This is the story of my third birth
The choice of birth place
A postnatal room at the birthing unit |
Te Awamutu birthing |
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 |
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 |
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 |
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 |
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 |
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 |
Lessan at home with the kids. We skyped a bit with them. |
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 |
Times and Stats from my medical notes
8pm arrived birth centrepalpitation 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 |