Thursday, 16 November 2017

Birth

There we were, 41 weeks pregnant at our weekly antenatal appointment, and there was still no sign of getting closer to giving birth. This is our first, it is normal, they just take a bit longer to cook. Of course, but still!
Can we and should we push it to 42 weeks? The week before, the midwives had already suggested to start with the induction process on Wednesday, 10 days past due date, but we didn't really like the idea of being induced.

This was weighing heavy on Cate.  She had been so anxious about the whole birthing process, but come around to be very calm and relaxed about it, so much that she wanted to avoid as much intervention as possible. It was amazing to see the transformation of her feelings towards birth throughout the pregnancy. We read a few books and took a few classes, which all helped.
In the week before, we had tried all of grandmother's recipes to help things move along:  eating spicy food, eating lots of dates, drinking raspberry leaf tea by the bucket, clary sage baths and showers, went for walks, had lots of cuddles - Cate even had a couple of acupuncture sessions. Stretch and sweeps by the midwifes also didn't go very far, as the cervix was just not cooperating.

That Monday was a long and gloomy day. It is odd how you can patiently wait 9 months, but once past that due date your mind starts playing tricks on you. Cate was still full of energy, very unlike being 41 weeks pregnant, though her confidence started sinking. So we went out for a walk along the cliffs. We talked a lot and I tried to cheer her up the best I could. There was no reason to worry, but the dreaded Wednesday was getting closer and closer and the induction appeared to be unavoidable.
So, I let in a bath for Cate in the evening, put on some relaxing music, lit some candles and just tried to help her find some peace and a positive outlook.
We still had a few more days and if nothing was going to change by Wednesday we would just go with it. Having had stillbirths and miscarriages in the family, and friends with pretty awful complications during labour, all sorts of scenarios started racing through my mind. We both agreed we didn't want to push it too far, putting baby or mum at risk.


Surprise surprise, the bath, the talks, the walks, all the things we tried, must have done something. At least the mucus plug had come now. Not that that is much of an indicator, you can lose it weeks before birth, but it is something in the right direction nevertheless.
Cate started cheering up again and returning to her more confident self.

Well, I guess, we asked for it. Around two o'clock in the morning that Tuesday, Cate was sitting up in bed with some new sort of pains. Within half an hour it was clear that these were not some practice contractions, but the real deal. "Hooray, it is all happening!" We knew things would ramp up slowly and we would get some rest before things got too strong. Good, because it was only 2:00am!
Now, that didn't pan out the way we had thought. The contractions happened every 4-5 minutes with each being roughly one minute long. There were a very few breaks of maybe ca 8 minutes, but other than that, the contractions just kept coming, again and again and again.
By morning Cate started to feel nauseous and lost whatever was left in her tummy.  She had trouble drinking and really could not eat food either. This was going to be interesting.

The day continued like this, we charted all the contractions and the baby's movements. At some point in the early afternoon it felt like the baby was moving less than usual, so we called the delivery suite and went up there to get things checked out. Of course the contractions suddenly were a bit less frequent and a bit more bearable as soon as we got into the car. The midwife checked Cate and monitored the baby. It was all looking good, except that Cate was rather dehydrated and only 2 cm dilated. Though the contractions were frequent, they were just not strong enough. As we expected they sent us back home.

At this stage Cate started to doubt herself again - she was exhausted, had not eaten, and was dehydrated. Back home we let in a bath and put some more relaxing music on.
It was a long bath, probably not helping the dehydration nor the body to progress as we were told later.  But, it did help Cate shift her mindset. She relaxed and went inwards into her thoughts. Sometimes there was just a lift of a finger, while her eyes were closed, telling me this was a contraction and not a good time to start a chat. She was quiet and super calm, taking deep long breaths in and even longer ones out.

Eventually she got out of the bath, sat on the exercise ball, or walked around the house, calmly going through the contractions. I massaged her when I could, or just held her. The contractions started to visibly get stronger and a bit more frequent. We were approaching the 1+ minute every 3 minutes sets, though it did not feel like that was enough yet.


At 20:00ish things started to intensify quite a bit, so we rang the delivery suite again and went up there, though thinking they would probably just send us back.
They checked Cate and monitored the baby's heart rate and the contractions again.
Cate was still only 3cm dilated and the contractions were just not intense and long enough.
They did not send us home though, because baby's heart rate kept dropping and would recover slower than expected. So they kept us there for monitoring.

Great, this was the moment to make use of all of our preparations for the delivery suite. We had made a cute birth preference plan, we had a bag full of snacks and energy drinks, we had some electric wax candles to make the room more cosy, a speaker for music.... Nothing - we used absolutely nothing of it! Cate was exhausted from now almost 20h of contractions. She was still not properly hydrated and only eating the tiniest amount of food. Our mind was just not there to care about candles and birth plans, we just needed some rest to gain back some energy.

They put Cate on a saline drip and also gave her something for her heartburn and nausea so that she could hopefully eat a bit more. This was the first time Cate also asked for some pain relief, so they gave her some morphine. The morphine started to act and the litre of saline was also almost gone when she started to feel a bit chilly. Then, after a bit, she started shaking, and then more and more. It caught both of us by surprise. It was a horrible feeling of not being able to help or do anything about it. The shakes finally calmed down again and in-between contractions she started to drift off a bit. Time for me to have a good cry as emotions just overran my mind.


She has been powering through this for almost 24h, somehow quietly and calmly. Sometimes she laid down, sometimes she sat, and sometimes she walked around a bit. Whenever there was a contraction she just held on to me or hugged my neck tightly and breathed through it. It was amazing how well she was still holding up. Though looking at the monitoring charts I did start to worry. Baby's heartbeat kept dropping, and the contractions did not change much in strength or frequency.

At 4:30am on Wednesday the midwife broke Cate's waters as an attempt to get things moving forward. At this point we did not care much for our birth plan anymore, we just wanted the labour to progress and hold a healthy little girl in our arms.

A couple of doctors had come in during the night to check on Cate and the baby. They were not too concerned yet, but if things wouldn't progress we would need to help things out with some syntocinon, the drug they use for inductions. By 5:30 not much had changed - Cate was ca 5cm dilated, so she was put on a drip of a little dose of syntocinon. As the morphine had already worn off long ago, they offered another dose but Cate declined. Instead she was now giving the gas and air a go, starting with a mix of 30% nitrogen and 70% oxygen.

This was also around the time we got a new midwife as their shifts changed. Natalie was the first one to ask us about our birth preferences. We talked how things had been going and what we originally had imagined and hoped for. We talked about how things are likely to progress and about potential interventions and complications. She was very supportive and super lovely. It was very heartwarming to see someone care so much and taking their time with us.

They increased the syntocinon every 30min as things were not progressing much, but then around 6:30ish everything changed. The contractions got stronger and stronger. They checked Cate and by 7:30 she was ca 7cm dilated. The docs checked the baby with a little scratch on the head to test the lactic acidity of her blood. Though the heart rate was still dropping and not recovering as fast as it maybe should, they were all super positive and holding out for a natural birth.

The contractions started to get more and more intense, so much that they lowered the syntocinon dosage a bit. By 9:00 Cate was fully dilated. The docs checked the baby again and started talking about using a ventouse to help her along, but they wanted to give Cate a chance to have the baby herself. By this time the consultant had also joined the party.

Cate was now pushing like a trooper and everyone was cheering her on. The baby's head started to appear and then recede again. Cate started doubting herself as she was running out of energy, so I took a video to show her how well she was doing. She was only a contraction away from the baby's head just staying there.  She pushed, and pushed, she felt the baby's head herself and pushed more and harder.

In the corners of my eye I saw a pair of episiotomy scissors. We had about 2 contractions left before they needed to intervene and pull her out. Everyone was cheering Cate on. With perfect timing there was a push and a snip and out was the head at 9:25. Little one had the cord wrapped loosely around the neck, but that was an easy fix for the midwife. It was indescribable to see that tiny head, and before having any chance to process anything the last contraction came, the midwife gently tugging on the baby and out she was.


They put her on Cate right way, just as she was. I vaguely remember me cutting the cord. Another doctor/paediatrician showed up to check on baby's heart and all was fine. She was breathing and quietly crying, clearing the water out of her lungs. She started to pink up all over her body. I remember her feet looked huge and blue!? She had brown hair and a sceptical stern look.
We laid there snuggling the baby, holding each other, crying, smiling and feeling so proud.
We put the little one straight on the the boob just so she could give it a go. We were not really processing anything else going on around us. After 31 hours and all the excitement the brain just does not appear to function normally.

While we had time with our new baby, the midwife took care of everything else. Cate got another saline drip and some more hormones to help the placenta come out quicker as there was concern about blood loss and a slower contraction of the uterus due to a couple of fibroids. The placenta didn't appear to want to cooperate as expected, so the consultant was back helping the midwife. We later found out that Cate had a velamentous insertion of cord, which can cause quite some trouble with rather awful outcomes during early labour and birth.


Once everything was checked and deemed to be OK, Cate was stitched up. The midwife was quite proud of her job and had me check it all out. Then the baby was measured and given her first immunisation and vitamin K injections. She was a healthy 3395g, and 53cm tall.

They wrapped her up and all of the sudden it was just us three in the room.
Cate went to take a shower and I got some snuggle time with the little one.
We were transferred to our room in the recovery ward. We unpacked a bit, put down a mattress for me next to Cate's bed and Lily was asleep. Then it hit us, and we basically just passed out for a bit. Nurses checked on us,  we texted friends, video called family and had some dinner - the first real meal in probably 48 hours.


The first night was very uneventful: we changed her when she was wet/full and Cate gave hear the boob whenever it looked like she wanted it. Both looked like they were taking to the feeding like fish to water. When it wasn't quite working, Cate was the loveliest mum I could have ever imagined her to be, so patient and so caring. We had lots of skin-to-skin time with her and just enjoyed being with our Lily.


The next morning there was a hearing test which she passed with flying colours, and we went to a talk by Dr. Howard Chilton, the author of the excellent book "Baby on Board", which we both had read.
Everything was going so well that we contemplated going home if they'd let us. Cate dropped by the breastfeeding class and they were super happy with both her and Lily, so we asked if we could be discharged. They got the paediatrician to check the baby and again she passed with flying colours.
At 16:00 we were discharged and went home, ready for the adventure.


It took me a few days to be able to process the whole labour and each time I tried it would bring tears to my eyes. Birth is an amazing adventure, even only experiencing it second-hand. I am grateful to have had the chance to be there with Cate all the way. She has been such a trooper and I will never really know where she found the strength and the serenity to have made this all happen.

The staff at the Royal Hospital for Women in Randwick have been absolutely amazing, caring and supportive. A big shout out to our lovely midwife Natalie and Dr Lee for believing in Cate and being such lovely people through the whole time.

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