Slow, slow, quick – the birth of M, by Louise
The hospital birth of my elder daughter, in 2009, was traumatic and upsetting. My daughter was back-to-back and I had contractions which manifested themselves as intense back pain almost from the start. After about 24 hours at home, we went into hospital. Unfortunately, progress was slow and the support from the hospital pretty limited – the general view seemed to be that I was making a lot of fuss for someone who was in ‘early’ labour and only 3cm dilated. All that was suggested was that I try to keep upright and mobile. Eventually, I consented to having my waters broken, then (when my contractions almost completely stopped after that) syntocinon and an epidural. Finally, my daughter became distressed and she was delivered using forceps. She was born about 48 hours after the contractions started in earnest.
When we decided to have another baby, I was determined that this time was going to be different, and that I would feel like an active and engaged participant in my own labour (including if interventions were needed). There were two key aspects to this: booking for a homebirth and hiring Rebecca to be our doula.
Rebecca came to do preparation sessions with us before the birth, and we spent a whole session focusing on mine and my husband’s emotions on the first labour, before other sessions preparing to make this one a more positive experience. I went into the last month or so of pregnancy feeling very positive and excited.
That mindset was quite hard to maintain over subsequent weeks as I experienced lots of Braxton Hicks and cramping, which made me wonder if this baby would put in an early appearance (my elder daughter was 8 days late). Unfortunately, she didn’t, and as my due date passed and late pregnancy insomnia set in, I got increasingly frazzled. Rebecca was wonderful – sending me encouraging texts and arranging a reflexologist who was willing to visit me at home (which, although it didn’t bring on labour, did help me feel a lot more awake and energetic).
Finally, 8 days after my due date, I started to have contractions. Throughout Wednesday they were regular but widely spaced (about 4 an hour). As the day wore on, they gained intensity. I could still manage to continue a conversation with my toddler during one if I needed to, but my husband certainly had to wait until it was finished.
We decided to inflate the birth pool. As our house is open plan downstairs, Robert had also been practicing screening the area around the pool, to make it more private. The contractions were still the same, so when it got to 10pm we decided to go to bed and see if we could get some rest. However, the contractions soon became too intense for me to comfortably rest. They had also moved into my back, which I found scary after my last experience. Rebecca was really helpful and gave Robert some coping tips over the phone for us to try using.
Around 2am I was finding it hard to keep going and we phoned Rebecca. Her gut instinct, like ours, was that it was still fairly early in the labour, but she said she was very happy to come over. Even though they were intense, the contractions were erratically spaced, and certainly not the classic 3-4 minutes apart that midwives suggest should trigger calling them. Rebecca said to turn off the lights, hide the clocks and gave us some more advice on coping with the contractions.
When she arrived at about 3:30am, Rebecca observed us quietly for a while and then began suggesting various positions we could try to help me cope with the contractions and maybe open the pelvis to relieve some of the back pain. She told me afterwards that she is usually far more ‘hands off’ than this, but felt I needed to feel I was doing something constructive. This was definitely the right call. At this stage, I felt like I was living a replay of my first labour and was becoming quite scared and disheartened (although I think this would have been a lot worse if not for all the preparation we did beforehand). Of the various positions we tried, the position I seemed to gravitate back to was hard work for all three of us. As a contraction began, I would stand with one leg up at right angles on a chair and the other on the floor, leaning forward on my husband. He and Rebecca would ‘ooooh’ or ‘mmmm’ with me through the contraction and Rebecca supported my bump and ‘sifted’ it with a long scarf (how her arm muscles held out I will never know). This position wasn’t necessarily any more comfortable than others, but for some reason it felt more productive. The ‘vocalising’ also really helped- as I’d had an epidural in my first labour I never knew I’d be a noisy type. The neighbours must have wondered what on earth was going on (though they very sweetly told me afterwards that they hadn’t heard a thing!). Between contractions I would try and rest. I had been practicing natal hypnotherapy and, although I didn’t find I could use it during the contractions, it did help me come back to a rest place in between.
During this time, Rebecca and Robert were filling the birth pool. When it was nearly ready, Rebecca said she was going to ask me to do something for a couple of contractions. She asked me to kneel on an armchair and rest my arms and head low down to the floor – known as inversions. The idea is that the baby can slip back up the pelvis a bit and, if the position it is in isn’t quite right, it gets a chance to move into a more favourable one. I think I remember Rebecca saying that it might make the contraction feel less intense. In fact, it was the most painful thing I have ever done in my life! It really felt as if my pelvis was being pulled in opposite directions. But when I got back up, something had changed. Although I will never know for sure, I believe that my daughter may well have been wedged in some sort of malposition, and that the inversions gave her the chance to sort herself out. This change also gave me the clarity to say to Rebecca that I felt as if my body was fighting against the contractions. Saying that out loud helped me to acknowledge the fear and tension I was feeling and that I knew I needed to let go. At some point, Rebecca also said to me “for some women, the first bit is the hardest”. Although I don’t think I really responded, this did sink in and I kept repeating it to myself in my head.
I managed another couple of contractions on dry land, this time walking around and semi squatting for each contraction, before Rebecca suggested that maybe I would like to get in the pool. At this point, I still believed I was in the early stages and that, after a bit of a rest, I might have to get out and walk around again. Rebecca had warned me that water can slow down labour if it isn’t fully established, so I was prepared for this.
The pool was total bliss. Every muscle in my body relaxed – I think probably pretty literally given what happened next. I apparently went really quiet and both Rebecca and Robert thought that the water may have slowed things down. I had a couple of small contractions, but they felt manageable and I just sort of let them wash over me. Then I heard a pop, and told Rebecca that I thought that my waters had just gone. She shone a torch into the pool and said that, if they had, they were clear and with no suggestion of meconium, which was reassuring.
Robert went to phone the midwives to ask them to come out. It seemed that we were finally getting somewhere! I was in my own world at this point, but I became aware of a sensation of something moving down. Without me saying anything to Rebecca, I heard her tell Robert to ask the midwives to hurry, and then saying that actually he should call an ambulance too. Rebecca tells me that there is a very distinctive noise that women make when they are ready to start pushing/are pushing, and I was making it! The point when she asked for the ambulance was when she realised she could see the baby’s hair!
The pushing was amazingly easy. I don’t remember needing or deciding to push as such, just becoming gradually aware that I was pushing. I didn’t find it difficult, or painful, or scary. It felt really instinctive and ‘right’. The only slight surprise was that, whilst I knew that the baby slid back between contractions, I was shocked how definitely I felt that sensation. It felt like it was hitting my ribcage each time. Rebecca reassured me that it sounded normal and within a few contractions, my daughter was born. I had expected the head to be born first, and the body on the next contraction, but she shot out with one push (behind me, as I was kneeling leaning on the side of the pool) and Rebecca caught her for me. As she was being born, I heard the ambulance arrive and they came into the room a minute or two after she was born. After all that hard work, her notes show her as a BBA (born before arrival)! It was around 40 minutes from getting in the pool until delivery.
The paramedics arrived and were very eager to cut the cord straight away, which is not what we had wanted. I think Robert and I were both in a bit of shock and probably would have agreed, but Rebecca gently and calmly reminded us what we wanted and why, and kept the nervous paramedic talking long enough that, by the time we consented to cutting the cord, it had stopped pulsating anyway. The midwife arrived in time to deal with the placenta (which was a bit stubborn) and a few stiches (I had torn along the line of my previous episiotomy scar), following which I had a blissful shower in my own bathroom and hot buttered toast. After checking that we were all ok, Rebecca headed off home.
My daughter was born at 6:35am on Thursday morning. By around 9:30 everyone had left, and by 11am everything was tidied away and back to normal. It was amazing to have the rest of such a special day to spend as a family of four.