Tuesday, 16 February 2010

What exactly IS a normal birth and delivery? Does it exist?

Forgive me for appearing to be cynical but does a 'normal' birth and delivery really exist? During recent months I have enjoyed watching my little sister, Claire, blossom during her much-wanted pregnancy. There is a 10 year age gap between us so she will always be 'little' to me! As a baby I was her 'second' mother and our Mum reminded me today that she hardly got chance to feed, bathe and change her as I was there first!

Claire had a fairytale wedding (yes, in a castle with a horse-drawn carriage) and finally became pregnant and was due on March 2nd - the day after our Parent's Golden Wedding. They had a magnificent cruise and holiday booked in Mexico, which they cancelled, willingly.

Little sis had a sickly first term of pregnancy but then has blossomed during the next months, only finishing her job a couple of weeks ago. Like me, she has read all the glossy books and magazines, attended antenatal classes and NCT sessions. Claire has been very healthy and rarely has seen a doctor in her life!

The beautiful nursery is only just put together and when I called this time last week to see it she commented that she hadn't yet packed her hospital bag, but there was plenty of time. Her birth plan was neatly sorted. The birthing ball was in the lounge. Baby clothes and equipment neatly stored. Lists made. Plans in place.

Like me, Claire has been painted a picture of the 'normal' birth. The impression is given that it can be done with a few deep breaths and that you are a failure as a mother if you dare to ask for pain relief. That nature intended us to suffer and that you are weak in someway if you cry out for even so much as a paracetamol!
The magazines tend to create the scenario that your partner will also have almost a sensual experience out of it and if they choose not to be present at the birth, they too are failing. All it takes is a few screams, a couple of pushes and bingo! Job done. Then perfect baby takes to perfect breast and another contented family is created. And woe betide you if you aren't back in Sainsbury's by teatime in your size 8 white jeans!!

Within a couple of weeks you meet up at the Mums and Tots groups and those who managed to get their bundle of joy out just before watching Nigella Lawson on television and already have restocked the freezer with amazing couscous dinners, make the rest of us shrink into 'I must be a failure' mode. I was lead to believe that some of these new babies only soiled their nappies once a day and even then they cleaned and changed themselves!  I am aware that there is a little bit of exaggeration in there but do you get my drift?

Yes we can argue I am cynical because it didn't happen like that for me and I needed surgery for postpartum hemorrhage and a retained placenta. I will never forget being told the next day that I 'should think myself lucky - had it been a home birth, I'd be dead!'. And then of course, I went on to develop postnatal depression and puerperal psychosis. Not quite what I had planned or expected!

Anyway, back to little sis. On Saturday she had an upset tummy. By 10 pm. she was curled up in agony. Her husband called the labour ward, and an ambulance was sent for. After giving blood and other samples in A & E they realised it was serious and Claire had to have an emergency C section. Baby's heart stopped too. Both have survived BUT since then Claire has needed 24 hour care. She is still in the labour suite.

What happened? It appears she has suffered with pre-eclampsia (a complication of pregnancy. Women with pre-eclampsia have high blood pressure, protein in their urine, and may develop other symptoms and problems. The more severe the pre-eclampsia, the greater the risk of serious complications to both mother and baby. Pre-eclampsia is thought to be due to a problem with the afterbirth (placenta), and so delivering the baby early is the usual treatment). She then suffered further complication of HELLPS syndrome. (HELLP syndrome occurs in about 1 in 5 women who have severe pre-eclampsia. HELLP stands for 'haemolysis, elevated liver enzymes and low platelets' which are some of the medical features of this severe form of pre-eclampsia. Haemolysis means that the blood cells start to break down. Elevated liver enzymes means that the liver has become affected. Low platelets means that the number of platelets in the blood is low and you are at risk of serious bleeding problems.)
Full description here: http://www.patient.co.uk/health/Pregnancy-Pre-Eclampsia.htm

Baby Sophie is lovely! And here she is with her Auntie Elaine...

We are all thrilled and very grateful for the care and attention both she and her mum continue to receive. At the moment there is no sign of them being discharged and although improving, Claire remains poorly.

I feel angry and upset - at no-one because these things happen. But sometimes life seems so unfair. Claire has taken every precaution during her pregnancy for herself and her baby yet she has resulted in this trauma. When Mum and I left the hospital last night an expectant mother was standing in her night clothes, in the rain, having a cigarette under a sign that clearly stated 'No Smoking'. I am not saying that mother deserves to have problems but just added to my feeling of injustice about Claire. I am upset for her and her husband because they too have had their expectations of what society has lead them to believe was 'normal' has been shattered.

I share this story with Claire's permission. Perhaps we are in the minority of those for whom the 'birth plan' was thrown out of the window? I am usually the voice of optimism in whatever I do and look for the bright side, yet today I do question, as I have done before, what can we do to help prepare mothers and fathers to  about the birth? That is isn't all about helium balloons and 'nothing to it'. That for some it can be problematic?

I guess we need just to prepare them that maybe there isn't 'normal'; that everyone is different. That nature plays it's part. But whatever happens, they are not to consider they have failed or caused the problem (if that is true).

Claire was lucky in that she was dealt with swiftly and promptly - if not, I dread to think what could have happened. Her constant nursing is provided around the clock so if further complications happen, help is there immediately. This isn't a private clinic, but an NHS hospital. We are all grateful for the ward management that must be needed to enable this. But what about other ladies who develop this illness? What if they are told the hospital is full? That staffing levels are low? That their symptoms are missed because of lack of resources? My plea for improved maternity services funding remains as high as ever. My passioned plea is now even higher!

And also for the key factors which I uphold for all patients and their families:
Hope - we all need reassurance and good communication that both Mum and baby are being given the best care and will be okay.
Attitude - that Claire is genuinely poorly and 'not making a fuss'.
Needs - are very unique and special; although we may be statistics for us as a family this is a special but scary time.
Zest - that we all need to smile, even though we may want to cry; that simple pleasures of the senses, e.g. having a shower and helped to put body lotion on, are effective healing mechanisms
Altogether - we need reassurance that a whole team are involved in their care who all know what is expected of them. As a family we have to support each other.
Kindness - a smile to us relatives is much appreciated but we need to know that Claire is being surrounded with empathy, compassion and caring for the ordeal she is experiencing.

And please can someone tell me that it is not just my sister and I who have been unlucky? Did your birth plan go to plan?

Elaine Hanzak



Rai Furniss said...

I'm sorry to hear that things went to such extremes for your sister and I hope that everything improves for all involved.

I just thought that I would mention that, having watched "One Born Every Minute" earlier in the week the programme seems to be subtly trying to dissuade people from believing it's all roses. Perhaps this is a good sign that there are still some facets of the media that, at least, try to show the public some reality.

Elaine said...

Hi Rai,
Thank you for your comment.
Little sis and baby are now out of danger and doing well, thank goodness.

I agree with you about the Channel 4 programme - I am a big fan of it! I haven't been convinced yet by it of the useful role of men though!!!!