In my previous blog post I briefly listed ten things that I wish I had known before having a baby, and said I would expand on them one by one. This is the first in that series.
I was so terrified about what the reality of having a baby would be like that I rarely allowed myself to even think about labour and birth for the first two thirds of my pregnancy. I would happily read all about the growing baby inside me, about what was normal for pregnancy and what was not, and so on, but I could never bring myself to even click on the ‘labour and birth’ tab on the NHS choices website. Partly, it’s because there was a bit of a taboo around it when I was growing up. It’s something of a joke in our family now, but every so often conversation would swing round to childbirth at some stage during family meals, and my father (who’s somewhat squeamish) would retort with ‘not at the table!’ This usually meant whichever story that was being recounted got curtailed, so giving birth seemed to be shrouded in mystery to me.
At the apparently tender age of 27, I was the first among my cohort of friends to have a baby. I have no sister or cousins who have gone before me, and the last person I am close to who’s had a baby recently was my step-aunt back in 2005. You get the picture: I had no clue. My knowledge of labour was limited to having read Call the midwife a few years ago, what others tell me of One born every minute (never could bring myself to watch it) and my mother’s half-finished tales of panic (brother born prematurely with a (thankfully minor) heart condition that involved father arriving at the hospital in a helicopter; self (breech) born by emergency caesarian in the middle of the night after 2 hour labour following ten weeks of bed rest for my poor mother because of a strange condition that had almost resulted in me being born at 26 weeks).
When my midwife asked me at one of my appointments whether I had thought about where I might want to have my baby, my immediate thought was hospital (and I told her so), because in my limited experience everything always seemed to go wrong and you definitely wanted to be in the safest place possible with the most highly trained specialists on hand. Paul (my husband) was on side because he wanted whatever I wanted. I had decided I would just let labour happen, not think about it until the moment arrived, and then work out what to do (head in the sand approach, so beloved of my family).
As it happens, two friends of mine (who don’t know each other) were a couple of months ahead of me in their pregnancies. (Curiously, they share the same name, are of similar ages and both had beautiful baby girls within two days of each other.) I got chatting to one of them soon after the birth of her daughter as she had very kindly offered to give me and Paul a crash course in how to change a nappy, hold a newborn, bath a baby, that kind of thing. She told me that she had given birth in a stand alone midwife led unit (MLU) in South Oxfordshire with no pain relief. My jaw nearly dropped to the floor. No pain relief? HOW did she manage that? She must be superwoman! ‘Well, it didn’t really hurt.’ Come again?
Said friend had been on a Hypnobirthing course (say what? I hear you say), something I had heard of but dismissed out of hand as total poppycock and a nasty attempt to swindle money out of scared, vulnerable pregnant women. Obviously I had not remotely looked into it when I made that judgment. Said friend very kindly leant me the book she had on it and I have to say, it proved to be a very interesting read. I can’t say I bought into the whole philosophy of it, but I learnt an important skill: reading up on and trying things that work for you, and leaving the rest. I did learn that Hypnobirthing is not nearly as scary or new-age as its name sounds. And a lot of what I read made sense – about how mammals in the wild and indeed many women in non-Western contexts just get on and give birth with little bother, about how labour pain is only felt when one is tense, about how relaxation can help you to take control of your birth. I learnt a couple of the breathing exercises and practised them often at night while I lay awake with restless legs (a frustrating side effect of pregnancy). I began to actually look forward to labour, as a challenge, as something exciting, as something transcendental.
But mostly what struck me about the book was the opening chapter: the history of childbirth in the West. I realised on reading it that childbirth had become ‘medicalized’ during the twentieth century, that the majority of women for many decades had been out cold and not witnessed the birth, their babies whisked away from them immediately after, that most women gave birth lying on their back going against gravity, and importantly that women labour better when they are able to be mobile in a calm environment where they are allowed to take as much time as they like and when there is as little medical intervention as possible. It really resonated with me that giving birth isn’t an illness, so why does it need to happen in a medical environment? I could also see how one thing could easily lead to another: mum is not in a calm environment and feels out of control, so mum feels stressed, consequently mum feels more pain, mum feels rushed and cannot cope with pain, mum opts for epidural which is available 24 hours a day, mum cannot feel to push so needs an assisted delivery, which results in an episiotomy (if you don’t know what that is and are of a strong disposition, have a Google) … of course this wouldn’t be true for everyone, and there is definitely a place for an epidural in some circumstances, but I decided to invest everything I had in avoiding one if at all possible.
Armed with this new knowledge, I promptly decided the best place for me to give birth was at a midwife led unit in the same building as the delivery suite at the John Radcliffe. That way I’d have all the benefits of an MLU (calm environment, midwife led, option of using a birthing pool etc) but I could easily be transferred if something ‘went wrong’ (I still had my mother’s experience in the back of my mind). The Oxford Spires (as it is called) don’t allow tours, so my midwife booked my 36 week appointment there so we could have a nosy round. The same week, I attended a (free) NHS antenatal class organised by the community midwives. We got talking to other couples about where they wanted to have their babies and one couple told me they had been to look round the MLU at Chipping Norton and they were definitely going there. There was something about the way they said it that made me know I had to check out Chippy before ruling it out. The lady said that having looked round, she would never opt to have a baby anywhere else. This had to be seen. We phoned up and booked a tour for the following Saturday (unlike Spires, the Cotswold Maternity Unit do weekly tours). In the mean time I read every document I could lay my hands on about the hospital transfer rates, breastfeeding statistics and reviews of the various different places I could have our baby. Despite many of my medic friends thinking I was crazy, I became convinced that for me (with my low-risk pregnancy), going to an MLU was just as safe as going to hospital. Not only that, I realised that should something ‘go wrong’ and I needed specialist medical help, it would take me as long to be put in an ambulance and get to the nearest hospital as it probably would for a consultant to get around to seeing me in hospital anyway, as normal hospital births are all midwife led. Midwives, not consultants, are the specialists when it comes to normal births.
On arriving for our tour at the MLU in Chippy I knew why that lady had seemed so serene in her decision – it is in a community hospital and the rest of the complex is shut at the weekend. Talk about calm with a capital C. It took us 25 minutes to drive there. There is no risk of bad traffic (unlike down the A40 to the JR!) There is free parking. They gave us tea. They have two birthing rooms, and only once have they both been used at the same time. Both rooms have a pool, and are ensuite. You have access to a simple kitchen (microwave and kettle) throughout your stay there. Your partner can stay in with you. There is unlimited breastfeeding support afterwards. They seemed to share the philosophy of as natural a birth as possible. We’d made our minds up before we had even seen the whole premises.
The Oxford Spires did a great job at our 36 week appointment. But it wasn’t quite the oasis of calm I’d been hoping for. We asked the midwives about how busy they were and sometimes they did have to turn people away. They have three rooms and only one of them has a pool (and I had decided that I really wanted to use one by this point). There were people coming and going and the midwives seemed a bit stretched. They didn’t appear to have an altogether brilliant relationship with the delivery suite people downstairs. As we fought our way out of the car park I was practically already on the phone to my midwife to tell her I’d changed my mind. Chippy it was to be.
When the great day arrived and we thought I was in the early stages of labour, I was mainly concerned that the midwives would think I was making it up and I’d be wasting their time. I was reassured twice on the phone by Becky, the community midwife on duty, that I wasn’t a time waster. We decided the moment had come to make the beautiful drive through West Oxfordshire to the MLU. It was a warm, spring day. When we arrived, I was examined by one of the midwives there called Claire. She was full of good cheer and told us all about how she had had six children and breastfed the last one till he was at school. It was a Saturday so there was only her and one other staff member on site. I mumbled something about being worried that I was wasting her time. She told me in no uncertain terms that I would be having our baby that night. ‘I can’t be sure whether it’ll be this side or the other side of midnight, but it’ll be tonight.’ This encouraged me. Claire said I was still in the early stages of labour. I assumed therefore that I would have to go back home and come back in later. She explained that this was up to us. There was no policy at Chippy to send women away. I could stay, go home, or go for a walk, but in her view I needed to stay active to get things moving. She made me understand that she wouldn’t ever offer me pain relief, it would be up to me to ask for it, as every woman knows their own body and deals differently with pain.
Fear not, I’m not going to go through my ‘birth story’ blow by blow. That’s not the point of this piece. But I do want to reflect on that day. I’m not sure I could put my finger on exactly what it was about the experience that was so positive. Perhaps it was the fact I was totally in control of it all, deciding where and how I wanted to labour at all stages. The midwives took it in turns to care for me, and they were happy to stay in the room or go, depending on how I felt. I never felt abandoned. I always felt safe. Perhaps it was the realization that my husband and I had never been through anything so powerful together before, and it bound us together even more tightly. Perhaps it was the quiet sense of calm that pervaded the building (the box set of Marie-Claire Alain playing J.S. Bach’s organ works that we’d brought with us lay unopened). Perhaps it was the fact that we were doing something so ordinary, and yet so remarkable, something that united us with all people everywhere throughout history and into the future. The name of those helping me -midwife – caused me to reflect on this. The name of their profession is from an old Anglo-Saxon word, meaning ‘with-woman’, akin to modern German words like ‘Mitmenschen’ (‘with-people’, or fellow humans). We were doing something as old as time itself. Perhaps it was the feel of the warm water surrounding all the pain. Because it was painful, in the end. I did pretty well for the first four hours or so with my breathing exercises as per the Hypnobirthing book. But as it all got more intense, and as I tried to remember to relax, all I could do was tense up in agony every time I felt a contraction. It was the only way I could deal with it – it was more effort to try to relax. And I learnt that the best pain relief does not come in the form of drugs: no, the best pain relief was the team work of the midwives and my husband in helping me to get through it, along with good old fashioned back rubs and warm water to sit in. By far the worst bit of it all was having the regular examinations to check how things were progressing – right as I was in my stride, I would be interrupted, and I found that more painful than ever (HOW do so many women labour on their backs? I was in agony for the three minutes I was on my back for the examinations). There was a dark time when I thought I wasn’t making any progress, and I remember whispering to Paul that I didn’t think I could take much more. The baby had been ‘back to back’ (notoriously more painful!) and we had had to spend a while turning her, meaning all sorts of weird and wacky (and painful!) positions. And yet isn’t it always the hardest things in life that are the most rewarding? Because I found labour and birth to be one of those moments that C.S. Lewis describes as ‘signposts’, pointing to another place. In those moments, time seems to stand still and you get lost in it all. Before I commited my life to Christ, I used to live for those transcendental, ‘zonal’ moments, and didn’t pay much attention to where they were pointing. But here, in all the mess and pain, the theological parallels were not lost on me. Through toil and sweat and blood and pain comes new life, hope, a new beginning, a miracle.
When little Phoebe emerged into this world at 11.15pm that night (Claire had been bang on with her prediction), covered in more bodily fluids than I care to remember, life changed forever. My memory of it is such a blur: the release from the pain as soon as she was born, the look of jubilation on Paul’s face, Becky (the community midwife) stifling back tears when I told her I couldn’t have done it without her, embracing my daughter for the first time, who I’d known for so many months from her kicks and wriggles and yet not known, feeding her for the first time while I lay down resting …
Without us noticing, Becky and Claire had left us to it for a couple of hours to get to know our daughter together, alone. They had gone well beyond the call of duty. Becky had been at work since 9am, and she didn’t leave till 2am. Because we had wanted to stay in over night and no other member of staff was available, Claire said she would stay on. Neither of us could sleep. For the first and last time since she was born, Phoebe slept six hours straight. We stayed awake staring at her. We did it. She’s here. A new beginning. A miracle.