I have started to write this post many times, and stopped many times. I even put virtual pen to paper a week after the girls were born. But it all became a bit of a rant, and therapeutic as it was for me, I didn’t think it would help anyone. Quite the contrary, and I questioned my motives for doing so. The desire for revenge, as I pointed out last week, is a bitter poison and tends to only hurt you.
However as time has gone by, I have a new perspective, and I think this IS important. Because the more new mothers I meet, the more horror stories I hear. And these are genuine horror stories. A fellow twin Mum realised just in time that a nurse had mixed up farenheit and celsius, and had put her jaundiced (but now bright red) baby to roast at the same temperature Blummenthal cooks his meat. For example.
In fact, I haven’t heard a single happy story, and that is why this is important. Mother Nature is ruthlessly efficient and you forget the physical pain. Otherwise our species would die out in a generation. But the emotional ache lingers. And I get the distinct impression the medical establishment are blissfully unaware of that upset because, unless someone has died, who complains? You’re so blooming grateful your baby is alive, that you’re alive and also YOU HAVE NO TIME. You have less than no time. The whole fourth dimension has vanished from your existence, to such an extent that you seriously consider having a potty in the lounge FOR YOU because otherwise, seriously, when are you going to go? Given that, who’s going to reach back through the pethidine haze and try to explain that you weren’t just crying because of contractions.
So here it is, in all its gory glory. Those of a delicate disposition may wish to look away. It will still be a bit of a rant – and for that I make no apologies because DAMN it feels good. It’s also incredibly long. Well, so was the labour. But at the end I try to be sensibly constructive and draw some lessons for both prospective parents (especially, but not exclusively, those who’re going to have multiples) and the medical profession. I’m sending a copy of this to TAMBA, who are Boudicca-like in their campaigning for twin parents, and to the hospital in question, whom I will be mature and not name here so they have their right to respond to me first. So let’s just call them Queen’s College, a renowned university teaching hospital (and that’s important, because younger staff learn by observing their supposed betters). On Sweden Hill. In London…Ontario.
It occurred to me in a moment of cold and distinctly unhelpful clarity the day before we were due to be induced that childbirth is statistically the closest a woman gets, willingly, to death. We walk right up to the edge of the cliff, holding our unborn children, and stare over the edge. That thought is scary enough without thinking that a team of people, through a mixture of bumbling ineptness and mardy vindictiveness, might just jostle you over.
It’s as if, each year, 800,000 pregnant women were rounded up, stood on that cliff, and then 64 pushed off. That sounds like quite good odds, doesn’t it? But that’s SIXTY FOUR DEAD WOMEN. Now. In the UK. In 2013. When we’re ploughing billions into shaving an hour off the journey time to Leeds. When we can find the God particle and buy tickets to space. We still can’t safeguard our mothers. Interestingly, if they were all from London…Ontario… that would rise to 160. And is that because of complications and octuplets and House-like conundra? No.
An NHS investigation into maternal deaths in London found that 26 of 34 deaths in 18 months involved “avoidable factors” – meaning that if the cases had been managed differently, some of the lives might have been saved.
In 16 cases, the deaths occurred after consultants failed to supervise junior doctors, or when the trainee medics did not recognise “the limits of their abilities” the damning report says.
And that’s just the mothers. One in 200 babies are stillborn. That’s really not very good odds, is it? The British Stillbirth and Neonatal Death charity SANDS produced a recent report Preventing Babies’ Deaths: what needs to be done in which they claimed “Around 500 babies die every year because of a trauma or event during birth that was not anticipated or well managed. These deaths, when they occur at term, should never happen and almost always could be avoided with better care.”
I think part off the issue is we’ve become inured to the perils of childbirth. In civilisations gone by, they may have been without pain relief, but what they had instead was a healthy respect for the mystery and the severity of the act (not to mention being surrounded by the women of the village who visibly cared for the mother and the outcome). It’s so commonplace, one born every minute, it’s just how babies happen…but it is SERIOUS. And twins, well. Their incidence is on the rise and partly, yes, that’s due to IVF. But mostly it’s because more of them are surviving. Nature doesn’t mean for you to have two, she was just covering her options; we’re not designed for it, and EVERYONE needs to fight for you, and them. For a start, they could do with remembering there’s two inside you. Or even just that you’re there .
So now let’s begin our story, one in which both Jon and I felt instead that the only fighting that was being done was Us against a ‘sorry, it’s shift changeover time’ Them.
It didn’t start auspiciously. According to the NICE guidelines which TAMBA helped write and, indeed, Queen’s own best practice, expectant multiple Mums are meant to have a named team who meet with you during the pregnancy and should, where possible, be present at the birth, headed up by a named consultant. I saw 4 different consultants. People kept saying, ah, twins, you’ll be with Mr Marsh, he’s brilliant. Well, all power to him, but I never met the fellow. However, thankfully, all processed well (split pelvis and broken ribs aside). In this we were lucky, as 60% of twins are born before 34 weeks. At 36 weeks the scan was fine, although Romilly was pushed up behind my ribs and wasn’t growing as much. I had to ask about an induction which is meant to happen automatically at 38 weeks. The consultant said, OK, we’ll book you in, in a way which suggested I was forcing the issue. So we were scheduled for Monday 19th March, and told to call at 9am before we went in. Which we duly did, and were told they were busy and to call back in an hour. This then continued hourly till 3pm, a tummy fluttering limbo, at which point we called a friend who, fortuitously, was heading up Women’s Services at Queen’s at the time. Lo and behold, we were asked to come in at 4pm (reading between the lines, I think we will have been de-prioritised as ‘just another induction’, without realising how pressing an induction for twins is; the 38 week cut-off is not an arbitrary one, especially when one of them isn’t growing).
So we duly arrived, checked in with Reception and then sat. For another hour. We didn’t want to make a fuss as we’d been told they were busy, but when the receptionists changed, we asked how long the wait was, she went and checked, and then surprise were shown straight through. The first instance of obviously having been forgotten; interestingly I saw my name wasn’t on the main wipeboard. We went into a sort of holding bay with beds for Mums in the early stages. A nice enough Irish nurse – let’s call her Maureen (or maybe Margaret, wasn’t concentrating!) – checked me and the twins’ heartbeats. We then sat on the bed till 7pm. At this point she gave me the drugs to induce the labour, and strapped me to a monitor to check the contraction timings and the girls. After about half an hour I began to cramp. It feels, in the early stages, a bit like needing to go to the loo, so I asked to be unhooked and lumbered off. The nurse had told us I’d probably have the twins by midnight so I thought it might be an idea to go before (see Mum, some lessons have sunk in!)
Maureen never came back to rehook me. In fact, she vanished. The contractions had now properly kicked in and were rapidly becoming agonising. It was now after 8pm. Jon, on the first mercy mission of many, went to ask at the main desk if someone could see me, and was told there was a shift changeover. Another half an hour passed and he asked again. He was told the new team were doing their rounds and we would be seen shortly. Another half an hour. The team turned up in their hosts. They were just checking in and would see me properly later. The consultant said I would be induced in a while. I said I’d already had the drugs, which seemed a surprise to him. He asked why I wasn’t on the monitor and got one of his team to do it. I said I was in agony and he said he’d come back.
Another half an hour passed. I was trying not to scream now, for the sake of the other Mums. I’d had not so much as a Paracetamol. Jon went to the desk again and said I was going into labour and needed to be in the delivery room. With reluctance, someone came 15 minutes later, unhooked me again, and moved us. I looked at the wipeboard again and I still wasn’t there. I finally changed out of my jeans. I was kneeling on the floor and yowling. The whole primal process was well and truly kicking in. Jon went again to the desk and said he wasn’t moving till someone saw me. The receptionist called the delivery room I was in to speak to me. Bizarre. She finally got hold of the midwife who was meant to be looking after me. In the meantime another midwife had heard me and come in and was asking why I was on my own, on the floor. She was in the middle of another birth but managed to find the midwife who should have been with me. She ambled in with her junior, said they’d come back . More time passed. Still no monitor, and no pain relief.
Finally, about 6 hours after arriving, I was seen by the midwife and a doctor, and the monitor was set up. I was in hyper contraction mode; the drugs had sent me too quickly into a too rapid labour as they were pretty much constant. Two doctors were now on the night shift and called the consultant who they told me was ‘worried’. So I was given a drug to slow the contractions down, and given some pethidine and gas and air. Bliss. And they also finally set up two heart monitors for the girls, which showed Romilly’s rate being erratic. Cue then a lonely vigil with those two doctors floating in and out like shadows to peer anxiously and lengthily at the three traces for me and the girls. Thank GOD I had one of the midwives – let’s call her Noemi – I’d seen during the pregnancy with me as they’d summoned her from her bed. She was Italian, and brought with her all the warmth and chattiness associated with that country. She was brilliantly meticulous about moving the pads to keep the traces, as it’s hard to monitor two hearts and make sure they genuinely are two hearts, not just one measured twice. She checked on dilation and was there when my waters broke (the first amniotic sac as obviously with twins there are two!) My only slight moment of irritation was when she suggested I sleep. I was having blooming contractions!!! But she warned me she had to do a home birth in the morning, so the team would be changing. She was also great about telling anyone else who came in to introduce themselves and explain to me what was happening, something which didn’t happen naturally. At one point when let’s-call-her-Noemi was sleeping someone marched in and started examining my genitals, without introducing themselves much less asking.
I spent the night, in between contractions, playing Solitaire on my Blackberry and discussing baby name options with let’s-call-her-Noemi. Jon tried to sleep on a rollmat on the floor.
I hadn’t been seen by a consultant since 10pm the night before, and then only cursorily. It’s worth remembering that. I was having twins. I was booked in. I’d been induced. It had gone wrong. But in the 16 hours I’d been at the hospital so far, a consultant had spent less than five minutes with me. At about half eight, a new consultant – let’s call her Nicola – finally came in. She said labour was some way off as the contractions were slow. I pointed out that was because I’d been given drugs to slow them down. ‘Well, anyway, you won’t be dilated’. I said I thought I was and asked what the risk was in checking. Cue pursed lips, but she did, and surprise, I was 10cm.
Two new midwives came in and said we’d probably start pushing at 9.30. The brunette seemed well meaning enough, but had the look of a markedly unsure WI volunteer who’d been drafted in from the hospital canteen. She said she’d never been at a twin birth and was looking forward to it. Confidence inspiring. I said I should probably have the epidural now then. Why? asked the blonde (let’s call her Becca). I said that it was normal with twins because of the likelihood of having to turn the second twin after the first was born (Romilly was transverse) and it would need time to kick in. Huffing. At 9.30 it was done and Becca said we’d wait a while for the pushing because of the epidural having to kick in…So at 9.45, finally, we started.
I’d said in my birth plan that I wanted to be as mobile as possible and not push on my back. Becca said we’d start with me lying down because it was easier for them with the monitors. I said we could use an electrode scalp monitor on one of the twins and that would help. She said no, let’s just have a go. So I started pushing, with Becca at one end, using that sing song voice you talk to toddlers with in a way guaranteed to send any woman on the brink over it. The other midwife was in charge of the heart monitors for the girls, but had lost Romilly. I was told to stop pushing. Much faffing later they called a sonographer (I presume, we were never told) who didn’t speak English. Now just more people faffing. She got an ultrasound machine but couldn’t work it. We now hadn’t seen Romilly’s heartbeat for 30 minutes. Jon started getting stern with them, and asked if there was anyone else who could help. Again, minutes slipped by with us obviously thinking Romilly’s life could be too, given how concerned the doctors and the absent consultant had been with her heartbeat during the night. Finally, at 10.30, let’s-call-her-Nicola, came back. Things sped up. She asked for another ultrasound machine. It didn’t work either. She sent someone to the Oncology department. At some point I snapped at Becca that it was like the Keystone Cops. Sue me. I thought one of the twins was dying, or worse. She asked what was that, and someone explained. She stormed out of the room.
The oncology machine didn’t work either. It had now been over an hour with no heartbeat. The consultant started looking grave. She said we could try pushing again, but we’d have to go to theatre just in case and she would probably need to use forceps so that Charlotte could be delivered quickly enough to get to Romilly in time. Or we could have an emergency caesarean. Jon was ashen by this stage and visibly trembling. I asked let’s-call-her-Nicola what she would do, and she said we needed to get Romilly out as quickly as possible, so EMCS. Jon and I looked at each other, he was sobbing now, I was floating somewhere over the room but everything felt very clear now, and the decision was made.
The consultant asked who wanted to be there and Becca, who had been brought back, said no and walked out again. Great show of support. But from that point everything was so much better. I guess it was the sense that we were now being taken seriously, that we couldn’t be forgotten, that there was one person who had now made it her job to deliver our two little girls. We were whisked off to theatre, now with about 15 people in the room, and two little respiratory units set up for the girls, just in case. The anaesthetist was brilliant at making me feel safe in his hands. I laughed at Jon in his scrubs. It was all going to happen, and duly did. The bizarreness of feeling two people with their hands inside your guts aside, at 11.39 and 11.40, the ladies were born and THANK GOD Romilly was OK. In fact they were both OK. I’d been so focussed on Romilly’s heart that the general worry had been pushed to the back of my mind – the fact they’d had live yellow fever, epileptic drugs, anti malarials, endless raw fish, cigarette smoke, a month long holiday’s worth of pisco sours and dodgy Peruvian home brews; all the factors that had worried the medics and us during the pregnancy. But they didn’t have two heads. All limbs were present and correct. In fact, they were blooming gorgeous. One of the pleasant side effects of a caesarean is that the babies don’t get squeezed, so instead of the blue conehead mutants you see on One Born Every Minute for which I’d prepared Jon, they were pink and smooth and PERFECT. Like dolls.
Somehow I managed to take this photo from the trolley!
Fellow Mums will recognise the disembodied strangeness of the aftermath. You’re so whoozy with the anaesthetic, and the side effects they don’t tell you about (your face swells up, your nose is completely blocked, you are thirstier than you have ever been) and this extraordinary thing has just occurred. You’re cuddling your dolls (are they yours? What just happened?) with the screen still raised, aware that you’re being stitched up, feeling the pull of the thread, but you’re in a bubble, there at the head of the bed, your little family. One of them was crying and I joked with the anaesthetist that they probably liked the theme tune to the West Wing because they’d listened to the entire box set through my tummy, and he found it on his iPhone and played it and they stopped. A rare moment of being treated like an adult human and not a deaf and mute and particularly thick whelping sow. They were whisked off with Jon to the recovery area.
But the upset doesn’t end there, sadly. I wish we’d upped and left the hospital then and there. We would have coped so much better just with a maternity nurse at home. But instead we had three days of pretty much everything you’d NOT do to help newborn twins and their Mum recover from trauma.
In the afternoon we were moved onto the normal ward. There was a mother next to me who was having her baby taken away by Social Services. There was a guard on the door. She had two male visitors and a toddler and I felt desperate for her for, oo, about one minute until I heard her telling the boy to ‘put that in the effing bin or I’ll effing chop you into pieces’. Another woman was walking round the ward singing gospel music. Everywhere there was noise and bright light and I just wanted to sleep. So badly. I hadn’t slept on Sunday night through nerves. On Monday I’d been in labour. So very tired. Multiples are meant to be in private rooms, because of space, and the interventions needed. Again, we had to rope in our friend and finally we were moved in the evening.
I think the combination of moving ward and another shift change then meant we just weren’t seen that first day. None of the checks that should have been done on me or the girls happened. I didn’t get a meal. Jon left at 10pm and I was on my own. The girls needed feeding and with the C section it was very difficult to lift them. I pressed the alert button at 2am and someone – no idea what her role was – helped me for half an hour. The girls weren’t feeding very well and she said to persevere for an hour. So I kept trying to feed them for an hour, every three. It was agony to try to lift them (try lifting a 12lb dead weight with your abdominal wall sliced in two), hold them, to reach any of my things. I was attached to a catheter, and still bleeding, but with my stomach wounded I couldn’t lift them from a sitting position, so kept getting out of bed to do it.
A minor point in comparison, but more evidence of the lack of empathy – with the catheter it’s difficult to put pants on. They put a pad between your legs, but obviously you don’t lie there immobile with your legs clamped, so it falls off, and you’re left in your own blood. But even when the catheter was removed and I could wear pants, the pads they give you aren’t sticky, so they still move. It’s imaginably horrid having nine months’ worth of blood all over you and the bed. You try not to move when you have visitors because you don’t want them to see. My sheets weren’t changed during the time I was there either. I guess they work on the basis that most women who have a natural delivery leave the same day. Well, I didn’t.
I occupied myself during the night taking pics…
I was also starving. At 6am a bell was rung and breakfast was announced. I could smell it outside my door. They basically set up a trolley and everyone has to go and get theirs. Obviously it saves the ward staff time and they can tick their sheet which says they’ve served breakfast. Indeed they have. But I couldn’t get to it, and heard it being wheeled away.
Late on Weds morning, someone came and did the blood tests on the girls which should have been done the day before. We were told Charlotte’s blood sugar was low and she needed to feed. I explained to the lady – let’s call her Stephanie – that I’d been trying an hour at a time during the night. She pulled a face and said that was far too long, she’d never heard of anyone feeding for that long, I’d exhausted them and the reason Charlotte was poorly was because I’d made her use up all the calories she was getting by feeding her for so long. I explained it was what I’d been told and she said she didn’t believe me, asked what the other lady’s name was and I couldn’t remember. She consulted my notes and said there was no record of my having been seen. Obviously I was lying.
In the early afternoon, she summoned Jon to her room, not speaking to me. She told him the twins were being admitted to the special care unit. He came back and told me and looked ashen again and I was terrified. We were told to wheel them up ourselves, this being the day after major abdominal surgery, me still with my catheter and stitches in the lift. We were there for a couple of hours that felt like days. It was awful, seeing all the tiny babies, the hush, the general fear. But they simply gave them some Aptamil and both of them rallied.
I asked Jon to stay with me that night to help. The girls’ blood sugar was now being monitored before and after every feed, which we were told now needed to be mixed as my milk wasn’t enough (it takes longer to kick in with a CS as the natural hormones aren’t released; I imagine if the induction had been successful there wouldn’t have been an issue). With the time it took to do the tests and the feeds I only had 15 minute windows to sleep. I now basically hadn’t slept properly for NINETY SIX HOURS, and felt every minute of it. Worse was the awfulness of Charlotte’s heel being pricked and the blood squeezed out incessantly. With the thought still lingering from let’s-call-her-Stephanie that I had done this.
But morning finally came, and she had stabilised. Jon even managed to get breakfast for me. I was now hellbent on going home and pushed for us to get seen by the paediatrician. We were told that it was practice with multiples to keep us in for another night (funny how they now quoted the guidelines, having flouted them at all other times) but a wonderfully feisty Scottish (ha!) midwife took pity on us. Two days after they should have done it my bloods were taken and I’d predictably lost a lot of iron in the operation and my blood pressure was all over the shop and I had to have injections and take pills. We waited for the paediatrician. We waited for our discharge notes and meds. And waited. And waited.
A moment of light relief when we saw the paediatrician and he asked if I’d taken any drugs through pregnancy. I went through the list of undesirables from the Peru trip eg the vaccines. At which point Jon thinks it’s hilarious to say ‘what about the cocaine?’ Non native English speaking doctor’s eyes dart to me, ‘you took cocaine? How much?’ Jon explains, sort of, ‘it was just in tea.’ Doctor asks, looking ever more alarmed ‘you had cocaine in your TEA?’ I am kicking Jon now, and explaining, that I had coca tea, the national drink in Peru, it’s made from the same leaf but has minute amounts of the drug in it. All the while imagining we’re about to be part of our own Social Services intervention…
And then finally, at lunchtime, we walked out of the gates of hell, our little family. We’d made it. Not before they tried to get me to sign a piece of paper which said the reason for the EMCS was a ‘failure to labour’. No. My waters broke, I was fully dilated, contracting and pushing. I was told to stop. The reason for the emergency was a lack of monitoring which meant I went into hyper contractions which were then counteracted and in the process one of the twin’s hearts was affected, not helped by now not having amniotic fluid, a heart which couldn’t be monitored properly because of faulty equipment and faulty staff. I didn’t sign.
So. Phew. Phew for getting to the end of this, both then and now.
What can we learn?
FOR QUEEN’S AND HOSPITALS IN GENERAL:
- The NICE guidelines for multiple births exist for a reason. Follow them. A named consultant during pregnancy who is then with you for the birth or at least on call. One person taking responsibility.
- Enforce on everyone involved the difficulty of monitoring the two heartbeats and therefore its importance. A scalp electrode on one as standard, which will stay put, leaving only one to find and stay on top of.
- A changeover in person with both staff members at the patient’s bedside, to ensure notes and messages can’t be lost. If Maureen had stood with the new midwife at my bed at 7.30 then I would not have had to wait till midnight for pain relief and the hyper contractions would have been spotted much earlier. In fact, I may well have been able to give birth before midnight as promised, because they wouldn’t necessarily have had to deliver the drug to stop the contractions.
- Try to do everything possible to facilitate a natural birth, particularly if that is the mother’s express wish. A Caeserean may be speedy and efficient in the short term, but medium term it’s not good for Mum (and therefore baby) as she then has to start caring for a demanding newborn (or two) whilst barely able to move. The lack of the hormonal rush from a natural delivery can also lead to bonding issues (which upsets Mum) and delays the onset of milk. None of this is helpful. Try to think, and care, about the patient after the hospital.
- Can there be one person with overall charge for Mum and baby on the maternity ward? This happened in my mother’s day. So one person who would spot that the baby testing nurse hadn’t been for a day, that you hadn’t been tested for two – because it would have been their job? And that would mean you weren’t interrupted by a different person every 30 minutes: in a space of a few hours I had someone come in to take a meal order, a different person brought it, someone else collected it, someone emptied the bin, someone changed the water, someone brought some medicine for me, someone did a heel prick on the girls, a feeding assistant checked in, I had my catheter removed, we got given a questionnaire, someone got the wrong room and someone else asked if I had my notes (it transpired they lost them for half a day which may explain some of the issues!)
- On which note, sleep is the best medicine, so do everything to make sure Mum can get some, uninterrupted. Explain and emphasise this with staff. Consider, as happened in my own Mum’s day, having the babies of C section Mums in their own nursery, brought to her when it’s time for feeding.
- Do everything possible to facilitate breastfeeding. This is as much attitudinal as practical. Obviously, it would be much easier for all concerned if babies were bottlefed a set amount at regular intervals. But easier is not better. I was made to feel rubbish because Charlotte’s blood sugar was low. Well, of course it was. She hadn’t been checked for 24 hours. I was having difficulty feeding because I couldn’t lift both of them, was dog tired, and had a C section which delays the milk. Be encouraging. Empathise. Certainly don’t accuse Mums of lying, of exhausting their own babies and have secret conversations about them. There are breastfeeding assistants on the ward but they seem to be volunteers and only there during the day. Babies get hungry at night too. Women with C sections should be supported at EVERY feed, and not made to feel a nuisance for pressing the buzzer. Alternatively, let partners of multiples/C sections sleep over as a matter of course and provide space and bedding for them. And if the first option to address low sugar is to top up with formula, surely that doesn’t necessitate a trek to intensive care, which is physically and emotionally trying for Mum, and takes up the time of doctors who are caring for genuinely sick babies?
- Don’t treat labouring women as small children (that sing song ‘there, there dear’ voice that GRATES) or worse, as some mute beast to be talked over. Introduce yourself. Explain why you’re there and what you’re doing. For everything that is against her birth plan, explain why, and the risks and benefits. Take birth plans seriously.
- Provide a quick and easy way of mothers feeding back on their experience. In the private sector we worked on the 1% rule ie that only 1% of people who experience a problem actually complain. I imagine it’s MUCH less when it comes to women’s maternity experiences because of the mixture of relief/lack of time outlined at the start of this piece. You therefore have NO IDEA about what, qualitatively, seems to be a huge problem.
- Provide maternity towels that stick or put proper dressing on the woman so she is not lying in blood and dripping it everywhere. Change her sheets occasionally.
- Give women who can’t get up food at their bedside. It would be nice if the water could be in her reach too rather than the other side of the room.
- Treat pain relief as a priority and make sure she gets it in good time. This is 2013. We shouldn’t have to just get on with it. My National Insurance has bought that pethidine and I’d like to have some of it, thank you.
- Have something on multiple Mums’ notes which flags up that they’re having multiples as soon as their name comes up so that eg their induction is treated as a priority.
- Just CARE. When patients are feeding back, ask them about staff attitudes as well as just the practical. Let’s-call-her-Becca storming out, let’s-call-her-Stephanie implying I was lying, sending us to the intensive ward out of what seemed like spite, people talking about you, not to you, not introducing themselves before they start prodding your genitals, ignoring your suggestions, getting you to lie down to labour because it’s easier for them…all these would be bad at any time, let alone when you’re terrified and being washed with a tsunami of hormones. A kind and respectful word can make all the difference and, in the long run, we’re then more likely to be cooperative. And if you don’t care then, well, why the bloominora are you there? We keep being told the pay is sh*t, after all.
FOR EXPECTANT PARENTS:
- Try to give birth during the day. Seriously. There just didn’t seem to be enough people there that first night. I wish we hadn’t kept calling back on the Monday and had just waited till Tuesday instead.
- And try to give birth naturally. Again, I wish I hadn’t pressed for an induction date. Maybe I could have held off, safely, longer.
- This is an awful thing to write, but assume the worst. Expect that you will be surrounded by the incompetent and mean-spirited and get ready to fight your corner. Swat up on the NICE guidelines, have them to hand, and wave them when necessary.
- If it feels like you’ve been forgotten, you may well have been, so remind them of your presence, quickly. Find out when the shifts change and ask the person who’s handing over to introduce their replacement.
- You may not be a medical expert, but you have known your own body for decades and are an expert on it. You may not have had contractions before, or dilated, or had your waters break – but if you suspect something, you’re probably right and if the staff disagree, ask them what the risk would be of checking.
- During a multiple pregnancy, if you don’t have a named consultant, insist on one. It is your right. Agree the birth plan with them and get them to sign it. Check that they are going to be there when and if they book you in, or at least on call. Give copies of the birth plan, with their signature, to everyone who waltzes into your labour, verbally going through the main points agreed and saying if they want to veer from that they are to speak to the consultant.
- Agree your partner’s role. Forget the massaging which is about as useless as a chocolate ashtray – would you massage a stab victim? They are there to be your knight champion, fighting for your life, their child’s, and your dignity. And then afterwards to be a guard dog, making sure you are only disturbed when necessary, and that everything is being done that should be (it would be helpful to have your own checklist so you can remind about bloods etc).
- On which note, certainly for multiples, they should plan on living in the hospital with you. Take a sleeping bag, roll mat, pillow and blanket with you.
- Take your own maternity towels and pants. Insist on the catheter being removed as soon as possible (given you’re having to get up to feed anyway).
- Take a sponge, towel that’s bigger than a postage stamp and softer than a brillo pad, and shower gel for the shower afterwards (you’re marched to the shower the morning after).
- Take sterilised water with you in case you need it in the operating theatre. You are beyond parched and stay there for ages afterwards with no access to a drink.
- Assume that you won’t be given any food or drink on the ward so take your own. Get your partner to bring you thermos flasks of hot drinks.
- Stock up on sleep beforehand. You need a lot in the bank.
- Push to leave as soon as you possibly can, ideally with a maternity nurse at home waiting for you. If not, a relative, and for your partner to take as long off as possible. The majority of multiple births result in a C section and it is difficult enough lifting one when you can barely stand, let alone two.
- Forget the Diptyche candles and the soft music, I think the reason so many more home births seem happy is that it’s much harder for the midwife to forget about you when she’s in your house. With one on one care, she’s solely responsible for you, and also she has to do everything, instead of a team of distracted people getting confused about their individual task and disappearing off into one of the multiple wormholes that seem to exist in maternity units (someone call Dr Who). Were I ever to get pregnant again (I’m not), and were it to be a straightforward singleton birth (less than 10% chance for me, hence the not) I would now insist forcefully on a home birth, purely for that reason. It’s not that I want some hippy dippy ‘baby will arrive into a serene world and take that serenity with them through their life’ hokum. I just want to matter.
So, there you go. I think at the time the prevailing mood was helpless fear. A sense of inevitability that it would go wrong, but no one else seeming to realise that much less doing anything about it. In fact, for most of the time, just no one there. Now, ten months on, it’s a mixture of relief, anger and disgust. It is just not good enough, and I do wonder whether, if men gave birth, it would be allowed. That it would still carry such risks, and such sloppiness and basic lack of actual and emotional care could abound. I was reminded of it all in last week’s episode of Call the Midwife, when one of the (childless) nuns whinged about women demanding gas and air and said they should just get on with it. That was sixty years ago, but the attitude still prevails. A simple absence of compassion. Why on earth do people go into the profession if they don’t care?
To those that do – our friend who got us into the hospital in the first place and then into our own room, our brilliant midwife Noemi who went on to do all our home visits, the anaesthetist who made me laugh through the pain, Nicola the consultant who delivered our girls, and the feisty Scottish midwife who fought The Rules to discharge us…THANK YOU. And grim as it is to relive much of the above, I would do it again in a heartbeat, a thousand times over, without any pain relief at all if need be, because it brought us our lovebugs.