Sunday, 3 March 2013

One birth and three painkillers-what you can sometimes expect when you have a sweep

Pains of Motherhood-the short but realistic lowdown on painkillers during Labour

Now unless you have nerves of steel and are planning to a hypo-birth or ‘alternative’ pain killers you will be considering your options of painkillers during the arrival of your cherub.

I know you are all fully capable of using a search engine and looking up your options however my article is written mainly from my own experience after all during my Labour I actually experienced THREE of the painkillers available to you on the NHS. No ladies that wasn’t a ‘typo’ I did indeed have three different painkillers during my prolonged Labour that started on Monday and ended on Wednesday morning via an emergency cesarean section (c-section/section as you will find it be referred to online).

So my birth was to say the least; rocky. I will try my best to talk you through the various things that happened so you have a heads up.

I was told early on in my first pregnancy that I would be induced this was basically on medical grounds. It’s not very often you will find a Diabetic mother going to full term of 40 weeks. The medical complications outweigh the benefits. Besides a baby born at 37 weeks is classed as being full term; in other words there really isn’t much the medical staff would be looking at in terms of problems with little one.

My induction started with a ‘sweep’. My Midwife visited me at home to perform this. So what is a sweep and does it hurt? A sweep (full name Membrane Sweep) is when your Midwife will insert her finger into your vagina in an attempt to stimulate your body into Labour. Your cervix will be stimulated with sweeping movements which should in theory separate your amniotic sac from the cervix. If the sweep is successful you should go into Labour; not straight away mind but if it works it can take up to 48 hours to work. My Midwife was aware that I was booked in for a induction at the Hospital which would involve a pessary being inserted inside the cervix to ‘ripen it’.

By the time you get to the stage where you may require inducing you will have built a relationship with your Midwife. I saw my Midwife a total of three times during my pregnancy as I was seen by the Diabetic medical team on a regular basis (who also offer full telephone support). I would be lying if I said a sweep is the most comfortable experience; it’s not. However it can be made slightly more bearable preparing in advance by taking a warm bath or shower to relax, possibly having a nice cup of tea beforehand and having the sweep performed in a comfortable environment that doesn’t bring you out in hives. Your Midwife will ask you to remove your garments from the waist down. Treat the sweep as you would treat a Smear Test (you are up to date with them; right?). You lay on your back and the Midwife does her magic.

Unfortunately the sweep didn’t bring me much joy and I had to go into Hospital as scheduled for inducing via the pessary. Sweeps are a natural way of bringing on Labour although yes they don’t work for everyone.

The pessary is inserted and if it works your waters will break and within hours you should in theory be on your way to giving birth.

Well without giving away the ending the pessary didn’t do much for me to begin with. And to top off the frustration Midwives had to perform an internal examination on a regular basis which after 24 hours become super irritating and uncomfortable. Those who are shy should be reassured by the fact that Midwives don’t get a ‘kick’ out of these examinations and once you’ve seen one set of genitalia you’ve basically to some extent seen them all. Plus you are having these examinations to access your Labour. It’s not for the joy; so ladies please don’t worry about what the Midwife thinks of your bits.

So what happened next? Well I was examined repeatedly for progress. I’m not sure how but my waters actually breaking was MISSED by the staff. Now ladies please pick yourself off the floor and sit back down. I survived and I’ll explain what happened.

The induction happened on the Monday and no progress was monitored by Tuesday afternoon although I was feeling contractions (and these could be seen on the graph-yes I was rigged up to every machine you can imagine reducing any possibility of walking around). I was told constantly I wasn’t making progress, and I accepted that. I felt the contractions yet was told no progress was being made. On the Monday night I was given an injection called Pethidine to ease the pain (one Midwife actually believed me when I said I could feel contractions). The injection was given in my thigh, and within hours I was sound asleep. I did wake up at 4AM not sure to where I was; yes I was delusional not knowing where I was or why there was a bathroom next to my bedroom or why I was sleeping on a weird posh medical bed. I didn’t feel any sickness as some women report from it. The advantage of Pethidine is a Midwife can give it without having to wait for a Doctor to come along and supervise the insertion of the injection. Pethidine will only be given if your Midwife feels you are NOT close to Labour so it’s often given in the early stages of the birth. Pethidine can also be given to a Mother who wishes to have a water birth (of course with supervision as it can cause drowsiness). And Pethidine doesn’t slow down Labour.

By Tuesday night the head of the Medical team gave me by options. They were to either try inducing again or go for a c-section the next day. Either way I would need a detailed internal examination to note any progress or lack of it. I decided to opt for a

Section the following day as I was now exhausted and wanted to go home. In came some female members of the team to perform the examination. As I was so sore I was given gas and air to help with the examination. Now this made me slightly wheezy and I can just about remember hearing the medical examiner telling me I was dilated to 10 centimetres. She quickly requested a monitor to check baby heart and as everything was fine I was prepared for Labour. As I was feeling quite ill at this point I opted for an Epidural (anaesthetic). This is the painkiller that is fitted with a needle near the nerves that carry the pain signals from your uterus. The painkiller can be topped up at any point should you require it. It works by numbing the nerves. The insertion of it was pretty painless; the area is cleaned and a thin tube inserted. The Anaesthetist kept me up to date with what was happening. Once the Epidural was in place the staff checked to make sure if was working; this was done by tapping my legs and I couldn’t feel a thing. Epidurals are renowned for making your legs feel heavy and this doesn’t actually ware off for at least 10 hours in my personal experience. The main advantage of this type of pain killer is you are awake when your little one is born. However you may find the next few hours or days become slightly blurry as you drift in and out of a drowsy sleep.

Now at this stage I was preparing for a natural birth; my little ones heart rate dropped which sent the medical team into a frenzy and the emergency alarm was set off to inform other staff of what was happening. However before the alarm was set off a member of staff came up to me and informed me of the procedure and that I shouldn’t be scared. She explained what was happening.

The staff then took a blood sample from my little one which was checked over to make sure little one wasn’t in distress. Luckily little ones heart rate stabilised and at this point the Surgeon asked me if it was important for me to have a natural birth. Of course any Mother would give the same answer as me; it wasn’t above the health of my child. I was given a document to sign in case I needed a section. The document explains the risks of the section and what could happen, and if something did happen who would be liable (which is basically you). Then my little ones heart rate dropped again and I was rushed into theatre for an emergency section. My husband went in with me. The surgery began at 5AM and the staff explained I wouldn’t feel any pain; it would simply feel like someone was washing the pots and pains in my stomach and if for any reason I was unable to take the pain I was to say and the painkiller would be topped up. During the Surgery I was sick-this was due to me having a chocolate bar to bring my sugar levels up to a reasonable level so that the section could actually happen. At 5:25AM little one was born-with her cord around her neck; twice. But she was healthy.

The staff that carried out the Surgery were fantastic and cannot be faulted in anyway. The staff that missed by progress well I do wonder how on earth they are practising medicine in the United Kingdom but I’m sure that’s a different issue completely.

After the section you are expected to rest however you will be encouraged to start walking around within 12/18 hours of Surgery. Yes it’s major surgery but walking around as soon as humanly possible will aide your recovery. You’ll be encouraged to take a shower too. Both these steps in my humble opinion are vital for any Mother who has had a Section.

I actually lost a lot of blood during the operation and was told that I would be needing a blood transfusion. I ended up having two but it didn’t bring my iron count up to a safe level this combined with my little ones antibiotic course resulted in an extended stay in Hospital post birth.

When I was preparing my Birth Plan (which you will do around your third trimester) I didn’t out rule any painkillers as I wasn’t sure what to expect. With birth two I have a grasp of painkillers and the procedures and feel more comfortable with how and what they do and why. There’s not a painkiller I would avoid; and if I am offered a sweep again I would take it as I would like to actually have a natural birth.

My advice for any first time Mother would be:

  • Do your own research into pain killer/numbing options available. If you are healthy with no pre-existing medical conditions the world if your oyster. Look up hydrotherapy and birth as well as other natural options as well as the other options available to you on the NHS or privately if that’s what you are paying for.

  • Remember that works for one Mother won’t always work for another-everyone’s bodies are unique

  • No two births are the same-even in the same family

  • Ask your Midwife about what facilities are available at the Hospital/Centre you will be giving birth in

  • If you are opting for a birthing partner discuss your Birth Plan with them in detail-and give them a photocopy too.

  • Don’t be afraid to ask questions. Medical teams are aware of first time Mother/parent niggles and won’t laugh at your questions

  • Try to be flexible and allow ‘room’ for suggestions which the Medical team may make to assist with your Labour

  • Remain positive-if people tell you about a negative story concentrate on the positive-they’ve had a healthy baby at the end of the ordeal and if they’ve gone on to have more than one baby it cannot have been too traumatic.

I really hope that I’ve helped you understand a more complex birth which started with a sweep. My pre-existing Diabetes were the fuel behind my sweep and inducing. As I’ve said before if you are healthy you really can leave things to Mother Nature to start your Labour off when your body and baby are ready.

If you have any questions leave me a comment below and I shall get back to you.

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