Miranda was born on 24th February 2005 and I wrote this up three weeks later on 16th March 2005. There is also a photo album: Miranda's Birth.
Before you start: This is a really long and involved account of the birth of my daughter by Caesarean section. I've written it up mostly for my own benefit to record my feelings about the birth (both positive and negative) and I've put it here on the web because I think the level of detail might help other women who find they need Caesarean sections. If you're likely to be offended by intimate medical details please don't read it! It's also very long. Consider yourself warned.
Before I was even pregnant I looked into the best way to have as natural a birth experience as possible. It seemed as if the best thing to do was to stay at home and have the baby with as little medicalisation as possible; sounded good to me. The first time I met my community midwives I asked about homebirths expecting some resistance as this was my first baby but was told it would be no problem providing there were no complications during my pregnancy. Things didn't work out that way.
Three weeks ago today I was at home crying for the umpteenth time about the Caesarean section planned for the following day. The section had only been scheduled two days before as I'd been really reluctant to commit to it and hoped until the last minute that something would happen to avoid the need for a surgical birth. My baby had been stubbornly breech since at least the 20 week scan. We'd been monitored for low levels of amniotic fluid for the whole second half of the pregnancy and although our worries had abated as the baby continued to grow and develop normally as far as we could tell on the ultrasound scans the baby had never had enough fluid around it to allow it to somersault over into the conventional head down position. This lack of fluid combined with my own blood pressure rising towards the end of pregnancy meant that the hospital doctors wouldn't try and turn the baby by means of external cephalic version (basically manipulating the baby from the outside to swizzle it around) and I was strongly advised not to try and turn the baby by any other means (acupuncture seems to have good results). There's plenty of research showing that the outcome for breech babies is better if they are born by Caesarean. I was pretty sceptical of this and kept asking about breech vaginal births but the combination of breech and lack of amniotic fluid wasn't looking good and I was finally convinced that the best thing for me and my baby was to go for the surgical birth. The doctors told me that even if breech vaginal births were still standard I'd still be one of the ones being recommended a Caesarean. Being so reluctant a patient was actually a good thing for me because it meant I had all the arguments before the birth and I'm not sitting here now wondering if I really needed the section. We came to the conclusion that if I waited to go into labour the chances were very high that we would end up with an emergency Caesarean section and so we went for the planned section (I hate the term "elective section" that medical professionals insist on using, "planned" I can deal with but it's not the way I would have elected to give birth!).
On Thursday 24th February 2005 my alarm clock woke me up at six and I was surprised to find I'd slept. It was still dark and Brian (Darren's dad) was coming to pick us up at seven o'clock to get us to the hospital by half past seven. Snow had been falling all night and the roads in the village didn't look good. I had a shower and got Darren up to help me shave the bits that needing shaving for the operation! Ever wished you hadn't left something to the last minute? Well we did then! That bit took longer than we expected! Brian turned up later than we expected because he'd had to leave the car at the bottom of the hill leading up to our village - the road was impassable. We were going to have to walk back down the hill to the car. I called the delivery suite and told them we were coming but that the snow was causing us trouble. They said not to worry, to be careful and that they didn't really need us there that early anyway. So we said good bye to the cats and set off down the hill carrying the vast quantity of bags I seemed to need to take (most of it unneccessarily!). I wish I'd taken a photo of the snow on the hills as we set off, it was fabulous and definitely made it a morning to remember! The snow also took our minds off what was about to happen, misdirection of the mind is a good thing.
Brian dropped us off at the hospital getting on for an hour late and we found our way up to the delivery suite where we met our midwives for the morning Lisa & Melanie, Melanie was a student midwife and the fact that she didn't really have anything to do a lot of the time meant that we saw more of her than Lisa. Darren & I were taken to an admissions room and left to fend for ourselves for a bit, I don't know what would have happened if we'd arrived on time as they didn't seem to be ready for us yet anyway. Darren went out to find the gents, I took my boots off, Darren came back and discovered we'd actually got an en suite bathroom in the admissions room and then pulled the red cord by the loo thinking it was a light cord - midwife comes running in response to the emergency call.... a little drama... Our midwives came back and hooked me up to a CTG monitor checking the baby's heartbeat and my blood pressure. The baby's heartrate was about 150, my blood pressure was the lowest it had been the entire pregnancy and I was surprised because I didn't feel in the slightest bit calm. When you're hooked up to the monitor you're supposed to click a button when you feel the baby move (as the baby's heartbeat should go up when it moves) and I clicked it once and that was the last time I remember feeling the baby move inside me. I remember reading an old wives kind of tale that heartrates over 140 mean girls and below 140 boys; the only time the midwife had told me what the baby's heartrate was during pregnancy it had been 160. I wondered whether the old wives tale would hold up or not.
The anaethesist and the surgeon came in to see us, I can't remember who came first. The anaethesist asked the same questions I'd been asked at the pre-op two days before about allergies and previous anaethesetics. Lisa felt the baby and couldn't figure out if it was still breech (people get sent home again if their babies have turned and get very upset about it by all accounts - I was hoping it would have turned despite knowing it hadn't). She thought she could feel a pair of knobbly knees but wasn't sure. The surgeon brought in a portable scanner to have a closer look, baby in exactly the same breech position as ever - on my right side with it's head under my ribs, legs extended up to it's face and knees where the Lisa had said. Oh and Lisa declared Darren's shaving to be a master barbers job...
I got undressed and put a hospital gown on, Darren was taken off to get some blue scrubs to wear, when he came back to the admissions room Melanie took a photo of us together. We got left on our own for a little while, I burst into tears and Darren followed. At this point if I could have magically got unpregnant I would have taken it. As the operation got closer I was being less scared of it and more scared of it all at the same time.
Darren had to wait outside while I went into the operating theatre and got anaethesised. I walked down the corridor to the theatre, Lisa held my gown together at the back though there was no one else around and I couldn't have cared less about anyone seeing my bum at that point! I sat up on the operating table and Melanie held my hands while I got a shot of local anaesthetic in my back. She asked if we'd got names picked for the baby and what they were; I said we had them chosen but we hadn't told anyone else yet so we'd tell the baby first. They managed to find a vein in the back of my hand to put the drip in (my veins are always tough to find), I think the drip hurt more than anything else going in. The local anaesthetic on my back meant that I hadn't felt the spinal block go in at all. Two things I was dreading about the operation (among many others...) were having so much of my body numbed by anaesthetic and having a catheter in. Neither were as bad as I'd expected. They helped me lie down on the operating table before my legs went and I gradually felt tingly from my legs down. I'd been warned that the operation would feel like somebody rummaging around inside me and that it might hurt when they pushed down on the top of my tummy to help get the baby out since the anaestetic stopped about there. The anaethesist also asked me if we knew the baby's sex; I told him that everything I'd knitted for it seemed to be blue so at least one of the baby's grandmothers thought it would be a boy (and the other said it was bound to be a boy because it was giving us so much trouble) but that we really didn't know. After a couple of minutes the anaethesist sprayed something ice cold on my arm to show me what it felt like and then started spraying it on my body. He sprayed me from thigh to chest and it felt like he was just spraying warm air on me until he got to my chest where it turned icy again. I could feel the spray but not the ice. That meant that the anaesthetic was working and they called Darren in.
They erect a screen across your chest so that you can't see what's happening during the operation - I believe you can ask to watch but neither of us wanted to! - I was expecting something less makeshift than a green surgical drape duct taped between the drip pole and another pole, but it worked. My left arm was almost free, it only had a blood pressure cuff on it, but it got lost in this drape, I'd wanted Darren to hold my hand but he couldn't find it and I couldn't manoevre it out. I was given an oxygen mask for the first part of the operation, it was just to make sure the baby didn't go short on oxygen.
I could feel the surgeon painting my tummy with some kind of antiseptic paint, permatan orange coloured I later discovered, and then it felt like they were drawing lines on me. I was talking to Darren, he said waiting outside was horrible but he heard me giggling which had calmed him down, and it only dawned on me slowly that the what felt like lines being drawn on me must be them cutting into me!
Time seemed to go really quickly when I'd expected it to drag. I felt pulled about but it wasn't unpleasant. I don't recall hearing the surgical team say anything until the surgeon said "Oh, hello!" and we heard the baby cry! The baby was still inside me at this point! I felt someone push on the top of my tummy as I'd been told but even that didn't hurt at all. Someone said "It's a girl!", Darren said "It's a girl!", she was wrapped up in a hospital towel and handed to Darren. They took the oxygen mask off me at this point. I could only see the top of her head and we both said "She's Miranda!" and were thrilled. I said "Hello Miranda!" and Darren brought her closer so I could see her a bit better. She looked tiny and we thought she had red hair like Darren (it looks more brown now). I asked what time it was and they said she was born at 9:47am.
Melanie took a couple of photos for us and then took Miranda off for a few minutes to clean her up, weigh her and check her. They shouted over to us that she was 6lb 5oz and in no time she was back with Darren dressed in the vest and babygro we'd given to Lisa earlier and wrapped up in a blanket. I felt like they were doing patchwork on my body but I've no idea where the time went in the operating theatre. I'd read that you don't notice the sewing up bit (which takes a lot longer than the getting the baby out bit) but I didn't really believe how distracted I'd be by our new baby until I'd experienced it myself.
When everything was finished they took Darren & Miranda off to the recovery room to wait for me, slid me off the operating table onto a hospital bed and wheeled me through to meet them. The last thing I remember from the theatre was the anaethesist telling me that she would look just fine in blue.
It was 10:20 when we got to the recovery room. I got a better look at Miranda, time kept speeding by. I asked when I could feed her and was told they'd just make sure I was stable first. I went really really itchy, apparently that's a side effect of the diamorphine I'd been given, and Lisa put a lovely pair of very tight white socks on my lower legs to help prevent me from getting blood clots after the operation. Melanie was taking my blood pressure etc every five minutes and at about 10:45 when Miranda was about an hour old they helped me put Miranda to my breast. She suckled strongly right from the start which pleased me no end. After about quarter of an hour she sucked and swallowed so hard she forgot to breathe at the same time... I saw her turning blue but couldn't work out what was going on fast enough. Fortunately the midwives saw what was going on and grabbed her from me and she started breathing again straight away. Bit scary that bit. While I was feeding Miranda (I think) Darren went out of the ward with my mobile phone to let our families know the news.
After about an hour in the recovery room I was declared to be ok for transfer to the postnatal ward. Miranda was given a little fishbowl cot on wheels, Darren managed to load all our bags onto the cot and the bed. Darren wheeled Miranda's cot and the midwives wheeled my bed down to the other end of the delivery suite and through a back corridor to the end of the ward and down to a private room where we'd stay for the next couple of nights.
I was really relieved to have the operation over with after spending so long worrying about it and totally and utterly thrilled with our new daughter.
No idea where the next couple of hours went to! We were on our own for a while and took some more photos. We talked to a midwife and decided 2pm would be a good time for Miranda's grandparents to come and visit. I fed Miranda again about one o'clock, the midwife showing me an easier way to position her under my arm to avoid my wound. I wanted something to eat and drink but just got a jug of iced water. I was given a bed bath just before our visitors arrived, managing to swap my hospital gown for my own nightie and cleaning off most of the permatan coloured antiseptic paint.
That's about it for now! After all the worry and panic beforehand it had all turned out fine. My recovery from the operation hasn't been straightforward but it might not have been an easy recovery from a vaginal birth either. Miranda is 100% ok which she might not have been if I'd have refused the Caesarean. And mostly I'm glad I don't feel that the Caesarean was a disappointment, it wasn't the birth I wanted or had hoped for but it was Miranda's birth just the same and though we had a surgical team helping Miranda into the outside world it was still a very special experience for all three of us.
Things I thought of later.... When I read this back I realised I'd missed out a few details I'd meant to include. (Yes, I know it was long enough to start with ;-)) These really are the yucky bits... in no particular order.
I was dreading having a catheter in but it was fine. The midwife put it in after the anaesthetic was working and all I felt was a little twiddling, nothing hideous. And afterwards after spending all my pregnancy running to the loo every five minutes it was lovely to be able to drink as much water as I liked and stay in bed! Darren arranged the bedclothes over the catheter's exit route when our visitors arrived and the only person who noticed anything about it was my mum, and all she noticed was that I was on a drip and not needing to go to the toilet and she was bemused.
At the end of the operation they put painkillers up your bum - they told me when they were about to do this but I didn't feel anything at all.
I was dreading bleeding after the op and being stuck in bed and not able to change the pads by myself. Not a concern at all in the end, the midwives and nurses do this all the time and were very matter of fact about it and I didn't feel at all odd asking them or having them do it.
I really hated having the drip in the back of my hand, especially as they wouldn't take the needle and tube bit away even when they stopped the drip in the afternoon and it made my hand really awkward to use. I finally got a midwife to take it out about 10pm when I told her I'd never be able to sleep with it in and I seemed to be able to drink by myself just fine (I was on my 4325th jug of water and she was fed up with emptying the catheter out) so I wasn't likely to need the drip again.
I had thirteen staples in my wound and they were sharp and nasty and hurt when I moved about. They came out on day 5 and I was very happy when they were gone.
My electric bed was lovely, nice to be able to get to sitting up without needing to use my tummy muscles. Moving around in bed was really hard for at least a couple of weeks.
I'll probably think of some more extra bits to add later...