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Episode 354

Matilda

In today’s episode I chat to Matilda who is a midwife in Midwifery Group Practice (MGP) and a first-time mum to baby Roma. When she and her wife, Al, started talking about having a baby, they presumed Matilda would carry the pregnancy using Al’s egg and anonymous donor sperm. However, Al’s brother agreed to donate his sperm so they began their conception journey doing home insemination. After five months with no success, they opted to go through an IVF clinic and started with IUI before moving onto IVF. Matilda talks at length about her expectations of labour through a midwifery lens and the reality of contractions, birthing and breastfeeding. This is a beautiful, inspiring episode that details an intuitive and positive physiological water birth.

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“When we first thought about having a baby, we were talking about what was important to each of us. I didn’t care so much about the genetics but I really wanted to grow and birth and breastfeed our baby. Al wasn’t so interested in that experience but she wanted to use her eggs so we thought we’d do reciprocal IVF and that’s when we started thinking about a donor. We originally thought we’d use an anonymous donor through the clinic but when we started looking into it a lot of the research says that kids who are conceived using anonymous donor sperm don’t do as well as those who can know and connect with their donor. We started talking about asking Al’s brother if we could use his sperm and we weren’t sure what he would say but he was really enthusiastic and of course that meant we’d use my egg.

“We thought we’d also be able to do a more natural form of conceiving. We started at-home insemination in November 2020 so James would come around and we’d go for a walk and then we’d come back and I’d do insemination with a syringe. I’d been getting acupuncture and my acupuncturist advised doing it four times, two days apart around ovulation. We did five months of that before we decided to go through a clinic to do Intrauterine Insemination (IUI).

“We signed up to one of the IVF clinics and went through all the testing and luckily everything was really good for both James and I. We had to do counselling and that was all fine. First we planned to do IUI so we were hoping we could do a fresh transfer but because James isn’t my partner, they legally had to quarantine his sperm for three months and that’s because there are some blood borne diseases that might not come up straightaway.

“The first IUI I was scheduled and as I was lying on the bed the doctor came in and said the semen hadn’t done so well in unfreezing so the sperm count was quite a lot lower than what they like to use for IUI. They went ahead and did it knowing it may not work and it didn’t. We could have used that sample on the next cycle but then we’d also have to wait another three months for the cycle and that’s when we decided to go straight to IVF. It was a really smooth process and we got eight embryos and the first one was baby Roma.

“I did a home test the day before the blood test and it was so lovely to know we were pregnant. I was so lucky because I didn’t get nauseous at all through the pregnancy but I was exhausted.

“I felt really strongly that I wanted two midwives who were also my colleagues at my birth. And I wanted a home birth. I was born at home so I’d grown up looking at those photos and I’m a homebirth accredited midwife so I attend them regularly. Al and I felt really safe with my midwives – Karen and Belinda – and we did it through the hospital homebirth programme.

“I wasn’t too set on having a waterbirth; I wanted it as an option but I was more interested to see where I would end up birthing. I just kept my options open. The last couple of births I attended before I went on maternity leave were five homebirths so it was really good to get into that space.

“I was adamant I was going to go past my due date because everyone always thinks they’ll go early and they never do. But then I went into labour at 38 weeks. On the Thursday we went for a long walk on the beach and I lost a tiny bit of mucous afterwards but I had no other signs. On the Saturday morning I woke up with the tiniest period cramps but I thought I’d have them for weeks. I went to yoga that morning then went to the park with Al’s sister and her daughter. The cramps were regular but they were so light so I just got on with it. We hosted a dinner for friends at my parent’s house that night and we were making ravioli from scratch and I had to get a wheat bag for the cramps. I was definitely in early labour but I was in denial.

“Everyone arrived and then I had to go to another room for a bit and then I came out to eat dinner and had to wiggle my toes under the table through contractions. I called Belinda just to talk through it and she reassured me that it may mean something or it could go on for a few days or weeks like this; I felt silly but I’m glad I called. Deep down I knew it was quite possible that I was in early labour and it was nice to chat to her. After a while Al made the executive decision to head home and get the house ready and just settle in for the night.

“I couldn’t lie down, I had to be upright and I was having to really breathe through the contractions. I was trying to stay really hydrated but then I vomited. I made sure I was going to the toilet regularly to make sure my bladder stayed out of the way. I started doing vaginal examinations on myself and at 3:30am I felt like I was about 5cm and I thought it was best to call my midwives then. Once they were there I was so glad and Al felt so much more relaxed having their support.

“In some ones it felt how I expected it to feel. I wasn’t surprised by contractions but I definitely understood why people don’t know when to come to hospital or why they come in earlier because they want to get settled in their birth space. When I was in active labour I didn’t want to go anywhere. Belinda asked me if I wanted a vaginal examination and I did and I was 8cm and Roma’s head was nice and low.

“Belinda asked me if I wanted to get in the bath and I’d almost forgotten it was there. Once I got in it was really lovely and by that point I could feel that Roma’s head was much lower and the contractions were more intense. Something that surprised me is that I thought I’d be able to go off into labour land but my brain was going so fast and I was thinking of all these random things…it was really interesting. I felt like I was in two minds; my body was doing everything it was supposed to but my mind was present and racing.

“I didn’t feel different at all during transition. I knew that I was getting close but I didn’t feel bowel pressure and again I was wondering if I was close or not, doubting where I was in labour. I felt a bit pushy for a while and I might have said that and then time passed and Belinda suggested getting out of the water to sit on the toilet. As soon as I sat there I started pushing properly. I had three contractions there and they were the worst I had. I remember saying to the midwives: I don’t like this. I got back in the bath and pushed in there. I put my hand down and I could feel her head right there. Karen had a mirror underneath me and once I’d birthed Roma’s head she came out in one contraction and she was born to her waist and then I reached down and pulled her out.

“She was really pink and screaming and covered in vernix. She was so squishy and it was just lovely. I got out of the bath and lay on the couch and the placenta was right there and ready to come but I couldn’t work out how to push and what muscles to use. Karen put a bowl in the toilet and I sat on the toilet and the placenta just fell out. Karen and Belinda were looking at my perineum and they were a bit concerned that my tear was third degree which would mean a hospital transfer. Karen took me up to the bed and gave me a local anaesthetic and she had a really good look and she was really confident that it was a deep second-degree tear so she sutured me and I’ve healed really well.

“I was so happy; it all felt really natural and right. Al was really close with me the whole time and that’s exactly what I needed. I was really worried about breastfeeding because the only bad pregnancy symptom I had was raynaud’s syndrome in my nipples and it was so horrible. If I ever got cold my nipples would go white and be really sore and it was awful. I’d spoken to one of the lactation consultants at work and some people believe that it’s worse when you breastfeed. Thankfully, I haven’t had any troubles.”

Topics Discussed

hospital homebirth programme, IUI, IVF, known sperm donor, one vaginal waterbirth, physiological third stage, Same sex couple

Episode Sponsor

Today’s episode is brought to you by ForWhen helpline. ForWhen is a first-of-its-kind FREE, national support line for parents and carers who need to access nearby perinatal mental health support but don’t know where to begin. In Australia 1 in 5 new and expecting mums and 1 in 10 dads experience perinatal depression and/or anxiety.

ForWhen has be created to support parents/carers from conception until your child is 12-months-old, through a range of moderate to severe perinatal mental health issues. They have a team of skilled clinicians from around the country who can expertly triage and navigate your call, connecting you to the appropriate service that best matches your needs, at the right time.

Parents can self-refer by calling the helpline on 1300 24 23 22, or have a family member or health professional call on their behalf, if they’re struggling to make that first crucial step. To find out more about how you can get support yourself or for a ,loved one head to

Call our national helpline on 1300 24 23 22

Visit https://forwhenhelpline.org.au

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