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Week by Week

Maxine's Birth Story

It’s a truism that every first-time mother, during pregnancy, believes deep down that she is the first woman ever to go through the experience. Once the baby is over a week late, she also starts to believe that she is going to be the first woman in history to be pregnant FOREVER. No matter how much my rational mind told me not to be so silly, I couldn’t shake this feeling, except, of course, during the moments when I believed instead that this was actually the most advanced case of phantom pregnancy known to medical science and no one had the heart to tell me.

My husband, Martien, and I were very eager to have a natural birth with no medication or intervention, but the idea of an induction was becoming increasingly seductive. I had been suffering copious migraines during the last trimester, for which I could get little relief, and daily vomiting caused by reflux courtesy of Relaxin: The Hormone that Hell Forgot. I’d been having pre-labour contractions for two weeks which sometimes got as frequent as every five minutes, but faded into nothing whenever I relaxed sufficiently. It was all getting to me and I was worrying that I would be physically and emotionally exhausted before I got anywhere near the Birth Centre. I had three options for induction, which I would attempt in order of increasing intervention: acupuncture, prostaglandin gel and IV syntocin (known as pitocin in the US). If either of the first two worked, then I would still be able to go to the Birth Centre, attached to Sydney’s King George V Hospital for Women and Babies. If I needed the big guns of syntocin, I would have to give birth in the hospital’s Labour Ward, because this form of induction can bring on sudden and strong contractions which would probably require drugs to relieve the pain. As I neared the one week overdue mark, an internal examination indicated that I was not at all dilated or effaced and that my cervix was lurking somewhere in the region of my oesophagus. We had a vision of it as tight as a cat’s bum or as the lips of some stereotypical librarian-spinster type and my "condition" became known as "prissy cervix". After discussing the matter with the Birth Centre’s midwives and obstetrician, we decided to book in for a prostaglandin induction on Sunday 10 August, a week and a half after my due date. In the meantime, however, I would have an acupuncture session to see if that would move things along, along with the traditional methods of sex, a curry, raspberry leaf tea, nipple stimulation, walks and massage.

My first acupuncture appointment was made for the evening of Tuesday 5 August, but the fates had decreed that we would instead leap into the world of sitcom. Martien and I were driving to my appointment through heavy peak hour traffic, when our car (Mabel) broke down in a terminal way. The engine had seized. Mabel was a cheap second-hand car and we had got our money's worth from her, but such timing! She was pouring oil and water, not a good sign (a bit like having meconium in your amniotic fluid, I gather) and it would cost more than the car was worth to have it fixed. So... I missed my appointment. Vastly pregnant woman looks on wanly as car's precious bodily fluids flow out onto busy peak hour street and husband recovers from near brain catastrophe due to pushing said vehicle up hill and out of path of oncoming trucks. The following day we tried again. The acupuncture clearly had an effect on me and the tardy one within, because she wriggled and squirmed dramatically during the treatment and afterwards I had some spectacular contractions. But, alas, they again dwindled into nothingness and I spent another night as the Whale Who Wanted to Become a Cow. The acupuncturist had warned me that it might take two sessions, so I had tentatively booked a second appointment on Friday, hopeful that I might be cancelling it. She told me that her success rate was 85%, so we were optimistic that it might counter the effects of "prissy cervix". But it didn’t.

The weekend crawled by. Martien and I spent the sunny winter afternoons walking in parks and by the harbour, and then on Sunday evening, he drove me into the hospital in a borrowed car. Because the induction was part of the hospital’s, rather than Birth Centre’s jurisdiction, he couldn’t stay with me overnight while the effects of the gel were assessed. He had been thoroughly involved in my pregnancy thus far and we hoped that he would be as involved as possible during the birth, so I was sorry that we had to be parted at this point. Things were starting to feel very medical to me, which wasn’t what I had hoped for, but now the priority was having our baby out in the world. I was examined and my cervix pronounced undilated, uneffaced, at station -2, firm and posterior. All our efforts in the preceding days had left it unmoved. In other words, a classic case of "prissy cervix". The first application of prostaglandin was given at 8pm, Martien was sent home at 9.30, and my contractions began at 11pm. It had finally started.

A couple of hours later, I could no longer sleep through the contractions and spent some spectacular minutes in the bathroom being ill. A good sign, the nurse told me, since it meant my body was purging itself in preparation for labour. This, of course, was a "good sign" that I’d been having for the last nine and a half months, but I chose to believe her. I went for a wander around the hospital, lugging a hot pack and dropped into the Birth Centre to chat with Helen, one of the midwives who had given me checkups during the course of my pregnancy. I looked longingly at the deep pool and the birthing rooms and knew that my turn would be soon.

By 6.00am, my contractions were strong and regular. I was leaning over furniture, breathing deeply and swaying my bottom to get through them. I’d thought, seeing videos of labouring women undulating their behinds that this looked comically like a queen bee laying eggs, but soon realised just how soothing the movement was. The nurse asked if I’d like to ring my husband and he arrived half an hour later, carrying our bag of birthing equipment (tennis ball for massage, aromatherapy essential oils, CD player and carefully selected classical music CDs, hot water bottle, none of which I ultimately used!). At 7am I was admitted to the Birth Centre, my contractions 3 minutes apart and strong. Helen was no longer on duty, having been replaced by Rose, who was the head midwife. The contractions grew in intensity. An hour or so later, I told Martien that I’d changed my mind and wanted to go back upstairs and have an epidural. Given my enthusiasm throughout the previous nine and a half months for an unmedicated birth, he was understandably unconvinced. He told me he didn’t really think I meant that, and how about a hot shower? I agreed, readily. I just wanted -something-.

The shower was bliss. I sat under the steaming water on a plastic stool and let it beat against my belly. Martien, meanwhile, directed another stream from a hose against my lower back. At this point I wasn’t able to go into the deep pool, because one must be at least 5cm dilated first. It is so relaxing it can stop labour if used any earlier. The "prissy cervix" hadn’t progressed that far as yet. At 10.30am, Rose ruptured my membranes to give it a hint as to how it should behave. Shortly after, my friend, Annie arrived. She and I had been close since school days and she’d agreed to be a support person at the birth. Her humour, wisdom, calmness and experience of having had three children I had expected to be invaluable to me, and I was right. I promptly burst into tears on her shoulder, happy that she was there, exhausted, emotional. At 11.20am, Rose gave the okay for me to get into the pool. I fell in love with that pool. We’d been told in one of our prenatal classes that studies had shown that the pool could reduce the pain of labour by as much as 75%. I was convinced. Martien got in with me and I lay back in his arms between contractions, then leant forward and squatted as each one rushed over me. At one point I made the mistake of being out of the water as a contraction hit and it felt like a freight-train ramming into me at full speed. Annie started taking photos. We hadn’t discussed this in advance, so she asked permission to take the first one. I gave it, scarcely concentrating on the request and as the day progressed she became more and more audacious in her shot selection. Consequently, we now have a wonderfully vivid record of the birth, something for which I will always be grateful. My perception and memory of the day, distorted as they are by the endorphins that flowed through me, are strengthened by the sight of them. It’s extraordinary for me to see now how it all looked from the outside, since I was focused so thoroughly inward.

At 2pm, Rose suggested that I get out of the pool, since the contractions seemed to be slowing down. The pool’s magic was a little too strong. We waited till the end of a contraction, then the entourage hurried to the shower, so I wouldn’t be hit by a new one en route. I was beginning to feel dispirited. The labour seemed endless and unproductive. After I spent an hour in the shower, Rose examined me again and found that I was almost fully dilated, but that the lip of my churlish cervix was keeping my baby from seeing the light of day. She gently moved it with her fingers and fifteen minutes later I went into transition. It wasn’t as apparent to me that this was the case as I had expected, although I certainly did start to feel rather panicky. From my reading, I knew that this was because the endorphins were being overriden by adrenaline, in preparation for the second stage, but this knowledge did little to make me feel better. I couldn’t see how this baby would ever get out. At this stage, I was sitting on the toilet, Martien and Annie standing by. I felt an overwhelming desire to move my bowels, as though I were constipated and needed to excrete some minute, hard pebble. Suddenly, I was deeply coy. I couldn’t poo in front of Martien and Annie! I asked them to leave (politely, I’m told), so I could attend to my toilet. Rose asked if I’d like the lights off and that helped the coyness too. I pushed furiously, but to no avail. No poo. Needless to say, it wasn’t poo my body was trying to expel. It was a baby. Rose came back in and I poured out to her my tale of woe as she examined me. I told her it was hopeless. I couldn’t do it. I was hurting my baby because nothing was happening. I wasn’t progressing. She begged to differ. I was now completely dilated. There was nothing stopping me from having my baby. The time was now.

Her pep-talk worked. At 3.30pm, I returned to the birth room where against the bed, on the floor, was a soft rubber mattress and a bean bag. I got on all fours and pushed with the contractions. Rose, now joined by Kate, another midwife who had just come on duty, checked the baby’s heart rate with an external monitor. It was dropping with each contraction, not a good sign, because it meant that the baby mightn’t be getting enough oxygen. Rose urged me to change position. I leant back against the bean bag, lying on my side and holding my upper knee with my hand, to keep my legs apart. It was perfect: no longer was the baby’s heart rate dropping and I was positioned in such a way as to let me relax between contractions. My concentration became complete. The baby’s head started to crown and I was asked if I wanted to feel her hair or look in a mirror, but I declined. All I wanted to do was have this baby. A strange change had come over me. No longer was this my pregnancy or my labour; this was my baby’s life. Nothing else mattered. I felt each contraction approach and with Rose’s guidance, waited for the optimum moment, then pushed with all my being. She knew exactly when I should breathe out and in again, while maintaining the pressure, and this way I managed as many as five solid pushes with each contraction. I was amazed how much control I had. Between contractions, I sipped ginger ale and distantly heard the words of encouragement and comfort from those around me. As I pushed, Rose massaged my perineum, stopping any tearing, and suddenly the baby’s head was out. Alas, I had no push left with that contraction, so she was left half in and half out. Rose assured me that she was fine and indeed, the disembodied head began to cry. With the next contraction, Rose instructed me to pant, not push and Maxine, our baby girl was born. My fears that I had been crushing her or otherwise harming her were unfounded. She had Apgar scores of 9 and 10 and calmly looked about her. She was 3,410 g (7.5 lbs) and 50 cm (20 inches). Rose put her on my belly and we stared at her in amazement. I had just given birth to this wonder! Because she was late, she didn’t really look newborn. I refuse to believe it is my bias that makes me say she was (and is) utterly beautiful. Now, the pain had completely vanished and joy filled the room. I delivered the placenta within a few more minutes, but scarcely noticed. Then, for the next few hours, Martien and I lay on the bed with her as I learned to breast-feed, patiently instructed by Sarah, another midwife who also brought us some well-earned dinner. Everything was tranquil and Maxine was alert and calm. This was the pay-off of the drug free birth.

I have heard women who choose a natural birth described as "martyrs", usually with scepticism. The implication is that drug-free means pain-filled, but that really isn’t the case. It is, rather, that we choose forms of pain-relief other than drugs. Knowledge of the process, good positions for labour and delivery, supportive birth partners, hot packs, hot showers, a hot pool, an experienced and empathic midwife. All these decrease the pain and lend a calm and control to the process. By no means am I anti-technology or medicine. Pregnancy and childbirth, however, aren’t a problem to be cured, but a normal part of life. If things go wrong, wheel in the mainstream medicine. If they don’t, then let’s revel in the power of these bodies of ours, so well equipped to see us through this extraordinary process.