Too Posh to Push!

I am unsure who originally phrased Caesarean section (c-section) as a woman being too posh to push but as April is C section awareness month it feels appropriate to write and challenge some perceptions around this. It is also feels apt as we have been given our date for C section in the month of April.

Around 1 in 4 pregnant woman in the UK has a Caesarean section. It is a major operation that carries risks as any surgical procedure would. It is usually only carried out if it is the safest option for the mother and the baby(ies).

It is major abdominal surgery and the cut is usually made along the bikini line. The incision goes through the skin, the underlying fat, into the abdomen and the uterus.

There is sometimes a preconceived idea that a c section is an easier alternative than vaginal birth. However your baby(ies) enter the world it will not have been the easier option (there isn’t one)! It will have been the safest method of delivery based on circumstances.

When I fell pregnant for the fifth time with our twins, I didn’t really think about delivering the babies as my anxiety to get to ongoing and constant milestones was all I could really focus on.

When we hit second trimester it dawned on me that no matter what happened now Neil and I would be in the same position as we were with Kora and Ava and that was to deliver these twins dead or alive.

It was at this point I started to consider delivery and what that may or may not look like for Neil and I. To be honest i made the assumption that it would probably be a vaginal delivery like I had with Kora and Ava.

I wondered how different it would feel if we were blessed enough to deliver babies that were not sleeping. I wondered how the room would feel in comparison. With Kora and Ava the love was very real and clear between our babies and Neil and myself but the room was surreal.

The midwives (2 of them) were sat opposite us behind a table. It felt like they were invigilators in an exam room. I was full of fever as they had to overdose me by 12 times the amount of medication to induce labour. I was on an antibiotic drip and wasn’t even aware of my contractions at first.

Neil was by my side the whole time. We knew that we had to go through delivering our sleeping angels but it was not anything we had ever expected to face or endure when we first found out we were pregnant.

I remember asking the midwife if the contractions or labour was somehow less than that of a mother who carried full term. Her response was that it was the same except of course the size of our babies.

This time round as we got further along in the pregnancy, I couldn’t help but think about what the size difference and what that would mean. Would I be more tiered? Would i possibly tear? According to the midwife the pain would feel the same but would their size mean my waters would break this time?

Kora and Ava were delivered in two hours and one minute. I wondered if the twins would be a quick labour or if them being bigger meant it would take longer. Maybe as it would be my bodies second time in delivering it could possibly be even quicker.

Of course all these thoughts were soon benchmarked when we went for our 20 week scan and were told that our girl’s placenta was lying low. We were told at the time that this could move as she got bigger and that they would make a plan for delivery at our 32nd week scan.

Each scan we had following that we were told different information regarding her placenta. One time we were told it was hooked, another time that is was partially blocking the exit and another time that it was laying low and completely blocking their exit.

Our internal scan at 32 weeks however confirmed that there is no way for the twins to exit naturally as her placenta is definitely blocking this route. Therefore it was decided that we should be booked in for a c section.

Originally we were told that this would be at about 35 weeks as most twins tend to come early (36 weeks). They did not want to risk us going into natural labour as blood loss can be significant especially if they factor in other circumstances surrounding our pregnancy.

However when we got the date it was booked for 37 weeks and 4 days. Twins are considered to be full term at 37 weeks. The consultant who spoke to me (Neil is still not allowed in appointments) asked me what my preferred birth plan would be. I found this an odd question as it was presenting to me that I didn’t have a choice.

I stated that all i wanted was to bring these babies home safe and healthy and whatever they recommended as the best and safest option was definitely what I would accept.

Truth be told as discussed above I had only ever thought about a natural birth and the thought of a c section upset me a little. I wanted to be able to move around much quicker and enjoy the time off i have booked with the twins not use it to recover.

I know its naive of me as some woman can take just as long to heal from a natural birth but i was going on my previous experience. I was also worried that I wouldn’t be as aware of what was happening especially if I didn’t make it to the date and had to have an emergency c section.

With this in mind, it is probably useful for me to talk about the fact that my c section is referred to as an elective c section. This makes it sound like i have chosen to have the c section.

Of course there is a very small amount of woman that choose to have a c section for many reasons including mental health such as anxiety. In this circumstances they have elected to have it but it is still considered the safest or best option for them.

Whereas ours is classed as elective as it is pre-booked and not because its what we have chosen for our birth plan. However when considered statistically it looks as though we have elected to have a c section even when a natural birth is impossible for us this time.

Of course if I don’t make it to the date they have chosen for us then we have strict instructions to get to the hospital as quickly as possible and we will be rushed in for an emergency c section.

A friend of mine had commented that I appeared quite relaxed about the thought of a c section. I guess at the time it seemed so far away that I kept just marking each day off as closer to bringing them home rather than the actual delivery method.

It was when I went back at 33 weeks and 3 days pregnant and saw my usual consultant that I started to worry more about the surgery. I am a sign language interpreter and have therefore been present at c sections and witnessed them from both sides of the blue surgical paper.

I had not been deterred about the operation from what I had witnessed. In fact it was quite the opposite. It had been a very special moment and I was honoured to be involved in such an amazing and private moment.

However I am now more concerned about the c section itself due to the conversation with the consultant and the realisation that we have many risk factors that could lead to significant loss of blood.

The consultant actually crossed out the risk statistics and informed me that my risks were much higher and then proceeded to write a plan B and C in the blood loss scenario.

It’s not that I don’t trust the medical professionals as I can appreciate that they are prepared for our individual birth plan based on our circumstances. I am however now a little more apprehensive of the seriousness of our circumstances and more importantly the stay in the hospital and my recovery time.

I know for the rest of the world it may seem like normality is around the corner in relation to the pandemic but the hospital especially in our area is still very strict.

I was told by the consultant that if i lose lots of blood and have to have further intervention then Neil will be allowed to stay longer to help with the babies. At present if all goes smoothly Neil is only allowed to stay for the c section and whatever visiting hours are left of the day.

He will not be allowed back into the hospital until the following day for the maximum of three hours to visit me and the babies. I am so grateful to be sat here writing this blog with a plan around bringing our beautiful babies home however it also feels disappointing.

We have waited so long for this and when its within our reach we have strict rules that mean Neil will miss out on what other dads were able to have. I will also be more alone than other mothers have been and as a new mum to babies and this does petrify me. I have always mothered teens but now I might be mothering not just one baby but two and its new to me!

What I do know though is we will face whatever restrictions and whatever happens in the same positive manner we face everything. We will face it together and we will manage as we always do. We know that nothing is as hard as standing in front of the small white coffin of your babies so as long as these beautiful twins come home, it really doesn’t matter how they come into the world.