Last Wednesday I was lucky enough to attend a TalkAbout session at my local midwife led unit. A TalkAbout is an opportunity to go through your hospital casenotes from your birth and discuss what happened to you; particularly useful for filling in the gaps or if it was in anyway traumatic.
I arrived and was greeted by Nikki, a TalkAbout midwife who had read through my file and had everything ready for us to go through.
Since having Florence, I've thought about my birth experience a lot, probably at least once a day. I'd written down a number of questions in preparation, hoping that this session would bring me some sense of closure.
Before the birth
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| 7 month bump |
At around 18 weeks, at our second scan it was discovered I had a low lying placenta. A low lying placenta is where the placenta is positioned in the lower part of the womb and can be covering the cervix, preventing a natural delivery. I was reassured this was relatively common at this stage and "11 out of 12 will move in time for you to give birth". At this point, I felt completely reassured and confident that I could still have the birth I so hoped for.
Skip to 32 weeks after a number of other scans and it was confirmed my placenta hadn't yet moved and my notes now showed I did indeed have placenta praevia. Unfortunately there is nothing that can be done to resolve this. I was booked in for fortnightly scans and it was a case of waiting and watching this space to see if it would move in time for a natural birth.
At 35+1 weeks, I woke up in the night to feel what I thought my water breaking but to discover there was blood everywhere. As we had been instructed, Lee called an ambulance; if I were to go into labour, a rupture of the placenta could cut off supply to the baby. It was so worrying but thankfully after a couple of nights in hospital, plenty of tests and steroids to develop baby's lungs in case it happened again, I was discharged to come home and rest.
During my time in hospital it was decided I should be booked in for a planned c-section as I was getting close to term and things hadn't changed at my last scan. The date was set for 15th November and I had a couple of weeks to get my head around it and finally realise I was the 1 of the 11 whose placenta wouldn't move!
Leading up to the date, I felt like a ticking time bomb, constantly worrying about having another bleed...and on 10th November, that I did.
The birth
After waking up again in the night to once again find I'd had a bleed, I called ahead to the Maternity Unit who advised I should come in via ambulance should labour start to happen- another ambulance, ooh what were the neighbours thinking?! This time, I started to feel tightenings but they weren't painful and I had a lovely chat with the paramedic on the way to the hospital ready to go through the same process as last time.
And so begin my notes from the TalkAbout session (in italic)
2.20am arrival and attached to the monitor
3.55am saw Registrar and category 2 emergency c-section confirmed. Consultant informed. 2 x units of blood ordered
After being hooked up to the monitor for about an hour and a half, it was pretty clear that I had started to get contractions and after an internal examination it was confirmed I was 1cm dilated. The Registrar advised he wanted to go ahead with a c-section. I asked him when? His response- now. I will literally never forget that word. I should probably add at this point, I was on my own. Lee had stayed at home with Isabella and he and my parents were waiting to hear what the situation was- as we all thought I'd just come home! I immediately rang Lee and so the logistical nightmare began for a journey that would take about an hour- the exact amount of time I had until I would be going into theatre.
4.25am into theatre- increased contractions
4.46am spinal and catheter
After the monitor had started to pick up an increase in contractions, the registrar was keen that we proceed to theatre to at least get prepped whilst we waited for Lee to arrive. I rang him in a panic worrying that I was going to end up having this baby on my own. He was on his way but said if the worst came to the worst and they needed to get the baby out before he arrived, just to do it. It must have killed him to say that but it was exactly what I needed to hear. I just needed to focus on this baby arriving.
4.55am Lee arrived
When Lee walked into theatre, I actually thought it was a doctor. Haha, he'll love that I put that. He was in scrubs and looked like an extra from Holby City had just joined the team. He took his seat next to my head (and held the bowl whilst I threw up) and the drapes were raised so I couldn't see below my midriff.
5.09am knife to uterus
5.10am baby born
5.11am clamped and cut
5.12am placenta out
5.13am baby wrapped
5.16am internal bleeding, requested the presence of Mr Reid, consultant. 2 x blood units requested. 2 x blood units ordered
After the initial delight at Florence's birth, I was aware of a hell of a lot of suction going on. There was some discussion and I was informed that the consultant would be coming in to assist. It was now that I started to feel as though I was getting feeling back. I told the anaesthetist and further drugs were administered through my cannula. For nearly 20 minutes, the registrar and surgeon were stood, packing my uterus trying to stop the bleeding, waiting for the consultant to arrive. No one was saying much and I was starting to get worried. Again I started to feel pain, more alphentanol was administered and a further cannula was put in my other arm.
5.35am consultant arrived
5.45am consultant scrubbed and into theatre
6am first blood transfusion
6.30am second blood transfusion
Upon arrival, the consultant and registrar checked my total blood loss and it was confirmed as 2 litres and there were multiple bleeding points from the endocervix. The consultant managed to get the bleeding under control with multiple, small stitches and a pressure ballon was inserted as compression to help stop any further bleeding before stitching up. A cut was made above the incision and a drain inserted to clear any further bleed, should it occur.
Throughout this process, I continued to get feeling back again and again and the drugs chart in my notes shows how two different drugs were given regularly throughout my time in theatre so much so that for the last half an hour I fell asleep. As they had started to consider general anaesthetic to finish off, this was probably for the best! After 2 hours in surgery, I woke up in recovery with 2 cannulas, a drip, a drain, a catheter and a tube from the balloon preventing further bleeding. It's fair to say, it was a shock.
7.05am into recovery
7.10am skin to skin with baby
8.15am oramorph administered orally
As requested, as soon as I was able, our baby girl, whom I'm sure you know, we named Florence was placed on my chest and I finally got my long awaited skin to skin. To finally hold her was the most amazing feeling and momentarily I forgot all the pain and cried with happiness, not fear.
After meeting recovery criteria, I was moved back onto the labour ward, a requirement under these circumstances where I would spend the first night. Unable to move from the bed, I relied on Lee, family and midwives to help me with everything from passing Florence to me when she needed to feed to getting me food and my toothbrush. As someone who would much rather do things myself, relying on others was incredibly frustrating. Equally, I'm incredibly grateful for that time and the midwives who helped me through that first night, successfully establishing breastfeeding.
From then on, my recovery continued in the right direction and after an awful second night on a shared ward in postnatal, I came home for a night to my midwife led unit. I had my own room with ensuite with the most amazing midwife care.
After the birth
My whole birth experience has left me with incredibly mixed emotions. On one hand, I feel I've had to grieve for the calm, natural birth I wished for; on the other, I am completely humbled and thankful for the amazing health service we have. I am so glad I had the chance to go through my birth notes and fill in the gaps. Nikki was so patient, explaining everything and had even come in on her day off to do my appointment. It has definitely helped me get the closure I needed.
If you think a TalkAbout appointment could help you, call 01952 565990.
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