care of the medical team and was happy with how they involved her in decision-making. She took some time to recover but had no difficulty breastfeeding her son.

Second pregnancy and birth

Her second pregnancy was much less comfortable than her first. She had frequent Braxton Hicks contractions ('false labour') and enduring sickness, which she put down to the sex of the baby. She was pleased to have the same midwife as in her first pregnancy and discussed options for birth after caesarean with her early on. She decided to attempt vaginal birth with her second child, viewing it as 'the way your body is build to do it'. She was disappointed to learn that a water birth would not be available to her, but her midwife suggested that she could use the pool for pain relief during the early stages of labour. 

She went past her due date again and was starting to feel quite depressed while waiting for things to happen. Having experienced so many 'false labour' contractions, it took her a while to recognise when labour set in for real. She arrived at hospital when contractions were two minutes apart. In between check-ups she was left alone and got anxious about the extent of her labour pains. The epidural she had asked for was not very effective despite repeated top-ups, which meant she went on to the pushing stage with almost no pain relief. Having her midwife spurning her on during the final stages of labour was very helpful. Her daughter was born healthily after 10 hours. 

Looking back, she is very happy with her decision to have a vaginal birth despite the 'indescribable pain' she experienced. During labour, her abdominal muscles had separated, which meant that her ability to lift and sit up from lying down was limited for several weeks after the birth. However, her midwife assured her that this was a common occurrence and could be remedied over time with a special set of exercises. She feels a sense of pride and achievement having given birth vaginally, which contrasts with her experience of caesarean as 'just having things done to you'.  

Overall she feels that her two birth experiences have made her more likely to speak up in encounters with health professionals, to ask about what she wants to know and to make her wishes known. She thinks midwives in particular can be reluctant to provide women with detailed risk information about delivery options, so it would be helpful for women to have access to further information resources they can use at their own initiativ

She didn't feel comfortable stating her preferences too resolutely but thinks she'd be more...

And had you thought much about how you wanted to deliver your first baby? 

Not' well, I mean, I'd always sort of liked the idea of possibly a water birth, but I think because it's the unknown you ' I don't think you tend to' feel so comfortable to say well actually I want this, I want that, and this, that and the other. Whereas this time, I do feel more comfortable. Okay, I can't have the water birth, but'I felt more comfortable to actually ask and talk about it. But yeah, I think it's because it being your first, you' like I said, you don't tend to sort of ask so many questions. Which really you should do because you don't know what's going on, so '
 

Even though she admits that seeking out information about birth and labour can be scary or...

And what information did you get, where did you get your information from in the first pregnancy? Did you go to antenatal classes? 

Yes, yes. I went to antenatal classes and I got information off like my mother-in-law and my mum and you read books. I know people say, 'Oh don't read too many!' because, you know, it's obviously other people's opinions, but I found it quite interesting. And also on some of the channels on Sky as well, I found them interesting even though'

I always think- don't you think they're scary?

Um'

I think they're terrifying.

Yes and no, but [hesitation]' I mean, when my partner was working at his previous job, his ' his boss sort of said, 'Oh I don't want to know, I don't want to know', and she didn't want to know anything about the actual contractions or anything whatsoever, the labour. Okay, it just so happened that she did have a caesarean in the end, which was kind of lucky in a way, but I'm one of these people that like to find out as much information as I can so I can sort of prepare myself in that regard. I mean, I can remember saying to my partner when we went to the antenatal. I said 'Oh, if it's a load of breathing I don't want to do it. If they're starting to do all this huffing and puffing it's going to be so embarrassing'. But it was very good, very informative. But still, at the end of the day you don't really know what to expect.

She didn't care what was done to her as long as her son would be alright. The thought of...

He was' overdue, so they actually booked me in for an induction for the twelfth day after. But I was so upset and everything, I actually went to the midwife and she said that she'd do like a sweep, and that actually did the trick' I ended up going into labour, I think it was very sort of twinges and everything were sort of like half past six in the morning. Obviously I didn't tell my other half, and they went on through the day, and then I think it was midnight that night my waters broke and we went in. But what they found out was that my son was' even though he was head down he was sort of back to back, but he' I went in because every time I had a contraction' his heart rate would just go. And then they- then they sort of said to me, 'oh look, I know you're only sort of nine, nine and half centimetres dilated, but can you give us a bit of a push'', because where he was back to back his' the bit of the cervix was swollen on the side. So they thought well if you give a push then might be able to push it out of the way. Well, I gave a push and then obviously the midwife just all of a sudden pushed the emergency button and I got rushed in. And they did a load of tests on his head and everything, and they said that he was fine. But they said, 'Well we'll wait an hour to see if you fully dilate', which I didn't. And they said, 'Oh, how do you feel?', and by that time I was thinking, 'Well, as long as he's alright I don't care what happens'. So I ended up having a caesarean and they actually said that the cord was round his neck as well. So, you know' but it was really, really worrying actually 'when his heart rate went, and when she just smacked the button. I can just remember just her hitting it like that (makes hitting motion with her hand) and I just' oh, I couldn't look at my partner. And he couldn't look at me sort of thing, because I knew that we'd both end like in tears or something, and it was just' it was surreal because'obviously you go through this pregnancy and it's all okay and everything's fine, and then it's like you get upset because you're overdue and everything, and then all of a sudden the thought of something happening right at the end is' it's ' that was horrible, that was the worst feeling ever, but' yeah, that was, that's it really [laughs].

She experienced bleeding for six weeks after the birth. Sex was the last thing on her mind.

And did you have any problems either going to the loo or resuming your sex life afterwards at all?

No, no. I mean, I did kind of panic a little bit obviously because of it healing and everything, I sort of thought, 'Be gentle with me'. But I mean obviously the last thing on your mind is sex [laughs] once you've had a baby, but obviously you've got all the heavy bleeding and everything afterwards and mine sort of lasted about sort of six' it was about six weeks-ish. So obviously that was another no-no really. But, I mean, that's the funniest thing when you go to the doctors and they ask you what sort of contraception you're on, and you're thinking, "Well I don't want him anyway near me', keep him away!" [laughs].

She made a detailed birth plan for her VBAC and felt more confident to express her wishes knowing...

And have you made a birth plan with this pregnancy?

Yes.

You were just saying then about the midwife coming to talk to you?

Yeah.

And what have you said in this birth plan?

Well, to be honest, first of all I was thinking, 'What do I put?' I'm going to have a baby, it's like, 'Okay' mmm.' But I mean you can really go in depth. I mean, if you want music and if you want different oils and all sorts of things like that, because I'm actually having reflexology as well.

Oh, lovely.

So [hesitation], it's like that sort of side of it, did I want those in there, but the thing is because I've, I've had my son, I kind of know about the pains in my back and everything like that. To be honest, if I'm really in the throes of labour, I'm probably not going to want anyone to touch my feet so, you know...? But that option is there if I want it, so obviously I've sort of written about that. And, like I said, because of knowing that I've got labour pains in my back, I kind of have said, "Well if there's a chair I'd like to sort of maybe put my arms over the back of it then my partner can rub my back and'" I think it's because obviously I've sort of been there and done that, I kind of know what to expect and, like I said, I've got more confidence to say, "Well yes, I would like that and I would like room to move and I would like this and that...", you know? 

In her experience, midwives will often gloss over the risks to reassure women.

I mean, I think to some extent you, you have to be blunt, to say look, this is what could happen, because if you sugar coat too much, do you know what I mean, and then when someone- something actually happens to someone, you know, they're kind of shocked then. It's like, 'Whoa, I didn't realise it was going to be like this and ahh'", you know? 

I think in some ways you do need to be blunt and sort of say this is this and that's that.

I think with midwives, they can sometimes skirt round things a little bit, whereas obviously the program, if you wanted to know about a certain thing, it would give it to you, you know, in plain English. It's like, 'Yes, this is this, that is that, boom, boom', whereas like I said, I think sometimes- I don't think they mean to but I think sometimes they can skirt round it a bit and say, 'Oh, well that's nothing to worry about', or 'Well, no, no', or you know, so, but if you really do want to know about certain things then yeah, I think that's quite a good thing to, to click on and have a look at, I think.

She thinks midwives don't encourage discussion about complications because they don't want to...

Well, I mean' I'd probably say my doctor doesn't, hasn't really given me any information as such, and the midwife I think she only tends to give you the information if you ask more, because I don't know whether they sort of want to panic you so much' if that's the right way' of putting it. But I mean, with the study, like I said, it'll say, 'This is what can happen, these are the risks', so you've got them there in black and white. If you choose to read them, you know, that's up to you, if you don't then' but they're there if you, you know, you've got a query or something, but yeah, I'd say like with the midwife it's more if you've got the concern you bring it up to her and she would sort of let you know rather than, you know, 'Well you can have this problem, you can have that problem', so' yeah.

She thinks TV programmes will often give you a more personal perspective but might not be as...

I mean, in view of the fact that you'd looked at books and you'd been on the internet and tele, is there anything that was different about the information that you got from there at all? 

[Hesitation] Well no, I don't suppose so but, I mean, obviously if you're watching it on the tele you've basically got a woman that's going through birth and it's like her experience and that sort of thing. Whereas obviously with the information on the computer and that it was' It was basically this is this and this is what happens and that's what could happen. Whereas obviously, like I said with the TV, it was her experience, so I think in that regard if you've' I don't know, I suppose in some ways it's a bit easier if' you're just, you know, you're just told well this could happen, that could happen. But, I mean, you know, like with the woman on the TV it's more like this is what's happening to her so obviously they focus on that, but obviously if that's not, if that's not what you're after information wise then obviously it's just, you know '

Having had a vaginal birth has made her look at pain differently. But the sense of achievement...

How do you feel about the way that you delivered this time?

Oh yeah' To be totally honest, I'm glad that I had a natural birth because, like I said before you, your body is built' to give birth naturally like that, so I think. I mean, it's almost like I've really achieved something. I know I sound a bit sad, but, yeah, I, I feel, I'm quite proud of myself in a way because, because I had no pain relief as well, well, technically' yeah, it does give me a sense of achievement. And I think having a natural birth made me look at pain in a different way as well [laughs] I can't moan, you know, you stub your toe and you think, 'Oh, that hurts' and it's like that's nothing! [laughing] I mean, I must admit as soon as I had her I did turn round to my partner and say, 'That's it, no more', and within five, ten minutes I'm like, 'Well, maybe' [laughs].

I'll come on to that later, but you said something really interesting in there about the sense of achievement. And did it make you think differently about the fact that you hadn't had a natural delivery the first time?

Yeah, yeah, it did.

Could you say how? 

Well, I mean, obviously, I was all' with having my son first, and then being told to have a caesarean, yes, I was disappointed because I didn't get the experience of, you know, the natural birth, as it were. It wasn't to say that, you know, I'm not as close to my son as my daughter or anything like that, but I don't know, it's almost like I was cheated out of something. I mean, obviously I know that the caesarean was the best option that was, you know, for him, which is fine and I wouldn't change it because of that, but if I could have had a natural with him, I think I would have felt better' in a way. But you know, obviously that, that was by and by but, yeah, I don't know' even though how painful it was it's 'you do get this sense of achievement because you've done it and, you know. I mean, I can remember my mother-in-law talking to me last time and saying, 'Oh, well done', and it was like, I felt like, well, I did actually turn round and I said, 'Well, I didn't really do anything, I got cut open and he got pulled out', you know? It's like at least this time I could actually, if someone says, 'Well done', it's like 'Yes! I did do it', you know [laugh].

She thinks women should be able to have full choice, but they need good quality information to...

Well, I mean, obviously at the end of the day it is down to the individual. But, I mean, me personally, I think if you've got all the information available to you, it's up to you what you decide, but obviously if you're only given a certain amount of information you can't really make an informed decision, I feel.

She thinks that women should have a choice over how they give birth, but that women who are 'too...

Do you think it's realistic for us to encourage women to have a choice?

Yes' This is probably going to make me sound really old-fashioned, but I mean, all these women... like celebrities... who are too posh to push, I think they are missing out really. I mean, obviously if they are told... if you are told, 'It's better if you do have a caesarean than have a natural birth', then by all means, fine, that's the way to go. But if you're just choosing it for vanity then I don't really agree with that.

Unless the chances are stacked against them, she would advise women to attempt VBAC, because it...

I'd probably say if you've had a section before and the chances are okay for you to have a natural, I would definitely go for the natural.

Personally, I, you know, I know I keep saying it but it's the sense of achievement afterwards, and you know, you do feel proud that you've done it, it's like, 'Yes, I have done it, like I can do it' You know, there's no shame in actually having' I'm not saying you have to have it all with no pain relief or anything like that, but I think it's the sense of, you know, the fact that they've actually come out the way that God intended, you know. I think it does, you know, it does sort of, you know, it does sort of make you feel proud and everything, you know.

She thinks it's important to be confronted with the facts, even if they can be scary.

I mean, I think to some extent you, you have to be blunt, to say look, this is what could happen, because if you sugar coat too much, do you know what I mean, and then when someone- something actually happens to someone, you know, they're kind of shocked then. It's like, 'Whoa, I didn't realise it was going to be like this and ahh'", you know? I think in some ways you do need to be blunt and sort of say this is this and that's that.

I think with midwives, they can sometimes skirt round things a little bit, whereas obviously the program, if you wanted to know about a certain thing, it would give it to you, you know, in plain English. It's like, 'Yes, this is this, that is that, boom, boom', whereas like I said, I think sometimes- I don't think they mean to but I think sometimes they can skirt round it a bit and say, 'Oh, well that's nothing to worry about', or 'Well, no, no', or you know, so, but if you really do want to know about certain things then yeah, I think that's quite a good thing to, to click on and have a look at, I think.