June 25, 2021

My Labor and Delivery Story

Now, if there is one thing I want any man or woman to get out of this blog post, it would be to feel more empowered heading into the birth of their child. It doesn't matter if this is your first baby or your fourth - everyone experiences pregnancy, birth, and parenting in diverse ways. Mother or father to the child, your experience will differ. I am sure my partner remembers things about the birth of our baby, that I simply would not recollect. It's essential to note that all fears are different, yet universal. It's okay to be apprehensive, afraid, excited, overwhelmed - or a messy combination of all these feelings. You are not alone. So let's talk about my labor and delivery as a first-time mother. 

My labor and delivery journey began much earlier than I would have wished. It was 10 pm one evening in February 2021, when I started to sense something I hadn't felt for the entire pregnancy to date. They were tightenings. I'd encountered loads of Braxton-Hicks contractions up until this point, but this was something offbeat and I could feel it. The tightenings were gradually maturing into more intense versions of the same as time passed, and I stopped being able to hold a conversation with my fiance through a few of them too. We started timing. One in fifteen, one in ten, one in seven, one in five. Something just wasn't right. Of course, I had the thought "Is this labor?" - but surely it couldn't be right? I was only 30 weeks pregnant at the time. So, in a frantic mess, we seized our 'hospital bags' (which were only half-packed), chucked them in the car, and traveled to hospital. 

After some expeditious assessments by the midwife; a doctor soon followed. We completed the works - CTG monitoring, my vitals, full history, examination, and much-dreaded speculum exam (god I hate those things so much, anyone else?). We discussed a test called Actim Partus, which I'd only really been familiar with because of my eight-week rotation in obstetrics in medical school a few years back. For those of you who are reading this and have zero ideas of what this is, let me try and explain it (keep in mind I am not an obstetrician). Actim Partus is a bedside investigation that involves a cervical swab (so yes, a speculum examination, unfortunately) and is used to detect the risk of preterm delivery. For those who love that bit of extra detail (especially my medical mums out there), the test aims to detect monoclonal antibodies that bind with phIGFBP-1. This is a phosphorylated (the addition of a phosphate group to the compound) form of insulin-like growth factor binding protein-1, which is a hormone produced by one of the layers of the uterus (the decidua). During preterm labor, phIGFBP-1 leaks into the cervix due to the detachment of the decidua from the chorion (fetal membrane). A negative result (with a very high predictive value) means that you are extremely unlikely to deliver in the coming two weeks. A positive result means there is disruption of the choriodecidual layers, which is a reason to be concerned about preterm delivery. So in a very long-winded kind of way, I have gone into depth about this test because mine was positive. 

Shock washed over me like a tidal swell; each one drowning out the senses more and more. I just panicked, no two ways about it. The medical team was wonderful, promptly commenced Nifedipine to (hopefully) prevent the contractions I was having and pain relief. I was also given a steroid injection to support the development of my unborn baby's lungs just that bit quicker, in preparation for an unexpected welcome to the outside world. And of course, all of this meant hospital admission. The long and the short of it is this… We did not deliver that truly terrifying week, and we didn't deliver the week after. I was sent home on bed rest and requiring abrupt leave from work to commence early maternity leave. This in itself was majorly stressful; needing to secure time off, project finances, and communicate all this with seniors in my department. I was told that the plausible reason I went into "threatened preterm labor" (as it was officially labeled), was because: (1) I had just come off 4 days of back-to-back overnight shifts in ED (2) I had concurrent pyelonephritis (kidney infection) stemming from a UTI (urinary tract infection) the week previous. No baby came in those few weeks of hospital visits. Instead, we yo-yo'd week to week, with intermittent contractions here and there and a whole heap of worry. Thankfully, we reached 38 weeks successfully keeping bub at bay, and looking back on this I could not be more grateful. The interventions worked, and we had our baby at term. 

Sunday 4th April 2021, I was ever so casually waking up for the morning. You know that birds-nest top bun, one-eye open, zero glamour, 38 weeks pregnant waddling catastrophe type morning look? Yeah, that was me shuffling off to the bathroom twice in 20 minutes. I did have this fleeting idea, "Did I legitimately pee myself?". In my insomniac-sleep-deprivation state, I dismissed it and went back to bed. But if you fast forward one hour we were up, preparing to go to a farewell lunch - as my sister was moving to Perth the very next day. But as I tried to gather myself and look somewhat decent enough to be seen publically, I was continuing to have this leakage despite sitting or standing. That's when it hit me, it was my waters breaking. This time I did not want to be caught with a half-packed hospital bag and no toothbrush, so we thought ahead and packed it all in the car and went to the farewell lunch. I didn't eat a whole bunch, as I feeling rather squeamish. Most of the table remarked on how I looked even creamier than my normal pasty self. I wanted to see if contractions started spontaneously but since my waters broke that morning, nothing had happened. After three or so contraction-less hours, we decided it was time to get checked out.

At the time I was coming down with a cold (brilliant timing, I know) and so my time through the pregnancy assessment center seemed to dwindle on forever, as I required a swab and to be placed in a droplet precaution room. Finally, the doctor arrives with some marvelous and terrifying news. That leaking I felt, was indeed my waters and now we were on a timer to get our baby delivered. The decision was made to admit me to the birth suite. However, there was one small issue. And by small, I mean not a single birth suite available for me to deliver in. I was encouraged to head home for some much-needed rest and to anticipate a phone call from the hospital letting us know when a suite became available. So we did just that. By the time we got home and crawled into bed, it was 12.30 am on Monday 5th April. The next time I opened my eyes, my fiance was standing over the top of me waving his hands to wake me up. I finally came to, blinded by the intense aloft lights and slight derangement. "It's time, they have a room," he says to me, with a smile. I looked at the clock thinking that the cosmos had imparted me with a semi-decent sleep before subscribing to this marathon they call labor. We dragged ourselves back to the hospital, at 2 am. 

As we followed the midwife, I found myself zoning out - gazing at each birth suite door as we approached them. Door after door, soon-to-be parents' names scribbled on signage in black marker. Some doors barely kept the howling at bay which only heightened my nerves, while other rooms settled in the quiet of the night. We were given a swift tour, and I was asked to put a gown on and make myself comfortable on the bed. Cannula went in, we discussed my birth plan and preferences with our delightful midwife, and before I knew it I was on 8mls of syntocinon. I honestly had no notion of what to expect from here. Would the contractions come on hard and fast? Would it be a gradual transition? How much would I be able to endure before I needed something to take the edge off? I am confident that I am not the only mother who fretted about these things, especially when it's your first delivery.

In the first hour after the IV was established, I was capable of participating in my fiance's vlog escapades as he gallivanted around the room documenting everything but the toilet seat. Admittedly, I still watch these videos at three months postpartum and they bring me so much joy. I still laugh seeing my mum all tucked up in a jacket, chilling out in a recliner chair like she was on holiday by the poolside. However, it wasn't long before I was started to feel the effects of regular mild contractions. As part of my birth plan, I desired to remain as mobile as possible. I opted for positions that would assist gravity, such as kneeling or walking around the room. Even standing and swaying side to side helped… for a little while. As the pain began to escalate, I needed to find a way to sit comfortably. I found the best way to manage this was on a birthing ball at the side of the bed. I used a pillow under my chest and arms and leaned into the bed for support. I would occasionally bounce on the ball; but during a good-going contraction, I needed to pause and breathe my way through it. Heat packs became my best friend and we found a way to keep them on too - tucking them underneath the CTG band. It's here I started to lose focus on everything around me. I could no longer happily participate in the vlog content or hold much conversation with anyone in the room, aside from the occasional grunt for "yes" and a head shake for "no". 

My midwife and fiance were excellent advocates for my birth wishes and offered to get me into the shower. What a stellar idea this was. I would highly recommend water therapy for pain relief to any woman who would like to try it as part of their birthing experience. My trusty side-kick (aka the birthing ball) was rolled into position, I was connected to wireless CTG monitoring and off I went. I truly believe that my whole experience would be vastly different if I didn't spend the better part of 2 hours sitting under the warm water. I wouldn't say that I was completely pain-free, but with each contraction that came, I felt as though the heat enveloped my whole body and redistributed the pain in a more bearable way. Eventually, I needed to couple my shower party with some gas to take the edge off. By this point, the contractions were extremely painful and frequent. It felt like just as I'd gotten over one, the next was building again. I remember saying to my fiance in between groans "This is.. wild". It's is like the inside birth joke between us now, but at the time it was the most pleasant adjective I had for the pain I was feeling. My poor fiance at the time was soaked pretty much head to toe, while fully clothed. Kind of like those swimming drills we used to do at school? I can't imagine that would have been overly comfortable for him (poor guy), but he didn't mention a word of it. Frankly, I don't think he dared to. 

The time finally approached where I was no longer coping with the pain too well, but until this point had received no pain relief whatsoever, aside from about 30 minutes of gas while sitting in the shower. I had no idea how dilated I was and no idea when this pain was going to come to an end. My midwife decided it was time for an assessment, my first one since I entered active labor. Holy goodnight, that was an anti-fun experience but it delivered some excellent news. I was 6 cm dilated, drug free. I had two intruding thoughts at that moment. "Wow, I've made it so far" and "Oh god, it's too late for an epidural even if I wanted one" - yikes. After a quick throw-up on the floor (glamorous, I know), I felt this sudden and indescribable feeling to just push. Push where? Not sure. Just down. Something deep inside told me I needed to do this. It's a feeling like no other. It was finally go-time. I did try to continue laying on my back for a while, but I found this extremely uncomfortable and exacerbated my back labor pains. Again, I opted for a kneeling position with the bed head positioned near vertically like a bar for support. My midwife team told me to start pushing as hard as possible during my contractions and to stop and catch my breath when they abated. I will admit this seemed relatively doable until we reached the ring of fire. For those who are asking themselves, what is this ring of fire? Let me tell you. This the moment of crowing, and when delivery is imminent. It's here I was coached to hold my pushing, even if everything internally was telling me to keep going. This is said to minimize your risk of tearing. I managed to mash together a string of beautiful swear words and shouted them at the top of my lungs. From here it was only a couple of contractions, and my baby entered the world. 

I remember feeling pure shock as she was put in my arms. I took a seat and while the midwives did their thing (with the cord and everything else), I just stared at this beautiful freshly pinked-up little face. She made her first cry and a wave of emotion came over me. My fiance was a mess, my mother was balling, and I just looked between the two of them, and then my daughter and burst into tears myself. This was the purest, and most moving moment of my entire life. After six hours and twenty-one minutes, our lives were changed.

If I had to make a shortlist of labor must-haves, it would be these. 

  1. Document everything. Whether you show your entire family, keep them for just you and your partner, or if those videos and photos never see the light of day - you will not regret having them to look back on. 
  2. Be well informed about your options during labor. Take the time in your antenatal visits and in those last few insomnia sprinkled weeks, to become aware of all options available to you for birthing and pain relief. It benefits to know exactly what you want (or maybe don't want), and have a clear birth plan so that you can be advocated for when you can longer hold a proper conversation. 
  3. Do not be afraid to ask for what you need. Whether this is a bucket of ice chips, a back massage, 37 packets of chicken crimpy's, or finding out where that damn epidural is - make sure you (or have your significant other) ask for what you require to make you the most comfortable and relaxed you can be. This is your story, don't hesitate to pick up the pen and write. 
  4. Breathe and listen to your body. Before I experienced labor, I did not truly understand what "listen to your body" meant. But it does intuitively tell you exactly what you need to be doing. Breathe through each of those contractions, focusing solely on getting that air in and out of your lungs to ride the wave of each one. I found birth music extremely helpful for centering and grounding myself.  
  5. Remember there is no "right" way to birth. Natural, medicated, or c-section. Every birth is beautiful and unique. Some are straight forward and others have complications. A good birth is open to interpretation based on your views, values, pain threshold, facility and care team and so much more. In the end, do what feels right for you.

So, having now been through childbirth, and I can tell you this. Yes, it is so very painful. Yes, you will question if you can even do it. Remember as women we were made to do this. Our beautiful, strong, and capable bodies have been birthing for thousands of years. Trust in yourself, listen to your instincts and to the wise words of your midwife. And just like so many women before you; you will approach the gates of motherhood and be granted passage to a place where love knows no limits.

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