What a week

In the last week Jack has started rolling over, back to front to his right side and cut two teeth!

He'd been working on rolling over for about a month, getting as far as his side, sometimes turning his hips over so he was twisted in the middle but his shoulder wasn't making it out from under him. Then suddenly one evening on our bed he just did it, flipped right over like it was the most natural thing in the world. I rolled him back and called Andy in to see and Jack kindly obliged and did it again for Daddy. He did it again the next day on his play mat and this time got both arms out in front of him and pulled his head up to look around. He's only done it a couple of times since, seems to have lost interest a bit and still hasn't managed to go over to his left, or roll back onto his back, but I'm sure that will come with time.

He cut his first tooth last week, it came through at an angle with one pointy bit sticking out more but has evened out now and the one next to it came out at the weekend. He now has two front bottom teeth and his teething rash on his cheeks is starting to clear up, so that looks like the worst is over for now at least.

For about the last 3-4 weeks he has been having trouble getting off to sleep properly. Some nights he'll wake after about an hour screaming the house down and I had decided he was suffering night terrors. But some nights it wouldn't be so bad, just normal crying that was easily soothed with a cuddle or feed. Other nights he'll just refuse to go to sleep at his normal bedtime, instead staying awake for an extra hour or two and still wake an hour later! It was as if he thought he was going down for a nap, like during the day.

It may be connected to his teething, but Andy and I talked about it at length and wracked our brains to find a pattern. What we came up with was that the nights he seems to be worst have been when Andy was not around, or not participating in his bedtime routine. The night before last I stayed in the room with him after putting him to bed, Andy did too but left after about half an hour and ten minutes or so later Jack woke up crying.

So last night we both stayed with him, talking quietly and at that crucial 50 minute mark when he normally wakes he started to stir. We went quiet and watched him, he started to whinge so we both spoke up and reassured him that we were there and low and behold, he slowly went back off to sleep... have we cracked the mystery? Is it separation anxiety from Daddy? We'll try the same tonight and see what happens.

Development

Dating scans are accurate because all embryos develop at the same rate. At 24 weeks I'm viable because all foetuses develop at the same rate. I'm due at 40 weeks because all pregnancies are the same length as all bumps develop at the same rate. My baby will have growth spurts at 2 weeks, 6 weeks and 3 months because all newborns develop at the... hang on a minute... what's this? 4 months? My baby is hungry, s/he must need solids! But the research says it can be harmful before 6 months... but it's fine for my baby as all babies develop differently!

Where does it change?

The very same people who claim their pregnancies are utterly predictable because all babies develop at the same rate in utero claim that their baby's gut is ready to digest food two months early because not all babies conform to the same development patterns.

I find this odd. Now, I'm the first to say that there are differences in development between babies both in utero and out. I openly promote the fact that pregnancy can last anywhere from 37 to 42 weeks and that babies come when they are ready (i.e. not all are developed for birth bang on 40 weeks). Children do reach developmental milestones at different times, some roll first, other cut their first tooth first etc.

But when it comes to physiological development we can't actually see their insides so we can't actually know from observation whether their gut is mature enough to take solid foods. Isn't it best to err on the side of caution when it comes to our child's long term health?

Yes, the guidelines are a recommendation, not a requirement and it is every parent's right to ignore it or not. But recently I have encountered a number of people who not only ignore the research, but seem to think it is fictional or in some way unreliable. We are talking about dozens of academic, peer reviewed studies of tens of thousands of children. But when parents who have already decided to wean their child early they will, understandably, close their ears to the research that contradicts that decision one or more months down the road.

I have found, however, that many parents, at the time of making their decision are aware of the guideline, but haven't looked into the reasoning behind it and are not aware of the health risks associated with early weaning. They tend to say things like "I was weaned at 3 months and I'm alright, so I don't see the harm in weaning my baby at 4 months."

With very narrow world views like this it is easy to see why they would make such decisions, but I can't help but be disappointed that more parents don't take the time to look into these issues more.

Independent Midwife

(I made my 100th post last time!)

So, Andy and I had a meeting with a local independent midwife (IM) on Monday to go over the hospital notes from Jack's birth. It wasn't quite as tough as I was expecting it to be, I think because we had read over them on our own already and got the worst of it out of the way. The IM, Debs, asked us to describe, from our perspective, what had happened. That was the tough bit and I did cry a bit towards the end.

Then she had a look through the written comments from my labour and studied it alongside the partogram so she could see what physiological signs were going on at the time. She came to much the same conclusions as we had, that we had an inexperienced MW on the day who should have been suggesting specific movements to encourage Jack to turn as soon as poor position was suspected (from the very first examination).

Also, artificial rupture of membranes (ARM) should not have been offered as Jack's heart rate was elevated at this time which the MWs attending on the day themselves said this suggested he was in distress, which they confirmed on breaking my waters and finding meconium. Debs, however, says that "thin meconium liquor" as described in my notes is not really of much concern and that ARM is known to cause foetal distress, so when his heart rate was up anyway it was a very poor idea. It is also known to make it more difficult for poorly positioned babies to turn into a better position. All in all it was an extremely inappropriate intervention to offer.

On the positive side, however, she thought that the MW at the hospital stretched her guidelines and protocols for us, albeit in a very medicalised way, she still piled the interventions on, but did not put any time pressures on us for well beyond what her superiors will have been advising. When Debs was in the NHS she said that she found it almost impossible to provide woman-centred care and when she did she was repremanded for it. The implication is that the hospital MW we had was probably in a bit of trouble for the leeway she gave us.

Another thing that she advised us of is that prolonged periods on the syntocinon drip can increase risk of uterine rupture, which is why it is ill-advised for VBACs. We were not advised of this risk at the time of being offered augmentation of labour, nor was it raised as a reason to come off the drip and go into theatre. I do feel that this was poor medical practice. The MW and consultant did not allow us to make an informed choice, they did not mention any risks. I do not believe that the onus should be on the client to request this information, though sadly it seems to be the case.

I feel like a weight has been lifted off my shoulders. My own thoughts about what happened have been confirmed by an experienced third party and although we can never know if things might have gone differently with another MW I can at least take comfort in the knowledge that my body did not fail me.

It was also great to meet someone who we may well hire next time, her fees are doable if we save a little each month, but as she is currently expecting her first baby we had better make sure we wait as long as we intend to!

Party

On Saturday 1st August we held a large house/garden party to celebrate Andy's 30th birthday and Jack's Naming Day. In the week leading up to the event we kept a close watch on the weather forecast and crossed all our fingers as it looked more and more likely that the day would be plagued by rain. We invited rather a lot of people and knew that we would have a problem if we couldn't use the garden.

Andy wanted to barbecue and we were planning to plant a tree for Jack. We decided to get the tree planted the day before, so as not to have to get dirty on the day or battle with the weather to get it done.

We had friends and family coming from all over the country, some arriving on the Friday and some staying with us, so there was a lot of cleaning and tidying to be done!

It was fantastic to see friends that we hadn't seen in a year and friends from Bristol not seen since our house-warming in December. We also got the chance to meet my second cousin's little boy, who commanded a lot of attention with his loud screeches!

Saturday came and the weather did not look too promising, but the forecast was for light showers and that's what we got. For most of the afternoon we were able to use the back garden, where Andy tended the bbq surrounded by friends. At the peak of the party we had over 40 people and there was a heavy shower at one point, meaning the house was full to bursting!

In a break in the weather we did get everyone outside to show off Jack's tree and propose a toast to him and Andy. I hadn't wanted to do a speech or anything formal or fancy, but this seemed appropriate. Afterwards though I felt a pang of regret for not mentioning our chosen Supporting Adults or why we chose Jack's name. Having lost the little book I had wanted people to be able to write their hopes and wishes for Jack's future in there really wasn't much about the day to mark it out as a naming day :(

That said, I did commission a fantastic cake for Jack, which was completely beautiful and much admired by everyone. It tasted amazing too! Luckily there was quite a bit left for Andy and I to enjoy over the following week!

Once the guests began to drift off we wound things down, Andy and some of the remaining family and friends went down to the local pub, who were having a beer festival. It was a chance for Andy to be the centre of attention and really celebrate his birthday. I got Jack into bed and had a precious hour to myself before heading to bed!

All in all it was a lovely day, so nice to see Jack with his cousins and our friends' little boy with his interesting mode of transportation - bum shuffling! I wish I had filmed it!

Milestones

Jack is over 4 months old now and developing wonderfully! He cut his first tooth today, poor little mite is really uncomfortable, is drooling constantly, chewing everything and has sore cheeks. Hopefully now that the first one is out it will get easier for him.

He isn't rolling over yet, but can shuffle about and is very partial to grabbing his feet! His coordination is fantastic and he is interested in everything around him. He is a very happy boy, he giggles at being bounced and having his neck cleaned in the bath and has started to laugh at the sight of me! He can almost sit unaided already and will take his weight on his feet when supported in a standing position. He loves books and can turn the pages of board books himself.

Most of the mums I shared my pregnancy with have started weaning early and I have recently found myself drifting away from them. It's hard to stay friends with people who have such different ideas about parenting. Jack won't be having solids until he is at least six months old, at which point we will be following baby-led weaning (BLW), which is the practice of including children in meal times and offering them real food, not purées. It helps ensure a happy and healthy relationship with food, teaches table manners and is generally a lot easier than spoon-feeding! I'm looking forward to it :)

The Recovery

At 6 days post partum it was found that I had an infection in my c-section wound. I was then on antibiotics for most of the next 7 weeks, and having my wound dressed by the district nurses at my local GP surgery every few days.

I developed post natal depression, had trouble breast feeding Jack and found it virtually impossible to participate in the basic care of my new baby. I couldn't bend or kneel to change his nappies, couldn't lift him from the floor or his bouncer, couldn't get out of bed in the night to fetch him to me for feeding, couldn't lift him in his infant carrier or push a pram and couldn't take him out anywhere without help. It was hell and seriously interfered with my ability to bond with him.

Luckily, Andy had over 3 weeks off work so was able to help a lot during the worst of it. My mum then took over, visiting every day to take me to the nurse and help look after Jack.

We had trouble with BFing, mainly, I believe, because of the surgery. I wasn't able to hold him for several hours afterwards, we didn't get our immediate skin-to-skin, in fact it wasn't until the next day that I got this. We were advised to use nipple shields to help him latch on, so we used these for a couple of weeks, but they were a pain to use, had to be sterilised and were generally unpleasant and interfered with normal feeding. At about 2 weeks we cracked it, we ditched the shields and Jack managed to latch on on his own and from there on I was able to feed him normally. We did give him a few bottles of formula in those early weeks, but stopped when Jack was about 5 weeks old. We've been exclusively BFing since, Jack will be 19 weeks old tomorrow!

When my physical recovery took off I was almost immediately better able to bond with Jack, I could do more with him and began to enjoy being a parent. But the events of his birth continued to haunt me and although I had felt ok with each decision at the time I began to look back with deep regrets about our decisions to call the MWs so soon, consent to ARM and hospital transfer and the cascade of interventions we were coerced into accepting. I have since learned of many women who had extremely long latent labours (days long), who had posterior babies etc who gave birth naturally at home. I applied for my hospital notes and on examining them we found that there had been more progress than we had taken in at the time (at one point I was 5-6cms) and Jack was posterior, not transverse as predicted. Transverse babies can become lodged in the pelvis, but women give birth to posterior babies all the time with little more difficulty than anterior babies.

I believe now that the NHS MWs did not try hard enough to help me have a normal birth, protocols and misguided use of interventions led to the c-section. We have an appointment with an independent MW next Monday to go over the notes with an impartial 3rd party and I am keen to know what she thinks about what happened and what she may have advised differently had she been in attendance.

I have agreed with Andy that the only way I would consider having another child in the future is if we can hire an IM and shun the NHS. He agrees with me. A dear friend asked me why it matters what happened and I had to tell him that I feel I failed as a woman, I did not give birth to Jack, he was surgically removed from me and the experience of giving birth that I was very much looking forward to was stolen from me. It also has implications for Jack's health (c/s babies are higher risk of asthma and diabetes) and makes a normal birth in the future less likely. Hiring an IM goes some way to increasing the chances of me being able to give birth next time and there is no way I will trust the NHS to have my best interests at heart in future, they will have their arses as their top priority.

The Birth

OK, so it was another four weeks after my post about normal birth that Jack finally decided to arrive. I wrote this birth story a few days after the events, it was still very raw but also written with some naivety... Jack was born on Saturday 28th March 2009, at 18.37, weighing 8lbs 7oz.

It's hard to say exactly when labour began! We thought it had got going on Sunday 22^nd March. I was having regular surges at five minute intervals and went into the trance-like state I had been practising for so many months. It was a euphoric experience, pain free and very intense. The MWs were called out and I agreed to an internal to see where we were at. It was fairly gloomy news, I had barely begun to dilate and my cervix was still high. The MWs left us to it and the surges almost immediately stopped. I then spent the next few days in an almost constant state of frustration waiting for things to start again but only ever had occasional irregular surges.

It wasn't until Friday 27^th that I knew things were starting for sure. I woke up at around 5am with surges accompanied by cramps. I got up and wandered about a bit, squatted by the bed and tried to put my breathing to good use. After almost an hour I woke Andy to tell him something was happening. I couldn't concentrate on my breathing, I was excited and restless and it did hurt a fair bit, so I was a bit frustrated too!

We kept an eye on the surges and after a while we were happy that they were coming five minutes apart. So my mum was called and we put some music on for me to try and get into my deep relaxation. I got half way there, was using the breathing techniques I'd learnt and it was all going pretty well. Soon the contractions moved up to every three minutes and we thought things were progressing quite quickly so called the MW.

My mum arrived and sat with me while Andy started getting the pool ready. Shortly after my MW arrived and I remember being so pleased that it would be my MW who I had seen antenatally who would attend the birth. She examined me and again it was not great news. Despite the frequency of the contractions I was barely 2cm dilated and my cervix was still high and posterior. She also said that it felt like the baby's head might be in an awkward position.

She agreed to leave us to it for a few hours and I sat on my birth ball by the bed, trying to breathe through the tightenings. They were getting very intense and I found it too hard to get into my relaxed state. It was very different to the previous Sunday.

We decided to try and keep busy so the three of us went into the front room and put a film on. I sat on the sofa with my birth ball in front of me and with each surge I moved to my knees on the floor and leaned on the ball. It was getting more painful and even harder to relax and I desperately wanted to get in the pool. We had to turn the film off half way through for me to go back to bed and put my relaxation CD on. Things improved a bit then and we called my MW back early afternoon but there had been no progress.

I was getting frustrated now and all attempts to get relaxed were failing. But I was still reasonably happy with the pain and it felt great to know that we would be meeting our little one soon. My MW called in the on-call MW for the evening so I could meet her before needing her in the night – everyone was still sure baby would arrive soon – my MW was going off duty so it wouldn't be her delivering our LO after all. So we met the new MW, she was young and seemed a bit nervous, but I was barely able to register that at that point. Both MWs left with the parting advice to give them about an hour's notice when I felt we would need them again as the second MW, who I had not yet met, had to come from Leeds and go to Bradford first.

It was only an hour or so later that the intensity really picked up and I felt desperate to get in the pool for the pain relief. So we called the MWs back and they arrived just over an hour later. I was told I was 3cm and could get in the pool. By now it was about 7pm and all I'd eaten all day was half a sandwich, but I just wasn't hungry.

Andy and I got in the pool and it was absolute bliss! The pain eased up but the contractions kept coming. But they weren't as regular as the MWs would like, and hadn't been for a number of hours. They would come in pairs with a bigger gap between each pair. But this didn't seem to be of much concern. I spent most of our time in the pool up on my knees leaning against the side of the pool, aware of being in a good position for the baby to descend.

The MWs and my mum sat in the living room chatting while Andy and I laboured in the pool for a number of hours. I was back to enjoying it now but soon the contractions became much more painful and I asked for the entonox. I didn't use it right away, I didn't want to feel sick or drunk, I'd always been wary of using the stuff but after a few more very intense contractions I relented and started sucking.

I told the MWs I felt like I needed to push and they came to sit with us, everyone was quite excited now. I'm not sure what time it was or how long it went on, but I was using the “J” breathing from hypnobirthing rather than trying to actively push. The MWs wanted me to get out of the pool to examine me, they had guidelines to examine me every four hours. I didn't want to get out, but I agreed and we went into the bedroom.

Here is where it all started to turn. I think it was about 3am, so I had been contracting at least every five minutes for 22 hours, I was exhausted. The MW examined me and found that I was still only 4cm, if that and I began to feel very disappointed. She said that she could feel the sac between baby's head and my cervix and she offered to break my waters as it might make the contractions more effective if the sac was no longer forming a cushion. I had heard of other women finding that they progressed after ARM so I agreed to it. She went ahead – it didn't hurt, much to my surprise – but her face said it all. She told me there was meconium present and that we should transfer to hospital.

I resisted at first, I remember saying a few times that I was post dates and that baby probably just had mature bowels. But she was concerned that the last few doppler readings had shown an elevated heart rate. I asked them to keep monitoring with the doppler for a while, which they did, they checked him about every five minutes for half an hour, while the lead MW talked to her supervisor on the phone regularly. His base line rate was up in the 160s consistently, whereas it had been around 140 earlier.

My mum and Andy were starting to really worry, Andy was even a bit tearful so I agreed to transfer. I was devastated and cried a bit, saying that I was going to end up with a c-section – I knew the hospital transfer story well - but felt we were doing the right thing. In the ambulance I really got stuck in to the entonox, I was becoming distressed and the pain was getting very intense. Once we got to hospital I had to stop a few times on the way in for contractions, I was holding onto my V-pillow for dear life and was barely aware of where I was.

We got taken into a room on the delivery unit and I was offered a bean bag rather than the bed, which I accepted. I was very woozy from the entonox and couldn't focus on any of the people coming in to the room to talk to me. I remember a woman offering me an epidural and telling me they were going to put a canula in my wrist. I shouted “No!” I didn't want a routine IV or anything and really didn't feel the need for an epidural. People came and went in a blur as I got more and more drunk on the entonox.

I remember my dad trying to tell me to stop taking it and someone said to only use it during a contraction, but the pain went on between contractions as well and I was finding it hard to tell where one ended and the next began.

I don't know how long I sat there, but I remember them putting me on a syntocin drip to try and get my contractions into a regular pattern and I dozed my way through several hours, sucking on the entonox.

A some point I moved to the bed and was examined again and there had still been no progress, I was stuck at 4cm. It was confirmed that the baby's head was transverse, so the widest part of the head was pushing down, basically preventing dilation. Breaking the waters hadn't helped, the contractions were still not regular enough to compensate for the position of the head and I had a premature pushing urge. I tried to fight it, but god that's hard! I remembered from our antenatal class a tip to lift your chin to resist pushing, which I kept doing but it just didn't help. I could feel fluid rushing out of me every time a contraction peaked and I was screaming the place down. It was the most horrific period of my life. I cried and screamed through each agonising contraction and couldn't stop myself pushing hard even though I knew I had to try.

The MW examined me again and found that my cervix had swollen and closed up. She strongly suggested an epidural to stop the pushing urge. I agreed and we were given four hours to get my cervix to unswell and start dilating before we would have to talk about a c-section. I remember the anaesthetist telling me to lay off the entonox and taking it away from me! Once the epi was flowing I didn't need it and I became properly lucid for the first time since about 5am.

The epidural was pure heaven. By this point it was about 11am, I'd been labouring without food or sleep for 30 hours. I was able to sleep and the pushing urge disappeared completely. Four hours later and my cervix had started to unswell but was still only 4cm. We talked at length with the MW, who I was finally able to focus on! She was wonderful and had been looking after me all morning, though I was oblivious. We asked for another two hours to try and get the baby into a better position. The consultant wasn't happy about it but he agreed as the baby's heart rate had settled down significantly since we arrived and was holding steady at just under 150.

I managed, with difficulty, to get onto my knees and lean on the head of the bed, I was desperate to get the head to turn so that I could still give birth to him. But we had very limited time now and I knew that it was going to do no good. I actually felt fine about it, I was reasonably cheerful in fact. The most important thing seemed to be that we had done everything we could and that we just wanted a good outcome. People kept telling me that my body just wasn't going to manage it and although I was upset and disappointed I felt we had taken the best decisions we could based on the information we had at the time.

I was checked again at about 5pm and had barely got to 5cm in 36 hours. So we agreed to the section. The anaesthetist came back to top up the epi, the consultant went through the consent form and got me to sign it and Andy was taken away to get into scrubs. When he came back I remember declaring to the room at large how sexy he looked! We had a giggle with the MW about Dr “McDreamy” Shepherd in Greys Anatomy and everything seemed quite cheerful, despite what was going on. The MW cleared the room to put the catheter in and shave me, concerned about preserving a little dignity for me, which was much appreciated. My mum went to meet my dad and wait for it to be over and we were wheeled into theatre.

It wasn't too bad, I still felt calm and reasonably content with what had happened, I had Andy right by me and the MW who had looked after me all day was there too. We insisted that Andy be allowed to announce the sex, it was the one part of our birth preferences that we could still have, so the MW made sure everyone knew to keep their mouths shut! The epi made me really shaky and I kept trying to breathe and relax to stop my arms from lashing out.

When they held him up for us to see there was really no mistaking him for a boy! Andy announced it anyway and I started to cry. He was taken away to be cleaned up and he needed a little help breathing as he had swallowed some meconium. But we soon heard him cry and the MW yelled that she'd been weed on - twice! He was handed to Andy all wrapped up and he sat with him by my head while they stitched me up. I tried to look at him and stroke his face but I had to crane my neck and it really hurt and I was still shaking uncontrollably. The stitching up seemed to take forever and I did ask at one point if everything was ok, as it was possible they had been busily stopping a haemorrhage or something without alerting us! There was a woman stood by my head on the other side to Andy, I'm not sure who she was, but she reassured me that I was fine.

When it was all over we were taken to recovery and the next hour or two is a blur, except that I kept on shaking and couldn't hold Jack yet as I was still being kept on my side. I remember someone manhandling me to put Jack to my breast and he sort of fed for a minute. My parents came in to see us and my MIL popped in just as they were tidying me up to take me to the ward! I actually had to ask for some privacy, I think they would have had everything on display to my MIL if I hadn't said something and then I was on the ward and Andy was saying a heart-wrenching goodnight to us both.

The three days in hospital passed slowly. Although Jack slept lots I couldn't and various midwives kept trying to help get him feeding, some of whom with very little regard for my personal space, getting very hands on without asking my permission. The MW who was on duty during the day for all three days was wonderful and I am very thankful to her for being very supportive. She wanted me to stay in longer to get the breastfeeding working, but I was desperate to go home. I couldn't stop crying and the nights were getting harder to be without Andy, so on the third day I insisted on going home and she told me she had every confidence we would persevere at home and crack it, which was a nice confidence boost.

It was good to get home, but the recovery was hell.

Oops!

So looks like I have been somewhat remiss here, not only have I failed to blog about the arrival of Jack but I haven't updated on anything since! I'll get caught up now, but will split it all up into multiple posts.

While I'm thinking of what I wanted to post in the first place I will get it down now: I was just reading about the changes to the Strictly Come Dancing judging panel for this year and I had a wonderful memory come to mind... me (and my bump!) and Andy sat in the window of our living room in the dark, with no curtains, surrounded by a mountain of boxes, eating fish and chips and watching Strictly: It Takes Two on our little 14" TV every evening. The memory made me smile. How long ago that seems now (November 2008), how different our lives are now, and how sublimely ridiculous that situation was lol!