Alice’s birth story

Consider yourself warned. This post is graphic, describes labour and birth, and it is long. Very long.

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This is the story of a girl who planned everything. She loved planning and arranging and sorting things, was convinced that forewarned was forearmed, and that by being prepared every eventuality could be anticipated and accounted for.

This is the story of a girl who got it wrong.

I wanted the birth that was best for my baby – the only birth that was good enough, in fact. I wanted a drug-free, intervention-free labour and delivery where I trusted my body which in turn rewarded me with a straightforward, safe and entirely manageable birth with a healthy baby at the end. I knew that allowing my young and healthy body to labour naturally would achieve everything I wanted, and that there was no reason to assume that I couldn’t do it. I was going to be the calmest, most serene birthing woman they’d ever seen. They were going to marvel at my ability to endure contractions, remain collected and keep it all together. I was made to do it. I was built to do it. I would do it.

My husband and I attended a Calmbirth course in preparation and we wrote a birth preferences plan including everything that was important to us about our baby’s birth: no analgesia or anaesthesia, no internal monitoring or examinations, an active labour, no directed pushing, delayed cord clamping, and a physiological third stage. Many of these things were standard in the birth centre we planned to attend, so we were sure that we were doubling our chances of success. We included a statement that we understood that these were preferences and in the event of an emergency they would have our full co-operation – but we knew that this was lip service because we’d never need any assistance at all. We’d planned the perfect birth.

When my waters finally broke at 4am on Thursday 29 November 2012 they did so with a pop and a splash during one of my frustratingly regular night-time toilet breaks. I called and called for Luke, who sleeps the sleep of the dead, and once he came to inspect the evidence and get me a pad we went back to bed to see what would happen. Like the sleep champion he is, Luke was fast asleep soon after while I lay awake not quite sure how the next few hours would pan out.

Contractions began at 4:54 am (according to the handy tracker app I’d downloaded in my planned out way), and came at 5-7 minute intervals lasting for anything from 30 to 90 seconds. They felt like bad period pain and I practiced breathing through them, thinking it was all a bit of a doddle so far and wasn’t I a clever girl.

By 6am-ish the contractions were 4-5 minutes apart and lasting well over a minute each. They were more and more uncomfortable and I began to moan and groan. Still, not so bad and a few heat packs helped ease the cramping and back pain quite well. Wasn’t I clever?

At about 8am we called the hospital to let them know I was in labour, and I mentioned to the midwife (in between contractions on the phone which I was careful not to make too much noise through because I wanted her to think I was handling it all very well) that there had been some greenish-yellow staining on my first pad. The midwife, Zoe, said that if it was greenish then it might be meconium, which would mean an automatic transfer out of the birth centre and into the birth suites. Although I knew that meconium in waters could be very serious, I didn’t know that this was a reason for transfer. Zoe suggested that we come in to check the colour of the staining, and then go home if labour wasn’t too progressed. I agreed, thinking that the trip to the hospital would be tough but that I could do it, and said that we’d wait to come in until the peak hour traffic had passed as we had to drive on the freeway. I blithely ignored any small whispered suggestion in my head that his wasn’t in the plan. I was still quite in control of myself and the situation – what a clever girl I was.

After this call the contractions became more and more intense. I had a hot shower and did the stamping recommended in Juju Sundin’s ‘Birth Skills’ book, telling myself that I had to become bigger than the pain. Barely able to stand up I’m not sure how I was bigger than anything much, but at least I was clean. I was still quite clever though as I was able to move around on my own.

Contractions were getting closer and closer together, now around 2 minutes apart and lasting for about 1 minute. I began an involuntary high-pitched yelling, a sound I’d never heard myself make before, sounding like an prolonged “aaaaah”. I sat on the toilet and lay on the couch, staggering between each and directing Luke in the packing in between bouts of yelling. I was so clever to be able to co-ordinate this in between yelling, wasn’t I?

After checking my pad again and finding an ominous green stain we rang Zoe back. I said I wasn’t going to come in and go home as I wouldn’t make it and she agreed that once I was in, I was in. The thought of the car journey was daunting, as I was unable to sit or stand for long, but it had to be done so at around 9:30 and after a few false starts where I ended up doubled over on the couch, I walked myself slowly to the car and prepared for the ride. Gosh I was still clever to have lasted at home for over five hours, which would surely mean I was well-progressed already.

Traffic. An accident had caused a backlog of traffic along the freeway and at our exit. I will forever be grateful to Luke for being the calmest I have ever seen him in a traffic jam, allowing me to focus solely on managing the increasing pain. I’m sure other drivers saw my yelling and fist thumping as signs of road rage, but as we got closer to the hospital I could hear my yelling becoming louder and louder and more and more rhythmic as the only way I could get through each contraction. I began to vomit. I kept timing them using the app, but for the most part was still able to speak normally between them. At one break between contractions I checked my email to find a message from my dad’s cousin in England letting us know that my great-uncle had died. I couldn’t take in more than the bare details, but it made me think about the turning of life and the strange synchronicity of the world. I was pretty clever to be multi-tasking through this, wasn’t I?

Each time we’d visited the hospital for ante-natal visits we’d giggled at the signs apologising for the lack of parking and promising a new carpark soon. Never had those signs seemed more mocking than as we drove around for a quarter of an hour desperately seeking a park, any park, any where. I refused to be dropped off and be alone, and continued yelling (windows up) as we circled and circled. With great relief we saw a man heading towards a car and Luke asked him if he was leaving as I was in labour. The man said he’d forgotten where he’d parked but would remember extra quickly for us – which he did, thankfully for poor Luke’s eardrums. I was still able talk normally between contractions, which meant I was still a clever girl.

I had a contraction waiting for the lift but managed to swallow the tail end of it as we entered, carefully ignoring everyone inside. I walked slowly and painfully to the birth centre, aware that the waiting room was watching me. I ignored them too, wanting only to lie down again. I was able to walk so I still felt pretty clever.

When we arrived at the birth centre and I saw Zoe I almost cried for the only time during the whole labour. The relief to finally be there and to have someone else see what I was going through was overwhelming. We were taken to a room where I immediately went to the toilet and had another, very loud contraction – I could hear Zoe, Luke and the student midwife outside and when Zoe entered the bathroom I couldn’t have cared less. I’m sure I was going to the toilet as she did but it bothered me about as much as the fact I still had wet hair. But still, I was sure my increasing pain reflected incredible progress and I was a clever girl doing so well.

Zoe had seen the colour of the discharge on my pad and confirmed it was meconium. I would have to be transferred to the birth suites – but I still didn’t care. I tried to tell her during a break between contractions that I wasn’t as hysterical as I sounded, still keen to seem together and with it. I lay on the bed, vomiting during some contractions, and yelling and yelling and yelling. The student midwife brought cold towels for my head and a bag to be sick in which I clutched and bit for dear life. The pain now was all-consuming – I knew I was nowhere as in control as I had been. I felt less clever and this was the last time I cared.

I rolled on to my back with great difficulty when asked for a CTG of the baby’s heartbeat. I waited. I focused on myself. And then I saw Luke with tears in his eyes and a look on his face that I never want to see again. I realised that they couldn’t find a heartbeat and I reached out and gripped his forearm, not looking at him and feeling like my worst fears throughout the whole pregnancy – every time I’d presented for monitoring because I hadn’t felt a kick for a while – were being borne out.

We waited.

I looked anywhere but at Luke.

I looked at Zoe. She did not look at me, but concentrated only on moving the trace around my belly. She was quiet. We were all quiet.

Thump.

Thump thump thump. The best sound bar none I’ve ever heard. There was our baby, faint but clear and regular. Zoe said they would need to monitor it internally and I had no objections after that. Being a clever girl was over.

A clip was attached to the baby’s head, but throughout the course of the labour it had to be replaced four times as the cord did not match the machine or some other technical problem. A doctor attended, and another midwife, but I was oblivious to anything but my own yelling. The pain was now a constant. When I moved I surprised to see blood on the bed – I hadn’t expected it yet.

I was finally transferred to the birth suites, doubled over in a wheelchair and desperate to get horizontal again. The pain intensified as I was moved and I lost the rhythm of my yelling and instead began to writhe and kick to get through each contraction. There were fewer breaks between contractions where I felt like I was returning to being myself. I knew that this pain was more than anything I’d imagined and that I was somehow a different person when contracting – I sounded different, I said different things, and I didn’t like this person very much. She was whiny and weak and she was beginning to think about pain relief in a little secret corner of her mind. The ‘real me’ wondered when the ‘ideal birthing me’ was coming to take over, because what was happening now was not going according to plan.

The period between each contraction now seemed to run on without a break, with each peak followed by no respite. I remember telling Luke, in the other me’s high pitched voice, that it just didn’t stop and I just needed a break and if I could just have a break between them I would be ok.

I was determined not to say the ‘e’ word. I would wait. I could wait. I must wait. I wouldn’t break. I wouldn’t say it first. I wanted it so badly. I wanted anything so badly that would make it stop. I wanted a c-section if it would make it stop. I sobbed and whined and I just wanted a break in between to pull myself together.

The new midwife, Andrea, told me I needed to open my eyes during contractions, focus on something, and try to control my breathing. I felt like she was saying I was out of control, which I probably was, but I was also doing what came naturally and when I tried to force myself to do something else it lessened whatever control I had, taking energy away from my unconscious coping mechanisms and directing it to conscious action. Things were getting worse – I wasn’t coping at all as I thought I would, because the pain wasn’t at all how I thought it would be. When would someone suggest an epidural for heaven’s sake? It was all I wanted but the last thing I’d say.

At about 10:30 am another internal examination to re-attach the monitoring cord found that I was fully effaced and 3 centimetres dilated. Andrea seemed to think this was quite good and that I’d done a lot of work already, but I was crushed and so disappointed. I’d expected to be much further along, and despite Luke reminding me that dilation only told you how far you were at a certain point in time and not how far along you’d be soon, I was fearful that I had hours and hours to go.

Andrea suggested the gas and air which I said I’d try. She showed me how to use it but on my first sucks I was sure I wasn’t getting enough oxygen and began to feel panicked. I threw it away and despite being told it needed a few goes to get it right, I knew it wasn’t for me. Luke says that I did get a bit spaced out after each puff I took, but I felt nothing except that my breathing was compromised and I knew I didn’t want to use it again.

Andrea suggested pethidine, which I refused as it would make me sick. Even though I’d had Maxalon to prevent more vomiting, the idea of nausea on top of the pain was unthinkable. I also knew this left only one option for pain relief, but I’d be damned if I’d suggest it first.

Luke left to get the rest of our bags. I yelled and yelled. It was worse and worse and contractions were steady at about 2-3 minute intervals although there was still no relief between the peaks of pain. Where was my labour bouncing on a fit ball? Where was my hot shower and sacral massage and deep breathing? Where was my inner calm? All the things that I was sure would be my tools to help me birth my child were the last things from my mind, because they would have been useless. Even if I had managed to sit up, or stand, or move in any way from the bed, none of them would have touched the sides of this pain. I knew it was time to abandon those things.

I asked for the epidural while Luke was gone.

Luke came back and I told him I wanted an epidural.

Luke and Andrea did the right thing and offered the gas again. I gave it another go and found it as terrible and terrifying as the first time. Maybe it was now that she offered pethidine, but I can’t remember.

I said it again, and Andrea made the call.

I told Luke I couldn’t cope, and having tried to support me in our original plan, he now supported me in this.

Finally a proper room became available and I was transferred on a trolley to a birthing suite. I contracted on the trolley and tried so hard to keep it in while we were in the corridors, not wanting anyone else to see (or worse, for some poor pregnant woman to hear and have the fear of God put in her). Again, the transfer intensified the pain and reduced any control I had, so that by the time we were in the birth suite I was completely oblivious to everyone in the room and anything except my pain and the sound of my own wailing and the kicking and twisting of my body.

I remember feeling a gush of liquid and asking in surprise if I’d wet myself. It was just fluid but from them on I was more aware of how much I was leaking, and how little control I had over it.

I was examined at about 12pm and was 5-6 centimetres, which meant that I had dilated 2-3 centimetres in just an hour and a half. In retrospect I’m sure that it was the speed of dilation that caused the intensity of contractions, and as I’d had no pre-labour I think I had begun dilating from 0 centimetres when contractions began at 5am that morning. I’d gone almost a centimetre an hour on average from the get go including full effacement, and in hindsight was actually dilating much faster because it wasn’t long after that I was at 10 and fully dilated.

When the anaesthetist arrived I was in a rare break between contractions, and when she introduced herself I told her I loved her. I’m sure she gets that a lot. I knew the risks of the epidural but was willing to take them – I knew that I was distressed and that could compromise a safe birth in and of itself, and as I was incapable of moving I wasn’t jeopardizing an active labour either. I was put in a gown and instructed to sit and not move at all costs. I kept saying that I needed them to wait until I was between contractions and was told that they needed to get it in quickly – I just wasn’t sure I could hold still. I hung on to Luke’s neck, biting and clutching at him. With each contraction I started to push involuntarily, feeling more liquid gushing out. I think I may have begun to transition now, telling everyone that I needed to push. I also said I needed to poo and was told quite firmly that this was just the contraction and it would pass. I insisted that it wasn’t – pretty familiar with the feeling after a lifetime – but it did in fact pass and to be honest I wouldn’t have cared too much if I had gone then and there.

I barely felt a thing as I held on to Luke and the needles went in. I distinctly remember feeling so grateful that I’d had a rare longer break between contractions as I was prepped and anaesthetised. It was 12:30 and there were a couple more contractions at full force to get through before it took effect. And once it did, it was like a heavy curtain had been lifted and I was myself again. Within 15 minutes I felt only a lovely numbness from the waist down, and complete relief. I sounded like myself again and the wailing ended. I could see a change in Luke’s face too as the burden of helping me through each contraction lifted. I dozed for 20 minutes under the initial fog of anaesthesia, and Luke did too.

A new midwife, Siobhan, and a student midwife, Katie, came on duty. For the next hour I was observed, checked, had my contractions and heart rate and blood pressure and level of anesthesia monitored. Luke and I chatted with Katie and I even put some make up on, sure that I’d been undignified enough that day and there was only more to come, so I might as well feel presentable.

When Luke went to get a coffee and a sandwich Siobhan checked me as I lay on side. Quite calmly she said that she hoped Luke would get back soon or he’d miss the baby. I double-checked – oh yes, she could see the head. I felt nothing!

At 2pm Siobhan went to check with the doctors when I could start to push. They agreed that seeing as the baby’s head was descending so nicely on its own there was no point in me pushing and exhausting myself just yet, so we waited some more for Luke to return while I marveled at how calm this all was, when in my ‘ideal birth’ we would just be getting to the pointy end.

Luke returned, somewhat surprised to be told we were so close to push time (and offended we’d thought he’d got lost). We waited and timed some more contractions, and Siobhan went to check again with the doctors. At 2:55 we could start pushing. It was 9 hours since my waters broke, and just 4.5 hours since I was 3 centimetres dilated, meaning that I’d gone 7 centimetres in either 3.5 hours (to 2pm when Siobhan first thought I might push), at double the expected rate, or in 4.5 hours (to 3pm), still a cracking pace.

I’d been lying on my left side to keep the epidural at an even level, and Siobhan suggested that I push in this position as well. Holding my right leg in the air was one of the least dignified positions I’ve ever been in but it was effective. I was told to put my head to my chest, hold my breath and push with each contraction – exactly the directed pushing I wanted to avoid, but with the epidural I couldn’t feel any contractions, pressure or urge to push to do anything else anyway. I pushed as hard as I could, with Siobhan placing a finger on my inner thigh and telling me to aim for there. She kept saying ‘keep going keep going’ and I didn’t know if I was doing a good job or not but just went as hard as I could. Luke stood to my right, helping hold my leg and giving me an arm to pull on to get leverage.

Siobhan said that the baby’s heart rate was decelerating at the end of each contraction, and she urged me to push more and more. Luke would tell me when the heart rate would pick up so I didn’t have to crane my head to the monitor behind me, and I just kept pushing.

And then suddenly there were doctors in the room, Claire who had seen me much earlier in the birth centre, and (I think) Kristen. I don’t know who called them but they were there and telling me that they needed to use forceps to get the baby out as the heart rate was dropping too low and not rising. At the time I didn’t realize the implications – that each time the birth would be described from now on it would be as a forceps delivery; that the use of forceps was something more serious than it seemed at the time – which I think I did objectively but in the moment it just seemed like the next thing to do. I just kept pushing.

I was placed into stirrups and Kristen told me that she was very skinny so she needed me to push hard to help get the baby out. I remember saying something about being the fattest person in the room, and her laughing that she should have said she was weak rather than skinny. Nothing seemed too dramatic or urgent, and I just kept pushing.

At some point Claire took over the forceps. In retrospect changing doctors would indicate that someone more senior needed to do it, but it didn’t occur to me at the time. I now know that Claire was the registrar. I just kept pushing.

I told them that they had my consent to do an episiotomy, and they laughed and said it had already been done to get the forceps in. Usually I’d be outraged that my consent wasn’t sought for such an invasive intervention, but given the time pressures I know there was no choice and it needed to be done for the baby. I just kept pushing.

I could see the heat lamp being turned on for the baby, and a paediatrician named Gemma introduced herself. I became more worried that she had been called, but I just kept pushing.

Luke was able to see our baby’s head crowning as I pulled on his arm. He could see the top of the head; he could see the head; he could see the face … and I just kept pushing.

 I heard Claire say that they needed to “do a MacRoberts” and the bed was tilted so that my pelvis was lifted and my head fell back. The next few moments are absent from my memory, but I do remember a sort of slithering feeling and then …

At 3:16, less than twelve hours after my waters broke, our baby was lifted up and I reached my arms out to her. I don’t remember the first words I said but I told her that her name was Alice and she lay on my chest all red and purple and white and wet. She didn’t cry so I blew on her face for what seemed like minutes and minutes, sending air to shock her into life.

Her cry was loud and cross, such a piercing sound from such a little girl. Luke and I looked at her, taking in her molded head, bloody scalp and vernix-covered face. She looked like neither of us despite months of speculation about which of our features she would inherit, and we couldn’t believe she was ours. We talked to her and stroked her and held her tight, our little squashy girl finally in the light.

While we had skin to skin, gazing at this little squirming creature just minutes old, I was being stitched up and given an injection to deliver the placenta, all of which I felt none of. Claire pressed hard on my belly and told me something about the placenta but I really didn’t take in any of it – what was happening at that end of my body may as well have been on the other side of the world. The placenta was delivered by cord traction in the end, all of which I was completely oblivious to. I asked if Luke had cut the cord and he had, which I also didn’t realise. I don’t know if we had delayed cord clamping in the end, or if it wasn’t possible given the effort required to get the placenta out, but I suspect that as with many things we had wanted, it was a moot point in the end.

Once the work to finish the delivery was done and Alice was wiped clean of the worst of her blood and fluid, she lay on my chest screaming but searching for a breast. Another midwife, a second Andrea, and another student midwife, Britt, took over shift and Britt helped as I tried to attach Alice for her first feed. She suckled a little and I thought we’d done a good job considering neither of us knew what we were doing.

An hour or so after her birth Alice was held by her Daddy for the first time. He looked so natural and in such wonderment, and I took some photos of their first cuddle. The photos now show a shocked and exhausted Luke holding a little bundle so tenderly and in some bewilderment.

I called my parents and sister, letting my dad tell me about my great uncle’s death before mentioning that I had read the email earlier in the car, while I was in labour. Which I wasn’t any more. Because I’d had the baby. Get it? The squealing in the background was loud as loud can be, and I found out later on that it was just my sister – I had assumed it must be her and my mother given the volume. Luke called his parents at home, reaching his dad first and asking what he was doing that evening and whether he’d like to visit his granddaughter. He rang his mum who was at his sister’s house, checking her availability too. Funnily, Luke’s sister had texted about twenty minutes before we rang saying she had a feeling that I’d go in to labour that night.

We also sent out text messages and posted on Facebook, knowing that the news couldn’t be contained long, happily announcing the arrival of Alice Elizabeth to the world.

My sister arrived at some point, as we were allowed to sneak her in for a visit as long as we were still in the birth suite and not on the ward. She was the first family member aside from us to cuddle Alice, and had apparently demanded to be driven to the hospital by our dad “now!” when told to come.

Alice screamed and screamed – understandably given what had happened to her.  She was weighed and measured (7lb 8oz, 51 centimeters long, head circumference of 35 centimeters) and dressed, with Luke taking charge of learning how to change and dress her as I was still on the bed and unable to stand.

My parents arrived (bringing food as requested after the kitchen’s attempts at a vegan meal for me ended in disaster) and an entire river of mushiness flowed as they met their first grandchild. Alice was slightly over-heated and needed to lie by herself in a crib so they couldn’t cuddle her, but they did try to put clothes on her, taking an age until Britt insisted she have some space. Alice seemed to agree as she stopped crying and lay still quite happily!

Luke’s parents arrived just after my sister left, and my parents left shortly after too. I never really imagined receiving visitors while lying naked on bloody sheets, covered in amniotic fluid and blood, draped with a sheet, but there it is. Once measured again Alice’s temperature had dropped so she was allowed a short cuddle with Mimmi and Pappy, while I was monitored more closely for high blood pressure, a side effect of one of the drugs I’d had.

After Mimmi and Papi left I finally had enough feeling back in my legs to let me stand up and have a shower. I was quite sad to see the catheter go because it had been the longest I hadn’t had to wee since I got pregnant and getting up every hour wears thin! A shower and clean hair made me feel human and presentable again even though I giggled at wearing for the first time the bathrobe I’d specifically bought to use getting in and out of all the showers and baths I was going to have to help me manage labour pains.

We were ready to move and head up to the recovery wards. Luke got everything together, looking like a packhorse, while I wheeled Alice in the crib. After the hours spent in the birth suite we couldn’t really imagine what would come next, but as with all things we had no choice but to find out and meet it. It was surreal to think of everything that had happened that day and what we had achieved. We’d brought a whole new person into the world together, who we were responsible for wholly and completely forever.

We took our daughter out of the room she was born in, and left for our first night together as a family.

 

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I have done a lot of thinking about the way Alice’s birth panned out and how I feel about it. I feel a bit conflicted in that even though I am disappointed that we didn’t get the drug and intervention free birth that we wanted and did everything to promote, I know that even if I’d avoided the epidural it is most likely that Alice would still have required forceps to be born, and if so I doubt that I would have been able to push as effectively as I did if I was trying to cope with the pain of contractions and crowning, as well as the necessary episiotomy.

I spoke with one of the attending doctors, Kristen, the next day and she ran through the interventions with me. She said that the maternal effort had been good, the force required on the forceps was minimal, and the MacRoberts manouvre, normally used in the case of suspected shoulder dystocia, was used because Alice’s chin got caught on the perineum which can indicate a dystocia. It is usually expected in an instrumental delivery and Alice was not in fact stuck at all. This was very reassuring and a relief to know that as concerning as it had all seemed to me, to the doctors they had done their jobs well to prevent anything more serious happening and they were happy with the outcome. It also convinced me that if I had been dealing with the pain of the final stages of labour and the intensity of the moment I do not think I would have been able to co-operate or contribute as well as I did, perhaps delaying Alice’s exit and causing unknown additional stress to her.

I am also happy with how our birth went because of the excellent care we received at every stage. I think that many women who have births that don’t meet their original ideals feel disappointed or cheated because they feel like they were victims of the cascade of consequences. I, however, had complete trust in my caregivers to recommend what they thought was necessary, and am certain that what happened was inevitable and important in ensuring Alice’s safe arrival. Even when I was most distressed and being ‘the other me’ I was always treated with respect and with just the right amount of bossiness and direction to let me know that they knew what they were doing no matter how desperate I felt. I am grateful that I was in a place where we could both receive immediate interventions to avoid disaster, and that it was all done so quickly and so well. I am also grateful that I was supported firstly to try to have the drug-free birth we wanted, and then to have the anaesthesia I needed when I called for it.

 I have realized that the unknown factor in any labour is the actual pain of contractions. It is the X Factor and can throw all plans in to disarray. I am convinced that each person experiences an objectively different level of pain, and it has nothing to do with pain thresholds or perceptions of sensation: it is different amounts of pain, full stop. It is not conceivable that any amount of changing positions, heat application, breath control or immersion in water could have made any difference whatsoever to the pain I experienced, any more than an aspirin would be an appropriate response to a amputated limb. If other women birth and these things are sufficient to manage the pain that they feel, then I’m pleased for them and that their level of pain allows them to manage it in those ways, but that is not what I felt nor would it have been possible.

Before having Alice I thought that saying that all that matters is a healthy baby was a truism but also a bit of a platitude. Of course the birth itself mattered, which was why we went to such lengths to ensure we were going to get the one we wanted. This is still true to an extent and each woman is entitled to make choices about what she wants for her body and her birth, and we shouldn’t diminish impact that not getting a longed-for birth can have, but more than ever I whole-heartedly agree that the outcome every parent wants is a healthy mother and healthy baby, and the ways of getting there are many and varied. Each woman has to consider how to achieve that given the labour that they actually have, not the one they imagine they will have, and the means taken to get there may need to change once labour begins.

Next time I will still attempt a drug and intervention-free birth because I do believe that, all things being equal, it is the healthiest way for mother and baby. It is still my ideal but I now think that the ideal must adapt to match the reality of experience. When I have another baby I will think about at what points I will consider different pain relief options which may help arrest the climb of increasing anaesthesia, and I will go into it open to changing my mind to suit the circumstances I encounter and the things I cannot anticipate.

As I look at my perfect and healthy daughter I know that all I need to do is make the best decisions I can for my child, which is all that can be asked of anyone.