The means to an end

On Monday I see my obstetrician and for the first time in this pregnancy, birth is going to be on the table for discussion.

I've not wanted to go there yet and either has she. The pregnancy has been good, fine, normal for many weeks now, just as the one was before it, so there has been no urgency to rush any decisions or lock in any plans.

But now, I want plans. I want dates. I want to talk about this.

I have freely admitted since I lost Hope I don't care how any of my future children are born. Just so long as they're alive and healthy. Birth is just the means to an end. Not something I have to experience. It is just one day out of your life and whilst it is a day you will remember forever, your baby wont. You learn that the hard way when you birth one dead.

When we found out Hope had died in utero, four days past my due date, three days in to a confusing early labour, c-section wasn't really offered. I was told I'd have to do it naturally (with the help of a lovely cocktail of synthetic hormones and drugs) as that would be better on my body and my recovery would be quicker. I was also told it would be the best option for my future pregnancies. I was happy to go along with that line of thinking at that point. I was too numb from the shock. My family were confused and angry as they thought ending the pregnancy with the surgeon's knife would be better for everyone concerned. They were wrong. The hospital was right. I'm so glad I pushed her out of me. That is my proudest achievement in life. By far.

Many assumed that when I got pregnant again that I'd simply chose a c-section this time around because you know, it would be easier. Quicker. Less stress and worry and we could lock in a date nice and early. People are so horrified that I gave birth to death. It makes their stomachs flip. They cannot wrap their heads around the fact I laboured for hours on end with no reward. They seem to think I'd never want to do that again, because of the sheer horror of it all. I read somewhere recently on another blog that what most don't realise is, giving birth to our dead babies is actually the damn highlight of this whole sordid mess. It is the living without them for the rest of our lives that becomes the really hard part. Excruciatingly hard. Pushing them out dead then cradling their lifeless bodies - that is the fun part. Seriously.

But I don't feel c-section is the answer for me. I pushed out a dead baby. I want to push out a live baby. So the plan has always been to attempt a natural delivery again, unless there is reason to do otherwise. Unless a life goes on the line, especially that of the baby. Unless we have an emergency on our hands.

You see, Hope's birth, while relatively straight forward, was also incredibly difficult. I haven't discussed it much as some of the details have been a bit sketchy. But I've been putting pieces of the puzzle together of late. Talking to Simon, my Mum and my midwife and figuring out exactly what went on. And some aspects of it I'll never forget. Burnt in to my brain forever. Seared on my memories like her name is inked on my skin. Permanent.

She became stuck, my little girl. So very, very stuck. Because my little girl, was a big girl. A nice and robust 8 pounds even. But when she entered my birth canal, she wasn't much of a help to her poor, broken Mummy. She got stuck.

Her head didn't seem to be a huge issue for me. A few hearty pushes and it was out. But then her shoulders, which were coming down straight, got stuck. And the midwives attending my birth started to get a bit panicked. And I pretty much lost the plot.

At that point, I didn't think I could do it anymore. I was on the brink of giving up. But of course I didn't, because I had no choice. I had to finish my job. It was all I had left to do for her really. That and bury her.

Given there was no longer any real emergency with her birth, as her sweet, little life was no longer on the line, it became "Operation Keep the Mother in One Piece". If it was a live birth, there would have been an episiotomie, forceps and vacuum extractions because they would have needed to get her out much, much faster. But they didn't want to do that, as that would have just caused me more pain and discomfort and I really didn't need any more of that. I had suffered enough and the real suffering of living without her was still to come.

So they called the senior obstetrician in. That was the first time I had met the woman, and she's the one who is still by my side today. We loved this woman. We still love her today.

At first though, I wanted to punch her. She came in to the room in quite a huff. She was rude. She shoved my Mum out of the way and started pushing heavily on my stomach. She knew this baby had to be born and fast, because they could all see how traumatic it was becoming for me. As if the fact she was dead wasn't quite traumatic enough.

My legs were put in to a position that I didn't know was physically possible and while she pushed on my swollen, lifeless belly, the midwives pulled at the other end. But she was still stuck.

Eventually, the ob ended up getting on the end of the bed, "going in there" and pulling Hope out herself, with one final and mighty push from me.

It went down in my records as a shoulder dystocia birth, but no one is really sure if it was a true case given Hope was no longer with us. I know after looking at my sweet girl, her arms weren't hanging as they should have been. She was really damaged by the birth process which I think is one of the reasons I found it impossible to unwrap her once she was all bundled up to have another look. No one needs to see their baby looking like that.

Babies are supposed to be able to twist, turn and manoeuvre through the birth canal to make their way out. They are supposed to drop one shoulder to make it easier for the mother to push their body out, after the head has crowned. My Hope, my baby girl, couldn't do this for me. She was no longer of any help to me. Her birth simply became a corpse retrieval mission, as awful and cold as that sounds. But it is the truth. It was beautiful, peaceful and serene, but it was also gruesome. Our babies are not supposed to be dead when they are born. That is all sorts of wrong.

Whilst the entire pushing process still only took an hour and a half, and I've heard of much longer, even when it has been a live baby, it was very harsh on my body.

I'm so traumatised by the fact that to date, this is my only experience of birth. This is why the fear is deep and real. This is all I know. That said though, I really don't think it was too bad and I'd do it all again in a heartbeat if I had to. And I'd do it all again a million times over for my Hope. To have one more chance to hold her again and tell her again how loved and wanted she was.

But with my Thumper, it leaves me in a bit of a pickle. With his size, I really don't know what to do. I'm not looking for advice, I'm just trying to figure out what the best course of action is going to be. And I know on Monday, I'll get to work through all of my big questions. I'm sure Simon, myself and the ob can come up with a plan of attack we are all comfortable with.

Just with his size, I'm worried about him becoming stuck like his sister did. But then if he remains alive, I know he'll be able to help his Mama more through the entire process. I also don't plan on (I shudder to say plan) being laid up in bed for the entire eight hours with an epidural. I'd like to put some of what I learnt at pre-natal yoga and read about in all my damn books to good use and remain upright and active, where possible. Not glued to a bed in grief and shock with a giant needle feeding pain relief down my spine. The pain at this point is the least of my worries, even though I'm not denying the fact it is going to hurt like a bitch.

I also know, anecdotally, most subsequent births are easier and quicker. Our firstborns pave the way. That was one thing my Hope did for me, she carved a path out of my body that I hope will make it easier to bring all my future babies in to this world. Things have moved. My body has changed. Nothing is in the same place anymore and things are stretched. So I'm hoping with this and Thumper's aliveness, we can avoid a repeat scenario of having a child become trapped half way out of my body. I took the opportunity to look using a mirror when Hope's head was out. And it broke my heart. It was hanging there, limp. Not glancing up and taking her first look at the world. It flopped out of my body. My poor baby. My poor, poor baby.

With Hope being almost a week overdue, I know for a fact at this point that will never happen to me again. I wont let it happen nor will the obstetrician. All of my future children will be born before a due date now. While physically it might be best to avoid induction and keep them cooking, mentally I can't do it. No way.

I had been prepared to go as far as 39 weeks six days this time around but the longer this pregnancy has gone on, the further forward that date has crept. A few weeks back, I was thinking 38 weeks. Now I feel like 37 will be it. But then people start fretting about lung maturity and how ready and ripe my body will be. After seeing his estimated 5 pound 11 body on the ultrasound screen last week, I, as his mother, don't feel this will be an issue. I think he's big and strong, and I really feel that at 37 weeks he'll be ready. I'll be ready. We'll both be ok. But this is all up for serious negotiation as I know the ob will want me to hang on a bit longer. I just worry the longer I hang on, the bigger he might grow and the more difficult the birth might become. And I of course also worry the longer he stays in the more chance he has to die. I don't feel like my womb is the safest place at this point, even though there is no real reason to think that. There is no increased risk he will suffer the same heinous fate as his big sister. It just seems with every single decision there is to make I'm damned if I do and damned if I don't.

I know some will think the best option at this point will be to just book in for the c-section. But I really don't want to. I know I said I didn't care, but I do. If I try naturally and it doesn't work, for whatever reason, and I need to be wheeled around to surgery, so be it - they can take me and cut me open without thinking twice about it. Just get me my baby. Just make sure he's ok.

But right now, I still really want to attempt this the way nature intended. I think pushing out a live baby would be so healing for me. To have that live, squirming baby placed on my chest. Who looks to feed almost right away. Who is allowed to stay with me as long as I want. I don't like the idea of the baby being dangled in my face, taken away with Daddy while I get wheeled in to recovery. I also don't like the idea of major abdominal surgery, not being able to lift anything or drive for weeks on end and an extended hospital stay in the ward, where Simon wont be able to stay with me. Right now, that's not the choice I want to make, and by having chosen the natural option with Hope, that is the luxury I have been afforded this time around. More of a choice. I know if I'd taken the c-section with Hope this would be a no-brainer. I'm certain I wouldn't be brave enough to attempt a VBAC and I know the c-section would have been the best and easiest option. But I want to try this naturally. I want to try it again.

After having Hope, I was up and walking around within an hour of her birth. I was able to shower myself and get right back on my feet. I was walking about the birth suite, cradling her in one arm and texting my friends about her death and birth with the other (ahh shock, it does wonderful things to you). And a week or so later, I was feeling reasonably healed, physically that is. Sitting down was still hard from time to time, especially at her funeral, but my body felt good and strong, despite how much it had been tortured inside and out.

Of course there is also a real possibility here that despite the plans we make, Thumper might have plans of his very own. Who's to say my membranes wont rupture at 36 and a half weeks and that I wont go in to hospital, labour for a few hours then have him in my arms a few hours after that? I mean none of us really know and none of us are in control here. So when I say I want to make plans and I want to discuss logistics, I know I have to keep in the back of my mind, those plans may very well all end up out the window. At this point, I think my greatest wish would be for Thumper to make up his own mind on all of this. I'd love for him to announce to me and to the world exactly when he's ready. I really hope we can avoid having to reach a date where medicine, one way or another, brings him forth. If I could request anything of my son at this point, other than to please not die, that would be it - that he just arrives of his own doing.

So there is no real rhyme or reason to this post. I'm not looking for answers or suggestions. I'm just working through my confused and complicated thoughts. There is so much to take on board here. So many considerations to make and so much at stake. And when it all boils down, I'm really the one who has to decide here. I'm the one with the job ahead of me. As much as I'm being wonderfully supported by so many around me, I'm flying solo here.

But I'm not after an experience. I wont feel cheated if my wishes don't come true. The baby and his needs comes first and I come a very distant second. I just feel after what I lived through in August 2008, I deserve a much better birth this time around, for more reason than one.