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How to Plan for Postpartum
In today’s episode I chat with Chloe Mackie. Chloe has two children - Sunny (3) and Maya (2 weeks) - and is a midwife with a passion for antenatal care. “I want to empower women with knowledge and education. Ultimately I want to work in Midwife Group Practice or private midwifery because I believe that every woman should have the opportunity to have a known care provider through pregnancy and birth,” she says.
Image by Bek Grace
Chloe was working at the Gold Coast University Hospital when she and husband, Jason, started trying for a baby. After two years and a few miscarriages, they sought the advice of a fertility specialist who told them they had unexplained infertility. In the months following they did three rounds of intrauterine insemination (IUI) but to no avail. Chloe found the experience to be emotionally taxing so on the fourth month she opted to have a break. She decided to go back to the basics – yoga, acupuncture and improving her holistic health – and she fell pregnant naturally on her next cycle.
“When we were trying to conceive people would often tell me that if I stopped thinking about it, it would happen. That was the hardest thing to hear because you can’t stop thinking about it; every minute of every day you just want a baby. And every time I got my period I’d feel like a failure. Coincidentally though, when I did start thinking about it…thinking about me and my husband and our health…we fell pregnant.”
Chloe opted to have a private midwife who would support her throughout the pregnancy, attended her home birth and care for her six week postpartum. Like her mother and her cousin before her Chloe suffered from hyperemesis and was so sick in the first two trimesters that she needed constant care as she was unable to get out of bed by herself. She enlisted the help of her naturopath and acupuncturist and by 30 weeks she improved.
She experienced a typical first labour with contractions over three to four afternoons and nights that seemed to stop come morning. After her fourth round of acupuncture in as many days, labour established quickly and her contractions were strong and steady. She settled in at home where she paced and listened to music and later that evening her midwife arrived and discovered she was 5cm dilated. Not long after her membranes ruptured and there was meconium present which indicates that the baby had done a poo in utero. It’s one of the reasons that a woman must transfer to hospital from home and so Chloe and Jason made their way to Gold Coast University Hospital with their private midwife. On the car journey Chloe noticed increased back pain and when she got to the birthing suite she discovered that baby was posterior with a asynclitism presentation (his head was off to the side). “It’s like trying to push a triangle through a circle,” she says.
She opted to have Sterile Water Injections – non-pharmacological pain relief which is administered by two midwives mid-contraction. Ultimately they trick your brain into thinking there’s no localised pain in that area and allows you to remain upright so you can stay active and help rotate your baby into a more optimal birth position. They only last 1-2 hours and they are very painful when they’re administered – like hundreds of bee stings – but the pain only lasts a few minutes. Chloe spent the following hours sumo stomping, walking up and down stairs and practising side-lying releases (you lay on the bed and drop one foot off to the side as someone supports your hips; it changes the diameter of the pelvis and encourages baby into better position).
Unfortunately all of Chloe’s work hadn’t encouraged her baby into a better position so she opted for a second round of water injections (not a common occurrence) and went through the motions again. At 7cm she talked to the Obstetrician who was empathetic to her situation and her birth plan. They discussed an emergency cesarean and whilst Chloe accepted that it was a safe option for both her and her baby, she wanted to buy an extra hour of time and opted to have an epidural. Thirty minutes after it was administered she felt the urge to push.
“When my midwife checked me she asked me to put my finger inside to feel my baby. And he was right there! It was a perfect example of an epidural working beautifully. It released my pelvic floor muscles and allowed my baby to come down on his own. We did an hour of passive descent and then I pushed for 15 minutes and he was born!”
They went home 6 hours later and Chloe was having excruciating after pains but no increased bleeding. Eighteen hours later she had taken her quota in paracetamol and Nurofen and started developing a fever so they returned to hospital thinking that she may have retained placenta but nothing was found. She was administered IV antibiotics and went home with oral antibiotics but within hours, Chloe declined rapidly.
“The pain was getting worse by the minute and I had this overwhelming feeling that something was very wrong,” she says. “I was slipping in and out of consciousness and I lost control of my bladder so Jason called the ambulance and I was given broad spectrum antibiotics on arrival.”
She couldn’t feed Sunny or access donor milk so her best friend came to the hospital to feed him and continued expressing during Chloe’s hospital stay. Chloe was diagnosed with Group A Strep that had colonised in her genital tract and developed into Septicemia. It was a traumatic time but thanks to fast acting antibiotics, she fully recovered within a few weeks.
When Sunny was two, Chloe had a miscarriage and then fell pregnant the following month. Bracing for the worst of hyperemesis, she enlisted the help of her naturopath and acupuncturist early on and whilst she definitely was sick, it wasn’t nearly as severe as her first pregnancy. At 41 + 1 she went into labour and headed to the hospital shortly afterward so she could settle into her birth space with its dimmed lights, music and birth pool.
Once again the baby was posterior with an asynclitism presentation so Chloe opted for water injections and side-lying release which worked instantly. “I felt her turn and then I slid off the bed and had the sudden urge to bear down. Jason picked me up and put me in the bath and Maya was born 12 minutes later. It was very healing and we really needed that,” she says.
Image: Bek Grace
Hyperemesis, Sterile water injections, Side-lying release, Asynclitism, Group A strep, Septicemia, Infertility, Acupuncture, Posterior
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