Maddy – Three vaginal births, MGP care, third-degree tear recovery

Maddy’s, a registered nurse working at Gosford Hospital on the Central Coast, shares her journey from teenage sweethearts to parents of three. Married to Ryan since 2019 after being together since they were 15, they planned their first pregnancy strategically around Maddie’s career progression. “I’d done my new grad year, the year before. I wanted to get that out the way and so then I could get my maternity leave as well,” Maddie explains, highlighting the practical considerations many healthcare workers face when planning families.

Conceiving quickly at 22, Maddy’s first pregnancy was marked by severe nausea and vomiting that bordered on hyperemesis gravidarum. “I was so sick. I was probably borderline having HG to be honest… I’d be vomiting in the side of medication trolley bins or it was just, it was not discreet at all.” Working 12-hour shifts whilst battling constant nausea, particularly during night shifts, required early disclosure to colleagues for safety reasons around medications and aggressive patients.

Choosing Midwifery Group Practice Care

Despite her medical background, Maddy admits she “didn’t really know a lot” about birth options initially. She chose the MGP blue group at Gosford Hospital, which offered continuity with six midwives rather than just two. “I went ahead and was lucky enough to get into that,” she reflects, though she initially felt overwhelmed by their low-intervention approach and expectation to go home four hours post-birth.

At 37 weeks, protein in Maddy’s urine and borderline pre-eclamptic symptoms led to induction discussions. A growth scan suggested a “really big baby,” though Maddy notes, “in hindsight they can’t really accurately tell how big your baby is, right?” The induction began with her cervix “long closed, nothing happening,” requiring multiple doses of prostaglandin gel over two days.

The insertion of an ARDS balloon catheter proved traumatic: “I’ve never experienced anything like that… I was in so much discomfort from that. I remember just having no control. I was just rolling around the bed. I was having back to back contractions. No break in between at all.” After the catheter was removed, Maddy had dilated only two centimetres, leading to an epidural at 3 AM when she began involuntarily pushing.

Bowie was born vaginally after a relatively short pushing phase, but complications quickly arose. “I had quite a large postpartum haemorrhage at that point. So I had 1.2 to 1.3 litres,” Maddy recalls, along with a third-degree tear requiring extensive repair. The registrar, Liz, offered to repair the tear in the room rather than theatre, saying, “after what you’ve been through overnight, I really don’t wanna separate you from your baby.”

Recovery and Reflection

The recovery was challenging both physically and emotionally. “I just felt so fragile. I felt so violated. I didn’t know why. I just felt like my whole body had just been violated,” Maddy shares. Her midwife Sam’s emotional response—”I’m just so sorry that you’ve had that experience”—validated Maddy’s feelings and secured her a private room for additional support.

Physiotherapy revealed the potential long-term implications: “the physio was like, oh, like with the tear that you’ve had, like you could be incontinent ongoing of faeces. And I was like, what? I’m like a 23-year-old woman, like I cannot be incontinent for the rest of my life.” However, with dedicated women’s health physiotherapy from three months postpartum, Maddie recovered well, feeling “a lot better” by nine to ten months.

Second Pregnancy: Advocating for Different Care

Discovering her second pregnancy just after Bowie’s first birthday, Maddy’s immediate concern was avoiding another severe tear. She initially consulted a private obstetrician who was supportive of vaginal birth but realistic about risks: “baby’s been through there before. It’ll be different this time, but you do have scar tissue there and it is likely that if you do tear, you could tear to that point or worse.”

When MGP accepted her back, a hospital obstetrician took a different approach, immediately recommending caesarean section: “you’ve had quite a substantial tear. You’ve had pre-eclampsia, so you’ll be having a C-section because that’s the safest thing for you and the safest thing for your baby.” Maddy’s response was firm: “I’m not silly, like I’m not a silly person. I’m a registered nurse… I know that you know how you’re delivering it isn’t right.”

Second Birth: Healing Through Empowerment

Maddy’s preparation for Florence’s birth was meticulous, creating detailed birth preferences focused on protecting her space and avoiding unnecessary interventions. After three nights of prodromal labour, a stretch and sweep from midwife Kate—who claimed to have “magic fingers”—triggered active labour.

The birth was transformative: “it was like this dark room with fairy lights around the bath… it was just the most amazing space, like for a hospital.” Florence was born in a controlled manner with warm compresses and careful perineal support, resulting in only a second-degree tear. “I was like, I’m fine with that. Like I’ll have that any day of the week,” Maddie reflects.

The recovery was dramatically different: “I literally got up, I had a shower… I walked wheeled her back in the bassinet to the ward. I was like, this is crazy. I feel so good.” This experience was healing not just for Maddy but for her support team: “for all of us, I think it was, yeah, very healing Florence’s birth.”

Third Pregnancy and Birth: Navigating Grief and Joy

Maddy’s third pregnancy occurred during a difficult period following her father-in-law’s death. At 39 weeks and two days, her waters broke, creating anxiety about being “on the clock” when her body didn’t feel ready for labour. After 48 hours without spontaneous labour, she negotiated with doctors for oral antibiotics and an additional 24 hours rather than immediate induction.

“I was like, I have to go into labour today. Like this is it,” Maddie recalls of her final day before the induction deadline. Curb walking and breast pumping helped trigger contractions, leading to Lennox’s birth at 4 AM. Though he was initially flat and required resuscitation, he recovered well. The birth was particularly poignant given the recent loss: “having a boy was like, yeah, very full circle moment for us.”

Maddy’s journey demonstrates that birth trauma doesn’t define future births. Her story offers hope to those who’ve experienced difficult first births, showing how subsequent pregnancies can provide opportunities for healing and empowerment. The contrast between her medicalised first birth and her subsequent births illustrates the profound impact of care provider choice and birth environment.

Her experience also highlights the importance of:

• Trusting your instincts about care providers
• The value of continuity of care
• How professional knowledge can aid advocacy
• The healing potential of positive birth experiences
• The importance of processing and debriefing difficult births

Breastfeeding and Postpartum Experiences

Maddy successfully breastfed all three children, though each presented unique challenges. With Bowie, initial latch difficulties and nipple damage required support, but she persevered for nearly two years. Florence had a suspected tongue tie that resolved naturally, whilst Lennox required blood sugar monitoring due to his size (4.16kg) but fed well from the start.

The transition to three children brought new challenges: “I feel like that’s my life since it’s like being pulled in three directions, like different needs and just feeling like you just don’t meet them all.” Maddy’s honest reflection on the realities of managing multiple young children whilst maintaining friendships and family relationships will resonate with many parents navigating similar transitions.