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Pre-eclampsia and high blood pressure in pregnancy

Experiences of labour, induction and birth

Because pre-eclampsia can be very dangerous, women’s birth options were sometimes limited for those we interviewed. Many had caesareans sections – either as an emergency or planned. 

However, having pre-eclampsia does not mean that a pregnant woman will definitely need a caesarean section. Some women went into labour naturally or were induced, and a number went on to have vaginal deliveries. This was the case for Angela, though it’s an unanswered question for her as to “why didn’t I end up with an emergency caesarean as opposed to somebody else?” Julie and Philippa had both been overdue and were induced. As Julie found, sometimes inductions don’t work or the situation becomes more serious and so a caesarean section may be needed anyway.
 

At 32 weeks into her pregnancy, Helen X agreed to stay in hospital overnight to check that medication to lower her blood pressure was working. It came as a shock when she was told the situation had become more serious and her baby would be born that day.

At 32 weeks into her pregnancy, Helen X agreed to stay in hospital overnight to check that medication to lower her blood pressure was working. It came as a shock when she was told the situation had become more serious and her baby would be born that day.

Age at interview: 31
Sex: Female
Age at diagnosis: 31
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And so anyway, eventually on Monday, they decided to put me on medication. And initially they said like, “We’ll put you on medication. We’ll just keep you in overnight, just to make sure the medication’s had an effect on your blood pressure. And then you can probably go home tomorrow morning.” And so anyway I said, “Fine.” So I spent my first night in hospital and I was actually quite happy, because they had the electric beds and I call pull my bed head upright and I was actually comfortable sleeping, and I was like this is great actually. I’m quite happy to be here [laughing]. And then the next morning was when it really kicked off like, so I’m sure it was about 7 in the morning. I just had this army of doctors come in and say, “You’re liver function is so far off, we have to delivery your baby today. It’s going to have to be by caesarean, because you’re too early for any of the drugs we’d give you to induce it to work. So basically you have to have a caesarean and your baby’s coming today, and that’s it.” So I was just [blerrr] [laughs] and then I wanted it, so obviously I’d been anticipating that someone would tell me my blood pressure was better and I could go home. And that’s what happened, and so obviously I just immediately called Michael and said, “Come here now, your baby’s coming today.” And then we just, the rest of that day, I think, we were just completely shell shocked. We just had a parade of, you know, anaesthetists, neonatal specialists, just every single specialist coming in and giving us information that I’m sure didn’t sink it at the time at all, and we just, you know, we were flabbergasted by all these people coming in and out and everything that was going on and all of the rest of it, and its really funny actually. I look at, we have photos from that day, and like one of the anaesthetists came in and he, Michael was all dressed up in the blues to go into surgery, and like there’s this photo of us and we’re both smiling about this day, and I just look back at it now and think ‘how were we smiling?’ [Laughs]. And we’re just, I think we were just shell shocked. We just had no idea of what had hit us, you know, it was so far from what we’d anticipated for the birth of our child. It was just bizarre.
Labour and induction

Some women we spoke to had been induced or naturally went into labour. For some, labour starting or being induced earlier than expected came as a huge shock. Lyndsey remembered a moment when she was sat alone in the labour ward and thinking “what the hell am I doing here? I’m not meant to be here for a good three, four, five weeks”. Some women were unsure what to expect from labour.
 

Angela’s waters broke whilst she was at home and before labour had started. She went into hospital to be examined and had some tests taken. Soon after being discharged, her contractions began.

Angela’s waters broke whilst she was at home and before labour had started. She went into hospital to be examined and had some tests taken. Soon after being discharged, her contractions began.

Age at interview: 36
Sex: Female
Age at diagnosis: 34
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Anyway, 4am I woke up and my water's had broken. So, quickly woke my husband, and then the policy at our hospital is once your waters break you go down to be checked.

And, you know then we'll probably going back home kind of thing, but their policy is waters break, straight for a check-up. So, got up, showered, took everything with me as you do [laughs], the bag and everything. And was feeling a few cramps but nothing big, so I was thinking, 'OK, this is OK, this is alright.' So I got there about 6am in the morning; was checked and there was a lot of umming and aahing about how much the waters had broken. Because it had been in the bed they kept saying, "How much pads?" and all that, but I didn’t have pads in. I don’t know but it was a lot because I ran to the toilet and there was a lot, a lot of water and there was a lot coming out. So, I was convinced and then there was talk of high waters, low waters, all that kind of thing. 'Maybe it's just your low waters,' – I don’t know, you know it was all news to me these different waters. So I was just like OK. But to me they had properly broken. So, did all the tests – blood pressure; blood pressure was again always hanging at around a 150/90s – always about that. And I said to the woman, you know I've been monitored for high blood pressure, this is a… and they examined me and I was two centimetres. So, she said to me that they had a lot of inductions booked in that day and because I was booked in for the induction the next day, to go home and if nothing happens in the day, to come back tomorrow for your continuing… for your induction. 
 

Munirah had pre-eclampsia and her baby was very ill. She was induced on the advice of her doctors. She hadn’t been to an antenatal class yet and so needed her midwives to explain about labour.

Munirah had pre-eclampsia and her baby was very ill. She was induced on the advice of her doctors. She hadn’t been to an antenatal class yet and so needed her midwives to explain about labour.

Age at interview: 27
Sex: Female
Age at diagnosis: 27
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They kept checking my blood pressure and everything and then the midwife came in and said, "We're going to induce you tonight; if your blood pressure stays OK, we'll induce you and it may take 24 hours, the labour may take 24 hours," and even at that point I was like… they said… she asked me, "Do you have any questions?" And I was like, "Yeah, I don’t know about labour." I had an antenatal class booked for a few weeks and I didn’t know what to expect. I was like, "I don’t even know…" She goes, "You'll start having contractions." I didn’t even know what a contraction is; I've never had one, no-one's ever told me. And I remember her saying, you know… the midwives were really good and she was like, "It will be really painful, it'll be like really bad cramp and you won't be able to talk through it, and it's going to be really hard." And then they got the anaesthetist to come and talk to me through the pain relief and stuff. And then we talked a bit about that and we decided that if it starts to get really bad, we'll get morphine and things, and then he said, "That’s fine, I'll see you as-,as soon as you want it - you let the midwives know and I'll come and give it to you."

And he was born?

He was delivered. I was extremely exhausted; I didn’t think it would be that tiring, and I remembered my husband was like, "Can you kind of take him away and just clean him up and make sure he looks OK." And I was so exhausted I fell asleep, and I remember, as soon as he was delivered, that I was in no pain whatsoever; I couldn’t feel any pain. And I literally fell asleep straight away. And then about nine o'clock, I got up and I was like, “I want to see him”, and they'd put him, my son, in a different room and that’s more because we'd kind of requested he'd be in a different room. And I was like, "I think I'm ready to see him." 
During labour, women were usually monitored very closely. This often included ongoing monitoring of their blood pressure, other vital signs and the baby’s heartbeat. However, some found this monitoring overwhelming. Dominie felt she had “lost a lot of control because I had tubes and wires everywhere”. 

Some women had a midwife in the room with them at all times. If they got on well, this presence could be very reassuring. Dominie remembered a “compassionate and caring” midwife who looked after her during labour. Olivia said she had some midwives who “didn’t give a crap” but was glad to also have a student midwife who was more supportive and “coached me through the last bit”.
 

After being induced, Claire was monitored overnight. When her health deteriorated and after a scare with her baby’s heartbeat slowing down, it was agreed that a caesarean section would be best.

After being induced, Claire was monitored overnight. When her health deteriorated and after a scare with her baby’s heartbeat slowing down, it was agreed that a caesarean section would be best.

Age at interview: 39
Sex: Female
Age at diagnosis: 39
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And then I did have a bleed. So it was a case of, "OK we will continue with the induction at the moment, and you will be monitored overnight." So, I was moved from the delivery room but still in the labour suite.

Onto the ward. And that was…I think it was between half an hour and fifteen minutes obs, so again it wasn’t a restful period. Overnight there was a deceleration where the baby's heartbeat was lost. That was sort of middle of the night, early morning.

So again that was that. The midwife was there thankfully, it wasn’t you know all the alarms going off; the alarms did go off a few times but the midwife was actually there and that was a red button hit and everyone came running, and placed on oxygen, rolled over onto my side, and the baby's heart rate came back, but by then I knew, 'Right, something really isn't, isn't right.' I was probably more aware then that things were getting serious.

That there was perhaps now going to be risks. I hadn’t felt her move as often but again I'd assumed that that was perhaps the stresses of what I was going through, that I maybe wasn’t feeling it because I wasn’t concentrating. So that kind of went on. But they decided to continue with the induction, which again at that point, was the best thing.

And that then changed in the evening. They had come round with soup and a sandwich about 6pm, and I thought, 'OK I've not eaten but I'll try soup; I know I need to for my strength and if you want me to deliver this baby I'm going to have to try and build my strength up and that." I managed one spoonful of soup and projectile vomited everywhere which is embarrassing for me because I had no… you know it just happened. And then it wasn’t till… you know I kind of looked and I thought, 'It's black and it's like lumpy and, you know what's going on?' So, I was still hooked up to the CTG machine as well, it was like, oh you know, I can't get up to clean it, and the midwife came and it was a case, "OK we'll get you cleaned up," and stuff; didn’t seem overly concerned at that point.

Until it happened again and it was a different midwife who then went and spoke to the consultant there, and I believe that’s when he came and checked and said there was fluid on the lungs. My tests, my blood tests still weren't showing everything, that I had sepsis and they started the Sepsis Six treatment.

So that was more medications and things.
At any point during labour or following an induction, the situation could change and require a switch to caesarean section. Sometimes there was a serious complication with the pregnant woman or unborn baby’s health, or she reached a point of being too ill and exhausted to continue with a vaginal birth. It could sometimes become a medical emergency. Hanna coped well with her contractions at first and hoped it would mean an easy birth. But after her waters broke, she was “engulfed” with pain, became very ill and had to be rushed into surgery. Emma reached a point where she had no strength and “things were shutting down”.
 

Mairi was induced. Nothing happened the first time so it was repeated, but still nothing. A few hours later she started having very rapid contractions and her doctors advised that she should have a caesarean section.

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Mairi was induced. Nothing happened the first time so it was repeated, but still nothing. A few hours later she started having very rapid contractions and her doctors advised that she should have a caesarean section.

Age at interview: 36
Sex: Female
Age at diagnosis: 30
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So then I got taken into the labour ward and they gave me the gel on the cervix; they were trying to speed up natural labour – fine - did that, nothing happened. Everything else was really…everything else was fine. Then they did it again three or four hours later – still nothing happened. They did it again three or four hours later – still nothing happened. And it got to about ten/eleven o'clock at night and I was lying in the bed; Stephen jumped in the bed beside me because he was tired. So we were just lying sleeping, and about…must have been about one o'clock I started to feel contractions. So I'd woken Stephen up and I said, "Oh I'm feeling these contractions." He was like, "Right, quickly let's buzz." So we buzzed and the midwife came in and she brought the consultant with her, and straight away they were saying, "Is that OK?" and I was like, "Yeah." I was like, "Oh there's another one, oh and another one, and another one and another," and they were thinking, 'This is really fast.' So, I had the heart rate monitor on. I was OK but Alex’s heartbeat was about a 180, then it suddenly dropped to ninety. So, they all disappeared out the room and then they all came back in the room and they just said, "How would you feel about having a section?" and then they said, "In fact you’ve got no choice in this, you're having a section." So that was fine. We were rushed in for emergency section; within 20 minutes it was all over with.
 

Lyndsey was induced and went into labour for several hours. She became tired and was very unwell, so a caesarean section was arranged.

Lyndsey was induced and went into labour for several hours. She became tired and was very unwell, so a caesarean section was arranged.

Age at interview: 39
Sex: Female
Age at diagnosis: 34
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I eventually got given a pessary to be induced which didn’t do anything at all, and then I think… mm when did I get the pessary? I think I got the pessary at some point in the morning once they managed to lower my blood pressure down to a reasonable level, and then I think I had another pessary in the afternoon and then I think it was getting towards evening and I was very tired by then because obviously I'd been on this drip and had my blood pressure checked every five minutes and not slept and there were no contractions. I think at that point they… someone had mentioned caesarean and I think the consultant had come in with the senior midwife and they were discussing what to do with me, and I sort of seized upon that at that point because I was tired. And I know I wasn’t going to have the birth that I thought I might have wanted you know with a bath and getting up and everything, because I was on a bed with a drip and they then tried to talk me out of it [laughs] because it's an operation and they left me to think about it for another hour because they wanted to give me another… I think they wanted to try and induce me again but my… they'd already tried twice and I thought, you know, 'My waters won't break, I just want to get this over and done with basically.' So, so then I had the caesarean at about eight o'clock that evening, or somewhere around there, and it was actually quite nice in theatre; it was nicer than labour ward anyway. 
Vaginal births

Some women had vaginal deliveries and did not need surgery. Sometimes extra help from midwives and doctors was necessary, such as an episiotomy (when a cut is made to make the vaginal opening wider to fit the baby’s head) and/or use of forceps (to help pull the baby out).
 

Emma went into labour very soon after being induced. The situation became serious and a suction cap attached to the baby’s head was needed to deliver him quickly.

Emma went into labour very soon after being induced. The situation became serious and a suction cap attached to the baby’s head was needed to deliver him quickly.

Age at interview: 38
Sex: Female
Age at diagnosis: 34
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It wasn’t a great birth [laughs].

OK 

Unfortunately the induction kicked the labour off very quickly. Which I think got me into distress and then there was fetal distress as well, which I didn’t realise was the risk also of pre-eclampsia.

But my son, yeah got into fetal distress – had to be pulled out pretty quick with Ventouse; had breathing difficult – well he wasn’t breathing so had to be resuscitated and then taken to SCBU (Special Care Baby Unit), so it was, it was a very traumatic birth.

And I don’t, I guess I look back and I don’t know how much of that was related to pre-eclampsia or whether that was induction or whether it just would have happened anyway or, I don’t know so, so yeah but it's -, yeah, it wasn’t a great birth.
 

Dominie came close to having a caesarean section. Her baby was born following an episiotomy and forceps, which was a bad experience because she hadn’t had sufficient pain-relief.

Dominie came close to having a caesarean section. Her baby was born following an episiotomy and forceps, which was a bad experience because she hadn’t had sufficient pain-relief.

Age at interview: 25
Sex: Female
Age at diagnosis: 24
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So yeah, so they turned off the hormone drip, and I think it was at this point that my husband said like… not that I remembered, but he said to me that he had said to the midwife, "Is it normal that there's blood on the floor?" and she went, "Oh no, that’s normal." He was like, "No, it's all over the floor," and she looked down and she could see all this blood. So, they pulled the emergency bell and the consultant came in, and again I still couldn’t stop myself from pushing, and they did a quick scan because they hadn’t heard his heartbeat for quite a while. They did find his heartbeat but it was only about 60 beats per minute which is very low. So they decided for delivery then and there and it looked like I was going for a section because 30 minutes prior I'd only been three centimetres. She did a quick examination and I was fully dilated. So, I had a very nasty episiotomy which I do remember her saying, " These scissors are blunt, has anyone else got another pair?" and that to me just makes me cringe. And then I had a forceps delivery and he was born, and I don’t really remember anything about him being delivered; I don’t remember seeing him. It turns out that I had an abruption at the end so that’s why I was bleeding and everything, and that’s probably why it was so painful.
As with all pregnancies, induction, labour and vaginal birth can be very painful. To cope with this, some women requested pain-relief. Nicola found it very painful when the midwife tried to break her waters so she had an epidural before the second attempt was made. However, not all the women we spoke to had pain-relief – either because they didn’t want the options offered to them or they had asked but not received it. Sometimes the woman was too far into labour for a certain type of pain-relief (such as an epidural/spinal anaesthetic). Other times it was unclear why they weren’t given pain-relief and, if it was for a medical reason, this was not always explained.

Some women talked about the benefits of giving birth vaginally over a caesarean. Dominie said her preference had always been a vaginal birth because it would hopefully mean fewer restrictions on driving (as women who have had caesarean sections cannot usually drive for six weeks).
 

Melissa’s anaesthetist tried to give her an epidural but her contractions were too rapid that she couldn’t stay still for long enough.

Melissa’s anaesthetist tried to give her an epidural but her contractions were too rapid that she couldn’t stay still for long enough.

Age at interview: 27
Sex: Female
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Epidural, yeah, and I really wanted an epidural and by the time the anaesthetist had come round and to do it, because they were so busy, it was too late, basically. And he was trying and trying, he tried to put the needle in my back about 10 times and it’s a big, thick old needle and I just couldn’t keep still for him to do it because I was contracting too quickly. So in the end I had to have him naturally, I didn’t like the gas and air at all and I thought it was horrible so I couldn’t, couldn’t have that either. It made me feel sick. And yeah, so like I say, he come, he come out naturally and it was quite painful.

So you had no pain relief at all?

No pain relief at all and they had to cut me all the way to my bottom, basically, and that was quite horrific. But the actual birth itself didn’t, didn’t hurt. It was the contractions and this guy trying to put needles in my back [laughing]. That was the most painful thing, definitely. And also afterwards, it took an hour and a half for my placenta to come away and I had various people tugging on it and injecting me and oh, that, and that, that was the worst bit, actually, the stitches afterwards and the placenta, trying to remove the placenta. That was definitely the worst bit and that was it, really. But I’m sure people have had worse pregnancies but that seemed quite bad [laughing]. Not pregnancies, births, that seemed quite, quite bad to me for a first one. I just wish I had pain relief. That, that would have been much better, I think, definitely.
 

Kelly had pre-eclampsia in her first pregnancy and her baby was born by emergency caesarean section. She didn’t develop pre-eclampsia in her second pregnancy, and compared these two birth experiences.

Kelly had pre-eclampsia in her first pregnancy and her baby was born by emergency caesarean section. She didn’t develop pre-eclampsia in her second pregnancy, and compared these two birth experiences.

Age at interview: 22
Sex: Female
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I had an emergency caesarean, I think they must be a big difference with having an emergency caesarean and a planned caesarean. Because obviously when it’s an emergency, you’re not prepared, you’re not sure what’s going on, especially if it’s your first one. And you really do feel like you’re sat on Casualty and you’ve got, you know, that anything could happen to you, you really feel like that, so… I don’t know. Having a normal delivery, you do feel scared, because you’re waiting, especially once you know the pros and cons, you’re waiting for something to happen, and in your own mind, you’re sure that something bad is going to happen. But I think that a lot of that is the gas and air, all the emotions, the pain that you’re in. I think if you were thinking on it, on a clear head like I am now, then I’d definitely say it was a better option to have a natural delivery.

And you said also about in terms of the recovery, because you didn’t have an abdominal scar this time. 

Yeah.

Do you feel that you’ve been more independent and able to do more this time? 

Definitely, yeah. I mean, the minute I got onto the delivery ward, not the delivery ward, the mums’ ward, where they put you after you’ve had your baby, I was… didn’t need any nurses at all. Nobody had to come and, other than popping by and “oh, are you okay” or doing their usual routine tests and examinations on us both. Other than that I was fine, I was just happily getting some rest. Whereas when I had a caesarean, I was in, a lot of it was down to the emergency one, but I was in delivery suite for 24 hours, being monitored every 15 minutes for my blood pressure, so I didn’t really… and obviously my baby got took to the special care unit as well, so I think that does put a lot of impact on my caesarean.
Caesarean sections (c-sections)

Some women felt they were given no choice by their doctors about having anything other than a caesarean section. Caesarean sections were sometimes needed if induction and/or labour had not gone to plan, and were sometimes a medical emergency.

Sometimes there was not much time to explain about the surgery or midwives and doctors weren’t very forthcoming with information. Hanna called a friend who was a nurse so that she could explain it to her. Claire didn’t ask many questions as she was feeling very unwell.
 

The situation quickly became serious for Tracey and required her to have an emergency caesarean section under general anaesthetic.

The situation quickly became serious for Tracey and required her to have an emergency caesarean section under general anaesthetic.

Age at interview: 39
Sex: Female
Age at diagnosis: 29
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And you needed to be put to sleep to deliver your baby?

Yeah, yeah 

Did they explain why or?

No, they just said that , "We need to get the baby out, she's killing you," well we didn’t know it was a girl, " she's killing you, we'll just knock you out and pull her out," because otherwise you know my liver would have just burst through the walls.

Yeah and you just can't take it in; it just doesn’t… you know they could be talking about somebody else for all you know. You know you're looking in on yourself; it's a weird feeling because they pumped you full of some many drugs as it is and you're just not taking it in. It's so frightening because at one minute you're fine, next minute you're not; it happens so quick that you're just so unprepared for it; no leaflets, nothing in the… before all the… you know the classes that you go to – I didn’t even get to that point. But there was no information from midwives about pre-eclampsia.

So, I do feel let down really.
Most women we spoke to who had caesarean sections were given local anaesthetics, which meant they were awake throughout the operation but couldn’t feel any pain. Their partners were usually allowed to come into the operating theatre. Stewart tried to reassure his wife, Claire, throughout the operation. Samantha X said her husband helped “make it feel a lot less scary than it actually was”. Aileen has a medical background and so felt she had more insight into “what’s going on inside me” compared to her husband, and so she worried about how he was coping.

Helen X, Janine and Tracey needed general anaesthetics and so they were asleep during the surgery. Some partners found it very hard to be separated from the pregnant woman and not knowing what was happening. This situation was often very different to what they had imagined. As Michael explained, “I’d always envisioned that I’d be in with my partner, helping her, and then the baby would pop out and there the three of us would be together. So what actually happened in reality was quite different. I was waiting in a room down the hallway for a doctor to come and tell me it had happened”.
 

Stephen went into theatre with his wife, Mairi. He was relieved when a screen was put up so that he didn’t see the operation as it happened.

Stephen went into theatre with his wife, Mairi. He was relieved when a screen was put up so that he didn’t see the operation as it happened.

Age at interview: 41
Sex: Male
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And anyway when we got to that point and it was like, "Right, you're up at this end." I was thinking, 'Thank goodness for that.' And then… I'm like sort of talking to Mairi but like at the corner of my eye I'm aware of all the stuff going on. But, 'God I don’t want to see that; I don’t want to be able to see that,' and so I was like… so I was getting a bit of a panic on, and then I was thinking… not like the chopping open and all that, and then I was thinking, 'Would it be totally like unreasonable to say something,' given that your wife's lying out here; is going to get chopped open and have, you know all this, to be worrying about your little… whether I see it or not. And then just as I was thinking, 'I'm going to have say something,' somebody just came and put a massive big curtain and I was like, 'Oh thank goodness.'

And then after that it was pretty smooth sailing. 
 

Betty focused on her husband during the caesarean section. She was sad to have missed out on some things she had wanted for the birth but glad they got to see their son.

Betty focused on her husband during the caesarean section. She was sad to have missed out on some things she had wanted for the birth but glad they got to see their son.

Age at interview: 38
Sex: Female
Age at diagnosis: 37
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I was just looking at my husband. I could feel the cut but it wasn’t painful. It's a very strange sensation. I guess it's like when you've sat on your hand for a long time and it feels all rubbery, and you can feel something at it but it doesn’t hurt. There's no… you can't… it's a numbing… it's a numb sensation. And so I could feel the cut but I wasn’t worried. I think I heard a few sounds. They told us that the baby had… was healthy I think. I heard a tiny little cry from him and then I just remembered feeling really, really tired and peaceful, and I was dozing off but my husband kept trying to keep me awake. I don’t know whether that was dangerous and hence he was trying to keep me awake.

I still don’t know. If I had fallen asleep would that have been OK, who knows? And then I remember them sewing me back up; again didn’t hurt. And so we just spoke for a few minutes whilst they were cleaning [son’s name], and then they brought him round. He was all wrapped up. We had a quick photo taken. I mean it was… it was a little sad that I couldn’t have skin to skin but obviously the most important thing is to make sure he's OK, and they explained that they were going to take him immediately to the intensive care unit, so I understood that. Again in an ideal world I would have asked about cord clamping and requesting for that to take place, but it just wasn’t the time or place for it.

So, was it the ideal delivery – of course not. There were other things I would have preferred but I'm just very grateful that everything happened the way it did.
Whilst the run-up to a caesarean section could be quite chaotic, most women found that it was calm and efficient in the operating theatre. Aileen said that “it wasn’t a traumatic experience; it was a very good experience I must say”. Julie and Samantha X both said the set-up in the operating theatre was like a “well-oiled machine”. However, the emergency meant there could be a lot of different medical professionals in theatre. Some women found this overwhelming. Betty was “absolutely astonished by the number of people”. Mairi thought it was good that everyone introduced themselves but did so briefly and efficiently. 

Most women were surprised at how quickly the delivery happened. For those who had a local anaesthetic (e.g. an epidural), there was no pain but they could usually feel some tugging as the surgery happened. Aileen described the feeling as like “having a good old rummage in your handbag”.
 

When there were delays with fitting an epidural (spinal anaesthetic), Mairi realised that the situation was time-pressured. Even so, she appreciated the efforts of everyone in the theatre to keep the atmosphere calm.

When there were delays with fitting an epidural (spinal anaesthetic), Mairi realised that the situation was time-pressured. Even so, she appreciated the efforts of everyone in the theatre to keep the atmosphere calm.

Age at interview: 36
Sex: Female
Age at diagnosis: 30
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I think at that point you’ve got no real… you’ve got no knowledge to… I mean I just trust… I like people to trust me as a teacher, so I trusted them that they knew what they were doing. And I remember [doctor’s name] coming back in and he said to me, "I wanted to do this section but I'm not allowed; I've got to pass you on to my boss. It's too cut and dry and we've got to get it out now." But they couldn’t get the spinal in either and it took them four attempts for the spinal, and they got to the fourth one and they said, "We're going to have to phone for the senior anaesthetist to come," and she… just as he walked in she popped it right in, and I remember the consultant said, "Hurry up, get that in, get it in now, we've got to get going, we don’t have time for this." So, it's funny I do remember bits that it was quite time pressured, but then we had [member of staff] the orderly who was asking me what music I wanted to choose. So, I was aware that they were trying to keep it very calm and let's have some Christmas music, and it was all very calm but I remember the consultant getting really snippy with the anaesthetist saying, "Just get it in because we've got to go."
 

Paige didn’t like the effect of the spinal anaesthetic (epidural) and it made her vomit.

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Paige didn’t like the effect of the spinal anaesthetic (epidural) and it made her vomit.

Age at interview: 20
Sex: Female
Age at diagnosis: 19
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When I was actually in the delivery room, there was a horrible feeling because obviously they numb you because they’ve got to do a c-section, and the woman's there going, “Lift your legs up,” and I'm going, “I can't”. She's like, “What do you mean you can't?” “Because I can't lift my legs up”. She was like, “Good”. And, “Well, if you know I can't do it, why are you asking me to do it?” sort of thing. And she said like, “It means that it's working if you can't lift your legs”. It was horrible because it's just like your feet are in cement and you're trying your hardest to try and lift your feet up, and you just can't do it and it was just horrible. And then I think because I hadn’t eaten and I was bed-bound and then all of a sudden they moved me round, I got quite sick. So, they were upping the anti-sickness drug for ages. I had loads; I just-, I can't-, all I remember is like going, “I'm going to be sick, I'm going to be sick”.
A caesarean section could mean that the pregnant women didn’t go into labour or have contractions at any point. Whilst this could be a good thing, especially for those worried about the pain, it sometimes made women feel they had missed out on a ‘normal’ part of (vaginal) births. As Lyndsey said of her own experience, “it wasn’t really labour [laughs] as such, so I didn’t really give birth, you know. Well I suppose I did in a way but not in the way that I thought I would”. This could be upsetting; some women felt it affected early bonding and that it could have a lasting emotional impact.

A few people talked about there being stigma associated with caesarean sections, even if these were emergencies and not the woman’s preferred choice. Kelly had heard other people talk negatively about women who have caesarean sections as being ‘too posh to push’.
 

Claire was pleased when she had a chance at a vaginal delivery after circumstances with her baby being breech and a low-lying placenta changed. However, her pre-eclampsia meant that she ended up having an emergency caesarean section.

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Claire was pleased when she had a chance at a vaginal delivery after circumstances with her baby being breech and a low-lying placenta changed. However, her pre-eclampsia meant that she ended up having an emergency caesarean section.

Age at interview: 39
Sex: Female
Age at diagnosis: 39
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Because I'd had a low lying placenta, and the baby was breech, a section had always been on the table I guess. My placenta moved, baby turned and I thought, 'Oh yay get to do it, try and do it myself now,' you know and do it, and once I was admitted to hospital I started thinking, 'Actually this… I don’t know if I'm going to be in here till term or I would have an early baby,' and I think the longer I was in hospital the more it became likely I was having an early baby.

I feel cheated, that would be my honest answer, is I feel cheated that I wasn’t able to deliver her myself. I feel cheated of the last few weeks of your pregnancy – the prep time and things – it wasn’t how I thought it would happen. I'd been to one antenatal class [laughs], I'd been to one ante, you know aqua yoga class. I hadn’t finished the nursery; we hadn’t… you know she came by surprise for the right reasons. It wasn’t how I envisaged as I said earlier. Yes, section had been on the cards; I'd got my head round having a section, that got taken off, I'd got my head round delivering myself which was a whole different recount on its own [laughs]. And then of course it was then the emergency section. 
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