Prepare for a confident birth – The Birth Class

Episode 484

Hannah – PROM, induction, gas+air, MGP, waterbirth

Hannah’s three vaginal births are so different but they all started with pre-labour rupture of membranes (PROM). Her first was induced and she explains the intensity of contractions and how she navigated them. In her second birth she waited days after the trickle of her waters began, was guided by an obstetrician willing to wait and she went into spontaneous labour and had a physiological waterbirth. With her third, her baby was posterior and while her waters broke labour never started. She made the informed choice to have an epidural before the syntocinon started and really enjoyed her labour. As she says: “A positive birth is when mum and bub are fine, and mum comes away thinking ‘that was really good’. I was involved in all the decisions and I felt supported every step of the way.’

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“Zoe, my first, was planned. We conceived on the first or second month we started trying. I knew from 5 weeks and 0 days because I’m a sonographer and I scanned myself; I could see the gestational sac, then over the next couple of days I saw the yolk sac, and then I saw the baby and the heartbeat. It varies when you can see the heartbeat but I saw it at 5 weeks and six days.

“I knew about MGP and when I called the hospital to book in I requested it. My midwife, Bec, called me and introduced herself and she was really reassuring right from the start. My pregnancy was uneventful and very low risk. My waters went at 39+6 – it was a big, obvious gush. I called my midwife straight away but unfortunately she had been at so many birthed in the days prior that I just had to have whoever was on. I went to the hospital to get checked but they sent us home in the hope contractions would start.

“I had cramps overnight but I woke up in the morning and nothing was really happening. I went into hospital for more checks; I didn’t have a temperature and I thought Zoe’s movements were good but on the CTG the obstetrician said they weren’t ideal so she suggested an induction that day. I was really happy to go ahead, not knowing how intense the syntocinon would be.

“It’s that feeling of contraction on top of contraction – there’s no space for a breather. I felt like I was trying to get out of my body. I had a student midwife who was a familiar face and she was incredibly supportive but I just remember the contractions going form 0-100 – it was very intense. I tried the shower for pain relief but the bands on my tummy kept slipping off. I was 6 centimetres and they offered to put the monitor on the baby’s head which worked for me and it meant I didn’t need the monitors on. Sally suggested the gas and air and it really worked for me; I felt like I was lifting out of my body.

“There was a midwife change and they new one really encouraged me into different positions and she really helped. I got to 10 centimetres but I remember feeling that my body wasn’t ready because it felt counterintuitive. After fifty minutes Zoe’s head was born and then her body but I was so out of it from the gas, that they lifted her onto my chest and I felt it was the best thing that had ever happened.

“I had a 3A tear and I was passing clots so someone had to push on my stomach but regardless of all of that, I wasn’t scared or traumatised because Zoe was on me. My notes say I lost 900 ml of blood and I was offered a blood transfusion because I was quite dizzy and couldn’t stand up. I was able to be stitched in the room so I could stay with Zoe and she was feeding which was great.

“I got my own room because I was classified as a ‘falls risk’ so my partner, Dean, got to stay with me which was lovely. I ended up staying for three nights so I got a lot of help with breastfeeding which I needed because my nipples are quite flat. I used nipple shields for about six weeks but I got through that and then we has a 12 month breastfeeding journey.

“We planned Eden’s pregnancy but I was denied MGP because of my postpartum haemorrhage and my 3A tear. I scanned myself again but I didn’t want to find out the sex. In all my pregnancies I have a low placenta and I wanted to see where the placenta was and he just popped out. That was at 28 weeks. At my antenatal appointments I’d see the same midwife but occasionally I would also see the obstetrician. That same midwife wouldn’t be at my birth though so I made the decision at 27 weeks to hire a doula so I had continuity of care. The obstetrician told me I couldn’t have a water birth because they couldn’t monitor my perineum but I disregarded that because I knew water would be good for me.

“I had a trickle of waters so I started to get a bit worried about the clock. I didn’t call the hospital but I was in discussions with my doula – I knew to check my temperature, keep a really close eye on Eden’s movements. Three days later it was still trickling so I went to hospital for a check-up. They used a speculum to check that it was amniotic fluids and that was confirmed but they also told me that I wasn’t dilated at all. I had a wonderful obstetrician who was open to a discussion about what induction could look like. I was happy to have antibiotics and be admitted to do the cervical gel first. He was really happy with that. I was given my own room, Kieran came around that night and did a vaginal examination and I was 2 cm and he told me he could feel his head. That was really encouraging to me. I just relaxed, Kieran was happy not to do any gel so he was happy to leave me overnight and check on me in the morning.

“I got a good amount of sleep and I woke up at 1am with regular period pains. I couldn’t sleep from then on and it just got more intense. At around 7am I called my doula and she arrived soon after. I was in a rhythm; I would go to the toilet, bounce on the ball, lean over the bed and Dean would squeeze my hips. I had earphones in, I was in the zone, and I knew the midwife who was on which was really lovely. She told me it was time to go to the birth suite so I walked down the hallway, gripped the rail, but I could talk and laugh between each contraction. It was such a good labour – so different to the syntocinon. I could feel the contraction starting, then you’d have the contraction and then I got a big rest.

“I got to the birth suite at 9am and they were filling up the bath. It took me a while to adjust to the water and I felt something come away – it must have been the big bag of waters; the sac was hanging out of me. I knew low sounds were good for labour so my doula asked whether I wanted to use the gas to help keep my sounds low.

“I’ve listened to The Birth Class with Rhea Dempsey and I had that rest phase just before Eden was born. It’s amazing – it really doesn’t happen. Someone might look at me and think I’m exhausted and nothing is going to happen but I just rested and soon after I felt the ejection reflex. I wasn’t doing anything; his head was going out and in. Eden’s head and body was born at once and I was just euphoric; I was on such a hormonal high. They helped me get onto the bed, put a lovely warm blanket over me and we did delayed cord clamping and the placenta came out easily. I had a second degree tear which I was happy with.

“I had a hard postpartum; breastfeeding issues, not much sleep and a lot of mum rage. I really thought I was done and then I started considering another one and before long I was pregnant. I stopped scanning myself at 13 weeks because I really wanted to keep the sex a surprise. No one said anything about being excluded from MGP and I requested Bec and she was available.

“I went in for low foetal movement at 39 weeks because I didn’t feel like he was moving as well as he had been. Everything was fine and then four days later I had a trickle and the next day there was a big gush. I waited a day before I called MGP and I told her the fluid was clear and I felt well and she encouraged me to come in the following day. I had great experiences with the obstetricians during that week; they really gave me the confidence I needed. I should also note that the week before at an appointment with Bec, she told me he was posterior.

“I went in the following day for a CTG and she was a locum obstetrician and once again, she didn’t think I needed antibiotics and she thought I’d go into labour that night. This was Thursday and my waters had broken on Tuesday so we made a plan for the induction on Friday. I was going so well for the whole week but on Friday as we were driving to hospital I was feeling doubtful because I knew nothing was happening. Bec suggested doing a stretch and sweep and then she said we’d wait for a few hours to see if anything happened. I could feel tightenings but they weren’t painful.

“I resolved to the fact that I needed the drip and I just froze. I obviously had underlying trauma from Zoe’s birth and it really came up for me then. I was so fearful of the syntocinon and I didn’t want to do birth at all – I just wanted to walk out of there. Bec suggested an early epidural and it immediately took me out of that frozen space and I really felt like it was a positive plan. I knew that an epidural increased the risk of episiotomy and instrumental birth but I was happy with my decisions. The epidural was really smooth and everyone was so lovely. The only negative of the experience was that my blood pressure went down so in turn Micha’s heart rate went down. A team of obstetricians and midwives came in and they moved me to my side and it was all okay.

“I could feel my stomach tightening with each contraction but I didn’t have pain. Micah still wasn’t in a great position so every so often Dean and Bec would roll me from side to side and I had my leg resting over the peanut ball. At around 6:30pm I was 2 centimetres and Bec rolled me onto my left side and I facetimed the kids who were going to bed and chatted to my two best friends, too. Within about 40 minutes I could feel a lot of pressure in my bum and I asked Bec to check me…sure enough his head was right there. I was rolled onto my back but a bit upright. I knew how to push and I could feel the progress but no pain. I felt the relief of his head being born. It was amazing.

“I love birth and I have such fond memories of my second birth in the water. But a positive birth is when mum and bub are fine, and mum comes away thinking that was really good. I was involved in all those decisions and I felt really good about it.”

Topics Discussed

Breastfeeding, Epidural, gas+air, Induction, MGP, PROM, Three babies, Waterbirth

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