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Interview 26

Age at interview: 33
Brief Outline: 1st child born prematurely at 30 weeks by emergency CS due to preeclampsia. Had good physical recovery but felt 'in shock'. 13 years later felt keen and confident to have VBAC with 2nd child. Had short but intense labour, birth was painful but 'amazing experience'.
Background: Homemaker with one daughter aged 13. Lives with her partner works as computer software engineer. Ethnicity: White British (English)

More about me...

Previous pregnancy and birth

Her first experience of childbirth dates back 13 years. She was 19 at the time and living with her parents. At a routine scan at 30 weeks, there was concern about her baby's small size. Further tests found her to have high blood pressure and excess protein in her urine (a symptom of pre-eclampsia). She was advised to have bed rest in hospital, where she would be closely monitored for the remainder of her pregnancy. Four days after she had been admitted, her blood pressure rocketed and she was told that an immediate caesarean was the only safe option to stop the pre-eclampsia from getting any worse. She was less scared about the operation than about becoming a Mum much earlier than she had expected. Having so little time to prepare herself emotionally left her feeling slightly unreal about what was happening to her. She received a general anaesthetic and did not see her baby daughter until a day after the birth. A bad reaction to the painkillers meant she had to stay in hospital for another six days. Born 10 weeks premature, her daughter weighed only one pound fifteen ounces and had to stay in the Special Children and Babies' Unit (SCBU) for seven weeks. Coming home from hospital without her baby was a horrible experience. She expressed breast milk while her daughter was at SCBU, but had difficulty breastfeeding her once she returned home. It took her a while to develop the confidence to handle a small baby and she didn't feel that her daughter was really 'hers' until several weeks later.

Physical recovery was much easier than coping with the emotional side of things. Her scar healed very well and did not affect how she felt about herself.

Second pregnancy and birth

Her second pregnancy 13 years later and with a new partner was a very different experience. She had a urinary tract infection at 18 weeks. Due to her previous pre-eclampsia, she had weekly midwife appointments and felt a bit anxious until she had gone past 30 weeks. However, having a family to look meant she did not have too much time to worry. She decided early on in the pregnancy to attempt vaginal birth as she was keen to experience it and felt confident and empowered by her partner's support. Her midwives and doctor encouraged her plans, but she was disappointed that the hospital would not allow her to have a water birth even though her scar had had 13 years to heal. She only attended one antenatal class and decided that reading up on labour and pain relief by herself would be more useful. Having a keen interest in child development she read widely about the different stages of pregnancy and watched TV programs about pregnancy and birth. She also had a very good relationship with her midwife and felt comfortable about ringing up with questions as they arose. She briefly considered a planned caesarean when it was suggested that her baby might be breech but a scan closer to the due date showed his head and body to be in perfect position for a vaginal birth. 

Her contractions started early in the morning of her due date but were bearable until they were 6 minutes apart. She came into hospital at 2pm after labour had become increasingly painful. She used gas and air but found that it made her contractions dip, so continued with breathing techniques only. When she had dilated to 8cm her waters broke and she asked for an epidural, but by that stage the midwife judged labour as too advanced. Her son was born after 3 hours of intense labour. Giving birth vaginally was more painful than she had imagined but also a very emotional experience. She was amazed when her son was placed on her chest directly after the birth. Watching him take his first breaths felt very special. Comparing the experience to her previous caesarean, she felt that bonding came much more naturally. Her recovery was very quick and she was able to return home with her baby the same day. She is grateful to have had a ‘comparatively easy’ vaginal delivery and thinks she might have another child.

Generally, she thinks health professionals should be careful not to rush women during appointments and make sure that the details and measurements they provide them with are accurate as otherwise they are likely to cause much undue anxiety. For women, she thinks the best policy might be to keep an open mind and ‘go with the flow’.
 

She felt scared when she first looked at her scar but it healed very well and eventually faded.

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She felt scared when she first looked at her scar but it healed very well and eventually faded.

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I think the, the scary part was when I looked down and I've sort of been half, half-shaved, and it looked, it did look quite, obviously bruised and tender and there was sort of still the anti-bacterial dye but then, as time went on and the shape went back to normal, and the hair started to grow back, it was like, looking in the mirror, sort of, you know, 'This is me again', and it didn't bother me, because the scar did heal up ever so well. It went quite faded and wasn't quite noticeable.
 
 

She was admitted to hospital with pre-eclampsia at 30 weeks and went on to have a caesarean under...

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She was admitted to hospital with pre-eclampsia at 30 weeks and went on to have a caesarean under...

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Right. Well, there was no labour to begin with, it was just a thirty, well, almost thirty weeks a routine ante-natal scan and check-up at [Hospital] hospital and the consultant was sort of quite concerned with the scan that my daughter was still very small for dates, and my blood pressure was quite high and also I'd protein plus two* in my urine test. Things obviously, lots of weight, was carrying a lot of fluid, and he advised that I went to [Hospital] to have nine weeks' bed rest. So I was obviously referred on a Thursday tea-time, put on the monitors, just general check-ups, and then it got to the Sunday afternoon where I just had a really bad headache, obviously still had the monitors, blood pressure checks every four hours and so one of the nurses had to get someone else to check my blood pressure, and it was obviously dangerously high, that they just took me down to the delivery suite, put me on a drip to hopefully get the blood pressure down, which it did stabilise by itself, but they said, you know, due to the risk with the pre-eclampsia that had set in, the only way, you know, to sort of, you know, stop the pre-eclampsia of getting any worse was to just do a caesarean for the next day, which they did. So of course, it was a general anaesthetic, you know, fast asleep and then wake up in recovery and my mum's going, 'Oh, she's beautiful' and I was like, 'Who is, who is?' because of all the morphine and I didn't see her until the next day and they, they did a scan previously on the Friday and estimated her weight to be about three pound, and she was actually one pound fifteen when they weighed her, so that was how the caesarean all came about really. 

I thought being young and fit, you know, you'd just, your body was physically enough to cope with a normal delivery. It was still a blur, because I can remember coming round and still sort of in shock, because they'd brought me the Polaroid round of the baby and of course, having morphine for the pain, I was just like, 'Whoo, it's a baby, yeah!', and people were coming to visit me and I was just sort of like, laughing. But I couldn't take it seriously. I mean, when I saw her for the first time, even then, I was sort of still in some kind of state of shock, really.

* Proteinuria, a symptom of pre-eclampsia
 
 

Her daughter weighed 1 pound 15 ounces at birth and was kept at the Special Care Baby Unit for...

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Her daughter weighed 1 pound 15 ounces at birth and was kept at the Special Care Baby Unit for...

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So, your baby was taken, was she taken to SCBU or ITU?

The SCBU straight away.

So how long did she stay there for?

Seven weeks, which wasn't that bad really, sort of compared to other babies that were in there for like five months. Because she was breathing on her own, and didn't need ventilation, that she, you know, she had antibiotics to overcome infections and possibly, there was the chance of a blood transfusion for septicaemia, but then, you know, once she got over these little infections, it was just a general case of sucking reflexes to take feeds properly and then just to gain the weight.

So she didn't have any other problems, just apart from the fact that she was one pound fifteen?

One pound fifteen, yeah. It went down to one pound eight. I, my mum, she sort of knows obviously more'

That's alright, there's no right or wrong answers, don't worry. And what about you, were you well afterwards? You didn't have any complications?

No, no. I think I had a reaction to the morphine, burning hands and itchy face and, sort of tiredness and people wanting to come and see you all the time and you didn't get a minute to sort of sit down for yourself, because everyone sort of expects you to, because you're walking about and you're wearing make-up or something, everyone expects that this is how you actually are, but not on the inside.

So when did you go home?

I had her, got referred on the Thursday, everything went kicking off on the Sunday, she was born on the Monday and I went home on the Sunday, so I was in there for nine days in total.

So, what was it like going home without your baby? 

Horrible. Really horrible. I mean, my daughter's dad had said, you know, he'd pick me up, we'd have a Sunday lunch and just sort of stay in at his house and just relax and he came to pick me up and I just said, 'I can't, I've got to go back in and see her', and we went back in and sat, just sat with her and had a quick cuddle, but I just ' I, I got used to it as the days went on but the initial, actually going out into the air and back out in, because I'd been in that hospital all that time, not even gone outside the building. It was horrible, leaving her there.
 
 

She felt like her baby was not really hers for the first few weeks. She expressed milk for her...

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She felt like her baby was not really hers for the first few weeks. She expressed milk for her...

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It was... I really can't remember exactly how I felt. It just sort of' I, because I think back then, I was sort of quite a quiet, withdrawn person who did lack a lot of confidence that, you know, I just let the nurses, it felt like, you know, she wasn't mine until weeks had gone past when my confidence built up to change a premature baby's nappy and, you know, what with all the wires and the tubes and things, it was, it was quite a daunting experience, really.

And you said you didn't feel like a mum. Was that because you think it was worse because you went home without her?

Well, sort of, I don't know. I know the situation couldn't have been helped, you know, that all hands were on to save, to save her life really, and to sort of save mine, because it's quite a sort of life-threatening condition, and I think it was because she, you know, she didn't feel like mine because of how small she was and holding her body temperature, she could only come out of the incubator for so long and obviously get put back in. And we felt helpless, you know, when they're so tiny as well, you think they're going to break as well and all you want to do is just pick them up and cuddle them and, you know, nurture them and, you know, as time went on, you know you accept it and it becomes more natural and the bonding sort of begins and you know, the confidence builds up and, my nan had a field day of knitting dollies' clothes. I was going in, and I sort of started feeling more like she, she was mine, and when she came home, it was exciting, but still really nerve-wracking, because'

Did you have any long-term worries that she'd been affected by being delivered early?

Not really, no.

And what about feeding? Presumably you couldn't breastfeed her because she was in'?

I did try once to breastfeed. They'd advised me straight away to try and express, because obviously of what the breast milk contains, but they said they'd use donor milk, and that thought' I didn't like the thought of it, so I started to express and it came through, and I expressed every four hours for five weeks. And I tried to feed her the once, but confidence, again' she was too small and my mum was sat there, there was a nurse there and I think that if they'd put me into like a room on my own maybe [yeah] I perhaps would have, would have kept it going, but I think, still stressful situations, it suddenly, just suddenly, just dried up and that was it, so, you know, they had the sort of bottle premature milk there.
 
 

She did not experience many worries during her pregnancy and was happy to leave things to...

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She did not experience many worries during her pregnancy and was happy to leave things to...

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And what kind of information have you wanted this time with this pregnancy?

Well, I've asked as and when if I've been with the midwife, or if something's cropped up and I've been at home, I've just rang the midwife, and whatever's been on my mind I've been able to ask her over the phone or, or when I remember something at the surg' you know, like [midwife's name] I've mentioned it to her, but I've not had really much, much in the way of sort of worries, really.

And again, you've not gone to any ante-natal classes or anything like that this time?

No, I went to one out of the four [laughs]. Me and my partner went and I just thought, I've watched programmes and I've read the books, and you know, you've got to have a bit of common sense with it really, because I think it's the same sort of thing, being open-minded as to which way it's going to swing. At the end of the day, it's a call away from the hospital, you know, the staff are there, they can sort of see for themselves how, how far you're dilated and what your blood pressure is and you sort of leave the professional judgements to them really.
 
 

She always wanted to experience vaginal birth for herself. The support of her partner made her...

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She always wanted to experience vaginal birth for herself. The support of her partner made her...

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I mean, I simply just, have always wanted to experience natural birth. I've heard friends and, the majority of it has been friends talk about it and, you know, seeing it on some of these programmes, just to experience it once, because it would be a maybe once in a lifetime experience, you know, because I sometimes think, 'After this one, no more', and my partner, [partner's name] is like, 'Well, if it was a girl, I think it would be nice to try for a boy', and I'm like 'No', because I had a feeling that it was a boy.

And what's the main thing that's informed your choice about wanting to have natural?

I think just getting more confident in myself and being with a partner that I can put my confidence in as well, and faith and trust and we've got this bond that I know he'll be there and, you know, do what he can do in terms of being a supportive partner. There's no sort of doubt in the back of my mind that he's not going to turn up, or he's not going to get involved. He, he's this person who's going to be all hands on deck, you know.

 

Her decision to attempt vaginal delivery was guided more by instinct and listening to her body...

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Her decision to attempt vaginal delivery was guided more by instinct and listening to her body...

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But where do you think the most important and useful information came from for you this time?

'I think it's instinct really, because I think if you want to ask something, or you' something crops up, obviously the midwives, the staff, the consultants, they are there, because I didn't hesitate when I had questions, I think first' I think you listen to your body and then some people don't listen to their body in' I don't know, it's another thing that depends on the individual again.

But for you, it was instinct?

Yeah. Because I think you... I think, same with anybody where you get an instinct where you know something's wrong, so you take the initiative and you phone up the midwife but then some people might delay that call, or' yeah.
 
 

She felt slightly self-conscious during her vaginal birth and the pain was intense, but being...

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She felt slightly self-conscious during her vaginal birth and the pain was intense, but being...

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I just felt very uncomfortable because I felt uncomfortable for a start, just sat there, and I felt very slow to move and of course every move you make after the baby's born, fluid still comes out and you feel a bit self-conscious about making a mess and the midwife's, 'Oh, it's alright my love, don't worry', and you're thinking, 'Well, yeah, but'', and, it wasn't until she'd gone out of the room and said, 'I'll leave you now', you know, 'He, the cord's clamped, he's been weighed, he's had his measurements, he's had his little bits checked' and you know, that I eventually got myself out of the bed, that the thought suddenly came how I felt after I'd had my daughter, because of having a caesarean, you don't want to stand up too quickly, because you feel like your scar's going to tear, and psychologically, I was sort of re-living the memories of after I'd had my daughter, but then I thought, 'Well, not necessarily, I've just given birth normal, there's no cuts, there's no tears', there was a few little scratches but I think that was from his nails, and I wasn't until I actually got in the bath, that part of me still feels' you go tense because you sort of' I think because having, having the caesarean, that was the psychological thought that, 'Oh, better not move too quick', but I was fine, you know.

And what about baby, how was he?

He's fine.

So have either of you had any problems that you think are due to the way that you delivered this time?

None at all.

So how did this compare with having had a section? I know it was a long time ago now.

It was more natural, the bonding was definitely a main factor, to bond at that moment they're able to put him on your chest.

Because your daughter went to SCBU after, didn't she?

She, yeah, I didn't see her until the next day because I'd had general anaesthetic with that. I think the bonding' to be able to appreciate how important it is, that first moment, their first breath even, that was, that was the difference to just go through it with no problems, to be in at two and he's out at half past five, because you know, you hear stories of, 'Oh, you know, we were in there and all night' and then the midwife had given us the option and saying, you know, 'Do you want to go home later on?' after the paediatrician had come round and done the checks, which was the case, and we did come home the same night. But it wasn't until like a few weeks afterwards, it was like an anti-climax and it's like, 'Wow', and then it's the emotions, tears and you know, the sort of 'Wow' because it happened so quick, you know, like with my daughter it was you know, a booked caesarean, you know, you've got the anxiety of a premature baby, incubators, the tubes, it's overwhelming in all aspects. But you know, I can remember just sat in the bath and [partner's name] was just holding him, he was wrapped in a blanket and everything, and I was just, just in a maze, just in a maze, think, 'No way he was in there so many hours ago and now he's here and he's fine', it's just, it's overwhelming.

So what was your experience like compared to your expectations of what a natural delivery would be like, because you obviously had some idea of what it would be like. Was it like that or was it different or'?

It's the pain threshold I think, you know, you hear people who have a bit of gas and air, some have epidural obviously, so they can't feel anything anyway, but the experience, I think with the pain threshold at one point I thought, 'I'm going to have to have an epidural, I c
 

She thinks health professionals should make sure that information that might influence women's...

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She thinks health professionals should make sure that information that might influence women's...

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And what message would you sent to health professionals who advise women about second deliveries?  What would you say to the midwives and consultants, what would you tell them?

'Not, not to rush your patients when they are feeling anxious. Because my sister, I took her for a scan last week and some, some seemed quite keen about the pregnancy and seemed excited whereas some professionals didn't seem interested; they just want to get you in, get you out, and I think it's just spending that bit more, and I know you've got so many people that, you know, the waiting lists and you know, appointments, you can just go on and on really, can't you, and you have got to give yourself limits to spend so much time with patients. I don't know. Maybe if they're unsure on something, like I said with the birth weights, if they're unsure, don't give false information, you know, not to sound nasty but to be cruel to be kind, you know, tell people you have got to be open-minded. It's like with the birth, you know, there's me thinking, 'Oh, it's an eight pound baby', and it wasn't. And like I said, if you tell somebody, 'Oh, no, you've only got a seven pound baby, you know looking at the scans and the size', and then they end up giving birth to a ten pound baby that gets stuck because the pelvis is too narrow, it's, it's things like that, isn't it, really, that you're sort of, if things are done a little bit sort of more, like measurements and appointments, taking more time over certain details, that perhaps there wouldn't be difficulty in childbirth, that, you know, perhaps sometimes, if they know it's going to be a big baby and this person could struggle, because obviously they say to them, you know, give them the opportunity to try a natural delivery, but when literally push does come to shove, they can't push a big baby out and then it ends up being a manic situation, where a C-section's got to be done, like now, isn't it. It's, it's just, I don't know, it's a whole circle of scenarios really, isn't it.
 
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