Well, Keith and I are finally grabbing a few minutes between the glamour of feeds and burping to bring the blog up to date with the birth of Alfred Ángel Batsford at 21.34 on 12/11/2009.
The blog last saw us going in for daily monitoring and haranguing by the staff of Lister Hospital as the days slowly counted down to the day when I hit 43 weeks by my scan dates (42 weeks by my own dates) and we were booked in for induction.
We had agreed to stick a date in the diary after speaking to a lovely midwife on the delivery suite who told us that we could still preserve a lot of the important elements of our homebirth, such as bringing in our birth pool, and being very supportive of what we were trying to do.
The day before we were due to go in, I decided that I needed a day of peace to centre myself, and being a chicken, I booked in with the community midwife and had Keith call the hospital to tell them we would not be seeing them until the next morning.
Obviously I could only hear one half of that conversation but judging by Keith's tone, the reception to our plans fell below even the usual levels of disgust. I'm not entirely sure but I believe the point at which he rolled his eyes for the seventh time was about the time we were told once more that we were going to end up with a stillborn baby.
The next morning (the 11th) we arrived at Lister for induction. It's hard to describe where my head was at that point. I was fairly calm about the idea of being induced, I think in my head that day "off" had given me the time and space to reconcile myself with the knowledge that we had thrown everything we could at the situation and that I had complete trust in my husband to help make this birth as positive as it could be.
On another note, I have to record for posterity the fact that we did look like a pair of the nomads that morning. We moved into that hospital with every last thing we thought we might need for the birth – pool, hoses, stereos, CDs, food, baby equipment. It was a two person job just to haul it around the maternity department for the next few days until someone thought to bring us a trolley.
After my baseline monitoring was done (and I had had the chance to smugly watch our baby's perfect heartbeat for the last time) I was taken down to the delivery suite and given my first dose of Prostin, made to lie for an hour and then sent off round the hospital to see if we could get things going.
On the seventh lap of the hospital, we decided to spend some time in the "wild garden" which was clearly code for random-patch-of-ground-we-ran-out-of-money-to-landscape. I sat on the bench with my TENS machine slightly concerned that the back labour that had been taunting me for the last few nights wasn't going to miraculously turn into constructive labour.
Looking back, right there should have been the warning sign that all wasn't going to go well, if a baby is in the wrong position to trigger contractions himself, then forcing them to start with him still in the wrong position was hardly likely to improve matters.
That afternoon passed slowly, first walking around and then later in the Day Room, which we had to ourselves, the lights low and me rocking and bouncing on my birth ball in a last ditch attempt to get Alfie to turn. My TENS machine was my best friend and despite having no appetite I think I was well stocked up on tea and digestives by the time evening rolled round and our progress was checked.
Actually, it was lack of progress because for all that discomfort, nothing had happened. I mean not a single chuffing thing. Oh, apart from the little matter of a swab result which showed I had Group B Strep. Ordinarily not something I would have allowed to change my plans, but then I wasn't in Kansas any more, and now I was being told that there was no way that I would now be able to have my water birth.
It was around this time that negotiations started around what Keith was going to do that evening because Lister is one of those enlightened hospitals where they still send dads home as soon as is decently possible. Frankly, I was having none of that, and even if I had been, Keith was having even less of it. I think we were helped by the fact that my notes with strewn with snotty comments about being difficult so when I said I would walk if Keith were made to go home, the staff knew to take me absolutely seriously. Several calls later and the Head of Midwifery (no less) gave permission for us to use what they call a Home from Home room.
For those of you who don't know, the Home from Home room is a hotel style room the hospital uses for grieving parents who have had a stillbirth. Consequently, every last thing in the room is dedicated to the memory of a lost child, which is just perfect when you are being induced with a child you have been told for 10 days is going to die as a result of your stupidity.
Frankly I didn't care by that point because my back labour had ramped up after the second dose of Prostin and the only way I could cope was if Keith put his full weight into my lower back with each contraction (or contraption as we somehow ended up naming them). I was staring down the barrel of a second night of no sleep and I knew that wasn't an option so I asked for some parecetamol and codeine and got into a nice hot bath.
The bliss!! The unmitigated, boundless bliss of that hot water. I floated there until my toes went wrinkly and debated whether it was physically possible to sleep a night in a bath. Deciding it wasn't I dragged myself out, and it was then that I had my lowest point in the labour.
I was tired, I was hungry, and despite the best efforts of the midwife on duty in packing me into different positions and Keith in pressing my back, I felt out of control and railroaded by the back pains. I could see I was facing a second sleepless night and it was the time I most wanted to sit and wail about the unfairness of it all.
Instead I happened upon a solution and like a drowning man, clung to it with everything I had in me. I discovered by a sheer fluke of timing, that if I was sitting bolt upright on the foot of the bed when a contraction hit, I could breathe through them quite effectively.
Obviously this solved the back ache issues, if not the sleepless night issues. I had also made Keith hit the hay on the basis that at least one of us would need their wits about them the next day so I couldn't even share my newfound comfort with him. And TV is about as interesting as playing spot-the-polar-bear-in-the-snowstorm in the early hours of the morning. All of which meant that I was forced to find some way of sleeping upright, which I did just about manage after a while with the aid of the sofa and a shedload of cushions. That said, I certainly wouldn't suggest it as an option unless all other options, including sharpened spikes, have been exhausted.
The next morning, we knocked about making the most of that little room until we were taken back into the delivery suite for The Next Step. We met another in a long line of registrars who explained the schedule of events that they were proposing, which in summary involved breaking my waters, with the threat of a syntocinon drip to follow, and a C Section grand finale if none of the previous steps had done the trick.
Unfortunately the idea of breaking my waters posed a bit of a conundrum for the staff because by doing so, they were increasing the risks of infection to the baby, and they already knew that I had Group B Strep … ooooh what to do, what to do!!!! Well the obvious solution when creating a problem, is to mitigate it with more medicine: In this case, IV antibiotics before during and after breaking my waters.
The amniotomy itself was a painless, if odd experience, one I suspect to be familiar territory of the old, infirm and paralytic. Despite the fact that something had gone well with my induction, there were slightly furrowed brows all round at the sight of my waters. There was meconium, grade 2 out of a possible 3, which it transpired was old mecomium, there most likely because Alfie was post dates, rather than green meconium which would indicate any level of distress on his part. In an amazing turn of events, the registrar was actually pretty calm about meconium as a development, and was apologetic about the fact that it meant my previous timetable would now have to be halved.
Strangely I wasn't surprised, or in fact worried by that announcement. I think looking back I knew deep down that nothing was going to shift Alfie and that we were essentially just going through the motions. He had been in the OP position for over a week, which was the reason he hadn't kicked off labour, and nothing we were going to throw at him was going to change the basic physiological premise of labour which means that if a baby isn't pressing down on the cervix, the cervix isn't going to dilate.
I wasn't going to stop trying for him though, not now, because he deserved every chance I could give him at as natural a birth as possible. So I got back on my beloved birth ball, monitors attached, and rocked and bounced and wandered as far as the leads would allow.
My contractions were still stubbornly unchanged though, 8-10 minutes apart and slap bang in the small of my back. Keith had resumed back pressing duties and combined with my TENS machine, each contraction seemed quite reasonable. Part of our caravan of luggage was a folder of CDs and it was now that I felt like I needed to be motivated by some "doing" music. There was only one CD I wanted and that was Audioslave. I'm not sure how much it helped because there came a point where I was locked in a little bubble of my own, but while I could never tell you what tracks were playing or when, the vibe from that music was absolutely right for what we were trying to do.
It felt like minutes later that it was time for my next progress check and, as predicted, nothing much had happened. The syntocinon was wheeled in and I was hooked up on the lowest setting, 1mg, which was to be doubled every 30 minutes until my contractions numbered 4 or 5 every 10 minutes.
The only slight problem was nobody had explained the plan to the infuser, and it insisted on malfunctioning every time I was due a dose of the drug. It was quite farcical really, the number of midwives I had trooping in and out of the room trying to make this thing work, and all of them failing to tame the miserable, temperamental machine. I would love to say I found it amusing, but the extra attention meant that for the first time that day, I wasn't able to buy extra time because of staff shortages and busy departments. The dose was ramped first to 2mg, then 4mg and on to 8mg and with each increase the contractions seemed to carry me off further into my own little world.
Right about now, I have to hand you over to a guest writer for the rest of the story, because my memories of everything that happened next are confused and patchy. Over to you daddio!
At this point the contractions were coming thick and fast, the monitor measuring Tash's contractions (which had previously been told meant nothing) were going off like a seismograph in downtown San Fran, and I was trying to fold myself around the front of Tash's bed to be able to look her in the eye and offer words of encouragement. It must be said, you do feel somewhat pathetic uttering the words "breathe, drop your shoulders" as someone is going through what looks like some kind of exploding pelvic experience.
She was then offered further pain relief, and was told Morphine was available. I was unable to workout if her reply was muted due to the intense nature of the contraction, or because she didn't really want it. Anyway, the midwifes didn't hear anything, and so I ignored her mumblings. This went on for a few minutes, until the student midwife informed her senior "she has been offered Morphine" … at which point Tash exploded " YES, I WANT MORPHINE!". We had always planned to hold off drugs as long as possible, because you hear so many people with stories of "we got so far, had an epidural, and two minutes later the baby arrived - the drugs hadn't even taken effect".
Anyway, Tash's mind was made up, her drug intake NEEDED to step up. Looking back I think our error was to assume that when a patients request was made, then a reaction from hospital staff would shortly follow. What actually happened was Tash's request got passed from midwife to midwife, as one either left or entered the room. Anyway, eventually it arrived, injection injected, and Tash very quickly went from hugging the 'head' of the bed to pretty much passed out on it. This must have been mid-late afternoon by now.
This was the hardest part for me. I knew Tash didn't want the dosage to be increased anymore and I knew the midwifes were relying on me to time the contractions … yet all of a sudden I was presented with a wife who responded to very little, and a machine that wasn't showing when contractions kicked in. Occasionally I would ask if she was going through the same contraction, and I'd manage to make out a response saying that there had been one or two since! I had no idea when I needed to be pressing the "boost" button on the TENS machine as I had no idea when the contractions were hitting – so I kept it on more often than not, it was just great having a button with "boost" on it! Of course the midwives and Registrars would ask about contraction frequency and I would just tell them what they wanted to hear. Five or six in ten minutes, a minute or so apart. I didn't have a clue, but it kept them from turning up the dosage on the drip.
Anyway, time passed by … we must have listened to the Audioslave album another three times through … maybe it was 8pm … and eventually a doctor comes in to inspect Tash. Hospital timescales are shocking btw. I remember working out at the start of the day that it would all be over by 3pm, or else she would be in very active labour. He has a peek and declares nothing has progressed whatsoever. So here we are, some 5 hours later than predicted, and still no son. This registrar, maybe the 6th or 7th we'd had the pleasure of seeing, was brilliant though. He sat down next to us, clearly feeling like he had bad news to break. "I'm really sorry, we have tried everything, and I know its not what you both wanted but I don't see any point in continuing with the Syntocinon drip" … to which Tash interrupted and informed the bloke that "the only way we are carrying on with that drip is if you're attached to it!". We had our plan, and it didn't include a c section, but at every crossroads we were faced the path we chose was always our own. We were now at a point where, for once, we agreed with what was being suggested to us. Alfie wasn't going to make an appearance without someone going in and grabbing him!
And so the registrar disappeared, and the midwives started to prepare Tash. A few minutes later the registrar reappears, "I've got some bad news I'm afraid". It appears he's spoken to some higher power, who as it turns out has no idea about us or our situation, and he refuses the caesarean. Tash needs to have an epidural, and the drip be cranked to 16, and then 32. If Alfie still refuses to come, then we will be granted our caesarean … in 2hrs time. I don't remember if I asked, or maybe it was the anger on my face that requested, but everyone then left the room. I checked with Tash she was happy with a C section, that this was definitely the result we were looking for now … and prepared to fight for the birth that we wanted once more.
NOTE FROM TASH: My mind was pretty fuzzy by this point, but I remember three words going round my head like a claxon when the Registrar said we would have to try the drip for another 2 hours at the max dosage – Pit to Distress – for those not familiar with the term, there is a great post about it here Basically, the practice is to crank up the drip as high as it'll go on the premise that either it'll get things moving, or else the doctors will have to perform a C Section due to foetal distress. I was determined that there was no way this was going to happen to our child.
The midwifes came in first, to which I fairly calmly point out that a)we have been made to feel like sh*t for 2 weeks, being told we are risking a stillborn baby and that it was imperative the baby was born 'immediately', b) we had been told all along that it was most likely we would have a caesarean section, and c) that we have just been offered the C section, so clearly you agree with me. We wanted a C section, and we didn't want to wait. I was just getting into full flow when they cut me off, and said I would need to say it to the registrar.
He reappeared and I went through it all again – "we aren't prepared to have our son on that drip any longer than needed, and now we are FINALLY agreeing with you, and it's you guys dragging your feet, delaying what you have been saying all along was the inevitable. We want the caesarean, so I ask you go away and speak to whoever you need to speak with and state our position and see what they say".
He clearly agreed with us, and Tash said she heard the midwives say they agreed with everything I said. He reappeared a few minutes later and confirmed we were on for the caesarean. A few months earlier I remember being really worried that an incident would appear, I would have to make a decision 'cos Tash was so drugged up, and I'd end up making the wrong call. Now the incident had appeared, and I felt pretty good about myself knowing I'd passed that little test … then I realised the result of my actions … I was going to have to watch my wife be operated on, and my child be delivered by C section!
Now, I'm generally ok with blood, guts and pain, but when certain things are left to the imagination I can get quite squeamish. Casualty is not always an easy watch for me! So as I entered the theatre in my 'obese American' size scrubs I pointed out to Jo (the BEST midwife we encountered over the whole 43 weeks!) that I had been awake for 3 days, was running on pure adrenaline, and "wasn't really sure how I was going to be with this". Jo pointed me to where I needed to be, and rolled a stool over to me "you wouldn't be the first to faint Keith!"
The operation is real quick. The screen goes up across Tash chest. I am head end, so don't have to see all what's going on at the business end! They confirm Tash cant feel anything below her armpits, and we start chatting complete BS to try and pass the five minutes we are told its going to take for little Alfie to make his grand entrance. Suddenly I heard a quick whimper, and all of a sudden they are whisking a very small blue baby over to a cot a few metres away to the left. His hat is rapidly placed on his tiny head, he's wrapped in a towel and the attending midwifes begin rubbing him madly. They pull down the heat lamp. By now I'm up on my feet, edging closer because I want to see what's going on, but am also conscious not to get in the way. An oxygen mask comes out and is placed over the little fella's face … and immediately you can see him go into shock, arms and legs rigidly forced out in front of him.
I turn and walk back to Tash, telling her that everything is OK, yet I can hear "come on little fella" in the background so I have no idea how convincing my words were. The next few minutes pass very slowly, yet his temperature rises and breathing sorts itself out, and he is presented on Tash's bed. I asked afterwards, if what I had witnessed was common, or if that's the way C sections usually went … and was told that was a common C section delivery - why hadn't anyone told me that in advance so I could prepare myself!!!
The time is confirmed at 21:34, and with the doctors work now done we are very quickly carted out of theatre and whisked around the corner to a recovery area. Jo, our attending midwife at that moment, helped Alfie take his first feed and I took the opportunity to grab some photos of our gorgeous son. An hour later we were rolled back onto the ward, a further 60 minutes later I was turfed out of the hospital.
I'm disgusted that a partner is removed from his wife and newly born son so soon after birth, but having fought to stay one night it was made very clear to me that a second would not even be contemplated! My Dad – dogsitter extraordinaire throughout all this – collected me from the hospital, and I know I slept very well, and very happily that night. As it turns out, far better than Tash did!
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