When things don’t follow plan A… or B… or C…

My first birth in 2023 absolutely did not go to plan at all, I gave birth to my son Magnus at 26 weeks and five days pregnant via unplanned (and really quite urgent) cesarean birth at the Royal Infirmary Edinburgh just 3 days after moving to the UK from Australia. Looking back on it after two years I’m still confident that I haven’t taken any trauma away from the experience which I’m very grateful for. 

At the time I thought I was sooooo prepared. I’d been listening to Megan Rossiter’s incredible podcast Birth-Ed (highly recommended listening), and it had given me the basics to put together my birth plan. I knew I wanted to be at home… aaaand that’s about it. I had a vague idea of how I felt about augmentation and induction, pain relief and monitoring, but felt a lot more “go with the flow.” I had no idea about pre-eclampsia, I didn’t have a cesarean birth plan, and I definitely hadn’t spared even a cursory thought about the Neonatal Intensive Care Unit. Spoiler alert, the cookie most definitely didn’t crumble how I expected. 

In the lead up to his birth, I’d been experiencing a lot of pain at the top of my bump, which I had attributed to heart burn (I’d never experienced heartburn before so figured it must be what was happening) or trapped gas from being in long haul transit for two days - it got to a point where nothing I was doing was helping ease the pain and I couldn’t sleep or stand up without being in excruciating pain. We made the decision to head to the emergency room to get checked out because something just didn’t feel right and we’d not had a chance to register with a doctor or midwife since arriving. 

After my vitals were taken by the A&E nurse, I was immediately admitted to the maternity unit. My blood pressure was through the roof, and with a lot of protein in my urine the doctor determined that the cause of my rib pain was severe early onset preeclampsia and it was likely my son would need to be born that week. As the night went on, the time frame for when my cesarean birth might be got shorter and shorter, from “this week” to “the next 48 hours” to “probably around lunchtime tomorrow”. My husband and I went to sleep, or tried to at least, without realising our lives were going to change completely in a short couple of hours. Around midnight the doctor and midwives came bustling in because it was surgery time, they were concerned about Magnus’ heart rate and thought it safest that he came out as soon as possible. Earlier in the day, we’d spoken to the obstetric consultant and a NICU consultant about our options, risks, benefits, the works. Even though things were spiralling a bit, I felt well informed and like I was still somewhat in control of the chaos. I was wheeled into theatre, put under general anaesthetic (they were worried about the “stickiness” of my blood) and away we went, my son was born in the wee hours of the morning weighing only 640 grams - which was small even for 14 weeks premature. 

When I woke up in the recovery room I felt a bit out of it, and unfortunately quite disconnected from the idea that I was a parent now. I’d not been really “present” during my first birth because I was under GA, and I struggled for a long while to connect those two sides of myself - mum and not mum. I spent two weeks in the hospital following the birth, and even though the care I received was okay (shoutout to the very kind midwife who heard me full body sobbing in the shower and came in with a towel and a hug) I had an awful time. Separated from my husband and son (husband at home, son in a cube in the NICU) I’d never felt so isolated. I had so desperately wanted to breastfeed and hadn’t done much research into pumping, and was all of a sudden expected to pump 8-12 times per day if I wanted to give my son colostrum/breast milk, which of course I did! 

But there really wasn’t much lactation support and I felt very much like I was trying to navigate a dark forest without a trail of breadcrumbs to see me back safely to the other side. I know a lot more now than I did then, but at the time I didn’t know where to turn to ask for help. I really struggled to pump consistently, and trying to visit my son in the NICU at the same time it all got a bit much. I spent a lot of time violently sobbing in the shower but the midwives were very kind. Once I was able to go home from the hospital I found it even more difficult pumping as much as I was “meant to” even though my son was very poorly and wasn’t taking nearly as much milk as I was producing. 

Even though I loved my son, I wasn’t enjoying being a “parent” which made me feel really guilty and sad. After four months my son Magnus died, and trying to navigate drying up my ample supply and not being able to donate the litres and litres of milk I’d so lovingly expressed was devastating and one of the hardest things I’ve ever been through. 

The best thing about this birth experience was the lead consultant who handled my care for the most part, she was so knowledgeable, kind, and honest, and spoke with my husband and I very frankly about the situation. At no point when we were going through the situation did I feel “out of control” so to speak - it didn’t feel like decisions were being made about my body without my input and any questions we had were answered clearly and in a way that we easily understood. Some other positives include the midwives who did everything they could to support me through the whirlwind admission and urgent surgery, especially the midwife that was with me before my surgery after my husband left who stroked my hand and told me it was all going to be okay. 

Of course amongst the good things, there are bad things that can be attributed to a maternity system that can’t support the women who need it. The overnight team felt much less interested in my personhood, and rushed through as much as they could. After my surgery, there was a lot of delayed doses of medication, lots of people coming in and out but never when I needed something. It seems to be a commonly held understanding that the postpartum ward experience is overwhelmingly terrible, and it’s a real bummer that I consider myself “lucky” so to speak that I was in my own room on the high dependency unit. 

In the three years since then my feelings around the birth haven’t changed, I think given the circumstances it was really the best case scenario. I did feel a little grief at the fact that I didn’t get even remotely close to the birth that I wanted, and ended up with a cesarean scar that would now impact my later births and the care that I received. But I’m very confident that it was just a really crummy string of events and a case where medical intervention was absolutely necessary to save my life and for that I’m grateful. I’m also exceedingly grateful that my thoughts about birth in general, that it’s safe and our bodies are fully capable of getting on with it without intervention, haven’t changed either.