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Induction at 35 Weeks

Sarah shares the birth story of her son Jonty

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My husband and i had been together 9 years and married for 3 years before we decided we were both ready to start a family. 2 months after coming off the pill we were pregnant with baby number one.

The first 28 weeks of my pregnancy went by pretty uneventfully, I loved being pregnant and feeling the baby move.

At around 30 weeks my blood pressure had become what the doctors classed as high (over 140/90) so I was monitored closely and was also put under the care of an obstetrician. I was told to cut down my hours at work (was working 40hrs a week) and to rest more.  I did cut back on my hours but filled up the time getting ready for baby as i felt fine. I had been showing trace amounts of protein in my urine but the blood tests I had done (to check for onset of pre-eclampsia) all came back ok.

At my 32 week growth scan, they picked up that there was less amniotic fluid around the baby than there should have been, and that his growth had slowed down. I was sent straight to the hospital and had a CTG (where they monitor the baby's heartbeat over a period of time) more blood tests and a consult with my obstetrician. I had to stay in hospital overnight and do a 24 hour urine collection (to check for protein) and I had blood pressure checks done every few hours. The next day I was allowed to go home as everything had come back fine and the baby was showing no signs of distress.

Over the next week my blood pressure was up and down until it spiked at around 156/110. Again I was sent straight to hospital and there I would stay until our baby boy was born.

So at 34 weeks I was facing an early induced labour. The obstetrician team decided because of the low amniotic fluid and the IUGR (intrauterine growth restriction) that our baby would do better out of the womb than in there. Plus if I did have the early signs of pre- eclampsia, I would be better off too, before it escalated too far.
The registrar did a stretch & sweep but all that did was cause a few niggles. I was admitted to the antenatal ward to start an induction. I was given 2 steroid shots, one the day before induction and one on the day of. So they started with a dose of prostaglandin gel up there.

I did get a few very very mild contractions, but no more painful than mid-period pain. They were very irregular and faded after a couple of hours, and after an internal exam, seemed to have little effect. The next day they tried again with the gel. This time the contractions were a bit more painful but still irregular but they did soften my cervix. Although again they did stop after a couple of hours. All the time, I was hooked up to a CTG machine to ensure the baby wasn't in distress, but he seemed to be handling everything ok (the risk of inducing this early is sometimes the baby is too small and fragile to handle to rigors of labour contractions so they are monitored very closely). They let me rest for the night and a plan was made for the next day.

The team decided to induce labour using IV Syntocinon (a synthetic form of oxytocin). I was warned that a lot of induced labours can end in c-section due to the baby not handling the intense contractions.

This did scare me, as having a c-section was on the top of my worries list. They also advised that I would be more likely to need pain relief, again due to the intense labour. Also, having an epidural can help lower blood pressure, this freaked me out too, this was #2 on my worries list, I really didn't want an epi. I had wanted a drug free natural birth, and was slightly disappointed that it may not happen.   But I was realistic that everything they had to do, was for the baby's benefit and my own.

At 35 weeks gestation I was admitted to the delivery suite (closest to theatre in case of emergency c-section). At 11:15am my waters were broken to try to start labour. At around midday I was starting to get some irregular contractions which were very mild and soon after that they started the syntocinon infusion.

After about half an hour, the contractions were still mild but more regular. Throughout this, the infusion was gradually increased. From 1pm it got a bit crazy and I had to read my birth notes to remember what happened when!!. At 1:30pm I was getting contractions every 2 minutes and I remember being in extreme discomfort, although I don't remember the pain too well (probably a good thing!!). I remember the midwife asking if I wanted to get off the bed, I wanted to, so they removed the CTG and attached a fetal scalp clip (i was around 3cm dilated by this stage) to baby's head. I tried to get up but every time I tried, another intense contraction hit and I had to lie back down to try to get through it.

The infusion was reduced and then stopped. In my notes the midwife has written "Sarah becoming ++distressed". This was around 2:30pm.

I tried the entinox gas but hated the taste, and found I couldn't concentrate on getting through the contraction and breathing the gas at the same time. The baby had started to show signs of distress (heart rate dropping during contractions) so I was given some pethidine to try to relax me. i don't remember it working? but I don't really remember much.

By 3ish I was 4cm dilated, baby was getting quite distressed (as was I) as the contractions felt like they were one on top of another. I was being prepared for an emergency c-section, at that stage I didn't really care, I just wanted it over. I do remember saying that I don't want to do this anymore, and my midwife kindly responded that it's a bit late for that.

According to my husband there was a bit of a panic, then the obstetrician came in calmly, decided to do an internal before I was taken into theatre and found I was 9cm dilated (so I went from 4cm at 2:50pm to 9cm at 3:20). He said we should be able to deliver the baby naturally. At 3:30 I was fully dilated and ready to push.

At 3:40pm Jonty was born weighing 2020gms. He was small but very healthy and had good apgar scores. I got to hold him for a bit but he had to be taken to the special care nursery to go in an incubator to keep him warm. I did tear a bit, I think because he was born so quickly, so I had to have a few stitches.

Other than that though, I felt great. By 5ish I felt well enough to get up for a shower. All I wanted to do was get up to SCN to see Jonty, it all felt so surreal, like did that all just happen.

I was closely monitored over the next 3 days as pre-eclampsia can worsen after the birth too, but everything was ok. I was put on BP tablets to try to bring that down, as it was still quite high. I was discharged around four days post birth, but didn't want to leave, as Jonty was still in special care.

Luckily for us, the SCN wasn't very busy, so I was allowed to stay in one of the rooms there. 10 days later Jonty was allowed to come home too!!

I feel really lucky that everything worked out ok for us. I was glad I didn't have to have a c-section or an epidural. I was pretty stoked that my labour was only around 4 hours, even if it was really intense.

I am now 31 weeks pregnant with #2, and this pregnancy is being treated as high risk, so the next few weeks will be anxious ones for me.

Hopefully everything will work out ok, and I am writing a birth plan again to be optimistic. I am hoping for a drugfree birth, but I am more aware of what I am in for this time, so I am keeping an open mind.

Kind regards,
Sarah Somervell

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