I fell asleep at several points in the water / Kate

I found out I was pregnant just after my niece Scarlett was born. It’s crazy to think when I met her I had a baby inside me and didn’t know it yet!  She was two weeks old when those two pink lines appeared on the pregnancy test. After seeing my baby’s little heartbeat at our dating scan, I immediately applied for the Family Birth Centre. I was nine weeks pregnant and midwifery-led care was a huge priority for me as I wanted a continuity of care model with no unnecessary intervention. I also booked my partner Bret and I into Hypnobirthing classes with my sister Renee at The Birth Space. Now I had got the two most important things scheduled in, I just had to get through the rough first trimester of morning sickness, dizziness and fatigue. I could not prepare myself for the morning sickness – and hats off to anyone who has battled HG, I don’t know how you do it. The nausea saw me spend most days, until week 17, bedridden, living off white bread and crackers – even water made me throw up. At 20 weeks we had our anatomy scan, which we planned on being our last scan for the pregnancy. The sonographer told us everything was fine and we never gave the scan a second thought.

We both met my FBC midwife at 16 weeks. I went alone to the next appointment at 24 weeks. Bret was at work. I’d told him not to come as it was just a routine check up. When I arrived my midwife started telling me I needed to get another scan immediately to check the issue with my baby’s brain. What issue? I was shocked and had no idea what she was talking about. It turns out they thought our baby had ventriculomegaly. Due to a communication breakdown, no one had told us. Ventriculomegaly is when a baby’s brain ventricles are larger than they’re supposed to be, and in some cases there’s extra fluid on the brain. It can lead to developmental delays or severe intellectual disabilities. I was texting Bret, my mum and my sister, “something might be wrong with the baby’s brain”. But I somehow managed to remain calm. “Everything will be fine”, I told myself as I sat in the ultrasound alone and watched the sonographer measure my baby’s ventricles. They were still larger than they were supposed to be. My midwife ran through what the outcome could be – but I would need another scan to check my baby’s brain. I was then taken to a doctor’s office where the doctor handed me a box of tissues and told me I could “cry if I wanted to”. But I wasn’t upset. Nothing had been confirmed, my NIPT from weeks earlier had shown no abnormalities and I was confident everything would be ok. For a usually anxious person, pregnancy had made me so calm and positive – I was sure my baby would be healthy. We’d also just started our Hypnobirthing classes around this time and had been manifesting a positive birth with an affirmation board I made, and weekly practice of the Hypnobirthing techniques. This helped us immensely, as after the scan that day, every night we would manifest a healthy baby. Both Bret and I would rub my belly and talk to the baby. I declined an amniocentesis, but did have a TORCH screening to check for any infections in the baby, which came back clear. And then our next scan at 27 weeks came around. Bret was by my side, holding my hand as we watched the ultrasound screen. We saw the line as the sonographer measured the ventricles and breathed a sigh of relief as they had shrunk. There was nothing wrong with our baby! I wrote in my birth journal that day “we had our ultrasound today and everything is fine! I knew you would be ok!” We had crossed that hurdle and could go back to our low risk, birth centre pregnancy. Until we faced another hurdle. We went straight to our midwife appointment after the scan where the good news was confirmed, there’s nothing wrong with our baby’s brain, but the baby might be on the larger size, given Bret was over 4kg when he was born, this wasn’t a surprise. The abdomen was measuring in the 99th percentile. We would need fortnightly scans to monitor our bub’s growth. Babies suspected to be over the 90th percentile were ruled out of the birth centre. Again, I didn’t stress. We went back to manifesting. I would tell the baby “grow big and strong, but please be average-size”, and Bret would joke back “my baby’s not average! He/she is above average!”

Unfortunately the next two growth scans at 30 and 34 weeks showed the baby was still measuring in the 99th percentile. We were told we couldn’t have the baby at the FBC because of the risk of shoulder dystocia. At this point we’d completed our Hypnobirthing classes and we had learnt we can ask questions, and to use the B.R.A.I.N method to choose a path we were comfortable with. We also knew that a suspected big baby is not always a medical issue. I asked to speak to someone at the hospital higher up, to get approval to stay at the FBC. My baby was apparently big – so what? I knew my body wouldn’t grow a baby it couldn’t birth. I could totally do this! My midwife agreed and was very supportive of the birth I wanted, so she arranged for Bret and I to meet with a consulting obstetrician at King Edward Memorial Hospital.  Thank goodness I had Renee as she pointed me in the right direction of the evidence so I could discuss it during the meeting. Renee’s blog on big babies and Dr Rachel Reed’s were my go-to as they included links to studies that showed the potential risks of a macrosomic baby. RANZCOG guidelines also noted that 48% of shoulder dystocia cases occur in babies less than 4kg and early induction of labour for women with a suspected large baby, who do not have gestational diabetes, does not improve maternal or fetal outcome. We also pointed out that had we not had the suspected ventriculomegaly, the 20 week scan would have been my last one, and we would never have known my baby’s suspected size. The obstetrician agreed with the information, yet because of hospital policy he had to advise we book in a caesarean at 38 weeks, or set a date to be induced. After going through the risks and benefits of all options, we decided to  decline an induction or caesarean and voiced my preference to birth at the FBC with my midwife. The OB agreed I could stay there, but said I’d need fortnightly scans. I asked if I could decline the scans but he advised if I didn’t do the fortnightly scans then I would automatically become a hospital patient. Following each scan I would then have to meet with the OB to discuss my birth plan for the next two weeks. Basically where I would be birthing was in limbo as they wouldn’t confirm if I could stay at the FBC more than two weeks in advance. I felt like the hospital was trying to make me into a high-risk pregnancy, when there was nothing wrong with me or the baby at the time.  

After this appointment, at 34 weeks I frantically started calling independent midwives to see if they had space for a home birth. But the home birth model of care is so popular that most were booked out until August – our baby was due in March. We did meet with one midwife but ultimately I made the decision to stay with my FBC midwife as I’d formed a relationship with her and trusted her . It meant the last six weeks of my pregnancy were physically and mentally exhausting. I had to go to these scans I didn’t want to go to, and then meet with an obstetrician who agreed with the evidence but his hands were tied by hospital policy. I would leave these two-hour meetings exhausted from having to fight for my birth every fortnight. I lost count of the number of scans we had and they all showed the same thing – bub was in the 99th percentile, I didn’t see why continuing with the scans would change anything! At 38 weeks I was told if I went into spontaneous labour before 40 weeks, then I could birth at the FBC. I found this extremely stressful as it meant I was desperately trying to naturally induce labour, knowing full well my baby would come when it wanted to (and when mumma was not feeling stressed!) I tried everything, eating eight dates a day, taking raspberry leaf tea capsules, bouncing on a fitball, getting foot massages, weekly acupuncture and chiropractic care.

At 39+5, which was a Tuesday, we had another scan. Three different sonographers did scans and came up with three different measurements, which just shows how inaccurate scans are. They decided to go with the largest measurements which estimated a birth weight of 4.7kg. Straight after the scan the obstetrician confirmed I had one day to give birth, because from Thursday I would be 40 weeks and be moved to the hospital. It was upsetting, but unsurprising news as we had spent the past two months in limbo, with them trying to control our birth. We had prepared for this, and thanks to Hypnobirthing we had written up our birth preferences should we be moved to the hospital. In that final meeting we went through those preferences with the obstetrician, who unfortunately was still using scare tactics to persuade me to book a caesarean or induction. He told me the baby would just keep growing and if I go into spontaneous labour my “baby might die”. We discussed a physiological third stage, where he told me he doesn’t recommend it, as I could “bleed out and die”. He tried to book me in to be induced which I declined. He said “so when will you be induced? At 41 weeks? At 42 weeks? If you don’t get induced your baby could die”. I lost count of the amount of times he said my baby or me might die. The language was so negative. My baby was referred to as “huge” numerous times and a lot of pressure was put on me to adhere to what the hospital wanted, not what I wanted.  When I asked the obstetrician for the perinatal death rate for shoulder dystocia and he didn’t know it!  I asked him how many babies he had helped deliver, “over a thousand”, he told me. He said he had been at many births that had cases of shoulder dystocia, but no mother or baby had died. Despite that I specifically remember him telling me my baby could get stuck and die. The statistics were on our side, but the system was not. I had found the WA perinatal death statistics for shoulder dystocia on the Health Dept website which confirmed a negative outcome was extremely low so I was happy with my decision to wait for spontaneous labour. I managed to get most of my birth preferences written in my hospital file and the obstetrician was supportive of our wishes for a calm atmosphere, to labour in a birth pool, have delayed cord clamping and to only have my FBC midwife in attendance if my labour was progressing well. Yet he also included notes that I would only be allowed to push for one hour, and a hospital obstetrician would check me every four hours, possibly to offer intervention. I left the meeting feeling exhausted and mentally drained.

That night, just hours after the meeting, I started feeling strong cramps so I went to the beach and walked on sand dunes, which helped to intensify them. I managed to get two bouts of a one-hour sleep overnight, but otherwise I was awake. The next day, the Wednesday, the cramps subsided. I was only getting them two or three times an hour and felt it all in my back. Despite being anterior for 9 months, my baby decided to turn posterior. I had read up on posterior births and knew it would be more painful than a standard birth, but I was in a great mindset and was prepared. Renee came over and we did some OMP exercises, and I downloaded the Baby Come Out track. This was really calming and I fell asleep on the couch listening to it.

Towards the afternoon the cramps intensified and I texted Bret at work and said “I think I’m in labour, we are going to have our baby tonight or tomorrow”.

I went to the beach to walk on sand dunes again and then when Bret got home we did kerb walking, up and down our street, in the dark. I had to stop every few minutes as the surges would stop me in my tracks. I called my midwife when we got home and explained to her what was happening, but she said labour could still be days or even weeks away, so to try get some sleep. I remember thinking how can I sleep, the surges felt pretty strong. We started timing them on a contraction app. They would last for 50 seconds and were coming sporadically, sometimes every three minutes and then every six minutes. Every now and then when the surges were close the app would say ‘go to the hospital’ but my intention was to labour at home as long as possible as we lived quite close. I lost some blood and fluid about 9pm and wasn’t sure if my waters had broken so we went into the FBC to meet my midwife. My waters had not broken, it was my mucus plug. My midwife reminded us that from midnight I would have to birth in the hospital. That was just over three hours away. She told me to go home and rest until it got more intense. I remember thinking “why does she keep telling me to rest, how can anyone sleep through these surges!”

At home I told Bret to go to sleep because I knew we might be in for a long few days. While he slept I used the shower and bath as pain relief. When Bret woke up the next day it was our estimated due date – Thursday 18 March. And I was officially a hospital patient. Despite being in labour, and my surges coming closer together, Bret had to leave to pick up the birth pool that we hired last minute the night before. When he got home we got into full-on labour mode. Bret covered the windows with alfoil and closed blinds so I could labour in the dark, we put on music and I sprayed clary sage.  We learnt from our hypnobirthing classes that we needed to cultivate a safe space to help my labour progress. As my baby was still posterior and I was feeling all the pain in my back, we tried some OMP and rebozo methods we learned in Hypnobirthing to turn the baby. I bounced on my fitball and moved my hips, trying everything I could to turn my baby. I texted my midwife to let her know I was pretty sure I was in labour and told her the techniques we were trying at home. I never heard back from her, so part of me was thinking ‘maybe this isn’t active labour otherwise she would have called.’

I just wasn’t confident that I was in labour though as it was my first time, I had no clue what it was meant to feel like. I kept telling myself that I was still in the early stages and things would get stronger later, even though the surges felt pretty strong already! I didn’t want to think I was close in case I wasn’t, as I think that would have really set me back mentally. In hindsight I’d actually been in active labour since the day before!

We barely left our bedroom all day. I used the Tens machine on my back while smelling clary sage. Then I’d hop in the hot shower. I stood in the shower, lied on the shower floor and sat on the fitball in the shower. Then I would get out and Bret would do light touch massage while we listened to Surge of the Sea. Then I would start again with the Tens machine. I liked having the routine, and I really liked listening to the tracks because it would remind me to breathe properly.

We had been practising these techniques weekly and then nightly in the lead up to our due date so it was pretty easy to know exactly what we needed to do, it was like we were on auto pilot.

The hot shower was amazing to deal with the pressure I was getting, I stood in there for so long, I’m still nervous to see our water bill.

At 6pm Bret was helping me walk from the bed to the shower when I felt massive pressure in my pelvis and then splash! There was a lot of fluid, just like the movies and it was very obvious what had just happened! That is when I thought this is it! My body just did that, my baby is on the way! Bret called the midwife while I got in the shower. My midwife was in another birth, which is why she had never replied to my text earlier that day, so my back up midwife answered. She said she would meet us at the hospital in an hour to check me. Bret packed the car with the birth pool, my affirmation board, our candles and lights, and our hospital bag.

Due to all the pain being in my lower back and tailbone pain (and the fact I was in labour), I couldn’t sit comfortably in the front seat so I was on all fours in the back of the car, leaning on the baby seat. When we got to KEMH at 7pm we left all our things in the car because part of me was still skeptical, thinking that I might get sent home if I hadn’t dilated enough. Who was I kidding, we started timing my contractions again after my waters broke and they were lasting a minute long and coming every 1 to 2 minutes. I had in my birth plan that I didn’t want to know how dilated I was, so I knew the midwife wouldn’t tell me. However after she checked me she turned to Bret and said “go get the birth pool from the car, we need to fill it up”. I remember thinking “I must be close, she wouldn’t want the pool filled up unless I was close!” (I later found out, I was already 8cm!) I got straight in the shower while Bret and my midwife set up the room with our candles and filled up the pool. While I was labouring in the shower my student midwife arrived.

Once the pool was set up I laboured in there for a few hours. It was exactly what I needed. At that point I had been up for two nights, and labouring on my feet for most of that. The feeling of being weightless in water was an instant relief, so much so that I fell asleep at several points in the water. Bret held my hand and he’d tell me affirmations that we had written down. Then my student midwife would jump in his place and she would do the same thing. I have a beautiful memory of her looking in my eyes saying “You can do this, you’re going to meet your baby soon”.

The pool started to get cold so I went back to the shower while more hot water was put in the pool. I just could not get comfortable in the shower. My legs felt like they were going to collapse. I was throwing up. I can not describe the level of exhaustion, from several days of no sleep, and hours of active labour, with a posterior baby. I tried lying over a fitball and that didn’t work, I tried sitting on it but my tailbone and pelvis pain was too strong to sit. Bret helped by applying the acupressure techniques we learnt in our Hypnobirthing class. I used my breath to visualise my baby moving down the birth canal. My hospital notes say “Kate vocalising++” so apologies to anyone on the ward that night who heard me. I was using gas as pain relief, which I’m not sure did anything to help, but was good to use as I concentrated on my breathing in and breathing out. It was a slow and long labour.

The next time I hopped back in the pool, I had the urge to push, it was my body’s natural instinct but I was so scared. In my head I was saying “I don’t want to push, I don’t want my baby to get stuck and die”. (I thought I was saying this to myself, but I found out afterwards that I was saying this out loud). The meeting with the obstetrician had been just two days earlier and his words were in my head, and I was so scared something would happen to my baby. For over an hour my body tried to push while my head wrestled with this. In hindsight I am so angry that I spent my whole pregnancy feeling so positive and excited for birth, only to have the doctor’s horrible words in my head when I was so close to meeting my baby.

At this point I was “on the clock” because of my suspected big baby, and the fact I was at the hospital and not the birth centre. I got on the bed so my midwife could examine me. I was fully dilated! I had done all the hard work of labour! I started to visualise my baby moving down the birth canal but then she told me the words I didn’t want to hear: my baby was still posterior and hadn’t descended. After some time, the baby still had not come down so the decision was made to have an epidural to see if the rest would help baby descend, and if need be, they could manually move the baby. It was disheartening to hear after all that hard work, but I trusted my midwife and knew I was in good hands.

Because I’d done my entire labour drug-free and was fully dilated, the epidural had to be strong, to ensure it worked this late in the game, so it meant I was now bedridden and unable to use the pool. Almost straight after the epidural was administered my baby’s heart rate dropped. My midwife came next to me and said “I have to push this button now and lots of people are going to come running in, but don’t worry you and your baby are ok”. I never once felt scared in her care. She pushed the button and half a dozen people ran in. The obstetrician confirmed due to the baby’s position, the baby still hadn’t rotated or descended, she said she would give us a couple of minutes to see if the baby’s heart rate went up before intervening, and thankfully it did. However, she reiterated that because my baby was big I was only allowed an hour to push and if the baby hadn’t moved then I might need a caesarean. The hospital staff left the room and it was just my midwife, student midwife and Bret again. I managed to push for a couple of hours before the obstetrician came back and confirmed my baby hadn’t moved and was still posterior. She said I would need to go up to theatre to try and manually turn the baby and if that failed, have an emergency caesarean. This was disheartening to hear, but I felt calm, in control and prepared.

I put my headphones in and listened to my Hypnobirthing tracks as I was wheeled up to theatre, so I could stay in my calm mindset and then in theatre we asked the obstetrician if we could put our music on a speaker and he said “of course”. He was so supportive of the calm birth we wanted.

The Obstetrician said “I’ll try with the forceps first and then we can do a caesarean if that fails.” I could not feel a thing as he put the forceps inside me, as everyone in the room was saying “push, push’, including Bret who I was looking at me and was saying “you can do it, push.”  The obstetrician asked if they could do a small cut to help. An episiotomy was not something I wanted as I would have preferred to tear naturally but I said yes as I wanted my baby out, however I was convinced my birth would end in caesarean. Two contractions later, although it felt like just seconds, the obstetrician suddenly placed my baby onto my chest. After months spent dreaming of meeting my baby, she was finally here. Seeing and holding her for the first time was exactly how I imagined it to be, I instantly fell in love.

Bret and I were both so shocked our baby had just been born in what felt like a matter of seconds after days of labour, that we didn’t even check the gender until someone reminded us to. That’s when we saw we had a baby girl. The obstetrician then handed Bret the scissors and told him to cut the cord, but I put my hand up and said “no! We’re doing delayed cord clamping!” All the staff then waited in theatre for six minutes, and then Bret cut the cord. I was later told by one of the midwives it was the longest delayed cord clamping in theatre she had ever seen.

I cuddled my baby while I was stitched and by the time we left theatre my baby had started to crawl up to my breast and feed. I had three hours of uninterrupted skin-to-skin before my midwife came into my room to weigh and measure her.

Sunny Odette was born at 3.34am on the 19th of March, just a few hours after her EDD. She was 52cm long and 4.23kg, still a large baby but nowhere near what they were telling me – and well within the Family Birth Centre guidelines so I could have laboured there after all. And despite the numerous meetings with the hospital, she never got stuck. I’m not sure how long I was in active labour for but my labour started on the Tuesday night and she was earthside by Friday morning. My hospital notes say I pushed for 4 hours and 23 minutes.

We left hospital the next day and had daily visits from my midwife and student midwife in the comfort of our home which was amazing. They checked Sunny and I, showed us how to use baby carriers, how to bath her, helped me with breastfeeding and chatted about my birth.

I am so proud of myself. I did it! I birthed on my own terms. They wanted to classify me as high risk, but I refused to be a high-risk birth because a big baby is not a medical issue. Birth is not just one day. Nearly three months on I think about my birth and I tell everyone I see about it. I can’t believe I did that! I birthed my beautiful girl after a very long, painful posterior labour. And I can’t wait to do it again! My birth was everything I hoped it would be: positive, empowering and life-changing. I recently had a debrief meeting with the consulting obstetrician so I was able to go through my birth notes with him to see how everything progressed. He said because of Sunny’s birth I am a great candidate for a home birth next time.