I had a maternal request elective C-section for tokophobia

I’ve just posted this somewhere else but I wanted to mention it here too because I think there’s too much stigma surrounding Tokophobia (fear of childbirth) and maybe it will help someone else:

 

I have always had tokophobia and it put me off wanting children for years because I was so scared of childbirth. I thought we would adopt instead, and justified it because the world is overpopulated (and isn’t it the height of self-indulgence to be a Millennial in the position of being able to afford a child). I had so many little justifications but underneath it all, I wanted kids. Twenty of them. Enough to fill a minibus or a classroom. Smashing the Idiocracy, one baby at a time.
 
With my first (unsuccessful) pregnancy I got such bad hyperemesis and I think a large part of it was because I was so anxious about giving birth, despite desperately wanting a baby. I was sure I would die. I ended up in hospital on IV fluids because I was so scared of having a baby that my body stopped digesting food. At the time, maternal-request C-section was not an option in England. In many parts of England, it still isn’t, and I find that abominable while on the other hand we tell women to trust their instincts about reduced foetal movement etc.
 
With my most recent and finally successful pregnancy, I had all my antenatal care in China where a C-section is the norm, which took away 99% of the stress. I got “normal” amounts of morning sickness, which isn’t great, but it also made me realize just how bad my hyperemesis had been several years earlier, despite so many people dismissing it as part and parcel of pregnancy.
I finally allowed myself to learn all about pregnancy and childbirth, and the whole thing fascinated me. I think I talked about random obstetric facts non-stop whenever my husband was home. I found myself craving the British model of pregnancy – midwife-led care, with emphasis on normality. In China, a doctor makes all your decisions and they get quite offended if you refuse any tests they’ve recommended (and they loved recommending tests).
When I got to Northern Ireland, there was uncertainty about my due date so they wanted me to have an induction. This was something I hadn’t really read about because I didn’t like it as a concept. It seemed unnatural to fill the body with gloop to force a baby out when it wasn’t ready. It really didn’t sit right with me, but no one said I had any alternative, and the baby had to come out somehow, so I actually psyched myself up to go for an induction.
I think I would have been okay except I had a cervical sweep three days before the induction and it was agonizing, and it left me unable to walk very well (I suspect this is when the baby accidentally got turned). I still kept telling myself I could do this induction, but now I had a lot less confidence because if that was just a little membrane sweep, how much worse was labour going to be. I was resolved that I was going to try and have a normal birth though (in between bouts of crying and telling my husband I was going to die because I was completely terrified).
I tried practising hypnobirthing and meditation, and even wrote a birth plan about 2 days before the induction date. On the day, I spent 6 hours having the worst and longest anxiety attack of my entire life, convinced my baby would die and so would I, while the poor midwife in the induction bay was trying to calm me down because I was crying and shaking, blood pressure through the roof, and she ended up getting the registrar to come and go through what an ELCS would entail with me.
 
Until a C-section was offered, I’d been too scared to ask for one in case they said no.
 
The registrar then did a scan to look at my baby and said he’d shifted to an oblique lie so couldn’t have come out any other way. She drew a diagram in my notes and everything, but I still don’t know if she was just trying to make me feel better.
 
When I was going into theatre to have the CS the consultant-midwife asked me why I was having it and I said about the baby being oblique because I was too ashamed of how scared I’d been. Of course, she could see my notes so I should have just been upfront but anxiety isn’t rational.
 
My notes say “maternal request c-section” but that doesn’t quite cover the time I spent agonizing over this, feeling like I’d let my baby down because I was too scared to try and push him out, or the fact I still mourned the loss of my envisioned “perfect” birth, a waterbirth, surrounded by delicious snacks, with my husband in the water with me and holding my hand. It doesn’t come close to making me feel better about what happened, when I know what the statistics say about C-sections and the chance of babies developing respiratory issues and digestive problems.
 
I dreaded having to tell my family what had happened so I didn’t tell anyone I’d had a C-section for weeks before I finally admitted it, and everyone was fine about it. This is the first time I’ve openly admitted it was partly down to my own terror of childbirth.
 
It’s taken me months to come to terms with the fact I “failed” at having a baby the “proper” way but I know now that a lot of that stigma comes from within me, from the phobia of having a baby, not from other people’s genuine opinions. Literally no one has said anything nasty to me about having had a C-section.
 
I wish I’d been honest with my consultant about my fears and felt brave enough to ask for a C-section when I first got back to the UK instead of letting the situation go on for weeks with me thinking I was going to be able to try for a vaginal birth. But I know why I didn’t. I was hoping I’d just “get on with it” on the day. Within minutes of us arriving for the induction I’d been told I was too high risk for a waterbirth because of the baby’s size (because he was broad-shouldered), and that was when my anxiety got the better of me and everything fell in on itself in my mind.
 
I also wish I’d been honest about my history of mental health issues, but there is a lot of pressure on us as women to be fine when we’re not, and I was trying so damn hard to be ok with something I just couldn’t do. If the baby had been low-risk, I would have gone home and waited for labour (and maybe even freebirthed) but I was terrified of refusing the induction and putting my baby at risk of death so I got paralysed with anxiety.
I was also terrified of social services being alerted that I had a history of bipolar on my medical notes (we still don’t know what’s actually wrong with me, currently Autism, type II bipolar, borderline and ADHD are all being floated around) and taking my baby away. I was convinced they were going to take my baby and nothing anyone said could divest me of this belief. I might have had a teensy bit of psychosis over this but it seems to have resolved itself and I managed to keep enough of a lid on it that I didn’t get mental health sectioned over it (just C-sectioned haha) despite being sure at several points over the last few months that I was going to be an inpatient and separated from my baby (we don’t have mother and baby units in Northern Ireland so women with post natal psychosis or severe post natal depression get sectioned and put in a normal psychiatric hospital).
And despite at least 2 suicide attempts post-partum I am still at home and with my baby. Turns out NI don’t really intervene beyond community mental health teams unless you’ve set yourself on fire so that’s relieving because I don’t think being imprisoned in a mental hospital without my Jellyfish would help me to recover very well, and anyway I’d have to stop breastfeeding.
 
Overall, I am glad I had a C-section rather than a prolonged birth in a strange place where I couldn’t be myself because there were too many strangers, and where my husband would get sent home outside visiting hours. But I still really wish I could have had that water birth. I’m looking towards a second baby, and I’m pretty certain I want a homebirth (homebirth after C-section, or HBAC, is allowed in Northern Ireland and the rest of the UK but as far as I know it’s not allowed in Southern Ireland) with a birthing pool. I’ve seen some beautiful videos on Youtube of vloggers who had natural waterbirths at home. 
 
The first mental health keyworker I saw said to me that it doesn’t matter how your baby came out as long as they are healthy. This effectively shut down the conversation about why I was there, lost in the depths of post-natal depression. While I do think a birth is just a means to an end, at the same time it is a part of our story and lived experience as a woman and for that reason we should respect each other’s decisions and hear each other’s words about birth, especially when that has deeply affected someone’s outlook or mental wellbeing. I don’t think dismissing this as unimportant actually moves anyone forward or helps them get over things.
If I am lucky enough to get onto a midwifery course (yeah I haven’t told the fam about that, either, because I might not get on a course), this is how I want to work for my pregnant ladies; I want to ensure they know their options and get the closest thing possible to the birth they want.

Applying for Midwifery Science and Dietetics

So I’m still thinking on this, but it’s something that I’ve been wondering about for a long time. Being a midwife over here isn’t the same as being one in America. Over here you’re part-obstetrician and part-obstetric nurse (we don’t have ob nurses over here at all, just midwives).

In Northern Ireland, midwives do all the antenatal care and deliver babies in any “normal” birth, and doctors only get involved if the abnormal presents itself. It’s supposed to mean that, because the state of pregnancy is one of the normal, natural states for a woman to be in, it isn’t a condition that usually needs to be treated. So keeping doctors out of the ordinary pregnancy cases means no one is looking for problems. Which is supposed to avoid the cycle of intervention that happens once doctors involve themselves. Quite a few women get all their proper healthcare throughout pregnancy, including their scans, blood tests etc, but they never see a doctor.

Sometimes midwives get a bad rap in the press. Especially in England, where maternity services are very underfunded. The problem starts when midwives, for whatever reason, don’t refer genuine medical issues to doctors. This endangers the mother and the baby. This happened with my first pregnancy when I nearly died, and long-time readers know that ended in a lot of tears, and with me thinking that I couldn’t get pregnant. That was one big reason why, when I came back to Europe from China, I didn’t go back to England and I never plan to live there again. When I was in China and found out I actually could have a baby safely, I felt quite angry at the two unnecessary losses I had in England.

In Northern Ireland, we have the best maternity services in the UK. I think it’s because half of the country (traditionally) was Catholic, and had a lot of babies, so there is high demand for services. From my baby classes and Facebook groups of Northern Ireland mums, I know a lot of people with at least three children. Maternity services is a huge priority over here because family is important. A lot of people over here complain about the health service but I think it’s fantastic compared to England.

The training pathway for both dietetics and midwifery is a bit intimidating. I was good at science until I was about 15 then I struggled epically. I could follow the teacher in class with no problem, but I just couldn’t hold all the information in my head and by the time I did tests or exams, I just forgot everything. I’ve read recently that this is an ADHD thing, but I don’t know if that’s true.

Anyway, midwifery and dietetics are both very scientific subjects, with a lot of anatomy, medical science, biology, and in the case of midwifery, all the medical procedures like intubating babies and taking blood samples and doing urine tests, as well as diagnosing things like pre-eclampsia.

I’m so excited about doing this but I know it’s not going to go down well with my wider family, particularly if I do midwifery. I was thinking of applying straight after high school but my aunt who I lived with said it was a bad plan. Looking back, at the time I do think she was right, but since then I’ve grown, I’ve drifted through my twenties without purpose or direction, and I have spent a lot of time trying to discern what career would suit me. However, I am not sure if my aunt will agree or if she’ll tell me I outright shouldn’t do it.

I want to stay in touch with all my relatives but it’s hard when I want to do something they don’t think is a good idea. She used to be a midwife and I don’t know what happened but I think she got very disheartened with the way things went in England and I think she began to hate her job. My other aunt is an Advanced Nurse Practitioner, having had a long and varied career with the NHS (our free healthcare service which runs 99% of all medical services in the UK), and my sister recently got a job at the NHS and it’s been the absolute best thing for her, she’s so happy in her job (finally). My other other aunt is a podiatrist, fixing people’s feet problems, and my mum was a cadet nurse (like, the lowest entry point into nursing) for a very short time after school, before she freaked out over the sight of blood and ran away with a motorcycle gang (I wish it weren’t true). My grandma was a nurse, midwife, matron and then a district nurse, and she couldn’t walk down the street in the town where I grew up without people stopping her to say hello. And that’s all just on my mum’s side.

On my dad’s side, my other other other aunt (the one we don’t speak of) is a physiotherapist. That’s not even mentioning all the cousins, my sister, great aunts etc who work in the health service. It’s like our family industry is taking care of sick people.

Except me.

So coming from a long line of nurses and allied healthcare workers, I think I’ve got a pretty good idea about whether this is a good move or not. On my husband’s side, literally no one works for the NHS, which I find a bit odd.

I am drawn to midwifery specifically because I have seen extremely good and extremely bad maternity care, in four different countries (England, Nepal, China and Northern Ireland), and I know the best midwives advocate for women and put women’s best interests at the centre of everything they do.

I discovered feminism fairly late compared to a lot of people, as I only really came to it when I started my master’s degree. But I really engaged with it and I see midwifery as an inherently feminist role because you’re supporting women to make their birth choices, but also supporting women to actually give birth.

On the dietitian side, I could really see myself getting my teeth into that as a job, too. Dietitians are different in the UK to America, too. They predominantly work for our state healthcare service and they don’t get paid to go to events sponsored by Pepsi or McDonalds. Over here, dietitians follow the scientific evidence.

The downside of them not getting funding from unhealthy food corporations is that there’s not many dietitians around, there are very, very, very long waiting lists, and generally, to cut down waiting lists and make the healthcare service look good, doctors simply don’t refer people to dietitians when they would benefit from it.

Having said that, I am fascinated by nutrition and have written tons of articles about it in the past so dietetics does also appeal to me, but I’m not sure if I will be able to keep up with the 2-year course that’s 4 years of work condensed into half the time.

Overall, midwifery science and dietetics both offer stable, structured career paths, while also both allowing for the option of private practice in the future, and both of them would be jobs I could do abroad, particularly in New Zealand, which I’d quite like to go to at some point, even if only for a few years.

Okay. Now I think I’m ready to finish those applications. Well done if you’re still with me haha I just had to get out all my thoughts on it.

PS The featured image is my jellyfish when he was a newborn.