I've finally managed to finish writing up Adelaide's birth story but it's more than 2500 words - so for anybody who's interested enough to wade through it all, here it is
I was approximately 41 weeks pregnant and not in any hurry to have my baby, but had been having prelabour symptoms (strong fairly regular Braxton Hicks that died off at night) on and off since Friday afternoon. I was scheduled to have a post dates discussion with the hospital obstetrician on the Thursday which I wasn’t looking forward to, so my midwife had suggested when I saw her on Tuesday that there were some natural things we could do if we wanted to give baby a gentle nudge along – acupressure, homeopathy (three 200c doses of pulsatilla 12 hours apart) and sex (“but it has to be good sex”, she said!). So Tuesday night I tried a couple of acupressure points, took one dose of pulsatilla and...
I woke up at 2am on Wednesday morning with a contraction that was noticeably ouchier than those I’d been getting up to that point. When another similar contraction arrived 7 minutes later and DH woke up enough to notice I was in a bit of discomfort I told him to turn his alarm off as he wasn’t going to work tomorrow and we may as well get as much rest as we could (thinking we would be in for a long haul like we were with JJ’s 24hr+ labour). I tried to rest but when the next contraction was only 5 minutes later I decided I would rather be on my feet so got up, telling DH to stay in bed and rest. He tried but could hear me pacing and belly dancing (seriously! Hip circles really helped during contractions) so got up himself. He said “umm, honey, that wasn’t 7 minutes” – actually it was more like 3 – so I agreed that I should ring my midwife. I rang Michelle, who sounded surprisingly perky for 3.30am, and she said she would be right over to see how I was going.
The contractions were increasing in strength and I was now on my knees leaning on the couch so I ordered DH to do some acupressure and massage (mostly around my sacrum – sometimes I needed him to push hard in one spot, sometimes he had to do circles with the heel of his hand, or he held his hand in one spot while I did hip circles). (At this point I sent text messages to my two other support people, then opened up my laptop and posted in my due date threads online between contractions!)
Michelle arrived and after observing me for a couple of contractions suggested we should do a VE to see if it was worth heading to hospital. While we were doing that DH got JJ up and took him next door to our wonderful neighbours who looked after him that morning and dropped him at daycare.
Michelle said I was 3-4cm dilated and she thought it could be a good idea to head to hospital before I got too much more uncomfortable. I had in my birth plan that I didn’t want to know how dilated I was during labour, but I was fine with having a baseline, just didn’t want to get disheartened with progress along the way. So DH made sure we had all our bags and we left at 4.15am just as it was starting to rain (I needed to hold onto the car and do hip circles through another contraction just before we left, DH probably thought I was mental standing there in the drizzle!).
We had decided in advance that we would take the gentler route to hospital that goes through some townships and has mobile reception the whole way, but as we were leaving I told DH to go the route which is ten minutes shorter (and doesn’t have mobile reception) because I wanted to spend as little time as possible in the car. Sitting was very uncomfortable but I planted my feet against the floor and pulled myself up on the roof handle so I was as upright as possible. I couldn’t do hip circles any more but rocking my pelvis helped a bit at this stage. I focused on the reflective markers on the side of the road (as a kind of instinctive visual drishti) and used
vocal toning – lots of low, soft “aaaah” and “haaa” sounds – which really helped. I remember thinking how much I wished I was having a home birth!
We got to Waitakere Hospital at 5am exactly. Just the process of getting into the delivery suite was so wonderful compared to my experience at North Shore Hospital with JJ. At North Shore I had gotten out of the car and gone into the bright fluorescent lights of the main lobby, where I had to wait while DH found a carpark and various people waiting stared at me, then we took the lift up to the labour ward and went down the brightly lit corridor to our delivery suite. At Waitakere we pulled up right outside, and went through a side door into a darkened corridor then through the first door into a nicely dimly lit delivery room. No fluorescent lights, no lobby, no audience, no lift, just two doors at ground level
Turns out it was lucky I had insisted on the short route to hospital because my waters broke with a big gush at 5.03
Around this time my nice serene vocal toning went out the window – making noise still helped, but my “aaah” and “haaa” sounds became more like groans and bellows – and I instinctively stripped off all my clothes. Michelle said later that she thought I was sounding transitional then, but because I didn’t want to know how far along I was and wanted to just listen to my body, she didn’t want to know either. I told Michelle I felt like I needed to poo (both of us being completely aware of what I may be saying) and I went to the toilet to see if I could but it wasn’t happening.
We did an inital period of CTG monitoring while the birth pool filled, as we had planned, so we had something to show the OBs if they objected to me using the pool to labour in (they don’t really like VBACs using the pool). It seemed to take forever (we did it a little longer than planned, because it was showing some decelerations in baby’s heartbeat that were verging on
late). While we were in that initial monitoring period my two other ‘fairy godmother’ support people arrived, my friend Felicity and a CBE student (Sarah). I must have been quite a sight, starkers and making all that noise
They were both very supportive and helped keep me hydrated with water and powerade at the end of every contraction.
Finally I was able to get into the pool at about 5.50am, with Michelle warning me she would have to monitor using the Doppler a bit more often than we had planned. The water was a relief, I was able to rock back in the water to relax a couple of times, and the pool also had a hand held shower that someone could direct on to my back which was wonderful. (I was mostly on my knees, leaning on the side of the pool.) DH was able to get in the pool with me and continue the acupressure/massage, as he had been doing the whole time. Apparently Michelle actually used the Doppler during and after every contraction, but by this point I was “in the zone” and didn’t really notice.
After about 30 mins in the pool I reluctantly had to tell Michelle I was feeling some pressure/pain on my Caesar scar. She said that unfortunately meant I had to get out of the pool so we could do some more continuous monitoring. I said fine, but I was going to need gas in that case – but I had in my birth plan that I should ask for pain relief 3 times before it was provided, so they didn’t get it for me yet. While my fairy godmothers laid a path of towels from the pool back to the hospital bed DH kept up his pressure on my back. I apparently had a very pronounced
rhombus of michaelis at this point (go read that link! I find that sort of thing fascinating), and with the next contraction DH and I both felt and heard a loud ‘pop!’ as my tailbone moved out of the way (like when you crack your knuckles but much louder). We both exclaimed about it and I remember thinking that Michelle, who up until that point had been very good about not letting on how I was progressing, sounded quite pleased/excited about it in response. I thought “it’s obviously a good sign, which is good because IT HURTS!” (I didn’t realise then that it can be a signal for the start of the second stage of labour). That popping obviously freed up some space because my scar stopped hurting after that. But we still needed to check things out so I got out of the pool (but didn’t feel that I could step up to the steps out, so swung my leg over the side and dripped all over the floor, was probably really annoying for Fliss and Sarah having laid out those towels so carefully!).
When I got to the foot of the hospital bed I realised that there were some membranes hanging down (felt kinda gross actually!). We hooked up the CTG again, then Michelle suggested that it might be a good idea to do another VE and I agreed. So I hopped up on the bed (lying down hurt more than being upright, by a long way!) – then when Michelle did the VE she said “ok Rachael, why don’t you get up and let gravity be your friend” (she was quoting my birth plan) “and if you feel like pushing, feel free to”. Yay! I knew she meant that I was fully dilated but I was happy to know that! Nothing disheartening about that
I ‘officially’ started pushing at 6.45am, on my knees with my arms leaning on the back of the bed. Somewhere in the muddle that was the next ten mins I did ask for gas twice more, and it was fetched for me, but I never used it (would have disrupted my rhythm, but I was very bossy when I was in labour – my DH would say that’s nothing new actually! – so they fetched it just to placate me I think
). I know I was very loud, a couple of times my support crew had to remind me to relax my jaw, and to redirect downwards some of the energy I was putting into bellowing. These reminders really helped! I needed every member of my support crew then, DH was still pressing on my back as much as he could, Fliss and Sarah were so encouraging, telling me how great I was doing at trusting and listening to my body, even though Sarah made me laugh by saying I was serene when I knew I wasn’t! (I know I was very focused though, except that I kept apologising for making noise or being difficult!)
That first 10 mins or so of pushing was hard, I didn’t feel like I was getting anywhere, but I obviously was. I had in the back of my mind that Fliss had agreed to be a support person for me because she thought this baby’s birth could be a positive experience for her too, and around this time I remember thinking “I should tell Fliss to go home, this isn’t going to end well”. Right after that though, I remembered another friend’s advice that when I felt like it was the end of the world and I couldn’t do it any more, that was the worst it was going to get – thank you Andrea
. So I sucked it up, grabbed Fliss’ hand, pressed it to my forehead and squeezed with all my might (sorry Fliss!), redirected my energy downwards, and pushed.
At 7am the baby’s head started peeping out. Michelle told me with the next contraction to put my hand down and I would be able to feel her head – the fact that her head was right there wasn’t news to me, I could feel it alright (I think that might have been when I started swearing! “sh!t that hurts” I believe was how I put it), but it was motivating to feel how much the head moved with each push. At 7.18am, just as daylight was starting to peep through the blinds into the room, baby’s head popped through which was a real relief – but the pain wasn’t gone, baby’s shoulder was stuck.
Michelle stayed very calm (although I did detect some urgency in her voice) and got me to turn over onto my back so they could tilt my pelvis in order to wiggle baby out (McRoberts manoeuvre). DH was directed to hold one knee up towards my belly and sure enough the rest of Adelaide Frances popped out. (I’m very glad now that I didn’t know then how dangerous Shoulder Dystocia can be.) She was stunned for a few seconds, but then gasped and started breathing, and was immediately handed to me for skin to skin on my chest.
I was happy just to be holding my baby and not pushing it out any more, so I didn’t ask about baby’s sex. I think it was a couple of minutes before DH said “so, we have a daughter” – I really had no inkling what we were having but when he said that my reaction was “no way!”, guess deep down I’d been expecting another boy.
I had wanted a physiological placenta delivery, but about 10 mins after Addie’s arrival there was apparently a big gush of blood followed by ongoing bleeding, and there was too much blood for Michelle’s liking, so I ended up with a managed third stage – the placenta came out easily enough after an injection of syntometrine (“no bones in this one” Michelle said as I pushed). I was really focused on Addie at that time so it didn’t bother me how the placenta came out! (I would have asked for the cord not to be cut until the placenta had been delivered, but I’m rhesus negative, so we chose to clamp and cut the cord after it stopped pulsating, to reduce the risk of her blood passing back to me.)
For about 20mins Addie simply snuffled around a bit on my chest, clearing a bit of mucous and resting. Then she actively started looking for the breast (doing the
breast crawl) and at about 50 minutes old latched herself on. (Since then she has only ever self-latched, I’ve never had to actively latch her on, and it’s been perfect every time.)
I did have a couple of grazes and a couple of stitches, and my tailbone is still a bit sore, but honestly the recovery from Addie’s birth has been so much easier than recovering from my c-section with JJ was. It didn’t all go exactly to plan (NB if anyone is interested my birth planning notes have been uploaded to Google Docs
here), we did end up with slightly more intervention than I had wanted, but my aim had been to avoid a long protracted labour and we certainly did.
My first stage of active labour (from the VE at home to when I started pushing) was officially recorded as 2 hours 40 minutes and I was pushing for half an hour. That's roughly 10 percent of my labour with JJ - I've told DH if we could guarantee the next would be 10 percent of the time again I'd do it in a heartbeat
I don’t think I would class the birth experience as joyous, but it was certainly empowering, and a bit surreal – I woke up in the middle of the night and was holding my baby before breakfast, so it all seems a bit dreamlike!
I am so grateful to:
- my midwife Michelle, who was on the same page as me throughout my pregnancy and never got annoyed at my singlemindedness,
- my DH who allowed himself to be educated about natural birth, overcame his own fears and traumatic experience from JJ's delivery, and ended up with a very sore back, shoulders and thumbs from the constant massage and acupressure!
- my wonderful friend Felicity who also overcame a traumatic previous experience to be a no-nonsense, quiet and calm rock of support (after an initial "OMG what have I let myself in for" moment I think!)
- my other birth support person Sarah (a CBE student) who knew exactly what I wanted, knew every facet of my birth plan and was very good at knowing the right thing to say at the right time.
My VBAC birth "novel"
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