[Hospital transfer] L e o's awesome vaginal breech birth *extremely long & detailed*
WARNING: Though this birth went wonderfully well for a prem vaginal breech, the ending is very sad and could be distressing. Our baby son died soon after birth from a previously undetected congenital problem.
Background
The pregnancy went well. I spent the 1st trimester scared silly we’d have another miscarriage. I started feeling less neurotic once I felt the baby move about 20-21 weeks. All the scans showed a normal, healthy baby. I did develop SPD at 21 weeks which progressed to the point I was on crutches and I ended up with rotated ribs from bub’s position, so there was constant pain. Apart from that, I enjoyed being pregnant and watching and feeling the changes. I had been doing the Hypnobabies home study course and was planning on using that for “discomfort” management.
We were planning a home water birth with an IM (J). The birth plan meeting was scheduled for week 36. At 32 weeks the fundus was measuring 32cm and bub was head down. At 34 weeks, my fundus measured 37cm and the midwife could not feel bub’s position. She suggested another scan which we scheduled for Tuesday 27 July, when I’d be 35wks4days.
NB: in Hypnobabies speak, contractions are called “pressure waves” or “birthing waves”, “discomfort” is used instead of “pain”.
Early labour – is this the real thing?
I went to bed about 10:30 Sunday 25 July 2010. I woke about 90 minutes later to cramps in my lower back. I lay on my side and rocked through it. It probably lasted about 30 seconds. I assumed it was constipation. I went to the toilet a couple of times. I tried to get back to sleep, but noticed the pains were coming at about 7 minutes apart. I got up and went downstairs. I turned on my computer and went online, asking in a couple of forums what this could be.
I had read other women’s experiences of long pre-labour, with Braxton Hicks occurring for a few hours, then settling down. I knew it was too early for labour and being a first timer, I wasn’t sure what I was feeling. I found it better if I got up and rocked through the cramps. Someone online suggested I use the contraction master website. It was about 3am, I logged on and saw the cramps were definitely coming every 7 minutes, but they were lasting between 40 seconds and 1minute. I was tired, so I figured I’d go back to bed and see if I could get some sleep. I decided not to wake DH or J as I figured they may disappear on their own.
For the next few hours, I rocked through the cramps, which were still 6-7 minutes apart. At 6:30am, DH woke up and I told him I was getting regular pains. He got ready for work, then I got up and had a shower, to see if it would ease things. I texted J about 7am to let her know I had been having regular pains. I went downstairs and logged back on to contraction master to measure them again. I also tried to have breakfast – all I could manage was a couple of mouthfuls of cornflakes. I would walk around, then when the cramps came, I’d lean against the table rocking my hips and moaning. DH would massage my lower back. I stopped measuring the timing when I decided I just couldn’t be bothered rushing to the computer each time.
DH called J about 8am to let her know what was going on. She heard me moaning over the phone and told him she’d be right over. She came over and saw me moaning and rocking through the cramps and confirmed this was real labour. Her main concern at this stage was why the baby was coming at 35 weeks. I had a VE and the cervix was still back without much dilation. We decided to head into hospital to have things checked out. First, she put a TENS machine on my back, which ended up being my very best friend for the rest of the day. At this stage, I thought we’d go in to see if this was real labour and see if they were going to give me something to stop it. I think I was still in denial, but then I’d never done it before and it didn’t feel like what I’d read in books.
Transferring to Hospital
On my way to hospital, I had my TENS machine and my ipod plugged in, playing a hypnobabies track. I didn’t want to play a birthing day track in case we were going to stop the labour, so I didn’t want it progressing yet. I was pretty calm throughout. I’d always dreaded the thought of having to transfer to hospital in active labour, but it went well. One, my labour was still early, certainly not as intense at later on. Two, I had my TENS machine and hypnobabies. Every time a “pressure wave” would come, I’d breathe through it with an “ahhhh”, pressing on the TENS button.
We got to the RWH about 10am. We checked in, then it was up to the birth suite, get into the horrible hospital gown, up on the bed and be wired up to the continuous monitoring machine. I still thought we may be here to stop the labour.
A doctor came in (Dr O) to discuss the birth. I mentioned I wanted as little intervention as possible. He wanted to do a VE. Due to my SPD, I wasn’t sticking my legs in the stirrups, so we made do with me parting my legs as little as possible. In the end, he used a speculum. I was about 2cm dilated. I think he tried to palpate my stomach, then called for the ultrasound machine to try to determine the baby’s position. He thought the baby was head down, but he wasn’t sure. (In retrospect, I realize he wasn’t very good, but he seemed nice.)
Change of plans
Another doctor came in (Dr D) and did another scan. (I found out later J had gone to get him) He said the baby was definitely breech and I’d need a c-section. I didn’t react well and wanted to know what kind of breech it was. I don’t remember a lot of the discussion, but I was reluctant to go with a c-section. At the time, it seemed like the worst scenario, after I’d been preparing so hard for a natural birth. Dr D went away. I was lying on the bed strapped up to the machine discussing having to have a c-section whilst the pressure waves were starting to feel a bit closer. Everybody seemed to agree that the c-section was the best scenario for a breech.
Dr O came back and went through the thing with us. J started writing out a birth plan that she later made copies of and handed out. This included things like mine being the first non-gloved hand to hold the baby, for me never to be alone, that DH would go with the baby and J would stay with me, that there’d be no formula given, only breastmilk. J mentioned that a baby coming at 35 weeks would probably need some sort of extra care, but it didn’t really register. She started hand expressing me to get colostrum for baby’s first feeds. We did this a couple of times throughout the day.
The anesthetist came in to talk to me. Apparently it was obvious to others that I found her patronizing (I get a look). I discussed it with her, including my reluctance to have big needles near my spine. She wanted to give me a spinal block and explained it all. It felt kind of surreal to be having that conversation. She pointed out I could only have 1 support person with me in theatre, so J couldn’t be there. J disagreed. After the anesthetist left, J sorted it out with the powers that be so she could be there too. Dr O came back and we signed the paperwork to have a c-section. This was about 12pm, with the expectation of going into theatre at 1:30pm.
Things get moving
Once that was done, I asked to finally be let off the bed. I then started pacing up and down as far as I could being hooked to the machine. The midwives swapped me over to the telemetric machine so I could move around more. I finally started playing my hypnobabies Easy First Stage script in my ipod. This birth could finally get underway.
The next period was spent with me pacing around with my ipod and TENS machine on, breathing through the pressure waves. I never used all the hypnobabies cues properly (I think I forgot them). I just used the peace cue at each wave, sighing “peeeeaace” with each exhalation. I was still able to relax through them. I leaned on the bed or DH or J whilst someone else rubbed my back. (I don’t know why, but I never swore, though apparently I did crack people up by my “Fffffar outs”)
The c-section was put off twice whilst I was labouring and it started to irritate me. J mentioned that if my birth wasn’t so urgent, then I might as well do it myself. Or maybe I said that. By then I was in the shower. Apparently I looked at her and said “I can do this”. I was tired and hungry and thirsty and p'd off about the nil by mouth policy, so I was sneaking sips of water in the shower. J went out to see the consultant. I was breathing through the pressure waves, rocking away, talking to baby, talking to myself. At one stage, I turned around and saw the consultant (Dr K) standing in the bathroom door and he said he could approve the vaginal birth if certain criteria were met.
I then had to get back on the bloody bed. Dr K examined me again, saw I was 6cm at this stage and scanned the baby again. Bub was in the right position, with his chin down. Dr K’s shift finished at 5pm, but the consultant on after him was OK with a vaginal breech, so we were OK to go. I was thrilled. I knew there were some breech positions where it was safe to birth. Our little munchkin was in the right position. He mentioned he expected me to be fully dilated by 8pm. I heard this to mean I needed to be dilated by 8pm or I’d get a c-section, so I was determined to get things moving.
Progressing labour
The next period had me alternating between leaning on the bed, sitting on the toilet or in the shower. At one stage I threw up onto the bed. I though my water had broken as well, but I just wet myself. I don’t know when I got a bloody show. It all started to blur. The intensity ramped up and I started moaning about being tired. I went back to lie my side on the bed because I was just so tired, even though the pressure waves felt worse in that position. I started asking how much longer this would take.
At one stage, J had me get back on the bed to practice the position for birth. She knew the consultant had only dealt with breech births with the woman in the lithotomy position. With my SPD, it was important to see just how wide I could spread my hips. So reluctantly, I practiced and we worked out the stirrups were too far apart. Two midwives would hold my legs themselves.
I had moved back to the toilet. I knew by then that certain positions were more effective and I could move it along if I went with it, rather than avoiding the pain. I was moaning through, holding hands with J or F (the other IM). Then I felt this enormous pressure down towards my backside, as I let out an almighty roar. I couldn’t have stopped it if I tried. It just took over – an expanding downward pressure, though I wouldn’t have described it as pushing at the time. I think this is when my waters broke. I was reluctant to move from this great position, but I needed to head back to the bed. I didn’t realize this was pushing time already.
Pushing
Apparently the second consultant (Dr J) came in, saying she needed to examine me. At that time, I leaned on the end of the bed and gave another roar. She said she didn’t really, she knew exactly where I was at, but bent down to have a look anyway (I didn’t register this). I asked if I could have a go birthing on all fours, so I was given 2 contractions to do so before I had to move onto my back. I tried, but I didn’t realize exactly how much pushing is involved. I’d heard so much about breathing the baby out, I kind of figured the baby would just slip out. Not so. So then I had to flip around onto my bum again. Before we started, a medical student came in to ask permission to observe. I said yes. I figured the more people who could learn a vaginal breech, the better. In the end, with the consultant, 2 observing doctors, 2 pediatricians and the midwives, there was a host of people in there.
I lay on my back, in a reclined position. I had a midwife on each side holding my legs. Dr J gave me a local anesthetic in both sides of the pudendum (in case she needed to use forceps to get the baby’s head out). DH was by my side holding my neck. He reminded me to cut my breath of at the throat as I pushed and to keep by chin down. For the next hour, he held my head and helped me keep my chin down while I pushed. He kept leaning in encouraging me, telling me how great I was doing, that I need to keep pushing harder. He drove his foot into the floor so hard he bruised a bone and ended up getting an x-ray later in the week. Actually he was wonderful throughout the whole thing.
The midwives held my legs back and helped me rotate my hips to prevent aggravating the pubic bone. I grabbed their hand, closed my eyes and with each contractions I bore down. The midwives and the Dr J kept saying I needed to push harder. They were encouraging, but I thought I wasn’t doing a very good job, that I was letting people down, which says more about me really. I seriously hadn’t realized how much work was involved in pushing a baby out. Dr J was instructing Dr O and the medical student about keeping hands off in a breech birth.
The intensity was amazing and I worked so hard. I was in tears trying to push harder. The contractions started coming longer and closer together, so instead of 2 pushes, I could get 4 or more in. Dr J asked me to then start pushing up, to get bub past the bend in the birth canal. Weird instruction, but I did it. At one stage they showed me what I was doing in the mirror. They’d already been joking that they knew what sex the baby was. I took a quick glimpse and saw this weird fleshy thing coming through, with a big purple plum attached.
We were having a boy. I closed my eyes again and kept pushing. Later, I was upset with myself for not looking more because I missed out on that little part of Leo’s life, but I was concentrating on getting him out. J’s told me I did push harder after I saw him. I was in my own world. Sometimes between contractions, I’d feel the baby kicking and I’d end up giggling. Everyone felt it was going well. Everyone was so encouraging. Later looking at the photos, we can see from “rumping” to the baby being born was 15 minutes. Once his legs came out, his little head popped out easily. No forceps needed.
I was pushing and pushing and then he was out. They lay him on my chest before I’d registered I could stop. I can remember his legs pointing towards me. I don’t remember touching him, but apparently I did. I remember DH cutting the cord. Then they whisked him away to the cabinet in the corner.
When our hearts broke
I’d love to say he quickly responded and gave out a cry, but none of that happened. There was no breast crawl or even time in NICU. We found out later he would never have been able to live outside his mum. His birth was his last gift.
I won’t go into the 3rd stage here – L eo died during that time, so I’ll continue the rest under Stories of Loss.
After such a wonderful pregnancy and birth, it still seems surreal that we couldn’t take him home.
Here’s the stats:
L eo Jam es was born 9:10pm 26 July 2010. He lived 18 minutes. He weighed 3.324kg or 7lb, 5oz. He was 46cm long. He had a heartbeat monitor on him at all times. His heart never wavered.
Established labour was a total of 5 hours. 1st stage: 3hours 30 minutes, 2nd stage: 1 hour 10 minutes, 3rd stage: 30 minutes. I received a minor 1st degree tear, no stitches.
He was so beautiful and the spitting image of his Daddy. We miss him so much.
Story continued here.
