The minute that never happened

Does birth order matter?  Are you the oldest? The youngest? Or somewhere in the middle?

And what about the age gap?  Is it a year that separates you from your siblings? Or ten?

How much do those two facts make us who we are?  How much do they inform our personalities, our status within the family, our lives?

Is L who L is (and am I who I am when I parent her) because she's the eldest?  Because she was nineteen months old when she stopped being an only child?

Am I who I am when I parent her (and when I don't) because I'm the eldest too?  Because I was two and a quarter when I stopped being an only child?

And if that order and that gap matter, what about when the gap is only a minute?  Does it matter who's the elder then?

What about these two?  Who's the younger here?

One of these pictures was taken at 10.10 am on Thursday 11 December 2008; the other at 10.11.

They may, or may not, be in the right order.

I know who's who.  I know who's older.  I know who's the "big (and little) sister".  They, as far as I am aware, don't.

Should they?

My father is nearly 71.  He is ten minutes older than his brother.  As a fraction of their age, that difference is *reaches for calculator and one remaining brain cell* 0.000019 (I think).

Does it matter?  Oh yes.  You hear them, on the telephone across the Irish Sea, bickering like my three year olds.  And the clinching argument? 

I'm the oldest.

Here's a fact.  My girls were born by c-section.   In theory, therefore, the surgeon could have just grabbed the nearest one.  Birth order set by convenience.  But she didn't.  They don't. They go, deliberately and by choice, for "Twin A".  The lead twin.  The one whose head, unchanging (I am told) from your earliest scans, is nearer the cervix.  The one who would have come first however they were born.

You can say it doesn't matter.  But if that's true, why do they go to that trouble? It's not as though we've got a title to inherit...
 
So should we tell A and S?  It's not a big secret.  It can't be. It's on their birth certificate, as it is legally required to be. (In England.  In Scotland time of birth is on the birth certificate for everyone.).

They will find out, anyway.  Either when they see their birth certificates or because someone (probably L, and no, I don't know how she knows, will tell them).  And at first, I wasn't that bothered.  I felt it was just a fact, and not one to get het up about.  But as they have got older and as they continue to jostle for position, to find a level with each other and in the family, I find I don't want to give them a fixed hierarchy, an immutable fact that makes one, whichever one, "better" or "worse".

I find, now, that if adults ask, which, occasionally, they do, I bristle.  Why does it matter? I want to say,   although what I actually say is mumble or Oh! Look! A thing!   But I find myself increasingly reluctant to answer, which I would have done, and did, quite happily when they were tiny.

My brother and sister-in-law, who also have twins, claim they can't remember who was born first.  Now clearly that's nonsense (it's on their birth certificates too, after all), but I wonder whether it's not actually quite a good line to take.

Age gap?  I will say. What age gap?  You were born at the same time.  You're twins.  That's what twins are.

And when the biological confusion that will create all gets too much I will tell them that in France they (apparently) say that the second twin to be born is the elder.  After all, he or she must have gone in first...



 

What would you do if your anaesthetic didn't work?

Rhetorical question surely?  Of course anaesthetics work.  That's the point.

Well no. They, specifically epidurals and spinal blocks, don't always.  And they didn't for my friend S when she was having her second baby by caesarian section.  She is not alone and she believes that this may be due, at least in part, to the protocol and questions used as standard in the NHS.  S's story, in her own words, is below, but suffice to say, she is taking an experience so horrendous it never occurred to me it could be possible, and campaigning to ensure it doesn't happen to any other woman again.

She's starting with an anonymous survey, to gauge women's experiences of epidurals and spinal blocks and please, please, if you had either, whether for a c-section or vaginal delivery and even if you read no more of this post, click here to complete the survey.  It'll only take two minutes.

And if you can spare another minute after that, please email the survey or this post on to more women.  Your responses really could help.

Thank you.

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"I had to have a c-section for placenta praevia. I had a consultant anaesthetist who put the epidural in and was VERY confident it was in the right place. However, the anaesthetic worked on my motor nerves so I couldn't move, but did not work on my sensory nerves so I could feel. The test the anaesthetist was using to check what I could feel involved spraying alcohol onto my skin and saying 'Can you feel that as cold? You may be able to feel the sensation of fluid on your skin but can you feel it being cold?' I definitely could feel but found it really hard to distinguish between the sensation of the fluid on my skin and cold. I stalled and stalled but eventually the weight of expectation that it would be working and the number of people waiting got to me and so I said I supposed I must be only feeling fluid not cold... Which was a bad thing to do because the first incision felt like I was a bean bag being opened and it got worse from there. They stopped the operation 3 times, topped me up with seriously potent painkillers intravenously and gave me gas and air - the last was surprisingly effective but maybe that's because I was out of my mind with pain and just needed to be totally out of my mind. I stuck it out to see my baby boy born but then had to have a general because the pain was indescribable. 

In all it was a really traumatic experience and then it was compounded by nobody being told on the ward, and my GP and community midwife not even knowing I'd had a general anaesthetic - so I left an operating theatre after a horrific operation to zero support. Thankfully when, after 10 months, I told my GP that I was still having flashbacks and wondered whether I could have PTSD, she was brilliant - which was just as well because initially the hospital maintained that I had been 'conscious and comfortable' when my baby was born. But while I could push for more than an apology (which I did eventually get) it's only ever going to be a hollow victory because it doesn't change a thing. 

I started thinking about why I let it happen - and kept coming back to that one odd question. Talking to others I've realised that it wasn't me not knowing my own body and mind but that lots of people have found that same question very hard to answer - which made me wonder whether a better question could be used. I was put in touch with a very senior obstetric anaesthetist in the States who told me that he would never use cold and would only test using pin pricks - and that's what he teaches his students to do. 

So I've set up a survey (which respondents do anonymously) to gauge as much as I can in 10 questions about women's experiences of epidurals: whether they've felt under pressure, whether they could distinguish between sensations on their skin, whether they needed further pain relief after the epidural was administered , whether their GP was well informed and whether their experience put them off having more children. And now I need as many mothers as possible to complete the survey."

Soundtrack to our Son.

Did you give birth to music?

I flatly refused the first time. B was keen on the idea. He would be. He likes a constant backdrop of anything from Charles Ives to Charles Aznavour, but I know myself and I realised that in the stress and pain of labour, the wrong song could be fatal to my irritation levels, and there was then a distinct possibility that the cd player might end up being used as an offensive weapon.

So L was born only to the melodious tones of her mother's voice.  Apparently I swore. A lot.

When it came to A and S though, we were firmly told by the surgeon that we really ought to bring in a cd, as otherwise our daughters would be born to magic fm.   Now I don't want to be rude about magic fm which has, after all, brought me hours of cheesy listening pleasure, but it is certainly true to say that it has the shortest playlist of any radio station I've ever listened to and Celine Dion is always on it.  Even I wasn't prepared to have the girls' first auditory experience of the outside world be that horrendous.

So B made a playlist.  Weeks of thought went into it, culminating a heated debate of the irrational sort that only a woman 35-weeks pregnant with twins can achieve.  B wanted the Killers.  I refused to have my babies born to the line, "Are we human?"   I still maintain it was the right decision. The first song ended up being Here come the girls (Ernie K Doe, not the Sugababes, although EMI have taken it off YouTube so I can't link to it, sorry), which gave the anaesthetist the giggles, (not such a good thing given he was waving a large needle at my spine at the time) and they were actually born to Aretha (sorry Celine....)

Two and a bit years later, here we are again.  And if baby T* has turned, which we will find out on Friday, then silence and swearing will once again hold sway. But if he hasn't, he'll be coming out of the sunroof, and, on the basis that  Radio Borders is not much better than magic, we'll need a soundtrack.  So far, it goes something like this...

Here comes the "sun"
He ain't heavy, he's my brother
Baby love
Boys, boys, boys (although actually I've just listened to it for the first time since about 1986 and it's awful, so maybe not.  You have been warned).
Mad about the boy

And maybe, optimistically, a new dawn, a new day, a new life... Feeling Good.


My gut instinct (which isn't really in my gut so much as kicking at my ribs) is that he has turned, and so the chances are this list will never be required, but in the meantime I'm going to have fun adding to it...

*T.  To follow on from L, A and S.

My baby is upside down (or should that be the right way up?)

I've got the title of a draft post sitting waiting.  It's called "Too posh to push, or too nice to slice?" and in it I was going to wonder about how this next baby is going to make his appearance into the world.

I've got form for both, after all.

L was born vaginally*, without drugs, intervention or tearing, at 41 weeks and 4 days, after about seven hours of labour (although I've never actually worked out when you start counting from, so it might be more (or less) than that).  B and I were alone for most of it, which I know some women would have hated, but which felt right, and in fact the midwife wasn't in the room until L started crowning, and I panicked (having totally, despite both NHS and NCT ante-natal classes, not at all realised that what I was doing was pushing, and also somehow forgotten that the whole point of the exercise was to get the baby out) and pressed the call button.  She was born, with me on my feet, about two pushes later.  We were home in less than twelve hours.

S and A, on the other hand, were a planned c-section at 36 weeks.  I realise this isn't the norm at all hospitals, but where we were we were flatly told that this was the safest for our babies, due to the added risks of delivering twins with a shared placenta.  I wasn't enormously keen on the idea at first, particularly given the good experience I had with L and the quick recovery, and the fact that I knew it was possible, as my sister-in-law had delivered her girls (also with a shared placenta) vaginally (although she did give herself two black eyes, she pushed so hard), but when the third consultant tells you that yes, they really do think this is the right thing, we went with it.

It was utterly different and equally wonderful.  It was the day after my mum's birthday, so she and my dad came up the night before and cooked us a meal.  We had a glass of champagne and an early night and at 7 a.m. the next morning, with a kiss at L's door as we went past, we headed off to the hospital.  The scariest bit was the epidural, but otherwise I felt nothing worse than as though I was being poked through a very thick blanket.  The girls were born within a minute of each other, and came out screaming. I fed them both in theatre, possibly in specific defiance of the doula who had told me, when I enquired about her helping us after their arrival, that if I had a c-section not only would I not bond with them, but I'd also never be able to breast feed.  On the advice of friends I refused the codeine based painkillers (apparently the resulting constipation is worse than labour) and was up and about the same day, and out of hospital two days after that, although with strict instructions (vociferously enforced by my husband and father-in-law) not to drive or pick up anything heavier than the babies for six weeks.

I am, obviously, incredibly lucky to have had two such great experiences, but when thinking about what I wanted to happen this time (having had a previous c-section, they had assumed I might prefer another), I realised that the practicalities of another operation have to, for me, make aiming for another vaginal delivery the preferred option.  If I can't lift anything heavier than the baby, how am I going to get S and A out of their cots, or into the swings at the park, or push all four of them up to the nursery?  If I can't drive, now that we are no longer within easy reach of public transport, how are we going to get anywhere?  We'd cope, I'm sure we'd cope, but it'd be tricky.

So we'd decided.  We would hope, realising again how lucky we were, for a repeat of L's arrival.  This all depends of course, on the position of my scar.  So we had it checked out:  looks fine, we'll check again at 30 weeks.  Then we were told that the placenta was low:  it'll probably move, we'll check again at 30 weeks.

I'm now (nearly, the consultant is on holiday next week) 30 weeks.  The scar is fine.  The placenta has moved.

But the baby is breech.

They won't try to turn him externally because of the scar (much to my relief, as I've heard lots of anecdotal evidence about how much it hurts and none at all about how it works), and they certainly won't let me try a vaginal delivery for the same reason.

So we're left with waiting, and hoping he'll turn over of his own accord, and me spending a lot of time on all fours wiggling my bottom.  Which if nothing else is amusing B.

But the irritating thing of course, is that I can't stop thinking about it.  Every time I feel a kick or a movement, I'm trying to work out what it is that's poking at me, and to extrapolate from that which way up he is.  And, again of course, it's perfectly possible that at 30 weeks L was also breech, we just never knew.

So we wait.  And wiggle.  And do anything else that anyone else thinks will work....?



*I realise that's quite an in your face sort of word, but I just don't like the implication in saying "natural", that there's something "unnatural" about the way that S and A arrived.  Sorry.

Oh, and I know I've posted that picture of A's arrival several times before, but I just think it's awesome.

Why are more women "choosing" caesarian sections?

Yet another piece in another national newspaper today about "birth choices" and why women are, or aren't, giving birth in accordance with whatever the latest guru/bit of research/NHS funding report says.

And, actually, this time this one didn't really irritate too much. Mostly because Joanna Kavenna, a mother of two herself, acknowledges that each woman's "choice" is personal to her, and based on her history, both medical and emotional, the circumstances she finds herself in, the size and position of her baby and a million other factors, over most of which she has absolutely no control.

But she did get me swearing at this:

Now it seems we have lost confidence in our ability to give birth naturally: today one in four babies is born by caesarean, up from one in 10 in 1990"

Why, why, why, why, why, can't she and any of the other hundreds of people who opine on this subject not see what seems so perfectly obvious to me: this isn't about our confidence in ourselves; women don't choose to have caesarians.  The medical profession chooses for you. Women simply, in the main, do what they are told is best for them and their baby.

Look around at your friends and relations. I bet lots of them will have had, or their partners will have had, caesarians. How many of them actually, prior to the birth of their first baby, decided, with no medical requirement to do so, to have a caesarian?  One?  None?

How many of them, rather, after a 24, or 36, or 58-hour labour, exhausted and frightened, were medically advised that it was necessary; or were told their baby was breech and the hospital didn't have enough midwives with the necessary expertise to deliver a breech baby; or they were (like me) having identical twins and were informed (although it turns out this isn't the policy at all hospitals) that the risks to mother and babies meant a caesarian was the safest option? Pretty much all of them, I suspect.

So why do we say this is about maternal choice?  Why do we use words like "elective" caesarian, when what we mean is "planned" or "medically advised", or even "had an absolutely horrendous time last time, culminating in an emergency operation, followed by weeks of painful recovery, and is understandably terrified to go through it again"? Why does the media label four in ten British women "too posh to push"?

Now, I accept that there may be women who really do have the mythical tummy tuck at the same time, or want to time their birth so it fits in with the release of their latest fitness DVD or whatever, but I don't know any of them, and I'd be pretty surprised if they make up even a thousandth of a percent of the many, many women who have caesarians, on medical advice, and against what they had originally hoped for in this country every year.


So can we please, please, stop beating women up about this?  Why can't we accept that any delivery that results in a healthy mother and healthy baby (or babies) is a successful delivery, whether it costs the NHS more or less and whether it is the one we planned or not?