Sunday, September 21, 2008

Milly's Home Birth


At 40+ weeks I was starting to be a little ‘over’ being pregnant but trying to focus on not wishing my pregnancy away I did my best to stay positive. At 40+6 my midwife came and I asked her to do an internal to see how things were looking. My cervix was very soft but still a little long so my midwife asked whether she wanted me to do an S&S. I shared with her a traumatic experience I had with an S&S done by an OB (not my own) with Karlie, which left me feeling violated and in a lot of pain. She said that it would be uncomfortable but would walk me through the whole procedure (the OB had not explained anything and was certainly not sympathetic when I was voicing how painful it was). So I agreed to the S&S and amazingly enough it was not traumatic and if anything was ‘healing’ from my other experience.

That day Marty and I went shopping with the kids and enjoyed some good time together being a family of four. Around 8pm that evening I had my first show, which again helped me to remain positive that something was happening and I should enjoy the time I had left of pregnancy. I potted around and got the house ready, pulled a yummy banana cake out of the freezer that I made ready for after birth. Marty made some of his famous chicken & vegetable soup for dinner with plenty of leftovers for the coming days. We went off to bed around 11:30ish but I couldn’t sleep as I was so excited about what ‘could’ happen in the next day or so.

Labour Starts

At 12:20am that night (14.9.08 - 41 wks) I started getting mild period pain and at 12:35am my first ‘contraction’. Another one followed at 12:50am and then I felt I needed to go to the toilet and got up at 12:55am and my waters broke as I got out of the bed. Marty rang our midwife as she told us to call us if my waters had broken. She said to call her back as soon as my contractions were stronger and I felt she needed to be on her way (she lives around an hour away). I jumped into the shower and got into another nightie ready for the night ahead. Over the next 1 ½ hrs the contractions got more painful and at 2:48am, Marty rang my midwife again. At 3:29pm my midwife texted to say she was on her way with the ‘back up’ midwife. Marty started filling the pool at 3:05pm and I was coping with each contraction by standing leaning on the side of our couch with him rubbing my lower back (was getting a lot of lower back pain – this made sense a little later). It was around this time that Karlie woke up for a toilet stop and Marty told her I was in labour, she started jumping up and down in excitement. We suggested she go back to bed as it may be a while still, but she refused to miss anything and wanted to stay up and ‘help’. At 3:45am my contractions were coming every 5 minutes and I was still feeling great between them so I popped on my parenting forum to let people know I was in labour (yes I know I am crazy, ha ha). When I stood after telling my due in group and my home birthing group, I had another spill of my waters much bigger than before. I jumped into the shower again and changed into another nightie and then things hotted up. I told Marty at 3:50am that I didn’t think it would be long before this baby entered the world. At 4:10am I started feeling sick with each contraction, which were coming very close together (Marty took notes and all he wrote after this was ‘constant’). Keenan woke just before the midwives arrived and also was so excited that he didn’t want to go back to bed.

Midwives Arrive

My midwives arrived at 4:40am and I was so relieved as I held off getting into the pool until this time. My midwife checked me and bubs and everything looked good so I got into the pool. It was at this time that my midwife told me that I could not give birth in the pool as there was meconium in my waters when they broke so it would be safer to birth on land. I was disappointed about this but from the relationship I had established with my midwife I was happy to trust her. I was still able to labour in the water, which I was happy about. The relief from the pool was not as great as I thought it would be (maybe as the pain in my back was horrid and I was on all fours so didn’t have the water relief on my back). The main benefit from the pool was the weightlessness, which allowed me to be active with my contractions in a good position (I have always laboured on my back in hospital, so this was great and different). I lent over the side of the pool between each contraction for a rest as they started to have some time between them again (as I was heading close to transition). I was still chatting and smiling between contractions as I was transitioning which again was different from my other births. Marty said that I had the same look on my face as I did from my pethidine shots from Karlie and Keenan – that natural oxytocin stuff rocks! The back up midwife kept cold towels over my neck which was just heaven (as the pool was very warm) and kept offering me ice water between contractions which I drank like crazy!

I started to get some urges to push around 5:16am which came stronger at 5:20am with my midwife noting some ‘pouting’. At 5:56am my midwife suggested I change position which I think my response was something like “WTF???”, but again I knew she might know what she was doing and so I moved into a new squatting position with one leg up in the pool. Milly’s HR remained steady though so my midwife said she sounded too ‘happy’ to be in the 2nd stage. At 6:05am her HR started to drop into 2nd stage HR and I started pushing strongly through my contractions. At 6:16am my midwife suggested I get out of the pool as I was getting close, again my response was “WTF? You expect me to move when I feel like this??”. I rebelled a little bit and complained about not being able to do it, but had beautiful encouragement from everyone including Karlie with “You can do it Mum”. This is when Keenan exited the room as it was getting a bit too much and he didn’t understand why I had to get out of the pool (we had shown him a birth video of a water birth which he was ok with, but seeing me pushing out of the water was too much so he went to his bedroom).

At 6:23am I was out of the pool and pushing with better progress. This is the first time my midwife noted “Direct OP?” in my notes as she thought Milly was taking a long time and was not in the ‘normal’ position coming down. Milly’s HR was still great so there was no hint of panic with this ‘interesting position’ just another suggestion of another position change at 6:30am with me on my back leaning onto Marty with my legs up. My midwife confirmed Milly was direct OP (posterior) at this point (which explained the back pain and long pushing session). My episiotomy scar from Karlie was bulging and my midwife was concerned it might tear so put a hot face washer on it whilst I did my final pushes (she did not say this at the time, just remained calm and asked for the face washer whilst I waited through a contraction understanding the possible risk of the scar opening).

At 6:42am Milly Grace entered the world with a lovely lusty cry with an agpar of 9. Due to the next turn of events Milly was weighed at hospital later that morning weighing 9.5 lb’s.

Transfer to Hospital

Immediately after birth I was feeling very sore and could not find a comfortable position to start enjoying baby Milly. I asked to go back into the pool as I thought the warm water might give me some relief from the pain ‘down there’. My midwife said I had a 2 degree tear and that due to Milly coming out direct OP, I was very bruised down there so not surprising that I was in pain. I got back in the water at 6:54am but found no relief and suggested that maybe I needed the 3rd stage to be managed with an oxytocic (the cord had stopped pulsating by this time so Milly had received all her cord blood). My midwife said that it was my decision if I wanted to do this but suggested I get out of the pool which may encourage the placenta to come which may help with how I was feeling. So out of the pool I got and as I stood up I had a major blood loss and then again as I birthed the placenta at 7:11am. Over the next hour or so I had some more blood loss which took me over a litre (1100 mls) and my uterus kept softening even after my midwife massaged it to try and harden it. At 7:55am I had a shot of syntometrine, the blood loss then stopped but my BP and pulse rate were both concerning and my veins shut down so an IV could not be put in for extra fluid. At 8:10am I breastfed Milly who fed like a pro and fully off both sides, this was a relief as by 8:45am an ambulance was called as I had no improvement in my BP (106/80) and pulse.

My midwife (holding Milly) travelled with me in the ambulance and we arrived at the hospital just after 9am after a lovely ambulance ride (the ambo’s were great). I won’t go on about the hospital experience as it was definitely the ‘down side’ of my whole birth story, so the basic conclusion was that I received 2 units of blood in hospital plus some fluids. I also had my 2 degree tear stitched (the up side of going to hospital, I used the gas whilst they stitched, that stuff is divine!!! Oh and I also had a midwife who also does home birth attend during the stitching, she was amazing and refreshing to some of the other midwives we experienced in hospital. We had a great chat whilst I was ‘high’ on the gas, everyone in the room was laughing how candid I was, also my questions about long term studies on the effects of gas, ha ha).

We were encouraged to stay in hospital over night but by the evening Marty and I were ‘over’ being in hospital and since I had not bled before I arrived at hospital, we believed we would be ok to go home. As we live 5 minutes from the hospital we knew we could call another ambulance if needed and I would get more rest and sleep at home then in the small hospital room with 4 other mums. I was also concerned that Marty would not be able to stay with me and I was not up to looking after Milly on my own and did not want to have midwives taking her and any possible mishaps with her being given formula etc (yes we all know it still happens without permission!!).

So it’s now 1 week on and Milly is feeding beautifully, sleeping beautifully and just a treasure of a baby.

Benefits of Home Birthing

I started out on the pre-pregnancy journey wondering how I could get out of birthing at the local public hospital, which doesn’t have the greatest reputation for maternity care. I also had some concerns due to my line of work about who I could possibly run into during my pregnancy care and birth. I have also always liked the idea of water birth but knew that wasn’t possible in the local public or private hospital. I found out my old OB was now working in Ballarat who was fantastic so had a brief entertainment of the idea of taking out PHI and waiting a little longer to be under his care. I actually have no idea where the first idea of home birthing set in, I think it was from around the time I saw Ricki Lake’s documentary “The Business of Being Born”. It confirmed for me that home birthing was not only safe but gave me the greatest chance of not have interventions (inductions, drugs etc) that I had with my Karlie & Keenan which I believe impacted on my birth experiences. I also knew it was the only way I could get a water birth which again would help with the pain and allow me to labour drug free. So my hopes at the start of my journey were only two fold, to have an intervention free birth and to birth in water.

I had no idea that the benefits would go way beyond this. The first thing Marty and I noticed was the benefit of our midwife coming to visit us in our own home. Her visits were for 1 ½ hrs at a time and consisted of about 15 mins of pregnancy care and then lots of personal bonding, sharing stories of our lives, families, philosophies of birthing and health care in general. She did not batt an eyelid when we refused certain testing (after fully researching each test) and gave us the respect that we could make the best decisions for our own care. Marty noted about half way through my pregnancy how relaxed I was compared to Karlie and Keenan and that it was a benefit that he did not expect as well.

Since the birth, the other benefits have been in the area of breastfeeding. Since Milly was not drug affected at all, she attached beautifully to the breast immediately and so far I have not had any cracked nipples or issues as I had with Karlie and Keenan. With Keenan it was at least 3 months before those issues cleared up and I started to enjoy breastfeeding (with Karlie I had given up by that time as it was way too hard). Milly is also the most content baby I ever have (again I believe due to not being drug affected and being born at home into calm and peacefulness). On discussion with my home birth midwife she confirmed that she does not see the same issues with breastfeeding with her home birthing mums as she does in the hospital job she also has. She believes the biggest difference is that the babies are not drug affected and therefore have their breastfeeding instinct in tact from the start.

So would I do it again? Well it’s only been a week and I am still recovering ‘down there’, but if I was to have another baby, I would DEFINITELY home birth even with the chance of the PPH issues. I could not have asked for better pregnancy care or such a lovely experience of labour and birth at home with my independent midwife.

1 comment:

Jason said...

Hey Mich,
great to hear your about your pregnancy and birth. i think it is a real encouragement for women looking for a better way to give birth and to be in control of those important decisions regarding intervention.
I'm especially glad that the breastfeeding is going so well.
lots of hugs, christa