The birth of Alister - 18/9/07 (Posterior birth with Shoulder Dystocia)
I woke up on the Tuesday morning feeling rotten - I was in a lot of pain again and very uncomfy. Got my eldest child off to school and came home to start the usual around the house and I had a contraction - not a bend-over-double one but definately a contraction. This went on for about 20-30 minutes and I told my DH. We ummed and ahhed about heading in and then thought bugger it, nothing to lose by going in so we got MIL to come over and take the girls and headed off just before 9am. Contractions still coming, not gaining strength but getting a little closer (about 10min-ish). We got there in good time (the hospital was 1hr away) and was taken to my room and monitored first for a bit - and the contractions were registering on monitor. Good, things were starting. My Dr came up at lunch time and examined me - still only 2cm and about 50% effaced. He asked if I wanted my waters broken and I said yes. I knew ideally I wanted them to break on their own, but I didn't want the labour to stop again like it had before so he went ahead and broke them. Not much fluid came out and he wasn?t sure if he got them or not, but once I moved there was a little trickle. He was satisfied things would start to progress so he left again. At first I could walk around my room no problems at all, but then I started to really leak a lot of fluid so I went and sat on the toilet. I knew I had to move around and try to stay in the best position to get him to turn into an anterior position from posterior, so all was not lost by sitting on the toilet. Over the next few hours the contractions didn?t really change much in their intensity from when they began, but I had soaked several pairs of knickers and pads from the leaking fluid. I managed to get on my knees and lean forward over a chair and just had a towel on the floor under me to catch any fluid as I needed to give him the best chance possible to turn. I was very lucky that the midwife had left us alone and monitoring was very minimal ? I hadn?t had any since arriving, but she eventually came in about 2pm just before her shift finished and wanted some more monitoring to see how bubs was coping with the waters being broken so she could hand over to the incoming midwife. As it turns out he was fine and not showing any signs of distress, but while I was laying down the contractions got a bit irregular.
The contractions didn't pick up until about 3pm when they started coming every 5 mins and were very ouchy. I had been on my feet all day walking and kneeling etc still trying to get him to turn and when they got stronger it was harder to keep upright. By 4pm I was in the labour ward as I felt that if I didn't go, I wouldn't be able to walk there later, it was just a feeling I had. Anyway another hr goes by and contractions are 3mins apart roughly and I requested the gas as I just couldn't keep a good rhythm with breathing through them effectively anymore, so by having the gas, I was able to regulate my breathing again.
Things got really hard not long after that and I just couldn?t stand up anymore so laid on my left. I was examined at 6pm and I was only 5cm and I thought I have hours to go yet and I was getting worried that things might go a bit pear shaped ? I knew he was still posterior and that labour could possibly be long and my concerns were that further intervention would be needed. So I just closed my eyes and focused. I sent my midwife to have something to eat as she had been with me since I moved to the labour ward and I felt I just needed the time with DH. So DH and I just spent the 1/2 hr or so together, him rubbing my back (which was aching like nothing I?ve ever felt by then) and then my midwife Lisa came back and I sent Doug for dinner because I wasn?t sure how much longer it would be and I didn?t want him to be out of the room when the time came. Lisa and I spent the time just being silent and her putting a cold cloth on me because I was getting hot and just being what a midwife should be ? ?with woman? . Doug came back and by then I couldn't talk - it just hurt - I mean really hurt. I have never had contractions like these ones - one on top of the other. So I just used the gas to help relax me and I think it really helped by taking me away so I didn?t fight what my body was doing. Then I had these "I just can't go on anymore" thoughts and I actually thought 'far out, this must be transition' and I got more excited then and the next thing I knew I gave my first push, closely followed by another.
Lisa saw me pushing and she said that this was it and both she and Doug helped roll me over on to my back semi reclined (again another thing I didn't want to do but I just didn't have the strength to get into another position). She called the assisting nurse in and phoned my Dr and he was there at lightening speed LOL. I think he was still in the hospital.
Anyway, the first few pushes I knew weren't right, I just couldn't feel him move down. I said to Lisa it wasn't right and my Dr felt around and said that bubs was still posterior, so the next time I pushed, the nurse had to push on the right side of my belly to encourage him to turn with the push. With each push they could see a little more of his head, but it was still high. Soon his head was anterior and I could *feel* that it was different. Lisa had turned away to get something (I assume the kit they need with the cord clamps) and I gave an almighty push on my own ? no one was ready for it so I was just bracing against the bed and I felt this huge movement and bulging and he crowned. I surprised them all into action as now his head was pushing on the perineum. I gave anther small push and then started to breathe his head out. Then Lisa told me to stop right now - the cord was around his neck and over his face and the shoulders were transverse - his head had turned but the shoulders didn't catch up. They immediately clamped and cut the cord (no cord clamping either *sigh*) and I had to have my legs brought way up high and be flat on my back so they could get his shoulders out. Then they pulled him the whole way out - usually once the shoulders are out they just slide right out, but he was just too big.
He was flat when he came out and had to be resuscitated basically (suction, O2 therapy and IPPR: bag and mask according to the data collection form) and those first few seconds when he didn't breathe or cry terrified me - I have never been so scared. Then he started crying and started to get a bit of colour. He was then handed to me for our first cuddle and feed. He had a bit of bruising to his face and head from the cord being over it and the lack of oxygen but they said it would be gone by the next day.
Our big boy entered this world at 9.06pm on Tuesday, September 18, 2007, weighing 4.56kg, 59cm long and 37cm head circumference.
I asked to look at the placenta as I hadn?t ever seen it with my previous births and it was huge - I have never seen one so big before (having seen others in pictures). When I tried to push it out, Lisa said it was stuck, and I thought crap, here we go again (I had a retained placenta with my previous birth) and I asked her if it was stuck and she said it was away from the wall, but was stuck on my cervix, so she gave a gentle pull while I pushed and I swear it was just as hard as birthing the head LOL. When it was all out I asked to see it fully and when it was spread out it was the size of a dinner plate. It was also starting to get a bit gritty too - so I'm glad I didn't go too far over. I also didn't tear - just the tiniest of grazes, which I am absolutely stoked about as I have always had stitches before. All up labour was 6hrs from the start of active labour.
