Friday, 26 October 2012

Decisions. Part 2 - Time to Decide


Firstly a quick apology, I'm now on maternity leave and had been intending to update this blog a lot more. Unfortunately I've so far spent much of my leave waiting around at the hospital for routine tests, in bed with colds or dealing with a three year old with a vomiting bug! Fingers crossed that's all done now and of course I'll have loads of spare time once the baby arrives (hahahahaha...)

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I'm now 36 weeks pregnant, sadly neonatal teleportation still doesn't seem to be on offer on the NHS so at my Obstetricians appointment on Wednesday it was time to make the decision; try again for a vaginal birth (VBAC) or plan an elective caesarean*.

I've been thinking about this ever since E was born, at the time I was desperately disappointed and utterly shocked to have had an emergency C-section. In the bubble of middle-class London mums with ante-natal yoga, parent blogging and NCT groups, childbirth isn't just something that must be endured to bring your baby into the world, it's supposed to be a life enhancing, "empowering" experience with bonus points if you home birth with no pain relief and minimal medical assistance. C-sections, even emergency ones, can be looked on with suspicion. They are an easy option, or an "unnecaesarean" caused by mothers too weak to stand up to doctors who are terrified of being sued, desperate to do some exciting choppy surgery stuff or just in a rush to get to the golf course. My NCT teacher made it quite clear that my surgery meant I had failed the course exam.

So before I was pregnant again I was sure I would try for a VBAC, re-sit the test and see if I could get a pass mark this time. The first 24 hours of my last labour were really fine, sure it hurt but had E been smaller and in a good position I'm pretty sure I would have got her out without much medical intervention.

But then we got that little pink line, it all started to become real again and I changed my mind.

So on Wednesday I went to the hospital and booked myself in for an elective caesarean. Here's why:

Yes a successful VBAC should mean an easier recovery, I could perhaps even lay a few demons to rest by finally joining the "wonderful birth experience" alumni, but the problem with the term "successful VBAC" is the "successful" bit and that is far from guaranteed . I'm told recovery from vaginal birth is generally better than from surgery but I know from experience that recovering from both labour and surgery is, frankly, horrendous. If I'm honest I am now a bit afraid of childbirth and of the pain involved (which I wasn't last time), but both of those are passing, what really terrifies me is feeling as physically and emotionally shocked, exhausted and broken as I did after E was born, but this time with two children to look after. The only way to be sure to avoid that is to opt for an elective caesarean, rather than risk an emergency one.

Statistically an elective C-section is a tiny little bit safer, and a small part of me does worry that, although things went badly last time they could have been far worse - what if this babys head makes it through but it's shoulders get stuck? What if my scar ruptures? All very very unlikely but I still struggle to believe my luck that we both survived last time, that I have a healthy child and another well on it's way. Even in our western world of modern medicine I know those who haven't been that fortunate, who am I to risk it all, even with the odds on my side?

Finally, it looks like that much aspired to natural birth wouldn't really be an option anyway, to make a VBAC as safe as possible I'd have to be on a bed strapped to a monitor with an antibiotic drip in my arm (I tested positive for group B strep). The movement and water pool that helped so much in the early stages last time wouldn't be an option and without them I suspect I'll be reaching for the drugs far quicker.

So there it is, after swinging back and forth on this for years I've made a decision, signed a form and I'm happy with it. I'll never have that natural child birth experience**, and I will always be a bit sad about that. But what I can do is get my second baby safely into this world, with me in a fit state to care for him/her and that is an experience that millions of women across the world, throughout human history and even today can never have. So people can call me too posh to push if they like, I don't care, the baby is more important than how it arrives.

SB

PS. Of course sods law dictates that this baby will now turn up early. If I go into labour before the C-section I'll just have to decide what to do on the day as there are too many variables to make that choice in advance.


* I'm lucky enough to have been given a free choice by the hospital. It's often thought that once you've had one C-section all subsequent deliveries must be surgical, but modern techniques mean this isn't the case and in fact at the hospital where E was born the policy is to insist women try a VBAC. This is similar to many maternity units in the UK where the ceaserean rate is monitored, with targets to reduce it. In other country's especially the USA repeat C-sections are the default and it can be very hard to find any doctors willing to be involved in a VBAC because of the fear of litigation if anything goes wrong.

**Even if we were to have more children, after two C-sections the risk of scare rupture is much higher in subsequent labours, so the hospital have warned that they would be very anti- VBAC in that situation.

Friday, 5 October 2012

London Schooling - Educating E





I don't want to write this blog post.

I want to put my fingers in my ears and shout LaLaLaLaLa until it all goes away (I appreciate this isn't a very mature response).
 
My little girl only had her third birthday two months ago, but two months ago it was August so we must now start the process of "choosing" which school she will be starting in less than a year.

Despite being summer born, it's very unlikely that she'll be the smallest kid in her year and I'm fairly happy that she'll be ready for it. I'm just not sure that I will!

But emotional trauma aside, the process of choosing a school is far from simple. As a friend pointed out on facebook "this is the advantage of living in a village". That should perhaps be followed by "with a good school" but of course that sort of thing can be planned (and paid for) when moving to said village. Those of us still in the big smoke face a bit more of a challenge. Even though London schools are now rated the best in the country you can never guarantee you'll get into the one you want. There are 17 state primary schools within a 1 mile radius of our house, this isn't because we planned to move to an educational hotspot, it's just like that in London, there are lots of schools and lots of kids and our chances of getting into all but perhaps two of the 17 are very small indeed.

So here's how the admissions procedure plays out in Southwark:
1- Parents put down up to six schools in order of preference
2-The schools (who don't know preferences) rank every child who applies according to their admissions criteria*
3-The council put these two lists together and then:
  • If your number 1 school has 30 places and ranks you number 29 you get in there. 
  • If it ranks you 31 and your second choice school (also with 30 places) ranks you 29, you get the second choice school. 
  • Unless four kids at the first choice school already got places somewhere else, then you get       bumped back up to 27 there and get the first choice again, and so on down the list. 
  • If you don't get a place at any of your chosen schools you are assigned to somewhere else in the borough, or if you're really unlucky, you're not put anywhere at all.
4- Parents are informed of the school they have been allocated
5- Parents have a massive panic, followed by a jolly good moan about how unfair it all is on the East Dulwich Forum
6- Parents accept offers, reject offers, join waiting lists at other schools, go private, shout at local councillors, move house, move out of London, set up home schools, set up free schools, moan about it again on the EDF, slay a dragon and win the tri-wizard tournament.
7- Somehow, most kids end up with a school, somewhere.

Oh and then there is the wild card - the bulge class.

There aren't actually enough permanent primary school places in Southwark for the number of children who want them. So each year the council pick a few schools to take extra kids. This means a one form entry school that normally takes 30 kids, suddenly takes 45 or 60, just for one year.

Good news if you wanted to get into that school but live just too far away, less good if you'd paid a 70k premium to live opposite the gates of the lovely primary with the big playground, only to find that playground now full of portacabins. Or worse still, that you now can't get a place at all because the bulge was two years ago, and with only the normal 30 slots available this year, they've all gone to siblings of the bulge class.

Phew - does that all make sense? I'm not entirely sure it does, but as of this morning we are part of the process, we attended our first school open day. It was one of the two we stand a good chance of getting into and it seemed nice but how to tell? I've not been in a primary school since I was a pupil at one. This place has computers and interactive whiteboards, every child learns to play an instrument and the lunch menu contains actual fruit. It's very different from the tinned spag bol and one slightly prone to exploding BBC computer of my old primary, but as this is the first place we've seen I have no idea if what looks flashy and new to me is actually standard issue these days, and that's before we  get onto mind-boggling things like what system they use to teach phonics, their value added score or latest Key stage 2 results. Gah!

But we still have seven more schools to look at before we make our list and fortunately my husband does know all about white boards and phonics and er stuff and isn't afraid to corner an unsuspecting head teacher in the corridor and quiz her about them (at least if today is anything to go by).

So perhaps I could just stick my fingers in my ears and leave it all up to him instead? Maybe? Just a little bit?

SB

*Admissions criteria can vary between schools but generally first priority goes to children with statements of special needs, then those in care, then siblings of children already at the school. After that the faith schools can chuck in their religious quota then in goes on distance. In most places, including Southwark, catchment areas don't exist, it's normally straight line distance to your house and the furthest away child that gets in can vary a lot year to year.  Last year for one local school the furthest away child lived 191 meters from the school gate.