Prepare for a Positive Birth with THE BIRTH CLASS

Episode 332

Alannah

After preparing for a physiological first birth with midwives in her local birth centre, Alannah’s plans changed at 35 weeks when an ultrasound revealed a persistent right umbilical vein which can be associated with birth defects. She sought the guidance of a private obstetrician in her local public hospital and at 41 weeks, after a long, hard labour, she birthed her baby boy. A postpartum haemorrhage and retained placenta resulted in her needing to have surgery under general anaesthetic which significantly affected her postpartum experience. A few years later a blood test revealed unusual hormone levels and after further investigation, a 15cm ovarian cyst was found and later removed. Alannah fell pregnant with baby Alex easily and after a smooth pregnancy and a gradual start to labour, she birthed him at home while waiting for the paramedics to arrive.

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“I had a fabulous GP when I first fell pregnant. We were living in northern NSW and one of my best friends had birthed in the birth centre and had positive experiences so I was lucky enough to get in there. I had a really smooth pregnancy but at my 35 week check my midwife highlighted that his growth had slowed. She sent me for an ultrasound and they discovered a persistent right umbilical vein which can be associated with birth defects. That was really scary and we had to run around to get tertiary scans and they told me I couldn’t birth at the birth centre and that I’d have to give birth at a hospital where there was a paediatrician on staff.

“I cried and cried because I’d planned my birth and everything changed. I went to the hospital and was seen by an obstetrician who gave me a stretch and sweep without consulting me which was so upsetting. And then she scheduled an induction. I’d gone from preparing for a birth centre birth to a hospital where they were so insistent on me being induced and I really didn’t want that.

“I googled madly but it was very vague; there was a risk of down’s syndrome and heart issues. I wanted what was best for my baby but I also didn’t want to have an interventionist birth. I slept on it and went back to my original midwife and she helped me work through my options. I chose to go to a different hospital and see a private obstetrician in the public hospital system. He was shocked at my experience at the other hospital and he understood the risk we needed to work through but he agreed that I was still considered low risk. By this stage I was heading towards 41 weeks and he was happy to manage the pregnancy day by day and he really reassured me. I wished I’d never had the scan because Oscar’s growth was fine.

“My yoga teacher encouraged me to have acupuncture induction. Immediately afterwards I noticed a difference in my braxton hicks and then two days later I did it again and early labour started soon after. I went home and busied myself by cleaning the kitchen and going for a walk and by dinnertime I called my husband and asked him to come home from work. By 11pm they were really strong so I called the hospital and we got there and everything stopped. I could think and talk clearly. I could see that I hadn’t used any comforting techniques at home; I just got overwhelmed by my discomfort and went straight to hospital.

“At 4am I was 4cm and I was really disappointed. At 7am my obstetrician broke my waters and that really kicked things off. It was a relief and the pressure went and it felt good. It hurt but it was good. I was free to move around and I was so conscious of keeping my birth active – I paced and paced trying to do everything I could to keep myself comfortable. I was aiming for a drug free birth but I also wanted it to be over.

“I got really tired and at one point I realised I couldn’t do it anymore. I’m a pharmacist so I was going through all the pain options in my head and then my midwife suggested the gas and that really helped to calm me down and it encouraged me to focus back on my breathing. The gas was so helpful. Not long after I went through transition – I was on the ball leaning on the bed because I was so tired – and then when I started pushing my OB recommended I lie on my side and I pushed for ninety minutes and Oscar was born.

“I sat up and had a massive bleed and everything went to an emergency situation. There was a bit of confusion about my third stage management; I wasn’t attached to a physiological stage but I didn’t have the injection and they couldn’t get the placenta out so I was rushed to theatre. I felt so unwell, I was scared and shaking and cold. It’s just a shock, I’d gone through such a  long, hard labour and then to have that happen. I opted for a general anaesthetic because I didn’t want to be present while they removed the placenta, I was exhausted. I was separated from Oscar for about five hours.

“Dan and Oscar were waiting for me in our room when I got back. It was so nice to see them; I was desperate to get back to them. My obstetrician was so amazing and he’d been to see Dan after the surgery to reassure him. It took me a while to enter the new motherhood love bubble; I think I got there weeks later but it definitely didn’t happen straight away. I was groggy from the anaesthetic and sore and exhausted but my priority was skin on skin. My milk didn’t come in for a while…everything was just a bit delayed. Once my milk came in I had so much of it. I still had my birthing centre midwife and student midwife which was so lovely in postpartum.

“We wanted a two-and-a-half age gap and there were a few obstacles in the way of conception; covid and life stressors got in the way. But after six months I spoke to my GP and I asked her to do my bloods and she wrote a referral for the fertility specialists. The bloods showed that I was in menopause; my horomone levels were all over the shop. I’d been using the ovulation kits and nothing was clear. My new GP sent me for an ultrasound and that revealed a 15cm dermoid ovarian cyst so I made plans to have it removed with the same obstetrician who cared for me at Oscar’s birth.

“Once the cyst was removed I fell pregnant on the next cycle but I had a lot of bleeding. Scans showed a heartbeat at six weeks but then at 8 weeks there was no heartbeat. It shocked me and I was really upset and at the same time we were finishing our renovations and decided to move back to Tasmania. Life was hectic and the miscarriage on top of it was overwhelming.

“We moved back to Hobart and the one time we had sex in my seven week cycle I fell pregnant. It was a miracle really. I went with a women’s health clinic who have GPs, OBs and women’s health physiotherapists on staff. I felt like I needed specialised care and I opted for GP shared care through the local public hospital.

“I re-read Janet Balaskas’ birth book, I did a bit of yoga and between work and my four-year-old I was too busy to do anything else. I was expecting to go past my due date again and Alex was measuring a bit smaller, just like Oscar. Once again the topic of induction came up but I really didn’t want one unless there was a medical reason. I did acupuncture again and I went for a big mountain walk and the next day – the Saturday – I woke up and noticed a bloody show. I bounced on the ball and drank my tea and the contractions started but they were mild. We went out for dinner with friends and their toddlers that night but I couldn’t handle it; the light and the noise were too much. On Sunday my friend came to visit and I noticed I couldn’t talk through the contractions but then in between them I was fine. At 7pm I called Dan and asked him to come home and I put Oscar to bed at 8pm. I took some panadol so I could get to sleep, put a hot water bottle on my back and I actually slept for an hour or two. I woke up, put my birth playlist on, I was half asleep, half awake and by 11pm I really felt like I needed a heat pack for my front so I woke up Dan and he organised that. I went to the toilet and then I noticed a lot of blood and I didn’t know if it was normal. I had a shower and had a huge contraction and then got out and then back in and then my waters broke.

“The contractions were so strong and fast so we called the pregnancy team and they said they were on their way to hospital. We were only a five minute drive away but then I could feel the head and I told Dan to call the ambulance but he called the pregnancy team again. At some point our friend who was going to look after Oscar arrived and helped me get out of the shower.

“The head came out and I could hear him crying and then I pushed and out he came. The paramedic on the phone was amazing and took us through it all and encouraged us. I was afraid of what would happen if I sat up because of the bleeding so I just tried to look after myself as I knew I was at risk of bleeding. Once the paramedics arrived they checked Alex, they put a cannula in me and we got down the stairs and into the ambulance. They gave me the injection at the hospital and they had to do a fair bit of tugging to get it out; it definitely wasn’t easy. It was such a relief when it was finally out.

“It was such a different experience after birth; I was clear in my head and present, I felt like I was in that love bubble and it lasted for so much longer and I recovered so much quicker.”

Topics Discussed

Accidental home birth, Acupuncture Induction, Dermoid ovarian cyst, Miscarriage, Private obstetrician, Retained placenta, Two Vaginal Births

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