At 0311 on the 21st of December 2016 Kate woke me up by going to the loo. Pregnant women visiting the toilet 4 times a night isn't remarkable, so I stirred but stayed curled up under in thick PJs and three times the covers that ordinary people do. The side effect of human baking is that you generate your own heat like a geothermal vent and the heating has been pretty much off for months. Pregnant women fitted with a heat exchange unit is a viable renewable energy source.
Kate sounded urgent when she returned.
"That's my waters breaking."
Like with Child #1, it wasn't a flood but a weird trickle "like weeing yourself but not really". A quick phonecall to the Midwife Unit (which sounds hilariously and not unsuitably military to me) directed us to head in for a checkup. Kate phoned her Mum who arrived pretty quickly and by 4am we were in the Rushey Ward "Midwife Led Birthing Centre".
This is new. In 2009, the only options were "home birth" or "delivery suite". Home birth was (and is) available for low risk pregnancies, which Kate wasn't last time but this time we elected for it. I bought a bunch of plastic (ASDA shower curtains) and cheapo (ASDA) towels so that Kate could push Naomi out on the living room floor. Delivery suites are low-level operating theatres - not equipped enough to give women a ceserian section but decked out like one with all the friendliness of a remote windswept pub on the Yorkshire Moors packed with foreigner hating locals. Lots can go wrong when pushing out a new human from within its self-propelling growth pod and the delivery suites are well suited for that but for the majority of births they're over the top.
The new ward is run and organised by Midwives rather than doctors. I don't quite understand the relationship between the two but I'll come back to that. Rushey Ward wasn't designed by efficient clinicians but by someone who understands that anxiety makes giving birth harder. In 2009 Kate had undiagnosed anxiety and depression and the surroundings back then undoubtedly exacerbated her condition that coupled with a long labor made it all worse. Dimmable lights LED wall, burgundy walls, soft mats on the floor, a leather chair that wouldn't look out of place in a home (a nice home like Pete's, not mine!), one room had a rocking chair!
The first Midwife that we met, a kindly brunette with glasses, gentle smile and sense of humour (sadly, her name escapes me) performed the usual checks and when more of Kate's waters escaped, she looked a little concerned. Naomi had had a tiny poo (a black tar like substance called meconium) while still inside. Quite common for a baby that's 13 days late. This can be a problem if she breathes lots of it in while being born. There was only a tiny amount in the waters but I could feel that was home birth out. Any risk is too much risk. The kindly Midwife suggested not to make a decision right away but to wait an hour for more waters and then decide. She gave us a tour of the centre. Her pride in her place of work was palpable and I could feel Kate, who feared being forced into a situation against her will more than anything, relax.
More waters, a little more smear of meconium and the advice was firm - the best thing to do was to stay in the Midwife Lead Centre. We were given lots of time to think through the options. Every thought was in comparison to 2009: 46 hours, being largely ignored, sterile and stressful situation and now diagnosed mental illnesses but it felt different.
A few weeks ago I sent an email to the Consultant Midwife, Christine. Kate's contact with the GP surgery and midwife had been somewhat hit-and-miss during her pregnancy and I wanted some assurance that the errors made in 2009 weren't repeated. Christine phoned Kate post haste and wrote some powerful words that became stapled to the front of Kate's hospital notes. It was imperative that Kate had the choices communicated to her and that she was allowed to choose. That was key to keeping the anxiety under control and in turn the labour short and baby in minimal distress. These words were read by every Midwife before caring for us and you could tell. Every option at every point was explained in detail.
We were offered the "Winter Room", which was only a "temporary" room but was decorated like a hotel room. Hidden away in the cupboards were a soft bed, baby resuscitation chamber (yes, exactly as it sounds), drugs, spare linenware and a spare pop-up nurse. This became our base of operations to support a number of sorties deep into the hospital. Kate believe (correctly, it turned out) that moving about was key to keeping the labor going so we took three long walks through the hospital where she would pause every so often to have an ever deepening contaction.
While resting between walks, we were visited by the Midwife in charge of the unit who explained that the Rushey ward was now closed as two other women had noisily entered labour. Their screams echoed pieced the walls for the next hour. This news sent Kate into anxiety mode. It was not advisable to give birth in Winter Room because it didn't have a bath (only an en suite wet room loo and shower) but we were welcome to stay until someone more progressed with labor needed it. It felt like last time. It felt like we were being sidelined.
Another knock at the door and a middle aged midwife with considerable gravitas came in. It was Christine, the consultant midwife. She had come in, at first, to check that her instructions were being followed - which they were. She then went on to explain that we might have to be moved to the doctor run delivery suite downstairs. She allayed some of our fears; the monitoring system downstairs was wireless and allowed the mother to move around and they had decorated there. The reason was simple: not enough midwives to staff Rushey as well as the delivery suites and the delivery suites took precedence. Having Christine explain it made all the difference and I think we accepted our fate; this wasn't like last time.
While Christine spoke, Kate's contractions became stronger and closer together. By the time Christine had bid us goodbye Kate needed gas and air; a heady mix of laughing gas and oxygen. I popped out to the front desk and within a minute Kate was mooing through the rebreather. It was on. About thirty minutes later the pain was getting excrutiating. I found it difficult to watch Kate in so much pain and she dispatched me to find a midwife armed with morphine.
When the midwife (Charlotte) came, Kate was really screaming into the gas and air. Charlotte asked firmly and clearly between a contraction if it was OK for her to check the position of the baby with her fingers. Before Kate could answer, another crushing contraction. In the brief 30 second break, Charlotte asked again but Kate turned to me with tears in her eyes and in a tiny voice asked what was going on and what she was being asked for. I repeated Charlotte - before Kate could have diamorphine, Charlotte needed to see where the baby was. If the cervex (the apature part of the womb that the baby's head pushes open) is more than 5cm wide then the baby is gettng ready and it's too late for pain killers. 10cm dilated is the baby literally leaving.
Charlotte beamed broadly with wide, suprised eyes.
"Well done Kate, you're fully dilated! She's coming!"
She bolted out the room and two more nurses (Lola and another I don't remember the name of) joined us. I held Kate's hand and stood by her knees, Lola was opposite me while Charlotte stood back preparing for the baby, the third nurse was scribe, jotting down incidents and timing. Kate was now on her back (which she hates) in the standard giving birth fashion and I looked down to see Naomi's crown.
"Don't push, Kate. Just little breaths."
Kate hadn't pushed at all (unlike with Felix), Naomi was coming all by herself. The panting was to slow down. Less than a minute later and Naomi was being untangled from her umbilical. 16:04, 21st December 2016. Her exit was "Superman" with fist next to her head. Nothing can be easy, can it? At first Kate just looked traumatised and when Naomi was given to her for a cuddle, Kate looked frightened and dazed. It was a look I'd seen before - for about 6 months after Felix - but this time it faded within 20 minutes and soon Naomi had latched onto a boob and was having her first meal.
Everything was calm. Kate had something to eat, some stitches and began smiling down at Naomi. There was a mdwife shift change, thank yous and goodbyes and we were left to relax in the room. Another Midwife (Frances - good name for a girl) did the "new born checks" to check for any of the obvious big problems and all was clear. It was 22:30 before we were ready to head home. There was no rush to it, we thanked everyone and toddled out to the car.
I received an email a few days after from Christine, checking that our experience had been a positive one, even though we had remained in the "Winter Room". It could not have gone much better. Childbirth isn't fun but the lack of anxiety and trauma has given both Kate and Naomi a better start.