It wasn't an auspicious beginning. I'd been waiting in Perth since the last day of 2009 for our baby to arrive. It was really, really hot. Despite trying to remember to savour every moment of this, my last planned pregnancy, I was hot and bothered and not expecting anything to go my way.
BabyJ's birth, in 2007, was induced on his due date and after almost a full day of labour, he arrived in an emergency caesarean. This time around, my last birth, I wanted to attempt a "vaginal birth after caesarean", or VBAC. I wanted to be able to drive and lift BabyJ immediately after birth, I wanted to know I could give birth, I wanted to experience "the real thing". But in all honesty, I wasn't sure it would happen and mentally I'd started replaying BabyJ's arrival, and wondering how my scar would look after two incisions.
VBAC does have some risks, although it's pretty safe, and most hospitals and obstetricians have guidelines for care, such as continuous fetal monitoring and progressing reasonably quickly- dilating faster than 1cm an hour, in most cases. I knew my chances of achieving VBAC would be best if I went into labour naturally, so I'd been doing almost all the recommended steps to bring labour on: raspberry leaf tea for weeks, evening primrose oil for a few days, feeding BabyJ as much as possible (even though he's almost weaned), spicy food and walking, walking, walking.
But R couldn't help me with any of this, because he was still down at the farm. Our wheat harvest had been delayed, and he'd finally got the last of it finished and was tidying up with a few final jobs. With our due date Sunday the 10th, he'd intended coming up to join us on Thursday, but decided to stay because we were having 900 ewes delivered on Friday morning, and he wanted to get them organised before he left.
BabyJ's birth, in 2007, was induced on his due date and after almost a full day of labour, he arrived in an emergency caesarean. This time around, my last birth, I wanted to attempt a "vaginal birth after caesarean", or VBAC. I wanted to be able to drive and lift BabyJ immediately after birth, I wanted to know I could give birth, I wanted to experience "the real thing". But in all honesty, I wasn't sure it would happen and mentally I'd started replaying BabyJ's arrival, and wondering how my scar would look after two incisions.
VBAC does have some risks, although it's pretty safe, and most hospitals and obstetricians have guidelines for care, such as continuous fetal monitoring and progressing reasonably quickly- dilating faster than 1cm an hour, in most cases. I knew my chances of achieving VBAC would be best if I went into labour naturally, so I'd been doing almost all the recommended steps to bring labour on: raspberry leaf tea for weeks, evening primrose oil for a few days, feeding BabyJ as much as possible (even though he's almost weaned), spicy food and walking, walking, walking.
But R couldn't help me with any of this, because he was still down at the farm. Our wheat harvest had been delayed, and he'd finally got the last of it finished and was tidying up with a few final jobs. With our due date Sunday the 10th, he'd intended coming up to join us on Thursday, but decided to stay because we were having 900 ewes delivered on Friday morning, and he wanted to get them organised before he left.
There didn't seem any reason for him to hurry up- I'd been having lots of Braxton Hicks contractions and low pelvic pain (that "baby jumping on my cervix" electric shock sort of thing) for a few weeks, and didn't feel any different now. At the last obstetric appointment on New Year's Eve an ultrasound had indicated another biggish baby (3.8kg at 38.5 weeks), and Dr H had suggested an induction for Monday 11th January. I didn't really think anything would happen before then. My primary concern was getting the baby properly positioned- BabyJ had been posterior, which probably contributed to our unsuccessful labour, so I'd been working on optimal fetal positioning exercises, and again, lots and lots of walking.
On Thursday morning I was due to see Dr H again. I woke up late and BabyJ woke even later, and by the time I raced out of Mum and Dad's place, where we'd crashed the night before, I was running late. I was running even later after I reversed the Special New Ute down the driveway and into my Dad's car, parked behind us but invisible due to the dogboxes on the back of the ute. Not too much damage to anything except my mental state, fortunately.
At the appointment, my blood pressure was good (surprisingly), my weight was gargantuan but stable, and on examination she declared that my cervix was actually kind of ripe-ish and, in fact, 2cm dilated, so I wouldn't need to come in on Monday night for a Foley catheter, we could start induction on Tuesday morning with ARM. Woo hoo, thought me. She did a stretch and sweep, just to see if that would help things along, and said she'd see me Tuesday. I called R to pass on the good news, and then BabyJ and I headed out to the only roomy airconditioned facility in Perth that we hadn't yet visited- IKEA.
It turned out that BabyJ was too young for the playground there, so we amused ourselves by wandering every aisle, trying out all the funkiest furniture, and buying vast quantities of baby and kids' accessories. It was great fun until we reached the carpark, and I suddenly understood that in order to prevent unsightly trolleys littering the area, the IKEA powers-that-be have cunningly arranged their bollards so that trolleys can't enter. My heart and pelvic floor both sagged at the prospect of lugging our hefty haul to the far, far end of the carpark where I'd parked the ute. And then BabyJ dropped his icecream cone halfway across the carpark. Cue despairing sobs from both of us.
By the time we reached the ute, called in at a couple more shops and then made it back to Mum and Dad's, we were both knackered, and I was a bit disappointed that all the hours of walking, carting purchases and toddler around multiple shopping centres, had induced nothing more than a couple of Braxton Hicks in the morning and not a twinge since then.
At the appointment, my blood pressure was good (surprisingly), my weight was gargantuan but stable, and on examination she declared that my cervix was actually kind of ripe-ish and, in fact, 2cm dilated, so I wouldn't need to come in on Monday night for a Foley catheter, we could start induction on Tuesday morning with ARM. Woo hoo, thought me. She did a stretch and sweep, just to see if that would help things along, and said she'd see me Tuesday. I called R to pass on the good news, and then BabyJ and I headed out to the only roomy airconditioned facility in Perth that we hadn't yet visited- IKEA.
It turned out that BabyJ was too young for the playground there, so we amused ourselves by wandering every aisle, trying out all the funkiest furniture, and buying vast quantities of baby and kids' accessories. It was great fun until we reached the carpark, and I suddenly understood that in order to prevent unsightly trolleys littering the area, the IKEA powers-that-be have cunningly arranged their bollards so that trolleys can't enter. My heart and pelvic floor both sagged at the prospect of lugging our hefty haul to the far, far end of the carpark where I'd parked the ute. And then BabyJ dropped his icecream cone halfway across the carpark. Cue despairing sobs from both of us.
By the time we reached the ute, called in at a couple more shops and then made it back to Mum and Dad's, we were both knackered, and I was a bit disappointed that all the hours of walking, carting purchases and toddler around multiple shopping centres, had induced nothing more than a couple of Braxton Hicks in the morning and not a twinge since then.
Dad went to get takeaway Chinese for dinner (spicy pepper chicken for me), and late in the evening BabyJ and I headed back to the Daglish apartment we'd rented for the month, to crank up the airconditioning and jump into bed. Like every night before, we cuddled together for a goodnight story and BabyJ nodded off to sleep in my arms. But for some reason before I fell asleep, when I lay watching him- the angelic, tousled head, the steady rise and fall of each sweet breath, the limbs sprawled carelessly across the bed- I was moved to get up and take some photos of him. How on earth will I love any new baby as much as this?
Some time in the night I woke up feeling odd. The clock read 1.18 and there was a fine tingle of pain easing off across my abdomen. Just another Braxton Hicks, most likely. I turned off the bedside lamp and closed my eyes, but another BH pain started brewing so I got up and went to the toilet. When a third rumble started, I picked up my mobile phone and began internally debating whether or not to phone R. The pain wasn't any different in character or severity to the BH I'd been getting for weeks, but something wasn't right. I'd promised to call him if anything at all was happening, but what did I expect him to do? Drive up to the city in the middle of the night? Leave the farm work undone? What if it was nothing?
I could have phoned the hospital for advice, but I'd left my booklet (with phone numbers) at mum and Dad's place and there weren't any phone books in the flat. So I called R- and he was still awake, having spent all night tidying and cleaning the house. At least someone had some nesting instinct that didn't involve huge troleys full of Swedish homewares! But now what? He was exhausted and in no shape for a three hour drive. So while he packed his bag and then tried to get some sleep, I thought about making a coffee or trying to get some sleep or watching some TV. But I couldn't actually do any of those things, and just paced around the flat for half an hour or so, until finally I decided I didn't want to be on my own any longer.
I called my parents, who insisted on coming over to help, and R, to tell him I was going to the hospital and I would phone him later to tell him if they thought I was in labour. Mum and Dad drove over, we carried the still-sleeping BabyJ into their car and packed my hospital gear into the ute, and headed the few kilometres to their house. Sitting up in the ute seemed to increase the intensity of the pains, and I counted them at 4 minute intervals as I drove.
I could have phoned the hospital for advice, but I'd left my booklet (with phone numbers) at mum and Dad's place and there weren't any phone books in the flat. So I called R- and he was still awake, having spent all night tidying and cleaning the house. At least someone had some nesting instinct that didn't involve huge troleys full of Swedish homewares! But now what? He was exhausted and in no shape for a three hour drive. So while he packed his bag and then tried to get some sleep, I thought about making a coffee or trying to get some sleep or watching some TV. But I couldn't actually do any of those things, and just paced around the flat for half an hour or so, until finally I decided I didn't want to be on my own any longer.
I called my parents, who insisted on coming over to help, and R, to tell him I was going to the hospital and I would phone him later to tell him if they thought I was in labour. Mum and Dad drove over, we carried the still-sleeping BabyJ into their car and packed my hospital gear into the ute, and headed the few kilometres to their house. Sitting up in the ute seemed to increase the intensity of the pains, and I counted them at 4 minute intervals as I drove.
By the time we arrived at my parents' place, I was pretty sure this was something more than Braxton Hicks. BabyJ woke up as I carried him to the spare room, and wouldn't go back to sleep until I'd read him a story and lay down beside him, which was more than a little difficult given the state I was in. Then, when I tried to sneak out of the room, he woke up- whether it was my absence or the squeaking door or the sound of an anxious Bill scuffling around just outside the door, I don't know, but we replayed the wake-cry-story-cuddle sequence at least three times before I just couldn't stay any longer. I told him that I had to go to the hospital, and he burst into tears and wouldn't be calmed by his grandmother's hugs or a carton of new Matchbox cars or any of my attempted reassurance. Eventually he and I were equally hysterical, my parents were near tears themselves and even Bill was dizzy with anxiety. Only Jack the Dog seemed calm, possibly because he's too deaf and blind to realise anything was happening. Leaving BabyJ screaming in his Grouchy's arms, I sobbed my way out to Dad's car and he drove to the hospital, very carefully, as I braced and snapped at him with every new bout of pain.
While he parked the car, I hobbled down the corridor to the desk, clutching my orange pregnancy booklet, to tell the reception staff that I was in labour and thought maybe I should come in. The receptionist was less than impressed, informing me that I should have called for advice before coming in, that we needed to talk to a midwife to know whether I was in labour or not, and that I really shouldn't just come in whenever I thought something was happening. They didn't even have my file ready, and someone would have to go and get it from the clinic! Heavens above! But she begrudgingly sent me hobbling off down the corridor to the Maternal Fetal Assessment Unit (MFAU) to be assessed.
Dad met me in the corridor and walked through the hospital with me, raising his eyebrows when I started up the fire escape stairs (the anaesthetic shortcut) instead of taking the lift. Optimal positioning, optimal positioning, Dad! At the MFAU desk a lovely midwife asked how she could help me, and of course I burst into tears. Eventually I managed to give her the story so far, and she took me to a cubicle, set up a CTG and called Dr H. It was 3.15am. My contractions had slowed and become fairly irregular now, but I called R again to ask him to get up here ASAP anyway. A vaginal examination at 3.55am showed I was only 3cm dilated- "a GOOD 3cm!", she added, encouragingly, but I wasn't that encouraged.
After another phone call to Dr H, I was being admitted to labour ward. Dad came in, collected my stuff and promised to take good care of BabyJ. I thought about asking him to stay with me until R arrived, but as he'd already fallen asleep in the waiting area, I thought he'd be better off home, helping Mum with J. The midwife inserted an IVC in my hand and took some admission bloods, then we headed off to Room 5, Labour and Delivery Suite, arriving there at 4.30am.
Dad met me in the corridor and walked through the hospital with me, raising his eyebrows when I started up the fire escape stairs (the anaesthetic shortcut) instead of taking the lift. Optimal positioning, optimal positioning, Dad! At the MFAU desk a lovely midwife asked how she could help me, and of course I burst into tears. Eventually I managed to give her the story so far, and she took me to a cubicle, set up a CTG and called Dr H. It was 3.15am. My contractions had slowed and become fairly irregular now, but I called R again to ask him to get up here ASAP anyway. A vaginal examination at 3.55am showed I was only 3cm dilated- "a GOOD 3cm!", she added, encouragingly, but I wasn't that encouraged.
After another phone call to Dr H, I was being admitted to labour ward. Dad came in, collected my stuff and promised to take good care of BabyJ. I thought about asking him to stay with me until R arrived, but as he'd already fallen asleep in the waiting area, I thought he'd be better off home, helping Mum with J. The midwife inserted an IVC in my hand and took some admission bloods, then we headed off to Room 5, Labour and Delivery Suite, arriving there at 4.30am.
The next few hours are basically a bit of a blur. My allocated midwife was nice enough, but a bit disinterested. She said they were very busy (as they always are), and didn't look hopeful when I requested one of the mobile monitoring units, telling me there wasn't any reason I couldn't be mobile at the bedside. She said she'd go and see if one was available, but I'm not sure what the answer was. I didn't get one, anyway.
I was hooked up to the bedside monitor, and basically left to my own devices. I got the feeling that she didn't think I was really in established labour- the tocometry trace was relatively unimpressive, but each contraction felt like 'things were happening': often I got a grating sensation in my pelvis, and shooting pain lower down with the later contractions. I tried to remember the optimal fetal positioning techniques, and started off pacing or squatting by the bedside. I wandered to the toilet, where I had a really definitive show- I remember wondering how I could have thought I'd had a show with the tiny bits of mucus passed previously.
When I got back to the bedside, the contractions were really starting to bother me, and in between the pain, all I could think about was R driving up, and what I would do if he hit a roo or fell asleep at the wheel. I somehow got over to my bag between contractions and pulled out a book, intending to try reading to take my mind off it all, but that didn't work. I couldn't sit down on the bed, because of an uncomfortable pressure and shooting pains when I sat, and I didn't want to lie down. I remember thinking that I would love a back rub or a fit ball to sit on or someone to lean on, or oh my God a drink of water, but there was no-one there to ask for anything.
The midwife must have been around, I think she was writing at the desk and checking the monitor occasionally, and she did ask if I wanted a heat pack, which gave some relief but kept falling off my back and I couldn't reach down to retrieve it. In general I felt really alone and increasingly uncertain and scared, and just wanted someone to offer me something else to try, or someone to hold. At some point I asked to call R, who was - I told him I wasn't feeling well and he needed to get here quickly.
I was hooked up to the bedside monitor, and basically left to my own devices. I got the feeling that she didn't think I was really in established labour- the tocometry trace was relatively unimpressive, but each contraction felt like 'things were happening': often I got a grating sensation in my pelvis, and shooting pain lower down with the later contractions. I tried to remember the optimal fetal positioning techniques, and started off pacing or squatting by the bedside. I wandered to the toilet, where I had a really definitive show- I remember wondering how I could have thought I'd had a show with the tiny bits of mucus passed previously.
When I got back to the bedside, the contractions were really starting to bother me, and in between the pain, all I could think about was R driving up, and what I would do if he hit a roo or fell asleep at the wheel. I somehow got over to my bag between contractions and pulled out a book, intending to try reading to take my mind off it all, but that didn't work. I couldn't sit down on the bed, because of an uncomfortable pressure and shooting pains when I sat, and I didn't want to lie down. I remember thinking that I would love a back rub or a fit ball to sit on or someone to lean on, or oh my God a drink of water, but there was no-one there to ask for anything.
The midwife must have been around, I think she was writing at the desk and checking the monitor occasionally, and she did ask if I wanted a heat pack, which gave some relief but kept falling off my back and I couldn't reach down to retrieve it. In general I felt really alone and increasingly uncertain and scared, and just wanted someone to offer me something else to try, or someone to hold. At some point I asked to call R, who was - I told him I wasn't feeling well and he needed to get here quickly.
My legs were starting to ache, so I was leaning forward over the bed and rocking through the contractions. But eventually I just had to get off my legs. I remember calling out that I needed to shift position, I was too tired to stand up any longer, but I don't think the midwife was in the room or she was busy with something, because I ended up just flopping forward and lying on my left hip at an awkward angle on the bed. The monitor kept losing the fetal heart trace, so I'd try to reposition it when I could, but the contractions had got to the stage where I was struggling to do even that. When the midwife reappeared, I was just clutching the pillow against my face and swearing with every contraction.
She told me that I was too close to the edge and really needed to move but I said I didn't think I could, and I thought I really needed some pain relief. "What do you want?", she asked, "I don't care, anything, anything" I remember saying- which didn't sound like me, but I just couldn't think what would help. "You're in charge", she replied, helpfully. "Pethidine then, just get me something!"- but apparently they now only have morphine, so that sounded just fine and off she went to get me morphine.
While she was gone, I felt a real low grating contraction, and then a pop- and my trackie daks were soaking with fluid. I lay there for a while, feeling really uncomfortable, but every time I'd try to sit up to get my pants off, another contraction would roll in. Finally I managed to hit the call bell, and a different midwife came in. I told her I thought my waters had broken and she helped me get my pants off. There was a fair amount of meconium staining (thank goodness for those white knickers) so suddenly she was worried about the monitor position, and I was helped out of my gear and into a hospital gown.
My midwife arrived with the morphine, but after all the shifting around the contractions were getting unbearable and it didn't seem to help much. My midwife examined me, but declared that I was "only 4cm". It was 5.45am, and all I could think was, "I was 2cm yesterday- I probably have another 6 hours of this to go!". All the advice I'd got so far was to "remember my breathing", and that swearing wasn't helping. Well, it was bloody helping more than anything else at that point, thanks very much. So at 10 past 6 I told the midwife that I wanted an epidural. She said she'd call the anaesthetist, and I could hear a bit of discussion with the anaesthetic reg on call about why they needed to call their boss (I was a private patient). I almost called out to tell them to get the reg if it would be faster, but fortunately didn't have the breath.
She told me that I was too close to the edge and really needed to move but I said I didn't think I could, and I thought I really needed some pain relief. "What do you want?", she asked, "I don't care, anything, anything" I remember saying- which didn't sound like me, but I just couldn't think what would help. "You're in charge", she replied, helpfully. "Pethidine then, just get me something!"- but apparently they now only have morphine, so that sounded just fine and off she went to get me morphine.
While she was gone, I felt a real low grating contraction, and then a pop- and my trackie daks were soaking with fluid. I lay there for a while, feeling really uncomfortable, but every time I'd try to sit up to get my pants off, another contraction would roll in. Finally I managed to hit the call bell, and a different midwife came in. I told her I thought my waters had broken and she helped me get my pants off. There was a fair amount of meconium staining (thank goodness for those white knickers) so suddenly she was worried about the monitor position, and I was helped out of my gear and into a hospital gown.
My midwife arrived with the morphine, but after all the shifting around the contractions were getting unbearable and it didn't seem to help much. My midwife examined me, but declared that I was "only 4cm". It was 5.45am, and all I could think was, "I was 2cm yesterday- I probably have another 6 hours of this to go!". All the advice I'd got so far was to "remember my breathing", and that swearing wasn't helping. Well, it was bloody helping more than anything else at that point, thanks very much. So at 10 past 6 I told the midwife that I wanted an epidural. She said she'd call the anaesthetist, and I could hear a bit of discussion with the anaesthetic reg on call about why they needed to call their boss (I was a private patient). I almost called out to tell them to get the reg if it would be faster, but fortunately didn't have the breath.
It seemed like forever before M, one of my old bosses, arrived, but given that he only lives a minute or two from the hospital, it was probably a very short wait. Unfortunately when they tried to sit me up to get in position for the epidural insertion, there was too much pressure in my bum for me to sit straight, and it was tricky to get the right spot. Then I just started to push, which is not ideal during an epidural. The midwife kept telling me to stop it but it really wasn't voluntary, the contractions were pushing their way out from inside me and I was just grunting helplessly as they swept through me. I remember wondering if I could possibly be having this baby right now, and panicking that R would miss it.
At 6.45am M got the CSE (combined spinal-epidural) done successfully, and while he was packing his stuff away and the midwife was on the phone telling the obstetrician that I was "a bit grunty", R walked in. I don't think I've ever been so glad to see anyone.
Within a couple of minutes the spinal component of the CSE had kicked in, and I was pain-free but with good sensation and strength in my legs, so I could swing around and lie comfortably on the bed. Dr H arrived next, and examined me. It was 6.55am, and I was fully dilated. But given the recent CSE, they decided to let me rest for half an hour before I started pushing. The new midwife arrived for the morning shift, and she chatted to R and I while she got the room organised and called the paediatrician- then Dr H arrived, changed into scrubs, and I started pushing.
At first I was just pushing when the tocometry said I was having a contraction, but before too long I could feel the pressure in my bum, and I was pushing because I had to. It was really hard work. I tried changing positions, but it didn't seem to help, and then, just as I felt nothing was happening, everyone at the action end started getting excited. They got me a mirror so I could see the head starting to emerge, and for some reason, even though I've always wanted to, I didn't want to touch the head as it came down.
I was struggling to actually get the head out- I was extremely uncomfortable (as I kept saying to everyone), and I really wanted to get it out, but at the peak of every contraction I felt like my bum was going to fall out or something equally bad was going to happen, and I'd relax and stop pushing. Eventually Dr H told me that I had a band that might be obstructing things, and suggested an episiotomy. I was all for anything that would help, at that stage, but was thrilled when they removed the mirror (especially when I saw the scissors).
As soon as it was done, pushing felt much easier, and the next contraction, even as Dr H was trying to ease the head out and tell me to stop pushing to avoid a tear, I started really heaving it out. In two or three pushes the head emerged, swollen and purplish, and then out came the body.Dr H lifted the baby up- it was a girl. R cut the cord and she went straight to the paed team for suctioning and assessment due to the early meconium, but then she was in my arms. I didn't know whether to cry or cheer- all I could think was how amazing that we did it, and how much she looked like her dad.
I was struggling to actually get the head out- I was extremely uncomfortable (as I kept saying to everyone), and I really wanted to get it out, but at the peak of every contraction I felt like my bum was going to fall out or something equally bad was going to happen, and I'd relax and stop pushing. Eventually Dr H told me that I had a band that might be obstructing things, and suggested an episiotomy. I was all for anything that would help, at that stage, but was thrilled when they removed the mirror (especially when I saw the scissors).
As soon as it was done, pushing felt much easier, and the next contraction, even as Dr H was trying to ease the head out and tell me to stop pushing to avoid a tear, I started really heaving it out. In two or three pushes the head emerged, swollen and purplish, and then out came the body.Dr H lifted the baby up- it was a girl. R cut the cord and she went straight to the paed team for suctioning and assessment due to the early meconium, but then she was in my arms. I didn't know whether to cry or cheer- all I could think was how amazing that we did it, and how much she looked like her dad.
I bled quite a lot (1100mL or so) from the episiotomy, and had a brief hypotensive episode, probably vasovagal, but it seemed like minutes before I was having a drink (first one all night) and offering our daughter her first feed. She wasn't as keen as her brother had been, but then she may have been as shell-shocked as I was. And after all, she's a totally different person, and this is a totally new adventure for all of us. R and I decided that this little adventure looks more like a Kate than a Charlotte, so here she is:
Katherine Gwenyth McGuire
born 8.25am on 8th January 2010
weighing 4.1kg (9lb 1oz), 50cm long and 37cm head circ
Long fingers, long toes, her mum's earlobes, her dad's little toenails and no squashed head.
Long fingers, long toes, her mum's earlobes, her dad's little toenails and no squashed head.
With her dad:
Meeting her big brother (either that or the cleaning staff have misplaced a mop, I'm not sure):
First hat (thanks Kriszty):
First hearing test:
First bath:
First night out of hospital:
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4 comments:
congrats Sam.
We have missed your blogs.
It is so good to see you back - with addition!
Well done Sam - she's a cutie and I'm sure she'll bring you much joy.
Lovely post Sam.. :)
Kriszty
P.S is your email working??
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