People either think you are really mad or really lucky to be a midwife, I’ll go with the latter. Being a midwife is a privilege, I love my job. I don’t always love the place I do my job; a lack of resources and investment in services make it far from ideal. But it’s the same in most areas of health care in Ireland and we do the best we can to try to make maternity care a positive experience for women. So I’m the midwife… until I’m the woman in labour! Here is my birth story.
The midwife birth story. Going by my history (read here), I didn’t expect things to be plain sailing. Add to this my fairly big bump, that always measured 2 weeks bigger than my gestation, and the fact that I was 10 days past my due date. I didn’t have a written birth plan, it’s not that I disagree with them but I’ve seen so many perfect birth plans and the actual event rarely comes close to them. I did know exactly what I did and did not want. I did want to stay mobile, I would eat and drink as I liked, I wanted to keep options open around pain relief but avoid epidural if possible, I did want skin to skin with my baby and I did want to go home 6 hours after delivery. Then the things I didn’t want – no induction of labour unless I got to 42 weeks (unlikely given the size of me), no CTG monitor unless clinically indicated, no IV cannulas, no lying down on my back and no ARM (breaking my waters). None of this was written anywhere, it was all in my head and my husband had heard it all on a few occasions.
The last antenatal appointment I had was at 41 weeks gestation with a consultant obstetrician, I had declined a membrane sweep at 40 weeks so decided to accept one at 41 weeks to see if there was any sign of anything. She examined me and told me I was 3cm dilated, she could easily break my waters if she wanted and that it was likely I would go into labour in the next few days. The head was still high but just about engaged. She did a membrane sweep which I didn’t find uncomfortable at all. Happy days, I think antenatal expressing of colostrum (read here) helped make my cervix favourable. The obstetrician wanted to bring me in for induction of labour in 3 days but I declined so after some negotiation I was to have scans over the weekend and come in the Monday (at 42 weeks gestation) for induction. Not that it was likely I’d be still hanging around that long.
At 9 days past my due date (2 days after my membrane sweep), things started around lunch time. Just a few niggles but I knew this was probably it. I ignored the tightenings which were only about every 30 minutes and very mild. I went for a walk and had lunch with my mother – I didn’t mention what was happening, the excitement would have been too much for her! I then went home for a rest as I knew it might be a long night. When my husband came home at 6pm, we had a visitor so I couldn’t say anything even though the tightenings were now every 15 minutes and enough to make me feel uncomfortable. So around 7pm, we had the place to ourselves and I mentioned to himself to maybe just have everything ready at the door for later, god love him, he didn’t know what to do with himself. I went between the birthing ball, standing over the bed and the bath. It was all good, I felt in control and knew things were moving along as they should. In my head, I wasn’t going near the hospital until after midnight and until absolutely necessary. So around 11.30pm, I checked my own cervix (I know, I know but there was no way I was going to the hospital until I was at least 4cm). So I was 3-4cm dilated in my estimation but I could feel bulging membranes and couldn’t feel the baby’s head. This may have been because it was difficult to stretch to do the examination especially with my huge bump to negotiate around. Anyway, I didn’t want to take the chance of my waters breaking and a cord prolapse if the head was high. So I gave my colleagues on labour ward a call to tell them we were on the way in.
The 30 minute car journey was very uncomfortable but I encouraged himself to take it easy, there was no panic. It helped that it was after midnight on a Wednesday night so the roads were empty. Landed in and had the whole labour ward to myself which was great. My colleagues were fantastic, just let me do my own thing. I was examined around 1am and found to be 4cm, almost fully effaced with regular contractions (3-4 in 10 minutes) and bulging membranes so they offered to break my waters but I declined. I wanted to go with the flow. I started on the entonox (gas and air), it was so strange to be standing there in my nightdress in front of my colleagues puffing on the entonox. Surreal. I didn’t feel it made any difference to the discomfort but I couldn’t put it down just in case it was helping and it was worse without it.
The time flew, I couldn’t really chat. I stayed mobile as much as possible to try to get the baby’s head down. Plenty of rocking the hips. I decided that I needed more pain relief around 4am so they gave me pethidine. I never liked the thought of pethidine when working as a midwife, I felt it made people really “out of it”. But personally, I found it fantastic. I don’t know if I just took it at the right time for me but I really got a great rest, I lay down on my side and dozed between pains. I continued with the entonox also. At 5am I was examined again and this time I was 7cm dilated and fully effaced. Again, they offered to break my waters so I agreed – maybe it was the pethidine! Things really ramped up then, I felt I had to get out of the bed immediately, there was so much pressure. In hindsight, I think it was a combination of the waters going and the head coming down quickly. And the sensation of the warm liquor leaking out continuously is very disconcerting. It feels like you are wetting yourself and it feels like there’s about 10 litres of it in there! The urge to push at every contraction was overwhelming. I could feel myself pushing without ever deciding to.
This is when my birth plan went out the window! “Get me an epidural now” actually came out of my mouth. After some wise words from my midwife, I kept going without an epidural and stuck with the plan in my head. I could do it. I was walking and swaying and doing my own little dance with each pain and I knew I was coming close. I could hear the midwife saying the stuff I say to women that I know are in transition (coming up to 10cm and nearly ready to push – this is when most people lose control). I worked through each pain telling myself that’s another one off the list and I can do anything for one minute (about the length of each contraction). I let each one build and fade away, I was in my own world. I shouted that I was going to split in two any minute – to which the midwife calmly replied “well I’ve never seen that happen to anyone before”. It even made me laugh.
At around 6.30am, I decided if I wasn’t fully dilated I was getting an epidural so I asked the midwife to examine me and I was fully dilated. At this stage, they would have liked me to stay on the bed while pushing to see what was happening but I just couldn’t get comfortable on my back or even my side. So out of the bed I went, standing up, leaning on my husband, still feeling like I was about to split in two as I pushed with every pain. I could hear myself moaning like it was someone else.
After about half an hour my legs were tired so I kneeled up on the bed. The pressure with each push was so intense, I felt myself trying to hold back but my body just got on with it despite my brain saying “just stop for a minute”. The next thing I heard was “I can see the head”, yeah right I thought, imagining the tiniest bit visible and then disappearing as soon as each contraction finished. I was waiting for the crowning sensation but it all happened so quick, at 7.12am he was out in one big push. I was still up on my knees so the midwife handed him straight to me through my legs. I remember thinking “where did you come from?” and “he doesn’t look as big as I thought he would be” and “wow, I have just had a baby”. I turned myself around and took him all in, every perfect little bit of him. He cried for a few seconds then settled in skin to skin.
When they put him on the scales later, he weighed 10lb 3oz. That was a bit of a shocker to be honest. I know my bump was fairly big and I thought he would be big – as in 8lb or 9lb. My colleagues often joked that I’d end up with a 10 pounder not thinking it would actually happen.
I don’t remember the placenta coming out, I do remember a bit of a panic over me bleeding, a few unsuccessful attempts to get an IV line into one of my hands, a doctor coming to do suturing, bloods being taken but I didn’t care what they had to do. I had my perfect baby right there, the rest was just background noise.
So as far as my birth plan in my head went, I couldn’t have asked for more! I just couldn’t get my 6 hour discharge home because of the blood loss but I did get home the next day – there was no way they were keeping me. So that is my midwife birth story; I may not have had a easy time getting pregnant and I may have made a mess of breastfeeding (see here) but I did get my dream delivery and an insight into what it’s like to be on the other side of labour ward. I would like to think it will make me a better midwife too.