I suppose, that in a mother’s life there is a time where she feels the need to write down the story that accompanied her child into the world. The moments before, during, and after the life that grew inside her comes to us earth side, into a world that is full of infinite promise - much like the child itself.
I will take a moment to be frank. This is our story. These are the events that I recall and all opinions expressed are my own. They reflect nothing on the other people involved in the process, so please while OUR story may not be what you expect, I will not judge or bare grudge against anyone involved.
If you are easily upset or grieving, please read no further as OUR birth journey may upset some people. And with this in mind I will begin.
Baby Boo’s birth story begins much like any other birth story.
My pregnancy was difficult. I was confined to complete bed rest for 12 weeks after my body went into what was called pre-term labour. When 37.5 weeks came the obstetric physician I was under the care of let the bed rest rule lapse. The baby was safe to come.
I joyously waddled through baby isles of shops and had lunch with family, friends and myself while I could. Eleven days later I went into early labour on a Friday while out shopping with my mum and my sister. Ironically we were joking around saying I needed an ambulance because I was in labour. Turns out I actually was. I went to bed early that night with a sore back but figured it was because I was huge. I had gained a large 20kg by this point. About 1:30am Saturday morning I awoke with the urge to pee, as so often happens in the last stages of pregnancy. I ungainly waddled off to the loo at which point I must have lost my plug - it made a very loud kerplunk noise and I actually had to get up off the loo to look and see what it was. I didn’t get too excited, as I had been informed that it could still be a few days or weeks after the loss of mucus plug that true labour begins, so I went back to bed. After a few hours of irregular contractions 5am rolled around and the contractions became a whole lot stronger and were spaces about 10 minutes apart. Unperturbed I got up so I didn’t disturb my husband. I had breakfast and sat in the lounge on a tarp bouncing on the yoga ball. 8 am comes and the contractions were 5 minutes apart and pretty strong - which I thought was awesome! I was finally convinced that our baby was going to be joining us sooner rather than later. I woke my sleeping husband and told him that he was going be a daddy today. Adorably sleepy, he was flustered and told me we had to go to the hospital right away. Laughing I told him not yet. I would let him know when it was time and he should just go back to sleep cause it was going to be a long day. 11 am passed and the contractions were 2 minutes apart and closing. My husband who had made the most of a last sleep-in, got up out of bed to find me on hands and knees rolling across the yoga ball. He made me a second breakfast and put my hospital bag in the car. He had a shower while I wandered around the house singing and tidying up. I mean what else do you do while in labour? At 2pm the contractions were back-to-back for an hour and I was in tears. I swung wildly between saying “I can’t do this” and “stop being stupid you have no choice at this point just get on with it”. I honestly think that my husband thought I was going mad. I finally told him that we had to go, the baby was most definitely coming today. After a very painful walk across a car park in the grey light and drizzle, across a LONG foyer and sitting/standing/crouching in the labour waiting room, I was checked by the midwife who informed me that I was only 3cm dilated but 40% effaced! She said to go home and that they “will see you tonight.” While I was annoyed because I was in labour and cranky - pain tends to do that to me - we went home for about 20 minutes. At 3pm I said to my darling that we had to go back, upon our return we got shuffled over to the public maternity ward. And again I was checked by a midwife and thanks to all things good in the world I was 6cm and 80% effaced. I was admitted in active labour.
At this point I don’t actually remember much but I will tell you what I actually remember. I was in a mind numbing amount of pain. I asked for an epidural and after hours of waiting I consented to a shot of pethadine and maxalon. Apparently I had a bad reaction to the maxalon and am no longer allowed to take it. The epidural went in fine. I remember DH being told to check if I was still conscious because I was so still. I had gone to my happy place and was concentrating on my yoga breathing - and the nitrous gas that was my lifeline. The midwife who was attending to me had pulled my bra down so it was stuck in my belly and they had to cut it off. I don’t know why I remember that, but it annoyed me very much. Unfortunately the epidural wasn’t working but they kept telling me to push the button so I did. I ran out of the drug in the end. My husband even alerted the anesthesia specialist to the fact one of my legs was red hot and the other completely cold. The epidural was adjusted and still failed to give me any relief. I vaguely remember my charming husband asking if I wanted to have sex to get my mind off the pain. Apparently I told him to "eff off" - which was amusing to the staff in the room. I remember the doctor checking my progress, and me asking what the warm was. Turns out my waters had broken (unaided) as he finished his internal examination.
Next thing I remember is pushing for AGES…I was kept immobile once they administered the epidural and they called it a "failed second stage labour" meaning the baby had disengaged and prepped me for an emergency c-section. I don’t remember much except the strange feeling of a nurse shaving my pubic hair and the thought that it was odd trying to hold a pen and sign papers when everyone was so concerned. I was exhausted and my baby’s heart rate was dropping.
Now according to DH on the way to theatre in the lift I sat up and grunted really loud, by the time we got to theatre they could see my baby. So they attached the vacuum and with one more push he was out. A side note - they had removed my failed epidural in preparation of putting me under a general anesthetic for surgery. My baby was born and apparently they put him on me - soon after he was taken for the normal things they do to babies.
What I remember is, a clunk feeling when being loaded into the elevator and a overwhelming desire to push. I remember the shot in the bum cheek to ‘encourage the placenta to come away’. I remember feeling them stitching up my second degree tearing. I remember telling whomever was standing by my head that I was very cold. They got me warm blankets. I remember them pushing on my tummy and commenting on the blood loss - "that is about 600ml……1.5 litres" - someone called out "code blue - get the universal bloods STAT”. The last thing I remember was the sting of the transfusion needle in my arm. I remember thinking how awful for the family of the code called. I woke up in intensive care 18 hours later where my mum was sitting beside my bed holding my hand. My wonderful husband had only just left - to shower and get fresh clothes. He had been able to give our baby his first bottle feed as I was in critical condition. Apparently at 4am Sunday morning they told my husband to ring whomever he needed to say goodbye as they didn’t think I was going to pull through. In total I lost 4.6 litres of blood and had 3 separate blood transfusions. When I woke I was confused and sore as hell.
Staff then brought him over for me to see and I got my first cuddles. I don’t remember anything until the second day in ICU where apparently I refused any pain relief stronger than panadol.
Day three they took me for a shower in a wheelchair connected to a million IV drips and things.
Day four I was moved to high needs maternity, where I demanded that the baby stay with me 24/7 because they had only been bringing him to be for short bursts of time.
On day 8 we were finally allowed to go home.
Three weeks post birth I started to bleed heavily. In the next 5 weeks I went to emergency three times and was told three different things - it’s normal breastfeeding bleeding, it’s a mild uterine infection, and at 8 weeks post, it’s a super heavy period.
During this time, I went through many, many traumatic events that resulted in panic attacks, hallucinations and nightmares for months and years after. I passed clots the size of my baby’s head, I spent hours on the toilet waiting for the blood to stop flowing enough for me to reach the cupboard that held my maternity napkins. I fell asleep and faded in and out of consciousness while waiting for the blood to stop. The worst of all was loosing so much blood in one gush that my bathroom looked like something out of a horror movie, the stench of blood will never leave my mind. In the end I went to my GP and he took my heart rate and blood pressure. He rang the specialist maternity hospital and we were told to go straight up, no stopping or nothing. Drive yourself with the baby or an ambulance will be called. There was no discussion of why or what was going on, but by this stage I was too weak and tired to do much more than follow orders barked at me by this very small man.
I was there in less time than it took to feed baby Boo in the waiting room, and they had me in an emergency ultrasound booth where it was found I had a large amount of retained placenta and lots of very large clots. The blood tests they took showed septicimia and some other nasty things that I don’t pretend to understand. I was given another transfusion while waiting for a bed to be prepared. Later that night I was on the toilet and had such a big bleed that if I hadn’t have had that transfusion I wouldn’t have lived through it. I remember being cold and ever so grateful that I was so close to the call button, so that as I fell I could push it. I was so embarrassed by the blood everywhere, and all over me, I cried while the lovely nurse held me.
I was so beyond frightened waiting for the theatre the next day. I was sure I was not going to wake up if they put me under general anesthesia. Despite both my fears and tears, I had a curette done, during which apparently I had another bleed where I lost another 2 litres and again woke up in ICU. My uterus had gone septic and my kidneys and liver were on their way to failing.
Thankfully I have an amazing husband who took another 3 weeks off work to nurse me back to health once we were allowed to return home.
I was on alot of antibiotics for a good month or more after the surgery.
What I discovered was that during delivery CTT was used to “encourage the placenta to detach”. What was suspected to have happened was that this had ruptured the placenta and the placenta had sheared part of one of the main arteries in my uterus. The notes I have are vague and post dated, so I am not sure I will ever really know what happened. All I do know is that most people wouldn’t have lived through what happened and apparently most new mums wouldn’t have been able to breastfeed through a minor post-partum hemorrhage. So me being able to exclusively breast feed for 6 months and breastfeed for two years after that point is an achievement in itself. Yes I fought through supply issues and latch issues, with the help of my husband, mother and midwives who all held baby boo to my chest so that he could nurse when I was too weak to hold him myself.
Mr Boo turns three in June 2014 and is totally worth every second of pain. I have to think that what happened to me is unusual. The only part that makes me sad still is not being able to remember his birth. The redeeming thing is that his father and my husband does, and he was the first person to feed Boo and welcome him to the world - one of us has those memories so I can find peace in that.
Recently, we have been told I am infertile after two years of trying for another baby. I hope that the universe will gift us with another baby, I am not done yet. We will continue to try and wait for more specialist appointments until the very last hope fades into the dusk of day, and we will be joyous in the knowledge that we have created one miracle who is changing the world just by being present.
Thank you for getting through a very long post. That was not easy for me to write and share. I don’t write it to frighten pregnant women, I do not believe that fear mongering is the way forward into motherhood. I share because my story deserves to be heard and recognized, and maybe - just maybe - someone will read this and recognize that something is not right, and will not have to go through the trauma I did.
I do know that if we are granted with another successful pregnancy, I will be approaching birth in a whole new light. Not only am I older and wiser - I am more informed and have better support for the journey we choose.
Be a strong supporter of mothers, new and old. We fight for our own lives as well as the lives of others. We are all children, we are all equal. Build a community where you hold each other up instead of belittling and pulling one another down. Be strong enough to know when you need help. Be strong enough to ask for it.
This post started out as a piece on optimal cord clamping, but has become a whole new beast. (Optimal, or delayed cord clamping is the process whereby the umbilical cord is left to cease pulsating before cutting). I read and I researched, after which time, this article changed tracks. I don’t need to tell you the pros and cons of delayed cord clamping. You can read all about it on the websites listed below. After which time you can make your own mind up.
Could this be my shortest ever blog post? No, what all this lead me towards is the fact that in so many cases, women are not given factual evidence-based information to make a choice. Often it is the experience of others that leads us toward making our decisions, when it should be the combination of experience and information.
It is in our nature to want others to have the benefit of our own experiences. Informed choice happens when we consider the experience of others and combine it with scientifically proven, evidence-based information. Sharing experience is a vital way to keep ideas flowing. Experience, or the stories that we tell, should serve as a motivation to gather more information on a particular topic; people usually make choices based on what is best for them. Being that individuals are unique, this will vary from person to person. I have made different choices in all four of my births. Many of them ill informed, but all of them mine. I hope to share my experience, tell you a story, then give you some information so that you can make your choice. First, a non-birth related example:
My husband is the sort of person who falls in love with a new product, and immediately wants others to experience the same revolution that he has. If something makes his life easier, cheaper or gives him pleasure, he shares his experience with all around him. When we were first married, we bought an “upside down” fridge. He would show all his friends the said upside down fridge, spout the benefits on not having to bend down to get vegetables, and marvel at the convenience of the mighty upside down design. Despite his enthusiastic sales attempts, I don't think any of the afore mentioned friends jumped aboard the upside down fridge revolution. I am sure that they looked at them, but made their choice based on what suited them and their family and not solely on the eloquent ramblings on my husband. Simply put, they listened to his experience, did their own research and make the choice that was right for them.
So often advice is based on the experience of others, and not the evidence and information available. Many women that I speak to don’t know that they have a choice in regards to management of the umbilical cord after birth. The World Health Organization (WHO) recommends an actively managed third stage of labor, (another choice here, as you can request natural or physiological third stage) but recommends that after the birth of most infants, regardless of gestational age or weight, the cord should be left for 1 to 3 minutes before clamping.
When I discussed my preference for a natural third stage with my fourth child, my caregiver refused. She told me that there are too many risks of postnatal hemorrhage, and that she would “not allow it.” We went back and forward over the issue of delayed cord clamping and a natural third stage. Eventually she “allowed” me to have optimal cord clamping if I would agree to an actively managed third stage. Interestingly, I have learnt while researching optimal cord clamping, that what I fought my caregiver for is exactly what the WHO recommends should be standard practice. It was her experience that women having their fourth + baby were are greater risk for hemorrhage. I accepted her expertise and experience as my sole source of information.
I don’t want to underplay the importance of closely monitoring the third stage of labor. I understand in many cases, administration of an oxytocin based drugs has saved lives. In my circumstance, had I done my own research, and searched for evidence-based information, I would have refused active management. I was very low risk, regardless of the fact it was my fourth birth. I am left wondering how many birth related choices are influenced by experience instead of evidence. I was educated, informed and proactive, but still managed to be persuaded to do things differently based on the words that were spoken to me, and the manner in which they were delivered.
You always have choices. Don't let anyone take them away. You wouldn't go out and buy an upside down fridge simply because my husband, or even a well versed fridge expert told you they are the bomb. You might use his experience to motivate you go out and learn more about them; hey, you might even go out and buy one. Choice is always there, beware of advice and experience that disguises itself as information, and it truly becomes yours.
Over to you now- make your choice. Here is some evidence-based information on optimal cord clamping and different options for the management of the third stage of labour.
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