The Generation Game

I have just had a very heartening coversation with our midwife, and a very predictable one with my mother, both - unsurprisingly - on the subject of childbirth.

I had emailed our quite fantastic midwife last week following a consultation at the hospital. I'll spare you the gory details, but essentially if I am to deliver this baby via the usual route, I'm expected to be monitored for the duration of my labour, which in the case of our designated hospital means lying flat on my back or at most being allowed to sit up from time to time. Now no expert in childbirth am I, having had to date one caesarian section, one spontaneous miscarriage and one D&C, but everything I have read and learnt about childbirth across my various experiences has made it clear that lying flat on one's back is about the least efficient position possible for a successful labour.

I'm not playing.

As is always the way with these meetings, as the day wears on you think of 101 questions you wish you'd asked at the time. I wrote these down in a three page mind dump, immediately felt better, then emailed the midwife to ask how we went about discussing these concerns with the consultant and reaching a compromise with the hospital. In the intervening before she rang me today I had informed, scared and depressed myself about VBAC procedures, eventually reaching a point of total despair yesterday when I was seriously considering throwing in the towel and going for a c-section just to avoid all the hassle. I had succeeded in putting it from my mind today so was very pleasantly surprised when the midwife rang. What a star she is. Aside from giving me her total support, reminding me I have rights (a word that always makes me a little uncomfortable but I appreciate the point) and telling me just what she's going to do to move this along, she offered to accompany us to our 34 week consultant appointment and, crucially, said that she felt we were likely to reach compromise with the hospital, it just needed a bit of handling.

And is she ever the woman to do it.

After a ten minute chat to her I felt better about the whole business than I had since our consultation last week. Unfortunately she called when my parents were visiting us together with friends of their generation - I say unfortunately as I had to remove myself in order to talk to her and my mother showed what is a perfectly natural interest in the conversation. I would have preferred not to discuss it in front of their friends but hey, when did privacy ever figure in pregnancy and parturition? I explained the position - literally - with monitoring, ie being required to lie flat on my back for the entire labour in order to be continually monitored, and my mother said - drum roll please! -

"Isn't that a good thing?"

Well there we are. When I came into the world my mother was the person with the least control over anything - at least the way she tells it: the whole experience was utterly horrific, she was away with the fairies on painkillers for two days afterwards and my father messed up my names when he went to register me. Which is nice. For some reason, rather than leaving her with a horror of undue medical intervention in birth, she has developed an almost Munchausian desire for as much intervention as possible in any medical situation (and she's had a few). When I commented that she would no doubt like me clapped in irons, knocked out and opened with a bandsaw from sternum to ankle, my father laughed in recognition of the truth and my mother hotly denied it. There's no such thing as undue intervention to her mind, the phrase is a contradiction in terms.

Well I disagree. And I am the one having this baby, so I reckon I deserve a say.

Continual Fetal Monitoring as it is commonly called is little more than a butt-coverer for hospitals: the records are commonly used in legal cases arising from problems that result from the management of labour and birth. The main issue with it is that unless you give birth in a hospital equipped with remote or even waterproof monitors (which ours isn't - it has a pool but it can't be used for actual delivery as there is no midwife there trained in water birth...) walking about, squatting and labouring in water are out of the question. I hadn't thought too much about a water birth, but I had expected to be able to obey my natural instincts to stand up, move about and generally arrange myself as I saw fit for this most extreme of physical experiences. If monitoring and therefore lying down was going to make a crucial difference in a positive way to the outcome of my labour I would view it far more congenially, but as it is in fact proven to slow labour and consequently has a high chance of leading to an emergency section in women who have previously had one section already, it is fact dooming me to failure before I begin.

All of which is completely unnecessary.

I had a section as my daughter was breech. It's not absolutely essential but it is very common and it felt like the best choice for us at the time. All went exceptionally well and I have no complaints, well, none that I can remember now. That was 6 1/2 years ago, I had no other complicating factors and that makes me a low risk for a VBAC. In fact, there is no reason why my labour can't be treated like any other ordinary, low risk birth - this was our view and it was echoed by the midwife today, much to my relief. The more low-key the management of the labour, the more chance I have of a successful VBAC. Everybody happy.

All I have to do now is spend the next four months reminding my mother that I more than anyone want to ensure a safe birth for my son, and that refusing excessive medical intervention is entirely consistent with that. The consultant will be a piece of cake after that.