There has so much been said and written about our birthing in Western culture, that it seems somewhat redundant to add my thoughts ... but I will - because if it helps one other mother enjoy her birthing experience more, and be more confident in her birthing choices then it is was worth spending the hour to write this.
I am about to give birth to my fourth child. My first was born via 'elective' caesarean section two weeks before the due date. My second and third were born via what is known as a VBAC (vaginal birth after causarean) with no medical intervention or drugs.
It is still too painful emotionally for me to go into a great deal of detail about my caesar experience. My obstetrician at the time was (and probably still is) the best example of a medical bully I have ever heard of, and I had the unfortunate displeasure of engaging him, and paying him over $5,000 out of my own pocket for that experience. In hindsight and after much of my own research and knowledge gaining, I see how little he provided me in the way of choice. If I was stronger, braver, and not so focussed on my children now, I would definitely sue him and make a stand against his methods of dealing with mothers and birthing and infertility treatment and surgery.
His stated reason for the caesar was that at 30 weeks gestation, T was in a breech position. Never mind that by the time he was due to be born, he was head down and engaged ... which I discovered when researching my own birth records from the hospital after the birth, this barbarian proceeded to perform an unnecessary and dangerous surgery. All whilst keeping me in the dark about a) that T was now in the classical birth postion and b) that babies can and are born very successfully vaginally in a breech position. Obstetricians don't make as much money though, and they may have to attend births not in working hours.
I was fine (because I knew no better) as the date of the surgery approached and even when I was gowned up and awaiting to go in. But, I will keep it brief, so I don't drown the keyboard in tears, as soon as I walked into the surgical theatre I became very frightened. The epidural was extremely painful, the catheter painful and humuliating, the ten or so attendants (nurses, anaethetist and assistant, obstetrician and assistant, paedetrican and assistant) were discussing the horrendous parking problems with the hospital (and generally ignored me and D) - such that the only person who took any notice of the complete and utter distress I was in was D. The bright lights, the casual non-birth related talk, the disregard for my welfare ... was awful. T was born and was never handed to me. Luckily he went to D until we were all lead into recovery (how long? Not sure - 20 minutes?). I cried the entire time as it meant D had to leave my side. Okay not brief enough ... tears here now.
In recovery it felt like I had arrived in heaven. Everyone left us - just D, T and I. A lovely, lovely midwife came in and pulled away my gown, took T's clothes off and helped him latch onto my breast and start feeding. It was perfect and we never looked back with breastfeeding. Thank goodness for that woman.
Even in recovery the affects of the surgery started to take hold - shaking and shivering from the epidural, lightheadness etc. I was told this happened 'all the time' and was normal. I couldn't move, I was trapped to the bed and the wires/drains etc.
That night, D wasn't allowed to stay with me as I was sharing a room (even though it was a private hospital). I was unable to sit myself upright, let alone pick up my baby beside me, or adjust him on the breast. The midwives in the ward requested I move the baby to the nursery as the other mother I was sharing with did this, and it was 'unfair' if my baby cried and kept her awake. FINALLY my own voice kicked in and I said in no uncertain terms that this baby WAS NOT LEAVING MY SIDE.
It meant everytime he cried I had to call a midwife who would lift him out of the cot beside me and I would let him latch on. I couldn't roll over independently and I was woken for monitoring regularly (hourly) to ensure the drugs/operation weren't stopping my oxygen flow or heart rate.
The next morning things got better as D returned, I was moved to a private room with a double bed, and normality began to kick in. I was in a great deal of pain from the surgery - I was still unable to do anything independently - no more of a bonding moment than having your husband change your postpartun sanitary napkins for you every hour. D stayed the entire five days with me in the hospital, returning home only to feed the cat. D did all the baby lifting, washing, nappy changing as I still couldn't bring myself to standing independently.
Being home after that five days, I could not drive for six weeks, walking, laughing, sneezing any such movement was painful. I had to have the wound checked regularly. I have friends whose wounds became infected and those stories are worse than mine. Getting fit and losing weight after my caesar was a nightmare - as it took 9 months for me not to be in pain when running. I had particularly bad pain on my right end of the scar - the midwives said it was the side the doctor did the first incision and is often achy and sore for many months as a result.
From my experience - how ANYONE could choose this option as the easier/better choice for birthing I simply cannot comprehend. I know some people have "wonderful" caesar experiences - I am so relieved for them that they did not have mine.
T was and is a divine child - he fed easily, slept well, was quiet and contented. Lots of people say to me "Oh well you have T, doesn't matter how he came out..."
Well you know what - IT DOES MATTER TO ME.
I was absolutely and utterly determined that after two years of infertility and unnecessary further surgery from the above obstetrician that the birth of W would be different.
I engaged the most wonderful woman, L, as my doula on recommendation from a good friend who had used her. I had already started using my successful fertility doctor's recommendation of another obstetrician (I have top level private health cover so I didn't even consider going public). L gently and over time showed me how using an obstetrician greatly reduced my chances of achieving a VBAC. So I simply cancelled my next ob appointment at 25 weeks and never rescheduled. Interestingly he and his office never contacted me again even though I had signed up with them. I wonder what they think happened to me and my baby?
I went public. This meant I would get predominantly midwife care during delivery unless a medical intervention was necessary, in which case the registrar on duty would step in. My appointments were all at the hospital. I had one appointment with an obstetrician who played the "death card" about my choosing to not have another caesarean (the "death card" is their trump card to get you to do something they want you to do, namely "If you choose to not have a caesar your baby might die during delivery due to a ruptured uterus. Are you willing to still make that choice?" Normally works for them I know - but not this little black duck anymore) (BTW it was played again with this pregnancy by another obstetrician - I actually laughed out loud and said, "Ah the old death card!" She looked shocked and I said "Yes well I can die during the caesarian as well can't I?" She said no more. So funny.)
W (and E and this one as well sort of) was breech at 30 weeks. I did panic. L calmed me down. I did a lot of lying on my belly bag so that my belly hung down. W turned at 35 weeks. As had T and as did E and this one.
Ten days before W's due date, D and I went for sushi with T (I had lots of wasabi), we went for a walk along Oxford St and D got lucky at home if you know what I mean. Two hours later my waters broke as I stood up out of bed to go to the toilet. We were both so excited we couldn't sleep even though I had no contractions. I had called L, who was attending another birth and she asked D to keep her posted.
At 8am the next morning - still no contractions. If I had called the hospital I would have been on countdown - I think you have "24 hours" after your waters break to give birth or else ... I would have been so stressed by this deadline. But I wasn't, as I was at home and only D, L and I knew what was going on.
D took T to dancing class at about 9am and I picked up my mobile phone and started walking the suburb! I would have walked on and off for 2 - 3 hours in star formation from the house so as not to be too far way. And yes the contractions/surges started. We kept L posted. She was still with the other labour. At lunchtime we shipped T off to a friend's house (the friend who had recommended L). D and I closed the shutters in our bedroom and sat talking to each other and burning oils and listening to music. The surges slowly sped up. I rolled around on the swiss ball - nothing too uncomfortable in terms of pains really. About 5pm from memory the surges were pretty regular and without knowing why or how I started to make these low, gutteral noises (like gregorian chanting) in order to see them through. The sensations were mainly in my lower back like period pains. They were over in about a minute or so and D and I would chat in between or just hold each other. I had taken to leaning into D's chest during the surges to bury my face (have darkness) and smell his scent (I know, weird, but it was very reassuring). D was ringing L regularly as she was STILL going poor thing with the other lady. At about 5.30pm (?) L listened to my gregorian chanting through the phone and said to D, take her to the hospital and I will meet you there.
D was so excited/stressed he blew out the candle on the oil burner and sent wax and oil all over the walls, dresser, television etc in the bedroom - still trying to get it all off now! I don't remember much of the next half an hour - except surges on the stairs, out the front of the house, in the car, coming into the hospital. Tip for new players - if you can still question whether you should go to the hospital or not - then you are not ready to go yet! When you can not talk or smile or think ... you are ready!
When I was seen by the first midwife she wanted to do a vaginal examination to "see if I was in labour". I declined and she literally huffed at me that therefore she shouldn't admit me. Luckily L arrived right at this time, and we were shuffled into a 'waiting room' - that is not a delivery suite but had a small bed, separate bathroom. We never left this 'waiting room' as the hospital were so full that night they had no spare delivery suits. The midwife who attended us at the end said lucky I didn't want an epidural or pethedene etc as they could not have fitted the machines into that room!
L lead D and I straight to the shower in the bathroom, where I stripped down as did D to his swimmers and all lights went off. D and L each held a shower nozzle on my back as I leant on D's knees in a kneeling or squatting position. D was seated on a chair under the shower. L - I have little recollection of where she was at any time - she was perfectly unobstrusive and just guided D on what to do to help me.
We had one doctor visit me and play the death card again around my choice to to not have a canula and not to have continual monitoring. When I very politely (truly) declined in between contractions, he then asked me what I would do if I had not birthed by 10pm (why that time??!!). I said I would decide then but that I thought the baby would be out by then anyway. We never saw him again.
At 6 ish my gregorian chant sound changed to be more grunt like. I was a bit surprised. L gently, quietly asked me if I felt like pushing. I did! And yet it then became hard work, as I had to really push. (Have you seen the size of W's head even now?) It was tiring and less enjoyable than that first phase which is like a meditative trance where you just ride the waves. Pushing requires focus and effort! L suggested I not make sounds but direct all my energy downwards.
A little over an hour or so later, W emerged in the perfect position, and on a last surge slipped into the midwife's hands (all of us still in the shower), midwife on her hands and knees below me. (L had to run out into the corridor about 7 to get a midwife as they had left us alone during midwife changeover - she said that I was about to give birth and we needed someone NOW! She had left D saying, put your hands down here if you see the head ....!)
My placenta took about half an hour to deliver (I chose once again no drugs to fast track this) and it was a shock to still be getting surges as I held my new baby and breastfeed him whilst he still had his umbilical cord attached and throbbing.
I had a few internal stitches for a small tear. W had blood on his head from this tear (for a few days as I didn't bath him for a few days to keep that lovely good stuff on his skin). He was checked over and all was well. I had a shower and washed myself, went to the toilet, folded my and W's clothes, had a cup of tea, and started texting everyone like crazy. In his mad panic to get me to the hospital, D had put me in the car with no baby seat!!! He had to go home and get the other car! So just after 10pm we went home. I was starving. I made D go through the drive through McDonalds and I had a Big Mac. It was the best burger I have ever eaten!
The most wonderful thing about natural birth is that there were for me no side effects! I was up and about the next day able to cuddle T and hold W. I was tired (9 months of pregnancy will do that to you) so I did spend a lot of time in bed. With E I spent even more and with this one I intend to be in bed for 2 weeks and allow myself to be spoiled rotten - meals brought to me, etc, so that I can really enjoy my new born.
E's birth was very similar to W. I had surge like sensations for a few weeks prior to E's due date. I had a number of false alarm calls to L. On the day after his due date I had those same sensations again, another call to L, only for it to not really go full steam, so another false alarm call to L. I had asked my in laws to come get T, and when they arrived I still wasn't sure if this was it or not. But T and W I think went to Nanna and Poppy's for a play anyway. I sat on my ball again, rolling through the surges and D and I watched a replay of an international Cricket One Dayer.
I got into the bath about 5pmish I think and I was still not sure if we were on or not. By 6 I told D to cancel our dinner engagement as even if it wasn't it I was still pretty uncomfortable and wouldn't enjoy myself. By about 6.45 I think I knew were were on, so called L who said she would be on her way immediately. L go here about 7.15pm and I had moved out of the bath onto the swiss ball and had started gregorian chanting, but was a lot more coherent than I had been with W between surges. I felt great and was loving every minute of it. D was putting W to bed about this time so he kept popping his head in and out to see how I was going. I was all smiley and good.
When L quietly put her head in, she said to me softly, "Honey we need to go to the hospital now, otherwise you will have this baby at home." I was very surprised and said really?! I felt so good. But L has seen over three hundred babies delivered so she knows a lot better than me. As I walked down the stairs to the car I realised she was right! The car ride was fast and bumpy (thanks D) and L said to D that if he didn't slow down the baby would be born in the car! I laughed.
A big surge on the walkway to the hospital had everyone stopping, staring and asking if I was ok. L said I was fine and we kept going! Love it! We arrived about 7.45pm and we headed straight for the shower and the same birthing position. 8.15pm E arrived with little or no pushing and I think the midwife passed E to Damien between my legs immediately so D "caught him'! And placenta a few minutes later no problems.
I love this photo!
E was perfect and I felt wonderful - long soak in the shower, clean set of clothes, cup of tea and the obligatory Big Mac on the way home. When you are on a good thing stick to it! We arrived home about midnight I think as L and us stayed chatting in the hospital for ages.
The next day at home I had all my boys with me. It was perfect, I felt physically a million dollars and that I was the luckiest woman. I remember that day I had to get a birthday present for a friend of Toms and I dashed to the local toy shop. The lady behind the counter asked when I was due. I said I had had the baby last night and she nearly fell over that I was so well and mobile and happy. And not in hospital of course!
So what is the upshot of these long winded but beautiful in my eyes stories?!
Normal, healthy birth REQUIRES NO MEDICAL INTERVENTION.
Obviously we have a lower infant mortality rate because with complex birth we have wonderful medical and emergency services that are so necessary and important.
However where our modern age gets it wrong is treating all birth as needing medical intervnetion. It is more expensive and our statistics (particularly in the US) show that it worsens so many critical indicators, such as breastfeeding rates, repeat caesars to name a just a few. Also our 'death rates' are no lower than Sweden and other such countries that predominantly use midwives over obstetricians for deliveries.
People ask me why I didn't stay in hospital longer. Choosing a midwife delivery in Queensland means I cannot go to a private hospital even though I have full insurance. This is ridiculous and I hope changes in the near future. If I could stay at the ''Mater Motel'' - I probably would indulge myself to a few nights without toddlers, other children etc!
Midwife delivery should be the first port for all birth. If on initial assessment of risk factors it is appropriate, then an obstetrician should be involved. Just because we have private health insurance shouldn't mean therefore we have to have the most expensive care - obstetric.
So in conclusion, mothers reading this blog - check out your options - do your own research. See what is right for you. Don't accept what the medical professionals say first time around - even if they seem lovely people. The midwife in W's delivery said to me afterwards she had NEVER seen a birth such as mine - all natural, squatting in a shower. And she is a medical professional!
How many obstetricians will get down on their hand and knees to birth a baby in the shower? Why pay them to do that, when with all their smarts and studies they should be caring for preterm births and other complexities?
Do not engage an obstetrician if your pregnancy is progressing well after all scans and you are in the low risk factor range for complexities etc. It is unnecessary medical spending and you risk a complex birth simply because it is medicalised. Leave our ever diminishing number of very competent obstetricians to take care of those who really need it.
Stay tuned for news of bubba number 4's arrival and, of course, blow by blow (!) birth story - complete with photos!
Labels: Birthing
