24 hours in a birthing centre

Sarah Tennant spent 24 hours in a birthing centre, observing a day in the life of these hallowed halls of anticipation

10.00am
I have arrived at River Ridge East Birth Centre. For once, I’m not giving birth; I’m here to observe. “Hug lots of babies!”, my daughter cheerfully calls out as my husband drops me off. Past the stained-glass front doors, past the cheery receptionist, past the young father jiggling a tetchy baby on his shoulder. Ah, yes. I know this place. 

10.30am
Clare Hutchinson, one of the directors of River Ridge, has an hour or so free in a day full of meetings. We pop into the Whanau Room, among the goldfish tank and magazines, to chat.

My mental image of a director involves out-of-touch decisions made in shadowy boardrooms, far away from the action. That is definitely not Clare. A midwife for 41 years, she runs contraception and breastfeeding classes, and still has five more babies to deliver before she retires from active midwifery to focus solely on her work as a director.

Clare built River Ridge from the ground up. She made the quilted wall-hangings, chose wooden floors instead of concrete for the sake of her midwives’ feet, and used her architectural knowledge – gleaned from a Steiner education in the Netherlands – to make the building pleasant to work and stay in.

I mention the wall colour in the postnatal rooms, a two-toned warm pink I find appropriately womb-like and cocooning. Clare nods – that’s German colour theory. Studies have shown that colour is calming for mothers and babies.

There is even careful thinking behind the size of the window seats in the postnatal rooms. They are as wide as a single bed, allowing women to bring along anyone they like – mother, sister, friend – to stay with them as a support person. In some cultures it is considered inappropriate for a man to share a bed with a postpartum woman, so the seat can come in handy for partners too.

This cultural accommodation, or ‘targeted care’ as Clare calls it, is something she learned in the Netherlands, where a diverse population is the norm. New Zealand, apparently, isn’t so good at it. Clare’s also not impressed with New Zealand’s treatment of midwives: under constant media scrutiny, unappreciated and underpaid. A lot of the new trainees head for Australia, leaving us with a shortage. Clare takes care of her midwives – they eat, for free, the same food as the mothers eat, often all around the table in the giant staff room.

Warming to her theme, Clare suggests I ask in my article that if the government has breastfeeding as an official health goal, where is the funding for achieving this objective, and why do places like River Ridge not see it, despite running a free breastfeeding clinic for the last six years? Well, indeed.

I’d love to sit here soaking up wisdom, but Claire has meetings. I tear myself away from a discussion of the different attitudes of Polynesian and Maori culture to out-of-wedlock pregnancy, and she heads off to do important things. I head off to the kitchen. 

12 noon
Turns out the kitchen contains another Claire: one of the chefs. She’s making lunches. River Ridge believes in food – along with three square meals a day, post-partum women get morning tea, afternoon tea and supper. The menu hasn’t changed perceptibly since I first stayed at River Ridge eight years ago. 

It’s designed to be streamlined, as birthing-centre catering is tricky. Women can turn up at any time of the day or night; they may be gluten-free, vegetarian, halal or diabetic, and the fact that dinner finished two hours ago won’t change the fact that they’re starving after 18 hours of labour!

It’s lunchtime for us too. Claire brings in sandwiches, soup and fruit. The staff chat about their holidays, interspersed with asides about overdue babies and blood loss. 

1.00pm
Room 10 – a birthing room – is occupied. The noises emanating from it are the unmistakable sounds of a labour well underway. I have a vivid flashback to eighteen months ago, when I was making those same noises in, quite possibly, that same room. Good times. Right now I’m a few rooms down the corridor, watching Tracey clean up from a birth earlier this morning – scrubbing the pool, spraying prodigious quantities of disinfectant over every surface.

Tracey is a staff support person. She’s obviously picked up more than I’ll ever know about childbirth, and while delivering babies isn’t in her job description, she’s had her moment of glory. One night a woman turned up at the door when the midwives were down the hall – and the baby was crowning. Tracey managed to lift the woman into a wheelchair, rush her down the corridor, support the baby’s head and summon a midwife, who raced into the room just in time to catch the rest of the baby. I have never had a work anecdote as cool as that. 

1.15pm
Staff midwife Cathy eyes me. “You look familiar. Where did you have your babies?” I cast my mind back to the midwives who rushed in to assist during the vital moments of Morris’ birth. One of them could well have been Cathy; honestly, I wasn’t paying attention. I hope her memories of the event are as fuzzy as mine. 

2.15pm
I’m wandering the corridors again, admiring the artwork – there’s a particularly lovely black-and-white photo of nursing twins – when I hear a discreet beeping, too quiet for a fire alarm. A small red light flashes. It’s labelled ‘Birth Emergency’. Must be Room 10! I scuttle down to the birthing-room corridor and hover at a discreet distance, listening for that newborn cry. 

2.40pm
Still no baby! The mother in Room 10 has had enough. She wants to transfer to the hospital for an epidural. Kelly calmly calls the ambulance. The midwives are sympathetic; it happened with her last baby too.

There’s no judgement, no comments that she should have tried harder or done something differently. Having seen many a birth story dissected online by natural-birth crusaders, it’s nice to see realists who accept philosophically that birth’s different for everyone, and sometimes doesn’t go according to plan. 

3.35pm
Cathy has a tough case. A three-day-old baby has a healthy appetite, but can’t figure out how to feed. Nothing they have tried – nipple shields, different positions, SNS-feeding – is working. The mother has started expressing milk, but the family has to go home tomorrow and Cathy wants to teach the baby how to latch on before they leave.

She discusses the case with Kelly, another staff midwife who also works at River Ridge’s breastfeeding clinic. They talk about lip-ties, tongue-ties, other babies they have known and what worked for them. They worry that Woeful Baby is developing a breast aversion.

4.30pm
I meet a new family – mum, dad and their new baby Penelope. Penny is asleep, swaddled picturesquely in the cradle. Megan and Jordan are a lovely couple, relaxing together on the double bed. He expresses his feelings about the birth in typical Kiwi-bloke fashion.

“The hardest part of labour was watching her go through the pain and realising I could do sweet bugger all … except be there.”

“Being there’s huge, though” says Megan.

“I would’ve taken the pain if I could” says Jordan.

“I would’ve given it to you” says Megan, with equal sincerity. 

6.30pm
Dinner’s over: butter chicken for us. I meet more babies. One is a gorgeous Fijian-Indian boy. I comment on his lovely thick hair, but it’s going to be ritually shaved off when he’s five weeks old anyway. He doesn’t have a name yet; they’re stuck on a shortlist.

Another baby, Fern, is only 5 1/2 pounds. She didn’t come easily – posterior labour flared up a back injury for her mother, which turned a peaceful hypnobirthing water-birth into a hospital transfer with an epidural, vacuum and forceps. Her parents sound a little shell-shocked by it all, but game.
Fern has the distinction of being the 30th great-grandchild in the family. It does not seem to burden her.

All the postnatal rooms feel lived-in. The parents have made themselves at home with snacks, books and baby gifts. I think back to the last time I visited a post-partum friend in hospital: a shared ward, prison-cafeteria food, Dad perched on an uncomfortable chair keeping quiet because visiting hours had officially ended fifteen minutes ago. This is like night and day. These families are lucky – and they know it, gushing over the staff and the fancy electronic beds and the food. 

7.45pm
Staff midwife Lucie has a visitor – her nine-month-old son Max, who arrives triumphantly on his father’s shoulders in search of a drink. He is greeted like a celebrity by the other midwives and thoroughly snuggled before Lucie disappears into the treatment room to breastfeed in peace. Now that’s a baby-friendly work environment; but then, of course it would be! 

1.00am
A father paces the hallway with a small dark-haired bundle. He gravitates, as everyone does, to the collage of baby birth announcements stuck to the wall opposite reception. These babies are River Ridge alumni. Some of the photos date back to 2008. The names are trendy – Hunter, Jayden, Sophia, Liam. There’s also a Zeppelin. Huh. 

3.50am
Not much is happening. There are, to my disgust, no more births. “You should have come earlier in the week!” says everyone. “We were averaging six births a day. We’ve been insanely busy!”

There are linens to wash, rooms to make up and periodic visits to the room of Woeful Baby, who is now arching her back and wailing when presented with the breast. The midwives coach the mother through every feed, trying new nursing positions, encouraging, reassuring.

Still, it’s slow, the corridors dimly lit and hushed. Sania relaxes on the couch and we talk about birth, midwifery, teenage motherhood and – if I recall – the merits of kunekune pigs. 

4.10am
Lucie appears holding a pink burrito. Woeful Baby has been kidnapped to give her mother a rest. We all take turns cuddling the baby – certainly not the worst job in the world! I learn, to my delight, that professional 2016 midwifery care is not above sticking a washed finger into a baby’s mouth to suck on. Woeful Baby and I wander the corridors like this for some time. I wonder if the white-noise hum of the air conditioning is another intentional design feature by Clare; the baby likes it, anyway. 

5.25am
Woeful Baby is asleep! Jubilation all round. 

5.38am
Woeful Baby is awake again. 

6.05am
Tracey B, another staff support person, is busy in the kitchen, arranging tea and coffee for the postnatal rooms. The midwives look exhausted. At least, I think so until I see myself in the mirror, whereupon I decide the midwives actually look great.

6.30am
Sania is summoned to Woeful Baby’s side for the eighth time. 

7.00am
Shift change … in theory. A receptionist arrives; Tracey B is replaced by the first Tracey again. Sania is supposed to go home. Instead she spends an hour going over the details of each mother-baby pair with Glenda, the day-shift midwife. Woeful Baby’s case merits special consideration; once more, expert minds are racked over the small but pressing problem of how to make a baby drink. It occurs to me that in my 24 hours here, every single staff member has arrived early and left late. 

9:30am
Things are bustling now. LMCs are arriving to visit their postpartum women. One tries to pop in briefly, only to be press-ganged to deal with a tongue-tie.

Glenda is speedily typing up a care plan for Woeful Baby while also dealing tactfully with Woeful Baby’s father, who is upset about his baby’s crying and his wife’s sleepless night and thinks the midwives haven’t been trying hard enough.

10.00am
Time for me to go! I’m exhausted, but also wired. How will I learn what becomes of Woeful Baby, or if the woman in Room 10 ever got her epidural? I suppose that’s the nature of birthing centre work – slices of life, unfinished stories. Still, it seems vaguely anticlimactic to just leave. Maybe that’s why the midwives linger after their shifts?

Ah well. I’ll see it all again next time I have a baby.

Sarah Tennant lives in Te Awamutu. She stayed at River Ridge after the birth of her daughter Rowan, and gave birth to Miles and Morris there as well. She recommends the muffins.

Huge thanks to Clare Hutchinson, Dianne Mulhern and the staff of River Ridge East Birth Centre, Hamilton, and the families who shared their experiences with us.

We'd also like to thank Amy and Steven van de Poel for sharing the photos featured in this story. They were taken by Hamilton birth photographer Cassie Emmett (Capturing Life Birth Photography) on the day the van de Poel's daughter, Maggie, was born at River Ridge East Birth Centre.