Pregnancy
Looking back- vaginal birth
Most of the women we interviewed had a vaginal birth, although levels of pain relief and interventions differed widely. Some went into labour spontaneously and had little intervention. One woman who had an uncomplicated home birth felt very positive about her choices and the support she received.
Having a home birth in familiar surroundings with good support was a very positive and fulfilling...
Having a home birth in familiar surroundings with good support was a very positive and fulfilling...
Now I know that a home birth may not be for everyone, there may be reason, medical, real medical reasons why it's impossible. But, but I think that on reflection the, the number of medical reasons that are given for why people couldn't have home births may be larger than the actual real number of women who wouldn't physically be able to give birth at home. And it's a matter of, of deciding whether or not the reasons you may have been given that home birth is not the right option for you, are they valid reasons or are they not?
Another woman thought about a home birth for her second baby, but her first birth in hospital (with birthing pool) had been so good she did not think the location mattered very much. Again, what mattered was support and freedom to do what she wanted.
She considered a home birth for her second baby but her water birth in hospital had been so good...
She considered a home birth for her second baby but her water birth in hospital had been so good...
And are you thinking about home birth now, or are you still planning a hospital delivery again?
I'm, no, we've, we've decided to use the hospital facilities, because I would very much like to have a water birth again if possible, and just in practical terms having a water pool in the house for maybe up to 4 weeks doesn't really feel very, very realistic. And although the environment where I gave birth was clearly clinical, the actual process in terms of who was there and how it happened was that essentially my husband and I gave birth. I gave birth with his, primarily with his support, and the midwives were in the background. And, and that was absolutely fine. And I suppose I, you know, I just feel given that the facilities, should anything go wrong, are 10 minutes down the road, I'm not sure how I would feel if anything went wrong, I was at home, and the 10 minutes it took to get there made a difference to the outcome of the birth. I don't feel strongly enough about being in my own environment to desire a home birth.
Do they have just the one pool?
They have two, although there was one out of, out of order last time. But they tell me that they're not used very much, so the chances of actually getting there and finding someone else is using it are fairly low. So it seems to be under-utilised.
Some women had more intervention than they had hoped, but still felt positive about the birth, including one who had an induction. She could not relax in a bath as planned because of the drip and monitor, but birth was awe-inspiring and she was oblivious to her surroundings.
Giving birth was an awe-inspiring and emotional moment. She felt privileged to experience it.
Giving birth was an awe-inspiring and emotional moment. She felt privileged to experience it.
Oddly, considering I cried when they put the 2 little embryos inside me, I didn't cry, which seemed really strange. My husband cried, sobbed. I think I was in such a state of shock with my teeth chattering and my body shaking because I think it is an incredible thing for the human body to go through, to push out a human being. And you, you do become aware, it does become obvious why, traditionally, many women could die, could die in childbirth. All I could think of to say was, 'hello.' And it just, I was only aware of the immediate space around me. I think when it comes to the actual birth, though of course, I can only speak, speak from the experience of one birth, whether you're at home or whether you're on a floor or on a bed or, I was only aware of the immediate space around me, just myself, my husband and the baby. I wasn't really aware of anything else; I had no, I was no longer particularly aware of what room I was in or, or anything beyond a sort 2 feet area around me. And it was, without question, the most wonderful experience ever. Within about 24 hours I was, I was saying I would absolutely love to give birth again. It was awesome in the, in the true, genuine sense of the word. It was the closest I have or will ever come to a, a religious experience or spiritual experience. I think it's a privilege to have a natural birth.
A mother who had had a previous caesarean birth was pleased to have a vaginal birth next time, and said she recovered much faster. She needed some help with ventouse to help deliver the baby.
She was pleased to experience a vaginal birth with ventouse at the end. Recovery was much quicker...
She was pleased to experience a vaginal birth with ventouse at the end. Recovery was much quicker...
Had they talked to you about that possibility when you first went to talk to them?
No. No. But I knew what ventouse was. My husband didn't. He was like nodding when the doctor was saying, and then he went, 'What's, what's that then, what's ventouse?' I said, 'It's basically a, the things that plumbers use to unblock sinks on the, you know.' And he thought I was joking until he saw it [laugh].
And what was that experience like? Was that OK for both of you?
Yeah. I was a bit concerned that she might come in, out looking like an alien with a, you know, long head or something, but she wasn't, she wasn't too bad.
So they, that wasn't something that you'd sort of thought about in your birth plan..
No
..whether you were prepared to have any? Had you thought about forceps or anything either or?
No. The midwife said when the doctor was out of the room - because he sort of was coming and going - that at some stage she said, as we were getting towards when I would need some assistance, she said, 'There might be forceps or ventouse. He might consider using one of those, we'll have to see.' So that was the first time that I'd thought about it.
Would you have liked to think about it earlier, or did it not really..?
Not really, actually, probably not, because I'd only worry about it, and then if you, when you have to make a decision when you're presented with the choices then it's sort of easier, really. I was just happy to go with what they suggested, really.
And how do you feel about it now, several weeks on, looking back? Are you pleased that it went the way it did?
Yes. Yeah. I was, I was very happy that I didn't have to have another C-section. I could have done without tearing because I did tear at the end, and the stitches but, you know, a lot of, that happens with a lot of women, doesn't it? So.
Was that explicitly because of the ventouse, or you don't know?
I don't know. No
Did they suggest an episiotomy or anything or...?
He mentioned it and the midwife again said when he was out of the room that it's better in some ways to tear than to have a cut because they heal better, tend, or tend to heal better, so.
Mm. Ok, so you went to, I guess you couldn't feel the tear happening with the epidural?
No, not at the time. Felt it afterwards [laugh].
Yes. Not a nice experience. So, kind of, what were your emotions at the birth? Did it feel different to last time?
Yes. Yes. It was, the nice thing about it was I saw the baby straight away and they put her on my tummy, so that was, you know, nice. That was, that was lovely. Because with the caesarean they sort of, there was a screen across, so I couldn't see what was going on during the operation. And then when she was born they took her and did the checks. So I didn't see any of that until they brought her round to my head, so in that respect it was a lot nicer. I saw her straight away and..<
Another mother had a forceps birth after a long and exhausting labour. She was surprised that she was not very assertive and let staff make decisions for her, but she had worked on the ward as a doctor and trusted them. She had asked for a 'stretch and sweep' to start labour when she was only five days overdue, and wondered afterwards whether it might have been better to let labour start naturally. (In a stretch and sweep, the midwife or doctor places a finger just inside the cervix during a vaginal examination and makes a circular, sweeping movement to separate the membranes from the cervix).
Women's views about their birth were of course partly related to the length of the labour and how painful they found it. But their feelings were also affected by how supportive the staff were and whether they felt informed and involved in decision-making. This in turn affected how confident they were that the right choices were made. One mother was disappointed to have an induction and forceps, but it helped that the anaesthetist and obstetrician saw her next day and explained why it was necessary.
She was disappointed to have an induction and forceps birth, but it helped that staff explained...
She was disappointed to have an induction and forceps birth, but it helped that staff explained...
Was it quite important to you that people bothered to come round the next day and explain things to you?
Yes, I was very impressed and reassured when people came round and talked to me afterwards. Because it makes you feel that you're less on a conveyor belt, otherwise you're just in, you have a delivery and then you're out. You don't necessarily meet the people who were involved in the actual delivery in the aftercare so both can be very good but they're not really connected necessarily. But I was impressed that the people who were involved in the delivery did sort of do the follow-up the next day, and that was very nice.
Did it help you feel okay about the fact that your birth hadn't gone to plan because they had bothered to speak to you?
Yes, absolutely, it was very helpful that people followed it up and explained it. Especially as afterwards you're in a much better position to be able to talk to the person and to be able to think about it. Actually I'm sure that if people tried to explain these procedure whilst you were actually in the throes of giving birth you wouldn't actually be able to hear, you wouldn't be interested in listening. You just want it to be over with, you just want them to get on with it. So having these sort of detailed discussions about why we're doing this at that time is probably not the most appropriate. And it's only afterwards when you can actually sit down and talk to them that that's probably the most appropriate time to discuss it anyway.
Another mother having an induction described how her experience was transformed once she was given continuous support by midwives and taken off gas and air, to which she reacted badly.
The experience of labour improved once she was given continuous support by midwives and taken off gas and air, to which she reacted badly.
The experience of labour improved once she was given continuous support by midwives and taken off gas and air, to which she reacted badly.
And then about twenty past three in the morning I was really not managing with the pain any more so then I asked if, give me a bath to see if that would help, which it wasn't helping at all. So then I said, 'Look, I need to go downstairs for something stronger'. So they took me downstairs and I was in the delivery room. This is like nothing like what you expect your labour's going to be, because then you're basically strapped up, I was strapped up to the fetal heart monitor so I couldn't move. I think there were people coming in to check on me because they gave me a form to, to sign for consenting to a C-section if necessary. But, no, there wasn't anybody like with me, because I managed to just get completely out of it on gas and air, I mean really horribly out of it, like I did not know what was going on. It was horrible, I kept having flashbacks to it afterwards actually for about a month. And then I, there were people coming in to check on me but there was nobody with me constantly because it wasn't until the day shift staff came on and - by which point my husband arrived as well.
Where was your husband?
He was, he'd gone home because he, he couldn't stay overnight with me because I was still on the ward at this, until 3 o'clock in the morning. So he'd gone home about 8 o'clock because by that point I was only about 1 or 2 centimetres dilated and they'd said, 'Oh, nothing's really happening' and he'd gone home. But until, they, they didn't phone him until about half past four in the morning, so by the time he got there it was about half past five. I honestly don't know, because I can't remember. I didn't become conscious of what was going on about, for several hours. And then I honestly can't remember because I was so out of it on gas and air. He, I don't know if he was there before the day shift came on or whether, when the day shift came on. But the first thing the midwife on the day shift did was take the gas and air off me, which was great because then I knew what was going on. And she stayed and there was a student there by then, and then there was my husband there, and then the midwife that I knew came in.
So from having had nobody for several hours I then had two midwives, a student and my husband, which was, just transformed the experience. It was brilliant from then. I mean I, I know you don't normally think of labour in those terms but I knew what was going on, I was being told at, when my contractions were and what I should do with them. And it was just much better because - this sounds really silly - but because I had pelvic pain and back pain I honestly couldn't distinguish my contractions, and also they were coming very, very fast. So all of the stuff that I got told in my antenatal classes about breathing, well, apart from the fact that I had had too much gas, gas and air so I couldn't do anything anyway, it just didn't bear any resemblance to my experience at all.
Another felt unsupported by one midwife, but things improved when a different midwife took over. During a long labour, there may be several changes of midwife, and the lack of continuity upset one mother.
Being on a drip and monitor made her less mobile in labour than she wanted, but a new midwife...
Being on a drip and monitor made her less mobile in labour than she wanted, but a new midwife...
Yes, we did make a birth plan and we sort of opted to go for the minimum intervention possible, but obviously acknowledging that that might change on the, on the day. But that, yes, we were just basically sort of saying we didn't want to have any more drugs and things than we, than we needed to.
And what actually happened on the day?
[laugh] Well, it wasn't, it wasn't too divergent. I did manage on a TENS machine and gas and air in terms of pain relief, which was what I was hoping to do.
But we did, because the labour got off to a good start and then slowed right down, they wanted me to have a, an artificial hormone drip to speed up the contractions. And we did go for that because it, otherwise it was, it seemed to be starting to be a slight problem for the, for the baby because it was taking too long. And in terms of the position that I had wanted, I had wanted to be quite free and able to move around, and that actually proved to be more of a problem because as the labour got progressively longer the midwife was very keen to have me wired up to all sorts of machinery. And she was far more interested in making sure that the machinery was, you know, the monitors and things were all wired up and that I wasn't, you know, interfering with the wiring, than helping me get into a good position. So that was, that was, wasn't really what we'd intended in the birth plan.
Did you challenge her at all?
We tried to, and my husband in particular because he was obviously less involved in actually [laugh] trying to give birth. But it was quite hard to challenge her and that was, that was, I think that was difficult, given that we'd been quite keen to sort of have, have a bit more control over the whole process. She kept sort of saying, almost sort of saying, 'Well, you know, it's your baby's health that's at risk'. And I think in retrospect that, that was a little bit over the top, it wasn't really that much of an issue. And when we had a different midwife for the final stage because the shifts changed she had a quite different approach, and I think if we'd had someone like that a bit earlier the whole thing might have gone quicker because I would have been in a better position. And also she wasn't particularly helpful at explaining what I needed to be doing at different points. And as soon as we got the new midwife then it was, it was a lot easier all round. So it was just a shame I think that we had that particular person who didn't seem as helpful as other midwives that we came across.
If you were to have a second pregnancy and you found yourself in a similar situation, what, how would you handle it then?
Well, I suppose I'd try to be a bit more forceful, but obviously it's difficult because you do to some extent have to trust their professional judgment, and if they are saying that there's a risk to the child then you do to some extent have to obviously pay heed to that. But I think they also, you know, it's a shame if they don't recognise that it's, the importance of a woman being able to choose her own position and to do what feels right and what feels natural. And hopefully that message is getting across to midwives more and more anyway. I think a lot of the midwives seem to be quite, quite switched on to that.
The midwives changed shift several times during her labour. She would have liked more continuous...
The midwives changed shift several times during her labour. She would have liked more continuous...
One mother had a very distressing induction when she went past her due date, which she had tried to resist. Her husband was not allowed to stay with her overnight, and she felt disempowered and unsupported. Although it was a vaginal birth, she felt it was 'just as artificial as a caesarean birth'. The baby needed resuscitating for five minutes, which she felt was partly because the midwife cut his umbilical cord immediately. (This is usual practice if an injection has been given to help deliver the placenta, but she had not been told this). She contrasted it with her second, spontaneous labour with a doula (independent birth companion).
Her husband was not allowed to stay with her overnight after labour was induced - she felt...
Her husband was not allowed to stay with her overnight after labour was induced - she felt...
Anyway, I realised I wasn't going to get any sympathy from her. I asked her to call my husband. 'No, it's not really proper labour yet. We'll leave him to sleep. You can't call your husband now.' And at this point I didn't want to take whatever it was she was giving me. I felt imprisoned, and I literally was. I couldn't have walked out without getting past them. I hobbled along with my pubis symphysis pain, couldn't get anywhere very fast at all. So I couldn't leg it, which is what I wanted to do, and phone him. And I was literally imprisoned, with no help whatsoever. And they wouldn't even let me call my husband to talk to him on the phone, or anybody, for that matter.
So they'd, they'd given me a TENS machine when my contractions had started but she didn't really show me, she fitted it on me and then just sort of - obviously I was getting in the way of their chat or their magazine reading or their television watching or whatever - very sort of cursory, 'This is what you do, OK, bye.' You know, no comfort, no 'let me stay with you for five minutes', nothing.
Nobody else was on, in the ward. I was absolutely scared. I was scared of the whole labour process, I wasn't very positive about, about having labour. I was very, I thought the whole thing was very daunting, and it would just be excruciating pain and I, that just had to be something I went through in order to have children, but I wasn't very positive about it begin with. And then obviously this whole escapade and this whole psychological bullying and complete lack of support wasn't helping. I think if, even if I'd been positive to begin with, I now would've been completely negative. Which, I mean, all the an-, all the evidence, you know, says, you know, that this is really, really important, that pain is a psychological experience thing as well as a physiological thing. And that if one is given support and information and emotional support and guidance, and, and somebody's physically there with you, then that really helps. And it just stands to reason that it does, you know. Just for general life experience, if somebody is rubbing your back and saying, 'There, there,' then it makes it feel better than if you'
With her second baby she employed a doula. She went into labour spontaneously 15 days after her...
With her second baby she employed a doula. She went into labour spontaneously 15 days after her...
And did your doula come to the house or..?
She didn't, because she was coming from the opposite direction so she met me at the hospital. She was actually quite concerned I was going to make it in time, because it all kicked off quite quickly. And it, it, just the whole process made me, I was, it was actually very therapeutic for me to have my second child so quickly, in a way, because it confirmed what I had thought all along. My gut feeling and what I had really sort of known, that my body is actually very healthy at pregnancy and childbirth and knows exactly what it's doing, and can do it perfectly well with manageable pain - obviously with bits, you know, of help from a TENS machine and stuff - and my child can breathe perfectly fine, thanks very much, when you don't cut the umbilical cord, you know, literally sort of abortively, almost. And, and you just leave nature to its own devices and my body's fine. Now I know some people's bodies aren't very well suited to childbirth, and you need to have that intervention. You need to help, or else naturally speaking some women would, if we were completely left to our own devices, die in childbirth. But, you know, one should be left, you know, nature should not be interfered with unless there's a problem with it. And the whole process with the second baby was, was great.
Some people reacted badly to some of the drugs used for induction. One mother had an induction because she had pre-eclampsia. The pessaries made her very sick, but once she had an oxytocin drip and an epidural the labour went very smoothly.
The pessaries for inducing labour made her very sick, but once she had an oxytocin drip and an...
The pessaries for inducing labour made her very sick, but once she had an oxytocin drip and an...
Presumably when they're inducing early like that it's different to when they're inducing for overdueness, because the chances are that you're pretty much ready to go.
I had - the, the way they did it was exactly the same. The only difference was that normally they put in the pessaries the night before. But mine didn't start until eight in the morning, so they didn't want to risk it happening at, at night, so I sort of went down with the shift change in midwives. So I'm sure it was all partly to do with that as well. They want you to try and have a midwife for as long as possible, and you know, I went down at eight o'clock and we started, and nothing happened, apart from I threw my guts up and spent the whole morning on the loo. But no movement at all.
That was as a result of the induction drugs?
Yeah, drugs. So I had a terrible reaction to them, and I literally, there was nothing left inside. I was either, had thrown it up or you know, been on the loo the whole time. So, and I was having sort of semi contractions, but my cervix hadn't opened at all. And so they tried breaking my waters, which was excruciating, when there was no, you know, nothing there to really - they put in a great big needle [a plastic hook, called an 'amnihook'] and there was nothing there to open, to let the, you know, the needle couldn't get in. And it was excruciating, and so they put me up on a drip to try and - which was the sort of next stage. I wish I could remember all the drugs, but I can't.
Syntocinon [oxytocin]?
Yeah, that's right. Syntocin drip, and, but also put the epidural in at the same time, so that they could start to try breaking my waters quite early. And then once the epidural had gone in, it was quite a pleasurable afternoon. We, things were moving; the baby was being monitored. It had a, when there was room to get it in, it had a clamp on its head, to check it was all all right.
And, and things started moving really quite well. She went off to have tea, and, you know, said, "I don't think it's going to happen in my shift. You know, we'll have to get the next midwife in and introduce you to her", and what have you, and then I suddenly said to my husband, "Something's happening." And it had, it was about eight centimetres, my cervix, when she'd gone off, and then suddenly it all happened and twenty minutes later she popped out.
Amanda has diaomorphine and an epidural and says “it wasn’t the easiest of labours”
Amanda has diaomorphine and an epidural and says “it wasn’t the easiest of labours”
And Tuesday, they put me on diamorphine. And then I started getting all funny and a bit like a zombie “ooh”. And then one of the doctors actually came and checked me and I was 1 centimetre dilated. So what they then decided after they gave me some more diamorphine was to put me straight into labour, cos I was in so much pain, to go straight into labour. I did want a water birth, but that wasn’t obviously able to happen. So I had to have an epidural in my back [baby crying]. And so they gave me some epidural and I was getting really, I was getting really weird. Cos I said, “Bob the Builder. Can you fix it.”[Laugh]. And everybody else laughed apart from the anaesthetist. So I was in labour from 2 o’clock on the Tuesday 23rd of September and I gave birth to [Ruby] on the 24th of September. She weighed 7 pound. So she was very small. And it wasn’t easy of, easiest labours. And because I hadn’t eaten or really drank anything, I was dehydrated quite a lot. So they had to keep putting epidural in me, [baby crying] every, every couple of hours. And then they gave me some salt water. She came into the world and she was a beautiful little baby.
But, yeah, but for [Mitchell], he, he saw this beautiful little creature coming out. And it was just so amazing. And one of the things that they did do was they actually gave her straight to me, after he cut the cord they gave her straight to me. Put me, put her on there so she could smell you and everything. Cos you’re meant to cuddle the baby or something. One of the things we got told in one of the sessions was you’re not allowed to video the baby. We didn’t obviously. But we took pictures. And [Mitchell] took a picture of [Ruby] with gram-, his mum 7 minutes after she came out of me. And she was just such a beautiful, amazing little creature. And we were, [Mitchell] was actually crying his eyes out. And he, and if you ask him what, what the cord felt like, he will tell you it felt, it felt like, he thought it was like, was like elasticated or whatever. And I said to the midwife, “He’s cutting it. He’s got no choice.” [Laugh]. So obviously I don’t remember what I was saying, but obviously he does. So there are things that I still don’t remember [laugh].
(See also 'Looking back - caesarean birth' and 'Thinking about where and how to give birth').
For more information see our pregnancy resources.
Last reviewed May 2017.
Last updated May 2017.
Copyright © 2024 University of Oxford. All rights reserved.