It was past midnight when I was called to the labour ward for induction, so I was now exactly 42 weeks pregnant.
It felt weirdly calming to be walking to labour ward in the middle of the night. The waiting around is definitely more anxiety-inducing than when things actually start happening and you have a timeline to work with.
I was comforted by the idea that if things progressed quickly in the quiet of the night, we could be waking family in the morning with news of our new arrival.
Now that I was on labour ward, Sam was able to come into the hospital, and we’d be locked in for the duration of our time there – no going in and out of our labour ward room to prevent the potential spread of Covid.
Sam was just as surprised as I had been to be woken half an hour after he’d gone to bed and told to come to the hospital now. After my longest pregnancy ever, it was now all happening.
My birth plan for induction looked very different to my birth plan for spontaneous labour, so I made sure it was printed and tucked in with my notes, and I do feel like it was read and listened to by not only the midwives who would be looking after me in labour, but also by the antenatal ward midwife, and the midwife team lead on labour ward.
It essentially said two things:
- That I wouldn’t be able to lie on my back during monitoring, and that I would find continuous monitoring very difficult without pain relief, so if that was the plan, then we’d absolutely need to go down the epidural route before starting induction.
- That my last induction birth had been traumatic, and that I’d greatly benefit from a calm and confident midwife this time round (essentially saying politely that the nervous midwife last time hadn’t helped my anxiety at all and I desperately wanted an experienced labour ward midwife).
Whilst waiting for Sam to arrive, my midwife and student midwife introduced themselves.
My memory of this point is super hazy as it was the middle of the night after many days of hardly any sleep and I was still shaking like a leaf with anxiety. But I do remember the midwives taking a great deal of time to talk over my worries with me, my experiences from Otto’s birth, and my wishes for this birth.
The whole team seemed so much better than three years ago when I’d been having Otto, and I appreciated their attempts to work out where my head was at without ever making me feel pushed towards any particular birthing decision. For a short while, I felt like they gave me my choices back, and that is such a crucial thing for someone embarking on an unavoidably medicalised labour route.
I also really appreciated their attitude when the main midwife said “We are good midwives, you can trust us, and we aren’t going to let it be like last time”, and the student midwife nodded along with this too, great confidence all round – they had clearly read my birth plan ; )
The head midwife of labour ward also came in to chat with me. She said that the care and actions that I had experienced during Otto’s birth were unusual and that I should come in to speak to them formally about it – it was good to get that validation… but that was for another time, because right now we had an induction to focus on.
And then, she threw a curveball and offered me the birth centre. She said they would be happy for me to transfer there after breaking my waters here on labour ward.
Having already had three labours and vaginal births, all of the midwives were in agreement that I could likely do this labour without the need for further intervention after the ARM, and that choosing more medicalised pain relief shouldn’t be taken lightly. They wanted to empower me with the birth centre option to increase my chances of a straightforward labour. They knew I could do it, but they also knew that my problem wasn’t about me doubting my physical capabilities.
Although I knew they would prefer I chose the birth centre option instead of the epidural, the best thing about this interaction was that I never felt pressured or that I had to plead my case, it was just a conversation about options, and I knew they respected my choices as an experienced birthing person.
Sam had arrived by this point and was also able to back up that I was making a well informed, considered decision that I had actually made days ago when I knew this would be an induced labour, and not a panic due to last minute nerves that I would go on to regret.
The head midwife asked how I would feel if they induced me but it was fast and they couldn’t get me to a pool in the birthing centre in time for birth. I said that if this labour happens as fast and furiously as Otto’s had, then I would be regretful that I didn’t do it with the pain relief of an epidural. And so, we knew my decision was made.
I did feel a bit torn to be dangled this last minute carrot that I’d wanted all throughout pregnancy – the birth centre. Was I doing the right thing? Would the pain of a precipitate labour have been bearable in the pool?
I knew the pain would be extremely intense, but ultimately do-able and over relatively quickly. Plus with the hindsight of Otto’s fast labour, I wouldn’t be so freaked out as to what was happening to me, I would understand it was just everything happening at super speed.
But still, even on the birth centre, I didn’t quite trust that I would be left alone to labour without monitoring and being asked to keep still. I didn’t trust that I would actually be allowed to get into water. I didn’t trust what I was being offered. Therefore, I wasn’t willing to be without the safety net of the epidural for pain relief.
I had made my peace long ago when I knew this would be an induced birth, that opting for an epidural before labour might well lead to further interventions and surgery – I had already mentally checked out and handed my care over to the fates of a medicalised birth, knowing I would accept “what will be will be”.
If I could get through this birth without the trauma of the pain and loss of control that had had me completely out of my depth with Otto’s birth, I would be able to square away in my mind whatever ‘type’ of birth this turned out to be.
If I had been feeling bolder, maybe I would have opted for this unexpected offer of the birth centre – but who says you have to be bold in labour? Why do we have the attitude that we should power on through traumatic pain and experiences in labour? What does it achieve?
Epidural before Artificial Rupture of Membranes
Decision made, and now we waited for the anaesthetist to put in my epidural. This was also something I had been apprehensive about in the past, because of talk of how big the needle is, and what an uncomfortable procedure it can be.
But I was happy to have my worries proved completely wrong. I barely felt a thing thanks to the local aesthetic the anaesthetist used – the epidural was in with no pain whatsoever.
My main memories of the epidural are: A really cold icy feeling as the medicine travelled through the tube and into my body every time I hit the button for another dose. And getting the shakes after every dose (although I already had the shakes beforehand anyway, so I’m not sure what caused what).
The midwives wanted to give the epidural a bit of time to kick in before they commenced the ARM. The problem was, I wasn’t sure how to know it had kicked in – as I didn’t have any contraction pain to dull – I wasn’t in labour yet.
The midwives said that I would probably feel my legs go very heavy and I would be unable to move much. But I actually never did get this feeling, even later on when my epidural dose was much more increased – I could still move my legs around, put weight on them, use my legs to shuffle around the bed, etc.
The midwives conducted cold stimulus spray tests to see if the epidural was working, but I could definitely feel the cold spray, so I was quite worried that I was still going to feel pain once they induced me. In all my considered thinking, I hadn’t really considered the possibility that I wouldn’t know if the epidural had worked or not, I had just assumed that I would feel it working.
It occurred to me at this point that I could have made a terrible mistake if the epidural didn’t work properly and I was less able to move around in labour.
I was probably being a right pain in the arse at this point. Anxious that the epidural wouldn’t be good enough pain relief despite asking for it, and reluctant to let them break my waters still. But everyone was really patient with me and if anyone thought I was being a bit ridiculous, no one let on.
I am unsure of the timings, but I think the epidural went in at around 3am, and my waters were broken at around 4.30am.
The ARM was not as simple a process as when my waters were broken with Otto. It was quite tight around the baby’s head and it took the midwives a good while to successfully create a puncture. Not much water came out compared to the ARM with Otto.
I was giving 4 hours for contractions to start, and then it would be the hormone drip to stimulate contractions.
As per my birth plan, a clip was placed on the baby’s head so that we could continuously monitor his heart rate without the need for all the straps round my tummy that I had found so restrictive and unreliable last time.
I was quite surprised when 4 hours passed and no contractions appeared.
With Otto, they had started almost immediately after the ARM. But then, I had been able to stand and move around, so I figured maybe it was because I’d had an epidural. So much for everything I’d said about preparing for labour to be super fast once my waters went. This labour was obviously going to be different.
The 8am shift change rolled around and we said goodbye to the night shift midwives who’d been so great at putting me at ease. I held my breath for a confident midwife to see me through the next stage, knowing that I’d likely have a baby during this next 12 hour shift.
To great relief, a familiar face popped round the door frame – It was the birth centre midwife I had seen for most of my antenatal appointments. A few days earlier, she had conducted my last sweep, one last ditch attempt to kick start labour naturally, and listened to me as I offloaded a bucket load of anxieties about an impending labour ward induced labour.
She knew I would be coming in to be induced over the weekend, and had said that she was on shift on Sunday and would come and be my midwife if I was in labour then, and if it was Saturday, another midwife who I’d seen lots during my antenatal care would be on labour ward, so either way I would have someone I knew with me.
The midwives really had done an amazing job to keep continuity of care going despite covid conditions, and I was hugely grateful that she had come over from the birth centre to spend a shift on labour ward with me.
The syntocinon drip begins
At 8.30am, we started on the syntocin drip – Another thing I was always massively scared of in the past, but with the epidural in place it wasn’t a problem at all.
I could feel the drip working, and the squeeze of the contractions, but there was absolutely no pain. I could even feel low down pressure and just knew instinctively that when the time came, I wouldn’t have an issue not being able to feel when to push.
So, I concluded that epidurals really are some kind of magic and I’m not sure why I held off for so many labours.
Now that I knew that the epidural is definitely working, and the drip is in and I’m no longer scared of it, I started to relax a bit.
And as soon as I relax, I got really hungry. I haven’t eaten much at all in days because of nerves, but I am not allowed to eat now that I’ve had the epidural, in case I need to go to theatre.
Of course, just when I start to relax is when everything starts to go pear shaped.