My birth story actually starts at the diagnosis of my Gestational Diabetes (GD) at 27 weeks. I knew from diagnosis my OB wanted me to have an induction. Each appointment I would ask him if we could wait and see what happened and discuss it closer to the time. He would agree but insisted that he thought we would need to induce at 39 weeks as the risk of having a macrosomic (big) baby was high. I had told him from the first appointment that I wanted to hypnobirth and chose him because I had heard he would be supportive of this. At 32 weeks I had an ultrasound to see how the baby was progressing; all measurements were below 50th percentile except for his head which would not affect the need for an induction.
At the 38 week appointment Adam and I gave the OB our birth preferences which he read immediately and said that he did not think any of it would be a problem. He didn’t believe there was anything out of the ordinary on our preferences but that as we knew we were probably going to need to be induced, I said that I wanted to leave it as long as possible. I wanted to see if the natural things I was trying would work (acupuncture, naturopathy, homeopathy, acupressure massage, sex, sitting on birth ball, eating spicy foods, eating pineapple), to which he agreed as my GD was under control with my diet, metformin and insulin. I only put on 2kg in my third trimester. Adam and I both believed that our baby was not big and that he was not in any danger by staying as long as possible without being induced. One of the things on our preferences was that we wanted to discuss any medical interventions prior to them being performed.
We had agreed to an internal at this visit and I had previously discussed my thoughts on a stretch and sweep with the OB which was that I didn’t think it was “natural”, he had disagreed and said he thought it was. During the internal he said I am just going to see if I can stretch things a bit, to which Adam immediately said “is that necessary?” to which the OB said “yes” and proceeded to do it without asking. After he had finished Adam said, ‘this is precisely what we meant when we said we wanted to discuss medical interventions before they happened’. The OB apologised if he had jumped the gun but said that he was just trying to help things along without having to go the full induction. I then said that my concern was that the waters would be ruptured prematurely and then we would be on a timeline of interventions to which he admitted was correct. Adam was very angry and I felt a bit dazed that it had actually happened as well as it being quite painful and me having a lot of bleeding after.
At the 39 week appointment I made a point of saying that I was happy to have an internal but did not want a stretch and sweep, he decided not to do the internal as he said he didn’t see the point if we weren’t going to have any interventions. I said that I would like to give it one week from our appointment to book in the induction which would be 40 weeks + 2 days to give all the other things I was doing as much of a chance as possible to work, he agreed. I continued all my methods of naturally bringing on labour as mentioned above but unfortunately to no avail.
So we went into hospital on the Tuesday night 15/10 to have the gel inserted, baby’s heart rate was monitored for 1 hour and then stayed overnight where nothing happened. We went down to labour suites the following morning and after an examination at 8am my waters were broken by the OB, he then let us wait 3 hours to see if anything would happen naturally before he wanted to start the Syntocinon.
Adam then set up the room with my candles, essential oils, dimmed lighting and starting the hypnobirthing and relaxation cds. I had a few minor surges but nothing earth moving so we agreed to let the midwife start the IV. This was at 11am 16/10.
We had given our midwife our birth preferences first thing when we got there and then later in the day she brought up two of our preferences to discuss them with us. The first was that I wanted no reference to pushing and that I would be doing mother directed breathing/bearing down. She said that she had never heard of any mother who had not “pushed” when having a baby, I didn’t really comment when she said this. The second thing she mentioned was that she had only ever seen a couple of women have a physiological birthing of their placenta (no cord traction, oxytocin injection or manual removal of the placenta) and that they had to sit over the toilet and that it had an increased chance of the mother haemorrhaging. She sounded so sure of herself that I was considering changing my mind but I said we would discuss it when the time came.
Unfortunately due to the GD baby needed to be constantly monitored so I was fitted with a foetal heart monitor and a toca to track any changes in my uterus. They did put a portable one on so that I could move around and not have to lay on the bed but whenever I was comfortable, they could not track the baby’s HR. As the surges became more frequent and intense I was able to close my eyes, go limp and use my hypnobirthing breathing and visualisations of gently rising over the waves at the ocean well but I was not ever able to completely relax and surrender as the midwife kept asking me to move so she could get the baby’s heart rate. So if I was sitting on the birth ball she would ask me to stand up etc, she did wait until I had finished surging but this really impacted on my “zone” for later on.
At about 5.30 pm the midwife did an exam and as we had previously discussed this asked me if I wanted to know how far I was dilated. I said I did as the surges had been getting much more intense and I was finding it difficult to get into a comfortable position. She said I was 5cm which really disheartened me (I know Melissa had said this might happen but I honestly thought things would be further moved along by then). At this stage I said I didn’t know how much longer I could handle the pain (it was radiating into my back and I was exhausted from constantly having to reposition for her to find the baby’s heart rate. She gave me the options and I said I thought I wanted the epidural. Adam (who had been wonderful the whole time, getting me drinks and my homoeopathy tablets and asking people not to talk to me when I was surging, holding the monitor in place so that it would work when I was in a comfortable position etc) reminded me that I had said I didn’t want one in my preferences, we discussed this for a little while with the midwife about what it would entail etc and she suggested we talk to the anaesthetist and make up our minds after that, which we agreed to. At this stage I asked the midwife if she had any other ideas for positions I could try (I had tried sitting on birth ball, sitting on birth ball in the shower, tried over end of bed, laying on my side, walking around, standing and leaning over the bed) she suggested I get on all fours in the shower with a mat and after doing that for a little while she returned and said the anaesthetist was about 1/2 hour away as he was in theatre.
As Adam sat on the shower floor stroking me and trying to calm me through surges I told him that I thought I had let him down when I asked for the epidural. He replied that it was my choice and that his job was to uphold my preferences. All he wanted was for me to be happy so if I was happy to have one then he would support that decision. The only reason he had questioned it was because our conversations during the pregnancy and my preferences for the birth both firmly said “no” to any drugs including epidural. Shortly after I got into the shower I noticed that the surges had changed and I was feeling the urge to push. The midwives were in the middle of a handover for their shift change at this point. Adam later told me that he was worried that the next midwife would be even less helpful than the first at maintaining our preferences and that it would get completely out of hand leading to drugs or emergency caesarean etc. Unfortu
nately at this stage I lost it a little bit and kept asking for the epidural and asking how much longer until it was all over, the anaesthetist had been held up and the midwife kept telling Adam that as they couldn’t get the baby’s heart rate properly in the position I was in that they wanted to do internal monitoring (which is where they put a wire up through the cervix and screw it into the baby’s head), Adam kept saying that I didn’t want this and in a break between surges I asked what they were talking about, he told me and I growled “NO”. The midwife didn’t ask again and now their handover was complete.
Our new midwife Talitha had done the hypnobirthing course with Melissa a few weeks before and had helped her friend as a support person during that birth so knew exactly what to do. Adam spoke to her and said he didn’t know what to do as he was lost. Every time he tried to calm me or help me get through the surges I said that I couldn’t do it or I wanted an epidural. At one stage I even said “just give me the caesar”. I had lost my focus and he didn’t know how to get it back to where we wanted to be. Adam was afraid that he had failed me and that our hypnobirthing had gone out the window. Talitha got down on the floor in front of the shower and when I opened my eyes after a surge, she was there, she looked into my eyes and she said “Hello, I am Talitha, look at me so we can connect. I am your midwife, you are a strong woman and you can do this, keep breathing, you are doing a great job”, she then got into the shower so she could hold the baby’s heart rate monitor, this way I didn’t need to worry about moving so that it would work properly (throughout the labour the heart rate monitor had not worked properly and needed regular battery changes, and now the IV cannula that was in my hand kept occluding while I was on all fours so I had to alternate between this and leaning on my elbows).
Shortly after Talitha had arrived she pulled Adam aside (as our preferences said to talk only to him, the first midwife had failed to maintain this) and told him that the anaesthetist wasn’t far away and that he had been told by the midwifery unit manager to come straight to see us next. Adam said to get a message to him not to come and that he would send for him only if he was truly needed. He believed that the breathing had started to work and that while I was exhausted and in pain I should not be making these decisions as my preferences clearly stated the opposite. He was doing his best to uphold my preferences even if I was asking for something that went against them. He did not tell me about this conversation until the next day.
The OB started sticking his head in around this time. He made eye contact with Adam a few times to say he was happy with the progress or the baby’s HR and occasionally conversed with Talitha quietly away from us in the shower. A few times when I was in pain from the surges or asking for an epidural he said “you can do it Peta, just breathe”. Adam kept telling me to breathe down in the shape of a J and both he and Talitha kept telling me I could do it. Since the transition started every time someone said “you can do it” I said “no I can’t”. After Talitha had come and helped relax me and helped get Adam into the zone with his supportive words she once again said ‘you can do it” and this time I calmly said “I know”. Talitha and Adam mentally high-fived each other at this point, both of them overjoyed at the turnaround.
Talitha and Adam took turns sitting in the shower with their arms between my legs holding the FHM in place as this was a very uncomfortable position and tiring for their arms. Talitha and Adam were both saying supportive words and she would stroke me or rub Adam’s shoulders. She was supportive of both of us and really empowered Adam to get into his zone and help me to hypnobirth the way I had originally wanted. This was a turning point in the labour. Talitha really helped take it from where both of us were completely lost and Adam in near tears every time I was in pain from the surges (he is very protective and gets upset if somebody hurts the people he loves, at this point it was my body hurting itself which made him feel utterly helpless) to well on the road to what we had anticipated.
At about 8.30pm the OB wanted to check how things were going so they managed to convince me with much difficulty to lay on a bean bag on my back in the shower, at this stage I was 10 cm and the OB was concerned that if I delivered in the shower he would not have a lot of room to get underneath if the baby had Shoulder Dystocia (another complication of a big baby). I really didn’t want to move from the shower and I definitely did not want to get on the bed as I had tried several times and several different positions on the bed throughout the day and got off pretty much immediately. I didn’t think I could move as I was exhausted but Adam convinced me that we could do it and that he would help me. Adam all but lifted me from the shower floor and he helped walk me walk to the bed, the OB walking closely behind to help if needed.
I decided to lay on the bed on my back, the same position I had found comfortable in the shower when OB gave me the internal exam. I asked for a hot pack to lay on as the surges were localising pain into my lower back. I think this was mostly due to the bad posture I’d had throughout the labour trying to get comfortable with the monitors strapped to my belly. I then resumed my breathing down with the surges as Talitha and Adam helped me try to get into a relaxed state. Talitha stroked my legs and Adam held my hand and stroked my legs as he chanted the mantra of breathing down as each surge came quicker and more intensely. With each set of surges coming on like waves I struggled to breathe through the most intense ones. My support people grew louder each time this happened to try and guide me back to the hypnobirthing philosophy, I also tried to visualise the opening lotus flower. The labour continued like this for another hour and a half before the head started to crown. The rhythm of surges was steady as my baby made his way through the birth canal. The waves were strong and forceful and only the first in each set of four caused me to lose focus, the other three were breathed down with support of my partner’s words. Each of these surges were bringing my baby closer and closer into joining our world. As each set of waves overtook my body I remembered all of the strong women in my family – my mother, my grandmother, aunts and cousin – who had all been through this before me. And if they could do it, then so could I!
The surges now pushed my baby’s head out further each time and every time Adam told me this I felt better that it was not long now until I could meet my baby. These surges went on for another half an hour and then as I started to harness the first surge in each set, the OB told me to remember to breathe when his head was coming out and out it came. The OB, who had been standing back and waiting until this time slid a finger in to check where the cord was and noticed that my baby’s arm was up near his neck. He suggested that with the next surge I would breathe out the shoulders but as he repositioned the little arm so it wouldn’t get caught, the rest of him came straight out. He didn’t need the next surge.
Adam did not get to receive the baby initially but with lightning reflexes snatched the baby away from the OB and placed him on his mummy’s chest. We welcomed baby Elijah into the world at 10.42pm 16/10/13. He was very alert yet extremely relaxed. He let out one little cry as he was positioned on my skin but did not cry again that night, not even when OB wanted him to by firmly patting him on the bottom of his foot so that he would pink up. The cord was not clamped or cut until Adam was happy that it no longer had a pulse. This was about half an hour later; we continued our skin to skin for a further one hour after this. We discussed physiological birthing of the placenta with OB
and Talitha. OB checked to see if it had separated, when he was happy this had happened he asked me to breathe down once more as he gently guided it with the umbilical cord. I did not require stitches, my perineum remained intact and I only had a slight graze.
The paediatrician arrived to check Elijah. He weighed 3432 grams (7.56 lbs.) and was an average length and head size, definitely not a big baby and not what we were told to expect during the pregnancy.
While everything did not go exactly to plan, in the end we had a natural, drug-free birth and a relaxed and healthy baby. This was our main goal.