Sam

Registered Nurse Midwife, Calmbirth Childbirth Educator

Sunshine Coast, Australia

I was a newly graduated midwife when I became pregnant with my first baby. Becoming pregnant straight away was a bit of a shock as I have Polycystic Ovarian Syndrome (PCOS). I had been told it would be a long and difficult journey to conceive. We were thrilled; however, I was anxious from the start as my risk of having a miscarriage and complications were higher. I was told that I would need to take my midwife hat off and put my mum hat on. This was easier said than done.

I had seen many different labors, births and had time to think about what I would like to accomplish. I was pretty set in a no intervention or medicated birth. As the pregnancy advanced, I was excited to see what my body could do but became nervous as the weeks went on.

I was diagnosed with gestational diabetes and ended up on metformin and insulin late in the pregnancy. Growth ultrasounds revealed my baby was on the 90th percentile growth curve. With a supposedly large baby and unpredictable blood sugars, I agreed to an induction at 38 2/7 weeks.

I knew exactly what an induction meant, and I was scared. I really didn’t want an oxytocin drip, end up tied to the monitor and wind up with a failed induction leading to a cesarean section. I felt strongly about not getting an epidural due to my history of lumbar issues. In addition, I didn’t want increased interventions in labor or the side effects to play a role in breastfeeding. I had a strict birth plan that addressed every possible outcome including a c-section, an assisted delivery, and resuscitative measures after baby was born.

I tried everything to bring on natural labor and prepare my body. I used tablets, oils, acupuncture, you name it, I did it! We opted to start with a prostaglandin gel. It went in at 2:00 pm and I had after pains lasting a couple of hours. I felt her head drop into the pelvis, as I had a lot of pressure and sudden sciatic pain. The pains died down around dinner time. I ate, showered and tried to rest. I started getting tightenings around 7:00 pm which started becoming more frequent and stronger. I felt like I needed more assistance with relaxation, so I got back into the shower and breathed through each contraction. I even tried to sleep through some of them, listening to music in a dark room. This was great practice for the calmbreath, as they were rather easy to breathe through.

I was evaluated around 10:00 pm and I was 3 cm dilated. At this point, they were comfortable they could break my waters, so I went to birth suite. I was relieved that I wasn’t going to be in labor all night. My waters were artificially broken at 11:30pm and from then on, it was go time. I found it very difficult to focus due to the sudden increased intensity of the contractions. My body went into a bit of shock from a flashback I was having. I was having PTSD due to a previous sexual assault. My husband and student midwife were amazing to me. They suggested I get back into the shower to help calm me. It relaxed me immediately as the water on my back was like a repetitive, meditative drumming.

The contractions continued to intensify, and I hit transition quickly. I remember not wanting to do it anymore and begging them to pull her out. However, by the time I arrived at these thoughts, another contraction came and refocused me. On and on it went, and I breathed them through one at a time.

Ali, our midwife arrived quite quickly which was a great relief and reassuring to me. I started feeling grunty and pushy not long after. I couldn’t believe it was happening so fast. We moved from the shower to the toilet to rest my knees, and then went onto the bed when I was pushing. After twenty-two minutes of pushing in hands and knees, our beautiful Hannah arrived at 1:53am weighing 3785g, 52cm long.

Due to the very quick intense labor, I hemorrhaged and went to the operating room afterwards. I also used the calmbreath techniques in the OR, as a few hours later I was still there due to complications from the spinal block.

Looking back, it was definitely the most intense thing I have ever done. But meeting my girl made everything worth it. She was happy, healthy and breastfed so well, which was our ultimate end goal. I ended up with postpartum depression from the birth trauma I experienced with her. I believe it was a combination of the birth itself and pressured into being separated from my baby after birth. I didn’t feel heard by the staff and began to lose trust.

It took about two years to feel like we were ready to have another due to the postpartum depression, anxiety, PTSD and my physical recovery. It took us longer to fall pregnant the second time around. We were told we had a one percent chance of obtaining a pregnancy without fertility treatment. God ultimately had another plan for us.

During my second pregnancy, I had a few 2nd trimester bleeds and was diagnosed with gestational diabetes again. I had to begin insulin early which only heightened my anxiety. In addition, I had SPD, pelvic floor weakness, lumbar pain and investigations into my heart. The pregnancy ended up being considerably more challenging than my first and I had to decide mode of delivery whether it be vaginal or cesarean as the Obstetrician recommended. The recommendation came as a result from my third-degree laceration from my first delivery. I got onto the midwife group practice program and requested to see a consultant Obstetrician for antenatal visits. All of the midwives were incredibly supportive of my decisions.

I knew I’d likely be induced again if I chose a vaginal birth and wanted to wait for growth ultrasounds to help aid in the decision. Bub was in the 45th percentile at 36 weeks. After discussing it at length with Obstetricians, Midwives and PT I knew I didn’t want a c-section. I knew I would regret not attempting to have a vaginal birth.

My induction was again at 38 weeks. I went ahead after a few days of minimal sleep due to nerves and all was going well until it was time to break my waters. The baby’s head was at -4 station and kept floating away out of my pelvis. This made rupturing the bag of waters unsafe with the opportunity for the umbilical cord to prolapse. We were offered a c-section again but chose to go for a walk allowing for more time to getting bub into my pelvis. Soon I would have a new shift of OBs and nurses coming on and I felt that we could start fresh.

The decision was made to try the prostaglandin gel to get initiate some contractions. I reacted so quickly the first time, it was likely I would have the same result. I started having tightenings rather quickly after, but as baby’s head dropped into my pelvis it hit my sciatic nerves. I have a history of intermittent sciatica, but this was something else. Both legs were affected. I could hardly move and was in agony. We filled the bath, but I couldn’t get in. The only relief I had was lying on my side, but baby was posterior, and the labor began to drag out.

Twenty hours into the induction I began to realize how tired baby and I were. I decided I wanted to know what my cervical exam was to know where I stood. If it was going to be awhile, I wanted to have an epidural. I was still 4 to 5cm dilated and he was direct OP.

I’m so protective of my spine, so I didn’t make the decision to get an epidural lightly. I was upset I wouldn’t be able to labor in the bath, but I soon realized the most important thing was to be present for the birth, however that may be.

It ended up being the best decision as I could move with relief from the sciatica and managed to use gravity to help turn bub. Shortly after having the epidural placed he was ready to be born. I could still move around the bed and felt very in control, present and calm. I didn’t push for long and my amazing midwife worked hard to prevent any significant tearing again. I got to lift him up to my chest and had the best birth possible. I had a small second-degree tear due to him coming out in a compound presentation with his hand by his head.

My plan A and B did not happen, but it really was the birth I had imagined and focused on, just a little different. I never thought I’d end up with an epidural,l but the goal of a healing birth was achieved and it was absolutely amazing. We both felt on such a high afterwards. I felt like a million dollars in comparison with my first birth. Having such a supportive team around me made all the difference. I wasn’t rushed on decisions and everyone respected and trusted my choices along the way. 

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