I don’t mean that the four we now have were an accident, or unwanted, or even unplanned, but somewhere along the line something changed and I went from thinking that children were a nice idea, but not my own, to thinking that at this time, with this man, I could begin to think about dealing with the issues I had around birth.
It was never that I didn’t want children – I did; even as a child who could not envisage wanting to get married or give birth I planned to be a teacher but also to adopt, foster or generally look after as many little scraps of humanity as I could. My great aunt, a single woman who took in lodgers, took on a Barnardo’s boy, looked after nieces and nephews and was generally everybody’s favourite auntie, was my heroine and I planned to do much the same. My role as class agony aunt had put me right off boys so having my own children didn’t seem likely to be an issue. And then I met Bob.
This post is meant to be about health in pregnancy, as part of a blog hop to launch Tommy’s new 5 point pregnancy plan by encouraging us to think about our first pregnancy and what we learned from it about planning and having a healthy pregnancy. I guess that means it’s time for me to talk about my first pregnancy – the one that I had always insisted would never happen.
I was very lucky, I think, to find somebody who said he would support me in whatever choices I made. If I remained adamant that I didn’t want to have children then that was fine – we could adopt, foster or just make the most of ourselves as a couple without children at all. If my feelings changed then having our own children was fine too, and somehow, gradually and I think partly as a result of that unquestioning support, things did change until eventually I was quite desperate to have a child with this man, who was by then my husband. Of course, life being the way it is, having made that decision nothing happened and I spent several years working as a teacher but wishing, hoping, dreaming of having a child to stay at home with instead. I was still too uncertain about the whole thing ever to voice the longing but it persisted, overriding my fears, and eventually there was a line on a stick and….
all of a sudden it was real – and overwhelmingly scary.
My mother had died in childbirth, and I had never quite known why – only the explanation given to me by an older child at the time (I was 5; I don’t even remember who she was, only that she was telling me things grown-ups wouldn’t) that the baby had been cut out of my mummy’s tummy and had taken too much blood. I guess at that point she hadn’t yet died or presumably that would have been part of the story too; I found out later that she had held on for a while, although without regaining consciousness and received 16 pints of blood before the doctors gave up and stopped trying to pump in fresh supplies of what was pumping out so rapidly. My father never spoke about her and I didn’t dare to ask him. My paternal grandparents came out and took me and my new baby sister back to England with them, but they hadn’t been there so didn’t know much either and actually they probably wouldn’t have felt it right to say anything even if they had known the whole story. My mother’s family, although they might have talked about it, again knew very little. The whole thing was just a mystery to me and left me feeling that having children was somehow a very negative thing, unsafe and in any case unnecessary, given how many children in the world were unwanted and uncared-for. I got on with living a kind of adult childhood, taking very seriously the words of those who had told me, helpfully, that it was my job to look after my father and my little baby sister now (please, please don’t ever say those words to a newly bereaved child!) and concentrated on becoming a little mother to everyone, thinking as little as possible about my own mother because that made me cry and then people would stare…
Now I was pregnant I had to think about her. Everywhere, it seemed, I came across articles and advice suggesting that my pregnancy and labour were likely to echo my mothers’. Even at my booking-in appointment I was asked about family history and had to explain. Other women I met at ante-natal groups talked about their mothers and how much help they would or wouldn’t be before, at or after the birth while I sat there thinking how unfair it was that my mother wouldn’t have the chance to be helpful or not helpful at all.
My response to all the turmoil this caused was to seek knowledge. My aunt gave me the letter my father had written from the hospital just after my mother’s death, which tore my heart in two, his grief was so raw in it. From that letter I found that she had had a C-section on medical advice because of previous blood losses (when having my brother and then me) and that she had had multiple and massive transfusions but had not regained consciousness at all. It gave me enough to start to talk to health professionals about what might have happened. I needed to do this for my own mental health, because otherwise I wasn’t sure I could go through with this pregnancy but equally my own convictions meant that there was no way I could have a termination.
I was immensely fortunate in finding myself registered at a surgery with domino midwives, who prided themselves on being “the natural midwives” and encouraged me to find out as much as I could about how to have as natural a labour and birth as possible. I have a great need to stay in control of my body (I don’t drink as part of this) and that coupled with my mother’s death as a result of a C-section meant that I was petrified at the thought of giving birth any way other than naturally. The midwives were determined to help me to make that happen. Again, I decided that knowledge was my friend. I already had a healthy diet (vegetarian but balanced, so my iron count was good enough to surprise those who had been convinced I would need supplements as a matter of course) and was of a healthy weight. I reminded myself that I wasn’t eating for two but in fact for something more like one and a twelfth and made sure there were carrot sticks and similar healthy snacks available all the time. Actually, Bob did most of this, because the biggest physical problem I had was tiredness. I would get home from work and fall asleep on the settee, books for marking spread around me, and be woken by my lovely husband with food and drink then tucked into bed. Morning sickness was met with a cup of tea and cream crackers or ginger biscuits in bed the instant I woke up – plain carbohydrate in small but regular doses seemed to be the best answer for keeping nausea at bay.
The midwives ran an Aquanatal class at the local swimming pool, which was great both for the exercise and for the chance to meet the whole team – and fortunately for me fell on a day when I could get away from school for long enough to attend most weeks. Then there was an antenatal yoga class, which fitted in perfectly with all my dreams of natural childbirth – and taught me to drink fruit tea, which I had never been able to stomach until then. We squatted and stretched and shared ideas and even after the few sessions I could afford (it was cripplingly expensive) had finished I still maintained the exercises. I went to a chiropractor about my back, which had been dodgy since a childhood car accident, followed by a fall in my teens, and was delighted to find that he could fix it for me. In fact, I suspect that the time I was expecting my first child I was probably the fittest and healthiest I have ever been, physically.
Mentally, however, it was a different story. I was doing all I could to be healthy and to prepare for a safe delivery of a healthy baby, but there were so many things I just didn’t know and they ate away at my peace of mind. I had to know more. We had signed up for NCT classes on the advice of friends and finally the time came for us to go along to those. At first it was hard because once again we had the discussions about mothers and their influence, once again I found myself having to explain the reality of being (about to be) a motherless mother, once again I cried and tried not to cry. The tutor was excellent, though, and set aside time to have chats with each of us about our fears and concerns. She was training to be a midwife and so had access to more information than I had alone. I showed her my precious letter and together we tried to piece together what had happened. She said (and a doctor I spoke to later confirmed it) that she felt my mother had been poorly advised, that PPH, which appears to be what had happened in the first two births, is not generally considered to be best dealt with by C-section, that there were drugs now to deal with it if it happened. We talked about positions for birth and about the third stage of labour and how it could be managed (or not) to make risks as low as possible. I came out of those sessions feeling so much more empowered than I went into them that I felt this baby thing might actually work out okay!
I did optimal foetal positioning – scrubbed and polished the wooden floor in the hall until it was almost dangerously shiny and slippery just so I could get on my hands and knees and be “upright, forward and open”. I took prenatal vitamins and ate healthy foods, practised my yoga exercises and swam, squatted to get strong enough for upright birth positions and generally felt as much in control and connected with my baby as I could. Perineal massage (ouch!) was supposed to help prevent tears, Bob learned aromatherapy and massage for labour, we got a birthball and left it partially inflated so it would fit in the Mini but still be quick to blow up at the hospital. Bob compiled an album of music he thought I’d find helpful and I washed nappies, packed my hospital bag and practised using a sling. We felt just about ready – although I remember saying to Bob after we’d been visiting friends with their newborn that I’d love to offer to look after it for them for a few hours so they could rest, but wouldn’t know how – and then realising with a jolt just how soon we would have a newborn ourselves and would have to work it out!
Around 38 weeks I had a massive attack of doubt again. I had started maternity leave so I guess I had more time to think about things. I wasn’t sleeping, despite hot milk and warm baths. I had to wake Bob up to get him to help me turn over at night. Most of the other babies from our NHS and NCT classes were due before ours and the (grand)mothers seemed to be all rallying round to support their daughters, leaving me feeling conspicuously unsupported. I worked through everything I knew, planned and replanned, wrote out my wishes and expectations and tried very hard to keep things as open as I could so that I wouldn’t be disappointed if it went wrong. I would have liked a home birth, having lost my mum in hospital, but this was the one thing Bob put his foot down over – if anything went wrong he wanted to know we were where we could get medical attention as quickly as possible – so I made sure I knew exactly what was likely to happen (domino midwife system a saviour here – I knew one of “my” team would be around and that knowledge made a huge difference to me) and that I had written down everything anybody might need to know in any conceivable scenario. It passed and by due date I was feeling calmer again and managed to stay that way despite a letter from midwifery services saying that due to cuts and short-staffing the domino team would no longer be available all the time (just made a mental note to keep my legs crossed if baby started to arrive at the wrong time) for the few more days until my number one son decided to put in an appearance.
As it turned out, the labour was about as good as it could have been. I didn’t go into hospital after all, because things progressed very quickly, with the timing just about perfect to catch my midwife just as she came on duty (having been told by hospital when we phoned there that it couldn’t possibly be real labour if it was that fast and we should wait) and have her come out to us – only to ask if we had considered having the baby at home, because otherwise we’d have to go in on a blue light and probably still have it in the ambulance, which was always very annoying because you had to call the baby after the ambulance driver…
That house had a lovely big bathroom, so we went there and Bob sat on the loo and supported me in a lovely open squatting position while the midwife made me laugh and chat and work all at once until… there he was!
I’ve had three more since then, but this first pregnancy and labour is the one I remember most fondly. It was such a luxury, although I didn’t know it at the time, to be able to savour my baby, my moments in communion with that little being, that scrap of humanity, inside me. I am so glad that I sought out the knowledge I did – and so grateful for the help I received in doing that – because for me that knowledge was empowerment. Knowing just what might happen and just what I could do about it if it did, as well as knowing at what point I was prepared to hand everything over to medical staff (and having primed Bob to ask the right questions if I couldn’t) made it so much easier for me to birth the baby I had intended never to have. As things turned out it was in many ways an easy and straightforward labour and birth – except for the fact that he came too quickly for me to have got to the hospital, I tore and had to be stitched (by bike light, because there was no torch around) and PPH meant the natural third stage I had optimistically planned was not to be. I do sometimes wonder, if I had made it to the hospital, if I hadn’t had the knowledge I had and made the plans I had made, would it have been so straightforward? Being prepared gives power, knowledge gives power and if there’s one thing a woman in labour needs, and one thing which is frequently taken away from her, it’s power. Researching my options, looking after my health so that I kept those options open, exercising regularly so that I would be able to give birth the way I wanted, or recover more quickly from a more intervention-heavy birth – all of those things not only kept me healthy and lowered the risks of things going wrong anyway but also kept me sane at a time when I was struggling to deal with some big issues. My father, by the way, barely spoke to me from the time he found out I was pregnant until the baby was born; I guess he was wrestling with issues too.
All three of my subsequent babies were planned home births and all went smoothly, apart from the second who arrived two weeks early, when I was in full denial and panic mode, having the same doubts as at 38 weeks last time around, and then came very fast, while a midwife I had greeted with relief stood by and watched. Presumably she thought I had done it before and wouldn’t want any interference when actually all I wanted was the chat and fun and reassurance of the midwife at that first birth. As a result many of my fears returned and baby number three would not have happened at all had it not been for the really rather excellent Birth Afterthoughts service which helped me to plan and get in control again. Babies three and four were both born in water, with a clear plan and a list of what I did and didn’t want to happen and if not quite the healing process I needed were at least happy enough events not to haunt me as birth number two still does, just a little, usually in the wee small hours.
The biggest difference, I think, between my first pregnancy and my second was how much time and effort I was able to put into preparation. For baby number one I was (had to be!) ultra prepared, whereas pregnancy number two found me splitting time between work, toddler and bump, with bump getting the least share as I planned to catch up once maternity leave had started. Then he came early, before I was ready at all, and an apparently straightforward birth left me traumatised emotionally and wrung out physically. I was careful not to make that mistake again, but put aside some “bump and me” time for the others, made an effort to get to antenatal exercise classes, dug out the yoga stuff – and hired a birth pool, which made a huge difference!