Picture: labour 2, by Alexis EBP, copyright 2013
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.
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.