AISLING's Birth
Born 22 April at 00:40 - Weight: 3.485 Kgs - Length: 54 cm
Noel, my husband, and I had been together for eight years before we made the decision to have a child. That was in July 1995 and bearing in mind we had avoided pregnancy for so long, we were optimistic that I might have become pregnant by Christmas of the same year. Well, as parents, we now know nothing goes according to plan. I became pregnant the very first time! When my period was late I started using home pregnancy tests. I wasn't aware that the pregnancy tests could not give you a false positive! The first four tests were pink, and I suppose I convinced myself that the pink strip I held before me did not look anything like the purple strip on the pack. After four days of "Am I, Aren't I?", I bought a blue kit and this time the strip did match up with the colour on the back of the pack. I made an appointment to see my GP (family doctor), and just to be on the safe side, I brought along a urine sample for her to test. Without a doubt I was pregnant and the baby's due date was 4th April.
I am a person (hypochondriac by nature) with a very low pain threshold, but I was drawn to the idea of having a non-violent, natural birth. My greatest fear was of ending up in a situation where I would be told how to behave and decisions relating to the birth of my baby would be made without consultation due to my non-medical background. I knew if I was to succeed in having the birth of my choice, I would have to clue up very quickly on the pros - v - cons of natural birth. I found the writings of Shiela Kitzinger and Michel Odent to be very reassuring on the subject of natural birth and armed with my "knowledge is power" philosophy set about finding the right place to have my baby. We had only migrated to Australia in 1994 and knew few people and none who had given birth in Sydney, so I discussed the matter with my GP. She recommended some hospitals and a couple of Birth Centres and I started visiting them.
The staff in the labour wards at the hospitals were very pleasant, but in general their philosophy was diametrically opposite to mine. They appeared to feel that their role was to "manage and chemically relieve the suffering of labour" rather than to encourage you to experience a natural birth! The hospitals also half-heartedly encouraged partners to attend the birth, as long as they didn't get in the way or interfere.
When I visited the Birth Centres I felt I had at last met medical professionals who understood and agreed with my needs. The midwives were extremely friendly and explained that they took a back seat during the labour and did not perform as the main support person this was a job for your partner/friend(s). Although the midwives provided ante-natal care to most women attending the Birth Centres, I decided to have my care provided by a private obstetrician because of my age (33), my borderline hypertension and because if any problems arose during the pregnancy, the midwives would have had to exclude me from the centre because of hospital policy. I discussed these concerns with the midwives at both centres and they gave me the very short list of obstetricians who had, in the past, been willing to attend births at the centres. They also advised me to see an acupuncturist to non-invasively treat my now borderline hypertension.
However after telephoning the offices of over a dozen obstetricians, I found most would not attend first-time births at the centres the reasons given included several "you never know what might happen at the first birth" and several "believe me, when you go into labour, you will want pain relief, not a "natural" birth". By chance, I read an article by one of the obstetricians on the list, Dr Brian Peate of King George V Hospital, and it was obvious that this doctor understood and nurtured the importance of a woman's belief in herself and her ability to birth her child "in the majority of cases" naturally.
The first visit with Brian confirmed for me that I had made the right choice. He asked if I had given any thought to the type of birth I would like. When I replied that I felt strongly I would like to have an unmedicated birth in the hospital's Birth Centre, he agreed with my choice, but advised me to keep an open mind about pain relief. He was adamant that for some women pain relief was necessary and shouldn't automatically be excluded, but in a lot of cases a positive attitude and a willingness to make informed choices was equally necessary. I also expressed a desire to use the birthing pool during labour and also, circumstances permitting, for the birth itself. I knew that the pool was known within the centre as their alternative to the epidural. Brian was in total agreement of my choice and commented that he had found for a lot of women the water helped decrease their BP during labour.
Brian operates on the basis of "shared-care" with the Birth Centre midwives, i.e. from 4 months of pregnancy, I saw the midwives and Brian alternately for my ante-natal visits. This I felt was of extreme importance, as I knew by the time I gave birth I would know both the obstetrician and the midwife attending the birth well, and would be able to be at ease with them during what is, for many women, a very private intimate event in their lives. At this stage my husband and I also realised that a natural birth was not something that just happened "naturally", but involved work, both preparing physically for the birth, and educating ourselves for what was to come. In fact it is a condition of the Birth Centre that clients attend childbirth education classes prior to the birth of their offspring.
We attended natural childbirth classes run by my acupuncturist Paddy McBride, (who is also a qualified childbirth educator) and they were invaluable. Although the classes were classified as "natural", they covered in great detail the forms of available pain relief, their pros as well as their cons and we were again advised not to automatically exclude the option of pain relief, but to be aware of the natural alternatives. They also covered common types of intervention and again their pros and cons.
My pregnancy progressed well, although my BP started to creep upward from 31 weeks. At 35 weeks I appeared to lose the mucous plug while I was in the shower. I was terrified, thinking that birth was imminent - I was not psychologically ready and as I was less than 37 weeks pregnant, I would not be allowed to give birth at the centre, due to hospital policy. I called Brian and he was very pragmatic about it. He deduced as I my waters appeared intact (no leaking), birth could still be some weeks off, but if I did go into labour I would have the relief of having an easier birth because the baby would be that much smaller after that conversation, I stopped panicking and willed the baby to hang on in there.
At my 36 week visit, Brian performed an ultrasound and everything was perfectly normal, so it looked like Junior was just giving us a scare. At my 37 week visit at the Birth Centre, it was found that my BP had risen again and this time there was more than a trace of protein in my urine. Brian was paged and he advised the midwife to book me in the following Monday (as the day-stay facility was closed weekends) for continuous BP and protein monitoring. I left the Centre and went straight to Paddy who performed her usual miraculous acupuncture treatment. On Monday at the hospital, my BP was back within the borderline levels and there was only a trace of protein in my urine! They also did a couple of hours of EFM and this together with the ultrasound showed that the baby was fine and not at all stressed. The ultrasound technician also confirmed that I was having a girl (I was positive I was)!
I had two more acupuncture sessions before my 38 week visit with Brian the following Friday, but this time the acupuncture couldn't control my BP and Brian found it had elevated quite a bit and I was again excreting protein. He booked me in on the following Monday for further monitoring and prescribed anti-hypertensives and advised me to give up work straightaway (I was still working 50 hours a week). He explained that the standard treatment for pre-eclampsia was to take anti-hypertensives and be admitted to hospital for total bed rest and observation. He found that the medication usually worked, but that most women seemed to stress more when in hospital, causing their BP to rise, forcing intervention. Because of this he preferred to have his clients take the medication, rest up at home and to have their BP taken regularly I agreed that this is what I also preferred. I had acupuncture on Friday and Saturday and on Monday, my BP had dropped back a bit and my urine only had a trace of protein, so Brian increased the medication dosage and said it was still safe to rest up at home.
I took my medication, had acupuncture every second day and slept a lot (luckily the medication made me drowsy). The 40 week visit came and went without a hitch. The medication was controlling my BP and there was still only a trace of protein in my urine. After the scare at 35 weeks I didn't think I would still be pregnant at 40 weeks!
At the 41 week visit, Brian did an ultrasound which showed that there was plenty of liqour around the baby and she was moving around quite happily. At this point I was getting very impatient and irrational - resting up was driving me daft. My husband and I had tried everything to get labour started naturally, plenty of sex, nipple stimulation, visualisation, etc and Paddy had tried a couple of induction sessions, but obviously the baby was in no hurry to come out. I suggested to Brian that perhaps I should be induced "naturally" using prostaglandin pessaries - after all wasn't it prostaglandin which was in men's sperm (just in larger quantities). Brian explained that in his experience, inducing first time mothers with prostaglandin alone was not very successful, most ended up having something else to speed the labour up which usually made the contractions come hard and fast and then not being able to cope with the pain ended up having an epidural. He said it was my choice, but as I had expressed my desire to have a "natural" birth from the onset, his advice was to relax and let it happen naturally. As I left his office, he commented that he was sure our next meeting would be downstairs in the Birth Centre.
42 weeks came and the baby was still in there, despite our continuous attempts to get labour started . As with the previous week, there was plenty of fluid around the baby, and she seemed quite content in her surroundings. Brian said he would induce the following Tuesday if she had not made an appearance.
My moods were really swinging at this stage, from joy that it was almost over, to wondering what I had done to upset the baby so much that she didn't want to be born, to worrying whether I would know that I really was in labour (as I hadn't felt any Braxton Hicks)!
On Saturday night, Noel and I stayed up to watch a good movie. I went to bed at about 1:30 am on Sunday morning. At 2:15 I woke up, but I wasn't sure what woke me. After a few minutes I felt as if I was body surfing over very gentle waves. I couldn't believe for a minute that this could be the start of labour - not after waiting all this time I was now sure it wasn't going to happen spontaneously! The gentle waves started getting a little stronger so I thought I'd better time them. They were lasting 60 seconds and were about eight minutes apart. At about 2:45, Noel came to bed and I told him that I thought "this was it!" and I was going to ring the Birth Centre and that he should get some sleep before the big event. I called the Birth Centre and they agreed that I should get as much sleep as I could and they would see me later in the morning. I went to bed and although I managed to fall asleep, I woke up 30 minutes later. The gentle waves were now turning into frothy rollers. I didn't think there was any point in waking Noel, as at least one of us could sleep and I knew from our classes that we had a long way to go yet. I went downstairs to the bathroom and took a long hot shower. The pain became more intense. Typically, I couldn't remember how long, or how far apart, early contractions were supposed to be so I sat backwards on the loo (as this seemed to be the most comfortable position), with a fan heater trained on my back, reading all my birthing books and trying to figure out if the contractions were supposed to be intense this early! The contractions peaked at about 75 seconds long and about 5 minutes apart. At 7.15 am I went back to bed. Noel got up and after breakfast went off in search of the items on our "Labour Foods" list. I managed to fall asleep and woke up at 9:00 and the contractions had stopped. Noel arrived back and I told him the contractions had stopped. He suggested that they probably hadn't stopped, I was probably just getting used to them! Ggrrrrrr. I waited 30 minutes but they had definitely stopped so that's what pre-labour was like! I called the Birth Centre and they were sympathetic and reassured me that what I had experienced was a really strong pre-labour and that the good news was that true labour wouldn't be far away.
I went back to bed and slept like a log 'til about 2pm. At about 3pm, the surfing started again. At about 3.30, after about 2 contractions we decided to go for a walk. Every 10-12 minutes I got a contraction lasting 30-40 seconds. I relaxed around Noel's neck when it got bad. We walked down to our local park where some of the local football teams were practicing. I remember thinking it was really weird, 'cause here was I, in labour, and the rest of the world was just going about it's daily business oblivious to my predicament! On the way back to the house, we met our next door Neighbour, who was surprised to still find me pregnant as he knew the baby had been due over two weeks previously. We explained that I was definitely in labour, so if he heard any strange noises coming from our house during the evening not to worry about them.
When we got home, Noel cooked a lovely early dinner and I packed my bag for the hospital. We had been following a TV series for the previous 5 weeks and I was determined to watch the final episode at 8:30pm. I could barely sit to watch it the contractions had become so intense. I kept reminding myself that as the contractions were now only lasting 30-40 seconds at five minute intervals, we had a long way to go and I needed to keep focussed. At 9:15pm I called the Birth Centre, but as the phone was unattended I had to leave a message, towards the end of which a contraction hit and I ended up hissing out the last sentence. Noel was happy for us to go over to the Centre for me to be checked out, if it would put my mind at rest. (I knew if it was very early labour, I would be sent back home) I then took to the hot shower\sitting on the loo routine. The midwife on duty rang back while I was downstairs in the bathroom and said she needed to speak to me - I cursed as I was drawn to staying on the loo and not climbing the stairs Noel relayed the questions and I shouted up the answers in between the 2/3 contractions. The midwife insisted on speaking to me so I hauled myself up the stairs to the phone. I told her that even though it was my first baby I was convinced that there was something major happening and I wanted to come in to be checked out. During our conversation another contraction hit and the midwife told me that she had timed it and it was only 25 seconds long and it really sounded like I was in early labour not established labour! I said I didn't care what kind of labour I was in, I was coming in to be checked, even if it meant being sent home again. I cursed my bad luck in having the one midwife that I didn't quite "gel" with on duty that night!
I went downstairs and took another shower and got dressed. When I got back upstairs I cried and told Noel that I couldn't go through with this labour naturally because I was in so much pain. He tried to calm me down and suggested that as I was tired, I should lie down on the bed for a few minutes and he would play Sinead O'Connor's song "Troy" for me (I always played this song when I needed to gain strength - a bit like a battle song). Noel turned the volume up full blast and I lay on the bed. A couple of seconds later a contraction hit and I felt like I'd been run over by a Mack Truck I screamed out to Noel to help me get off the bed, but before I managed to get upright, I had another Mack Truck experience. I couldn't believe it, once I was upright, the contractions returned to feeling intense not excruciating.
We got into the car and half way up our street on the way to the hospital, with me kneeling on the back seat and "hanging like a whippet into the boot of our station wagon" (Noel's words), he announced that we appeared to be a bit low on petrol and would it be okay if we turned 'round and went back to the 24 hour BP station on the other side of our house. Who was I to argue! We arrived at the garage, which seemed to be extremely busy for 10:15pm on a Sunday night, and Noel proceeded to fill the car. I was watching the dial whiz 'round and 'round (we've got a very big tank) and thinking to myself "does he always have to fill the whole ****ing tank, could he not just put in $5 worth for once in his life". While he was doing the filling, I was getting the looks, and I could just imagine the thoughts to go with them "what's that fat woman doing grimacing and hanging over the back seat of her car like a whippet". Much to my relief, the tank was finally full and Noel went to pay for the petrol. My relief disappeared however, when I saw him join a very long queue of patrons armed with newspapers, take-away food etc. I again thought to myself "could he not just tell them his wife's in labour does he always have to be so proper". After, what seemed like half an hour, but was probably only five minutes, Noel strolled calmly back to the car and asked "how's it going". Through clenched teeth I politely suggested that it might be best to just get there.
When we arrived at the Birth Centre at 11:00pm, Sarah one of my favourite midwives was on duty. I was just so relieved to see her. She advised me to settle myself into the birthing room and then she would examine me. I told her the contractions were unbearable if I lay on my back, so I lay on my side and we waited for 3 contractions to pass before I was ready. She asked me how far I thought I was dilated, I announced I was probably only just dilated but I knew even if I was only 2cms Sarah would let me stay if that's what I wanted. She told me I was 8 cms dilated (luckily I hadn't listened to the advice of the first midwife)! Suddenly the contractions didn't seem that bad - because our baby was almost there. I jumped in the shower and Sarah filled the birthing pool.
I started to walk over to the birthing pool room, but I got this overwhelming feeling that I needed to poo, so I attached myself to the loo instead. Sarah told me that the feeling I was experiencing was because I was so close to birth but I felt quite drunk (and irrational) at this stage (presumably from the all the endorphins) and I insisted I needed to stay on the loo. Sarah said she would need to examine me again and said sitting on the loo was not the most dignified (or probably hygienic) place to be examined, but being irrational I refused to move. Sarah examined me and announced that I was fully dilated and I really did need to unplumb myself from the loo to deliver the baby - that sounded reasonable, so I moved into the pool.
The water felt fantastic, the contractions changed their feel completely. There was very low lighting and Noel had soft music playing on the cd player. It was easy for me to move around in the water and I felt totally in harmony with my body I was grunting with the contractions but it came from within, it wasn't something I consciously decided to do, but with each roar a lot of the pain was released. (I remember during the tours of the Centre hearing women scream and stupidly thinking "What an act!"). Sarah came in several times to check me with a waterproof doppler. (I was getting annoyed that she was coming in every two minutes but Noel assured me later that it was every 20 minutes.) She asked me if I wanted to deliver in the water or if I wanted to get out - there was no way I would have left the water, I felt totally at home there. When the contractions were at their most frequent, Noel suggested I should use the gas but I just felt that this would be a distraction - I didn't need anything except concentration. Brian arrived during a contraction and I wasn't even aware that he was there. He felt Noel and I were coping fine, so he joined Sarah outside to avoid distraction. I could feel the energy change just before the baby was born and the different tone of grunting alerted Sarah and Brian to the imminent birth. The only moment of panic\fear I had was just as before the head crowned I had read the stuff about "feeling like a Chinese burn", "a strong stinging sensation" etc, but I was convinced that I had split open and screamed at Sarah that I knew this is what happened. She very calmly took a torch and shone it through the water on my perineum and Brian held a mirror so I could see for myself! There it was the top of my daughter's head and my intact perineum! I was so relieved. Sarah told me to push with the next contraction and I did, but when I was advised to push again, I said no because instinctively it just didn't feel right, so I waited for the contraction after that to push again. During the pushing (which was hard work) I kept repeating to myself "a few more contractions and she'll be here", but during the next contraction she was born and Sarah lifted her out of the water and laid her on my stomach. I was so shellshocked, I remember thinking "this isn't my daughter she's not out yet!". It was the weirdest feeling seeing this beautiful creature on my stomach for a split second I was afraid to touch her. Sarah put a warm hat on her head and Noel cut the cord. As soon as the cord was cut I wanted to get ut of the pool, it suddenly seemed too hot. Brian was also concerned to minimise the blood loss as I was anaemic, so the baby was wrapped in warm towels and given to Noel. Sarah and Brian helped me out of the pool and wrapped me in warm towels too. Wow did that feel good. We went back to the birthing room where Brian delivered the placenta and stitched me where I had received a graze from the baby's hand which she had stuck over her ear. Noel and I agreed within a couple of minutes that Aisling (pronounced Ashling) was an appropriate name for the baby as the name means dream or vision in Irish (and we're both Irish). The three of us spent the rest of the night and most of the next day dozing in a big bed in the Centre. Aisling spent most of that time, curled up asleep on her father's chest, probably so content as she could hear his heart.
We chose to transfer to a private hospital 18 hours after the birth, as the alternative, transferring upstairs to the public wards did not appeal to me. As we had no family and very few friends in Sydney, I felt I would be able to get better midwifery treatment\advice\support in the private hospital. Aisling had been asleep most of the day and was still very peaceful. The next day, I noticed while walking down the corridor outside the other bedrooms that a lot of the newborns were very fractious. It dawned on me over the next few days that this might in fact have been related to the way they entered the world. It seemed to be quite popular at that hospital for the Obs to use Vacuum extraction to deliver the babies of their epiduraled, episiotimied mothers (of course these would be the mothers who had managed to have a non-caesarean birth anyway). I was quite appalled, it seemed that most of these women were powerless victims of the birth process whereas I was overjoyed and empowered at what I had achieved without so much as a hint of gas. I know that things don't always go the way they're planned, but it seems to me that if women have the attitude that birth is somehow a medical procedure and not a natural event, that it's a pretty safe bet that it will end up that way.
Two days after the birth Noel brought the prints of the pictures he took during labour, and after the birth, and in amongst them were three shots that Brian must have taken just as Aisling was being lifted out of the water and placed on my chest. I just cried when I saw them it was so emotional.
I, like many women I am sure, thought on numerous occasions that I would not be able to manage this amazing feat unaided but I was very fortunate to be surrounded by people who reassured me that it was quite normal to have doubts, but also it was within my power to have the outcome I desired. I was also advised that if at any time it was too much for me, or there was any chance of complications, help would be readily available and I would not fail in any way by availing of this help. However, I was not at any time encouraged to throw my hands in the air, play the sick patient, and relinquish all responsibility for the birth of my child. Aisling will be 2 on 22 April and I know I am incredibly lucky because I felt so empowered by her birth that to this date I am still suffering from what I would term "Post Natal Elation".
Fiona
