I haven’t really told anyone my birth story in-depth. At first it seemed too lengthy and kinda private. And when I did tell a small group of expectant parents, I copped a little flak for some of my decisions that bucked against medical pressure (though I have high respect for doctors and nurses). But now that I’m due to give birth again in about four months, the story feels like it’s hammering against my brain, screaming to be let out (even if no-one is very interested, because there are stacks of birth stories out there, after all!). And it may be rather long, because too much of it feels important to me.
Though this is perhaps a different kind of story, as it’s very much about what happens when your Birth Plan doesn’t go to plan. It’s also a story about balancing medical intervention with your own gut instincts.
Our baby girl chose her impressive birthdate of Friday the 13th, under a full moon, at 23:23, though via caesarean. She was close to three weeks overdue if you went by the original date, or two weeks and two days by the revised date. (Dates seem to change all the time with pregnancies.) At this point, most people raise their eyebrows and ask, “The doctors let you go that far overdue?! They didn’t induce you?!”
Actually, it was a real struggle to get to that point, as we did meet the customary pressure to induce once the ten-day mark was reached. Actually, I’d been told earlier in my pregnancy that it was likely I’d be induced at around 37 weeks due to gestational diabetes (as the babies can grow too large), may need a C-section, and that our baby could well end up on a drip afterwards and need expressed colostrum; however, I’d kept the diabetes well-controlled with diet, and my baby (nicknamed “Bean”, as we didn’t know the gender) kept measuring on target, so the hospital didn’t mention this again and said I should be able to have a normal birth and even go overdue.
At the ten-day mark, though, when we resisted pressure to induce and instead opted to come in for daily monitoring, an obstetrician that had never seen me before daily came and told me the statistics of stillbirths for going over, and the added rate for gestational diabetics going over. I felt I wasn’t being viewed as an individual case; nobody once checked my sugar levels or asked to see the records of the four-times-daily blood monitoring that I’d been performing for months (I’d been diagnosed early). But the statistics threw me into fear and confusion, which ironically I think could even put labour backwards, because I spent so much time stressing instead of relaxing. The obstetrician even said that the revised due date (which the hospital itself had changed) was wrong, and that we should be going by the original one, making our baby sound even more overdue. (Even though it may not sound it, I actually did respect this obstetrician. I understand the fear they must have that they may be responsible for a stillbirth, and the fear of being sued.)
We were also given statistics of placental decay, reduced umbilical cord function, and decreased amniotic fluid, and were requested to go for an ultrasound. This showed that everything was functioning perfectly well, with the Amniotic Fluid Index at 8 (5 being the minimum level required). The obstetrician reluctantly said he would wait till the two-week mark – Wednesday 11th – and in the meantime, we had to come in for daily monitoring. This was a bit of a hike as the hospital wasn’t close (since we’d moved), but we would rather be safe than sorry. I had the feeling they were disappointed when the monitoring showed Bean was healthy and active and showing no signs of distress; they reminded us that this trace was only for 20 minutes or so out of a whole day. We were pressured to book in on Thursday 12th for a Friday 13th delivery, and actually it was kind-of tempting to agree, just to have a Friday 13th baby! – but every time I went inside myself to check my gut instincts, I strongly felt that Bean just wasn’t ready to come out and should be given till the end of the weekend. I researched as much as I could, and discovered that 40 weeks plus two was really just a number – pregnancies around the world can go up to four weeks over (except in cases where medical intervention really is necessary).
Meanwhile, we were trying every natural way we could to bring on labour – baths with clary sage oil, acupressure and acupuncture, curries and chilli, long walks on uneven surfaces, raspberry leaf tea, even expressing colostrum (the midwives were all very surprised later on, when they saw how much I’d expressed over the past month, that I hadn’t gone into labour well before I did!). I also agreed on Tuesday 10th to have a stretch and sweep of the membranes performed, in hopes that it would bring on labour if Bean was ready; however, the midwife couldn’t do this as it turned out my cervix was “unfavourable”, with a Bishop score of 3 (you need at least a 7). But at least I was starting to dilate, so that gave me hope that an induction would be unnecessary. Then on the Wednesday I lost my mucous plug (I’d never been so excited about mucous before!), and my Bishop score also increased to 5, giving me further hope that Bean was on track and that I was right to wait for a natural start.
We also discovered that without our agreement, we’d been booked in for induction the next day, which caused further arguments and stress and another discussion full of statistics. I eventually agreed to be booked in for Sunday 15th. Whether it was the relief of finally having the staff off my back and my subsequent relaxing, or whether it was going to happen anyway, I don’t know, but my waters broke that night, the Wednesday. We weren’t sure if it was a “proper” break or if Bean had just stuck a toenail through it, and it was clear with no sign of meconium, so we didn’t contact the hospital yet, so as not to be put on a clock with further pressure to give birth within a set timeframe. I also started having contractions, though it was hard to tell as there was lots of lower back pain that just seemed to hang around.
The next day, Thursday, the back pain eased up, and we went to monitoring as usual. My Bishop score was now 6, and although it wasn’t the magical number of 7, the midwife did a stretch and sweep. I thought she might notice that my waters were leaking, but she said nothing about it.
That evening the contractions came back, and extraordinarily painfully. Even though I had no previous experience to compare with, I had the feeling that the pain levels weren’t normal; the contractions weren’t at the front, but in my back; it felt like my spine was being split in half, up the middle. There was no regularity or definition, just waves of pain that blended into each other and went on interminably. It was the hallmark of a posterior labour – I now understood what women meant when they spoke about “back labour”, and why the vast majority of women with it end up with epidurals. Bean had actually been anterior but towards my right side, so instead of being on the left and turning just a little to get into the birth canal, it had decided to go the long way round, via my spine! I had never felt such pain in my life, and despite having a high pain threshold, wasn’t coping with it, feeling I was going to go literally insane.
It was when I kept threatening to call an ambulance that my partner called our doula, Lu, in (I’ll link to her at the end), as we needed more help. Poor Lu had to travel a while to get to us, and after midnight too, but she and my partner supported me through the night; both were invaluable. Lu being there was incredibly reassuring and stopped me feeling so out of control, and my partner also stayed calm and was incredibly helpful – I didn’t even get the urge to swear at him once, despite my pain; he just kept providing heat pack after heat pack, massaging my back, remaining calm and soothing, never complaining. The counter-pressure on my back did help with the worst of the pain, and at one stage he said he could feel the baby actually turning. But it seemed to be happening so slowly, and was such a long night. I couldn’t lie down, but stayed half-up on the couch, drifting in and out of exhausted sleep and waking up with each new contraction.
Finally it was the morning of Friday the 13th, and I was past what I could manage pain-wise. We waited until after peak hour, which seemed interminable, and arrived at the hospital mid-morning after about an hour’s slow drive. I had barely been able to walk to the car, but went inside myself during the trip to try to manage the contractions. My waters broke or leaked even more on the way there, so the staff officially put that as the time of breaking. I could barely walk into the Birthing Unit, which was unfortunately in full view of all the pregnant women in the Antenatal Clinic’s waiting room, who got to sit there with their mouths open as they watched the woman in labour inching along bit by bit, stopping frequently to moan and lean on the walls whilst her partner put pressure on her back. There was just no way of hurrying me out of sight; I could barely move.
Finally in one of the birth suites, I was asked to pee into a cup to check hydration (I’d barely been drinking – I’d had the importance of keeping fluids up impressed on me, but just couldn’t take anything in), and I couldn’t even manage to do that because the contractions were so bad and I was so dehydrated. My partner and Lu even turned the sink taps on full to try to help me go, but no dice.
I had to wait for pain relief until after monitoring and examinations were performed to see where things were at. One of the items on my Birth Plan had been no pain relief and definitely no epidural unless necessary, but I hadn’t figured on a posterior birth, and was now asking repeatedly for an epidural straight-up! It seemed an interminable amount of time before I was hooked up to monitors – hampered by my seeming inability to move or do anything but make lots of noise – and was then given a range of different methods of pain relief, as Lu and my partner both knew I’d desperately wanted a natural birth and were trying to make that happen. We tried Panadeine Forte, and then gas. Lu ran me a bath, but even being in warm water didn’t seem to help. The gas in the bathroom was turned on full, which basically just made me feel really stoned, but didn’t actually stop the pain – though it felt great between contractions! Then a midwife came in and turned it down as it actually wasn’t supposed to be on full, so the feeling-great-between-contractions thing stopped. My partner kept putting pressure on my back, but even that was starting to not work as well. I then got sterile water injections in my back – they sting like hell going in and for 30 seconds afterwards, and have to be done during a contraction, but are meant to kind-of confuse the pain receptors for a couple of hours. That also didn’t work, except for maybe five minutes, during which time Lu got me walking to try to move Bean around. I was so exhausted, and nearly slipping on leaking bits of amniotic fluid (somebody should really put “Caution: Wet Floor” signs in birthing suites). Then the pain came back intensely and I was done; I just wanted an epidural, or to pass out, whichever came first. The welts raised by the sterile water injections also meant my partner could no longer put pressure on my back – even though the massage wasn’t working anymore, it had been something familiar to cling to.
It was a very long day, though time meant little to me. It was only when I looked at photos later and saw the times on them that I realised it was moving, as always, linearly. We had to wait for the anaesthetist to come out of theatre. More sucking on gas (not that it really helped, but the tube was something to cling to). Although my Birth Plan had been for a water birth, the midwife explained that an epidural meant being hooked up to constant monitoring for the baby’s heartbeat and my contractions, so with that and the loss of use of my legs, I’d have to stay in bed, but they’d coach me through pushing when the time came (since the epi meant I also wouldn’t feel the urge to push myself). Although it wasn’t ideal, I consoled myself that at least I’d still be able to give birth vaginally, even if on the bed.
The anaesthetist finally came and explained the risks of an epidural, though I was so out of it that I wanted to say, “Yeah, yeah, just get on with it.” Then when she found it was a posterior presentation, she said that epidurals don’t work for those. I didn’t understand how that was possible, as an epi should dull you from the waist down no matter what, but she insisted. At that point, I just felt such defeat and despair, especially as the pain was growing stronger and still felt like my spine was being torn up the middle over and over. My partner, seeing my face, said ominously that we were given certain information before and were now being told something different; Lu and the midwives hastily assured us that epidurals did work especially on posterior presentations. Luckily, they were right. It took almost no time from the epi going in to all sensations below the waist ending. Although having the needle put in meant I had to sit hunched over a pillow and wait till there were no contractions – a hairy proposition considering my contractions were still irregular and with little warning. And then I got to lie back on the bed in a raised position, and finally relax.
The midwives did an examination once I was numb, and discovered that I was not dilating very much. Which is not unusual with posterior labours, apparently, because you’re so tense from pain. So they put me on Syntocinon to try to force the labour to progress – another deviation from the Birth Plan. (By this stage, though, I was kinda out of it, and just wanted to sleep, and to bloody dilate so I could have this baby.) They also put a drip in for hydration, but had trouble with it because I was that dehydrated they couldn’t get a vein at first, so I got some lovely bruises. And they put a catheter in my bladder as well, which luckily I couldn’t feel due to the epidural.
Then I relaxed and tried to drift off to regain some of my energy, but it was difficult because there was always someone coming in or out of the room. Apparently my contractions (as shown on the trace – I couldn’t feel them now) were too irregular still (another hallmark of posterior births), so they kept jacking up the Synto regularly. I had been worried the whole time of the effect of all these drugs on our baby – even the Panadeine and gas, let alone the Synto – but was assured it was all okay (though who really knows).
Later another examination was done, and there the midwives discovered that on top of my contractions not doing what they were meant to, my cervix was actually thickening again, going backwards instead of dilating; it was as though my body had just given up. And as well as being posterior, the baby’s head was deflexed – instead of being chin to chest, its chin was up, being forced further and further back with each contraction. It also meant that a wider circumference was being presented and would be virtually impossible to push out. The bubbly young female obstetrician that they called in called it a cheeky baby, saying that it wanted to look out before it came out. (After Little Miss was born, this proved true. She was determined not to be a floppy-necked newborn, trying to hold her own head up until she managed it within ten days, and always trying to look up and behind her. She was – still is – a very curious baby.)
I was told that there was also a little meconium now in the amniotic fluid, and that monitoring wasn’t reassuring. Although it can’t have been too bad, because we were given the option of pushing on with more Synto and seeing if my body kicked into regular contractions (but likely ending in a caesarean anyway), or just going for a caesarean now.
It had been a bloody long day (or two nights and two days), and I was ready to just say, “Go the caesarean.” Again, completely away from the Birth Plan – but I was worried about the baby, too. I didn’t like the thought of more Synto pushing its head further backwards, I didn’t like that it was starting to show some signs of distress, I didn’t want to wait around hours and then have the same outcome anyway. I looked at my partner, though, afraid he’d be disappointed if I called it, but he actually jumped in and said, “Let’s get this show on the road.” He knew a caesar was inevitable by this stage, it was getting late, and we may as well get this baby born on Friday the 13th! (Which ironically was the date it would have been born had we had an induction.)
So I was wheeled down to theatre. My partner was gowned up, but had to wait outside while they prepped me, although he propped the door open a crack and watched. Prepping seemed to take ages – setting up, putting antiseptic on my stomach, shaving the area, raising a screen between my head and my torso. Then my partner came in and stayed by my head to support me, although I was calm by this stage. The only problem was upper body muscle shakes from the epidural, a rather annoying side-effect. I’d rather that than the pain, but they were getting worse.
They cut me open behind the screen, but I didn’t get to see my baby for what felt like ages. Apparently it was so wedged that they took four goes to get its head out, not even able to with forceps. Once finally out, it was taken off to the side for assessment. One of the side-effects of birth for babies is engorged genitalia due to the hormone rush (a lot of people aren’t aware of this beforehand and get a shock), so with that and the umbilical cord, apparently my partner got confused and announced it was a boy – however, although I apparently responded to it, in my out-of-it state I don’t remember that at all. All I remember is him turning to me with a big smile on his face and telling me it was a girl.
The adorable part was how mushy he went. Gushing statements such as, “I’m so glad you got a girl, you deserve a girl,” and, “I thought I wanted a boy, but I didn’t know how much I wanted a girl till I had one.” My partner had officially gone to goop.
Unexpectedly, the hard part about the caesarean emotionally for me was actually not so much the deviation from the Birth Plan, but the wait afterwards to see the baby I’d been carrying for over nine months. It hurt that she was whisked away by other hands than my own, and that I missed things like my partner cutting the cord. When she was put on my chest, it also hurt that I couldn’t hold her properly and reassure her due to my epidural-induced muscle shakes – which were by now surprisingly so intense that my shoulders and upper arms were actually aching – and that the shakes also meant the monitor clamped on my index finger clattered against her head when I tried to stroke her, so I couldn’t do that. I also had the insane desire to fall asleep – not really the reaction you’d expect after all that, but I guess it was after all that adrenaline.
My little one, by comparison, was wide awake – I had an impression of big blue eyes looking at me with uncanny alertness, along with one tear rolling out of an eye, which broke my heart. She pooped quite a few times, including all over my exposed chest. So much for skin-to-skin.
I’m not saying this just because I’m her mother, but her condition was great, vindicating our gut instincts to wait for labour to start naturally. She didn’t have an “overcooked” look, but her skin was beautiful – not dry, cracked, wrinkly, or discoloured. She got an Apgar score of 9 on both testings (I was told by a midwife that no-one ever gets a 10, so 9’s pretty damn perfect). My placenta was also extraordinarily healthy – no signs of decay or calcification, no signs that it wasn’t going to keep going overdue. My baby was fairly large at 4.21 kg, but no-one suggested it was due to the gestational diabetes, as she was in proportion (G.D.M. babies tend to have broad shoulders), and her sugars were also perfect on testing through the night, with no need for her to go on a drip or use the expressed colostrum.
I did find out I’d had a postpartum haemorrhage, though not badly (lost 700 mL of blood, with under 500 mL being the aim); however, since I’d gotten my iron levels up high (after having been anaemic earlier on), they weren’t worried. I did read in an article later that Syntocinon can cause postpartum haemorrhages, and was annoyed that nobody had told me that; but I haven’t gone on to research that further and confirm if that’s true.
I would recommend against electing for a caesarean if not necessary, because recovery is a bit of a bitch – despite my exhaustion, I was woken hourly that first night (apart from my baby’s feeds) for midwives to perform observations (blood pressure, oxygen, etc.) or to check Little Miss’ sugar levels. I still had the catheter in, as well as another drip, and cuffs on my legs that mechanically compressed them at intervals to ensure no blood clots formed. Morphine was put in my drip, which meant that having gotten over the epidural shakes, I then suffered morphine itch, and I’m sure visitors left thinking I had fleas. Then recovery at home takes four to six weeks (though I did recover pretty quickly), and you’re not supposed to pick up anything heavier than your newborn (which is hard when that newborn isn’t tiny), let alone drive – none of which is easy to follow if you’re home alone (luckily I had my partner’s help for the first couple of weeks). It also hurts to go to the toilet for a while, or even walk, though you’re supposed to do some walking to reduce the risk of blood clots (but too much can set you back!).
I also don’t know if a caesarean affected my ability to bond at first. I was very out-of-it after such a long time in pain and having had all those drugs. When my baby girl was placed in my arms, there was a feeling of unreality, almost like it was happening to someone else. I very often heartily wish I could go back to that moment and have it over again, but with a clear mind, to fully appreciate the wonder of the little miracle I held.
But overall, having a non-elective caesarean didn’t affect me as badly as I’d thought it would. I’d privately never really accepted the thought of having one beforehand, and thought I’d be shattered if I had to. But afterwards, I found I was strangely accepting of it. All I could do was be grateful that there are medical interventions for times of emergency, whereas a century ago I may have died in childbirth and my baby with me. That sobering thought bothered me for quite a while, and still does when I think about it, but having a C-section itself didn’t. I think the important thing was that I had a partner that educated himself in the birth process, was supportive, and actively worked with me to welcome our baby girl into the world.
I also very much recommend using a doula – their help can be invaluable during a stressful time; they can also give your partner a much-needed break, and keep a clear head when both of you are too wired and tired to think properly, and be your spokesperson. There is research currently being done into whether women in labour are really capable of making decisions, and it’s possible to agree to something that afterwards she has no memory of and can feel resentful over. A good doula with thorough knowledge of your birth vision and ideals can help there. I very much would recommend Lu (Birth InSight – website and Facebook) if you’re in the Sydney area, and take advantage of her placental encapsulation skills whilst you’re at it, which can help to build up the nutrients you’ve lost and prevent postnatal depression. My partner could definitely tell the days on which I’d taken my pills and those I hadn’t.
And above all, go to birth classes. (We chose calm birth classes with Birthing Rites Australia, also on Facebook, with the fantastic Marie who has been a pioneer in natural birthing education – her first child’s birth being part of an ABC documentary in 1976! The classes were intimate, relaxed, and fun, as well as educational.).If you don’t like the ones you’re at, find another class. The midwives told me that people educated about birth beforehand are likely to have quicker and easier births, which is better for everyone involved. And even when things go wrong, such as in my case, knowledge beforehand of possibilities such as posterior labour (with the back pain, incredibly slow dilation, irregularity of contractions, and sliding possibility of interventions such as epi and caesarean) can help you to understand what’s happening.
Thank-you if you have managed to read through my long story, and if you are pregnant, remember: My story does not have to be yours. Not all labours are painful and long. There are many tales of amazing labours that will touch your soul. I hope yours is one of them!