Elijah Charles born 6 October 2012

On Friday 5th October 2012 I visited the obstetrician at 3.30pm for my 39 + 4 week check up. I told her I had lost my appetite the last couple of days and couldn’t feel the baby move as much. She told me these were old wives tales for pre birth signs. Baby was all good and only 3/5 engaged so no need to expect birth anytime soon.

At 2.30am on Saturday 6th October 2012 I woke with a strange feeling in my stomach and I felt like I needed to go to the toilet. Nothing happened on the toilet so I drank some peppermint tea while doing a crossword and eating almonds to settle my stomach. After about an hour of this I realised the cramps were coming and going, so I started writing down the time whenever the cramps started. By 4am the cramps were 5-10 minutes apart and only lasting a minute. Then it dawned on me that I could be in labour. The cramps were only in my pelvic region though, not like Braxton Hicks at all which I had felt across my entire belly during pregnancy. I woke Josh up and told him to pack a bag – I have never seen him so alert so quickly. Josh phoned the Mater pregnancy assessment unit and they confirmed that I was most likely in early labour and to stay at home and be comfortable as long as possible. My bowels emptied and I continued to write down times and breathe through each cramp, in between finishing packing bags and making sure the house was in order. By 7am I had to stop and either lean over the kitchen bench during a surge or get on all fours on the floor, moaning through surges. The neighbours must have thought we were having a great time! The surges were getting more intense but in between I felt really good. I was starting to wonder how I was going to get through the 20 minute drive from our house to the hospital so I phoned the Mater again. They said I could come in as my surges were 2-3 minutes apart.

We presented to the Mater pregnancy assessment unit at 7.30am and an internal exam was conducted. My cervix was fully effaced but only dilated 1cm. This was very disappointing news, as I felt I was much further along and my body had already done 5 hours of good work. The midwife offered to do a stretch and sweep of the cervix to try and get it moving along, but I declined as I did not want to be induced and was unsure how natural this would be. It was a tough decision to make as the midwife was not very forthcoming with information, and we actually thought she had meant to rupture the membranes. The midwife asked us to choose whether to go home or go up to an early birth suite. I couldn’t bear the thought of doing the car trip twice more so we headed up to a suite.

From 8am to 12pm Josh and I went through numerous relaxation scripts in the suite on our own. I had a shower on a birthing ball and rocked my body or squatted during surges, making lots of noises which helped me get through the sensations. The obstetrician on call came to talk to us at 10am and was very encouraging, she also commented that the stretch and sweep procedure offered earlier probably wouldn’t have made any difference to the progress of birth. She said I was doing all the right movements during surges to bring the back down and open the cervix. By then I had intense back pain during surges and Josh was massaging the acupressure points in my lower back and she suggested I try the sterile water injections which would ease the pain for a few hours and allow me to focus on the surges. I thought it was worth a go and fit with my plan for a drug free natural birth. Two midwives administered the four injections simultaneously while Josh held my hands. The injections were so painful I screamed and lost my voice for an hour and nearly broke Josh’s hands. The midwives said it was one of the most extreme reactions they had had to the injections. I made Josh promise not to let me have them again, no matter how bad the back pain. The midwives also mentioned that the area could not be touched until the effects had worn off, that massage would reduce the effects of the injections. The treatment did ease the back pains but more because there was a constant stinging sensation in that area to distract me from the back pain.

At 12pm I started to lose focus and found the surges overwhelming. I started talking about an epidural as I was getting tired from the constant surging. The midwife came in then to check on us and I was 7cm dialated! It was just the motivation I needed to keep going and we were moved down to the birthing suite. Josh went through the birth plan with the midwife, who was very understanding of the plan and we felt she took the instructions seriously throughout the entire process and took it upon herself to relay important points to the obstetrician and anesthetist. Both the midwife and obstetrician were pregnant with their first baby too! We spent another 3 hours there during which time my membranes released. The surges were so intense at this time that I switched to birth breathing and felt like my body was telling me to bear down. The midwife kept checking for crowning but couldn’t see any. Near 3pm the obstetrician returned to check me again and although I was 8-9cm dilated the cervix had started to thicken. This was disappointing and I wasn’t sure how much longer I could continue this on my own. The obstetrician was concerned the birth wouldn’t progress. The midwife suggested gas, and I was hesitant as I didn’t want to feel light headed and lose focus. I tried the gas and although it made me light headed it forced me to breathe deeply which helped.

I asked again about the epidural and the obstetrician explained that either it would help me relax enough to progress the birth or it may even slow down the surges in which case a drip of oxytocin would be needed. I went with my instincts and asked for the epidural. Once I had made the decision the anesthetist couldn’t come fast enough. The gas tied me over until the epidural took effect about an hour later. The first thing I noticed lying down on the bed was the clock on the wall directly in front of me. I asked if someone could please cover the clock and the midwife said no one had ever asked for that before. I’m of the belief that a watched clock never ticks and I didn’t want to feel time pressured. The midwife suggested Josh stand on a chair and put a cloth on the clock, at his own risk. The second thing I noticed was that the midwife had strapped a heart rate monitor to my belly and I could hear every beat. I asked her to turn it down or off, but she said initially that she needed to hear it as epidurals often cause the fetal heart rate to drop initially and she needed to hear it recover. I asked Josh for the ipod so I could listen to Surge of the Sea birthing affirmations until they could turn the sound of the heart beat off.

The epidural was low dose so I could still feel every surge, which was confirmed by the midwife’s electronic monitoring system. The anesthetist showed Josh a button that could be pressed to increase the effects of the epidural but I didn’t want to use it. Very soon after the epidural took effect I felt more relaxed and the obstetrician told me I was 10cm dilated and it was time to ‘push’ at 4.30pm. The midwife kept checking how high the epidural had taken effect by rubbing ice on my skin. After only half an hour of the epidural taking effect they turned the epidural off to ensure I could effectively push. One of my concerns about having an epidural was delivering lying on my back which would reduce the opening. The midwife and obstetrician were creative with positions including side lying with my top leg in the air during surges. The left side was comfortable enough but I couldn’t stand lying on my right side as the back pain was too much during surges. Another position involved lying on my back with one person holding each of my feet and pushing them towards my body while I pushed against them. Josh, the midwife and obstetrician took turns holding my legs during surges. I
was very impressed that Josh was down the business end and so involved in the birth. In the final phase I was lying on my back with stirrups holding my calves at right angles.  I remember complaining about my back pain during surges and the obstetrician telling me not to, but vocalizing the pain helped me to get through surges even knowing there was nothing that would make it go away (except the time between surges). The surges and back pain were so intense now that I even used the gas in between surges to regain my breath.

The obstetrician had a frank discussion with me soon after the ‘pushing’ phase started, explaining that I could not breathe the baby down as the natural expulsive reflex would not be enough to deliver him. The midwife and ob did lots of coaching with me on how to push – they were very encouraging when I was doing it right and telling me when it wasn’t working. Without their coaching Eli would not have travelled as far down the birth canal naturally as he did. I was instructed to push by holding my breath and not making any noises while directing my efforts towards my bum and bringing my chin to my chest during surges. The ob reassured me I could not push too hard at this stage and that she would tell me when it was not okay to push. I focused on relaxing my face muscles, which was very challenging, and visualized the perineum stretching to allow the baby to slide out.

At about 6pm Eli had travelled down the birth canal and was crowning. The obstetrician offered me the mirror at this point but I declined.  I had only written it into the birth plan as an option. The obstetrician suggested the ventouse as my efforts during surges were becoming weaker; a sign of maternal exhaustion and Eli had a non-reassuring fetal heart rate. The obstetrician explained that the use of the ventouse may lead to an episiotomy and the only risk to the baby was a bruise on his head. I also asked if the recovery from an episiotomy would be as bad as a caesarian and she reassured me it would not, that I would be walking that night. The ob also explained that the use of the ventouse triggered the need for two extra staff in the birthing suite, the baby resuscitation team. Thankfully there was no need for them to act.  I agreed to the vacuum and the ob explained it would probably take 3-4 surges to get the baby out. In the end it only took two surges and an episiotomy to get his head out. Then they turned his shoulders to get his body out.

The feeling of him leaving my body was quite strange, it was such a quick drop in pressure within my belly it took my breath away. Josh received the baby and the ob helped him put Eli on my chest for skin to skin. The first thing I said was ‘he stinks’: during my pregnancy I couldn’t stand the smell of meat and that’s what he smelt like before they wiped him down. He cried and was a bit upset but settled after a couple of minutes. The next thing I said was ‘I don’t know what to do with him’ and the midwife told me to just hold him.

The obstetrician said she was concerned about my delivering the placenta unassisted given my maternal exhaustion and I consented to the syntocin injection. It felt like the injection went in and the placenta was immediately delivered. Then I realised we still didn’t know the sex of our baby and Josh had to check, although I suspected I could feel his boy parts on my stomach. Josh was tearing up with joy and amazement at the whole process. After a while they took him away for the paediatrician to check him while the obstetrician gave me two running stitches in three layers. I kept asking how much he weighed, thinking maybe he was a big baby since I needed so much medical intervention. I was slightly disappointed to hear he was only 7 pound 12 ounces (the midwife asked me if I wanted to know in pounds or kgs, I’m still quite a traditionalist when it comes to baby weight). The paediatrician commented that he was due, even though he was a week early by the conception date and two days early by the scan date, as he did not have vernix on his skin. The paed also said that his neck was very strong (he pushed his head up high while lying on me).

Then everyone left and the next midwife started her shift (actually the same midwife I had first spoken to on the phone at 4am). We ate sandwiches and drank cordial and the midwife showed me how to breastfeed Eli and we marveled over the new addition to our family. The only thing I had been able to stomach since arriving at the hospital was two bottles of powerade and a bite of a muesli bar. Surprisingly I didn’t need much to keep me going through the 16 hour birth. At about 8.30pm they moved us to our private room and we started calling family and close friends to tell them the good news.

Although the birth was nothing like I expected and took some unexpected turns, I was prepared by Hypnobirthing to ask questions, make fully informed decisions and accept the outcome.

Thanks again for sharing your wisdom with us at the Hypnobirthing course and instilling confidence in our bodies abilities to birth our babies.

Kim and Josh, Carina Heights, Brisbane


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