The birth of Little Woman Part 2: A horrible hospital experience
Little Woman is almost six weeks old now and I feel far enough removed from my experience in the hospital to be able to write about it. If you’ve read Part 1 of Little Woman’s birth story, you’ll know that labour itself was relatively easy – a gentle build up all day with an intense hour or so at the end. It was everything I could have hoped for a smooth manageable labour.
Unfortunately my experience in the hospital soured all of that, so much so that it has taken me a few weeks to be able to view Little Woman’s birth positively. First I had to struggle with feeling betrayed and let down by the hospital.
During my pregnancy, I attended the Midwife Led Unit (MLU) in the hospital. I had wonderful care and I was genuinely excited to be giving birth there. The unit is friendly and warm, with birthing rooms that are private and inviting. I imagined myself labouring in the pool in the centre of the room, then taking my baby into bed and Charlie and I spending the night getting to know our new arrival. When I met the midwife at my 38 week checkup and we discussed my birth preferences, we also chatted about contingency plans if something should go wrong. I explained that I figured I could deal with anything as long as I knew what to expect, so she explained to me what would happen if it was decided that a c-section was necessary (while simultaneously reassuring me that wouldn’t happen!).
What we never discussed was what would happen if I went into labour on the Easter Bank Holiday weekend and someone phoned in sick, so the hospital shut down the MLU for the weekend. But apparently we should have because that’s exactly what happened. And of course I only discovered that was the case when my contractions jumped to being every two minutes apart. Quite literally at the height of labour, my safe environment was whipped away from me and I was faced with the unknown of the public maternity ward on the hospital. I’m sure there are those reading this who are thinking I’m overly dramatic but I’d ask those people to try to empathise. This wasn’t news that I received early in the day or better still earlier in the pregnancy when I’d have time to process it. It was a shock change to plans that occurred at the eleventh hour, when I was in the height of labour and in a vulnerable emotional state. I think my panicked reaction was a normal one given the circumstances.
But now that I have the benefit of hindsight and distance from the events that occurred, I can see that it should have been possible for the hospital to manage the situation to minimise the stress on me. First of all, I was told that one midwife had phoned in sick. Surely she wasn’t the only one on duty in the MLU that night? So it should have been possible to assign an MLU midwife to me once I arrived in the main labour ward – someone who was familiar with the policies and practices of the MLU, and possibly someone who I’d already met during my pregnancy.
Instead when I arrived at the labour ward (having found it by following another woman who was in labour – without her I wouldn’t have known where to go), I met strangers who were unfamiliar with my care to date and were certainly not familiar with my birth preferences. And of course I hadn’t packed my birth plan because I was expecting a trip to the MLU where my preferences were their default policies. Little did I know that the policies for birth were entirely different just one floor away in the general maternity ward where I ended up.
There’s no denying that I was visibly upset when I arrived in admissions, and the midwives I met knew it was because I’d been transferred out of the MLU at the last minute. Rather than try to reassure me and put me at ease in my new situation, they seemed to take my upset personally, with one telling me to take it up with James Reilly, and a couple of them remarking “We’re not that bad here you know.” As if I was upset because of the people I was dealing with. Of course I wasn’t. I was upset because in the MLU I would have been admitted, laboured, delivered and stayed in the one room – a large, homely room with a birth pool for me and a pull out couch for Charlie. Now instead I’d be admitted in one room, with nothing but a curtain separating me and another labouring patient, then I’d deliver in a clinical delivery room, and finally I’d stay on a public ward with six beds. So it most definitely was not personal. Except to me.
The first indication that I’d be dealing with a different set of policies was the insistence on me lying back on the bed for an admittance trace. I had been reassured by the MLU midwife that I didn’t have to worry about experiencing this again because they didn’t do it in the MLU. But of course I wasn’t in the MLU. So I lay on my back for the trace, because it was obvious that the midwife wouldn’t consider an alternative, either in positioning or assessment method.
As you’ll know if you’ve read Part 1 of my birth story, I was already at 9cm at this stage and minutes away from delivering so you can imagine how uncomfortable I was. So intent was my midwife on following normal admissions procedure that she didn’t seem to be paying attention to what I was saying – that my contractions were every minute and I was feeling an urge to poo.
I was eventually transferred to a delivery room, about an hour and 15 minutes after I had arrived in admissions. According to my chart, I consented to artificial rupture of the membranes minutes after my arrival into the delivery room. I laughed when I read this because I remember wondering what was going on and then being surprised when I felt a trickle down my leg when they broke my waters. I’m not saying I wouldn’t have consented to it at that stage – but I was annoyed to read in my notes that I had because I was unable to communicate at that point in labour. I was too busy pushing my baby out. My mother told me afterwards that she consented on my behalf because they told her that the membranes were bulging and preventing baby’s head from moving down.
One of the most important points for me on my birth plan was my desire to allow the cord to finish pulsating before it was cut. I never anticipated a problem with this because it had been facilitated when I gave birth to Little Man in a different hospital, also in a general maternity unit rather than midwife-led. So I was shocked when I made my request as I was picking up Little Woman for the first time, only to be refused. The midwife said something about a danger of bleeding, but that doesn’t make any sense to me because a few minutes later they agreed to allow me try for a natural third stage, which surely would not have been allowed had there been an issue with bleeding. A few friends have suggested that the real issue may have been more to do with how long it would take because it was almost time for the shift changeover… I guess I’ll never know. But at the time I was extremely upset about it. All I could think was that my little baby was being denied all the benefits of delayed cord clamping simply because I was unlucky enough to have gone into labour on a day the MLU was closed. Why facilitate a practice on one floor of the hospital and deny it on another?
Although the midwives then agreed to facilitate a natural third stage of labour, they were clearly uncomfortable with it, giving me a running countdown of how long I had left to deliver the placenta. I was stressed and unable to relax, neither of which is conducive to rising oxytocin levels. So eventually the placenta was delivered, but not before several interventions including the injection to speed along delivery, and a post-partum haemorrhage. And then not one but two separate midwives remarking to me “You would have ended up down here anyway with that haemorrhage – you couldn’t have stayed in the MLU.” Now maybe I was feeling over-sensitive at this stage but the second one seemed almost gleeful when she said it. And all I was thinking was “I bet I would have had a nice relaxing third stage if I was in the MLU and there wouldn’t have been a haemorrhage.”
Apologies to the squeamish among you, but by the end of it, I was covered in blood and feeling really bruised and battered. I was hooked up to a drip to help stem the bleeding and then I waited.
A doctor came by and introduced himself and said that he would be stitching me up. I asked that I not hold Little Woman while I was being stitched because I remember feeling very out of it while being stitched after Little Man and I felt unsafe holding him. Little Woman was placed in a crib by my mother’s side. But then the doctor disappeared. After a while another doctor came by and introduced himself and said he’d be stitching me. So Little Woman remained away from me. But then he disappeared too. In fact, people kept wandering in and out of the room and I had no idea who half of them were. It turned out there was a shift change happening and the handover was taking place. Maybe that goes some way towards explaining the sense of conveyor belt care I was left with as people bustled around me, filling out forms, placing tags… and yet – and this really stayed with me afterwards – not one of them asked what my baby’s name was. It was Baby Healy this and Baby Healy that, and I just thought “She has a name, you know.” I guess when you’re delivering babies every day, you stop seeing them as people. (Except that doesn’t tally with my experience first time around, when everyone asked. Maybe it’s the contrast between the two experiences that made it more obvious to me that no one cared enough to ask in the delivery room this time.) Finally an hour after I had delivered the placenta, the first doctor came back and said he’d stitch me after all.
When he was done, I asked to have Little Woman returned to me, but first I wanted to be cleaned up. I was covered in blood. As I looked down, I could see it everywhere – arms, legs, stomach, chest. Because of the haemorrhage and the drip, I was told to wait until the following morning for a shower so I asked a midwife could I be washed down in the meantime. To my shock, she went off and got a packet of wet wipes, which she then handed me to use. Wet wipes! And disgustingly fragranced ones at that. Thank God my mother was there. She pulled some paper towels from above the sink and wet them to wash me down.
Shortly afterwards, my mother had to leave so that she could go and babysit Little Man to allow Charlie to come to see me and meet his daughter. So I was left in that room on my own with Little Woman, still reeling at how differently everything had turned out to what I expected.
When I got up to the ward, the staff I met were friendly and reassuring. “Maybe this won’t be so bad,” I thought to myself. When Charlie arrived I decided to take the opportunity to go to the toilet. You may wonder why I’m sharing this level of detail with you – but it’s important. I used the last of the toilet paper while I was there, using a shared toilet on a six bed ward. It was 11.30 at night and the bins in the bathroom were full to capacity, almost overflowing. I rang for the midwife to tell her that I’d used the last of the toilet paper.
Through the night I used that toilet numerous other times, and the first time I noticed that the toilet paper had been replaced was 10am the next morning. Almost 11 hours after I had reported it gone. The bins did overflow midway through the night. Disgusting.
That night I didn’t get any sleep. Little Woman wanted to feed for most of the night, which was fine with me. I couldn’t have slept with the noise on the ward anyway. Two women snoring, babies crying, and the woman in the bed to my left quietly crying through the night. I tried to imagine another night of the same and felt exhausted at the thought of it. How is anyone supposed to recover without sleep?
My one hope was that I had been told on my arrival on the ward that it might be possible to transfer back up to the MLU the next morning once it reopened. But when morning came I found out that actually the MLU wouldn’t be reopening that day. And that I was no longer an MLU patient anyway as I had been transferred out of their care. So not only did I not get to give birth in the unit but suddenly I was cut off from the follow up care promised by them. Doubly let down. If it was due to a health issue, I could understand it. But a logistical one, not so much.
When Charlie arrived, I hadn’t yet decided whether or not to stay another night. The nurse dealing with me advised me to stay, but I was worried I’d end up with another sleepless night. She checked my blood pressure and my iron levels and they were both good. I spoke to Charlie about it and we decided to see if I could get some sleep while he was there for the day. I figured if I did I’d have enough energy to make it through another night.
I still felt disgustingly dirty from all the blood, so I left Charlie looking after Little Woman and went for a shower. The final straw in my hospital stay was discovering that the shower heads have all been removed from the showers in the hospital due to fears about Legionnaires disease. Bad timing you might think. How unlucky to be in the hospital while they’re dealing with that. Except that they’re not dealing with it. It turns out the removal of the shower heads is their solution and it’s been like that for years. The only difference between using the hospital “shower” and washing myself down with the garden hose is that the water was warm.
When I got back to my bed, I said to Charlie “Whatever it takes, get me home. I can’t stay here any longer.” I was genuinely worried that I would end up leaving the hospital having caught something if I didn’t get out soon.
So by lunchtime, I was on my way home. And thinking how lucky I was not to have to stay a minute longer. As I left the hospital, I passed a large poster advertising the MLU. A wave of emotion swept over me. How dare they advertise something, promise something, and then take it away at the last minute. The MLU that I’d been waxing lyrical about through my whole pregnancy…I couldn’t even bring myself to look at the poster. I silently thanked God we had decided that Little Woman would be our last child, because at least I knew I’d never have to be a patient in the Irish maternity system again. Never have to feel so powerless, so vulnerable, so subject to “policy” again.