Fiona and Katrina's Birth Story born 15 August 07
Righto, I'd done quite a bit of thinking/reading beforehand to prepare me for labour and what made the most sense to me was Juju Sundin's Birth Skills book. Basically, she says that a) you need some techniques (other than simply breathing) to manage the pain and b) you will not feel disappointed with the birth as long as you feel you've done your best regardless of whether you ultimately have a natural birth or have drugs/interventions.
The techniques she recommends are ones that will help you distract you - anything from saying/shouting "ahhhhhh" as a contraction hits to stamping your feet to banging some stress balls together. It's a very simple theory - your mind can only concentrate on one thing at a time so if you distract it enough with something else, it can't register the pain as well.
So my birth plan was all in my head and consisted of this: a) try to avoid caesarean at all costs b) give Juju Sundin's stuff a red hot go and c) accept the fact that I can't predict how painful the labour or my pain threshold will be so use drugs if I need to if it turns pear-shaped.
My thinking was that having a caesarean would potentially incapacitate me in the days/weeks after the birth so I was keen to avoid that. I was willing to use gas, thought TENS sounded tricky, wasn't keen on pethidine and I knew an epidural would increase the chance of me having forceps/vacuum and episiotomy - none of which worried me. I'd asked my obstetrician whether an epidural would also increase the chance of me having a caesarean and he said no. Given that he has the lowest rate of caesareans in Melbourne, I figured he knew what he was talking about!
By the time I went into active labour, I'd had 48 hours of pre-labour and 7 hours sleep in three days so I was unbelievably buggered. Yes, everyone tells you to try to get some sleep but with a first baby and with contractions (albeit not 'proper full-on' ones) all over the shop, I just couldn't. Sometimes I'd get a few a minute apart and I'd think "geez I'd better hotfoot it to the hospital", then sometimes nothing for half an hour or so.
We were due to go back to the hospital (had already been once after my waters had broken the previous day) at 7am on Wednesday morning to be examined again for a possible induction. At 3am the pain seemed to be getting more regular and hurty and to be honest I was a bit sick of trying to time stuff and trying to gauge whether this pain was worse than it had been before.
So I phoned the hospital and said: "look, I'm completely over this, I don't care if I'm in proper labour or not, I'm coming in".
The pain was also all in my back which freaked me out a little as it sent me a red flag that this was a posterior labour. Super! Not only have I had no sleep, I get the most hurty kind of labour.
So I continued using some of Juju Sundin's techniques which saw me pacing up and down our street before I could get into the car going "ahhhhhhh" as a contraction hit. Glad it was in the middle of the night and not during the middle of the day!
I had four contractions in the car on the 10 minute drive to the hospital. When we got there I didn't have another one for 15 minutes. Typical. But I was EXTREMELY glad to be there so that I didn't have to worry any more about whether I was in labour, whether I should go to the hospital etc.
They hooked me up to a monitor which I thought I wouldn't like but it appealed to my sense of order - I found it quite fascinating seeing how high a contraction got and how regular they were etc. And the midwife was very nice, she said that the monitor wasn't the be all and end all - she also judged for herself from observing the woman.
Because I was soooo tired and not sure how long the labour would be (obviously), I asked her about an epidural mainly because it was the only way I knew I would get some sleep.
She said she could organise one straight away if I wanted one but I said no, I just wanted to check to make sure it was an option. So I carried on with my Juju techniques and I am so glad that I gave them a shot. If I'd had an epidural then and there, I would always have wondered how much longer I could go for.
So as the pains got worse, I said "ahhhhhhhhhh" louder and started banging together some stress balls and bounced on my fitball. If you'd told me this a few months ago, I would have said you were nuts because I'm really not a chanting/stress ball type of person at all - I've never been to a yoga class in my life and poo poo most new agey type stuff.
In a previous post, I'd said that I didn't think I'd be the type of person who'd want people around me when giving birth and didn't think I'd want the midwives there. That proved accurate. I completely ignored my partner (and got REALLY annoyed with him when he tried to chit chat between contractions). At one point I remember telling him, "look, I don't give a flying f*** where you parked the car or how much you put in the stupid meter, I'm in labour for Christ sake."
I remember the second shift midwife coming in and saying "the other midwife says you have some pretty interesting pain management techniques." I said "yep" and that was about it. I do remember her popping in and out and basically sitting in a chair just watching while I did my thing and I kept thinking "what's she doing here again."
I know some people on bellybelly complain that the midwives kept offering them pain relief when they wanted a natural birth but my midwives didn't offer me anything at all, probably because I seemed to be in my own little world.
So I did my Juju thing for about 4 hours until I felt like I was reaching the point where the epidural was really starting to look like a terrific idea - yes because it hurt but also because I was absolutely buggered and wanted to sleep and really didn't know how much longer I could carry on for especially when I didn't know how much longer it would be.
They'd told me that my obstetrician would need to check me before they could give me an epidural and he'd be there at about 7am. I did keep saying "why" at this point because I was quite annoyed that when I first got there an epidural was no problem but now according to them my ob needed to check me. I guess because they needed to see how close to pushing I was. Mind you, not sure why the midwives couldn't do an internal themselves - isn't that their job?
He didn't get there until 8.30am (he was off doing a vaginal delivery of twins so hardly his fault!) and by this stage I was getting very antsy because I'd been counting down the minutes to 7am and I then had to wait another 90 minutes.
He does an internal examination and I remember telling him that he has a very funny job and there is a brief discussion on who has the funniest job - obstetricians or proctologists. Anyhow, he announces I am now 7cm dilated.
He asks me if I want anything. I say, "yes please, an epidural and yes, I know it gives me an increased chance of forceps/episiotomy. Just give it to me."
Obstetrician tells me he's sending an anaesthnetist who is VERY good but I won't understand a word he says. All I need to know is "don't move".
He arrives probably about another hour later, does his stuff very quickly and it's not scary at all.My partner gets in serious trouble again because he warns me that it might not be very pleasant and he might have to fiddle around a bit to get it in. You can probably guess my reaction to that!
Anyhow, relief came almost instantly and I tell him that his name should be "Mister Magic". He then starts telling me about some of the risks which I find quite hilarious given that it's too late now to change my mind. No more pain. Yippee. Feeling better than I have in months as I have been in pain since 28 weeks with unstable pelvis.
Decide this calls for a celebration and ask partner to put on my specially compiled CDs. I swear I felt like cracking open the champagne there and then.
So we listen to those for a few hours. Didn't really get to sleep but I could doze a little and it was just sooooo nice to be able to relax as the last few days had been so anxious, not to mention painful.
Apparently, I had been given a really good epidural because it has worn off a bit by the time it is time to push so have some feeling down there.
But obviously not enough. I push for two and a quarter hours. Nothing doing. The midwives tell me I am pushing really well but it's just not working. I imagine they say this to everyone but it did make me feel good.
They get the obstetrician who checks whether I've been pushing, they assure him yes (I think he is just trying to avoid using forceps if I haven't given the pushing a red hot go).
And this is where the money I spent on a private obstetrician was worth every single cent to me.
He told me that he was going to have to use forceps but that the baby would be out in two or three contractions, that it would be a weird feeling but not painful, just a lot of pressure. I asked him if he would need to do an episiotomy, he said he would see how we went and I told him I didn't mind either way and to just do whatever he needed to do.
And his description of how long the forceps would take and how it would feel was absolutely right.
I freaked a little about halfway through because it did feel really strange. And if I hadn't known/trusted my obstetrician I reckon I would have freaked BIG TIME. But he calmed me down halfway through.
So he did his stuff and I did mine - he told me to give him a few half pushes so ultimately I did actually feel like I was 'birthing' my child and it was brilliant to feel her actually moving after two and a half hours of not feeling any movement at the business end whatsoever. And then out she came ... all 8lb 10oz of her. No need for episiotomy, I had two stitches.
All in all, extremely happy. And I managed to bludgeon out of my obstetrician that I'd done remarkably well given the lack of sleep, the posterior labour, using no pain relief for most of the labour and minimal stitches given her size.
Oh, someone was asking about new types of epidurals that allow you to walk afterwards. I'm not sure if I was given a 'new' type but from what my obstetrician said, there's definitely a skill to determining how 'much' you're given which will determine whether you get much feeling back for the pushing stage. I got quite a bit of feeling back and was able to shower unaided about 1.5 hours after the birth and walked to my room shortly after that. The catheter was removed before my shower.
Afterwards I was told by some of the hospital midwives that other obstetricians would only have 'let me' push for 15 minutes, then ordered a caesarean so even though I thought pushing for that long was all a bit much, I much preferred doing that and having a forceps delivery than having a caesarean. I think that's why there could be a perception that epidurals lead to caesareans - they don't have to, it's just that they do make it less likely you can push your baby out and some obstetricians may then decide to do a caesarean rather than using forceps/ventouse because they are less trained these days in how to use them. Someone please correct that if it's wrong but if you're considering an epidural, I'd say it's worth checking with your obstetrician how many of their epidural patients then have a caesarean and how long your ob would 'let' you push for. Like I said, my ob avoids unnecessary interventions so I trusted his judgement completely but from what the midwives told me, other obs would have done things differently.
What would I have done differently? Perhaps tried gas instead of going straight to the epidural (but really my main concern was rest/sleep so the gas wasn't going to help with that).
And I would consider hiring a doula next time who knows a bit about the Juju Sundin stuff. She recommends that your partner reads up about this stuff too so that they can encourage you but to be honest, I don't think I would have taken my partner seriously - I think you really need the support of someone who's been through labour. Which may be why I didn't really want a bar of one of the midwives - I guessed correctly (confirmed for me later) that she'd never had children herself. Anyhow, given that I laboured on my own (until the epidural) , I'm not sure whether I would actually use a doula but it might be nice to have one as a back-up.
But mission accomplished - I did my very best and was very proud of myself. And I started thinking about having a second a few hours after Katrina was born! She was gorgeous the moment she was born but gets more gorgeous by the minute. And is a complete nosey parker who would rather look at everything going on around her than going to sleep but I wouldn't have her any other way!
