Natural childbirth – why oh why?

In case anyone missed it, I finally gave birth the other week. I can honestly say that despite all the books I read, the other mothers I’d spoken to and the antenatal classes I attended, I was completely unprepared for how horrible it was going to be. I’d like to say that my (awful) experience was atypical, but from talking to staff at the hospital and others in my NCT class, it seems like it wasn’t that unusual. So, here’s what everybody seems to play down when talking about natural childbirth:

It hurts. A lot. You will be pushed to your absolute limits. You may find it empowering, I suppose, and afterwards you may be proud, but in that moment, in that room, you are probably going to feel like dying would be the easier option.

Warning: this is really long and sometimes a bit explicit. You might not want to read it if you’re pregnant or not particularly interested in long and tedious accounts of childbirth.

I guess things didn’t get off to an easy start for me – I’ve always been a bit prone to insomnia, and I hadn’t been sleeping well. I slept for maybe four hours on Sunday night, and then went into labour at around 10am on Monday morning. I did try and take a nap, but even the early contractions were too uncomfortable to sleep through. If I’d had any idea of the horrors ahead, I probably would have tried harder to get some rest in the early stages…

I spent Monday behind a laptop trying to finish the last feature for the new Three Rings release which was going into beta on Saturday (I finally got it working on Saturday after coding round Tiny’s sleep schedule on Friday and Saturday – workaholic? Moi?), during which time I broke half our test suite and didn’t even notice because I’d also broken my dev environment. Ladies, don’t code while having contractions, it’s not a good idea.

By the time the boys went to bed on Monday evening, I was already exhausted. The contractions were coming at less than 10 minute intervals, and lasting around 45 seconds, but were still irregular. At this point, the pain was noticeable but bearable – I was having to stop what I was doing during contractions, but a few deep breaths saw me through each one. I remember thinking it wasn’t so bad, and feeling like everything was going to be ok. Because I’d been at it so long, and the contractions had gotten so much closer together, in the back of my mind I felt like probably I was quite far along already. A friend had given birth a few days before and was already at 6cm dilation (out of 10cm) when she got to the hospital, so I was hoping for something similar.

Around 2am my contractions had started to come at less than 5 minute intervals. This was the point at which the NCT teacher had said we needed to call the hospital, so I rang up the Spires and spoke to a midwife there. I was taken aback when she seemed to think I was still very early in labour, since I’d been doing it for 16 hours and I was pretty frazzled, and rather than the ‘come on in, you’re about to give birth’ I’d been hoping for, I got told to take some paracetamol and call back when the contractions were regular and longer, or when I couldn’t handle the pain, whichever came first.

An hour later I was back on the phone, begging to go in. The pain was making me cry, and I wanted somebody to make it go away. I felt mostly guilty, because I’d been hoping to let the boys sleep a bit longer (they’d been at work all day, after all), but I was still expecting that I’d be having the baby in not too much longer, and didn’t want to risk leaving it to late to get to the hospital.

The drive to the hospital was actually pretty exciting. Grabbing up the last few bits and pieces and slinging them in the car gave me a shot of adrenalin, and as we drove along empty roads headed for the hospital to the strains of “Rainbow Road” from Double Dash – yes, really 🙂 – I felt a thrill of anticipatory pleasure which almost made the pain bearable again.

The Women’s Centre at the John Radcliffe Hospital is kept locked at night for security, so arriving at 4am we had to buzz to be let in. I’m not sure where the buzzer goes, but the person at the other end had no idea who we were, wasn’t really sure what we were doing there and may or may not have been familiar with the whole idea of giving birth. As a result, we were told to go to a different part of the building from the one I expected, and when we got there the staff were as confused by our presence as we were. Eventually it was sorted out and we were into the lift and on our way up to the Spires Midwifery Unit, where I hoped to be told I was soon going to give birth.

When we got there, though, I was in for a disappointment. I’d only made it to 2cm dilation (out of 10cm), and I wasn’t going to be having the baby for some time to come. After a quick stretch-and-sweep (basically the midwife poking me in the membranes to try and encourage my waters to break) I was given some codeine and sent home again. The drive back was much less fun, and the codeine made no difference to the waves of pain. Each time as I screwed my eyes shut and forced myself to breath, I felt like there was no way anything could hurt more than this.

And I was so wrong.

Back at home, I sent the boys back to bed and sat in the bath for a while (hot water seemed to help). When that stopped working, I curled up miserably on the sofa and tried to read – turns out Game of Thrones is not a soothing way to pass the time.

After a while I found the best way to get through the pain was on all fours, so I spent a couple of hours lying on the floor wrapped in a blanket trying to sleep in the scant  minutes between contractions, with only my bucket for company (I was also feeling very nauseous by now). My insides were twisting up painfully every few minutes at this point, but there was still no pattern and my waters hadn’t broken so I continued trying to stick it out.

Finally at around 7am on the Tuesday I couldn’t handle the pain any more, so I woke up the boys and we got back in the car. The second drive to the hospital was a lot more sombre. I was vocalising through the contractions now, drawing in deep breaths and letting them out with something between a grunt and a scream. Thanks to the floods, everyone seemed to be out early, too, so the roads were already clogged with traffic and it took a lot longer to get to the hospital. As we inched up the hill past our old home in Marston, I tried to take comfort from the fact that surely, surely, this much pain meant I was making some progress.

Nope.

A shift change was just happening as we reached the Women’s Centre, and several medical personnel gave me sympathetic grimaces as they headed through the halls in one direction or another while I waddled and panted my way slowly back to the lift. Walking was very difficult by now, and I had to stop every time a contraction hit, so it took some time to get from the car up to the Spires. I’d ceased to care even a little about my appearance, and was still wearing a pair of disreputable pyjama bottoms and a grubby vest from the night before, with a battered old hoodie over my shoulders against the cold.

The new midwife on shift had a student shadowing her, they were both very lovely and friendly but that didn’t help with the disappointment when it turned out I was still only 3cm dilated. This was to be the last time the midwives checked my cervix, I suspect because they didn’t want me to be focussed on how far I still had to go. I hadn’t slept and had barely eaten in nearly 24 hours at this point, and I think they could see that I was hardly managing to hold it together, because this time they didn’t make me go home (although they did suggest it as a possibility if I wanted – I didn’t. I wanted someone to look after me and make it not hurt!).

Instead, I was given Meptid. This opiate-based injection is offered instead of Pethidine these days, as being less strong and less dangerous. I’d heard bad things about it from our NCT teacher, but exhausted and overwhelmed as I was, and with the assurance that there was still a long way to go, I would have tried anything. First they gave me an anti-nausea medication, since the drug can make you sick and I was already feeling pretty unsettled in the stomach area. I then had to wait 15 minutes for that to take effect before I could have the injection. I was finding the contractions easier to cope with when standing up, but I was to tired to stand up all the time, and the pain was too great for me to be able to get up once a contraction started, so at this point the boys were hauling me out of bed when I started moaning so I could lean with my head against the window until it passed before sinking back into the bed to feel sorry for myself some more.

Once I got given the Meptid, though, I actually had a couple of hours which weren’t too bad. The pain didn’t exactly go away, and I couldn’t sleep through the contractions, but they became more of a nuisance than a threat to my sanity and in between them I managed to catch small fragments of sleep. When I had to get up to go to the loo the whole world felt very weird, though.

After about 90 minutes that started to wear off, and I spent some time stomping slowly and grumpily around the perimeter of the unit, pausing at regular intervals to lean my head against the wall and making extremely undignified noises. I feel sorry for the people I saw on antenatal visits during this time – I imagine they went away scared! About this time the boys took it in turns to go down to the cafeteria for uninspiring hospital food to supplement the snacks we’d brought with us. I highly recommend having two birth partners – makes it much easier to spare one of them!

By 1pm the Meptid had worn off completely and I was once again begging for more pain relief. Each contraction felt like it was tearing me apart. Unfortunately, I still wasn’t in established labour so they wouldn’t let me have Entonox. As an alternative, the midwife arranged for me to go and use the bath on the nearby recovery ward. The pain had got sufficiently intense by now that I was shucking my clothes and climbing in before she’d even closed the door. The bath did help a bit, and again between contractions I went to sleep, sitting up (which is a pretty weird experience).

Once again, when the bath went cold its magic wore off and I waddled back to Spires sore and unhappy. This time, though, the news was better – I was finally in established labour, and that meant new and exciting pain relief options!

I was moved to the ‘active’ birthing room, which has hammocks, birthing balls and other paraphernalia to encourage a variety of weird and wonderful positions for labour and birth. I made basically no use of them, though, since I was so shattered I mainly just lay on the bed and felt sorry for myself. The other plus of having finally made it into the birthing room, though, was that I finally got my hands on a cylinder of Entonox.

For a while, that stuff made the pain go away completely. I actually started tripping out. You have to start huffing it as the contraction starts and keep breathing it in until the pain has finished, and for a while (I have no idea how long – my perception of time was completely warped by this point) my brain just transformed the pain into something else and I was completely absorbed in the pretty pictures. I remember trying to explain what I was seeing to the boys between contractions, and failing miserably. I remember one particular double-peaked contraction which turned into a pair of majestic mountains sillhouetted against the sunset. Another time, I found sudden and intense beauty and meaning in the last verse of a hymn I’ve always liked:

Breathe through the heats of our desire

Thy coolness and thy balm;

Let sense be dumb, let flesh retire;

Speak through the earthquake, wind and fire,

O still small voice of calm

Again, trying to explain this to the people who weren’t tripping out on gas and air didn’t really work…

Sadly, all good things must come to an end and after a while the pain kicked up a notch and started cutting through the crazy hallucinations and dragging me back to reality. About now I noticed in a detached fashion that it was getting dark again, the second dusk I’d seen since going into labour. My life had shrunk to the few minutes of relief between contractions, and it was impossible to measure the passage of time in anything more substantial than moments, so the concept of another day having gone by seemed completely meaningless.

Just as I was starting to feel that I’d actually rather die than carry on trying to produce this child, the midwives said that the water birthing room had become available. So it was that I ended up in my 5th different room at the hospital, this time with the relief of a giant tub of water to climb into. For a while, again, the heat helped make me a little less crazed (although I continued to suck down the gas and air). Dan was a hero throughout this time, taking charge of the Entonox so I always knew where it would be and had only to look for him to find relief.

And then it suddenly got a lot worse.

Transition hit me suddenly and unbearably in the middle of a contraction. I had the Entonox mouthpiece in my mouth and started to choke on it, and in my exhausted, pain-addled state I blamed the gas and air for the ridiculous, mind-bending pain I was now feeling, and stopped taking it.

The contractions of transition were so, so much worse that all the horrible pain which had gone before suddenly seemed trivial. I couldn’t move, couldn’t think, couldn’t talk. I wedged myself facedown diagonally across the bath with my legs braced against the other side and refused to move. The midwives kept trying to get at my abdomen with the hand-held monitor to check on Tiny, but I was simply unable to move to help them. I have a half-memory of a conversation with one of the midwives where I begged to be told that the next stage would be better – somehow I remembered that transition isn’t supposed to last all that long, but I couldn’t remember what came next. All they could tell me was that some people find stage 2 labour easier because the pain has a purpose and they can feel the baby coming. Sadly, that wasn’t to be my experience.

I don’t recall clearly the point at which I started pushing. I remember being told that I should be feeling like I was doing the biggest poo of my life. It didn’t really feel like that – it was further back than I’d expected, true, but I was using whole new muscles and it was like nothing I’d felt. There came a point at which the midwives were urging me to push with each contraction, but I honestly couldn’t have not pushed if I wanted to. The pain was about the same, but I was getting used to it now and managed to roll over and even talk a little.

I remember JTA holding my head and giving me gentle encouragement. I remember recovering my mental faculties sufficiently to start taking the gas and air again. I remember at some point rolling into a squatting position in order to take a drink, and the midwives telling me how much better that position was for giving birth, and not giving a tuppenny damn whether they were dissappointed when I went back to lying on my back afterwards. Probably the worst bit was when the midwives did some checks and confirmed what I already suspected – Tiny wasn’t moving when I pushed. She’d become lodged somewhere in my pelvis and all the pushing I’d been doing wasn’t making the slightest bit of a difference. Mostly, though, the two plus hours I spent fruitlessly pushing and making no progress have blurred into one big horrible mess of pain and frustration. Some time during this time my waters finally broke, but I don’t think I even noticed.

The midwives’ first theory was that my bladder was too full and was blocking the baby from coming out. I hadn’t peed in many hours at this point. They encouraged me to wee in the pool (which would have been gross, but the pool was already gross at this point and anyway I was too tired and in too much pain to care), but I just couldn’t do it. Every muscle below my waist felt completely flat and limp, and I couldn’t even remember how to pee. Eventually they made me get out of the pool so they could do the catheter thing. It didn’t make any difference, and for a while I lay on the trolley where they’d put me while they poked me, poked the baby and muttered acronyms at each other. By now I was more tired than I’d ever been in my life, spending the time between contractions protesting weakly that I was too tired to push and then finding myself pushing uselessly anyway the next time one hit.

Eventually the midwives concluded that Tiny was rotated slightly sideways, with the wrong part of her head against my cervix, and wasn’t coming out without help. Once they’d made the decision to bump me to the doctors, things seemed to happen quite quickly. I was asked whether I’d prefer to ride downstairs in a wheelchair (ha! I couldn’t even have got of the bed, let alone into a wheelchair), then we rumbled off into a lift and down to… Floor 2? That’s my best guess. I was totally oblivious at the time. I remember the lift and then the delivery room, but I couldn’t tell you where it was. According to the boys, we waited around for a while for the consultant, but it felt to me like he turned up pretty much as soon as we were in place. Don’t underestimate the power of knowing that something is being done to fix things!

By a weird coincidence, the consultant was the same doctor who had seen me when I miscarried last year. I toyed with feeling uncomfortable about that, but the truth was it was sort of pleasingly circular. Of course, in my exhausted and whacked-out state, I spent some time trying to work out whether it was actually the same guy or if I was just confused.

Probably the worst thing from my point of view at this point was that they strapped me up to an external monitor which showed exactly when my contractions were coming. For the past hour or so I’d been lying and saying they’d ended earlier than they actually had so I could stop pushing, but now the jig was up and I was having to push all the way through them (still crying and saying I was too tired in between them, of course).

Finally the consultant was in place and set up with what I’m told was a scary array of implements (I refused to look). I was hoisted up into the stirrups, not exactly a dignified position but by this point I had no conception of modesty anymore. He told me he was going to inject me with a local anaesthetic, and something in the back of my mind connected “forceps” with “episotomy”. He didn’t tell me he was going to cut me, but I could tell that was what was happening – theory says I should have been too numb to feel it, in fact I could feel it but it barely registered compared with the pain I was already in. Technically I’d consented on my birth plan, which stated that I was ok with whatever interventions proved medically necessary, so I guess that’s alright.

I don’t think I even felt the forceps going in. The consultant (who’s name I still don’t know, which is weird considering he’s been inside me twice!) gave me a very serious look and explained that although he was going to guide the baby out I still had to provide the power. I think I managed a weak nod. I was desperate for this to be over, so I started pushing, which earned me a telling off – I was supposed to wait for another contraction. It felt like forever, but finally the familiar pain started ripping through my insides, I bore down and this time, miraculously, with a surge of relief, I felt Tiny moving. The midwives got all excited and told me her head was out – we were getting there!

And then the contraction ended. The baby was only half out. I was suddenly struck by the hilarity of the situation, half a dozen medical personnel stood around my naked lower portions, half a baby hanging out of me, all just waiting for the next contraction to come along. I tried to crack a joke about it being awkward, but my voice was basically gone after all the gas and air I’d taken in the last couple of hours.

Finally that last contraction came, and she was coming out. There was a moment when I was told to stop pushing and pant instead. I really did try, and at the time I thought I was doing it, but Dan tells me I was still pushing a bit which is probably why I ended up tearing despite the episiotomy. Then something surprisingly large and incredibly purple was being handed to the midwives, and it was over.

There’s a lot more I could say about the aftermath. I spent what felt like an hour huffing even more gas and air while the consultant stitched me up (and I could still tell when he strayed outside of the areas where I’d had anaesthetic injected). The midwives were super nice, and arranged for somewhere for JTA to nap, as well as ordering tea and toast for all of us (that piece of toast was the most delicious goddamn thing I’d ever eaten, by the way). In a weird way, that made it harder when I was carted off to the recovery ward by a different midwife (who was surprisingly unsympathetic about my inability to sit in the wheelchair) and plonked unceremoniously in a bed with only the grumpiest healthcare assistant ever to look after me. I’ll leave it there, though, because I’ve already written more than I ever intended to about this whole thing and I’m already doubting that anyone could possibly want to read this whole thing.

All I really wanted to say was this: natural childbirth is a ridiculous idea. I don’t feel like I gained anything by going through that. Would I do it again if it was the only way to have my incredibly cute daughter? Sure. But it’s not. Why, in a world where we have safe and effective anaesthesia, are people still being encouraged to do it the old-fashioned way?

Next time I’m just getting the damn epidural.