We woke up early on the Wednesday morning in order to telephone the labour ward, and were told to come in for our induction at nine o’ clock. A mad rush ensued as we’d expected to be called in a little later; Kirsty took the dog for a walk while I washed my hair and made toast. They returned just in time for us to gobble that down before we had to leave. I shared my crusts with Posy and told her all about what a wonderful time she would have staying with her grandma whilst we were away; we laughed about how they would have a movie night and watch Homeward Bound and Lassie.
It was so strange to walk through the hospital doors knowing that we would walk out again a family of three, not five.
We were shown to a bed in the induction bay and hooked up to the foetal monitors. The twins were fast asleep but their heart rates were fine, we were monitored for thirty minutes before the doctors made their rounds and the Propess pessary was inserted. I was a little surprised that the doctor didn’t seem terribly impressed with my cervix as I had been given membrane sweeps once daily for the previous two days and both the midwife and registrar had declared my cervix to be ‘very favourable’. The cervical check and insertion of pessary wasn’t painful but was somewhat uncomfortable and I found that whilst I could maintain a conversation through it, I definitely sounded breathless. The twins were monitored for a little while longer until the midwives were satisfied that they were tolerating the pessary, at which point they unhooked me and I forced Kirsty to sneak off with me to Sainsbury’s. We felt like children truanting from school as we snuck out of the front doors!
At some point during the walk there I noticed that the pessary seemed to be having an effect, at which point I lost all interest in choosing lunch. We returned to the hospital with chocolate and a book of word searches (for Kirsty) and a parenting magazine for me. I tucked up in bed under a sheet and Kirsty curled herself up in the pink armchair and knitted up a couple of hats! I think that it was around this point that I fell asleep for an hour, which was probably a good thing as it would be the last sleep I had until long after the birth. The ward was very busy at this point but I still felt myself to be in safe hands and was happy to be there. We knew all of the midwives’ names and even though we didn’t see much of them, we were sure that they were just around the corner and available to help if necessary.
I awoke to a visit from one of the lovely ladies from the Day Assessment Unit, who had come to wish us luck with the birth. As I wasn’t in active labour yet, I offered to come down to the unit with her to say a last hello to everybody and introduce them to Kirsty. The uterine cramps picked up a little with the exercise and as I stood talking to the team, there were moments where I had my fists clenched behind my back. Somewhat optimistically, I practically ran up the three flights of stairs back to the induction bay in the hopes that the stairs would encourage some measure of dilation.
Back in the bay, things were starting to get interesting. The woman in the bed next to mine had somehow progressed from munching breakfast when we came in, to moaning and having to breathe through contractions about five minutes apart. There were definite moments where Kirsty and I just stopped what we were doing (knitting in her case and re-reading I Capture the Castle in mine) to just stare at each other, wide-eyed. I hadn’t been at all nervous about the birth, but I was starting to realise how much it would hurt to have these children emerge from my body. I was surprised at how long it took for the lady to be given access to pain relief -codeine at this point – because surely in the induction ward, removing pain from those who didn’t want to experience it surely should be some kind of priority. It was also a little alarming how long it took for her to flag down a midwife and actually having her (they were all female whilst I was there) come to her aid, and then that when they did show up, it was to apologise for being too busy to assist her and then rush off again. My own midwife reported being in surgery all day, and only managing to eat a chocolate bar during her shift. She mentioned that she had fallen asleep briefly at the wheel the previous week as a result of missing breaks. Not nice for the midwives, not good for the patients.
Between the lady in the bed next to mine, and the lady in the bed opposite, there was a lot of need for involved midwives at that point. Both wanted pain relief, both were unable to access it. We were managing fine by ourselves at that point and were happy to be ignored in favour of the other ladies having as much attention as they could summon. At some point, my midwife returned from theatre and I heard her ask the other midwife how I was doing, and the other midwife reported that she hadn’t heard from me all day. I poked my head out of the curtain to assure them that I was fine. The contractions were feeling quite intense at that point and I couldn’t lie down at all (thank you, Balthazar’s head on my hip bone) but I found that I could get through them either by sitting very still and breathing or by locking myself in the bathroom for long periods and either pacing or bending over the sink. Kirsty had very wisely retreated back to her book of word searches and, knowing how much I can’t stand feeling watched, was pretending not to observe me.
At some point, the lady in the bed next to mine requested more pain relief, and after a delay of over an hour in which her partner repeatedly ventured out to try to find a midwife, was declared to be only three centimetres dilated and given a shot of pethidine. She was told that she couldn’t have an epidural because there was no room on the labour ward for her at that point. I decided to take a couple of paracetomol – thankfully, we had packed our own stash.
We started to feel concerned that I had not felt twin two move over the course of today. Somebody else’s midwife happened to pop in to the room around that time, so we nabbed her and asked her to hook up the monitors for us. She was absolutely lovely, and did so immediately. Unfortunately, we didn’t see her again. For the next two hours, we watched both the boys and the contractions on the monitors. My contractions were never longer than a minute apart – yuck! – but did rise in intensity, and I was amused by Kirsty’s mixture of satisfaction and horror as she reported on the numbers. The second twin was fine but the first baby was causing some concern with some decelerations in heartbeat whenever I dared move from my sitting position, so we agreed to stay on the monitor until a doctor had a chance to review the charts. The position favoured by twin one was decidedly uncomfortable so I was very glad to have taken the paracetomol at that point!
The doctor in question was happy that twin one wasn’t going into distress, but did pronounce me dehydrated and so hooked me up with a cannula. I have dreadful veins at the best of times and wasn’t best pleased with the idea, but also couldn’t countenance the idea of choking down litres of water and so offered up my arm. The first two attempts were a no-go and she did in fact hit the artery on her first try, which produced a fantastic blood spray and soaked both the bed and the doctor’s clothes. Poor thing! She was mortified and apologised profusely, and also insisted on having my bed sheets changed. It was very kind of her, particularly considering how stressed and busy everybody seemed. So we sat and rehydrated, and continued to be monitored as we were hooked up to the IV drip anyway and couldn’t much move.
The lady in the next bed was now alternating sobbing and vomiting, which her partner dealt with himself. We felt dreadful for her. She requested a cervical check and was denied, requested an epidural and was denied, and was given gas and air. She was told that as soon as there was room on the labour ward she would be admitted and given her epidural but at present the ward was extremely busy and there was no room for her. Then she was left alone – albeit with her partner – to continue contracting and crying. We were quite unnerved at this point, as surely vomiting was a sign of transition and shouldn’t somebody be paying attention to that. My own contractions were quite strong at that point and I could foresee a time when I might want some medical attention; I was reasonably confident that I wouldn’t receive any immediate care in that case and that frightened me, The only bright spot around this time was losing great gobs of mucus plug, which fascinated me! Horrifying – but an interesting distraction from the pain.
I was spending a lot of time in the bathroom because that was the only place with a lockable door and no people. I remember telling Kirsty that I wanted to bring my bed in there and move in! It had plenty of pacing space, which was rather nice. At some point during the evening I returned from the bathroom to hear the woman in the bed next to mine screaming as though she was being murdered. The curtains were around her bed, but sitting on mine I could hear the consultant remarking that she was bleeding quite heavily. Her cervix was checked – at which point she was told quite sharply by two voices to stay still – and she was pronounced to be at eight centimetres, with bulging membranes. Eight centimetres! Over the course of about eight hours on the induction bay. How does one get to eight centimetres, vocally, with nobody paying attention? The consultant also assured her that she was having a big baby, ‘ten, maybe eleven pounds’. They told her that she was being taken to the labour ward as a priority. She asked rather frantically if she could have her epidural at last. “Er… maybe,” was the reply. “Probably not.”
And then she was wheeled away.
So we were left with just one other lady moaning and crying in the room.
I couldn’t possibly lie down, never mind sleep, so spent the night awake. We decided that Kirsty should make some effort to rest her eyes and she drifted off in the small hours of the morning, wrapped up in my dressing gown like a burrito. It was adorable. At about three o’ clock I decided that there was no sense in heading into labour exhausted so went to find my midwife and ask for suggestions. Mine was nowhere to be found (I tried a couple of times) but I did find another midwife and explained my plight and that I had taken paracetomol. “We’ll give you codeine,” she offered. I’m allergic to codeine. She thought for a moment. “Let me find you another pillow.” So then I was still awake, but with two pillows. And every time I escaped to the bathroom, the visitors waiting for babies to be delivered – right outside of the induction room – would try to strike up a conversation with me. It was highly frustrating.
I was beginning to re-evaluate my plan. I had absolutely wanted as low-intervention a birth as possible but my vision had always included a supportive environment. by about five o’ clock that morning, I was wondering whether the possibility of a vaginal birth was worth the risk of it happening in the induction bay, abandoned by the medical staff. It seemed that my preferences were shifting, and I considered whether I would be open to a) demanding an epidural as soon as possible, Pitocin to speed up the contractions (because if I was having an epidural anyway, why not?) or b) having an elective caesarean. The caesarean was sounding vastly more appealing. Kirsty woke up just as the sun began to rise and diplomatically pretended not to notice my tears as I vented about the situation. We decided to go and find my midwife to discuss our options, and found her on the second attempt. We explained that we wanted to speak to her when she had a moment and that we would sit down and wait for her to come to us. She agreed. About an hour later, no midwife. Kirsty went to find her and was told that she had gone home. Disappointing, as we had really liked that one.
Then I really cried. It was okay though because two other women were also crying in the induction bay – one who was having contractions about four minutes apart, and another who had apparently been experiencing contractions in the induction ward for what was about to be her third day and wasn’t progressing, but was sure that she would if somebody would only break her water. Nobody would, though, because then she would have to move to the labour ward and there was no room on the labour ward.
I decided to have a caesarean.
My midwife had gone home and I had no idea who her replacement was, but I didn’t want to miss the boat for having an elective caesarean that day and so I waylaid a random doctor and let her know that I wanted a caesarean. She promised that the consultant would be around in about two hours and told me that she would be the person to have that discussion with. So I sat on the bed and waited. My contractions had all but stopped at that point, which I put down to stress, as I did nothing but sob for the three hours of waiting for the consultant to come by. I decided that if I wasn’t given a caesarean, I would go home and give birth in the bath. I so wanted to take a bath.
Eventually the consultant came to speak with us. With a very wobbly lip, I outlined my desire to have the twins surgically removed from my body and stressed that I found the risks from a caesarean section to be drastically lower than the risk of Post Natal Post Traumatic Stress Disorder from continuing to labour and possibly even give birth unattended in the induction bay. She looked a little puzzled. “That won’t happen. We’ll move you to the labour ward.” She clearly hadn’t heard about poor Eight Centimetres and to her credit, was suitably horrified when I described exactly what had gone on the previous day. I cried more, and she agreed to the caesarean. She promised to arrange it for that afternoon, and went away to do so.
And then I really cried, but I think it was from relief as much as disappointment.