Third Pregnancy

When Lessan and I were expecting our first child, we had come up with the idea of having 4 or 5 kids.  Well, Lessan thought 5, I thought 4 was a nice even number.  But, at the start of this story, in early 2017, we had two children - Thomas aged 3.5 and Ella aged 1- and we felt that two was enough for now.  We had been living in Melbourne for about a year. Lessan had been working in his first real job in an office and I was struggling with managing life as a stay at home mum. We didn't have any family nearby and we struggled to maintain friendships with other parents.  I guess it's complicated with kids and it takes a long time sometimes.  Nevertheless, as Ella got older, I started to feel like maybe it would be easier for me if I could do something outside of the house.  I wanted to study midwifery part-time (a long-held dream). I was accepted into the course and even got the kids enrolled in daycare two days a week, but just as the year was about to start, Lessan and I realized we just couldn't afford the cost of daycare if I wasn't working.  I reluctantly withdrew from the course and turned my attention to finding part-time/casual teaching work (I'm a qualified High School Teacher in ESL and Maths).  As jobs were elusive, I had settled for doing some work as a volunteer teacher at the Red Cross. We figured I could get back to studying when the kids were both at school.

However, the idea of having more children never really left us.  We were struggling with our two and we felt it would make more sense financially for me to work, but we did in a way have a secret yearning for another child.  I do remember thinking, if I start studying now, I likely won't have another baby and I wasn't so sure if I was happy with that.  Also, some friends of ours announced they were expecting a surprise third baby and I can clearly remember Lessan and I looking at each other like, "I wish that was us!" So, we certainly weren't trying to conceive, but we may have not been as careful as we should have been if we were really adamant about avoiding pregnancy.  We took a chance one time thinking it couldn't possibly be my fertile window and lo and behold, a few weeks later, I was late and... pregnant.

When I saw those two lines on the pregnancy test, it came as a shock.  We were both happy and excited, but also scared.  I honestly struggled a sometimes in the first few weeks to accept that I was pregnant, especially when the nausea hit. I hadn't prepared myself to go through this again! But, of course, it was when the baby arrived that we were most concerned about.  We immediately set about finding a way to get more support.

We looked at getting an Au Pair to help, but we would need more space for that so we looked at moving to another part of Melbourne, to a country area or to another state to be closer to our family.  One big concern was how to pay for childcare, now that there was little chance of me getting a job.  If I was not working or studying, we would not get any childcare subsidies from the government and so the cost would become prohibitive, and we couldn’t see how I would manage with three kids at home full-time.  Lessan’s sister-in-law had visited a few months earlier and often talked about the great and rather cheap childcare available in New Zealand, where they had moved to about 2 years prior.  She extolled the 20 hours of free early childhood education available to all 3 year olds and sometimes to 2 year olds. Since the issue with childcare subsidies would be the same anywhere in Australia, we seriously started thinking about New Zealand.

I initially didn't like that idea.  I was settled in Melbourne and starting to make friends.  But, we decided that Lessan should go for a visit to see what life was like in New Zealand to help us decide.  It seemed that his visit convinced him that we would feel more supported there and would most likely be more financially viable. (This last point I think turned out not to be quite true, but thanks to Lessan being able to do his job remotely and getting a pay raise shortly before we left, we are making it work).

At 38 weeks pregnant, with a henna tatoo

Earlier, as soon as I found out I was pregnant, I had applied for a government funded homebirth programme through Sunshine Hospital in Australia.  I attended one antenatal appointment and, though I liked the midwife I saw, I left feeling quite concerned about the care I would receive.  There were a lot of restrictions and I was worried some minor complication could easily ruin my chances of a homebirth and I would be stuck going to the local hospital, which did not seem like a good outcome at all.  I compared this with the options available in New Zealand - great birth centres, many homebirth midwives to choose from, good continuity of care, all funded - and New Zealand became infinitely more appealing.  This was especially so after I talked to Karene - a midwife based in the same village where Martha lived.  She was very experienced in home birth and had a very natural approach.  She determined that I should be eligible for maternity care as an Australian (planning on) living in New Zealand and agreed to take me on. (In hindsight, I know that there are many issues with the New Zealand maternity system, mostly to do with funding midwives, but I feel grateful that I still could access great care).

So, when I was 20 weeks pregnant, we made the big move.  We stayed with Martha (my sister-in-law) and her family for about 6 weeks while we waited for our stuff to arrive and then moved into our own rental home in Cambridge.  We settled into our new home and got the kids settled into kindergarten.  Lessan worked from home with his previous company based in Melbourne, but as a contractor.  This was working out pretty well.  We also tried to get to know our local Baha’i community, attending children’s classes and so forth. We had numerous visits with my midwife and got to know her very well and hash out all the details of how we hoped to approach the birth. By the time my due date approached, we were feeling quite happy and settled.

At the 200th anniversary of the birth of Baha'u'llah
celebration held at Te Awamutu library

Speaking of due dates, a dating scan determined that baby would arrive on approximately the 22 October 2017.  That happened to be the 200th anniversary of the birth of Baha’u’llah, the founder of the Baha’i Faith.  I was torn between wanting our baby to be born on this special day and not wanting to miss the celebrations! I was also worried that everyone we were counting on to be there to babysit would be busy at the celebrations.  To make sure things worked out, I spent several weeks looking for babysitters we could hire, if the need arose.  I also felt like it was very difficult for us to be involved in the planning of events for the bicentenary, which was a major focus of the Baha’i community worldwide, because I didn’t know if I’d be in labour close to that time.

As it turned out, baby came at the perfect time - 4 days after the bicentenary, when all the celebrations were over.

Reflections on having three kids!

So, I recently wrote about how we felt when we first discovered I was pregnant.  We had a lot of worries about how we would cope with three kids under five.  Was all that stress (and an international move!) warranted?

Well, I think the answer is yes and no.

Overall, the transition to a third child has, so far, been easier than the second.  I think we've been coping really well, but it's possibly because we were able to make all those changes and set ourselves up for success.

Lessan's family was really helpful for us around the time of the birth.  They have since left, but we feel like there is a lot we still have here that makes us feel well supported.

For example, the fact that Lessan is working from home is really helping us stay sane.  One reason is that bedtime can be a bloomin' nightmare. Okay, not a nightmare, because that would involve sleeping.  After the move, the kids took a long time to get into a good routine and it got disrupted again after the baby came. Ella stopped sleeping through the night, Thomas refused to stay in his room.  Putting three kids to bed, at our house at least, is like playing "Whac-a-Mole" for hours on end.    You know that game where you have to keep hammering down little moles that come out of holes.  Once Joseph was born, he would be up and down round the clock, anyway, so most of our evenings are a total right-off in terms of Lessan and I doing much.  This is why Lessan working from home has been so wonderful for us at the moment - on the days that Thomas and Ella both go to kindy, Lessan and I have an hour or so to just spend together.  We just wouldn't get much time to be together, otherwise, and I think that would be really tough on our marriage.  Also, the fact that Lesan is at home means that I can occasionaly leave Joseph at home if he is asleep to run an errand.  I feel a lot less trapped at home than I used to, even though there's one more kid!

Another important aspect has been the fact that Thomas and Ella are going to kindergarten - Thomas 5 days a week, 8.30am - 3.30pm, Ella three days.  This gives me time to write a blog post like this once in a while, but mostly just catch up on housework and go grocery shopping! And they really like their kindergartens! They are really good quality care environments and their behaviour at home is better than it was before as a result.

I feel really busy and tired most of the time.  Joseph is still waking through the night MANY times.  Ella is getting into everything (hello "terrible" twos!), Thomas is still having his lovely meltdowns and things are often messy and difficult in our house, but I am coping and generally happy!

I think that is in big part because of us living in a pleasant house, nice town, with Lessan working from home and he is also getting better at helping around the house, plus the extra childcare.  I also feel that the more kids you have, the more skills you develop.  I'm figuring out new ways to get things done with kids around, how to manage the logistics of attending to different needs,  accepting that there will be chaos and just letting go of stuff.  In a way, it's been easier to relax when having a third child because I've lowered my expectations of what I should be doing and that makes me feel less pressured.

We don't at all regret all the changes that have taken place over the last year.  We feel like it was somehow meant to be.  Joseph is such an angelic little boy.  Really very chilled most of the time.  Happy to sit in his pram when we go out, happy to lie on the floor and explore and handles many knocks from his siblings pretty well.  We love him so much and couldn't imagine life without him! And, in a way, it makes us feel like we could have a fourth at some point down the line, but I'd also like to work or study at some point...so we're back where we were two years ago in that regard.

Joesph's Birth Story

This is the story of my third birth

The choice of birth place

A postnatal room at the birthing unit

During the last trimester, there was a lot of discussion between myself, Lessan and my midwife about where to give birth - home or at a birthing centre. I never really gave much thought of going to hospital (unless an emergency situation would develop).  As you can see from my other birth stories, my other two were born at home and I definitely ascribe to the philosophy of homebirth. What I like about homebirth is the increased likelihood of a physiological birth -  this can be aided by being in a familiar setting, having access to food and comfort measures you can prepare at home, not having to travel in labour but the biggest factor is not having to contend with the factory-like atmosphere of a hospital where interventions are par for the course.  A birth centre is really a home away from home, and in New Zealand, with my midwife attending me, there would be no difference in policies at the birth centre to a planned home birth (except possibly limits on children attending).

Te Awamutu birthing

I had never had the option of a birth centre previously and from my previous births, I knew there were some downsides to homebirth.  I had felt stressed by the logistical planning needed - especially the pool part! (And I really liked the idea of having access to a pool for pain management).  During Ella’s birth, I had felt abandoned in my hour of need because Lessan was busy looking after our first born and inflating and then filling the pool, instead of being by my side.  For this birth, I wanted him to be able to be by my side and not to have anything to think about besides supporting me.  I wanted us to share the experience as a couple, for it to feel almost romantic. Lessan agreed, and that is what really sealed the deal for me. I like the idea of having kids involved in birth in theory, but in my case, I just find that them being there is stressful and not conducive to the birthing hormones.  I also liked the idea of having a chance to rest after birth. I just knew that if I was home, I would be forced to get up and cook or clean too soon after birth.  All of these things would be willingly overlooked if the only other choice apart from homebirth was going to a busy public hospital, but given that I had the option of a New Zealand birth centre, I thought, why not! They have a pool, they have a lot of other comfort measures, and if I really want it, I can even try gas and air, which is a pretty benign intervention, but not available at home.  The emergency equipment is all set-up already - there won’t be a delay in setting things up if the midwife is late (this happened for our second birth!).  So, anyway, the plan was to go to Te Awamutu birthing centre, a 17 minute drive from our place.


The Night Before

Lessan went to bed late, about 1am, after having put Ella back to sleep
Ella woke up again shortly after, so I went to her. Then, Thomas came into our room asking to sleep with us.  He was having trouble sleeping due to a cough.  I took him to his room and lay with him.  Soon after getting back, Ella woke up again.  It was a bit of a rough night, but at least I had had an early start to the evening. During the night, I had been feeling happy and grateful for my many blessings and had said several prayers.  I feel like this may have helped me go into labour the next morning.

Labour Begins

When I got up for Thomas the next morning at about 7:30am (he slept in at least!), I immediately started noticing that I was having contractions.  I had been having very frequent braxton hicks contractions for weeks and in the preceding days, they had been happening almost any time I was upright.  But, today, it felt different.  I was pretty sure these were ‘real’ contractions, as they were more of a cramping in the lower uterus, rather than just an overall tightening.

I was really excited that this might finally be labour! I was 4 days overdue and, having gone about a week past my due date with the other kids, I was prepared to have to wait that long or longer, but it was certainly a relief to (hopefully!) end the waiting game.

Thomas was too sick to go to kindy (coughing and asthma), which was a shame because it would have been really helpful to have the house to ourselves that day. I helped get the kids breakfast and make Ella’s lunch and Lessan took Thomas and Ella both out to drop Ella off at kindy. He also asked Martha to come over to help look after Thomas during the day so that I could labour in peace.

At 9am, the midwives arrived for a pre-arranged pre-natal visit (well, my midwife Karene and a student who was following her and I had agreed could attend the birth, Lucy).  I was half hoping that my labour would progress incredibly fast and that by the time they arrived, I would be ready to push and they could just help me deliver him at home.  In hindsight, I’m really glad that didn’t happen! Anyway, in case things progressed quickly, I did all I could to get everything ready - finish packing my bags for the birth centre, did the dishes and tidied the house.  I also had a quick shower and put on the clothes I wanted to wear for the labour.  I wanted to make sure I was wearing my nice new sports bra when the time to get in the pool came!

By the time the midwives arrived, my tiredness from the previous night suddenly hit me.  I spent their visit almost dozing off on the couch.  They assured me that this was definitely pre-labour and that it could last for days or even peter off.  That was a bit disappointing in a way, because I wanted to get things over and done with as fast as possible, since the logistics of childcare were a bit complicated.  But, it was important to hear, because I needed to be patient and just rest as much as I could, especially given the previous night I had had. Oh, and I was also still a recovering from a cold myself.

Soon after the midwives left, Martha arrived and that allowed me to go and rest.  Before doing so, I got Lessan to help me figure out how to use the TENS machine I had hired.  I had heard mixed reviews about the TENS for labour.  Some women (my mum included), swear by them, others said it made no difference and some even said it was uncomfortable or distracting.  I had never used one before, but this time around I figured, why not give it a go.  Anyway, I was really grateful for Lessan’s technical mind.  He quickly put it all together and helped me apply the pads and get it going.  The instructions said it was best to start in early labour, so I thought I might as well do that.  I thought it might help me handle the contractions better so that I could get some sleep.  I just hoped that the pads would stay on long enough for when they would really be needed and also that the batteries would last long enough.

Anyway, my first impression of the TENS was that it was really helpful.  It was kind of similar to using a heat pack, which I had done when in labour for Ella’s birth, but better in that it gives you an extra second sensation to focus on while having a contraction which is very helpful as a distraction.  In the early stages, it almost eliminated all the pain.

After trying to rest for a while, I got up and had a chat with Martha and Thomas at about 11:30am.  I hadn’t really been able to sleep.  I had had a burst of energy after the midwives left and just wasn’t ready to sleep, so I got up.  Lessan had just gone to take a nap at that point.  I timed some contractions while I was chatting with her.  They were pretty irregular - anything from 10 minutes apart to sometimes 4 minutes apart, ranging in duration from 25 to 40 seconds.  They were pretty mild, too, since I could easily sit at the table and talk through them.  Still, the TENS helped.

After about an hour of being awake, I started to feel drowsy again, so I thought I’d better try to nap again.  This time, I was more able to sleep.  I was still having contractions, so I would press that boost button on the TENS every time I had one, but I think I got some sleep in between.

At 2:30pm, I got up and decided I should try to walk around and try to help labour move along, since it seemed to still be mild and irregular.  Lessan told me Martha had just gone home, since she needed to take care of her kids and it seemed unclear when things would ramp up for my labour.  I completely understood that she needed to go, but I wondered how we would get through the next few hours until bedtime since, even though I wasn’t in established labour, I wasn’t really feeling up to chasing after kiddies.  Anyway, things worked out okay because Lessan took Thomas out with him to pick up Ella (who was needed to be picked up from kindy at 3pm) and in the car, Thomas fell asleep.  He had been really sick all day and really needed to rest, but hadn’t up until that point.  So, by the time Lessan got back, we only had Ella to contend with.

While they were out, I did a few laps walking around the backyard in the sunshine.  It didn’t seem to be changing the pattern of the contractions, but I thought it couldn’t hurt. After a while, I got tired and went to rest in bed again.  When Lessan got back, he asked me to hold Ella while he put Thomas in bed.  Ella asked to breastfeed.  Generally, she hadn’t been breastfeeding except maybe once a week, or even less, but this time I said yes, as I thought it would be a good idea to try to stimulate some stronger contractions.  It did seem to do that a bit.

When Lessan came back, Ella, he and I all went outside again and did some more laps around the back yard. I even tried walking like a sumo wrestler (which I’d heard about in a podcast as a way to help labour progress).  Ella thought that was pretty funny and soon we were all doing that!  Lessan and I also tried to hug and kiss between contractions, which was something we had enjoyed during the birth of Ella, but this time, Miss Ella was here and she wanted to get all of Daddy’s cuddles!

After a while, we came inside and just hung out. I think I did some chores and Lessan helped, we made some dinner and eventually started watching a series on Netflix.  We normally wouldn’t do that with kids around, but this time was an exception, as it was a good distraction.  I just had to keep reminding Lessan to stop Ella from climbing on me, which I really couldn’t handle at that point.

Active Labour

By around 6.30pm, my contractions were starting to get into a more regular pattern of 5 minutes apart, lasting at least 40 seconds.  They were also stronger in intensity and I was having to stop and breathe through them.  I had also increased the power on the TENS machine.  I called Martha and asked if she could come back, as I suspected we may need to go to the birth centre in the next hour or so.  Thankfully, Martha was able to come right away.  She also decided to bring Amy to help! I also called my midwife and explained what was happening and that I didn’t want to be driving with contractions that were much stronger than this.  She agreed that it was reasonable for me to leave in that timeframe and just asked me to call again once Martha arrived.

Soon after arriving at Te Awamutu Birthing

By the time Martha arrived, it was about 7.20pm.  Lessan was trying to put Ella to sleep and, unfortunately, Thomas had woken up maybe half an hour prior to that (probably due to his shortness of breath with asthma). I had been having to manage giving him a puffer and make him food between contractions, which were now even stronger and lasting longer, but still about 5 minutes apart.  I briefed Martha on the situation with the kids and then called my midwife again, explaining that I was hoping to leave as soon as Lessan had finished putting Ella to sleep in the next 10-15 minutes.  I was slightly concerned she would say I should wait longer, but she acknowledged that getting to the birth centre before it was too late had always been a major concern of mine and that she didn’t want to second-guess me.  She said, likely the contractions would slow down a bit during the drive and may take a while to pick up as I settled into a new environment, but they would probably intensify after that.  If for some reason they didn’t or petered out, it would be okay for me to just go home, but she doubted that, as it seemed labour was established.

Lessan soon emerged with Ella, having been unsuccessful in putting her to sleep.  Martha and Amy would have to handle looking after the two of them until they went to sleep.  Lessan got my bags and the carseat into the car and we said a quick farewell to everyone before heading off to the birth centre.

Driving in labour had been one of my major concerns for the birth.  I had seriously considered home birthing just to not have to do that.  But, the pros of the birth centre seemed to outweigh this concern.  Lessan drove very carefully and a bit slower to ensure I had a comfortable ride.  Luckily, it did go very well and I only had three contractions on the way, the last one just as we pulled up.  On the way, we sang a few prayers together and that helped me relax.  I also made good use of the TENS machine. I was really happy to be heading to the birth centre, as it was becoming difficult to labour in the conditions at home and some of my contractions were becoming the kind where you can feel the cervix opening just a little, so I was fairly certain we had made the right decision to go when we did. Overall, the car ride was easier than I feared.

Student midwife, Lucy, checking the fetal heart-rate and position

When we arrived (at about 8pm), Karene and Lucy met us at the door and escorted us to the birthing room.  It was all ready to go - there was mood lighting, the heating was on and the birth pool was already full! We got settled, set up the music and put out some more LED candles.  I was still having contractions, but they seemed shorter and a bit weaker than before.  I felt a bit foolish with the midwives observing me, as if they were waiting for something to happen, and I started to worry that we had arrived too early after all!

I tried to get things moving again by walking around, swaying and trying to ‘get in the zone’ and forget about being observed.  As I relaxed more, I closed my eyes and danced around the room to the relaxing ‘spa’ music we had on.  I also thought it would be good to get some oxytocin flowing by slow dancing with Lessan and kissing him.  He was only too happy to oblige and that was really nice.  The midwives let us do that in private for a while. I took my top off, as it felt good when he touched the skin on my back and arms.  I remembered something I’d heard about how the conditions that ‘get the baby in’ will get the baby out.

Before long, things had definitely intensified and I was also feeling more tired.  I leaned over the bed while Lessan stroked my back or pushed my hips together.  Then, I climbed onto the bed, which was partially raised and just rested on all fours.  I no longer wanted to be touched during contractions, but it really comforted me having Lessan close by, or gently stroking my upper arms.  When he walked away to do something, I immediately noticed and felt less secure.  I later reflected on how it was wonderful that I was able to let Lessan support me.  In previous labours, I wasn’t able to do that.  Perhaps out of fear, I often didn’t want to be touched at all, and in a way, pushed Lessan away.  This time, it felt like I had the strength and courage to let him touch me.  I guess it also helped that, after a day of slow labour, I was wanting things to intensify, rather than shying away from that.

Tens Machine pads visible on my back

At this point, I had put the TENS machine up to the second ‘intense labour’ mode and I noticed that I could feel my cervix dilating quite strongly during contractions and, though I didn’t have the urge to push, giving a slight push during contractions was somehow comforting.  I was vocalising through some of these contractions, but some of them I quietly breathed through.

I told Lessan that I might want to get in the pool soon, so he went and told the midwives (who were still just outside the door, listening) so they could make sure it was the right temperature. I wasn’t 100% sure getting in the pool would help.  I was slightly reluctant to take the TENS machine off and slightly worried it might be too early.  But I took my chances.  Lucy suggested I do a wee before getting in, so I rushed to the toilet to try to get it done before I had another contraction (I think Lessan was timing them at this point and they were about 3 minutes apart, lasting over a minute).  Just as I was climbing into the pool, I had a strong contraction and the act of climbing made it worse! But, it was immediate relief once I was in.

It was nice to feel buoyant and warm (I didn’t feel like it was not warm enough this time, like previous labours, thankfully! I think it helped that the air was nicely heated and not drafty).  But, I was still uncomfortable and had to find a new groove for handling the contractions, since I didn’t have a button (TENS machine) to push anymore.  I also noticed a shift soon after getting in the pool, as if the head had descended more and the cervix was dilating.

I felt tired and like it was difficult to find a restful position in the pool.  I think inflatable pools are a bit better at cushioning you.  I tried to lean on a towel on the edge of the pool, but because of the depth of the pool, I still had to cling to the edge so as not to fall in, and this was tiring.  Later I held Lessan’s hand and that was helful, and quite comforting. I started to feel shaky and my legs felt weak and a bit crampy, perhaps from the way I had been kneeling for about an hour prior to getting in the pool.  I had also done a fair bit of walking during the day.  At some point, Karene massaged my calves for me to help ease the cramping.  I was curious how I was progressing, so I ventured to check my own vagina.  I felt something softish not very far in.  It was possibly the bag of waters.  I asked the midwives if they could confirm what that was, but they encouraged me to just trust the process and not worry about that.  I decided to try to follow their advice and go deeper into the zone.

My contractions were now very intense. Sometimes I would breath through them, other times I would moan or ‘tone’.  I didn’t have the urge to push, but intellectually I thought that if I could push, it might feel better.  So, during contractions, I began giving a gentle push, and I could feel that opening my cervix.  Soon, I could really feel the coccyx bone moving backwards.  Between contractions, I also clearly felt the baby wiggling downwards.  That was a very odd feeling. All of these intense feelings left me feeling overwhelmed and a bit scared, so I decided to sing the prayer Lessan and I had sung earlier in the car - “Ya Baha’u’llah-Abha x 3, Allah’u’Abha x 3”.  Midway through the song, I had a contraction and couldn’t quite keep singing, but just kept a few notes going.  I also said more prayers in my mind, remembered all the women who had done this before me and tried to remind myself that it would be soon over.

About half an hour after getting into the pool, I had begun grunting a bit during my contractions, even though I (once again) didn’t feel like it was quite time to push.  I gave a gentle push during a contraction and suddenly I felt a big ‘pop’.  I was pretty certain my waters had just broken. This caused the baby to move down towards the vaginal opening almost immediately and the sensations, rather than easing, intensified dramatically.  Rapid stretching of the perineum just came on so suddenly.  I started screaming “ow, ow, ow”, panting and getting a bit breathless as the head started to emerge.  The midwives, who had up until that point been silently observing, apart from the occasional checks and words of encouragement, sprang into action to encourage me to slow down my breathing and when I pleaded for them to “Make it stop!”, Karene said “Melissa, it’s your baby’s head coming out.”  This reminder was somehow needed at the time! It was  like my brain couldn’t process what was going on.

Baby is Born

With one contraction the head had emerged, but then it went back inside soon after that contraction ended.  I was relieved to have a bit of a break from the intensity.  Despite the pain of this experience, I remember feeling like the head was really small, like it couldn’t possibly be this small.  Then, with the next contraction, the head half emerge and just stayed there for several minutes.  The intensity died down as my perineum stretched and got used to that size, but it felt strange with the head just sitting there.  I didn’t know if I should try to push the rest out or just wait for it to do so ’by itself’.  I asked the midwives, “Why is it just sitting there?  Will it ever come out?” but as they couldn’t see (I was kneeling facing them), they thought I meant it was just sitting inside.  Karene said, “It will come when you’re ready”.  When Karene realized that it was half out a couple of minutes later, she came to look, as I turned over onto my back and she said, “Okay, push the rest of the head out.”  Then, with the next contraction, she said “Push the rest of the body out.”  It took a couple of pushes to get him fully out, but when he did come out, he shot out across the pool.  At the time, I had my eyes closed and didn’t really realize what had happened, I just reached for him, and found him there in my arms, not realizing that Lessan had actually caught him from the other side of the pool (he was standing outside and leaned in) and then passed him to me.

It was such a wonderful moment to be able to have my baby in my arms, quite surreal, like I couldn’t quite process what had just happened.  My first impression was how small he was.  He was crying and had a good, robust cry.  He was a good purple colour and soon turned pink. After a short time, Karene asked if Lessan wanted to say the prayer for newborns.  He got the words from my notes and read it out as Lucy (the student midwife) filmed him. Soon after this, I said I wanted to get out of the pool so that we could let Joseph do the breast crawl (I was also feeling uncomfortable in the pool and wanted to get out).

Allowing baby to do the breast crawl

Fortunately, the umbilical cord was quite long (about a metre long, it turns out), so I could easily get out of the pool while holding baby myself.  (After Ella’s birth, I couldn’t get out of the pool easily because the cord was too short, and so I had to wait in the pool until it stopped pulsing and cut it at that point, rather than after birthing the placenta, as I had hoped).  With a bit of help, I climbed out and walked to the bed.  The midwives helped me lie down and lay Joseph on my chest skin to skin (I took my bra off first) and then covered me with towels and blankets.  It was comfortably warm in the room and I enjoyed the chance to rest and recover, but I was still in pain with regular, quite strong contractions, as well as cramping in my legs.  Karene offered to give me a homeopathic remedy for cramping that contained magnesium, but she then realized that she didn’t have it with her. I remembered I had brought some magnesium oil spray, so Lessan sprayed it on my feet for me and then later, Karene massaged it into my legs.  This seemed to help.  She also got me a hot water bottle to put under my back to help with the contractions. She also gave me a homeopathic remedy to help with healing.

Meanwhile, Joseph was resting on my chest, then gradually trying to suck his hands.  He then managed to suck his thumb.  He was doing this for quite a while and Karene seemed to be thinking he might like his thumb too much to try to breastfeed.  So, even though I could have let him try a bit longer, I decided to help him to the breast.  He latched on pretty easily and fed well.  This of course brought on more contractions, though.

I was eager for the placenta to come out, as I hoped that would stop the contractions.  Karene noticed that the cord was still pulsing 40 minutes after the birth and said that if the cord was still pulsing, the placenta wouldn’t have detached yet, so I had to wait.  I had been impatient to get through transition and be able to push, and now again I had to be patient to push out the placenta.  Finally, at about an hour after birth, the cord had stopped pulsing and so Karene suggested I try to push the placenta out.  I didn’t have much energy at that point, but I gave it a go and it half emerged.  Up until that point, I hadn’t had any bleeding whatsoever.  The pool water had been completely clear, apart from a tiny bit of mucus (my mucus plug, I guess, which hadn’t come out earlier, no bloody show). So, as the placenta emerged, blood started to come out that had been pooling behind the placenta.  It wasn’t much, though.  My notes say 100mL.  Karene rushed to get some pads and then encouraged me to push the rest of the placenta out.  Out it came with a bit more effort, and the rest of the blood.  Karene put the placenta in a container and left it between my legs as Joseph continued to breastfeed from the other breast. It felt like we stayed like that, resting and feeding, for a while.

Joseph found his thumb, but not the breast, so I gave him a hand

Then, while still breastfeeding, Lucy gave Joseph his vitamin K injection.  He unlatched to cry for a moment, but then comforted himself by getting back on the breast.  By this point, I was quite tired and hungry and also looking forward to having a shower, so I was happy that we could cut the cord and that I could pass Joseph to Lessan to hold for a while.  Lucy and Karene showed Lessan how to tie the cord tie.  It was one that Karene had made and she asked Lessan which one of two she had with her that he preferred.  I had previously read about cord ties and liked the idea that it was softer on baby’s skin, but had also  read that it was discouraged by some doctors because it could become infected more easily.  Karene had personally used cord ties with her clients for many years and never had any problems, so I thought it was worth giving it a try while being careful to keep it clean.  (A week later and the cord stump has finally fallen off.  There were no problems with the cord tie at all.  I did make an effort to keep it clean, keep it out of the nappy and not let it get wet, which were the potential hazards, and it was fine! I felt it was much more comfortable for baby, especially when he would like on his stomach on my chest.)

So, with that done, I ate some food, went and had a shower, got dressed (adult diaper included) and ate some more while Karene helped Lessan dress Joseph in some nice warm clothes.  Lessan craddled Joseph in his arms and he quickly fell asleep.

All dressed after his newborn examinations

The midwives then helped us move into one of the postnatal rooms.  By this point, it was after 1am.  I collapsed on the bed, Lessan holding baby, while Karene explained how everything worked at the birth centre.  After they left, the on-staff birth centre midwife came to see us, at which point Joseph woke up and I gave him one more feed and he fell asleep.  Lessan ended up holding him for the rest of the night.  Despite being exhausted, I wasn’t able to easily sleep.  I kept wanting to check on Joseph, my legs felt a bit weird after all the cramping and I was having afterpains.  The after pains, in my half-sleepy state, seemed to trigger memories from the birth, as if I was experiencing it again, and it wasn’t so pleasant.  I guess it was my brain trying to come to terms with the whole experience.  On the plus side, Joseph was having his ‘birth recovery sleep’, so he slept all night and only needed a feed in the morning at 7am. In fact, I had to wake him up for that feed, as Karene had said I should.  From that point onwards, she said I should wake him every 2 hours in the day and 3-4 hours at night for a feed, since babies in the first 2 weeks of life can often sleep through their own hunger.

Lessan at home with the kids.  We skyped a bit with them.

 Soon after we woke up in the morning, Lessan had to go home because Martha needed to go home.  From that point until I left, I stayed at the birth centre alone, with a couple of visits from Lessan and the kids.  It was a little lonely, but I was so grateful to have that time to recover in peace.  It was also a great way to get breastfeeding off to a good start, since that’s pretty much all I had to do.  My milk began to come in by the end of my first day at the birth centre and by the second day, it was well and truly in.  Jospeph slept a lot and was very calm in general, so I got to rest and recover a lot.  I was also given lovely meals and had plenty of support from the on-staff midwives, who came to check on me regularly.  I generally didn’t need any help, but it was nice to feel like help was there.  Pretty soon, it was time to head home and face the daunting, but beautiful, reality of having three children!

Reflections

I was amazed by how easy the whole birth was.  There were difficult moments, but I never felt like I couldn’t get through it.  Perhaps this was because I had experienced birth twice before and the familiarity of the sensations meant that I knew more or less what to expect and didn’t feel afraid of what was coming.  I was so grateful that my midwife and her student did so much to follow my birth plan.  During previous pregnancies, I had wanted to make a birth plan, but my midwives generally didn’t see the point, as they thought that they could just do what they normally do, since their philosophies aligned fairly well with mine.  However, Karene suggested I make a plan this time and took a lot of time to go through it with me to make sure we were on the same page.  I felt like that made me really feel validated, like I could trust her to make the experience as much how I wanted as possible.  Lessan later told me that during the birth, she and Lucy were re-reading through the plan to make sure they didn’t forget anything.  And really, they didn't.  Of course, it could have always been possible that a change of plan would be needed and fortunately everything went well.  In fact, it went better than well.  It was amazing not to have any tearing, to have minimal bleeding and for Joseph to have no problems breathing.

In the dining room of the birth centre one morning

I am also grateful that the plan of going to the birth centre worked well.  I was quite concerned that I would leave it too late to get there and accidentally give birth in the car, or have to stay home for an impromptu home birth.  I had agonized about how to know when to go so as not to arrive too early (and be sent home), but not to leave it too late.  I was also really worried that the drive to the birth centre, especially if left too late, would be unbearable.  Well, I’m so happy that when I thought it was a good time to go, Karene supported me and encouraged me to go, reassuring me that it would be okay if it turned out to be too early.  As a result, the car ride was bearable and, fortunately, my labour progressed quite quickly after arriving - baby arrived only 2 and a half hours after we got there.  The experience of being at the birth centre was exactly what I wanted.  I wanted to be somewhere peaceful, where I didn’t have to worry about the kids, about the logistics of the pool, about the clean-up and also in a space where Lessan and I could bond as a couple during the experience, and it was all of that.  So, overall, I don’t think there’s anything I would change.

Times and Stats from my medical notes

8pm arrived birth centre
palpitation of belly, blood pressure, pulse
baby lying Right Occiput Anterior, 3/5 engaged
8:53 lying Left Occiput Anterior (after kissing)
9:30 get on bed breathing through contractions
9:43 get in the pool
9:50 feeling tired and shaky, crampy legs
10:27 baby born
10:30 say prayer
10:35 out of pool onto bed for breast crawl
11:20 placenta birthed

Head circumference 34.5cm
Length 50cm
Weight 4kg

Joseph on the bed at the birth centre, next to a spoon for size comparison

Helping baby crawl and walk

My first child, Thomas, is now almost 3 and my second child, Ella, is now 6 months old.  We're not planning to have another child for a while, at least, so my thoughts are no longer so centred on preparing for birth, but on raising children! I am still interested in birth very much and delight in talking about it to anyone who will listen (and definitely overwhelm them with all my opinions), but for this post, let's think a bit about what to do with baby when he/she arrives!

In the next couple of posts, I hope to bring together a few themes that have been spinning round my head the last few weeks - fostering neurological development and independence in babies and children and how that intersects with parent behaviour (and public health). In this post, I'll focus on motor skills development.

Neuroscience and Education

I've been thinking about neurological development because I came across this website (http://www.celinealvarez.org/).  Celine Alvarez is a French woman who studied neuroscience and wanted to apply her knowledge in that field to education, as she felt that schools were completely going against basic principles of child development and therefore not only neglecting golden opportunities for learning but actually damaging young minds.  She set out to become a kindergarten teacher so as to put her theory into practice in an "underprivileged" school in France.  She was very inspired by the work of Maria Montessori, but didn't stick to her work rigidly.  Her experimental class was very successful.  Her students started with numerous delays and ended up surpassing the average in all areas, to the surprise of parents and colleagues.  The national education system eventually decided to shut her class down, but she wanted to share her experience with the world, entirely for free, so that all could benefit and further advances can be made.

So far, she has made at least 18 training videos to describe her method.  The first four are about basic neuroscience in children. These concepts are being talked about by many scientists and educators, I just found Celine Alvarez's descriptions helpful.

One of the first concepts she explores is neuroplasticity and critical periods.  She explains that babies begin learning even before birth and continue to learn as they grow up, but most intensively in the first five years or so.  At that time, the brain is especially plastic - that is, the brain is in a period of change and flux whereby children absorb everything around them without making much of an effort, the "absorbent mind", as Montessori calls it. However, there are certain caveats - firstly, though the brain is hardwired for learning, it must be sufficiently stimulated in order to make those connections.  For example, though we are all built to learn language, real life examples show that if a child is not spoken to, they will not learn language.  Conversely, if a child grows up in a multilingual environment, they can learn multiple languages with ease.  Secondly, there are critical periods in which that stimulation should occur in order to allow learning to take place properly.  If a critical period is missed, the learning will be much harder, and most of these lie within very specific months of early childhood. There is another window of plasticity that opens up at adolescence, but the level of plasticity is less.  Beyond that, though the brain continues to be a little plastic, the adult brain is more in a mode of performing expertly the skills it has learnt rather than acquiring new ones. This is why the environment of children should be as rich as possible to stimulate learning experiences.

The third caveat concerns synaptic pruning.  Basically, though a child has the capacity to learn any and every human skill, those practiced infrequently will be eliminated in the process of helping the brain become an expert at what it does.  The process takes place rapidly in early childhood, therefore, we should keep in mind that it is not the best or nicest experiences that the child retains, but the ones that are most frequent.

These concepts have amazing implications for how we treat babies and children.

In the next few blog posts,  I'd like to look at neuroscience and what it suggests about infant care and the education of young children.   In this post, I'd like to take a closer look at the development of motor skills, such as crawling and walking.

Motor Skill Development and General Development

It seems to me, though I'm no expert, that the motor skills of crawling and walking would be very important in a child's development.  It's not only the fact that these skills are vital in themselves, but importantly, in that they allow the child to begin exploring the world independently.  You'll notice a baby who begins to crawl has very little spatial awareness - it's only through the process of banging into things, getting stuck under and between furniture, do they realize how space works.  Crawling also enables them to access their hands - to pick up small objects on the ground, put them in their mouth (which helps them understand their shape), and experiment with them by banging them and so forth, all of which is really a scientific exploration of their environment which results in amazing learning. In the process of learning to crawl and crawling itself, the child is also developing skills of coordination (especially in bilateral crawling) and developing muscles in the upper back, arms, wrists and fingers which will be useful (nay essential) in later life.

Does it matter when a child develops these skills?   I wonder whether there are more optimum periods of plasticity for these skills and whether waiting a few months could actually be significant. After all, a couple of months in the lifespan of a baby is a huge proportion of this critical, ultra-plastic period of life.  But, can we control when a child reaches these milestones?  Don't they just do it when they're ready?

Well, yes and no.  There is nature - what the child is genetically programmed to be able to do, but there is also nurture.  In terms of nature, there is surely great variation between individuals, but on the other hand, those neural pathways need to be stimulated in order for the skills to be developed and so a child's development could be delayed by lack of proper stimulation.

Back-Sleeping

There was a campaign in the 1990's to get parents to stop putting their babies to sleep on their stomachs (which was the previous recommendation) and to start putting them on their backs in order to try to combat SIDS.  Though this isn't the purpose of this post, I personally think that SIDS is due to an internal abnormality (perhaps one of many possible abnormalities) that is aggravated by external factors, such as the presence of cigarette smoke, formula feeding, and stomach sleeping. That does not mean that stomach sleeping is the cause.  For many babies, it is harmless (as evidenced by the fact that before the Back to sleep campaign, the SIDS rate was still actually a tiny percentage of babies), but for some babies who have some unknown abnormality, they are more vulnerable in this prone position.  Possibly because of more Slow Wave Sleep and more trouble arousing naturally. A truly healthy baby in a safe environment (i.e. no dangerous gases around, no overheating and no suffocation risks), should be able to sleep on his/her stomach and be able to arouse safely.  However, since no one really knows what kind of baby they have (any baby could have hidden abnormalities which science needs to discover), it's safest to put baby to sleep on their back.

Back-Sleeping and Developmental Delays

Although this campaign was quite successful in getting people to change their habits, an unintended consequence of this campaign that is getting more attention nowadays is developmental delays as compared to the prone sleepers out there! Notably motor development, but also social and cognitive development. This information from Wikipedia on their "Tummy Time" page is enlightening:

"Since 1998 there have been several studies published which report that infants placed to sleep in the supine position lag in motor skills, social skills, and cognitive ability development when compared to infants who sleep in the prone position.[4][5] In a 1998 article entitled "Effects of Sleep Position on Infant Motor Development" by Davis, Moon, Sachs, and Ottolini, the authors state "We found that sleep position significantly impacts early motor development." The prone (stomach) sleeping infants in this study slept an average of 225.2 hours (8.3%) more in their first 6 months of life than the supine (back) sleeping infants.[5]

In the 1998 article entitled "Does the Supine Sleeping Position Have Any Adverse Effects on the Child? II. Development in the First 18 Months"[6] by Dewey, Fleming, Golding, and the ALSPAC Study Team the objective of the study was "To assess whether the recommendations that infants sleep supine could have adverse consequences on their motor and mental development." They used the Denver Developmental Screening Test (DDST) and studied infants at 6 and 18 months. According to the study, at 6 months of age, the infants who were placed to sleep in the prone position had statistically significant higher social skills scores, gross motor scores, and total development scores than those infants who were put to sleep in the supine position. In the 2005 article entitled "Influence of supine sleep positioning on early motor milestone acquisition"[4] by Majnemer and Barr they used the Alberta Infant Motor Scale Scores (AIMS Scores) to analyze the impact of infant sleep position. They reported that "Typically developing infants who were sleep-positioned in supine had delayed motor development by age 6 months, and this was significantly associated with limited exposure to awake prone positioning." But, the authors also note that awake prone (stomach) positioning is associated with prone (stomach) sleeping. No studies have been conducted which compare supine sleeping infants who have regular awake prone positioning to prone sleeping infants who have regular awake prone positioning.

Placing infants on their stomachs while they are awake has been recommended to offset the motor skills delays associated with the back sleep position[4] but positioning the infant on their stomach while awake will not impact the amount of slow wave sleep[7][8][9][10][11] since tummy time only occurs when an infant is awake."
https://en.wikipedia.org/wiki/Tummy_time

The developmental delays are mostly attributed to simply less time spent on the stomach (prone) engaging in "anti-gravitational activities" which encourage them to lift up their head, lift up their chest, roll in both directions, crawl, sit up, pull to standing and finally walk.  If a child is delayed in any of these milestones, the others seem to be pushed back and they are also missing out on the opportunities they could be getting to explore and interact with their environment, which are so crucial to stimulating those neural connections. One other possibility for delays is actually the amount and quality of sleep between the two groups, with prone sleepers getting more sleep and more slow wave sleep.

But, that aside, the reason that back sleepers have trouble getting enough opportunities to develop "anti-gravitational" skills is nicely explained here:

"Prior to the Back to Sleep campaign, infants who slept in the prone position also tended to spend awake time in the prone position. When an infant awakes in prone and becomes fussy or bored, it naturally learns to push up on its forearms and lift its head to explore the environment. Pushing up against gravity also has the added benefit of strengthening the muscles used in other prone skills such as pushing up onto hands and knees, creeping, crawling, and rolling over. Infants who sleep in a supine position are not in the appropriate position upon awakening to achieve these skills spontaneously. Without adequate prone time, the antigravity motor patterns may be underdeveloped. When the infant is then placed in prone, it is an uncomfortable position and the infant will often fuss and cry. The parents' response is to then say that their infant does not like this position, and therefore they may not provide prone time during the day."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595182/

Tummy Time

So, to compensate for these factors, public health workers have tried to emphasize the importance of tummy time for awake play.  But, it's been difficult when people are so afraid of SIDS.

"Although “tummy time” is also included in the Back to Sleep educational materials, it is often forgotten. In addition, parents are often so fearful of SIDS that they are often reluctant to provide prone time, even when the infant is awake. Mildred, Beard, Dallwitz, and Unwin (1995) found a significant association between the knowledge of SIDS and fears connected with prone play positioning. In a self-administered questionnaire, 93% of the parents reported that their knowledge of SIDS influenced the sleep position they chose for their infants. Eighty-four percent of these parents reported that they never placed their infant in a prone position for sleep, and 26% reported never placing their infant in a prone position for play. These results demonstrated a significant association (p = 0.002) between the knowledge of SIDS and the avoidance of the prone position for play."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595182

There is actually a little evidence that tummy time may compensate for the advantage prone sleepers have, but only "partially" - see "The Flip-Side of Back to Sleep".  To my mind, this is because in practice, babies sleep a lot and so if a child sleeps prone, it's simply getting many more opportunities to be in a prone position every time it wakes up, even between sleep cycles to turn it's head or shift around.  It is very difficult to get a child who is used to being on their back to play on their stomach and it's simply a challenge to remember to keep trying with the tummy time.  I personally think there should be more research done to discriminate between those infants at risk of SIDS for whom sleeping prone really is dangerous.  However, since we still don't have that information, I can understand that the message still needs to be "back to sleep and prone to play."  There just needs to be a lot of effort and attention paid to that area and a bit less fear around just leaving baby on their tummies.

Is it okay to skip a milestone?

To add, some children are not only having delayed motor skills but to even skip certain stages altogether, and this is linked back to supine sleeping/not enough tummy time.  Here are some consequences of not learning to crawl:

"Crawling helps strengthen the hands, wrists, elbows, and shoulders because babies have to constantly activate them to support their body weight," says Felice Sklamberg, a pediatric occupational therapist at New York University's School of Medicine. "We're seeing that because non-crawlers aren't as strong, they have a harder time as older children pulling themselves out of a pool, climbing a jungle gym, or even picking themselves up from the floor."

Skipping this milestone can also affect a child's ability to hold silverware or a pencil down the road, since the weight-bearing experience of crawling helps develop arches and stretch out ligaments in the wrist and hand that are needed for fine motor skills. "During the crawling period, the large joint at the base of the thumb is expanded into its full range of motion, so non-crawlers may have messier handwriting, for example," explains Mary Benbow, an occupational therapist and a leading expert on pediatric hand development.

Crawling is a unique experience in other ways as well. "It's a real step up for coordination because it's the first opportunity to practice bilateral coordination  -- using the arms and legs in reciprocal movements," says Jane Case-Smith, director of the division of occupational therapy at Ohio State University's School of Allied Medical Professions in Columbus and an early-intervention specialist. "This skill is used in activities like getting dressed, self-feeding, and sports. A child who sidesteps crawling may have more of a struggle catching up."

Babies who skip any kind of scooting or dragging miss out on the benefits of being on the floor as well. "Children learn through interaction with their hands. They don't get as much if they go straight to walking, because then they need to use their hands for balance," says Karen Hendricks-Muñoz, M.D., chief of neonatology and associate professor of pediatrics at New York University's School of Medicine. "Navigating on the ground also helps visual spatial skills and depth perception develop more quickly."
http://www.parenting.com/article/do-babies-need-to-crawl

Proponents of the back-to-sleep campaign, before it was even widely implemented, knew that supine sleeping could cause developmental delays, but argued that these were not significant, as children caught up to their peers eventually.  However, some have since questioned this, especially in the case where a child completely skips a milestone.  It looks to me like their development is affected beyond their infancy into early childhood and schooling and possibly further down the line.

Long-term Consequences

In an article entitled "Losing our grip: More students entering school without fine motor skills", it explains:

"...many therapists believe the Back to Sleep campaign...has delayed muscle development. The problem becomes more pronounced when parents skip wakeful tummy time because their kids don’t like it: toddlers might not be able to hold their bodies upright as well as their peers did years ago.

They might not be as adept at spreading their hands and using their arms to push themselves up, a fundamental base for good seated posture and proper shoulder support when writing. Their eyes also may wander, making focusing on detailed tasks difficult."

So, as I tried to explain initially, motor skills are important not only in themselves, but also in developing a whole host of other skills as they are the keys to exploring the environment and interacting socially with others.  And, it seems, that when a skill is delayed or skipped entirely, it can have flow-on effects into the future.

So, apart from providing plenty of tummy time, can anything else be done to assist motor skill development?

This "exersaucer" doesn't help a baby learn to walk. Au contraire...!

Beware of products that 'help' motor development

Sometimes parents (and manufacturers) think that they can allow a child to experience their environment more fully by buying products that 'support' the child in a more upright position (sitting or standing), such as walkers, jumpers, bouncers and seats of various kinds.  It makes sense, from a neuroscientific perspective to want to allow the child to get a better view of the world or be able to use their hands, but the way they go about that is misguided because those products actually slow down the child's ability to do those things themselves by reducing their tummy time and can in some cases be detrimental to development by, for example, encouraging the wrong muscle groups to be developed. I know that these devices can sometimes be necessary as a safe place to confine baby, or to make something like feeding solids easier. But, if you want to buy something to help your baby learn to crawl or walk, skip the jumper or exerciser that helps her stand, and buy a nice, comfy mat where you can both hang out as much as possible.

Here are some articles explaining why some popular baby devices are unhelpful:

Bumbo chair:
http://articles.chicagotribune.com/2012-03-15/health/ct-met-bumbo-posture-20120315_1_physical-therapists-developmental-benefits-babies

Jolly jumper:
http://www.coreonehealth.com/jolly-jumpers-and-infant-development

On the other hand, there are some 'devices' that seem okay to me, though I would like to know if I'm correct in saying this -

Carrying baby in a sling/baby carrier - if you are carrying baby this way, you are not forcing your baby to use muscles in an unnatural way, what you are doing is much the same as what happens when you hold bubba in your arms.  You are actually allowing them to develop head and neck muscles as they gradually learn to look around when supported in the sling. When baby is ready, carrying him/her on your back seems to me to mimic being on the floor on his/her tummy in some ways.  However, I have heard that carrying the child in a forward facing position puts them in an unnatural position that strains their back, and yours - http://www.boba.com/blog/nine-reasons-not-to-carry-your-baby-facing-out

Push-toy walkers - these are different from the other walkers mentioned above in that they do not force baby to stay in an upright position, but rather give the child something to hold onto when they need extra stability when starting to walk.  However, one chiropractor disagrees, saying that holding a push toy aggravates muscle weaknesses and imbalances, and is different from furniture surfing, which is okay.  Hmm... okay then, it seems that tummy time wins again!

Conclusion

Babies have amazing brain plasticity which allows them to learn an astonishing amount of information in a short span of time.  This time is precious, not stimulating him or her enough in critical windows can have long-lasting effects.  However, whether a few months delay would be akin to missing an optimum period of development or not is unclear.  Also, how to foster motor development precisely is still a subject of contention.  To me, it seems that allowing the child to develop as much as possible in a natural way (i.e. not allowing him/her to do what she cannot do unaided) and giving him/her plenty of tummy time, are both crucial.

Ella's Birth Story

My birthing space

As a bit of background, we were planning a homebirth, as we had had with Thomas.  This time; however, we were on a government programme called the "Midwifery Group Practice" through Bunbury hospital.  This programme is for hospital and homebirths with a known midwife, but homebirths are only allowed for very low-risk pregnancies.  I was really grateful that throughout the pregnancy I had been well and there were no risk factors whatsoever.

My plan for getting through the labour naturally included preparing physically through yoga and exercises like squats, preparing mentally through mindful meditation and setting up my birthing space with positive affirmations and inspiring quotations on the wall, mood lighting, a playlist of calming music as well as shelves full of everything we might need for the birth.  I had comfort measures on hand like a ball to rock and lean on, a bean bag, a portable camping toilet (so I wouldn't have to walk too far to go to the loo),  a "birthing blend" to diffuse and also to use for massage, plenty of hot packs and of course, the birth pool. I also worked with my husband and doula to see if they could help me with massage, acupressure points and many other things. In summary, everything was ready to go.  All that was needed was for my body to go into labour!

In my previous post, I talked about the weeks and days leading up to the birth.  In it, I explain how we had a feeling that baby would come on 5 September (that's six days past the due date). The night before (Friday 4th September) we had been acting like it would happen the next day, but with no real reason to believe it would.

Nevertheless, that Friday night, just after falling asleep at say, 10pm, I started having contractions! They were definitely contractions because they were a kind of sharp cramp in my lower uterus. I was comfortable enough to lie down during them, but it helped to focus on my breathing a bit and wait for it to pass.  I got up a bit more than usual that night to go to the toilet, walk around and also do fast hip circles on the exercise ball (spinning babies suggests that helps babies to engage).  I still managed to sleep a fair bit between contractions, but I think that most of them were too strong to sleep through. I was excited that things were starting to happen.  Of course, there was always the possibility this was a false alarm, but I had a feeling it wasn't.  There was also a bit of wondering how long the labour would last and how much worse the pain would get, but I tried not to worry about that.

In the morning, I got up and made myself a good breakfast of eggs on toast and helped Thomas get his breakfast. I was having to concentrate a bit through contractions, but could still move and talk through them if someone spoke to me.  I casually reported the contractions to Lessan and he just said, "Oh, OK!".  Soon after, mum got up and jokingly proclaimed "So, this is the big day!' (because we had all been expecting it to happen that day, despite there being no real proof as to why) and I was happy to reply, "Well, I think it is actually, I've been having contractions throughout the night."  She excitedly gave me a hug.

Lessan looking happy that today is the day!

After breakfast, I decided to lie down in bed and get a bit more rest between contractions, since I hadn't gotten enough sleep over night.  Meanwhile, Mum took Thomas and Olivia out to a park for the morning.  After resting for a while, I decided to time my contractions. They were consistently 8 minutes apart and lasting 40 seconds.  I thought that their being regular was a good sign, so I decided to call the midwife to let her know I was in early labour.  I called my primary midwife's number, but it diverted to a different one who was on call - the one I'd hoped would attend the birth! I asked her if there was any way of knowing how long the labour would last given how regular the contractions were and she didn't know, but said that often, for mums who have other children, things really kick off at night, when the kids have gone to bed.  

At about 10am, I got up and had a shower.  I then just walked around and did some yoga exercises on the rug in the living room and rested a bit.  Even though I didn't feel a huge need for it, I prepared a hot pack for myself (it needed to be boiled in the pan and I wasn't sure others would know how to prepare it if it was needed later).  I then decided to watch a documentary on Netflix about the fashion industry.  I was surprised that I wanted to do that, since the idea of watching a screen during labour was repulsive to me last time.  I assumed that the fact that I could handle it meant that I was earlier in the process, despite the fact that by the end of the film, I was having to really concentrate for contractions.

At about 11am, Lessan takes a photo of my belly between contractions

At about 1pm,  Mum brought Thomas home and Lessan went to take him to sleep.  When he was finished putting Thomas to sleep, I had gone outside to labour in the sunshine and he met me there. I had been timing my contractions again and they were between 6 and 3 minutes apart, lasting as long as a minute, but usually only 40 seconds.  The fact that they were kind of irregular puzzled me.  They were generally closer and stronger, but I was still coping well, so I assumed it was still pre-labour.  We spent a bit of time there together chatting, hugging and kissing.  During contractions I would lean on him and we'd sound/tone together.  'Sounding' is a technique I had heard of in the mindful birthing book - it's basically making a sound like 'ah' or 'oh' or 'om', kind of like chanting, and the partner joins in for support. 

When we got inside, I had a chat with mum and then I decided to labour a bit in the bedroom (where I planned to birth).  I put on my peaceful birthing playlist and tried different positions on the bed.  I tried becoming more meditative, closing my eyes and relaxing, even between contractions.  I was still able to talk between contractions, but doing this seemed to help.  At some point during that time, I started to think it would be a good idea to inflate the pool and asked Lessan to do it.  Mum and Lessan laid out the plastic sheeting and taped it to the floor and then Lessan inflated the pool.  The sound of the pump was rather jarring and I had to work harder to stay relaxed (at this point I was kneeling and leaning forward on pillows on the bed in the same room).  During that time, I was finding it a bit harder to get through the contractions and was experimenting with different mental strategies. I also noticed I was starting to feel hotter.  Soon, I told Lessan I wanted him to actually fill the pool, not just inflate it.  As time went by, I became more insistent that he fill it asap!  I didn't consciously think that I would give birth in the pool, just that I needed the warm water for pain relief.  You see, I had this whole debate in my mind during the whole pregnancy about the theoretical benefits of land versus water births for the microbial transfer and so had considered labouring in the pool, but birthing on dry land.  But, at that moment, I only knew that I was having difficulty coping and the pool was my only option of making things a bit easier.

I think that it was at this time, or perhaps a little earlier, that I first started feeling my cervix expanding.  I had forgotten that feeling, but now that I was having it again, the memory of the sensation seemed ever so familiar from my first labour, and that happened towards the end, though  since it wasn't so clear in my mind exactly when that happened, I was still thinking I may have a long way to go.

Starting to fill the pool

As he began to fill it, I got out of bed and walked around and timed the contractions.  This kind of helped as a distraction.  I had a good app on my phone for that. They were coming every 4-5 minutes and lasting a minute or so.  They were also really strong and I was finding it harder to stay relaxed.  I was breathing faster, moaning a bit and moving in weird ways just to cope. I decided to text the midwife and she called back immediately.  I let her hear in my voice that it was getting more intense and when I told her I wanted to get into the pool, she said she was coming.  A few contractions later, I was desperate to get in for some relief from the intensity of the contractions and so, though the pool wasn't full yet, I got Lessan to help me in.  That feeling of the cervix expanding was stronger and I was starting to feel the urge to bear down, so I suddenly felt like I might give birth before I got in.  I realized I didn't want to do that because the contractions were forcefully pushing on my rather closed vaginal area and it hurt!  I hadn't experienced that to such an extent with Thomas because things had progressed much slower.

Not long before getting in the pool.

Once I got in, I felt a little more relaxed, though I wished the water was warmer.  (It was the right temperature, but the recommended 37.5 degrees was just not warm enough to ease the tightening sensations).  It was now 3:25pm. Lessan was busy running in and out to adjust the water and also help mum out the door, who had just decided it might be time to take Thomas and Olivia out.  I don't think they realized how close the birth was. All of his coming and going made me a bit frustrated, but I tried to focus on the task at hand! Getting through each contraction!

Birthing affirmations and quotations on the wall

One of the first contractions after getting in, I gave in a bit to the urge to push and felt a 'pop'.  I knew that was my waters breaking, as I saw little bits of vernix appear in the birth pool water.  I then put in my finger to see if I could feel the head. Sure enough it was there, about 3cm inside.  I knew from last time that this meant there was no point worrying about if I was fully dilated.  The head was there ready to come!

I had a few more contractions that were a bit 'expulsive' and I asked Lessan to see where the midwife was because I was pushing.  He called her and she said she was 7 minutes away.

I tried lying on my side to slow the birth a bit, but one or two contractions later, the head emerged, but then receded back in.  The midwife still wasn't there.  The realization that I would probably give birth unassisted didn't really worry me.  I was confident that I knew what to do, as the sensations seemed familiar.

I probably could have pushed out the head in one contraction, but I wanted to give my perineum more time to stretch, so I held back and so after emerging once, it retreated back in.  I tried using a bit of clitoral stimulation between this contraction and the next to hopefully bring some more blood to the area and allow it to stretch (tip from midwife, Ina May Gaskin).  It did help and eased the sensations a bit.  In the next contraction the head fully emerged.  It just stayed there and started to rotate (which was a bit of painful sensation).  Then, with the next contraction, I pushed and most of the body came out.  I leant forward and pulled the rest of the baby's body out and up to the surface. She immediately started crying, but she also seemed to have some trouble getting the sounds out, so I was a bit concerned. Thankfully, the midwife arrived just moments later. I yelled at her to hurry in and she quickly reassured us that the baby was fine. She had just probably had some fluid in her lungs because of the fast nature of the birth, but it wasn't too much.

Right after birth

She asked about what had happened and together we tried to figure out what time the birth had occurred.  We guessed 3:55pm, although we later figured out it would have been exactly 3:53pm.  She also asked if we had checked if it was a boy or girl yet.  We hadn't even thought to check! We did, and realized it was a girl! It was a lovely surprise, but at the time it was still a bit surreal to process.  I had planned to cut the umbilical cord after birthing the placenta, but the cord was rather short and it would have been hard to get out of the pool with it being so short (and the MGP programme's guidelines state that it should be done out of water to measure blood loss).  So, in the end, we just stayed in the pool until the cord stopped pulsing.  During this time a second midwife came to help. They clamped the cord and Lessan cut it.

I then had the rather unsavoury task of birthing the placenta.  I tried sitting on our little camping toilet for a while, hoping it would come out, but it just didn't seem ready (from my giving the cord a gentle, little tug).  I was cold and uncomfortable (plus still having strong contractions), so the midwives suggested I could lie on the bed and give Ella a feed while waiting for the placenta.

That was much more pleasant.  Even though the contractions were still strong (and became stronger with breastfeeding and the weight of the baby on my belly). it was much more comfortable lying in my warm, comfy bed, holding my sweet baby.  Eventually, I felt a bigger contraction and announced that I thought the placenta was ready. The midwife helped me get it out with gentle cord traction as I pushed a bit.  It came out in one piece and looking fine! (I didn't see it, actually, but that's what they said).  I felt a lot better with it out!

I think it was when I had gotten in bed that Larissa, our doula arrived.  We hadn't called her until I was in the pool, as I hadn't felt the need for extra help until it was too late for me to be in a state to do anything about it!  She got me a cup of tea, some snacks and drinks and helped the midwives with a few tasks.

From then on, I got to continue lying there, feeding Ella, while the midwives checked how much blood I was losing and tried to make sure that it slowed down.  There was a bit of concern on that front, so they were vigorously massaging my belly as well as some accupressure points on my hand and ankle, whilst getting me to smell clary sage and visualize the 'flower closing'.  It was a bit amusing for me, as I felt fine and didn't really feel like I would bleed to death, but I was nevertheless grateful that they were taking care of it!

When it was clear that my bleeding had slowed, they checked for perineal damage.  There was just a graze going up (towards the urethra) and a small tear going down into the perineum which they thought didn't need stitching.  I was very grateful and surprised that with such a quick birth there wasn't more damage!

The midwives also checked Ella over, checked for tongue and lip tie (she has a small lip tie that's probably not a problem). They weighed her and measured her and also gave her the Vitamin K injection, as we had requested.

Once everything was done, they left us to relax and cuddle in bed! Larissa left soon after, as my parents said they were on their way home and they would be able to help with the clean-up.

We felt amazed and awed at the experience. For most of the labour, I had been coping well and so I thought it was still the early stages.  Only in the last hour or so had it gotten quite intense.  And though the sensations were powerful, I hadn't been traumatized by them. It was simply a matter of working with them as much as possible.  I also hadn't been afraid at all when I realized that I would likely give birth without the midwife.  Though they were stronger than I remembered, the sensations were familiar and I knew what was happening and I was confident I knew what to do once the baby was born (though I wasn't actively thinking about that at the time).  Though I hadn't planned it, I was happy that I got to birth on my own, because having to interact with people, feeling observed and having to have observations taken would have definitely made it harder for me to relax and birth instinctively.  In the end, I felt the midwife arrived at the perfect time - in time to make sure the baby was okay and to help me birth the placenta and bring bleeding under control. 

As I write this, it is days later and I have already started to forget what the labour felt like.  I feel only positivity about how I got through it all so well, how it was so much faster than expected and grateful that Ella and I are both recovering so well.  Of course, I'm loving these first days of discovering who this new little person is and getting plenty of cuddles! The confidence I felt in the birth is also continuing into early mothering and so I'm incredibly grateful that God allowed me to have this experience.

Happy that the hard part was over and getting to cuddle my baby!

Now for Lessan's perspective:

Leading up to the birth, I had felt like we had planned well and we had everything we needed in place (towels, pool equipment, food, the birth plan, the doula, etc). Once the due date past, I felt like there was no need to do any more active thinking about the birth but we could just enjoy the time we had together, as the birth would surely come. I thought as we approached the end of the second week we could start thinking of options, but there was no need to do so before then. It turned out somewhat like that in practice, although Melissa did have lengthy conversations with our support team (midwives and doula) as well as the last-minute viewing of the spinning babies video. None of this was particularly troubling, but I mention it just to picture the mindset I was in at the time.

On the day of the labour I was tired as I hadn't had enough sleep the night before, but when I realized it was actually happening I must have had a burst of adrenaline because as you can see from the photo above, I was very happy. I just wanted to do what needed to be done and help Melissa in any way I could.

As the labour was progressing in the early afternoon, I asked her about our support team and she said she had been in contact with the midwife, and she didn't really feel the need to call the doula yet. I understood where she was coming from, as I could see that she was labouring in peace, just focused on being relaxed through the contractions and there was really nothing anyone could do to help her in any way. No offering of heat packs, no touching of her, no suggestions about positions, no conversations really - none of those would have helped. She knew what she was doing and she needed her space to do it. I also knew what she was doing, having been actively involved in her learning about birth during both labours, so there was nothing mysterious or unknown about what was going on. And anyway, I had my hands full with errands that needed to be done.

Like Melissa, I was also under the impression that the labour would take longer than it did. After setting up the pool I anticipated there would be at least a few hours more before the birth. I didn't actively think about it; I just felt like there's more to go. When Thomas woke up I helped take care of him a little, at least enough to ensure he wasn't coming into the bedroom where Melissa was labouring. When I returned to the bedroom I realized Melissa was quite far along and she made it clearly known she wanted to be in the pool asap.

We hadn't practiced filling in the pool before (we had inflated it so at least we knew it would hold its shape), so I was a little anxious that nothing would go wrong. I also expected the midwife to be there shortly and didn't want it to go over the mandated 37.5 degrees, so I went back and forth a few times to the tap to ensure it was filling up at the right temperature. Then Melissa got in, I called the midwife to check where she was and the doula to ask her to come, and then I realized the hot water was running out - even though it was fully on the hot setting the water coming out of the hose was lukewarm. So I rushed off again to turn off the water, and I filled a pot and put it on the stove on high heat just in case it would be needed later.

By this time Melissa's contractions were very intense, and she was yelling at their peak. It seemed to help her, and it didn't really bother me, but it made me feel more urgently the need to help her in any way, so for one of them I tried 'sounding' with her.

Another errand was to rush to the front door and unlock it, as we don't have a doorbell and wouldn't hear knocking especially with the sound machine on, and I expected the midwife would try opening the door when she arrived.

Another few minutes in the bedroom, and Melissa announced the head was out. Sure enough, I could see it, and it wasn't moving in any way. I walked to the side of the pool infront of her in case I needed to help lift the baby out of the water, but with the next contraction the body came out and Melissa pulled it out herself. I then rushed to get the camera, and we have some video and photos of Ella's first minute or two (see the "right after birth" picture above). Melissa was getting anxious about the baby's breathing, as although it was crying the cry came in fits and starts. I heard a sound outside the bedroom and saw that the midwife had arrived. That was a relief, as just that moment was when we really needed her help.  Up until that point, I don't think there's anything she could have done that would have changed the outcome of the birth.

Lessan holding Ella

In hindsight, I realize it would really have been helpful if I could have been present with Melissa for the last hour or so, just to be there so she would feel accompanied and reassured. We could have called the doula much earlier, just to take care of the errands I had been taking care of. And we could have had the other children taken away earlier, which would have helped reduce the errands I had to run.

But otherwise, I don't think we could have improved much on what happened, it all went so smoothly.

Just one little thing was that we should have bought a new birth pool (or hired one) as the one we got was second-hand and later that night it started leaking (we had decided to empty it the next day). We had to hurriedly empty it and drag its remains out. But that's not so important, in the grand scheme of things.

I'm very happy to be a two-time primary birth support person and to have seen both our children raised out of the water into this world. Sometimes I felt overwhelmed by all the details Melissa was sharing with me, but for the most part it has been very interesting to learn more about birthing and also some of the social issues surrounding birthing rights. While my focus is not to change that - I let Melissa take the lead on that one - I do feel that more husbands need to accompany their wives on this journey and kick off their fathering career by being engaged and present. I really admire and respect mothers. I am especially proud of those who have taken charge of their own birthing and put the effort in to educate themselves about it.

I'm also very happy to have a daughter. I don't know what it means, but I'm looking forward to finding out. And I'm looking forward to expanding the circle of love from three to four, increasing my capacity to love and my understanding of what it means in practice. During the first few years of our marriage, I would feel like I loved Melissa so much it wasn't possible for it to be more, but then it would take a turn and somehow expand. Then with Thomas, after a confusing initial period, I started to fall in love with him, and that has followed a similar path. I anticipate Ella to also open new vistas of affection and dedicated familial service.