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05 Aug 2020

Our empowering elective caesarean birth

My pregnancy had been mostly straight forward, with little to no symptoms for the first trimester. Second trimester I had a negative GD test and experienced a little PGP, heartburn, and rib pain - at 28 weeks I found out why I had rib pain - baby 'Kiwi' was extended breech and sitting head up, but all was going well and I was hopeful baby would turn by 36 weeks and I could have my dream delivery - a relaxed water birth in the Meadows Birth Centre at Worcester Royal Hospital, praying it would be open in time.

At my 36-week midwife appointment, I was sent to the hospital for a presentation scan and to discuss our birth options. The sonographer told me I had polyhydramnios (excess amniotic fluid) and baby was measuring large; in the 90th percentile.

Breech vaginal delivery was not a recommended birth path as a first-time parent and the hospital do not have specialised staff to support breech birth. Our options were an ECV, to turn him, or elective caesarean. I chose the ECV and was booked in for the following week.

The next day I received a call and I was told that I had developed GD and needed to be put on Metformin. Baby Kiwi would need to be delivered at 38 weeks via induction (if the ECV worked) or C birth. Due to Covid, the fact husband couldn't be with me in early labour, debilitating sciatica, go through the discomfort of the ECV and it potentially been unsuccessful (meaning I would need a caesarean anyway) and the worry if I needed an emergency C birth after induction then my husband, Tom, could miss our baby's birth, we elected for the planned caesarean. It was booked for Wednesday 5th August, when I would be 38+3.

I woke up at 4:30am Wednesday full of excitement, anticipation and another day of sciatica. We got to the hospital for 7:30am and we were seen around 8am by the midwives. They informed me that I was booked in for an elective C birth as Kiwi was breech, but they would scan me and if he'd turned then I would instead be sent home and given an induction date.

They did the scan and he was still breech so at 10am we made our way to theatre.

One of my birth wishes was to know what was happening during the surgery and I asked if the surgeon could talk me through but he said no. That was it. Just no. He was busy operating and needed to concentrate. Thankfully, a lovely midwife called Amanda said she would let me know what was happening at key stages.

In theatre, we got to listen to our happy "post-baby" playlist as Kiwi was being born. Tom got to cut the cord and we enjoyed skin to skin. It was surreal and beautiful to finally hold our beautiful Grayson.

After an hour I was wheeled to the post-natal ward and had to say goodbye to Tom. All being well, we would be discharged the following day.

However, I spiked a temperature on Wednesday evening, and Gray and I both had to have antibiotics and I was put on a drip.

I struggled to feed Gray as he had tongue tie and, through recommendations from my other hypnobirthing mums on Anna’s course, we arranged for him to be seen privately on 13th August in Earlswood. The consultant was also amazing at telling me how best to feed him; we'd been trying to cup feed him to avoid nipple confusion and nipple shields on Friday (so he could actually feed on Friday and it felt amazing to be breast feeding him for the first time) but she said no to all of those; cup feeding can be dangerous for tongue tie babies and his suckling with nipple shields may be difficult and tiring for him and painful for me (it was). She recommended to bottle feed him expressed milk with Mam bottles as the teat is wide and flat so he will get a good suction. She also gave me advice on pumping as I'd started to become engorged, and if it continued, it meant an even longer stay and potentially more antibiotics. I diligently pumped the engorged breast every hour or so, used cold compresses and double pumped every 3 hours and it cleared up within 12 hours.

Gray was really lethargic on Wednesday and Thursday. He also had jaundice, polycythaemia neonatorum (thick/sticky blood), added to the fact I couldn't feed him - he vomited back up formula when we tried - and was put on a glucose drip for 3 days.

I felt so useless not being able to care for my baby, but I had a wonderful second time mummy in the bay next to me and her first baby had tongue tie. She told me to ask for a double pump and honestly that was a life saver in the end!

Due to our combined issues, the post-natal ward felt like a revolving door of people coming in and out constantly and I couldn’t sleep. I had tops of 2 hours between 4:30am Wednesday to 1am Friday and I felt emotionally wrung out. I had no schedule for pumping, feeding, sleeping or when I needed my antibiotics and was moved wards 3 times with no warning - I was honestly frazzled and exhausted.

On Wednesday I expressed around 10ml of colostrum for him, but by Thursday (when I was taken off my IV drip) I was only able to hand express 0.4ml for Gray, and was told he needed a minimum of 37ml every 3 hours. I felt like a failure.
The next expression was 3ml, then 10ml and gradually with the use of the pumps, my supply began to increase. During this time, I had been in touch with Anna and she gave me advice and words of support and encouragement which I really needed as we couldn’t have visitors. Gentle reminders that I can do it; I was doing it.

On Thursday evening we were moved from the post-natal ward to the Transitional Care Unit (TCU), which is where they look after mostly preemie babies (and one of the only wards where partners could visit!). I loved TCU and was honestly a little sad when we were discharged!

They were so attentive to me and to Gray, they explained what was going on and what they would be doing for him, which I really appreciated. I started to get more of a routine for pumping and Gray's feeding. Despite all his feeding issues, Gray only lost 80g when he was weighed on Saturday.

Tom was able to visit from Friday onwards and this helped me so much! Sometimes just little things like getting me a water or cleaning the pumps.

Finally, in the early hours of Monday morning (10th), Gray had his final antibiotic dose and his cannula could be taken out.

I was told I should be able to go home that day! Tom arrived at 3.30pm to help me pack and take us home. Gray had been cleared to leave and the Dr gave me the green light to leave at 10.30pm.

The three of us arrived home at 11pm; gave Gray a feed, nappy change and introduced him to our two cats. I took the first bottle feed at 2am and Gray slept until 6am when Tom took over and I could pump.

All in all, we had quite a few hurdles to overcome as first-time parents but we've done it and come out the other side stronger for it. Gray is now breastfeeding after his tongue tie was cut and is doing really well.

Thank you, Anna, for providing us with so much support throughout the course and during Gray’s birth, for providing us with the knowledge and tools to make informed decisions, remain calm and relaxed, reminding me of my inner strength and patience and picking me up at my lowest.