It is late 2014. I am in the obstetric consultant’s office, my knees shaking so badly that all 36 pages of the NICE guidelines I’ve printed out and brought with me keep falling to the floor. I’m picking them up as elegantly as a heavily pregnant woman can when the consultant says:
“So, tell me why you are requesting a caesarean section for this birth.”
“I have mental-health issues,” I reply. “Specifically, a severe panic disorder I was diagnosed with at 21. It has significantly impacted on my life – at one point, I was housebound for four years – and I’m concerned that I won’t fare well, mentally, during an induced birth.”
I have gestational diabetes in this pregnancy, so birth is to be induced at 38 weeks. I will be admitted into hospital and given drugs to start labour, which should take effect over the following three days. My midwife has already warned me that induced contractions are especially painful, and has basically said I should ask for an epidural as soon as I’m on hospital grounds. This effectively means being tied to a bed for three days with a question mark hanging over my head, and I can’t see any of my breathing techniques combating the panic attacks that this might trigger.
I explain this to the consultant, adding: “Since there’s a 22 per cent chance of an emergency C-section associated with inductions, I’d like to request an elective to mitigate any ill mental effects and make the birth as smooth as possible. According to these NICE guidelines, I’m entitled to one,” I pass the consultant my now crumpled and sweaty stack of papers. He does not read them.
“Hmm,” he says. “Birth is a scary thing, but there’s really no reason to panic.”
“Right, but that’s not really how panic attacks wor-”
“We will take very good care of you,” the consultant gets up and ushers me to the door. “Don’t worry about a thing.”
I have a severe panic disorder I was diagnosed with at 21. It has significantly impacted on my life – at one point, I was housebound for four years – and I’m concerned that I won’t fare well, mentally, during an induced birth
“So can I have a C-section?” I ask, confused now, trying to push from my mind the family friend who disapproves of my asking for a C-section “because it’s not like a real birth”. “Because the NICE guidelines state that–”
“No, we won’t be doing that,” the consultant smiles and holds the door open. “Goodbye, Miss Willdo.” The door closes.
For fuck’s sake.
“You’re panicking, I can tell,” the midwife is telling me, not unkindly. “Try and calm down. It’s important for the baby’s heart rate that you calm down. Calm down.”
“I’m trying,” I tell her. Then I vomit into a kidney dish and cry. I am 13 hours into my induction. I started dilating as soon as the drugs were administered, and the contractions rolled in one on top of the other. They were so painful that I kept hopping round the room, and it took three goes to get the epidural needle in. But, for the last 10 hours, I’ve just lain here, labour stalled completely, while I lost myself alternately to utter panic and the oblivion of pain meds. Finally, I start shaking and vomiting and the baby’s heart rate goes through the roof. I have gone into sepsis, it turns out, and the baby is tachycardic, his heart beating four times a second.
“Leave me, save the baby!” I call melodramatically as I’m wheeled into surgery for an emergency caesarean which, at three minutes from incision to birth, is the least traumatic part of all this. My son is limp, purple and silent when he is born. They take him to an adjacent room because he's not breathing. Time stands still. Then my husband runs in, and proclaims "he has a massive ballsack!", and I realise all is well. By the time they put him on me he is already regaining his colour. I smile at him and gratefully pass out from blood loss.
It is 2017. I am sitting a different consultant’s office, pregnant with my second child – this time with my NICE guidelines in a neat plastic folder – and a take-no-shit expression on my face. My knees are still shaking, though.
“Right,” the consultant begins. “What sort of birth are we looking a-”
“I would like an elective C-section,” I bark, almost. “I am legally entitled to the choice, I have considered the alternatives and I would like a C-section.”
“Gosh,” the consultant says in surprise. “I should think you do. It says here that you developed PTSD from your first birth – which isn’t surprising, reading your notes – and you ended up having an emergency C-section anyway. Frankly, Miss Wilder, I’m surprised we didn’t offer you an elective in the first place, given your mental state.”
“Well, yes,” I stutter, the wind slightly gone from my sails. “I was, too.” Then I tell her the story of the The Tale of the Door-Shutting Consultant.
She doesn’t say anything for a while and then she says this: “I’m sorry. I’m really sorry. In the past, we haven’t done mental health very well here. I know that doesn’t make up for anything, but I am sorry. For what it’s worth, I am recommending you for an elective caesarean, and referring you for two different lots of perinatal mental-health support. I want this process to be as easy on you as possible.”
The family friend I mentioned is present when I tell my loved ones the news. She wrinkles her nose sympathetically: “What a shame you still won’t get to experience a real birth.”
“C-sections are real births,” I tell her. I point at my two-year-old son, playing happily with his trucks and dinosaurs. “He is a real child. All births are real births.”
All births are real births.