Midwife Appreciation

Max is very happy we got a lovely midwife.

During every big life event you’ve ever gone through, the people around you will have mattered hugely at the time. Roll on a week, month, year or decade into the future and their name, manner or appearance may have blurred so badly that you can’t recall anything about them.

That’s certainly the case about birth. Both times I was in hospital for longer than average. 12 days in total on antenatal, labour and postnatal wards with Alexandra, then ten days on antenatal while pregnant and a week on delivery suite and postnatal with Max. (We’re just talking pregnancy/birth specific wards and stays here so not my long hospital admission postnatally with Alex or any of the care Max received)

Along the way we met many midwives and other staff who were utterly amazing, whose names and faces are imprinted on our memories, and none more so than the midwife who delivered Max. Her name was Antoinette and I knew from about 30 seconds after the start of her shift that I liked her.

She walked into the room on the morning of the 26th March, introduced herself and had a quick handover from the night midwife and then immediately began tidying the room. A woman after my own heart! She instructed Dylan what to get out of the bags then put them away, and got out everything she might need for the delivery even though it wasn’t imminent at that point. She wanted to be ready for every eventuality and, as someone who writes lists like it’s going out of fashion, I was won over by this!

She chatted to us about her family, asked us questions and got to know us as well as you can in a couple of short hours. Everything was sorted so she could focus on us – even fetching Dylan some breakfast. Then when everything ramped up (Antoinette told me once I got into established labour it would be quick and she wasn’t wrong!) she knew the time wasn’t right for chatter anymore and began guiding me calmly and efficiently through the process of giving birth. There was no panic, alarm or harshness. There were just suggestions, advice and care. She knew what to say and do at any moment and her decades of experience combined with the joy you could tell she still feels every time she helps bring a new life into the world.

Even once Max was born, she was fabulous. She made sure I was washed, changed and fed as soon as possible and kept me company while Dylan and Max were on the transitional care ward then got me in to see him as soon as possible once he started showing signs of being poorly and had been transferred to NICU.

I’m sharing all of this because I can’t believe what a difference having such a great midwife made to the birth. Altogether it was better anyway owing to the lack of need for intervention but she made it so positive and something I look back on fondly despite the pain and blood and gore!

Having someone championing you and telling you you’re doing great (other than your husband cause you know he’s GOT to say it and what does he know about delivering babies anyway), having someone who intuitively knows what you may need at any given point or how you may be feeling, having someone who makes you feel like the most important person in the world right now – let alone the room. That’s something you can’t pay for, you can’t order, it’s luck of the draw.

Whoever walks into your room to deliver your baby will be qualified, but what their nursing degree won’t have given them is that amazing attitude we saw that day where nothing was too much trouble, everything was kept calm (as calm as it can be when you’re pushing a human out of you) and we were the focus – not the doctors or the medical side of things or even Max, me as a woman giving birth and us as a couple having a baby that day.

Dylan’s had four children and been at all of their births. He can’t remember any of the other midwives’ names but we know we won’t be forgetting Antoinette ever!

Harriet, Alexandra and Max x

Max’s Birth

I was just about to write a post about the differences between both my births and the advantages of having an amazing midwife, then I realised while I’ve written about Max’s first few weeks in hospital, I haven’t actually dished out the gory birth story details. Here we go:

We had always known I’d be induced and we’d had a date for weeks that we were working towards, although a hospital stay at 32 weeks had meant we knew there was a fairly good chance we’d go earlier than 37 weeks.

As it was, we had a growth scan at 34+6 so the three of us (myself, Dylan and Alexandra) went along to the hospital with the intention of doing something fun in the afternoon before having some friends over that evening. At the scan it became apparent quickly to me that there was an issue. Normally they’d talk me through the details straightaway but instead the sonographer asked us to go and talk to our obstetrician. She said it looked as if our son’s growth had slowed down from the 50th centile to the 10th since the last scan four weeks previously. There was also a concern over the blood flow from the placenta indicating it had potentially started to fail.

The doctor said all this, combined with me having slightly raised blood pressure, meant now was probably the time to start the induction process.

We had to wait a couple of hours and my sister came to pick Alexandra up while my parents sorted out the arrangements for getting all our bags and hers sorted. Then we were shown to our bay in the induction suite.

At around 7.30pm that evening (Friday) I had the first prostin tablet inserted. Overnight Dylan stayed at my mom’s to try and get some rest (it’s nearer to the hospital than our house) and I had another tablet in the morning.

They ended up doing a third one because, while I was getting tightenings, they weren’t regular enough and my cervix wasn’t dilating very quickly. Then the doctor came at around 4pm on the Saturday to check if I could have my waters dilated, this was the most painful part of the process including giving birth! In fact the doctor who did the check came back a few days later and apologised to me for how awful the check was.

It was then a wait to get a room on the delivery suite: we were told it could take days although I was given priority because of my condition. In the end it was about 12 hours before we went round. In that time we’d gone on endless walks to try and progress things. I tried sitting on the birth ball but found it really uncomfortable this time round (although it did wonders helping me dilate during Alexandra’s labour).

It then took an hour and a half to get a cannula in my arm before they could break my waters. Nothing much happened and then at 8am our midwife Antoinette came on duty. She was fabulous! She got everything organised straightaway and then after a couple of hours it was time to start the drip to see if they could progress my contractions.

Nothing happened for a while and then all of a sudden it was like a switch had been flipped. I went from 2cm to 5cm in a matter of minutes. They decided I could have an epidural (they’d said no originally because of the blood thinning injections I’m on – but it had been long enough since my last dose to make it safer) so I said I’d like one.

The anaesthetist came to have a chat to me about the procedure and I agreed to it but it became quickly apparent there wasn’t time. I had a check as Max’s heart rate had dropped a little, to see if he could tolerate the epidural, but by this point I was 8cm. I was just using gas and air (although probably mentioned a few times that it was painful and I’d really like some more pain relief!) and feeling really out of control during contractions. I then realised instead of concentrating on breathing in the gas and air during a contraction, I actually needed to focus on the fact my body wanted to push.

Because I had a ventouse delivery with Alexandra, I’d never experienced the urges to push so it took me a while to realise I just needed to trust my body and go with what it was telling me. Dylan said he could visibly see when that happened and I became much more focused and wasn’t thrashing around the place like I had been previously.

All of a sudden I was fully dilated and it was time to push. Then his head was out and one push later our son Max was born at 11.57am weighing 4lb 13.

He was lifted onto my chest and Dylan got  to cut the cord (for the first time even though Max is his fourth child – with Alex because she needed a bit of oxygen straightaway the doctors cut it). We had 15 minutes of skin to skin before he was taken for his checks and taken upstairs to transitional care while I was sorted out. Although that process was a lot easier this time (just a small tear with no stitches required compared to an episiotomy with 27 stitches).

Antoinette had said to us it would all happen quickly once it started and wasn’t she right! It was amazing to actually get to push the baby out by myself this time. As I mentioned earlier, I definitely want to discuss the differences between the births soon!

Harriet, Alexandra and Max x

Rejecting Advice

I’ve written before, way back when I was pregnant with Alexandra, about the kinds of advice you get when you’re having a baby/a parent and how ridiculous some of it can be. Clearly if your mother/neighbour/another mom at a baby group gives you some advice you can decide for yourself if it’s useful or not, thank them and politely move on with your day. It’s your choice whether to accept and implement what they say or completely ignore it. However, one thing I’m finding myself baffled by is some people’s attitudes about rejecting advice which comes from experts (when I say experts, I mean proper trained health professionals, not people who went to a baby class once and now think they’re Supernanny).

Time and time again I’m seeing women calling into question every little thing their doctor, midwife or health visitor has said. Now clearly, you shouldn’t blindly accept what someone says just because they’ve got a piece of paper saying they know what they’re doing. If they suggest something which seems absurd, unsafe or just plain wrong then you have every right to question it with them, perhaps get a second opinion. But what riles me is when people just seem to have a ‘thing’ about saying no just because doctors/midwives are seen as a sort of authority figure.

‘I’m not going to have an induction because I don’t want one’ – now it’s one thing to do your research and decide that you’d rather opt for daily monitor than an induction just because you’re overdue if baby/placenta etc seem fine. It’s quite another to just blindly say you won’t be induced at any point. Surely it’s obvious no doctor is going to suggest inducing just because they feel like it? There’s always going to be a sound medical reason for it if that’s what they’d like you to do.

‘I’m so annoyed because my midwife/health visitor was ten minutes late. I don’t want to see her again’ – well I really hope you’re the person asking for help because your baby won’t feed or your stitches are infected or you just need to cry at someone for five minutes and she says ‘oh sorry, got to go to see someone else now’.

‘My midwife thinks I’m measuring small and wants to send me for a growth scan. I can’t be bothered to go to the hospital, what a waste of time’ – excellent. Going and finding out your baby is absolutely fine and feeling slightly aggrieved cause you’ve probably spent a fair few hours at the hospital is the BEST case scenario here. You just know these would be the same people complaining if a potential problem with their child wasn’t picked up.

‘My doctor says I need to be on these meds but I don’t want to take them’ – you know, cause doctors love handing out pills to pregnant ladies just for the absolute sheer fun of it.

I can’t even go into anti-vaxxers on this post because they deserve a whole post of their own quite frankly! I for one am super glad there are people in this world who spend their life looking after pregnant ladies, helping people give birth and offering advice in the newborn days. I am very glad there are people who know how to keep me and my children safe. I don’t blindly accept what they say but I do know that 99.9999 per cent of the time they are going to be far more knowledgeable than I am and, just because I have access to Google, that does make me a doctor.

Harriet, Alexandra and bump x

 

Take Two: Week 30

This picture is relevant, honestly…read on.

Week 30 really isn’t a milestone in your pregnancy, but somehow because it starts with a 3 and not a 2, it feels like one. I think especially when you know you’ll be delivering in a week beginning with a 3 not a 4, it makes it all seem eerily close. I don’t know if that really makes any sense but I understand it nevertheless!

This week has mostly been the same: feeling a little tired, struggling with my back and mostly just feeling HUNGRY. Like non-stop, I need to eat all the time, I’m angry because I haven’t eaten for ten minutes – although I’ve actually also got to the point where I’m quite looking forward to exercising after the baby’s born. I think about chicken nuggets a lot at the moment (I had not one single McDonald’s in the 11 months that I wasn’t pregnant between Alex and this baby. Now I could quite happily eat one every day. Nuggets are an all-consuming thought for me. I probably won’t get any work done for the rest of the day now because I’ll be thinking about nuggets).

In actual, important news I had a midwife home visit on Wednesday. This is where they normally talk to you about birth options I think (but obviously that’s highly irrelevant for me because I’m not giving birth in the county I live in) and they also chat a bit about breastfeeding. All the normal checks showed up fine, baby had moved again and was head up (I also got to feel his head which was pretty cool, the midwife said it was like a perfect little cricket ball).

Then on Friday it was back to hospital for a growth scan and an appointment with my obstetrician and rheumatologist. The scan went well, they estimated he was just under 3lb 12 and that equates to be just under the 50th centile. He’d moved again and was head down which is where we’d like him to stay! My regular obstetrician was on annual leave so there were some questions I went with which I’ll have to wait til next time to get answered, but overall the appointment went fine. I don’t have to see them again for another month which is longer than I was expecting, but I’m seeing the midwife weekly and the haematologist and cardiologist in two weeks so they’re definitely not leaving me to fend for myself!

Harriet, Alexandra and bump x

 

A High Risk Pregnancy

I’ve seen a lot of women ask on baby forums and elsewhere about seeing consultants and I think there’s a general lack of knowledge around low/high risk pregnancies so wanted to write a quick post about it. Please remember I’m in no way a medical expert and anything I say here is based upon my own limited experience – please ask a midwife/doctor etc anything you’re not sure on!

When I had my booking in appointment during my first pregnancy, I was categorised as potentially high risk as I’d got a history of mental health issues, including a previous hospital admission the summer before. This meant I had some extra appointments to see a specialist mental health midwife so they could check how I was doing and put in place a plan should my health deteriorate following the birth. Being high risk also automatically means they want you to give birth at a consultant-led unit rather than a midwife-led unit or at home.

At 33 weeks, it was decided because I hadn’t been on medication during my pregnancy and hadn’t been unwell at all, they would step me down to low risk and I’d just have a follow up appointment six weeks after the birth. But then because I started showing symptoms of pre-eclampsia at 37 weeks and my platelets became dangerously low, I ended up becoming high risk again and giving birth in the consultant-led unit after being induced.

This time round, I was automatically high risk and as such won’t even be giving birth at the hospital I had Alexandra in, I’ll be going to Birmingham Women’s Hospital which takes on the complicated cases from around the region. This has meant monthly obstetric and rheumatology appointments (more often from the end of the second trimester), monthly haematology appointments with plenty of blood tests, frequent cardiology appointments and echocardiograms and ECGs to check how my heart’s performing, weekly midwife appointments from 16 weeks (luckily I’m able to have these at my GP surgery) and more frequent scans (so far at six, eight, 12, 17 and 20 weeks as opposed to the standard 12 and 20).

It’s also meant a change in medication (although actually taking fewer tablets each day) and twice daily Clexane injections (which are a bitch but worth it if it keeps us safe!). We were told very early on that as soon as we had any worrying signs or symptoms we’d need to have a frank discussion straightaway. They will deliver at 37 weeks (considered term, although your due date is 40 weeks) but would be more than happy to deliver at 34 weeks if needed and will consider it beforehand if necessary. Thankfully we’re now at the stage where they would be looking at early delivery with every medical intervention possible to ensure baby was healthy, rather than being told we need to end the pregnancy to save my life.

Of course, a lot of this is fairly worrying and yes it would be lovely to have a low risk pregnancy! But equally, baby has been perfect on all scans so far and I would be much more upset if we had to contend with the thought of our little one being poorly. I’ve said from the outset that, while some people may have considered it too much stress to go through, this pregnancy and everything that has gone with it will be more than worth it if we have a healthy baby at the end of it.

If we’d been told at the start of our pregnancy with Alexandra what was about to happen, then maybe we would have considered our options. But knowing what we know now, and having her in our lives, would we go through that again? Absolutely, a million times over. And I think that’s what’s made this second pregnancy easier, knowing how much I already love our second baby and how much more I’ll love him once he’s here and I can hold him and watch him grow every day. Knowing how much being Alexandra’s mom means to me and knowing I have a chance to have that all over again and to give her a sibling to grow up with – a few people have said to me they couldn’t deal with the injections and all the appointments and the stress, but it’s more than worth it for that chance.

Sorry we got all a bit slushy towards the end there! Here’s to reaching 24 weeks this weekend and trying to keep baby in there for a few weeks longer!

Harriet, Alexandra and bump x