Waiting

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For the past week or so, on and off, I may or may not have been in labour. It depends who you ask. ‘False labour’ is one term that has been used, alternatives are ‘prelabour symptoms’ or ‘prodromal labour’.

Basically, every couple of days I start having mild contractions which augment, becoming stronger over a few hours until I find it hard to ignore them. With some of them, I have even felt my cervix stretching (it’s like a firm pinch). The first couple of times I had regular 3 minute apart contractions lasting for a minute each. The other night they changed and became three minutes long, coming every 8-10 minutes. They tend to start during the day, building up in the evening, then tailing off around midnight. I did have a bout of nesting and contracting at 2 in the morning, which lasted until 5am, but that came to nought too. At least the kitchen has been cleaned: I keep having unstoppable washing up urges.

Each term of diagnosis on offer signifies something different going on. False labour is just your body pretending to go into labour as a kind of warm up activity. Prelabour is a set of symptoms occurring prior to labour which may include irregular contractions, nesting, spurts of energy, as well as other lovely stuff like diarrhea, nausea, loss of mucous plug and so on. Prodromal labour is a form of actual labour where the early stages do not conform to the standard pattern of gradually mounting, far apart, contractions which eventually lead to stronger, close together contractions, and thereafter birth. Prodromal labour is characterised by contractions which stop and start, falling into diverse patterns, over a period of days or weeks. The contractions are not ‘false’ and do accomplish something, but they are not easy to time and progress is much harder to chart.

I have to say, the latter two explanations make me feel mildly less frustrated about what is going on in my body. As many other women have pointed out in the blogs that I have obsessively devoured on the subject, ‘false labour’ is just plain discouraging: ‘Here’s a lot of discomfort and confusion, but it isn’t real you understand. You are a hysterical pregnant lady. And a multigravida too. You should know better.’ I’ve been in real labour. Twice. It doesn’t feel much different to the experiences that I’ve been having this last week. Other than the bit where the contractions don’t disappear after a few hours and you get to hold your baby at the end.

I have had most of the prelabour symptoms that can be identified as spelling ‘delivery probably close’. It wasn’t. Perhaps it is now. I suspect it isn’t. I can’t exactly argue with the definition to explain much of what has been going on, but the contractions have followed a pattern, albeit a strange one, which is not consistent with ‘prelabour’ alone.

So, the next conclusion is prodromal labour. This means I may be in labour. Hurrah! However, this being the case, it is a marathon labour rather than a sprint. The stopping and starting may signify that my baby is ready to be born, but she can’t get in quite the right position, and therefore her head cannot engage. If she can’t get into the pelvis, she ain’t coming through it. Cue a visit to the Spinning Babies website.

I have started trying some Spinning Babies balancing activities and techniques to help little one get into a good place. After a spot of belly mapping, she seems to be anterior which is good, but it can’t hurt to try and improve matters. There may now be a number of unfortunate photos in our family album of me doing a ‘forward leaning inversion’ aka the ‘lean off sofa with bum in air’ manoeuvre. Also, the ‘pelvic tilt’, or ‘cat/cow pose’. I know which animal I feel I resemble more closely at present. Slumping over my birth ball is comfy and may actually be helping, so am now adopting this position for TV watching. It isn’t graceful, but it feels nice, and, besides, I am desperate.

Another theory about prodromal labour is that it is caused by a psychological blockage: the mother does not want to give birth for some reason. I cannot come up with anything that would be bothering me enough. I do not have a great fear of birth. I am confidant that I can look after a newborn babe. I am excited at the prospect of meeting our new daughter. I don’t think this diagnosis applies to me.

Besides the difficulty in deciding what is going on, there’s another thing that is bothering me. I am still only 37 weeks and 4 days into pregnancy. My previous two children were born at 36 weeks and 6 days, and 37 weeks on the dot. Both appeared quite ready to enter the world. I had my first set of serious feeling contractions at 36 and 1, so assumed that something might have happened by now. I did expect a few days of these shenanigans, but only days. I may have to continue in this ‘could it be today’ mode for several more weeks. Not a comforting thought.

Don’t get me wrong, I am glad to have got to ‘full term’ status. I know that the most important thing is that my lovely baby girl be born in the safest circumstances, at the right time, which is why I am not going to start taking blue cohosh, stimulate my nipples, or beg my doctor to sweep my membranes. Maybe she just needs a bit longer than her brother and sister to be ‘done’. I really am trying to accept this moment in my life, this slow burning labour, for what it is. Sometimes I manage it, sometimes I don’t.

On the other hand, I am finding that my patience wears thin with this ‘is it? Isn’t it?’ routine. I can try to ignore the twinges and contractions, but it is hard not to get my hopes up. I have the wonderful support of my husband, parents, and midwife on hand, poised for action and I would love to oblige. I am so looking forward to holding our baby. Given my birth history, the fact that crèche/ nursery holidays begin tomorrow, and family are only able to visit and help out at our home in Portugal for a finite time, I feel a greater sense of urgency for an expedient birth than I otherwise might. My midwife told me that now is the time to ‘enjoy’ my pregnancy because soon it will be over. I would like to agree, but now rather feels like the time to head butt the next person who can see me, yet still says ‘so, have you had your baby yet?’. People in the virtual world who are unable to examine my pregnant countenance, you are excused. For now.

Pam England, the midwife and author of ‘Birthing From Within’, likens labour and birth to a hero’s journey. In the manner of Theseus, a labouring woman must negotiate her own ‘Laborinth’. When her labour begins, she is thrown, ready or not, over the threshold of the labyrinth. Feeling her way, she must follow the path round and around until she reaches the centre and birth happens. There are no markers to tell her how far she has come or how far she has yet to go. There are challenges to be met along the way, decisions to be made. Things may not alway be as they seem and she must watch out for surprises. All she can do is take the next step and the next, until her journey is complete. Read more here. I wonder what Theseus would conclude about losing his mucous plug and whether he would decide to have his waters broken if it meant killing the Minotaur sooner.

I am unsure whether I have been ‘catapulted’ into my personal labyrinth or not yet. Is this the first challenge? On both a physical and psychological level, I would say I have begun the work of this birth, albeit without a definite starting point. Just like me, to have wandered into a labyrinth without even noticing the door.

I am trying so hard to go about my daily life, to enjoy this time, to remember that soon I will be running round trying to balance a newborn’s needs with those of my other kids. This is not normal life though. There is the part of me that is getting on with everyday activities, and the part of me that is feeling along the wall of the labyrinth, looking for a door to the next stage.

There won’t be resolution to this post just yet. As one wise blogger pointed out- labour is a retrospective diagnosis. After you have a baby, you can say ‘Yep. That was labour’. To conclude, here is her article, and below are some other links relating to this kind of, maybe, sort of labour:

http://belladolcebirths.blogspot.pt/2012/01/prodromal-labor-what-is-it.html

http://birthingbeautifulideas.com/?p=4428

http://adventuresinjuggling.me/2011/11/15/a-dummies-guide-to-prodromal-labor/

http://www.glorialemay.com/blog/?p=368

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Lessons from Birth: Part Two

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Picture: labour 2, by Alexis EBP, copyright 2013

Sam’s Birth

My second birth was much different to my first and much more of a model for what I want third time around.

I didn’t think about my first birth much, until I got pregnant with Sam, just under two years later. The realisation that I would be giving birth again and doing it in Portugal rather than England threw up some old memories and new concerns. I worried that I wouldn’t be able to give birth without help and that I would have another, worse tear, beyond the 3rd degree one that I’d already sustained. I had healed very well and was in no rush to screw that up.

In our local maternity hospitals in Portugal, women usually give birth on their backs. This is the general expectation and policy. Oxytocin drips are often used, and most women opt for an epidural. Episiotomies are still given to everyone as standard. I knew that to avoid a tear it would be best not to give birth on my back, so epidurals and stirrups were out. I also knew from reading reports of medical research that having an episiotomy could increase my chances of having another tear. This led us to consider private birth options which meant a choice between a home birth and elective Caesarian.

I had never considered home birth before, but began researching in earnest. I got a lot of great information from http://www.homebirth.org.uk, as well as talking to friends who had arranged private births, some at home, in Portugal. We found a local midwife online and arranged to meet him.

From the first meeting, Antonio was a wonderful source of calm and reassurance. He is extremely professional, well qualified, and experienced in delivering babies at home. From the beginning, we felt we were in safe hands, and the home birth plan fell into place. I met with Antonio regularly, as well as continuing my prenatal check ups with my doctor and the local maternity hospital.

Faced with the prospect of a drug free birth, I ordered Maggie Howell’s Natal Hypnotherapy CD pack with pregnancy relaxation, home birth preparation, birth music, and postnatal wellbeing. I started to listen to the relevant CDs every couple of days, beginning with pregnancy relaxation later moving onto effective birth preparation. Again, I did prenatal yoga, but not as often as with my first pregnancy due to balancing work, study, and toddler chasing.

In the middle of my 36th week we went out for lunch with friends and I developed a bit of an upset stomach. It was like having traveller’s tummy. I couldn’t eat anything much without rushing to the loo, and had abdominal pains.

Lesson 1: Every labour is different
A gastric clearout is quite a common beginning to labour, which I hadn’t had in my first birth. I’d been expecting to lose my waters and get going in established labour straightaway like the last time. This whole experience turned out to be worlds apart from the first time.

The day after next, I started having mild contractions on and off. After I put Rosie to bed at 8, they were every four minutes. I called my husband and Antonio to let them know what was happening. I paced around the kitchen table. I was so excited, expecting this to be it, but the contractions didn’t accelerate and eventually tailed off after a couple of hours. My husband got home and I sank onto the sofa. Frustrated.

Lesson 2: Prodomal contractions are a common early labour sign in second and subsequent births.
These contractions have been explained as false labour, though this is usually described as a series of unevenly paced, mild, contractions which wasn’t my experience. The key thing is that they don’t augment. They can, however, indicate that the uterus is warming up for the main event. Maggie Howell suggests that the best thing you can do in this situation is have a whisky or a glass of wine and go to bed. Perhaps I’ll try that if it happens this time. They didn’t augment, but I think they were doing some dilation, so not such a bad thing if the easiest phase of labour happens over a long time.

I woke up at 4am with more contractions. I got up and watched ‘Shakespeare in Love’ but the little surges tailed off again by the time everyone else was up. I was feeling tired, tearful, and pissed off at this point, so we dropped Rosie at crèche and my husband and I went for a walk. I felt a bit calmer and when we got home was instructed to sleep. I totally conked out until just before 3 pm and woke up feeling much better.

Lesson 3: Listen to your body and go with the flow
I kept trying to make the contractions pick up, but my body just wasn’t ready to give birth. My hormones were going nuts. The best thing I could have done was accept the contractions were happening as a good thing, but not worry about them not picking up. Getting wound up didn’t do anything.


Lesson 4:Fortunately, going for a walk gets things moving.
I felt better and Sam’s head was firmly engaged in my pelvis when we got back. Win.

I got up from my nap and ate a bowl of soup. I was just about to put my bowl in the sink, when I felt a trickle going down my leg. I phoned Antonio and told him I was losing a little water. He said to call him back if contractions got going. As soon as I put the phone down the cramps started. I could tell right away these were more serious. I waited until I’d had a few and then called Antonio again. He said he’d be right over. I did an excited little dance round the kitchen. Ha! Vindicated. False labour my arse. Better call Husband. Also, time to set in motion the ‘Rosie Emergency Pick Up Plan’.

Antonio arrived and examined me. I was 5cm dilated. This is why I think the contractions had been doing some work. I made him a cup of tea while still bumbling excitedly round kitchen. Antonio told me to do what I felt like and not to worry about staying and chatting if I wanted to be elsewhere. I was too hyper to sit down. Then Husband arrived, and I immediately wanted to be alone with him.

We repaired to the bedroom, leaving Antonio in the living room, and I sat on the bed. I suggested Husband entertain me by reading articles from ‘The Week’, but I couldn’t focus on anything so after a bit we gave up on that. We got out a bean bag and put it at the end of the bed, then arranged some cushions to lean onto and I sat. Husband ran me a bath, while I focused on relaxing as much as possible through each contraction. They started to feel stronger so I experimented with saying ‘ooh’ as the contraction hit. I imagined I was blowing out a purple cloud as I did so.

Lesson 5: Making noises and doing visualisations are a good idea in labour.
I found both these techniques really helpful and had had guided practice of the latter while listening to my hypnotherapy CDs. I have spent more time in preparation for my next birth visualising myself in relaxing locations as well as breathing in golden light and breathing out purple tension. Maggie Howell suggests losing yourself in happy memories from holidays, but also guides you through a visualisation of a beach scene and a woodland glade, so I used these in Sam’s birth.

For this time round, I have also practised visualising a natural, mountainside pool, which I visited in Thailand. I picture myself swimming in the pool, then leaning on its edge gazing at the mountain vista below. One day I was doing this and an image of my baby popped into my head. She was swimming next to me. Now, I visualise her with me. I tried it during a slightly painful dental check up and was impressed to see that I felt little discomfort and also felt wonderful afterwards. Imagination is awesome.

I then spent some time relaxing in the bath. Our bathtub is small and was plumbed in backwards, with the taps over the bit you should be lying on, so not ideal. I didn’t want to be on my back so I lay on my side with my arms on the side of the bath for support. I felt totally at ease and peaceful, not remotely worried or anxious.

Lesson 6: Hypnotherapy helps rehearse and affirm the labour process
I felt like my body knew exactly what it was doing and I was just along for the ride. The deep breathing and my ‘ooh’ noises helped me retreat into myself and let my body do what it needed to do. This exactly matched the affirmations which I’d listened to over and over again on my birth CDs. I knew I could do this.

After a while Antonio came to check Sam’s heartbeat, as he had been periodically. Sam was calm too, but Antonio suggested it was time to move through to the bedroom as things seemed to be progressing well. I made it out of the tub, threw on a long t shirt, and headed for the bedroom. I had to stop and lean against the wall for a contraction, but made it without problems. Husband had been busy laying down plastic sheeting and incontinence pads, and piling up cushions on the bed for me.

Antonio did a quick check and found i was about 8cm. I didn’t like being on my back for this, but he was very apologetic and gentle, and it was over fast. I climbed back onto my knees and leaned forward on the cushions by the headboard, only putting my head up to ‘ooh’ through some strong contractions. I started feeling like I was going to be sick and asked Husband to get me a bowl. Then I suddenly felt unbearably hot. I reached down and pulled off my t shirt in one sweeping movement. Far from being self-conscious I felt quite magnificent. The nausea and overheating passed.

The contractions were very intense now. I felt like I was being shaken apart from the inside and all I could do was cling on for dear life. I can’t remember when we started playing it, but we had my relaxing birth music in the background which really helped me to stay focused on relaxing. I couldn’t bear to be touched or to talk, or even have husband and Antonio say anything. I barked out ‘no talking’, ‘don’t touch me’ as fast as I could because speaking was a huge effort. Poor husband was a bit taken aback, but Antonio had seen it all before. I kept thinking ‘I am NEVER doing this again. I have had ENOUGH. ‘ I felt unbelievably hot and ripped off my t shirt. That felt bloody marvellous.

Lesson 7: I can’t do this anymore type thoughts are a sign of transition, as is a hike in body temperature.
Part of me vaguely knew this at the time, but it is much more obvious after the fact that this was me going into transition. The sudden change in body temperature will be another sign I know to watch for this time round.

Lesson 8: Try to help your birth partner prepare for labour
Next time around husband has a much better idea of what to expect than he did with Sam’s birth, by virtue of experience. It’s a shame we didn’t spend a little more time before Sam’s birth discussing how things might be and doing a bit of research together. I found reading birth stories helped me to prepare and form expectations, but I didn’t share the information and Husband didn’t read them himself. Maggie Howell’s book ‘Effective Birth Preparation’, which we didn’t have last time has been helpful in setting out expectations and listing helpful things birth partners can do.

I felt a popping sensation and liquid flew all over the place. I couldn’t work out what had happened and was absolutely startled, but Antonio said ‘it’s ok. It’s your waters.’ This was very funny in retrospect, but quite a shock at the time. Fortunately, I re-focused quickly on my breathing and settled down.

Lesson 9: Losing the waters at this point is a strong indication that the birth is imminent.
Hurray!

After my water broke the contractions changed. They were still intense, but came less often and the resting time in between was a great relief. Antonio said that I could push if I felt like it. After a few contractions I felt Sam moving down into the birth canal. I didn’t feel so much pain as great discomfort because I was so full up down there. I think the natural pain relieving endorphins my body was releasing were really helping by now. The pressure was immense. I tried a tentative push with the next contraction even though I didn’t feel a massive urge yet. The relief as Sam moved down was fantastic, so I pushed with the next one.

I forget how many contractions there were, but then I felt the unmistakable ‘ring of fire’. Antonio supported my perineum. I tried to push Sam’s head out slowly and wait through a contraction before pushing him out. He turned and came out quite suddenly. Oh blessed relief! I’d done it! I heard Sam’s first cry.

I turned over and Antonio passed Sam to me. He was blueish looking and covered in vernix, but obviously healthy. We were wrapped in a towel and husband and I welcomed our boy into the world.

We waited for the cord to stop pulsating and then cut it. I tried an initial breast feed for a little bit. Husband went to fetch baby clothes and call grandparents, while we waited for the placenta. I was chilly, but too zonked to say so. I was feeling happy, but still a bit shell shocked. Sam was taken and dressed. The third stage seemed to be taking ages.

Lesson 10: Being cold and being separated from baby can hold up the third stage
I should have said I was chilly and got something warmer to put on because being cold can inhibit oxytocin production, which in turn stops the uterus contracting to release the placenta. Cuddling the baby close also stimulates oxytocin production, especially when breast feeding. I was also lying a bit too flat perhaps. This time I plan to have a warm dressing gown waiting for me, and to hold onto the baby.

Antonio started palpating my stomach to help detach the placenta. He did so as gently and apologetically as he could, but it was a bit sore. Husband returned to the room with Sam, now clothed, and he latched on for really good breastfeed. This did the trick and the placenta slipped out painlessly.

After a bit more of a cuddle, husband took Sam, and Antonio had a look at my perineum. He thought at first I wouldn’t need stitches at all, but after a closer look decided a few would be a good idea. The whole thing wasn’t that bad, just an injection to numb the area and the boredom of waiting to be finished.

Husband ran me a bath and helped me to the bathroom. While Antonio packed up, he cleared the bed off as best he could. Unfortunately, the waterproof sheeting wasn’t actually waterproof, so this was a bit more tricky than expected. Fortunately, we do have a sofa bed, so he set that up. Antonio headed off.

Lesson 11: Check home birth kit before!
This time round we are taking no chances.

Lesson 12: Home births need packing away afterwards
Husband was running around quite a bit after the birth tidying, dressing, weighing, and so on, so he didn’t get a settled moment just to sit and bond with Sam. When Rosie was born he held onto her while I was in surgery and had some time just to get to know her straightaway. He feels he missed out on that with Sam’s birth, though not having me whisked into surgery was definitely a bonus for us both! This time round, we’ll try to arrange him a few moments to sit down with baby too, once the third stage is over with.

After I had washed and snuggled up in Husband’s dressing gown, I ate some toast with honey and enjoyed a whisky. Sam was conked out in the Moses basket. I had another cuddle, and we took the requisite ‘after’ photo of Sam and I. Husband and I chatted, then we all headed to bed. The house was so quiet. It was lovely not to be separated. We spent much of the night checking Sam was ok, between bursts of sleep, which he was. In the morning, we went into the living room and I breastfed. We had a cup of tea, called Antonio to arrange follow up care, and chilled out. Rosie came home after crèche to greet her baby brother and life started to unfold as a family of four. The grandparental cavalry arrived later that day.

I am so glad we opted to have a home birth. It was safe, calm, and much faster than Rosie’s birth. All went more or less according to plan and the continuity of personal care we had due to arranging a private home birth was fabulous. Worth every cent. I came out of it feeling like i could give birth all over again, and I was pleased to feel this birth empowerment that people talk about. Sam’s birth undid a lot of fears I had about childbirth and forced me to become much better informed about birth in general. The thing that I think about most as I anticipate my next one is how much I am looking forward to meeting our youngest daughter.

Lessons from Birth: Part One

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Picture: labour 1, by Alexis EBP, copyright 2013

I’m expecting our third child, second daughter, at some point soonish. My official date is 16th August. Preparing myself for this birth has been an entirely different, and more relaxed experience than the last two. I hope that it will my finale of child bearing: smooth, straightforward, and positive. It’s comforting knowing that stats are on my side, showing that birth is easier for many women by the time they are on their third and I have never been so well informed or experienced. Fingers crossed.

My daughter, Rosie, was born in a hospital in the UK, with interventions in the form of epidural, oxytocin drip, and forceps. I ended up with a 3rd degree tear. That is, quite a big one.

My son, Sam, was born at home in Portugal. It was a drug free birth attended by a private midwife. I used Natal Hypnotherapy. I had a small tear and a few stitches.

This is not going to be a short post. Birth stories take time. So, this is not for everyone. I wanted to write about my births because I have learnt a lot and derived a lot of comfort from reading other people’s stories. Here, I add my own to the canon, just in case it does the same for someone else.

    Rosie’s birth

The first time I wasn’t so much worried as apprehensive. I read the relevant chapter in ‘what to expect when you’re expecting’ and leafed through some other tomes on the subject. I did prenatal yoga and tried to work out how warrior position would actually apply to birth. I did kegel exercises to strengthen my then, rock solid, pelvic floor. I watched some DVDs with titles like ‘Holy Crap! I’m having a baby!’ I skipped over the stuff about inductions, forceps, ventouse, and c- sections as it made me feel panicky and I felt optimistic about my body’s ability to push out a bub, hopefully in a lavender scented bath. I decided to keep an open mind about epidurals. Friend’s birth stories took on a new fascination and I listened to their encouraging tones. The ones who had had a fairly crap time were sensitive enough to not scare me. I flew to England at 32 weeks, to stay at my mum and dad’s in Middlesbrough, while my husband was working in London. He planned to join us when I reached a spherical and splendiferous 38 weeks. As we know, first babies are always late.

Lesson 1: first babies are not always late.
As with many other things in life, there are no guarantees that you will make it to your due date. In a way, I am glad to be spared the waiting and watching as due date comes and goes. I had no warning signs that Rosie would show up early, so it was a bit of a shock.

I woke up at 1am on week 36, day 6 of my pregnancy to discover I was lying in a puddle of water. I stumbled, somewhat dazed, into my mum and dad’s room rousing them with a call of ‘I think my water just broke’. We phoned the hospital and they said we should come in, though there was a chance I had ‘had an accident’. I pulled on clothes, jumped in the car, and crampy feelings started up. On arrival at hospital I was found to be 4 cm dilated and in established labour. Got my dad to phone husband, as just couldn’t muster the words ‘hi honey, I’m in labour’. Dad passed me the phone and we had a shaky ‘are you ok honey? Yes, I think so’ conversation. Husband started packing and heading for car, I headed for a birthing ball. I had to go to the high dependency unit because daughter was 24 hrs away from being classed as full term. No bath and no lavender. Boo.

As the contractions got stronger I held my mum’s hand and squeezed with each one. She managed not to squeal in pain. My dad read the posters on the delivery room wall advising birth partners what to do. He made eye contact with me and said slowly and clearly ‘you’re doing very well’. We all fervently hoped husband would arrive.

Lesson 2: Relaxation is ALL
The trouble of preparing for something you have never done is that you can miss glaring details which turn out to be very important. I had been told to welcome, not fight my contractions and to relax my body through them. I had also seen hundreds of images of birthing women in soap operas, TV shows, and movies doing the opposite. I modelled what I was doing on the latter approach. After my second birth, where I took option 1 and relaxed my body as much as possible, I realised how much this helps manage pain. No hand squeezing at all. Now, when I have to do anything uncomfortable, like dental work, I relax and focus on breathing slow, calm, breaths. It really does work.

Memory becomes hazy, but I think at this point my blood pressure was found to be a bit high, so the midwives moved me through to another room where I and baby’s head could be attached to monitors. I changed into a hospital gown and sat on the bed. My contractions kept going steadily. I was encouraged to try gas and air, but wasn’t really sucking it in hard enough to have an effect. I started feeling nauseous. A midwife appeared to check me and said ‘oh you’re almost there’. What! But my husband isn’t here. Besides I couldn’t be possibly be about to have a baby- it’s just not the kind of thing I do. There must be some sort of mistake. Unfortunately this turned out to be the case. She had another look and gave a ‘silly me’ sort of laugh and then said ‘oops, no I was wrong. You’re actually five centimetres.’ What? So I’ve been doing all this work for one lousy centimetre.

This was the point that I freaked out. Yes, I was in pain, but the thing that was really getting to me was the lack of control and the nausea. I couldn’t leave the bed easily because of the monitor, and I don’t know why, but I just would not let myself be sick. I didn’t ask for a bowl. It was as if I thought, by controlling that I was controlling my body.

Lesson 3: if you need to be sick, be sick
I know now that this is part of the body’s mission to expel a baby and void everything else in the process. It can also be a sign that labour is progressing well. By the time I had my second birth I was fine with yelling for a bowl and accepting this as another part of the process.

Lesson 4: don’t be a control freak
I realise now that all one can do in labour is go with it. There is no time when going against the flow is less productive. Accepting that it is happening and a baby is coming out one way or another is another big lesson I took onto my second birth. Not only did this speed up the whole process A LOT, it also helped with lesson 2. By just letting things happen, I could let go of tension and anxiety associated with futile control attempts.

I said ‘I want an epidural’. An anaesthetist arrived presently and explained the process of injecting drugs into my spine, and the potential things that could go wrong. I wasn’t really able to wrap my brain around a conversation anyway, so didn’t take in much of this. He looked at me with pity in his eyes. ‘Do you still want one?’ Yup. As the drugs kicked in, I felt a new sense of calm and control. Things were looking up.

Even better, my wild eyed husband showed up after his invigorating 265 mile drive. I filled him in, he told me about the drive. This was surreal time: a civilised unreality. We chatted and waited to be pronounced fully dilated. I couldn’t believe that i would be pushing a baby out today. I could no longer make a connection between myself and the images of childbirth which I’d only a short time ago been enacting.

The midwife eventually told me it was time to try pushing. I could still feel contractions, but they weren’t painful, so I sat on the bed with my legs up to either side of me and pushed with the sensations. And pushed. And pushed. Nothing seemed to be happening. The attending staff said they thought the contractions were not strong enough and they started me on an oxytocin drip to rev things up. The contractions picked up. Rosie was still ok and didn’t seem stressed by the change of pace, but neither did she seem to be moving. We kept going. Still nothing. The obstetrician said that she needed to be born NOW and it was time to assist her with forceps.

Lesson 5: Learn about typical medical interventions and hospital policy before giving birth, so you can have an informed discussion about them if recommended
Many UK hospitals have a policy of intervening if the second stage of labour has gone beyond an hour in a first birth. Rosie’s heartrate was fine, so the decision to go for an assisted birth may or may not have been essential at that moment. Had we been better informed it would have been possible to have some sort of dialogue about why and whether the intervention was needed immediately. Each birth intervention has risks as well as benefits, and you have a right to understand how they apply in your situation. If delay poses no threat to mother and baby, it may make for a better, safer, birth to wait. Having a discussion will at least reassure you that it was absolutely necessary to have something done. Ideally, birth partners would be prepared well for this, because they are not in the middle of giving birth and therefore, are better able to talk through options and try to make your wishes felt. I wish we had been in a position to do this when Rosie was born because I am not totally confident that we needed the forceps. Rosie might have started moving down on her own with a little more time.

I was laid down and my legs put in stirrups. The obstetrician gave Rosie a little tug with the forceps, then retreated. I was prepared for an episiotomy so they could get better access. By now there were several people gathered around my nethers and it seemed that, to them, everything from the waist up ceased to exist, including my husband who was standing by my head. Because of this lack of dialogue and my muddled mental state, I did not communicate to anyone my perspective on what was happening. The contractions were quite violent. Though I felt only a subdued pain, they must have been huge, moved up a notch or 5 by the oxytocin drip. I suddenly felt pressure, as if I needed a big poo. On some level, I realised this was Rosie moving down, but this was still a bit too abstract, and I was more concentrated on getting the whole thing over and done with. I pushed as hard as I could and felt her budge. Her head shot out of me. My husband remembers the collective expression of surprise on the hospital staff’s faces, followed by a flurry of activity as she turned and exited my body.

Lesson 6: Try to communicate
Communication is something which I have found tricky during both my births and this is a well documented part of the natural labour state. The huge dose of drugs I had had may well have been more to blame the first time round. If I had said that I could feel something, the birth attendants might have been able to help me clarify what was happening and to better control the birth of my daughter’s head.

The good, nay wonderful news at this point was that Rosie was born and pronounced in good health. She was only 2.4 kg, but otherwise there were no concerns. Every cliche about holding your baby for the first time was true. We admired the miraculous child we had produced, while I was given a shot to move along the third stage. We managed a first, brief, breastfeed. Wonderful!

The bad news was that I had a third degree tear. I was given a spinal block and taken off to surgery, while my shellshocked husband cuddled up with Rosie. The stitching up took a long time, but it went well. I was totally out of it at this point and exhausted. I was wheeled to a recovery ward and reunited with husband, daughter, mum and dad. I was so glad to see everyone again and to have another cuddle with Rosie.

After this, I don’t remember anything until waking up after everyone had gone home for the night, which makes me sad. I can see that I was ‘awake’ at some points from the truly horrendous photos but it’s just a blank. That night I remember staring at Rosie as she slept, chatting to the midwives while trying and failing to breast feed. Someone brought me a cup of tea. Finally!

Lesson 7: Drugs do not necessarily lead to ‘pain free’ ease
I don’t know how things would have gone if I hadn’t opted for an epidural with Rosie’s birth. Third and fourth degree tears happen with natural births too, albeit less frequently. There were other factors like it being my first birth, and not having Husband around from the beginning, which complicated things. However, looking at statistics, I would have been less likely to sustain serious damage had I not opted for this kind of pain relief. I do believe that epidurals are a blessing in some cases. In this particular instance though, I suspect that having drugs did complicate a straightforward birth. Had I been up and moving during labour gravity would have assisted more, and my contractions may not have lost their momentum so much. Things would probably have progressed more quickly and I would have been a bit more with it. Ironically, the epidural had given me a sense of control, but actually removed my ability to birth Rosie’s head with control. Luck also plays a part in these things, so I’ll never know for sure how things might have gone.

With hindsight, a nasty perineal tear and longer recovery time, wasn’t the best trade off for a bit of pain relief during labour, and left me with greater sense of doubt and fear when it came to my next birth. I know plenty of people have uncomplicated, positive births using this intervention. So, I would not discourage people from making use of the epidural option where necessary, but I think it should be used advisedly rather than automatically. Fear of what is to come is not the best reason to have one and neither is the illusion of control.

In the morning, another midwife came and removed my catheter, helped me to sit up, then I could finally wash and have something to eat. I wasn’t in much pain thanks to ibuprofen, but still was at a bit of a loss to understand what had happened the day before. A doctor appeared at some point and told me I had had a 3rd degree tear. She gave me a leaflet to read. Really, this was just part of the blur of tests and visits from various staff in between more frustrating attempts to breastfeed. I didn’t have time to digest any information until much later, and by then I just wanted to forget about birth and focus on my little girl. After three days i was pronounced fit to leave, but we stayed an extra two days to get extra support with breastfeeding. Learning to breastfeed was a much bigger deal at the time and I am pleased to say that we did get there in the end and Rosie breastfed for 11 months.

So, overall, this birth and the immediate postpartum period was a real rollercoaster with definite highs and lows. Reading other people’s accounts leads me to believe this is quite a common experience the first time, as there is so much that is new. Any negative feelings I had were eclipsed by the absolute joy of meeting Rosie and becoming a mother. It was a mad, special time, and I have a lot of happy memories to offset the difficult moments. I knew, though, that I wanted my next birth to be different, so I took forward all these lessons when Sam was born. See part 2.