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Sunday Story Time: Anna & Aurelia

Beautiful Aurelia

The Gorgeous Meneghello Family

Happy Sunday folks…

Sunday story time this week comes from a very special lady. I had the absolute privilege of being her mentor for a while. She was an awesome student midwife. I knew that when I wasn’t in the room for whatever reason, the women in our care had as good as a qualified midwife in there anyway. It was always so brilliant to watch Anna grow in to the midwife she was meant to be. Her passion and knowledge are clear throughout this piece of writing too. She certainly has a way with words and being a fellow blogger I knew she would produce something fantastic to read.

So over to Anna…..

"My Birth Experience: Reflections from the Other Side:

Birth Trauma Awareness week prompted me to share my birth story. I preface this with a few comments.Firstly, I did not find my birth traumatic, but I honestly believe this was because I knew what was going on. Secondly, whilst it may seem crass to share my birth story on Birth Trauma Awareness Week if I did not find it traumatic it's not meant in a cruel way. As I suggested on my previous post about "good births" I feel the labour and birth conversation needs to become more balanced and realistic. My birth wasn't all positive nor was it all negative. I want to share my experience to help the conversation be more honest for all women, from those who have had traumatic experiences and are being told "a healthy baby is all that matters" to those pregnant who seem to be surrounded by a crowd wanting to regale them with their birth stories. This is not meant to frighten but empower. Best laid plans Throughout my pregnancy I was fairly pragmatic. When colleagues asked what my plans were for labour I would respond that "hopefully" I would deliver on the low-risk midwife led unit. This wasn't just a concern about the way my labour would be, but a reflection that things can change rapidly within pregnancy and, with that, so would my plans. I had an internal "hopefully" list which I held very lightly. The things I was certain of were very basic, that I wanted my perineum supported at delivery and I wanted active management (oxytocin injection) of my placenta to reduce my blood loss.When I went to my 36 week appointment and discussed my lack of official birth "plan" my colleagues seemed surprised. I was, however, certain that I didn't want to put something as uncontrollable as my labour within parameters that may not be achieved. I knew my colleagues would keep me and my baby safe, and I would go with their recommendations if I was diverting from my "hopefully" list. After seeing many women in various stages of labour I had know idea how I would cope with the pain and really wanted to not rule out anything that I might need. The Waiting Game... I left work at 34 weeks hoping to have some time to switch off my midwifery brain and get into mummy mode. I don't know how other midwives felt but I honestly found this incredibly difficult. Okay, scratch that, impossible.I over analysed everything that was happening, whilst simultaneously dismissing it as nothing. I learnt to nap in the afternoon but couldn't shake the foreboding of labour and what it might bring.I have a not so secret love of statistics; I use them to back up arguments and rationalise anxieties to myself. I also knew a lots of people who were pregnant a at the same time as me. When people would ask if we knew what we were having my answer was no, but everyone else I know is having a boy so this must be a girl. This soon stopped working in my favour as labour loomed. Everyone I knew was having vaginal deliveries, so my brain went into overdrive knowing that about 25% of deliveries ended in c-sections and out of the 10 or so women I knew who were due before me, no one had had one. Whilst pleased for them, each new story made my heart sink that I would be the one going to theatre. Time drifted on and my due date came and went without any signs of labour, and I slowly began convincing myself that I was headed for an induction, and the trip to theatre that I felt inevitably would follow (I was obviously in a very positive place.

Is this the real thing? Is it just fantasy? Perhaps that was why when labour began at 01:30 3 days overdue I didn't trust it. Perhaps it was all the women I had spoken to in the early stages of labour whose contractions had faded after a bath and some paracetamol to return on and off for a few days. Whatever it was I mentally told myself I needed to sleep, if I could sleep through it it wasn't labour. I dozed, remodelling and redecorating our house (it's an activity that I always finds works well to put me to sleep) when finally at 03:00 I was uncomfortable enough to follow my own advice and have a bath with some paracetamol. Still not convinced it was the real thing I didn't wake (soon-to-be) Papà up as he had an early shift that morning and I didn't want him to get no sleep. I felt better in the bath, my head mostly distracted by the repeats of F.R.I.E.N.D.S that I knew word for word (thank you Netflix that these were up in time!) but the contractions kept coming. Around 4 a.m. I thought I should probably be monitoring these for length. So I downloaded and started my contraction timer app (hideously under prepared Midwife). Another hour went by, the bath topped up and things seemed to be getting more serious. My contractions were about three in ten minutes and getting stronger. They were still a bit irregular so I convinced myself to stay in the bath for a little while longer until Papa got up for work. Well I couldn't wait that long, 2 almighty vomits later I waddled into the bedroom to wake him up and get the TENS machine going. I rang the hospital, trying to stay calm and positive that this all seemed to be going normally so far. The Midwife I spoke to I didn't know, she told me the unit was closed and I may need to go to another until about 30 minutes away. She would call me back.Whilst this wasn't something I had planned for I think I went into Midwife mode. I didn't want to stress out my colleagues by putting them in an unsafe situation so I agreed and hung up the phone. Papà was not pleased, he asked me why I hadn't mentioned I was staff. It hasn't crossed my mind at all. I began giving my rationale and then got a contraction. I will never forget that contraction leaning on the worktop in my kitchen where I was filled with a sense of dread that I had left it too late. The hospital (also my place of work) was less than 5 minutes away in the car. I suddenly was filled with anxiety that I couldn't actually make a 30 minute journey. During that contraction the hospital called back and spoke to Papà who was advised to bring me in, they had a room and a Midwife for me. Taxi called we gathered together our things, Papà checking the list I had made on the fridge, me struggling to put pants on in between contractions. The taxi arrived and I rushed (well as much as a labouring woman could rush) upstairs to get an Inco pad, my waters having not broken and I didn't want to ruin some car seats with them when they did. Deciding in the moment Whilst trip was the fastest I had ever got to the hospital I still had time for my mind to race about what I would do if I wasn't in established labour yet. I couldn't continue to cope with this pain (being unable to move in the taxi was awful), and if I wasn't close to the actual starting line of 4cm I was going to need something stronger than the TENS. This is where my birth preferences began to unravel in my head. My pain relief preferences were 'things that won't make me feel out of it' which basically meant I had planned to try water and perhaps gas and air and if they weren't cutting it move straight to an epidural, bypassing any lovely opiates. I think my Midwife brain needed to have capacity to me in the room somewhere, and if I was (albeit blissfully) away with the fairies on diamorphine that couldn't happen. The problem, as I foresaw it was that if I wasn't in established labour an epidural wasn't my best option, my best option was to have some diamorphine and hopefully snooze my way into establishing. I decided this would have to be the way forward. All this decision making was rapid over the short journey to the hospital and I was shocked at how quickly my plans were already changing. Be a mother not a midwife Arriving at the hospital I was settled in, and pacing the floor as the pool filled. I agreed to an examination because I needed to know where I was on this journey, and I was (thankfully) 7 cm. I breathed a heavy sigh of relief that I was actually in labour! The birth pool was heaven, and combined with gas and air (I felt exactly the same level of drunk where I used to make stupid decisions at 18, like walking home on my own from a night out [Mum, I never did this] ) I was coping again. My waters went at handover time, an audible pop that Papà heard from the other side of the birthing room. I, in typical Midwife fashion looked at the birthing pool that looked it look clear and left calling the Midwife until after handover. F.Y.I. DON'T DO THIS. Even though it wasn't an issue, someone still should have had a listen to Baby A's heart rate as soon as possible after this.

Anyway, the shift swap happened, and I was greeted by a lovely midwife, V who I knew and trusted. In between contractions and the fog of gas and air V asked if I minded a student being there for the delivery. I was transported back to the few times I had sat on the birth centre as a student with no women and how disheartening it was. I agreed quickly and the contractions kept coming. I could feel myself bearing down at the end of a contraction but really really didn't want to push. My head was flooded with memories of women who had been pushing for an hour, and not making progress only to find that this sensation was due to their baby's position and they weren't fully dilated. I did not want to be one of those women, so I resisted and resisted. V recognised this and in between contractions we talked about it and getting out of my own head. I asked to be examined, to sway my fears.

Since I hadn't been able to go to the toilet since my arrival we agreed that I would try to go, have an in-out catheter if not (bladder care is very important in labour) and then be examined.I honestly don't remember getting to the toilet, I have hazy recollections of trying very unsuccessfully to wee finally waddling out defeated. I don't remember the catheter apart from being told that I did in fact really need to wee. I don't remember the examination apart from being told I was fully dilated. I do remember being told that there was meconium in my waters. Yes, Baby A had got fed up and done her first poo inside rather than out. Being past term and hearing her good heart rate I was more concerned about getting the portable entonox sorted for the transfer to delivery unit. Somewhere in my head the statistics ran again, and I mental decided that I was on my way to theatre once I got to delivery unit. This in a very strange way calmed me down and eloped me cope wit the pain. I convinced myself that I would be getting a spinal soon. So could cope wit the intervening pain. The relief of allowing my body to push was great, and made the lift ride up to delivery unit bearable. After a swift transfer we were in delivery unit. In the smallest room which I frankly hated working in. It seemed to be were all my emergencies happened and was always so full of bodies and equipment. Now it will always hold a special place in my heart. V attached the C.T.G. and I heard the thudding of a baby heart rate. In a shared glance we acknowledged it was low, too low. I knew it wasn't my heart rate as that was rapidly climbing and pounding in my ears. Now decelerations are a complicated beast, their severity related to the stage of labour, contractions and several features of the decelerations themselves. Some are benign, the reaction of a baby unimpressed with having its' head squeezed out and others indicate some level of fetal distress for known or mysterious reasons. What they indicated to me was my prediction of going to theatre was right. I should point out that a sole deceleration doesn't mean this at all but I was doing disaster maths. The contractions were coming thick and fast and with each one another dip in the heart rate. My well practiced phrase of "the baby isn't very happy" was basically my entire discussion with Papà, apparently I said it over and over with every contraction. As luck would have it Confession time. As a midwife if you deliver where you work you have an internal (and in some cases if you choose explicit) list of doctors that you would like to see in labour and doctors you wouldn't want near you. This isn't solely based on skill; but potentially how you see them interact with patients or your experienced with them as a midwife. So as I waited for review I did, albeit briefly ponder who would come round the curtain. And this is the point where I get "lucky". I use this term to describe the next stage of my labour because I know the potential other outcomes, both for myself and Baby A. The first lucky was the doctor who walked into the room was a consultant I trusted. In this situation any doctor would have gratefully been welcomed but this was just a bonus. The second lucky was that both theatres were currently occupied. This doesn't sound like a lucky, and to be honest at the time I just wanted a spinal and to stop the pain for a bit. However, it gave me more time. Time where I had to work hard and keep pushing but time to get baby A in a much better position. The third lucky was that all that effort was worth something, my contractions and pushing had got baby A from looking sideways to looking down and whilst the time between my contractions had been punctuated with cannulas and consent forms by the time the consultant walked back it she was confident that I could push her out myself but that she would just stand by in case I needed some help in the room. The room by this point was very full and very warm. A resuscitaire had been set up in the corner and a paediatric doctor was ready to give baby A some help if she needed it. Plus a midwife, student midwife and consultant there wasn't much room left. Confidence boosted by the assessment of my pushing I struggled along for the last few pushes until she was out, and bright purple. Having decided to wear her cord as a necklace she was quite congested but a swift rub of a towel and she was screaming away. Calmed by being placed next to my skin I breathed her in. Thankful and amazed at my body's ability to create and deliver something so perfect."

I always love reading a midwife and a mama’s point of view. Despite being surrounded by pregnancy and birth everyday the prospect of me ever being in this position myself is actually pretty terrifying. We midwives are just like every other woman.

I also love how Anna puts in to perspective just what a traumatic birth could be. Not positive, not negative, just real and not always to plan. I agree with her thoughts on labour and birth. It needs to balanced and realistic. We need to manage our expectations accordingly and this can only be done if we use the same candour as all the amazing women do when they share their stories. And as always, it is never to instigate fear but to dispel it, to replace it with a sense of empowerment, of ownership.

Thank you so much for sharing this Anna. For being so honest and real about your experience and for writing all the amazing things you do on your blog. Anna is also known as @themidwifemama on Instagram. Her blog is fantastic. Truly. I often direct mums here as she really has that which I lack... the actual experience of being a Mama as well as a midwife! Check out her blog, you will not regret it. I learn all sorts from every post :)

Also, can we just take a minute to appreciate just HOW FREAKING CUTE BABY AURELIA IS??? Double of her mummy.

Nikki xx

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