I massively appreciate the NHS. It is an incredible institution that looks after us all as equals. Without our health we have nothing. And that’s why I want to do what I can to protect its existence for years to come.
So when I was pregnant with my first baby I thought; I’m not sick, I’m pregnant so why should I need a hospital? I was fit, healthy and my pregnancy was straightforward. I had an excellent community midwife who was totally committed to natural childbirth so we opted for a home birth. I know I am one of the lucky women who had a totally positive first birth experience giving birth to our son in our bedroom.
So when I was pregnant again, my husband and I hoped we could replicate our first experience. But this time I developed Obstetric Cholestasis, a pregnancy related condition where your liver stops functioning properly and you get itchy. I was booked in for an induction at the PRUH five days later. Despite being in hospital under consultant-led care, I was still determined to keep my labour as natural as possible. Fortunately breaking my waters was the only intervention I needed. Contractions started 4 hours later (after pacing the hospital corridors!), they built rapidly and 3 hours later, two pushes and our second son was born.
Once again, I was fortunate. I was fine and my baby was fine but it could have been so different had this been my first baby, or if I lacked the confidence to question the doctors. So I wrote a letter to the midwifery department; not complaining but giving my feedback in a constructive way in attempt to help others but also help the service improve and even save money. I wanted to know why was I made to wear hospital stockings when I had no risk factors for DVT? Why was I monitored with the continuous fetal heart monitor when I specifically agreed with the doctor that the intermittent hand monitor be used? Why did the doctor say I would receive oxytocin 2 hours after my waters were broken and when I challenged this short time frame it was quickly increased to 4? After delivering my baby and placenta, why did the midwife insert her hand and wipe out clots, causing me to cry out in more pain and discomfort than I had experienced while giving birth?
And I got answers. The letter had been discussed sensitively with the midwife concerned for her personal reflection and one of the labour ward matrons talked me through my notes and explained why certain things happened. She was grateful for the feedback on hospital stockings as she knew women were being made to wear them who did not need them. A box had mistakenly been ticked on a DVT risk assessment form which in the process of being changed to be clearer. Intermittent monitoring (using hand-held device) had been misinterpreted as using the continuous fetal monitor for only 20 minutes within every hour rather than all the time. Four hours was the usual time given between breaking waters and starting the oxytocin drip so I was right to question.
Some of my wishes were outside clinical guidelines and this caused a level of anxiety for the midwife caring for me. But the ward matrons are trying to change this by upskilling their senior midwives to be better advocates for women and to feel comfortable when women’s birth preferences deviate from guidelines. I have told my birth story at a couple of these training sessions and it is reassuring to see this work happening. And hopefully it will help other women keep childbirth as natural as possible, even if they do require doctor-led care.