Theos' birth [Shoulder dystocia]
Warning/apologies: This will be a long story. It is also quite an old one: Theo was born in 2009. Still I feel the need to write it out and share it before hopefully move on.
My pregnancy was unplanned, shocking, tolerated and gradually accepted; but never wanted.
It all changed the moment my son was born and I've loved him dearly ever since.
I mention it here because I feel that it may have had some influence on the birth, I certainly was not as pro-active as I could have been in the early stages.
In what is for me fairly typical fashion, I went into labour at 11pm at 41w 2d. I had an appointment with my midwife for a membrane sweep the next morning and if that didn't start things off, I had to go to the hospital the day after for a checkup and to talk about possible induction in the next few days.
I'd just gone to bed when I started to feel small contractions. They were short and quite manageable at first. After a couple of hours they became more bothersome and more frequent, though still only every 10 minutes. I wasn't getting any sleep, so I got up and had a bath, which felt wonderful. I stayed in there for hours. I sent my mother a message to let her know that things had started. I was in the Netherlands and she was in Australia so it was the middle of the day for her there.
By 8am my contractions were coming every 5 minutes or less. My husband woke up and we had some breakfast.
At 9am I called the midwives to let them know what was going on. The midwife on duty was busy delivering another baby, so I talked to the backup midwife. She said she would send the on duty midwife over to me when she was finished and I could always call back if I needed someone in a hurry. We'd planned a midwife assisted homebirth (normal for the Netherlands) and were being looked after by a team of three local midwives.
Around 11am the midwife and a trainee came to check up on me. Contractions were regular and 3-4 minutes apart and I was 2cm dilated. Everything looked like it was going well, if a bit slowly for my taste. But it looked like things were getting more serious now. They told me to keep doing what I was doing and they would come back and check on me later.
We put on the TENS machine, which was really helpful. Even just being able to press a button and do something for the contractions was great.
After a little while it got to the point where I really needed to concentrate and breathe through the contractions, but I was still quite mobile and able between contractions. We even played a card game while I moved around on a birthing ball.
The midwife and trainee came back a bit after 3pm. I was still having contractions every 2-3 minutes. But I was only 3 or 4cm dilated. They commented that I was a lot more dilated during contractions than between them and asked if they could so a sweep to see if that would help move things along. After the sweep, they left again with the plan to come back in a few hours unless I called them first.
The contractions got a bit stronger, but otherwise we continued on as before.
The midwife and trainee came back a bit after 6pm. I was having contractions every 2 minutes and they were lasting about one minute. I was still pretty mobile between contractions but wasn't able to focus on much other than the labour at this point. I was still only 4cm dilated, though they again noticed that it increased a lot during contractions and dropped between them. They were starting to get concerned that things weren't moving along faster and asked if they could break my waters. When they'd done that, they found meconium. That meant we needed to move to the hospital and the hospital midwives would take over from there. The trainee called the hospital to let them know what was going on and we gathered our things together. The midwife drove us to the hospital, since we didn't have our own car. These two ladies were lovely to us, very kind and supportive. They came back to our house to finish off the postpartum care and they were so kind and friendly the whole time. Thank you. After what ended up happening when we got to the hospital, they were very glad that they had handed me over when they did and I was very glad that we made the transition to the hospital when things were still quite calm. Though now I also wonder if things would have gone the same way had we stayed at home, you can't second guess these things too much though.
We got to the hospital at about 7pm. My contractions had gotten stronger after they'd broken my waters, but I was still only 4cm dilated. The hospital midwife decided to start me on an oxytocin drip to get things moving faster. They also now needed to monitor the baby, first with a band around my tummy and then with a clip on his head. This meant that I couldn't move much.
I found it really difficult labouring on my back. I'd been either on the ball or standing until now.
After a while I needed to pee and they catheterized me.
I got more and more uncomfortable on my back and eventually they agreed to let me stand next to the bed. I laboured like this for 2 hours and it went much better.
They moved me back onto the bed and checked my dilation. I was close to 10 cm. It was 11pm, 24 hours since my labour first started and I had been awake since the previous morning. I was exhausted and at this point I was even falling asleep between the contractions.
I started to need to push, which was a wonderful release from the pain. It was wonderful to be able to do something against the pain and to know (or at least think) that things were nearing an end.
I pushed for about 3.5 hours, though it went by quite quickly. They catheterized me again.
Eventually his head came out. I remember they told me he had black hair and I was disappointed, because I'd been hoping he'd have his father's red hair. But then his head turtled back in a bit. I pushed really hard again. He didn't budge. They did a large episiotomy to try to give both him and them more room to move.
Then his heart rate started dropping fast and I was told that we needed to get him out right now. They had already prepped a table and notified the pediatricians because of the meconium.
Now they pressed an emergency button and the pediatricians came running in.
We had only quite recently moved to the Netherlands and I still didn't speak much Dutch. It being the Netherlands, the staff all spoke very good English and had been speaking English to me without a problem up until this point. After this, their English failed and they were yelling at me, my husband, and each other in Dutch. Afterwards, the midwife and nurse apologized and said it was so stressful they hadn't been able to think in English. I told them it was no problem at all and just thanked them for doing what needed to be done.
They grabbed my legs and moved them up as far towards my head as they could go, they pushed down hard on my stomach. They repeated this a few times. The midwife reached in and twisted the baby around and eventually he came out. He was born at 2.44am.
I later learned that we'd had a shoulder dystocia: his shoulder got stuck behind my pelvis. They performed the McRoberts and suprapubic pressure maneuvers repeatedly and also the woodscrew.
He spent a few minutes over with the pediatricians. Then they handed him over to me and it was the most amazing experience ever. After months of not wanting him and largely being in denial about the whole process, I held him and I loved him. I got to feed him and have him skin to skin on my chest.
I later read that they had needed to resuscitate him, but after that he was given good apgar scores and a clean bill of health. I'm very grateful to the midwife and nurse who delivered him for knowing what to do and managing to get him out without any damage.
As soon as my son was out, my labour stopped completely. I didn't have another contraction after the one that got him out. They waited a little while and let me cuddle and feed my baby, but then they started to get concerned that the placenta was not coming out.
They pushed down on my stomach and they pulled on the cord. They increased the oxytocin drip to the maximum and they pushed and pulled some more. It was the most painful thing I've ever been through, much worse than the rest of the labour. One hour after the birth I started to hemorrhage and they still couldn't get the placenta out. So they called the gynecologist to arrange surgery.
We left the baby in the birthing room and they wheeled me off for surgery. The surgeons were just waking up with coffees in hand. The general anesthetic felt like an amazing relief. They removed the placenta, stopped the bleeding (I lost about 1.75L in the end), and stitched me all up inside and out.
We spent the next day together in the hospital and then went home.
It took me a long time to find out all the details of what happened during my son's birth and it's taken me an even longer time to sit down and write about it. I'm finally moving on from it though and this has helped.
Thank you very much for reading.
