The hospital I would prefer to give birth in (actually the only one I’m prepared to give birth in) is about to be taken over by a company called Circle; in fact, it will be taken over in the same month (quite possibly the same day) that Marmite is due to be born). This is fairly appropriate, since I am going around in circles about how on earth to get this baby on the outside with a 100% survival rate for the two of us and my sanity intact. Mostly I’m trying desperately not to think about it but with perhaps just 12 weeks at most to go, it is beginning to be a good bit harder not to think. So much will depend on the circumstances near the end, but so much also involves everything that has gone before, for me, all my children, Freddie and Josie in particular.
What really matters is that Marmite and I both survive, with all our health and faculties in one piece. Max has to survive the day too, as do the four girls who will be waiting at home.
Nobody knows why Freddie is dead. No one has been able to explain to me why a straight forward labour, well monitored and attended by not only an impartial onlooker but also an experienced midwife and a consultant, resulted in a baby with oxygen blood levels just the right side of a stillbirth. No one has explained why that happened when there didn’t appear to be a cord accident. No one can explain why he followed no obvious pattern and why when the country is full of the survivors of traumatic births, albeit damaged, Freddie died within a few days. He wasn’t even being discussed as the top end of damaged. He could breathe on his own. He could move. He could look at me and try to make noises. But he died – and surprised everyone but me by doing so.
So I have no idea what I’m trying to avoid. I have no idea whether I should avoid another normal birth, because I have no idea if he is dead because of that 3 hour, smooth as silk active labour where he never showed any signs of distress. Two consultants, a midwife and a doula have assured me that had that been my first delivery, at no time would anything different have happened. That delivery was never a vbac only because I wanted it, no one was umming and aaahing about taking me to theatre. 3 hours from 2cm to delivery.
It could be that Marmite is cooking up exactly the same outcome, for all I know 🙁
I do know that no one thinks going to 40 weeks is a good idea.
I don’t do early labour; the earliest of mine was due date Maddy.
I’ve had 3 sections, the last of which was now over 7 years ago. My last consultant (who retired straight after Freddie 🙁 ) was prepared to let me have one gentle induction attempt. My new one isn’t.
So I can’t be induced unless I happen to be in a position where breaking my waters is easy at say, tops, 38w 4d.
I’m not renown for well positioned babies; Freddie was the best of them. This baby has lots of stuff in its favour, my weight is good, the placenta position is good. But none of that is going to make me go into labour at 38 weeks.
So if I can’t be induced, I’m going to have to have a caesarean for the sake of sense and sanity.
It seems like that is the easy option.
I can plan it. I can organise it. It will be calm, organised and people who matter to me (my midwife, my doula, ‘my’ paediatrician, my consultant and the girls) can all be organised to be in the right place at the right time.
Except it won’t be calm, because I won’t be calm. Because the last time I had a section I ended up with 25cm bruises down my arm from injections that they removed references to from my notes, I was vomiting, I was bleeding heavily, I felt like I was falling off the table, I pushed my baby away and I heard people shouting at me to stay still while I was sick, I heard people saying “stay awake, stay with us” and my husband thought I had died and left the room. My notes say “normal caesarean”. I was FINE and so was Josie, before we went into theatre. There was not even a good reason for it to end that way.
I can’t even begin to imagine putting myself in that position again. It doesn’t matter what people say is most normal or most common, I know only too well what else can happen with statistics. It doesn’t matter that elective ones are different, they don’t ALWAYS go well. I already know I’m scarred and messed up in there.
I can see the positives and then I start to list all the things that frighten me about that as an option.
Actually getting there, with no adrenalin, and no’ need’.
Operating theatre lights. Panic.
Suction machines. Panic.
Epidural. I have a really dodgy back, already made worse by previous ones and getting them in is always horrid, painful, upsetting and leaves me in huge discomfort for weeks.
Knowing there is every chance the baby will be surprised to be born and need sorting out away from me.
The days of coughing and spluttering afterwards while he chokes up congealing amniotic fluid and has to be sucked out because he’s struggling to breathe. Happened with Fran, going to be all too close to watching Freddie.
The big one, the HUGE HUGE thing. What if this baby has to go to SCBU? I won’t be able to go too, I might never even see him alive. I’ll be in a bed, in a room, utterly out of my wits with fear and I won’t even get the time I got with Freddie.
What if he dies and I’m stuck in hospital recovering and can’t get away? I won’t be able to be with my girls (who will almost certainly not be allowed in because, again, the hospital will be closed down because of vomit bugs. Max won’t be able to care for all of us.
Even if it all goes well, it will mean 2-3 days in the same ward I paced up and down in while Freddie tried to live. I’m not going to cope with crying babies, being on my own, sympathy, lack of sympathy, accidental malfunctions of care.
Even if it goes well, there are the stockings and the overwhelming fear I have of bloodclots, the recovery, the Clexane injections, the wound checks and the miserable numbness and the coughing and sneezing and not being able to get about easily or drive or have the endorphins that make feeding easy and coping with a newborn easy.
And I know, because I’ve done it three times, that I don’t mentally recover well from caesarean birth. I just don’t. It does something to my hormones and my sense of well being and connection to people. It gives me nightmares and low self worth and I cut off and feel bad and I don’t enjoy mothering after it particularly well. I’m not sure that those things, risking those things, on top of the emotions of a rainbow baby, are a good idea. On top of another dead baby, they’d be a very bad thing indeed.
It’s just not an easy option.
So that takes me back to VBAC. I can’t be induced. I can’t seriously wait till 40 weeks, never mind beyond, not only because of my sanity and the rest of the families’ sanity, but medically.
I can’t be induced without some risk.
Induction ups my ‘maybe’ rupture risk of about 1%-ish to a bit more like 2% – but, quite understandably, not something a health professional can be forced to take on. That’s only 4 times my risk of another random neonatal death, which everyone assures me won’t happen. I wouldn’t give up my job on a 1 in 50 chance of winning the lottery, the fact that Freddie’s birth was smooth is a good thing. But.
I could even have a a totally different random event. A PPH. A cord accident. A baby who gets stuck. A long drawn out labour that ends in an emergency section.
I could have a perfectly smooth birth if I wait to 40 weeks+ and a baby who screams.
I could have another dead baby to say goodbye to.
I could die.
I could lose my womb.
I could go home that afternoon with a happy baby and a happy mummy to relatively emotionally intact children.
I could have all those things happen, bar the last, if I have a section.
If I’m too scared of random natural birth events to have another VBAC, I have to have a section.
But what on earth do I do if I’m too scared to have a section and can’t have a VBAC because I can’t be induced and I can’t make myself go into labour at a time that is sensible and safe?
What if I VBAC but the obvious concerns and stress it will cause me and Max and my carers means it is clinical and complicated and anxious and breaks all the good things and all the healing I got from Freddie’s birth?
I don’t feel like I have a single option that looks safe, risk free, outcome assured and emotionally manageable at the moment.
And through all of this, I know, I just know, that what really matters is a screaming baby who comes home.
But what if I make the choice that means this time it is ME that doesn’t come home? What if I make the choice to do it the ‘easy’ way and he doesn’t breathe and I never even get to hold his hand while he’s alive?
To be honest, and I know this might seem a small thing, what if it all goes well and I come to pieces so badly afterwards, like has happened before, that it turns out to be the straw that breaks the back of the camel that is our marriage. Because Max will NOT understand, if I lurch from neonatal death trauma, to birth trauma. He will not be forgiving of that because he will simply not get it.
Knowledge and experience isn’t empowering me at this point, it’s just terrifying me. It’s not like I can stop the clock either. One way or another, this baby is going to have to come out.
Edit: I’ve had a few emails suggesting that I opt for a home birth to reduce the stress. Just to clarify; I swapped hospitals after the girls and I love my new hospital, which has treated me with care and respect throughout. Freddie’s birth was perfect and couldn’t really have been more perfect if it had occurred at home. Leaving aside the remote possibility that somehow the car drive caused his distress (unlikely given he didn’t appear to be in distress when we arrived), all a home birth would have done for me would leave me feeling he could have been saved if he’d been in hospital and everyone else would think so too. Nothing would persuade me to give birth away from a SCBU unit now. I really appreciate the care and thought in emailing me, but it isn’t an option I want to consider.