The story of my second son (M)’s birth is very much dependent on what happened with the birth of my first son (T). T’s birth was somewhat complicated. We had a "substantial" shoulder dystocia where he was stuck for around 5 minutes and several manoeuvres were needed to free him. His heart beat was starting to fail and he didn't start breathing on his own after he was born. Thankfully, he responded very well to resuscitation, was quickly doing very well, and has not suffered any lasting damage from his birth. After this the placenta did not come out and I hemorrhaged and lost nearly 1.5 L of blood. So I ended up going off to the operation room for several hours so they could remove the placenta and stitch everything up.
It took me a while to heal from T's birth and feel prepared to give birth another go. I researched the risks of a recurrent shoulder dystocia and possible ways to lower those risks. From our first appointment with our midwives for M at 8 weeks we talked over T's birth, what it would mean for this birth and how we were going to manage it. In the end I felt really comfortable with the support and plan I had in place. I knew all four of the midwives in the practice, we had plans for the delivery and plans in place in case any of the complications happened again. My main concern at that point was that I would have to transfer over to a gynaecologist at the last minute and so just end up with whichever doctor was on shift at the hospital at the time of delivery.
I reached 39 weeks and all was looking good but my midwives were starting to get a bit anxious about getting the baby out sooner rather than later. Given what happened with T they really didn’t want this baby to be any bigger than T was at birth. I knew that size was not the only or necessarily even the main issue with T but still agreed it would be better to aim for a smaller or at least not bigger baby. So we started doing stretch and sweeps and I walked lots and ate curries and did everything else I could think of. Unfortunately it didn’t achieve anything.
I had another ultrasound at 39 weeks and 3 days which predicted that baby was currently the same weight that T was at birth (41weeks + 3days). So me, my midwives, and the gyno at the hospital decided that it would be better to do an induction fairly soon and get him out before he got much bigger. While I agreed that it was better to get him out sooner, I was now facing exactly what I hadn’t wanted: an induction with whichever doctor happened to be on staff at the time and likely changing doctors throughout the delivery (my midwives couldn’t supervise induced labours). I spent a couple of days adjusting to the new plan and preparing myself and DH for how we wanted to handle it.
So that was the backstory, now for the actual birth story…
On Sunday morning (39 weeks, 5 days) I played with my older son T knowing it was the last morning we would play together before his brother arrived. My parents arrived to stay with T while we were at the hospital and we got everything ready for them and T and for us to go to the hospital. At 2pm I called the hospital to check that we were still on for the induction, they said yes it was quite quiet there that day and to come on in. So we grabbed our bags and the car seat, said good bye to my parents and T and caught the bus into town and then out to the hospital. It was somewhat surreal heading in to the hospital to have a baby and not actually being in labour. We got to the hospital and settled in to our lovely room with a view of a little park with lots of trees.
At 4:30 they inserted the balloon catheter and we waited. Nothing much was happening so we decided that DH would go back home, be with T and get some work done. Soon after he left I started getting some very mild irregular contractions. After a while they got more frequent, pretty well every 5 minutes or so and we decided that DH would come back and stay the night with me. He got back about 10:30 and we went to bed. They’d checked the catheter at 10 and it was still in place and my cervix wasn’t ripe yet. The contractions were very mild, really just regular tightenings and I was able to sleep fine.
In the morning the contractions had gone away. At 8am they checked the catheter. It had fallen out and my cervix was ripe and I was 2cm dilated. They tried to break the waters but we didn’t notice any come out. I started getting contractions again, still not painful but definite tightenings every 2/3 minutes. I walked around the room and was getting rather excited that things were happening and going so well. Hopefully we wouldn’t need any more interventions and we could just do our thing from here on.
At 10:30 they wanted to do more ctg monitoring to check how things were going. I lay down on the bed and the contractions stopped. At 11:15 the OB returned to do another check: 3cm dilated and the waters were actually still intact. So she broke them (again) and this time it worked. There was lots and lots of water. I hoped that this would get the contractions kick started again, but it didn’t. So at 12:30 we started the syntocin drip. I must say the nurses and OBs we’d had so far had been very good, listening to us, and very supportive of my wishes to stay off the ctg and out of the bed as much as possible and limit the use of the drip as much as we could.
Once we started the drip and turned the dosage up a little the contractions returned every 2/3 minutes and had a bit more bite to them, though were still very manageable. About 2pm, I put the TENS machine on and between that, walking around and breathing everything was going great.
At 3 o’clock the contractions started to drop off again so we upped the dosage on the drip again. I was quite happy with the resulting contractions and felt it was very manageable. I was 5cm dilated and thinking things were going pretty well. However maybe it was too manageable :). The nurse and the OB certainly weren’t happy with it and wanted things to move along a bit more. So at 4:30 we agreed to raise the dosage again. The contractions then became really intense and I was struggling and feeling like I wasn’t getting a break. We kept on for a couple of hours, I was lying in bed now and DH was pressing the button on the TENs during contractions and I was just focusing on breathing through them.
At 6:15 another internal showed I was 7cm and I was quite discouraged, the last two hours had been really hard work and still only gotten me from 5 to 7 cm. The OB suggested lying on my left side to help shift the baby around and bring it down more. Lying on my side was horrendous, the contractions were much more intense and I was really uncomfortable. Within 10 minutes I felt like I needed to push. I thought no it must be too early, I’m only 7cm dilated. But with the next contraction I couldn’t stop myself pushing. So we called the nurse back who called the OB to come back. She confirmed I was now 10cm and clearly ready to push. So it was a good idea to lie on my side :)
We’d had a different OB during the day and after 5 o’clock we’d actually gotten the one from the night before back again. She was lovely (they both were really, but I was so glad to not be dealing with a new person at this point). She knew my history and we’d talked about what I wanted for the birth. I’d planned with my midwives to push on all fours to try to reduce the chance of a repeat shoulder dystocia. Unfortunately, this OB wasn’t willing to do that. She wanted me on my back so she would be able to have a good view. We compromised and I ended up in a kind of reclining squat with my knees to my shoulders.
I pushed for about 40 minutes. They really pushed me to push harder and harder. They did a couple of episiotomies (one on each side). Then with the next contraction he was crowning and the contraction after that his head came out and was immediately followed by the rest of him. It was such an amazing experience to have the baby come out all at once compared to last time when the shoulder got stuck. We were all very relieved. He went straight onto my chest where he stayed for an hour or so. He was breathing and perfect.
The placenta came out minutes after the baby and I only lost 500mL this time. The OB stitched me up while M lay on my chest. He had a little suck and then I handed him over to get weighed, cleaned and checked over.
It turned out he was actually smaller than the ultrasound had predicted only 3.644kg, 53 cm long and head circumference of 37cm. Born Monday evening at 7.26pm.
We ended up going home that night. We showed Max off to his grandparents, and went to bed. T then got to wake up the next morning and come and find his new little baby brother in the house.
It wasn't the labour I'd been planning or hoping for, but it was all ok. We were well supported and M was born healthy following a complication free delivery!
