Moral support for second timer please - Long sorry.

[Cooperoo]

Hello
I would appreciate any reassurance/advice that you can give me. I am 31 weeks pregnant now. I live in Cyprus as DH is in the services. There is a military hospital here that I would normally be delivering in but they have closed it for births because the theatres are temporarily out of action. As such I am booked to deliver at a Cypriot hospital in Limassol. I am finding this quite scary as our UK midwives are understandably not allowed to accompany us when we are in the hospital (they take us there and ensure a good handover and visit us after so are doing as much as they can) and so my care will be with someone who is likely to have English as a second language (albeit probably very good). This is actually not my greatest upset. That is the lack of pain relief. The only form they offer is pethadine. No gas and air (or epidurals). DD was a very straight forward water birth at hospital using gas and air. I wanted a home birth this time but this is not an option here and I am quite scared of trying to have a baby without any pain relief as I do not see pethadine as an alternative to gas and air (completely different thing IMO) and having managed without it last time I don't want it this time. How confident can I be that this labour will be quicker than last time? I want to stay at home for as long as poss as I believe I will be more comfortable at home without pain relief than in a strange environment at the hospital. How sensible do you think this is? The horror stories we initally heard about routine shaving, enemas and episiotomies are not true for us (although I believe some Cypriot first time mums have all of the above according to one of the midwives) as the Cypriots have been brilliant in accomodating us Brits and our 'cultural differences', but I am still worried. Am I being irrational? Will I really mind once the baby is here? I obviously don't want to take any risks with my health and esp with the baby. What happens if I leave it too late? (Unlikely I know). Anyway enough rambling. I hope that someone can give me some constructive comments. I know everything will be OK but having had such a lucky positive experience with my dd I want the same again, not to be scared and paranoid about where I am going and what may happen, I don't want to be just 'OK'. I just feel that all my choices/options have been taken away. .
Any help gratefully received.
P.S. I am off to bed now (it is 2230 here) just to let you know I am not ignoring you if you do post!

Can you discuss with your English midwife what would happen if you 'accidentally' stayed at home for too long and ended up giving birth there? Do you live far from the hospital where you are due to give birth - could you get there quite quickly if you had to? Presumably you can have someone with you at the birth - it's a long shot but what about finding a birth partner who can speak both languages and can make it clear to your carers what you will and will not accept if/when in hospital - surely they can't make you do anything you don't want to do.

I'm really sorry you're faced with all this worry - it's the last thing you need. But you still have time to get straight in your own mind how you want the birth to be and to make sure those around you know how you feel. FWIW my second time was much more straight forward than the first (and I was also in a country where I didn't speak the language). I'm not sure this is really any help, but I hope someone will be along soon with some sensible advice for you

Thank you Franke. Your post certainly has helped especially when you say your second time was more straightforward and that your were in a country where the language wasn't your native tongue too. I am sure that they wouldn't do anything I don't want them to but DH and I are feeling a bit of pressure to be on the offensive watching everything rather than trying to relax and get on with things IYSWIM. There have been plenty of good stories to come out of the hospitals praising the staff and care received but I am a bit cynical as all of the ladies I have heard from are first time mums and so have no UK experience to compare it too. Perhaps I was just spoilt last time. I feel the pressure to get home as soon as possible too as the after care is very different too with nursery style care for the babies away from the mothers which again is something we aren't used too. It has been described as the UK 20-30 years ago. .
I do know that everyone is making every effort to make things nice for us but.....
I will speak to my m/w about what they would do if I 'left it too late'. The hospital on camp is five mins away and still has staff on call for emergencies. The Cypriot hospital is 20 mins away. I do beleive the language will not be a huge problem as the majority of Cypriots do speak very good English, we have just been warned that they may seem 'brusque because of the language barrier. Thanks again

Hi cooperoo, I had 2 of my 3 children in Greece and things (then) 1990 1994 were very different from the UK. Especially as you mention pain relief and definitely the after care. I don't know how similar Cyprus maternity care is to Greek maternity care, for instance here all deliveries are done by your obstetrician. If thats the same in Cyprus then i would suggest that first off you get an appointment with him/her to go over what happens there and what you would prefer. Can you have someone in with you - here you used to have to fight to have dh or a birth partner with you during the birth.Here after the birth the babies are in the nursery especially at night and between midnight and 6.oo am they did not bring baby to mum for feeding but gave sugar-water from a bottle so thats something I would definitely check out too. I would have thought though that Cyprus with its strong Brtish connections might not be so dogmatic on those things as they are in Greece.

Glad my babbling was of some help. I don't want to labour the point (ho ho) but I think if you are absolutely clear now about what you would and would not accept it will make any battles in the hospital much easier. For example, I didn't want them to insert a cannula (sp.) as soon as I arrived at hospital. My husband was well aware of this so I said no to the doctor once and got on with the business of being in labour, my husband carried on the discussion with my doctor without me having to be involved.

Also, even though my second was a vbac, the birth was so straight forward that we left the hospital afterwards within a few hours. Even if you have to stay a bit longer for whatever reason, I can't see that they could force you to be separted from your baby for a second. Just make sure your husband is aware of all your concerns and galvanise him to have your discussions for you. I'm sure they'll be really lovely and reasonable, particularly since you've already got one birth under your belt. You sound like you have complete confidence in the ability of your body to birth your baby and I'm sure your carers will realise this. Agree also that you should maybe try to meet the team beforehand.

This thread about second births might help.

hi cooperoo

just a quick thought, i know your midwifes from the base can't 'work' at the crypriat(SP) hospital but is there any reason why one can't be your extra birth partner? She would be able to 'help' at the birth in the same way as a doula or your DH but able to give you that extra control/relaxation you want.

I think most people who have a straightforward second birth in the UK leave hospital after a few hours anyway so that would probably be your best option. My hospital was 3/4 hour drive away when I had DS and so it doesn't seem too bad - 20 mins.

My second birth (at home) was much more straight forward than my first. Although I had gas and air - it was only for about 5 minutes while I pushed DD out so could probably have managed without it. Have you considered hiring/buying a tens machine for pain relief? You could start with this at home and use it in the car and at the hospital. They are available over the internet.

Thank you for your posts and thank you esp for that link. That was really interesting and quite reassuring too. I am confident in my body being able to birth this baby (thankfully) although I am nervous how I will cope without the water and gas and air that I had last time.
GRMUM - Your experiences in Greece do sound very similar. Initially they were not letting the husbands in but this issue (and many others) has been overcome and indeed I have now heard that the Cypriot dads are being offered the option to stay with the mum to be. Not many are taking the offer up though as there is a huge cultural difference in this respect. So you can see that great inroads have been made and I am very pleased that I am not one of the first to have to birth at the Cypriot hospital. (The problem has been ongoing since the beginning of the year).
Kat - I initially thought the UK m/w would stay with us but understandably it places them in an impossible position professionally.
Bozza - I agree 20 mins is not bad but the 20 min journey to the hosp in the UK last time felt like the worst part of my labour, lying across the back seat getting thrown around and it does seem a long time compared with the 5 mins to the military hosp though. I am reassured that you didn't really feel the need for the gas and aor the second time round.
Franke - I think you are right that I need to make absolutely certain that DH knows exactly what I want and don't want and is aware that it will be he fighting my corner.
I know with my rational head on that it will all be OK but with my emotional head I am finding it a bit upsetting that I am going to be worried and on the defensive... and not have any of my choices for a best case scenario.
I actually wrote a letter to the head of the hospital arguing that for 'low risk' mums like me we shouldn't need to go to the Cypriot hospital as we shouldn't need a theatre anyway and that in the UK I would be opting for a home birth. He wrote back a very nice letter but suffice to say was not prepared to accept my suggestion .
I think they are organising hospital tours so I will make sure I go on one of those and I will try and get a tens machine too although last time I had no back labour at all so I am not sure how useful I will find this.
I am aiming to get home as soon as possible back to the care of our community midwives but do feel the pressure to do this because of where I may be delivering. Thanks again for all your constructive comments. I think even just typing it all out is helping me...

Cooperoo - I do know how you feel about the journey. It was rush hour when we went to the hospital with DS and it was definitely the worst part of my labour. And part of my reason for having DD at home. So I am more sympathetic than I sounded.

Could you try and have a bath at home/hospital to see if it helps at all. Also think about labour positions. I gave birth to DD stood at the side of the bed and I think that really helped but sounds like the standard legs in stirrups might be more the norm in the hospital.

Thanks Bozza. I knew what you were getting at and know I am fortunate in lots of other ways. My antenatal care for example is very thorough. You have all given me good ideas and I think the best policy is to be informed. Hopefully I will feel better about the whole thing when I have seen the hospital and had some of my questions answered. Thanks again.

Keep us posted about how you're getting on. I was thinking about you yesterady - I know exactly how daunting it is to be faced with giving birth abroad, but it can also be quite empowering (hate that word but can't think of another). I'm sure I was considered a difficult 'patient', although I wasn't outright rude or aggressive; I just wasn't playing the game their way because I knew it wasn't completely necessary (and actually there were only a couple of things I didn't go along with). You are the last person who will put your baby or yourself at risk, but you are also a grown up who doesn't have to accept hospital protocols if you know they are merely there for the hospital's convenience rather than your own comfort and safety.

I'm probably sounding a bit bolshy. I'm absolutely not suggesting going into the situation all guns blazing. My biggest fear was not being listened to but I now know if you go in well-informed and reasonable you will be listened to and you will get the birth you want, and you will probably meet some excellent carers along the way. Right, I'll climb down off the soapbax now and shut up because I'm even beginning to bore myself . Let us know how it all goes.

I know we're all different, but my first was a water birth with gas and air, and my second was a (much shorter) homebirth in water with no gas and air at all. The pain relief issue may not be such a major one in the event.

Franke - Thanks again for your post. Where in the world are you?? You have certainly given me some confidence and like most things I think I imagine the worst case scenario so hopefully the actual event will be better. Fingers crossed.
Purpleturtle - Thank you for sharing your experience too. I do feel reassured that alot of people do seem to be more incontrol/able to cope the second time round.

I'm only in Germany but since I didn't speak German I might as well have been in the middle of nowhere. We didn't have a clue about how the system worked here for pregnancy and I was 37 weeks by the time I got a midwife sorted (my last antenatal appt had been in the UK at 22 weeks).

Just referring back to your initial post, routine shaving and enemas were stated to be unnecessary interventions by the World Health Org. nearly 10 years ago. They produced a long document called Care in Normal Birth in 1996 which I found quite useful, it is quite a long read though. I'll post a link if you're interested.

Thank you for the offer Franke but I am confident that this will not be an issue as I think it is one that the midwives have overcome and I will certanly not allow it to happen to me.
I think many things are actually more British here than in Germany anyway. Much of the signage and literature is written in Greek and English and I am fairly confident that they will understand me OK. Is your DH/P German then? Did he speak the language?

Yes he's German, but we lived for so long in the UK he was absolutely no help whatsoever in figuring out the health system here. They're quite pro needless intervention here, which you may have gathered I'm not. So it took quite a bit of research and planning beforehand to make sure we weren't given any nasty surprises on the day. Of course it helped that he spoke German during the actual labour and I'll admire him forever for his super-fast translating during the pushing stage

Is there no way you can get your hands on some gas and air....?!?!?!

Mind you, if you coped with just g+a and a waterbirth last time, you are probably much harder than you think and won't find it much of a problem! xx

Cooperoo - if you are planning to stay home as long as possible, would it be an option to buy a "Birth Pool in a Box' and labour in it for as long as you can? My first labour was in hospital with an epidural and my 2nd (4 weeks ago) was at home with a birth pool and gas and air. However, I found that towards the end when the pain was really intense I wasn't using the gas and air effectively anyway so did the last bit without anything. I'm usually the world's biggest wimp when it comes to pain so if I can do then I reckon anyone can!

Franke - Lol about your dh's fast translation. He certainly had an active part to play in your labour! i do admire you and am glad you got the birth you wanted.
MP - I wish I could buy the gas and air myself. It is really odd to me that they don't use it but apparently it is quite a British thing. Lol about being hard. I am certainly not. Last time I feel I was lucky, dd was in a good position etc and so I was able to cope. All being well this second time round will be OK and hopefully quicker.
Bonym - Congratulations on your new baby! Am glad you are able to share a positive second birth story too with quite a difference in pain relief used. Your second time experience sounds like exactly what I wanted this time. I will look at that birthpool in a box thing as we have a UK address we can use to get deliveries out here. Might be just as well off in the bath though.
Thanks again for your posts.