‘Did you have an episiotomy?’ This is the most common question I get asked about my labour by my friends in Serbia.
‘No, they do not do that here. They let you tear.’
They also do not do anything to help you empty your bowels pre-labour, instead they let that happen naturally, too. Then they act on it later, if need be.
Pregnancy with NHS in a nutshell
I was under the care of the NHS (the UK’s National Health Service) through both my pregnancies and labours. The care was free of charge, but I did supplement both pregnancies with a couple of private scans. With the NHS, as a default you get only two ultrasound scans: one at 12 weeks and the other one at 20. After the latter, if your pregnancy is considered low risk (like my first one) you aren’t invited to any further routine scans. From this point onwards, your midwife takes care of you until the end. However, it is unlikely your midwife will actually deliver your baby – it would only be if she happens to be working that day and is not busy with someone else.
‘How about the doctor?’ People also ask. Well, you are not allocated one, unless they suspect there may be a problem with your pregnancy.
A ‘minor’ problem
At the 20-week scan with my second child, a ‘minor’ problem was detected. I was told this ‘issue’ could cause pre-eclampsia and as a result the baby could be small. Consequently, I was given two additional scans.
I would lie if I told you I was not worried, but after seeing my gynaecologist in Belgrade (who was happy with the progress the baby made), I arrived to the additional 28-week scan quite relaxed and on my own. The scanning commenced and the sonographer started looking a little concerned.
Once my anxiety reached a sufficient level to interrupt his examination, I asked what was wrong. He tried to explain, but failed terribly to send the message across effectively, that Baby’s long bones were measuring short. The cause for this, he continued, could be various things: constitutionally small baby, baby with the Down’s syndrome or skeletal dysplasia.
Game of Thrones
I explained that we had a ‘low risk’ result at the Harmony test. Then I asked what skeletal dysplasia was, to which he replied word for word: ‘Have you seen Game of Thrones?’. I was then clear he was referring to Tyrion Lannister and the condition known as achondroplasia.
I was left utterly shocked, scared and confused. 30 minutes previous, my pregnancy looked and felt fine. How could something as serious as this be detected as late as 28 weeks?
After all, specialist doctors do exist in England
What followed was a series of check-ups, both privately and with the NHS. This time, I was allocated a single doctor to look after me. After more extensive scans he believed everything was most likely fine with the baby. Yes, his long bones were short (only 3rd percentile), but that was simply how he was and not necessarily an indication of anything more serious. However, as with any other pregnancy, he couldn’t say he was 100% certain.
Amniocentesis test
Relieved but still terrified, I decided I was not able to spend the last two months of my pregnancy waiting in a state of heightened stress and worry – So I insisted on having an amniocentesis test.
Three weeks later, the results came back as NORMAL! They enabled me to spend the last leg of pregnancy slightly more at ease. But still, I knew deep down I would only be completely comfortable once I see him with my own eyes.
Why natural birth?
Even though the amnio results were good, the doctors wanted to keep checking the baby and mentioned that an induction of labour may be advised. I was really keen for this labour to start naturally. Why? Because the labour with my first child happened so and, to my surprise it was a brilliant experience:
Birth plan that never goes to plan
In the UK, you are encouraged to have a birth plan to state where and exactly how you want to labour: with epidural in the labour ward; in a pool or with gas and air at the birthing centre (a department run by midwives, with no doctors or epidural available) or at home.
The labour ward and epidural were my choices when my first labour started. However, when we arrived at the hospital, they established I was already nine centimetres open. They also concluded I had a high pain threshold since I hadn’t had any pain killers at home. Consequently, I was told there was no space at the labour ward and I was sent directly to the birthing centre. Thankfully, the pool was available and it proved to be very effective pain relief.
Midwives, pool and gravity
I like to say I ‘clicked’ with the midwives who took care of me. Conscious their shift may end soon, I told them I would like them to be the ones to deliver the baby. The main midwife asked me to get out of the pool (the hot water slows down the contractions) and walk. Very quickly, gravity did its own thing and Klara was out. This was 12 hours since the feeling of mild period pain started and approximately four hours of active labour. I had some stitches after they established I had a second-degree tear.
Empowering experience
Before this first labour, I was quite critical of the natural birth trend in the UK. However, my experience made me feel proud of myself, it empowered me and showed me my body was capable of labouring naturally and actively.
Armoured with the experience and confidence, I wanted my second labour to start naturally again. After some further scans the doctors agreed and said an induction was not necessary.
Speedy second labour and even speedier hospital stay
Eight days late, Oliver arrived two hours after what seemed like the first contraction. The labour was very fast. My husband was on the phone with hospital midwives while we were in a taxi and they were waiting for us at the entrance to the hospital. We made it to the birthing centre and five minutes later, Oliver was born.
This time I didn’t tear, Oliver started feeding successfully and we both passed the initial checks. We were dismissed from the hospital eight hours after the birth. My mum (and many others) still cannot believe we were not kept overnight.
In summary
In the UK, if you do not have any complications, you are encouraged and empowered to have as close to natural labour as possible. Medical staff seem to have a relaxed approach to pregnancy (only two scans offered by the NHS) and post labour (being dismissed from hospital after eight hours). However, if they suspect something may be wrong, they take it very seriously.
I was unlucky to have been scanned by a sonographer who didn’t have much skill in communication with patients. He used inappropriate language to warn me about potential complications. This made me feel uncomfortable with my own body and with the human being I was carrying. I can now say that the last trimester of my second pregnancy was completely disrupted. Thankfully, the relief I felt after giving birth to a healthy boy wiped out all the bad feelings that piled up during the last trimester.
Overall, I have a (relatively) positive experience of pregnancy, and a very positive experience of labour in the UK. On both occasions, I can thank the midwives for treating me with a lot of respect, for empowering me throughout the labour and for doing a terrific job at helping me out. Last but not least, I should also thank my own body for labouring well!
I am conscious that I belong to the minority of women who had such positive labour experiences. I have heard many bad labour stories originating both in the UK and in Serbia, especially Serbia. By telling my own story I wanted to show that positive birth stories do happen and I wish them for all.