"Prescribed timeframes & hospital policies"

I gave birth at Armadale Hospital. I was praised to arrive at the maternity ward at 8cm dilated as the hospital staff didn’t want me to come in earlier. I feel this mentality of praising about cervical dilation around the 8cm mark should have warned me that I should have gone home.

Since then I have learned from my experience and reading research papers that cervical dilation is not a true indication of labour progress, yet as I understand it hospital policies are still abiding to cervical dilation to dictate when women are in established labour. I feel I was naive to trust that I would be able to have an undisturbed physiological birth at Armadale Hospital. Yet, I believed what they told me in their antenatal classes.

Firstly, I requested the birth pool as I had signed the documents, yet I was told I could not have one (I believe probably because no midwife was qualified for it). We used the shower instead for pain relief and to keep me warm as I was freezing cold and shaking. I was given a very thin sheet by the midwife on shift. I lost my water a couple of hours later and then everything unfolded very quickly as it turned out that it would be a long labour. As a first time mother, I knew this and they tell you in the classes to expect a longer birth. However, they don’t tell you about the prescribed timelines that I believe they have in their hospital policies. It seems to me they want quick births because they perform so many vaginal examinations that it’s risky to have a longer labour due to the risk of infections (and yet, I recall cervical dilation doesn't indicate the labour progress!). I received at least 5 vaginal examinations.

After losing my water, I wanted to lie down and rest as I didn’t manage to get much sleep in the last few days due to heartburns. Yet, I was constantly disturbed and that’s when I first met the GP Obs, who wanted to augment my labour because my contractions weren’t the ones they expected I would have and also, I was no longer dilated ( I was at 5cm). They offered me the option by calling it 'syntocinon'. I felt I was lucky to know what they were was talking about and I quickly refused and preferred to get up to get the contractions going. I believe it would have led to more complications and more likely a C-section. I’m glad I refused as baby and I were doing fine.

This GP Obs might have gone home because another GP Obs took over on top of the midwife. From there on, I felt I was threatened a couple of times with a C-section if the baby wasn’t coming anytime soon. I felt I had to keep advocating for myself constantly, leading to huge fatigue and stress.

On top of that, I had what they call an 'involuntary urge of pushing'. I believe it's perfectly normal and is triggered by the position of the head of the baby but I was constantly told by the midwife don’t push! As if I can stop my body from contracting and pushing! I thought what nonsense! I was offered Entonox (gas) multiple times by this midwife as they said it might help to stop the urge to push. And I believed them! After more research, I believe that the gas doesn’t stop contractions or the urge to push. Again, I felt it was just non sense here, and I believe this probably stems from hospital policies about what they call 'involuntary urge to push'. It seems to me it’s because they believe women’s bodies don’t know what to do in labour and that I was going to hurt my cervix because It’s still 'not dilated' enough to their liking!

Once my cervix was 10cm dilated, I was told I needed to push, even though my body didn’t feel ready. I believe this led to more complications and I was exhausted to advocate for myself, especially because I recall the midwife had increased the levels of the gas without my consent. I was constantly passing out by then. I deeply regret not having hired a doola, they would probably have got me to stop taking the gas before I got too woozy, I couldn’t even talk properly! Since I felt I was put on a timeframe to birth my baby, I pushed as hard as I could in a position that I didn’t find comfortable or helping me. It’s also worth to note that for this hospital, a pushing phase longer than 90 min is classified as 'delayed labour'. I’ve learnt since then that this phase can take many more hours. Yet, it was a race to deliver this baby who had no distress signs. I capitulated by allowing a vacuum extraction and I was not explained the risk associated to this method, which I believe later prevented us to breastfeed in the postnatal ward due to other complications. During the extraction, they noted that the baby had an anterior shoulder, which I believe was more than likely caused by all the interfering and making me push before my body was ready to do so. Because of this, I will not be eligible for a home birth with the community program next time. It’s probably for the best, as I don’t trust hospital staff anymore based on my experience and I don’t want any vaginal examinations ever again when giving birth. I will hire my own private midwife instead.

Why does it seem my labour and baby’s program need to fit with the labour conceptions of GP Obs? How many physiological birth do they mess up with their prescribed timeframes? Especially for first time mums? Why did I feel 'groomed' by the midwife to accept the Entonox? And then the levels were increased and I didn’t know about it? I feel it's very disturbing. I had to advocate for myself and my baby during the whole labour!

In my opinion, all women deserve woman-centred, respectful care that recognises them as the expert regarding their body and baby. Please review your policies for physiological births Armadale Hospital! I believe breastfeeding rates would be higher if physiological births weren’t interfered with!