"Giving birth and waters breaking"

I want to share my birth story, provide feedback, and give insights into my experience as a patient.

My pregnancy was low-risk, and my water broke in week 39+0. I contacted my midwife at the family birth center where I was planned to give natural birth. After 18 hours, I had still not entered active labor, so I was advised to go to the maternity assessment unit at KEMH to get antibiotics every fourth hour to decrease the risk of infections. When I had my second dose at 24 hours (instead of 22, as the first antibiotics took quite some time), we were recommended to be induced by an obstetrician, as we were told that the risk factor was going to be significantly higher after 24 hours. However, we informed ourselves of what we believe to be the latest research on evidence-based birth (https://evidencebasedbirth.com/evidence-inducing-labor-water-breaks-term), that we felt the 24-hour rule is no longer evidence-based, as long as you get antibiotics. Based on this, my partner and I decided to go home and wait a bit longer.

Immediately after coming home, my contractions started, 4 min apart, and quickly getting more frequent and stronger. Being in active labor, our midwife advised us to stay home until due for antibiotics. Going back to the maternity assessment unit for antibiotics, we were treated in a way that impacted my experience and labor significantly. We were told that we were late, although we came in about 5 minutes after the time we had been told to get back at (I later understand the midwife had been advised we were due to come back half an hour earlier which shows miscommunication). We told the maternity assessment staff that I was in active labor and that we wanted to go to a birth suite but were told that I needed to go to a different room to get antibiotics and that they would call my midwife. Taken to this room, I had strong, long contractions.

Putting in the cannula took 1.5 hours, three different people, and six attempts. During this time, they refused to give us a birth suite and missed out on calling our midwife (prolonging access to the birth suite and my support). They also asked me to try to stay still and let them know when I had contractions (although I had already told them I had one minute in between them). No pain relief was offered despite my crying in pain, and when I asked for gas, they did not instruct me on how to use it, rendering it ineffective. Finally, I felt like they did not show any compassion or help me with support or guidance. When I was in most pain, it seemed they just smiled at me. It was like they did not understand I was in active labor and only focused on jabbing my arm to get antibiotics in. This environment and treatment stressed me and my body to exhaustion and did not allow me to focus on managing the contractions and progressing my labor in a natural way.

When my midwife showed up, they had finally managed to get my cannula in, and I was crying with relief to see them - someone who would listen and support us. My midwife took us to the birth suite, where we could get the antibiotics after 1.5 hours. I was stressed and exhausted, so I received morphine and a sleep-inducing drug for pain relief and rest. After some rest, this intervention slowed down my contractions, and it was suggested that I would get a hormone drop (oxytocin) to get them started again. The pain from these contractions was something else than the natural ones, but I tried to manage it with a TENS machine, gas, movements, and a shower.

After 11 hours of contractions, I reluctantly opted for an epidural. To me, it felt like a failure, as this was something I did not want, and I wanted to give birth as naturally as possible. All I believe women hear is that "the female body can do this, be positive," etc., but I could not do it anymore, hence feeling like a failure. But as I was shaking, exhausted, and in agony, I made the choice.

Here is the second thing that impacted my experience a lot. It was just a comment, but a comment that hit me hard in the position I was in. I recall the duty anesthetist said after asking routine questions (I assume): So why are we here? As in, why did I need an epidural? Hearing from an authority and expert like themselves that I did not need an epidural after enduring hours of the worst pain of my life shattered my heart and confidence completely. I already struggled to not see it as a failure, and I still have a hard time not seeing myself as a failure.

After another 12 hours, I ended up with a c-section due to me getting a fever, blood in my urine, a continuously very high heart rate of our baby, and potential obstruction.

My experience has unfortunately caused me trauma, something I never experienced before. I am recovering but wanted to give you feedback on the most crucial external parts that impacted my journey. I had prepared as much as I could for my birth, and while I know things can happen that make your birth different, I wish that I would have been met with more professionalism, compassion, and support by the maternity assessment unit staff and the duty anesthetist giving me the epidural (although they did a really good job with the actual epidural).

Finally, I wanted to give my thanks to the rest of the team from the family birth center who gave me invaluable support before, during, and after my birth. In addition, the team (medical and nursing) taking care of me until the c-section did a fantastic job to help me as far as I could to attempt vaginal labor. I am really grateful for that.