Vikki's Two Caesareans

Vikki tells how she achieved a really positive caesarean under epidural, following an emergency caesarean under general anaesthetic with her first baby.

My first pregnancy went very smoothly, I worked to 33 weeks commuting across London, only stopping work so early because I had four weeks' holidays to take. My maternity leave was spent catching up on housework and going swimming and for walks around the shops. Everyone thought I wouldn't make it to my due date.

My 40 week appointment was on my due date, and my midwife was convinced I was in early labour... at my 41 week appointment at the hospital with the consultant, my midwife spotted me from the other end of the corridor and came running over to ask why I was still a bump! When I saw the consultant we agreed to induce me at 10 days overdue if nothing had happened by then. I started to relax then, thinking that by Thursday night, or possibly Friday morning if things were slower than expected, I would be holding my baby.

Nothing went to plan. My daughter was finally delivered on Saturday night by emergency caesarean after nine hours of syntocin-induced contractions with nothing but gas and air to help because the anaesthetist had been unable to site the epidural properly. I'm very overweight and he'd been unable to feel the landmarks of my spine so had been feeling with the needle. After three attempts with my husband Ewan holding my legs down to stop me jumping with the pain, I couldn't take any more. My caesarean was performed under general anaesthetic, neither Ewan nor I were there when Eilidh was born, and she had a very poor Apgar score because of the drugs. It took me a long time to come to terms with my experience, and was too scared to let Ewan near me for six months after the birth for fear of getting pregnant again.

I did eventually recover from the post-traumatic stress, mainly through realising that if I did get pregnant again, we did want to have another baby, I could have a planned caesarean so I wouldn't have to go through what I'd been through with Eilidh.

I fell pregnant again when Eilidh was 15 months old, my new due date just five days after my due date had been with her. The pregnancy was much harder with the added pain of the scars stretching, and the exhaustion of looking after a toddler. I went through lots of mind-changes about the birth. For a time I was very keen to avoid another caesarean, but it seemed that the most likely reason for my failure to progress last time was due to my pelvis being too small (I'm very small-boned under all the padding) so even if I could get into established labour this time there was a high chance I'd end up with another emergency caesarean. In the end I came to terms with the idea of a planned caesarean as being the best option for both me and the baby.

My biggest fear was the anaesthetic, having had such a bad experience with the epidural last time. I saw the anaesthetist at 37 weeks to discuss the procedure, and she really impressed us both. She was so confident and pointed out that I wasn't the first larger woman to have a baby at the hospital. She felt my spine and said she couldn't say with 100% certainty that she would manage a regional anaesthetic, but that she would try. I asked if I could have gas and air as a sedative because I was so nervous and she agreed, saying it would make it easier for her too as she would be feeling between my bones with the needle. The plan was that she would do an epi-spinal - siting the epidural tube first then doing a spinal anaesthetic through the tube. If that didn't take then they could do an epidural straight away, and if that didn't work either I would have to have a general anaesthetic. We left the appointment feeling much more confident. I was booked to have the baby at 39 weeks.

On the night before the planned date I went into hospital and tried to get a good night's sleep. I was really nervous and both my mum and Ewan had suggested I ask for something to help me sleep. It wasn't until I was reading through the drugs chart afterwards that I realised they'd given me temazepam which has no effect on me, and it didn't help me sleep.

Ewan arrived early on the Monday morning bringing my dressing gown so I could change into the lovely hospital gown ready to go down to the labour ward. I was so nervous, and feeling edgy with the waiting, but at least I knew I was first on the list because I have a latex allergy. I was taken down around 8.30am and shown to a room in the labour ward. I had my blood pressure and things checked and people kept coming in and out saying they wanted to get me in by 9am but that time came and went. I was pacing up and down the room taking Rescue Remedy and feeling very nervous. Finally they told us there was an emergency caesarean in theatre and I'd be going in after that. It was about 10.20am when the midwife came to take me through to theatre. Ewan had to stay behind (looking rather fetching in his greens) and I did cry a little on the way in. This was the bit I'd been dreading, and was really worried that they wouldn't be able to site the anaesthetic properly and I'd need a general again.

Everyone was very reassuring, though where they had me sitting on the edge of the operating table to get at my back had me facing trays and trays of scary-looking surgical equipment that I was trying not to look at! The anaesthetist's assistant was in front of me preparing to put the canula into the back of my hand while the anaesthetist was preparing the epi-spinal behind me (I made the mistake of glancing back and seeing the needles at one point - didn't help my nerves!) They put my music on, though so quietly I could barely hear it. They gave me the gas and air mask and told me to tuck my head in and arch my back because they were ready to do the anaesthetic. The assistant was standing in front of me and put his hands on my shoulders to hold me steady. I closed my eyes and started on the gas and air. I concentrated on my music, trying to hear it and make out the words which helped keep my mind distracted. I felt like I was at the funfair on a roundabout. I could feel the pushing in my back, but not the needle, and each time I felt the push it was like being pushed faster and faster on the roundabout. There was no pain. Soon they said that was it all done and I could move. I lifted my head and opened my eyes and watched the spinning stop and the theatre reappear. Everyone laughed when I said "oh, reality's not as much fun as gas and air!"

They asked me to lift my legs up onto the operating table and to lie down. The spinal was taking effect so quickly I couldn't lift my legs. It was the weirdest feeling as the numbness spread. They asked me if I could wiggle my toes and I was lying there looking at my toes but nothing I tried would make them move! I could feel people's hands on me though as they were preparing me for the surgery - cleaning the bump with iodine and lying out covers over my legs. Then they rubbed an ice cube on the back of my hand and asked if I could feel the cold. I could, and then they ran it up from the bottom of my bump saying to let them know when it felt as cold as the back of my hand. I could feel the ice cube, but not the cold. It wasn't cold until they got to my chest. They said that meant the spinal had worked properly, but I was really worried because I could feel the ice but not the cold of it. I was scared I'd feel the pain of the incision. So the anaesthetist showed me a huge needle and said she'd prove I was properly numb - and stuck it in my tummy! I couldn't feel a thing so the screen went up and they brought Ewan in.

It was now about 10.40am, the whole spinal procedure and preparation had only taken twenty minutes. I think I could feel the sensation of the cut, but not any pain. There was a lot of rummaging and I could hear the suction thing (like at the dentist) going as they drained off the amniotic fluid. Then the consultant told the nurse at the top of my bump to push and she really pushed hard! It was a bit of a struggle (I believe they only cut a 4" incision) and then suddenly the theatre was filled with the indignant bellows of a healthy little girl! :) The midwife brought her round for us to see then took her back over to clean her up. She protested all the way, even louder when they did the vitamin k injection. Then the midwife came to collect Ewan and they went off to the recovery room to weigh and dress Mairi while I was being stitched up. Then I was back on the bed and wheeled into recovery where I got to cuddle Mairi while they did all my blood pressure checks to make sure I was stable. I'd lost a lot of blood again, 600ml same as last time, but because they'd had me on several drips from before the anaesthetic I didn't need a transfusion. We were back up on the postnatal ward by 2pm.

On the Tuesday I was in a lot of pain, I hadn't slept well again being confined to the bed and in one position because of the catheter and the drain in the wound, but the catheter came out at 6am so I could get out of bed. I think the night shift were fed up with me moaning by then! The drain came out later that day, a day early because the wound wasn't bleeding at all. It was a really hard day though, I was in tears a few times with the pain and feeling really demoralised because I remembered healing so quickly last time and having very little pain. Wednesday morning I woke up feeling fantastic though, and all the staff commented on how much better I was looking. I think maybe I'd just forgotten about the one day of pain and had only remembered feeling as good as I did from Wednesday onwards. I got to go for a shower and remove the dressing from the wound and felt even better! Thursday I just couldn't wait to get home. I was packed from as soon as I got up in the morning!

I still can't believe the difference in my two birth experiences. With Eilidh both of us were so tired by the time I was taken to theatre and the general anaesthetic had a detrimental effect on both of us. Eilidh's Apgar score at one minute was 4, Mairi's was 9. That really proves to me what a difference having a planned caesarean made to the health of my baby. The best thing for me though was being awake and hearing that first cry, and having Ewan with me. That made all the worry about the anaesthetic worthwhile.

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