The Two Week Wait
10 Questions To Ask Your Care Provider
Pregnancy After Miscarriage: How Long to Wait Before Trying Again
Bleeding In Pregnancy
Birthing Your Placenta : Active Management versus Physiological Management
5 Common Postpartum Experiences
In honour of cesarean awareness month, I chat to Emma about her pregnancy and birth. Despite her intention to have a birth with minimal intervention, days of prodromal labour coupled with exhaustion, dehydration and obstructed labour due to baby’s position, led her to an emergency cesarean. Despite everything, Emma admits that she felt empowered and supported every step of the way, particularly in the depths of her labour when she felt like she was losing control and was debilitated with exhaustion. “I honestly believe that it’s not about how you birth but how you’re treated in birth,” she says.
When she discovered that her breast implants were casing health issues for other women, Emma decided to have them removed in December of 2019. As a nutritionist, she understands how long the body can take to recover, so she estimated that by six months she would be ready to conceive. And she was right! After her body had recovered from the operation, adjusted to the change of hormones, and she had used herbs, and acupuncture to get her PCOS in line, she fell pregnant.
“I’d have 30-45 day cycles and it was hard to pinpoint when I was ovulating. I chose to have a mental break from it that particular month because I was so consumed by falling pregnant – it was literally all I thought about – and yet that month I conceived and the ultrasound showed that I did so on day 26 which proves that your fertile window can really be at any time.”
Emma opted for GP shared care in the public system but hired a doula so she had continuity of care and support. She really felt like her doula helped bridge the gap between the GP and the various midwives she saw. She also delved into thorough research and while she admits that not much went to plan in her birth, it was her knowledge of the birth process, the pain relief options and interventions that allowed her to make informed, considered and empowered decisions.
Morning sickness struck at six weeks and lasted till 15 weeks; it was her first lesson in surrender and she chose to be medicated till it slowly dissipated in the second trimester. The rest of her pregnancy was relatively smooth and a burst of energy halfway through her 37th week was particularly well timed as she made 25 meals – bone broth and slow cooked food to aid postpartum healing. She did notice a change in vaginal mucus that day and when she woke up the next day, she had mild menstrual cramps. They continued into the evening when she attended the Birth Time documentary with towels in her bag in case her waters broke.
After midnight she woke with more intense pains and wandered into the loungeroom to labour there. They were about ten minutes apart and quite consistent but still quite light and didn’t require much focus. However, as the sun came up they mostly disappeared.
“My doula reminded me that it was normal pre-labour and it could go on for a few days, and she just reminded me to get rest when I could and stay active when I felt like it. The same thing happened on the second night; they were closer, about 5-10minutes apart, and I was having to focus a bit more on breathing through each contraction. And then, as soon as the sun rose, they really slowed down again. I could tell they weren’t progressing and I was starting to get really frustrated. I was tired and vomiting and feeling quite sorry for myself.”
Prodromal labour is quite common for first time mums; the contractions intensity at night because that’s when your oxytocin levels are rising in tune with your melatonin levels. It’s the body preparing for active labour…but it really can take days.
“On Friday I had acupuncture treatment and that night, around midnight, I had to get up and they got quite close, between 3 and five minutes apart and lasting for a minute; I had to really focus and breathe through them. At 4:30am I called my doula because I just really felt like I wanted to go to the hospital to get checked and she supported my decision to do that. I was almost 5cm dilated and fully effaced, I was on the verge of going into proper active labour and I was really encouraged.
“The midwife said, if I didn’t want to be on the clock or have intervention, to go home and rest. I felt like that was a good plan. But they just decreased once I was home and I was so exhausted and fed up and upset; I just didn’t know what was going on. We went back to the hospital the next day and they confirmed I was still 5cm and encouraged me to labour there.
“I was still trying to have a minimal intervention birth but I suggested breaking my waters at 2pm and as soon as that happened I went into active labour and was having 3-4 contractions in 10 minutes. I was exhausted but elated that they were finally coming regularly. They told me that they would come and check me at 7:30pm…I spent 3-4 hours in the shower and I really felt like things were starting to progress. Elke was posterior so there was a lot of pressure on my back and my bowels and my back muscles just started to seize and I felt so dehydrated because I was vomiting whatever I drank; I felt like my body was not in the state to labour because I knew I had to relax but my body was doing the opposite.
“I was 7cm at 7:30 but then the midwife told me it would be another few hours and I just couldn’t do it. I need some help and requested an epidural and even though my doula suggested the gas, I straight out refused. I had a full-on tantrum at that stage, I couldn’t breathe, I couldn’t take a deep breath and my whole body was shaking, and I was yelling that I didn’t want the gas. I eventually tried it and it just made me feel nauseous. They started the epidural prep – it takes about 15 minutes prep and then 15 minutes to kick in and I was just waiting…..but it didn’t work. The anaesthetist said she’d have to take it out and put it in a different point in my spine and that time it worked. I had a doze and relaxed and the midwife said she would check me at 1:30 and I was 10cm..they wanted to wait for an hour to get the baby’s head to descend….the midwife could feel the front of her head so instead of the baby’s chin being tucked down it was flexed, in a brow-facing position which isn’t great for birth.
“Forty-five minutes after I started pushing I started feeling very funny and I got a really bad headache all of a sudden and I had a temperature. They called the OB in, and while baby was fine the whole time, as soon as I got the temperature her heartbeat started to decelerate, I started peeing blood which they could see because I had a catheter in and she said baby was too high and her head was in the wrong position, I was feeling the contractions again so when she told me that my body just wasn’t coping and I agreed that a cesarean was the best option.
“Within 10-15 minutes Elk was out; she was completely fine but she was totally posterior and her head was in the brow facing position so they said I had an obstructed labour and so while I was pushing it was doing more harm than good. Nothing went to plan but I still felt very empowered throughout the whole process and I still made all the decisions that I could. When I came to have the cesarean I just felt incredibly supported; the obstetrician listened to me and heard what I had to say.
“Every decision I made was done so with a lot of awareness and knowledge; I knew what the risks were and I felt empowered making each decision. It’s not about how you birth but how you’re treated in birth…I honestly believe that.
“My milk came in on day five and that was a really hard wait because I did wonder if it was going to come in at all. I had a lactation consultant and she checked everything and felt so supported. My left breast produces a lot of milk but the right just doesn’t produce as much; I had more nerve damage on that side so I do wonder if that’s the cause.”
Breast implant removal, Emergency caesarean, PCOS, Prodromal labour
You can connect with Emma at Emma Morris Nutrition
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