I am writing this birth story on the other side of Grace’s first birthday and with a new baby growing in my belly. Both of these events have conspired to have me look at what could have so easily been shelved and `forgotten’ as I immersed myself in new motherhood and family life. In order to tell the story I need to start with the reasons I ended up birthing where and when I did.
When I learned that I was pregnant with Grace, my first instinct was to sort out where I would birth. A hospital ward was incomprehensible to me; I knew that I could not contemplate having strangers at my birth, bright lights, pain killers or unnecessary medical intervention. The more research I did the more I became aware that there were well-founded reasons to trust these instincts. I had learned about the birth centre at the local hospital and reasoned that I would have the best of both worlds and thought it was a good option for my first baby. I had heard positive stories from women who had birthed there and, in retrospect ignored any negative stories as sour grapes from women who didn’t get to birth there. I also knew it was run on a ballot system, so I may not get in. Home birth was my back up plan.
I got the letter at 17wks to say I was in the birth centre and was delighted. I abandoned any further investigation of home birth, believing I had found the place that was right for me. Midwives at the birth centre work in teams of two, meaning you have all of your ante-natal visits with one and the other is there just as back-up in case your midwife can’t be there for whatever reason. My pregnancy progressed uneventfully. I enjoyed watching my belly grow and feeling the excitement of meeting my baby. I held a vision of that first magical hour in my mind, the intimacy of Paul and I meeting our baby for the first time.
I read voraciously and knew what I wanted from the birth – continuity of care, no drugs, natural 3rd stage, no episiotomy, delayed cord clamping and immediate skin to skin contact with my baby. It was to be blissful! I knew of the propensity towards over-medicalisation of birth but somehow believed I would not be touched by this, to say I naively sailed through the pregnancy is an understatement!
I worked too hard in my cafe throughout the pregnancy, some days I was in constant pain due to too much time on my feet. I certainly didn’t allow my body the rest it so richly deserves during this amazing time, but carried on expecting to be able to keep going. I thought I was doing well when I finally managed to stop working at 32wks – I had a whole 8 weeks to go! I even had time to pop down to Sydney to visit my good friend who had just had her baby 4 weeks prior. What was I thinking!
My waters broke at 5am on October 9, at 35wks gestation. My main midwife was on holidays, so I called my `back-up’, who I had met a couple of times. She was at the birth centre, having been up all night with a birthing woman and suggested we come straight in. We jumped in the car with nothing but the clothes we were wearing; clearly I didn’t think I would be having a baby that day! Upon our arrival our midwife informed us that we would have to go next door to the regular birth suite, as 37wks gestation was the earliest they accepted in the birth centre. I don’t even remember feeling disappointed as I just didn’t think it was happening, I wasn’t having any contractions at all.
A midwife from birth suite came in to see us and took my blood pressure and listened to the baby with the Doppler. All seemed fine. An obstetrician came in to suggest I take anti-biotics for Group B Strep, which can be a danger to babies pre 37wks, and steroids for lung development as there is a possibility they may not be fully developed at this stage. We said no to both of these things, I just felt everything was ok.
At this stage we were left alone for a while and I started to feel some mild contractions, I found myself pacing around the room during these and in retrospect they were probably only 7 or 8 mins apart and gaining fast.
The obstetrician came back and we were having a conversation about going home, I had read that this stage of labour could go on for 12 hours and I certainly didn’t want to be in hospital for all of that time. We had just got him to agree to let us go home on the promise I would take oral antibiotics (I wouldn’t have) and would come back if I hadn’t progressed by that evening (although he did mention something about that not being a good time to return due to staffing); when I had a sudden urge to take off my jumper and head to the bathroom.
I had a really strong contraction on the toilet and when I came back into the room the obstetrician had left and it was just Paul and I. I got down on the floor and buried my face in the bean bag, the lights were turned down and at some stage the midwife from birth suite came in, as did my back-up’ from the birth centre. The next three hours passed with me in that same space on all fours, riding each contraction and resting in between.
A Doppler was placed on my belly at every contraction as thankfully the electronic foetal monitor wasn’t giving an accurate reading and I found it really annoying to have the strap on my belly, so had it removed. Grace never showed any signs of stress throughout the whole birth. Paul would give me water to sip in between, nobody was talking and I was completely in my own space, having a great time actually!
Then I became really tired and felt like I wanted to sleep, I can see now that this was to be my transition time before 2nd stage. However, it was not to be and it was at this point that my birth was hijacked. My back-up midwife checked my cervix and told me that I was fully dilated and ready to push. I didn’t feel ready to push.
The next thing I remember she was down on the floor with me, telling me I had been doing a fabulous job of working with my body and she knew I wanted to rest, but the obstetrician was on the other side of the door and was giving me 45mins to an hour to push the baby out. It was at this point that I felt I had to stop listening to my body and do as was asked; it took a lot of effort to haul myself out of the trance like state I was in and start pushing despite not feeling to at all. I was suddenly watching the clock; it took around 20 minutes just to get the hang of pushing and into the rhythm of it. A mirror was placed between my legs and we could see the baby’s head!
However, despite my best efforts, I just couldn’t push her any further than this point. We changed positions, my contractions started slowing, Paul did some nipple stimulation, I was doing as much internal work as possible, trying to clear any blocks that may be stopping the baby being born. But she just wouldn’t budge. The birth suite midwife was coaching `Come on, you can do it! Let’s get this baby out!’ at every contraction, which felt completely wrong to me.
After just over an hour of pushing the obstetrician came in and said he wanted to do an internal exam to see the position of the baby. Suddenly lights were on, other people were in the room and I was up on the bed in stirrups. Paul later said he’ll never forget the look in my eyes. The internal exam was by far the most painful part of the whole experience, two hands inside my vagina feeling around the baby’s head was almost unbearable.
In fact I kicked the obstetrician off me and he left the room in disgust. When he returned he informed me that the baby was posterior (face up) and we would need a ventouse (vacuum) extraction to birth her quickly, otherwise a caesarean would be necessary. I couldn’t believe my ears! Did he just say caesarean? I could see the baby’s head! I looked to my back-up midwife, my supposed ally, she nodded that the ventouse was the best way to go at this stage and informed me that she and the birth suite midwife would be leaving as she was no good having been up all night and the other was finishing her shift.
Suddenly Paul and I were left with complete strangers. I was determined that this would be fast, if I was to suffer this indignity it would be over quickly at least. After refusing pain relief and some adjusting of stirrups (obstetricians just aren’t used to dealing with women who aren’t numb from the waist down!) a foetal monitor and the suction cap was attached to Grace’s head, I was given a local anaesthetic (“in case I needed an episiotomy”) and on the very next contraction Grace was born. The obstetrician tried to turn her, but she turned back and the cap popped off her head, leaving a nasty bruise. She was born face up, as she clearly wanted! The image of her being held above me is indelible, I will never forget it.
The next few minutes are a blur. Paul was crying. I was being stitched up after my `routine’ episiotomy, the placenta must have been delivered at this stage and I was no doubt given Sintocinin, Grace was taken to the resuscitation table. Paul was invited to cut the cord; he declined, but went over and started to ask that they give her to me. After some fussing, they brought her to me and lay her on my chest; I was unable to sit up properly as I was still in stirrups being stitched. Nonetheless, she started to suckle at my breast. After less than 2 minutes they took her away. Paul went with them. The obstetrician finished stitching me and left. It was just me and the new midwife, who was writing notes and saying I needed to shower and eat and then we’d go to see her.
I was strangely euphoric and it still gets me that I wasn’t outraged that she was taken. Yes, I wanted to get to her as quickly as possible, but I didn’t fight for her. I wasn’t the roaring lioness that demanded to have her placed on me straight away, that screamed `NO’ when the word episiotomy was mentioned, that didn’t allow them to cut the cord. I was meek and disempowered and the grief of that is with me still.
It was 45 minutes before I got to Special Care to see my baby. When I got there she had been cleaned up, dressed in someone else’s clothes, had a nasal-gastric tube inserted and a drip in her hand into which they had administered anti-biotics (for Group B Strep, which turned out negative when my blood test came through later) and paracetamol for her no doubt pounding head. Paul was holding her. The next three days were a blur of holding her next to my skin and feeding her through the tube while at my breast, expressing madly to get my milk in, being told by relatives she was in the best place, convincing the nurse to skip a formula feed so she could have a chance at attaching (she did on the very next feed), trekking up one level to my un-used bed in the maternity ward to eat cold food, sitting for hours on painful stitches, and falling in love.
What should have been the bliss of our first weeks together at home was tinged with grief over the separation. Grief that is still with me today. I feel blessed every time I crawl into bed beside my beautiful girl and have felt the self possession that only motherhood can bring as I watch her grow. I know we missed something precious through her birth, but there is learning and healing to be had in the simplest of moments every day, and we are on that journey together.