10 things I have to do this week

Ugh - I'm feeling a tad anxious as I have a HUGE list of things to do this week. So writing them down will help me sleep better.

1. Pay for and pick up our new car!!!!

 It's new to us - 2002 Nissan Pulsar. Which means Saffy is for sale:

2. Get Saffy detailed, serviced and that little scratch buffed out.
3. Deposit cheques (ugh I hate having to do that!).
4. Call my psychologist and get an appointment.
5. Call my massage therapist and do the same.
6. Restart my gym membership and go back to classes and aqua and swimming.
7. Post a lot of packages - yarn, Calorimetry, pattern books, purple shoes, letters, duck charms,
8. Wait for our tax returns!!!!
9. Wait for lots of packages and letters to arrive - damn AustPost is sucking the proverbial atm.
10. Prep for our Christmas in July celebration for next weekend:
* Menu thoughts? Turkey roll I reckon, and lots of vegetables, and mulled apple juice for drinks.

Reflections on my birth - and reasons why I would always birth at home

I was the first to touch her.
I was the first to hold her and smell her.
No one made her cry or worry and the look on her face when she was born was just priceless and serene and so calm.
She opened those big blue eyes and connected with me so solidly.
I couldn't believe that I'd climbed my Everest and roared a baby earthside.

Interestingly as well, my blessingway tie ended up very felted and tights around my left wrist by the end of this process (in and out of the shower, and then in the hot pool). It was a relief to cut it off today, on day 2, as it was tight and had done its job. It was gorgeous and amazing while I had it though. It is in Sally's box file now.

In reflection, my training only kicked in once I'd birthed and was worrying about the blood loss and placenta - before that I was just a woman doing what a woman does. Julie wasn't keen on doing anything about my placenta but I was done, and sore, and tired and just wanted the process complete. I have since printed my placenta, and cut up the smaller lobe for a placenta remedy (frozen in pieces to take every day) and the larger bit frozen for Sally to have planted in a wine barrel. We will find a tree that is fruiting around her birthday and plant it over the placenta once rotted down. That way we can always take it with us when we move.

I never had any strict plans for this birth beyond “at home” and “no drugs” and “it's probably all normal and I have a care provider to keep watch”. I was happy to take it as it came and in the end, that's what I did. Perhaps I took it too easy and didn't realise that things were taking a long time relative to the timeline of rushed births I've experienced in hospitals.

I wouldn't say that I enjoyed the process but it was such a huge experience that it's taken me months to write this story. Julie ended up doing way more than I thought she would, and I think she went beyond what she normally does in a birth as well. There were several examinations, and the water injection, and the intervention to get Sally to tip her head down, and to protect my perinium etc, and the surprisingly managed third stage. But for me, the alternative of transferring wasn't even considered. And these were things that I welcomed as I couldn't work around them, or through them, and when a solution was offered I considered it and either chose it or rejected it and was never pressured to do anything.

Julie wasn't there to save me. She walked the journey beside me in a way I never really understood before. She was attentive without being invasive or dictatorial, and I love that of her. She helped my support people be there for me – I wouldn't trade that for the world – and encouraged TheHusband to be there with me rather than hanging back, but in the end just let me get on with it.

In the cold light of day and in debriefing, I am pretty sure of a few things. If I'd been in hospital, I would have (a) begged for pain relief (b) been offered pain relief instead of support (c) had a c-section (d) had a different outcome if my membranes had been ruptured artificially (due to the succenturiate placenta) and (e) been a mess at the end of it. Instead I can stand tall and say:

I GAVE BIRTH

Labour started: 2am 11/03/2010
Established slowly but hard work from: 4pm 11/03/2010
Pushing: 3am ish 12/03/2010
Birth: 6:43am 12/03/2010

Do you have a uniform?

In the past year, I've gone from uni student to being a little pregnant, heavily pregnant, newly a mama and now basically back to where I was beforehand. Well that's not entirely true - I am now a size up from where I was before but given it's my beautiful childbearing hips that have changed shape, and my lovely baby-feeding breasts that have also gotten in on the party, I'm not complaining!

So on the weekend I went to a clothes swap, where a lot of my size 10 tops and dresses went to a good home and my size 7.5 shoes to the same home, while I picked up a couple of tops, two dresses, some light pants, a singlet or two and some flat shoes. I got rid of two pairs of court shoes for a few other things, and a scarf or two I think. I feel that I got as good as I gave, which is important as it's all in my head - there's no measuring or transacting going on with this, just people contributing then taking.

Anyway, what I did notice in the clothes that I chose, is that I have a uniform. Something like, during Winter:

• jeans and a fitted top and a vest
• jeans and a dress
• skirt, knee high socks, Mary Jane shoes and a top, with or without a vest
• pants and v-neck sweater
• skivvy and vest and long swishy skirt

Very preppy I guess, if I had to describe it. It makes shopping easy as I found the other day - I bought a vest to replace my outgrew from ones, and suddenly I had an entirely NEW wardrobe for winter. If I need a new pair of shoes, it's a pair of Mary Janes or sneakers. A new top - of a few colours (bright jewel colours), perhaps black or white at a pinch. It makes me life easy and I think I look good.

So what's your uniform?

More about yesterday's post - that AJOG article

Which can be read here.Just a short point while I eat dinner. The exclusions for this study:

To identify a low obstetrical risk population, we excluded multiple gestations, preterm deliveries <37 weeks, smokers, women with pregestational or gestational diabetes, chronic hypertension, hypertensive disorders of pregnancy, or prior cesarean. Demographics included maternal age, race, education, and timeliness of registering for prenatal care. Maternal morbidity measures in this low-risk population included chorioamnionitis (clinical diagnosis of chorioamnionitis during labor made by delivery attendant, usually includes 1 of the following: fever, uterine tenderness and/or irritability, leukocytosis, fetal tachycardia, any maternal temperature 38°C [100.4°F]), fetal intolerance of labor (in utero resuscitative measures, eg, any of the following: maternal position change, oxygen administration to the mother, intravenous fluids administered to the mother, amnioinfusion, support of maternal blood pressure, and administration of uterine relaxing agents; further fetal assessment includes any of the following: scalp pH, scalp stimulation, acoustic stimulation; operative delivery is operative intervention to shorten time to delivery of the fetus, eg, forceps, vacuum, or cesarean delivery), prolonged labor (labor that progresses slowly and lasts for >20 hours), precipitous labor (labor that progresses rapidly and lasts for <3 hours), and meconium staining (staining of the amniotic fluid caused by passage of fetal bowel contents during labor and/or at delivery that is more than enough to cause a greenish color change of an otherwise clear fluid). Newborn morbidity included assisted ventilation (infant given manual breaths for any duration with bag and mask or bag and endotracheal tube within the first several minutes from birth, excludes oxygen only and laryngoscopy for aspiration of meconium), assisted ventilation >6 hours (infant given mechanical ventilation [breathing assistance] by any method for <6 hours, includes conventional, high-frequency, and/or continuous positive pressure), birth injury (defined as present immediately following delivery or manifesting soon after delivery, includes any bony fracture or weakness or loss of sensation but excludes fractured clavicles and transient facial nerve palsy; soft tissue hemorrhage requiring evaluation and/or treatment, includes subgaleal [progressive extravasation within the scalp] hemorrhage, giant cephalohematoma, extensive truncal, facial, and/or extremity ecchymosis accompanied by evidence of anemia and/or hypovolemia and/or hypotension; solid organ hemorrhage, includes subcapsular hematoma of the liver, fractures of the spleen, or adrenal hematoma), neonatal intensive care unit (NICU) admission (admission into a facility or unit staffed and equipped to provide continuous mechanical ventilatory support for a newborn), seizures (seizure is any involuntary repetitive, convulsive movement or behavior; serious neurologic dysfunction is severe alteration of alertness, such as obtundation, stupor, or coma, ie, hypoxic-ischemic encephalopathy, excludes lethargy or hypotonia in the absence of other neurologic findings, excludes symptoms associated with central nervous system congenital anomalies), 5-minute Apgar
score <7, and birthweight <2500 g.

 Way to go for reinforcing lots of "risk factors" not supported by research. And why exclude fractured clavicles and transient facial palsy?

Shame on you, Auntie

On Stateline last week, there was a snippet about calls to change laws over stillbirth investigations (link is to video with sound). In a shocking example of "jouranlism", the story went from a woman who wanted her interuterine fetal death at 28 weeks (I'm guessing there - she said "7 months") investigated for some kind of explaination, to a beat up about homebirth. The woman's horrible experience had NOTHING to do with homebirth - she was under the care of a hospital and birthed there.

The tenuous bow that seems to have been drawn between these two stories was that one woman had her baby die in her pregnancy, and another had her baby die during birth, and that latter woman was birthing at home. The case of the latter woman has now rocked the entire concept of "life" because the assistant coroner seems to have an axe to grind about homebirth.

The findings of the case make for interesting reading (go on, read it - it's only 14 neatly formatted and well spaced pages). The assistant coroner seems to have ignored eminent experts in the area of cardio-thoracic medicine and has decided that something akin to the heat left in a boiled kettle, now constitutes life. Instead of leaving the Spencer-Kock family to grieve and live their lives, the decision has been made that their baby was in fact alive at some point and therefore is a "person" under the law and so the coroner has jurisdiction to investigate the death and make recommendations under other laws, like criminal law, against people involved.

This is a scary, scary path to go down. Life has to begin somewhere, just as it has to end somewhere. Funnily enough, the definition of life and the definition of death aren't the same thing - one can be dead but a teeny bit alive as is the case of organ donors. But the line in the sand has always been that "signs of life" be seen in a baby - heartbeat, breath, movement, crying, reaction to stimulus. If these are absent, and the baby is stillborn (oh how my heart aches to write that), then no investigation can be held, no charges laid, no blame attributed. This is a two-edged sword, no doubt - but it also means that until that baby is apart from its mother and is alive, it is not a person. Augh it's confusing and I'm sure someone has been offended by the way I've put it.

Anyway Lavender, as the president of the AMA in SA, then claimed in the Stateline article (yes I was getting back to my point) that homebirth is 7 times more likely to result in a baby's death, which is (a) not true, (b) not supported by any research the whole freaking world over, and (c) not what the recent Flinders University research said. The "data point" that Lavender is referring to ERRONOUSLY is the one I've previously blogged about and kind of indicates that not only is he an idiot, but he also didn't bother reading the study and only read the press release.


Add to that recent beat ups about homebirth being more dangerous with triple the neonatal (first month - hardly a lot to do with homebirth) death rate, which is hard to comment on as the actual study doesn't come out until September, and there is a lot of attack on the process from many sides. Add to that changes here in Australia to registration and insurance for midwives and you have a very muddy water from which to sup. I'm sure there's a line there about babies and bathwater but meh, I can't be bothered.

What I can be bothered with though is to say to the ABC - shame on you for such appalling and upsetting and shallow "journalism". You didn't check the facts, you didn't bother getting any other side of the story, you didn't stop to question what agendas might be being wheeled through your "story" and you certainly didn't bother to notice that a story about stillbirth suddenly turned into a witchhunt for homebirth.

And you didn't stop to think about what this means. Let's say that all stillbirths from 28 weeks onwards get investigated. That is a lot of deaths, firstly, because not all pregnancies end in a live baby. So the coroner is now overwhelmed with them. And what if the parents do not want an investigation? What if the answer is that someone is to blame, that something could have been done, that something could have changed the course of events? How would that help the family? Instead of supporting them, financially and socially, they'll be dragged through the courts. The coroner could then autopsy babies, which means that parts of their bodies can be kept for analysis.

And the funny thing is that hospitals, where 98% of births occur, will suddenly have to be party to many more inquests. And for what?

------------------------------------------------------------------------------------------------------------

From Medscape Medical News

Less Medical Intervention for Home Birth Linked to Increased Neonatal Mortality Rate

Laurie Barclay, MD

July 2, 2010 — Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate vs planned hospital birth, according to the results of a systematic review and meta-analysis reported online first July 1 and will appear in the September 10 print issue of the American Journal of Obstetrics & Gynecology.

"The American College of Obstetricians and Gynecologists does not support home birth, citing safety concerns and lack of rigorous scientific study," write Joseph R. Wax, MD, from Maine Medical Center in Portland, and colleagues. "We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth."

Selection criteria for the meta-analysis were English-language peer-reviewed publications from developed Western nations, in which maternal and newborn outcomes were reported by planned delivery location. The investigators calculated summary odds ratios with 95% confidence intervals for these outcomes.

Compared with planned hospital births, fewer maternal interventions were associated with planned home births, including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. Women who delivered at home had lower rates of lacerations, hemorrhage, and infections, and their offspring had lower rates of prematurity, low birth weight, and assisted newborn ventilation.

Perinatal mortality rates were similar for planned home and hospital births, but neonatal mortality rates were significantly higher with planned home births.

"Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate," the study authors write.

Limitations of this study include those inherent in the included studies, self-selection of women for home birth, and insufficient data for some outcomes.

"Future research needs to be directed at identifying contributors to and reducing the apparently excessive neonatal mortality among planned home births," the study authors conclude. "Data regarding maternal mortality, maternal and newborn readmission rates and indications, and newborn neurologic injury are insufficient for evaluation and comparison.... Ideally, the results of such work will contribute to an obstetric and newborn best practices model benefiting women and children regardless of chosen birth location."

The study authors have disclosed no relevant financial relationships.

Am J Obstet Gynecol. Published online July 1, 2010.

My birth story - homebirth for a first-timer

This is REALLY long so grab a cup of tea and settle in. It's not your usual light-hearted approach to a birth story, and it's not particularly emotional either - but it is very real to me.

10 March: Wednesday night I had a rehearsal for a concert that I'd been rehearsing in since November last year, and had dinner beforehand with friends including one with whom I'd been discussing motherhood and such things via email but hadn't seen in 5 years! I ate a large meal for the first time in ages. Rehearsal was fun and enjoyable, and I sat through the whole thing feeling very zen and with a smile on my face. I felt quite floaty and away with the fairies, struggling to concentrate on the music, and very calm. Puggles had been quiet for a few days and was low in my pelvis, resting on my thighs as I walked up stairs or sat to rehearse. It made it easier to sing though without a baby in my diaphragm!

11 March: At 2am on Thursday morning, I woke up from a deep sleep with an ache in my belly. I got up to go to the toilet, as TheHusband was coming to bed then, and went back to bed and put the radio on. I then had more regular pangs through the next hour – about 4 of them before the BBC shut off after an hour, so 15-minutely. I had visualised the ideal birth and it would be after a decent night's sleep, so after an hour or so of this I went and built a nest on the lounge with a pile of pillows, and slept through more of them until morning. When I woke up I was craving a hot breakfast, and TheHusband insisted on making me scrambled eggs and spaghetti on toast, with coffee. I mentioned that something was going on, and that we might have a baby today, but I was in denial in a big was as I was 39+2 at this stage and as a primip I expected to gestate longer yet!

I'm not sure when my membranes ruptured. It doesn't matter but I do know that I didn't have a big pop or gush of water. I also didn't lose a mucous plug in a clearly defined way – I did have a lot of mucous, and a bit of old blood tinged in one wipe, but no clear bloody show either.

About 10:30am I called my midwife Julie Garrat to let her know that things were maybe starting to happen. I was still in denial at this stage but wanted her there for the birth and to let her know that I might need to cancel our antenatal appointment for the next day. She talked to me for about 10 minutes and I only had to lightly breathe through one during that time and I knew she was listening to me to gauge how I going, which was “easy” at this stage.

I wandered around home, mostly wanting to be alone but also enjoying the quiet company of TheHusband and housemate / almost sisterfriend / fellow midwife Alice. We put on some movies in the couch room, and sat around watching Monsters Inc. I had to stand and sway through contractions but was dressed in a skirt and t-shirt still, barefoot in a gorgeous Autumn day. I had a glass of iced tea and a glass of water and some lipbalm, and an altar set up. I ate Clinkers and mint leaves, and Alice made popcorn which I ate a few pieces of, daintily and slowly. I had lit my candles and wrapped some of my blessingway yarn around the idol that Heather had given me when we were trying to conceive, and a heap of paper cranes left over from my blessingway.

I had downloaded an app on my iPod that I was using to time contractions by this stage to distract myself from them. They were 5-8 minutely and I soon couldn't talk through them but had to close my eyes and breathe.

Alice suggested we do a belly cast of my last day pregnant and even now, looking at it, I can't believe I was ever that big! I had a few contractions while in the cast which were good because it helped the otherwise stubborn cast to come off! I'd forgotten how much hairier I was with pregnancy and hadn't used quite enough Vaseline on some areas.

After the cast was off, I went and showered very thoroughly to remove the last of the Vaseline and plaster. I still had remnants of my blessingway henna and it was a wish of mine as well to birth with that on me. As I washed in the shower, the last of the henna faded and this was a huge transition point for me mentally to admit to myself that maybe I was in labour, before my edd or not.

I thought that I'd not be going to rehearsal that night or lunch with friends, but I did send TheHusband on his way to the lunch as I didn't want to be watched too much or to entertain anyone. After TheHusband left I got the WiiFit out and weighed myself, because I was curious as to how much I'd lose in giving birth.

I gave several groups of friends the heads up that things were starting and knew that candles were lit and thoughts sent to support me on my way. I love all the people I told because no one bugged me later that day!

Alice made lunch at this point and after dithering about whether I wanted it or not, I ended up eating a rather large bowl of meatballs and pasta. I was starting to feel spacey and wanting my own space, so it was good timing when Alice told me she was going to the gym that afternoon. My sister sent a text to see if I was free for a coffee, and when I told her I was in labour she arranged to visit to drop of her video camera. She came and sat for a little while but I shortly asked her to leave because I didn't need the distraction.

I set up my birth space in a room I didn't expect to use – the couch room, with tv and open doors and lots of couches. There was a table and a bit of wall to put affirmations and blessings and words of wisdom on the wall and candles and essential oils – kunzea and lavender and rose – and plenty of room for water and lollies and lipbalm and everything else I wanted. I took the time to go outside and paint some words on fabric to remind me – surrender, open, breath. I spent some time outside swaying and breathing through more contractions. They really weren't fading and Puggles was still wriggling around and things were getting more real.

I sent TheHusband a text to ask him to come home soon and he did – he brought home some mail, and I suggested he call his section leader and let him know he wouldn't be at rehearsal that night. I printed out my (as yet unfinished - never did write the transfer bit of it!) birth plan and talked with him about what I wanted. Some of the things I dismissed as I covered them – I was not in the mind space to quilt, for example. But most of it was still relevant and I was glad to discuss it with people between contractions.

I gave TheHusband the task of timing contractions and we watched another movie (one of the Harry Potters) and I continued to contract. They weren't slowing and were changing and at some point I said that I needed to let go of the feeling of being a pretender and embrace the fact that I was actually in labour, and just go about being in labour.

I had wanted the fitball blown up before labour, and of course tried sitting on that but couldn't. The one contraction that I had on there was far too painful and felt wrong, so I hauled myself up for every single other one. It was good later on to lean over but NOT to sit on! The one time that TheHusband tried to help me through one on the ball was the only time I forcefully pushed him away and couldn't stand to have him in my space.

Julie called back in the afternoon to see if I wanted her, and I said that things weren't going to get interesting until the sun went down, which proved to be right. I was in the shower when she called, swaying between contractions but not vocal. Still didn't want her there. My paternal grandmother also called my mobile I think during this shower as well, and TheHusband chatted to her as I was in no place to chat!

I had expected Julie to visit at some point between those two phonecalls but in hindsight it wasn't up to her to invite herself over, and I had to work out that I didn't need a tick of approval that I was in labour. I had to work that out for myself and tell Julie that this was for real. This was the first step in a journey during my labour, a journey to being completely in my body.

I had earlier that day sent Kate an email with subject header “Wolf” (as in crying wolf cause I was in denial, remember?) – I still was in denial about this! I let her know something might have been happening. I'd just seen her a few days earlier and said next time I saw her it'd be to have a baby, and that came back to remind me that I knew that things were happening. Some texts went back and forth with Kate about when to come over, and I sent her to dinner with friends rather than rushing over. She turned up about 7pm I think and made some comment about something (must ask her what) and I swore at her. It was then that I realised I really was concentrating to get through contractions and not really coming out of it when I was done.

I retreated to the shower for relief and peace, and it was glorious. I was just enjoying the last of the afternoon sun lighting up the window and wall and ducks on the wall, which are a lime green and the gorgeous clear blue that I've associated with Puggles this whole pregnancy. It was apparently a gorgeous sunset but I was in the shower when the sun disappeared so saw it in reflection, and I shed some tears at something. I've no idea what but it was another change.



Julie turned up around the 8pm point and my support people trooped to unpack the car. It was the last interruption that I was anticipating and now, my birth team was complete. I felt like a circle closed when the front door shut and the contractions stepped up again.


Julie came into the bathroom and talked to me through some contractions. I was bending my knees / squatting a little with each, and hanging off the glass in the shower, trying to open up. I looked up after a contraction and Julie was gone, which was fine by me – I shut the door and was glad not to have to ask to be left alone. TheHusband had set up my ipod in its player on the bathroom bench, and a playlist of Idea of North, and the songs went on as I kept patiently riding each out. They were starting to hurt and the endorphins were catching me half dozing in the corner of the shower. I tried to sway with the contractions, but that didn't work. I tried to have the water on my belly and found that the sensation was too much on my skin and my breasts. It was best if I leaned on the glass and rested my forehead on the glass and just breathed. Closing my eyes helped too.

The contractions kept going in the same spot – across my belly, under the edge of my bump. They were just contractions – nothing like period pain, but deep and visceral feelings of opening. Not a cramp, not a baby hug or a rush or whatever else you wanted to call them. They were undeniable and overwhelming and regular and so normal.

Up until this point it's all pretty clear what was going on. Each contraction would pass and I'd regroup. After Julie arrived it gets a bit blurry. I was surrendering to the journey and had left my glasses off in the shower, and didn't put them back on until after the birth.

Julie checked in and listened to bub's heart beat. I was getting upset and anxious and her heartbeat was higher than normal. That gave me the courage to regroup and let the contractions pass through me, over me, via me, rather than fighting them each time and tensing up. They didn't get easier but it did help to know that I was doing my first thing as a mama to calm the fuck down and just go with it.

I got out of the shower and was contracting back in the couch room, with Julie doing some effleurage on me which felt ah-maz-ing.



My birth team were at work blowing the pool up. I felt like throwing up at this point. The pump made a loud squeaky wheezy sound which got me out of my zone but it was comforting to know that normal stuff was going on around me. I threw up a little of lunch. TheHusband cleaned up and got back to blowing up the pool. Julie watched for a while as I swayed, naked, in the couch room still. My team discovered, after starting to fill the pool, that there was a liner to put in it. Julie left me alone and went to supervise the emptying of the pool and the lining of it. I wanted a change but didn't know what I wanted and I felt that the pool being filled would be another step in my journey. No prescribed marking my progress – no VEs, little listening to babe, no blood pressure or touching me in any way other than support – but another step somewhere.

 




I was hanging out for that pool to be filled and for me to get into it. Well a part of me was – most of me was just waiting for each contraction to come and then go. I counted 9 breaths for each, knowing it would pass before I got to 9. Then it took 11. The number of cranes on my altar. Then more. Then I forgot to open my eyes to see the cranes, and the number got higher. I would open my eyes after a contraction and look at the words on the wall and read the poems and the inspirations, look at the candle and the crowning head that was there, and then close my eyes and have another one.



I brushed my teeth and got back in the shower, and the contractions changed again. These hurt. Hurt in a way I couldn't escape or deal with. It hurt so much that I started to think about saying “enough”. I thought about an epidural. Surgery. Transferring. Anything to make this stop. It hurt in a way I can't convey – I couldn't go up, I couldn't go down, I couldn't go around or through. I couldn't do it anymore. I made bargains. I tried to stay with “just this one”. I tried to breathe and it wasn't working anymore. It hurt so much that I wanted off. I wanted out. My voice rose, and I could feel myself panicking. The contractions slowed and I rested in the corner of the shower, water hitting me and a small part of my mind had a moment to discuss this with my psyche after each contraction.


Transferring meant getting out of the shower.

Contraction.

It meant getting dressed.

Contraction.

It meant getting into a car and going somewhere and being examined and fighting and justifying and crying and blood and pain and more payment than I was willing to make for the off chance of relief. Contraction.

Plus I didn't want relief – I wanted it to change and me to be able to go back to coping with it.

Contraction.


Contraction.

I stood there in the corner and thought that it would take a couple of hours and a lot of things before I could have any promise of relief and that wasn't guaranteed and I didn't want to give in to what wasn't going to be an easy way out.

Contraction.


And so I just kept going. And it did change. Never knew that about labour - that it doesn't just get worse. It gets different. It really is a journey.



Eventually the pool was filled and I could get in. That feeling, of warm water and embrace, was like an orgasm. The contractions faded away, almost surprised to see some lovely happy smiles and feelings from me in the midst of their awesome and fearsome strength. Not for long though of course but enough for me to gather my strength and turn a bend in my journey. In the light of the bargaining I'd just been doing this was blessed relief!



My team gathered to support me as the night wore on. It was midnight ish by this stage. Kate knit. Alice watched and held the space and videod. TheHusband was my rock – he pulled up the stool for the piano, next to the pool and fed me water, Gatorade, whatever I wanted. I was down to one word directions and sounded a little whiney at times - “water”, “hot”, “cold”, and so on.



Why couldn't people read my mind?

Why did I have to come out of deep in myself to ask for these things?



The water was a tad cool, and the team set about working out how to get it hotter without it overflowing. I moved at one point and the hot water flashed across my legs and it really hurt. In a different way. I was upset that someone would do that! Offended even! In sharing that it hurt (I think I said “ow” in a different way I guess) I did pick up that my support team were a little uncomfortable with how I was going. This gave me pause – was I just going with it? Was it ok? Was Puggles ok still? Was I doing this right? Was I getting closer? I remember blinking and seeing the room with new eyes and a bit of fear. And then another contraction came and I was back into it.



Julie suggested turning off the lights and everyone settling in for a bit – Alice went for a nap, TheHusband stayed, Kate rested, and Julie lay on the couch in the other corner and napped.



I worked on in the water, in the blessed gloom.


I was hot. A fan appeared.

I wanted to brush my teeth again – TheHusband helped.

Twice.

I was cold. The water was fixed.



My team responded to me and I worked on. They rested as well, which helped me to be ok to keep people up.

It did strike me as amusing at this point that they could just go and lie down and rest – oh, to rest! To sleep! To give in and go away from the awful and majestic task master that is labour.

By this stage I'd been awake for a long time and was tired. I was starting to feel very worn and upset at this. Julie got me out of the pool and insisted on tucking me into bed – a change of scenery and energy. I was singing a loud birth song with each contraction, and my throat was getting sore. Julie heated up two heat packs, tucked me into bed with my husband's arms around me and left me for a while. Contractions continued and they hurt. Oh, how they hurt. I would sleep between them but would wake up, back arched and in agony, every few minutes. I was lying on my bed, on my left hand side, lights off and a little scared that I couldn't cope.

At this point I was scared at the pain to come and the pushing taking more out of me and I was way too out of the moment to continue on. I lasted about half an hour in bed before saying it was a stupidly bad idea and got back into the pool. Slowly by this stage but the pool was where it was at. I got back in pool – I can't tell you whether I ran or hobbled, whether I contracted or didn't on the way there. I knelt in the pool and faced my husband who was seated outside the pool waiting for me to need him.

I suddenly felt pushy and gave a little trial one. It hurt in a different way and I was disappointed! Where was the joy of pushing? Where was the change from pain to pleasure? Disappointed! Just a little of course – I was also rather amused to discover the true meaning of not being able to resist. I had an inkling that something wasn't going perfectly or easily but no one mentioned anything so I just continued to take it one at a time. I rested between the contractions, leaning against the pool side. They slowed quite a lot. Sometimes I napped, only to slip down the pool side and feel my face touch the water and waking me up. Mostly I rested. Sometimes I tried to ignore the first hint of a gathering contraction and of course, ignoring it didn't work and instead I'd be caught unprepared for the contraction and is hurt so much more. But I was tired and not able to always stay on top of when they were coming.

The pain was back with a vengeance. Some of the contractions hurt in a different way and my SI joints were starting to hurt, especially my left one which I'd separated 3 years earlier. This scared me but it just hurt, rather than really really hurting in a way I couldn't cope with. I waved my hands and TheHusband was there for me. I pulled on him as I pushed – a position that he held without complaint for 4 more hours (which I really regretted for a week as my L shoulder, only 12 months on from reconstructive surgery, really ached and meant I could only feed using my R arm) and that I used for every contraction unless I forgot and then I needed him. Alice was there a few times when he stepped away and a contraction caught me sooner than anticipated. I was careful not to squeeze quite as hard on her hands because the strength in my hands was awesome.


As discussed during my pregnancy, Julie offered sterile water injections into my back because she could see (from the fact that every third or so contraction I was bolt upright, hand digging into my back, head thrown back and obviosuly in a lot of pain) that it might help. I nodded my head, convinced I would be able to stand the pain (she did warn me that it was horrible) and admitting to myself that my fear of this stage was that my pelvis, injured a few years ago, would not cope with this. Some of the contractions had me still kneeling and ok with bearing down, opening up and pushing down. Others had me kneeling up with my pelvis thrust forward, head thrown back and howling with pain through them. Julie got out her equipment, checked again that I was sure I wanted this as the relief would be awesome but it would hurt a lot, and at that stage I didn't care. I wanted something to change. She touched my sacrum on the right, the left, then higher up my back, perhaps showing my support people where she was going to inject the water under my skin. And said she'd wait for a contraction and that I'd have to come to her side of the pool for it.

Sweet mother fucking OW – it was like being stung by a huge pissed off wasp with a hangover, an attitude, and a point to prove. It was like being whipped with hot snapping sizzling fat. It hurt WAY more than a contraction did! I cried out in pain, real pain, and scooted away from her. Shaking my head and whimpering, I said no more. No. No. NO. It made me cry a little but it did work. I only regret that I didn't ask her to put it in my left SI joint first on the off chance that I couldn't cope with more than one, because it did work really well. So much so that later contractions, with Puggles moving down, had me pressing on my left SI joint only.

It was about 3am by this stage I think – not having glasses on meant I couldn't actually see the clocks.

(As an aside, in debriefing this with Julie afterwards, it seems at some point the conversation was had between my support people and Julie about how I was going. There was concern about me not wanting to do this anymore and wanting to help but Julie told them that this was what I wanted and that it was all normal. I'm glad that I didn't know this at the time!)

With the pain and the pushing and the time and everything, I had to focus on bringing my voice down rather than letting it get higher and higher. Julie did suggest at this point too to change the word I was using. I'm a little amused to say that it was just a simple "ow" at that point because it helped to make an o sound then to close it out with a w. It made sense to me at this point but mentally wasn't that great was it? Julie suggested trying something else – so I tried instead to say “roar” which was funny to me even then, because talking about it meant I'd come out of my labour land and considered this at a very high level. So my roar started as a teeny tiny pretend roar and it wasn't until I got back into labour land that I got my ROAR going. So when I say I roared my baby earthside I really did!)



I was pushing with most contractions now, and running from the wrong kind of pain with the odd one. Julie suggested I reach down and find where Puggles was – Puggle's head was an inch inside my vagina. With a push it came down a bit further and went back up. It felt amazing. I was making progress. I was birthing.

I pushed for an hour with no more progress though. I was to find out later that this wasn't really pushing though – it was going with feeling but being pulled through the wave of pain, with bub sitting on my pelvic floor and perinium all the while. In hindsight I was waiting for it to take me along for the ride and that wasn't enough.

Julie listened with the Doppler and was suddenly alert – it was easy to hear a heartbeat over the anterior shoulder, but also with just a little movement in direction, to hear the cord. She wondered aloud whether this was something to be worried about, but listening to Puggles there was no hint of the cord being compressed, so on we went. She did encourage me to move around though and got me to lie on my back and float for a little while. She suggested TheHusband get into the pool with me to hold me but I didn't want him in my space at this stage. I didn't want help. I didn't want anyone to do it with me or for me. I wanted to be able to say I did it myself. I floated on my back.

With a push she commented to Alice that she could see a bit of a cervical lip coming down with bub's head. She asked me to see if I could feel that but I couldn't tell anything apart from where I stopped and a piece of head - oh that endless piece of head! - started so reluctantly sh did a vaginal exam to see what was going on, and pushed it back easily. She suggested moving around to an open squat. I didn't want to move from the comfortable position I was in. She suggested I stand up – I did to try it out, but immediately sank back into the water with a whimper as that hurt too much and felt wrong with a babe between my pelvis to be standing up. I moved around into a squat. That worked really well but my progress was starting to sink in. Or not as the case was.

(As an aside – this VE also revealed that bub's head was deflexed and was slightly crooked. I had to keep going because until my uterus had contracted down enough to hold Puggles against my perineum so Julie could help her to flex. But I had to keep going to get to that point. She didn't tell me at that point as there was no need to and it would only have frightened me to hear "deflexed head" and "brow presentation" mentioned, damn training be damned!)

I returned to my squat and kept going with the pushing. Another hour passed. Julie commented that I was leaking colostrum and that was a good sign. I felt a little bit of a burn – was that the ring of fire? The burning passed. No ring of fire. No baby born into my hands. The pushes were inconsistent and so frustrating – sometimes I needed to arch my back, sometimes lean forward, sometimes lean back. Sometimes I bore down and opened and felt my back bulge. Other times I didn't know where to push or how. I know Puggles was trying to change position but it was so frustrating. I started to get upset with this. I wanted help. There was no help to offer me. And then I said those magical words.

I can't do this anymore.

I cried. I wailed. I'd been pushing for 3 hours by this stage. I was so upset and still going but just couldn't do it anymore. Julie looked me in the eyes and said that it wasn't that I couldn't. She could see that I could. And I was doing it. I'd gotten this far. But I didn't want to anymore. I didn't want to and it was ok to say that. But I was doing it and would do it. And I was getting closer.

I sat with this for a while. Turned it over in my head. Considered that yes, I didn't want to go on. It was hard and it was harder than I thought. I had hit my limit and just over there, on the other side of some amazingly high barrier, was my womanhood and motherhood and power and goddess-like ability to birth and I was stuck, over here in normal land. Oh goddess I had to get through that, over that, into that. I've never pushed myself like I had to push through that barrier. It was 6 o'clock in the morning by this stage. I was exhausted and so tired and knew I was running on the last of my reserves. I was running in front of the last of the “easy” labour, where my body was pushing me onwards, and needed it to end or else other eventualities were waiting for me once the sun rose.

I've never felt so scared of a sunrise nor as invigorated.

I turned around for a change in scenery and because the lining on the other side of the pool was coming a bit loose with me leaning over it for hours. TheHusband came around and sat again on the stool.


I opened my eyes and did the scariest thing ever – I looked into my husband's eyes, the father of the child I was working to birth, and drew strength from him.

His cool blue eyes locked onto mine and looked back into my soul. It was scary how deep he looked into me and where we went in that little while of pushing.

It gave me strength and I pushed and pushed and pushed like there was no tomorrow because there wasn't for me.

I could see the clock over TheHusband's shoulder and shook the last of the “floating along with the labour” off and swore to myself that Puggles would be born before dawn. I was born at dawn myself and could see the sky start to lighten. I knew in my brain that I could not do this in the daylight. This kind of power and pain and challenge was a creature of the night and in the daylight I would be undone.


I pushed.

The clock ticked.

The world turned and the sun rose.

I pushed more.

Julie got closer and did a vaginal examination to help Puggles flex her head, then supported my perinium which gave way at some point close to her birthing but without support would probably have gone further than the second degree tear that I ended up with.

I felt no ring of fire but I did feel more fullness in my vagina which spurred me on.

I pushed and held and pushed and held.


Puggles progressed.

I celebrated.

I thought about all the women before me, and the future that I faced. I suddenly realised, at about 6:30am, that I was scared of being a mother. I was so afraid of repeating my past and I was so not ready to be a mother. I cried. I said all of that and more.

Then I pushed. I took another breath and I pushed.

I looked into TheHusband's eyes and I pushed.

I waited between contractions, feeling Puggles wriggle for the last times inside me, and waited for the next contraction.

I took a breath, and held on to TheHusband's hands. Her head crowned and stayed there.

Julie said pant. I tried. She said to reach down and feel her shoulders. I reached down and could still just feel head. Thankfully my vagina wasn't in full view - there aren't any photos or video of any of this and I'm happy with that! - so she was just guessing at what was going on. But I certainly didn't feel shoulders.

Why oh why did I only ever feel head? Hard and round and never ending. And then a pop. I took my other hand from TheHusband's and felt around quickly. You can see it on the video as I did it. I exclaimed “ears!” because it was the first soft thing of my baby's that I could feel. Julie asked if I could just feel ears and I checked around – no cord and yes, ears! My support people laughed and relaxed. TheHusband's hands were on my shoulders supporting me. I pushed and she wriggled which felt all sorts of wrong. I stopped and just let my hands rest there. Another little push and swoosh pop – she was out. I picked her up and she was here.




I was so relieved that I was crying without tears, from the sheer relief of being at the end of that journey. She looked into my eyes immediately that I picked her up, and then looked at TheHusband as if to say “Ah I'm home”. After a little while I wanted to check what I had birthed – people were quick to reassure me that they hadn't seen. I had, as I picked her up, and was sure we had a daughter. But I stood on that threshold because it was again the unknown. I lifted her leg and shared her sex with TheHusband and again cried tears of relief that it was over. I was really uncomfortable in the position I was but her cord was short so I scooted over in the pool to sit on the seat and share some bonding with TheHusband. Puggles had not made a peep and was pink almost immediately – APGARS of 9 and 10! – and was just so beautiful to behold.


Julie had gotten TheHusband to get a hat which was put on her head, and Alice was working to heat up some towels. The heater was on too as the room was quite cold. I was beholding the miracle I'd achieved and others were buzzing around. TheHusband made a heap of phonecalls – to his parents, to my dad and step-mum, and so on.




The sun finally rose.






I requested a cup of something hot and sweet. The water changed to rose colour. I sipped something hot while I took in her sweet face and little rosebud lips and amazing smell. Towels were changed and I started to feel SO tired that I was slipping off the little seat and into the water. After a while, I started to get really uncomfortable and wanted to get out. But Puggle's cord was fairly short so I could barely lift her to my navel. Which made getting out of the pool a challenge. The placenta had still not birthed and I was starting to feel odd, so I decided to cut the cord and hand Puggles over to TheHusband. This was about an hour after she was born. Cord was clamped – had completely forgotten about the cord tie that I'd made! - and I cut the cord.

No one else even asked. I climbed out of the pool and went to sit on the loo and wee. Ooooooh how good is that first post-birth wee?






I passed a heap of clots at that stage as well, and thought it was my placenta but when Alice peeked she said no the cord was still dangling down. Which was good as I was sad at the thought of my placenta ending up in the loo rather than being able to be used. I was starting to get cold and really come back into the reality of being so tired, and starting to feel a bit ill. Julie came to check on me and my placenta and I asked her to help me out with it. She had me try to push it out but it wasn't coming, and I was starting to worry about the blood. She wasn't but I insisted on something to help so syntometrine was given in my left thigh and a few minutes later the placenta birthed. That kind of hurt to be honest and I was aware of my tears by that stage!


The placenta went into a bowl and I went into the shower. Oh glorious shower! Julie brought my placenta in to have a look at it and it was so beautiful to behold. She then tucked me and Sally in to bed and got Alice to hold the torch. Yep it needed stitching and the worst part of that process was the local anaesthetic. Then tugging and so forth as I tried to stay awake. Kate left before this started and TheHusband was in bed with me as well, first dressing Puggles and then cuddling us both. Suturing done, a feed was in order but I was so sleepy by that stage and Puggles' mouth small and her lip tucked under that I ended up falling asleep cuddled up instead!


The washing was put on, some tidying done, Julie left (looking a little worse for wear) and Alice made me toast with peanut butter before crawling off to bed too! I sent a heap of texts to my friends to tell them the news and received some very excited ones back.