by Poppy Walters.
I didn’t know anybody who studied for birth as much as I did. I did one full antenatal course, plus two prep sessions from our local Action for Children, plus an online birth prep course plus an online “first days” prep course, and obviously an obscene number of books. I just had to know what was going to happen.
I had looked for resources about birth for dyspraxic people but it was difficult. Neurodivergent parenthood is a small space and even within that I saw mostly content by/for autistic people, a bit by/for ADHDers, some of which was relevant to me but I didn’t see much by other dyspraxic people. Which was a shame because I had concerns! I don’t have good interoception, how was I supposed to know when it was “it”? How was I going to follow instructions about tensing and untensing various body parts!? Would I understand what people were asking me to do? Could I articulate my own needs in a medical setting? What if I turned out to have no pain threshold? Every pregnant person has questions but I had so. Many. questions. And on top of that, I’m just a bit obsessive. The baby was my latest project, the biggest of my life, and her birth was an event I was preparing for, so in the same way as I scour the website of any holiday destination I’m going to, I relished the process of finding out all I could.
Apart from satisfying my obsessive need to study, a lot of the things I read and learned and practiced didn’t actually turn out to be that useful. But the things that were were godsends, so I thought maybe I would describe the bits of preparation I’m really glad I did, and follow that up with the actual birth story.
A good online birth preparation course. I loved going to antenatal class in person, the charity I did it through have been amazing ever since and I talk to my antenatal friends every day so I still rate going to one as an option. But as an anxious and easily distractable person, I spent half the time wondering if I was dressed appropriately and if the other pregnant people thought I was weird, and a lot of the time looking out of the window and feeling generally excited about the baby - I never took much from two hour lessons at school and I probably took away as much in biscuits and good vibes as I did in solid information in this case. Luckily the provider sent out videos they’d made during lockdown so I could revisit it, and I also bought a more detailed online course so I could go back over the things I’d forgotten or had questions about nearer the time. I could also rewatch something with my husband if it was important to me that he knew it or if I needed someone to help me understand the way something was being explained. We did “the bump to baby chapter” by Beth Kitt but there are endless options.
A bit of hypnobirthing study/practice. As a woman of science and a strong believer in evidence based healthcare I was sceptical, but when I looked into it a bit it was less about manifestation and more about understanding birth physiology, the way stress and fear exacerbate pain and impact the birth process, and ways to mitigate this. It was helpful to clearly plan how I would make my environment feel relaxing, and to practice things like breathing techniques to make me feel more calm and in control. And I wasn’t someone who could just read some text about how to breathe in the right way and automatically do it so I needed to practice a LOT - I’m glad I did this early.
Practising different positions for birth! With dyspraxia I find it very hard to follow instructions and muscle memory helps me a lot. Things like ‘knees in calves out’ didn’t make any sense to me without practice and so we spent a couple of funny evenings figuring out how I might be.
Having a few different birth plans for every situation! Not a birth plan that’s prescriptive of exactly how I’d like everything to be but just knowing what I’d want in any eventuality. I ideally wanted a water birth on the birth center so I’d put some bullet points about how that might go, but I’d also thought about what I’d like to happen if there were an emergency c-section, the fact that I would like my Mum to be called to be with me if me and Maisie were separated and Milo went with her. A lot of people say having a birth plan sets you up for disappointment but as someone who didn’t get exactly the birth I would’ve liked I disagree - more on this later. I also put right at the top that I’m dyspraxic and might struggle to follow practical instructions or needs things explained to me more than once.
Reading all different types of birth story so I would know about every different situation. Ties into the above really but I wanted to be prepared for whatever happened and I wanted to feel confident that any kind of birth could be positive, not just ones with mood lighting and a pool and panpipes.
Briefing my husband about what I wanted him to say or do in different situations. This meant he was ready to advocate for me if I wasn’t able to advocate for myself
I’m rambling.
So the birth itself.
My waters broke first in the bath. I was immediately a little more relaxed about birth - you hear of people being in the early stages of labour for days, but once my waters had gone I knew I couldn’t be one of those people; if baby didn’t come naturally she would be assisted into the world in the next day or so. Triage told me to come in in 12 hours if I hadn’t gone into active labour before then, and although I would’ve preferred a birth with less intervention there was something reassuring in this.
Overnight I laboured in our attic room, sleeping in between contractions. At first I could stay lying on my side and breathe through them, later I would kneel up and lean over the banister. It felt tiring but manageable and I was excited that things were moving on their own, so I was very disappointed when at about 4am my contractions abruptly stopped. My waters had broken at 6pm so at about half 5, with no further progress and virtually no sleep, I reluctantly went into triage to get examined.
Triage was boring but relatively inoffensive. We had to wait around for a long time and it was the first time I started to think about how ironic it is that the importance of oxytocin and a calm environment is drummed into you throughout pregnancy and then when you’re in labour you’re stuck in a plasticky room with harsh lighting and noise and people randomly wandering in and out and making you stay still on a bed. I bounced around on a ball while I waited, they ran a trace for a bit, confirmed that my waters had broken and told me if I hadn’t gone into active labour in 12 hours I’d have to come back for induction. This was all extremely businesslike. Milo asked if I’d be able to use the birth center and/or the pool and they said if I needed induction I couldn’t do either, and there was no “we might recommend induction for these reasons and you can decide”, and although I would have probably done it anyway, in retrospect I think it’s sad that it wasn’t a conversation.
We spent our 12 hours doing whatever we could think of to increase oxytocin and possibly trigger labour and it didn’t work but it was a lovely day. I still had occasional contractions but they weren’t intense - I might stop while walking to lean on a tree or sit down for a while and I enjoyed being surrounded by nature at such a pivotal time. I started to feel sad as it became clearer that I was heading for induction but I turned back to my online birth prep course to remind myself what the process would be like and it included advice that stuck with me - it’s easy to feel disappointed and like control has been taken away from you when you have to have an induction but you don’t have to do anything, you’re not being forced, you’re making a choice based on what’s in the best interests of your baby. It’s the first chance you get to do that for them.
I have known other neurodivergent people or people with anxiety who’ve had elective c-sections so they can plan and minimise the uncertainty. Having a time that I needed to rock up for induction, I can now see the benefits! There was no waiting to have exactly the right contraction frequency, being sent home by triage for not being dilated enough, or frantic journey to hospital in active labour. We went in at the time we’d planned, stopped at Sainsburys for snacks and fluffy socks, and knew she’d be with us soon.
I was on antenatal ward for less than an hour before a kind midwife took me down to delivery suite and left us with the words “this is the room where you’ll meet your baby”! Delivery suite wasn’t horrible but it wasn’t like the birth center with its big, nicely painted rooms and twinkly lights and aromatherapy - it was a small room with a bed, resuscitaire and armchair, and weirdly yellow lighting. Because of this I was really glad to have made a robust birth plan and studied hypnobirthing a bit- we had a few easy bits to make it feel nicer, like our own music to listen to and our own star projector, and we could turn on the gentle resuscitaire lamp instead of the main light to make the space feel more cosy.
Having learnt about the different types of pain relief I’d be offered was invaluable when the induction was underway- you can always change your mind but it’s harder to weigh up the pros and cons in context so I was glad I had a loose plan in place that I could deviate from if needed. I didn’t want pethidine ideally, because not feeling in control can exacerbate my anxiety and I felt I might not be as present if I had it. I did want gas and air, but I knew induction could take a long time and the pain might get worse throughout the day so I wanted something in the bag for later! I was open to epidural but not straight away as I thought it might slow things down. I also knew that with an epidural it can be harder to push at the right times because you can’t feel what’s going on, and I knew getting all the timings right at the end might be harder for me anyway so I kept it as an “only if I need to”. In the end I had paracetamol and codeine to get me to about 6cm (about 5 hours after the drip started) and then gas and air and I wished I’d done it sooner! The type of breathing you need to do with gas and air is different to the up breathing I’d been doin to that point so it did take me a few to get the hang of it - this is okay and not something to be discouraged by. It was worth the effort in the end!
The biggest disadvantage of being dyspraxic turned out to be a lack of faith in my ability to process what was happening with my body. I was on a monitor that picks up both baby’s heartbeat and my contractions and it wasn’t registering all the contractions I was having. In the end I was having long and intense contractions with minimal break which would usually be a clear indicator to turn the drip down a bit. But not all my contractions registered on the monitor so the sister in charge wouldn’t sign off on them dropping my drip again (it had come down a few times throughout the day after the initial ramping up to trigger labour - probably because my body was going into natural labour anyway). In the end the midwife who’d got to know me throughout the day could see that the monitor reading was inaccurate and did it anyway on the sly. A lifesaver because I really didn’t feel I could carry on otherwise! While the debate about dropping the drip was still ongoing I’d asked for an epidural but in reality I was in transition and it was too late. Again I suspected this (I felt like my body was folding in half involuntarily!) but the people around me didn’t agree and I hadn’t felt able to stick up for myself and stand by my instincts about what my body was doing. The poor anaesthetist was trying to run me through the risks of an epidural to facilitate informed consent while I was actively pushing, and eventually he was ushered out by a midwife!
The pushing stage for me only lasted about 40 minutes because baby was having frequent decelerations. This bit could’ve been scary - lots of people in the room and a pull on the emergency buzzer - but I actually felt very focused. Although I wasn’t scared, a lot of people were shouting instructions at me and this was really hard as someone who can hardly tie my laces after 27 years of practice. I abandoned the gas and air to maximise my ability to process information and eventually a confident obstetrician told everybody to stop shouting and gave me clearer instructions. What I hadn’t bargained for was the mind’s ability to tune out all the bustle and drama and focus only on me and my baby. It’s truly amazing! I had a big episiotomy and an injection to numb the area first and I imagine if you had this by itself it would be excruciating. But in the context of just wanting to bring my baby into the world I hardly noticed it happening. Even when my baby was lifted up purplish and not crying and had to be rubbed and blown on by a couple of members of staff before she’d breathe, I didn’t panic. I felt like she and I were completely in synch and would figure it out together and I had total faith in the team working with us. Maisie Indigo Forest had arrived.
After the birth I had to let go of a lot of my expectations. I’d wanted a natural third stage and an hour of skin to skin and ideally some time just the three of us but it didn’t happen that way. I was bleeding a lot, there was another buzzer pull, I had to have a lot of stitches and couldn’t hold her for more than a couple of minutes before she was taken and people got to work on me. Again, having plans for every eventuality and having discussed with my partner what we both wanted was helpful. He took his shirt off and she had an hour of skin to skin with him and then we prioritised holding her on my breast to establish feeding as fast as possible when I had her back. I couldn’t really understand what latching was supposed to feel like and I didn't feel very confident with feeding but I’d found out in advance what services I could contact about this and we were successful with a bit of practice.
When I was pregnant, me and my partner talked a lot about having a positive mindset and aiming for a positive birth experience. We were constantly spoken to like we were naive, often by people who didn’t even have their own babies - “it doesn’t always go the way you want you know”, “unfortunately you can’t really control what your birth is like”, “lots of people think that and think they’ve got a plan but you’re in for a shock when it happens”! In reality - and I can not stress this enough - they can do one. Tune them out. Having a positive birth experience isn’t about getting to have fairy lights and a pool and everything you wanted, it’s about making choices where you can make them, and being open to the wide variety of things that might happen so that you can feel positive whatever ends up happening. I could look at my birth in terms of massive cannulas, yellow lighting, continuous monitoring, scary decelerations and an enormous cut on my vagina, but I don’t see it that way. I remember the music we listened to, watching my projector, the jokes shared with the midwives while high on gas and air, and the incredible feeling of holding baby Maisie in my arms for the first time. Having a birth plan wasn’t a waste of time even though plan A wasn’t meant to be. It meant I felt as in control as I could and me and my husband were on the same page throughout, knowing what we wanted even in a non ideal situation.
If I did it again, I’d be even more assertive and I’d encourage every neurodivergent person to prepare to do the same. It’s common that people don’t understand the way we communicate or express pain, that they downplay what we’re saying is our experience, that they make us feel that we can’t make choices, but we can and we must. Trust your instincts and your body and your gut, and hopefully you can have an amazing time meeting your baby.
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