Like any good story, let’s start with a little bit of background. My views around childbirth and babies are largely shaped by the brave and beautiful women I lived with in a rural town in the Rocky Mountains in Canada as well as by the most wonderful book called Ina May’s guide to natural childbirth - an absolute must read for all women who are having a baby. The major difference between childbirth in Canada and South Africa is that it is largely managed by midwives rather that ob-gyns. Midwives believe that birth is a natural and empowering process which women are wonderfully designed to experience and have no need to fear, whereas ob-gyns largely see birth as a medical procedure which must proceed according to a set plan and when it doesn’t, they are much more hasty to jump in and intervene - whether that means pain alleviation or forceps or a c-section. My understanding of natural birth going into all of this was one of embracing the pain and joy of child-birth because I believed my body to be fully capable of bearing my daughter.
Unfortunately we live 2.5 hours from the closest city and hospital and so having a mid-wife led home birth didn’t seem to be an option. What we did find was a number of doulas available and our medical aid even gave us a ‘doula benefit’. The statistics are that having doulas present at births is reducing c-section rates by 60-80%. Little did I know I was about to add to this statistic! We found Colleen, who we met with before the birth to discuss our ideas around the birth process. She was incredibly supportive of my wish to have an intervention, medication free, unassisted labour.
Friday: With this desired natural birth in mind, we set off to PE for our 40 week check-up with our gynae. He knew our wishes and preferences but seemed to be humouring us a lot of the time, and was not willing to let me go further than 41 weeks, despite the fact that a standard gestation period is up to 42 weeks, so I was a little nervous as the time approached. On Friday morning when we saw him, he wanted to do a stretch & sweep, a process used to stimulate the membranes and encourage labour, which I wasn’t keen on quite yet because Colleen was away for the next few days and I wanted her around if I went into labour. It turned out to not be an issue because when he examined me, my cervix was soft but not even 1cm dilated so he could not do the sweep. He also said the baby’s head was still high and not engaged. We agreed to come back to try again the following Tuesday and decided to stay in PE for the weekend.
Saturday & Sunday: This was the weekend to get things going so that the gynae didn’t suggest induction! We tried it all - curries, walks on the prom, running up and down stairs, castor oil, bouncing on a gym ball, swimming laps, breast pumping - you name it. My legs and feet had become incredibly swollen from water retention and so they would go numb after about 10 minutes of walking so we would walk for as long as I could and then try and massage some blood back into them.
Monday 21st: Colleen suggested I come to water aerobics with her to get some exercise but get the weight off my legs. We did an hour of aerobics and I felt tired but not even a twinge of contractions. Later that day we met another midwife who said that my belly had become pendulous (hanging down too low) which is why the baby wasn’t engaging and we should try binding it up. We did that and kept bouncing on a ball. At about 9pm we got cabin fever and went for a walk which turned into a jog around the block. Still nothing.
Tuesday 22nd: We saw the gynae first thing in the morning and I was 1cm dilated so he did a sweep which was painless and uneventful. He said that if it was going to work it would do so in the next 24 hours, otherwise I should check into the labour ward for an induction the next morning! That came as a bit of a surprise as the next morning she would only be 40weeks + 6days. We asked about not inducing and he made it clear that would have to sign a form waiving any liability on his part as he could not condone going further than 41 weeks! We took the induction papers and went home to discuss our options. If we ignored the doctor’s orders, it meant a long drive back to Adelaide to wait indefinitely, or waiting indefinitely in PE. However an induction went against all I believed - not only did I feel that the baby would come when she was ready, I also knew that an induction is the first intervention that often leads to many more. An induction can cause labour to happen too quickly and intensely which leads to an epidural and often a c-section.
We were really indecisive but decided to wait until morning in case I went into labour over night. It was one of the hardest decisions we’ve had to make.
Wednesday: We went for a delicious breakfast date and then arrived at the hospital bright and early for the induction. They weren’t expecting us but soon cleaned up a room and got going. It felt very hospital-y and I was feeling a bit anxious. Because of my birth plan in which I had been clear about not wanting pain meds offered or any standard interventions, they altered the forms I had to sign to say that none of those things would be done without my permission. They tested me and established that my waters hadn’t broken, and went ahead with the induction. They inserted a small tampon-like device which releases hormones for 12 hours to get labour going and can be taken out if things get too intense. Then they hooked me up to a monitor to measure baby’s heart rate and contractions. Although I was having regular Braxton-Hicks (I couldn’t feel them) - there were no contractions. Baby’s heart beat was very regular and the graph spiked all over the place when she was active and kicking.
The midwife working with us was a lovely woman who we got on really well with and soon Colleen arrived and got us going - we walked the stairs in the parking garage over and over, bounced on a ball, tried it all - no contractions. My legs swelled up even bigger than ever - I had no knees and my thighs looked like tree trunks - it was hard to even bend my legs. Colleen rubbed my back while I snoozed upright in chair. They continued to monitor the baby and my contractions every two hours. When she hadn’t moved for a while they would buzz her with a sharp vibration to make her move. They said that the gynae said that the lack of movement was a sign of the baby tiring because the placenta was getting old. What nonsense, more like the baby is sleeping! This scare tactic made me more frustrated with the whole process - I had carried this child for 9 months and knew that she had quiet periods when she slept but everyone trusted the monitor more than me. The gynae called to say that if nothing happened by 10pm (12 hours) they should take it out, let me sleep until 4am and then insert a new one, which they did.
Thursday: At 4am the night duty midwife came in to insert a new epidural. No dilation so far. I went back to sleep and woke up at 7am when Colleen and Cam arrived back at the hospital. Colleen had chatted to the midwife and said we needed to ask our gynae what his plan was because there was a possibility he would want to break my waters. All four of us agreed that this was not on - there was no dilation, and no contractions and no active labour - but once waters were broken we were on a ticking timeline to a c-section. We were wondering if we could go home and wait things out but the gynae was having none of it and said that we had started the induction process now and the next step would be to break the waters. I was very unhappy with this but he didn’t really have time to listen and said he would be back at lunch time to check my progress.
We went for a walk and then a specialist came to fit compression socks for my puffy legs. The midwife had also suggested a reflexologist to help get things going and we managed to get hold of an amazing lady who came by for a quick session.
The gynae came back at lunch time and walked into the room looking rather severe with the midwife. Cam and I noticed that she had brought a hook into the room that is used for breaking waters and looked at each other apprehensively. Luckily we had seen one at our antenatal classes so we knew what it was. I was quite confused when he made Cameron stand in the corner of the room by my head. The midwife took one leg and he took the other and he examined me but I was still only 1cm and no change. When Cameron came round the bed he snapped at him to get in the corner and then he said to the midwife “Give me the hook!”. And just like that he tried to break my waters. Cameron jumped in-between them and said “Wait, stop!”.
The gynae took one look at him, removed his hand, ripped off his gloves, threw them at the bin and stormed out the room. I burst into tears and asked for Colleen. Cameron went outside to confront the gynae about trying to break my waters without consulting us but he insisted that we had known what we were getting into when we came for an induction and that now that we had started, we had to keep going. Cameron managed to keep his balled up fists under the counter and the gynae said he had other patients to see, I had until 4pm when the induction stopped working, and stormed out of the ward.
Needless to say, I was in a state but I asked the midwife if at least if it had to happen, could she break my waters at 4 rather than him and she agreed.
By that time it was 14:30 so we had 1.5 hours left. We needed to get out of the hospital so we went for a walk around the car park. I was totally shaken and demoralised, and I felt like my body was a failure and couldn't do what it was meant to. Cam and I walked and talked and prayed and I started to come to terms with a procedure that would likely end in a c-section. With all the walking I barely noticed that I had started to have mild cramps. Soon it was time to head back to the ward. We got back and Colleen had dimmed the lights, lit candles, and was playing music - the atmosphere of the room was completely different! The midwife came in to check me and I closed my eyes and turned away because I was really nervous but Cam says she felt around and then her eyes grew large and she announced “3cms, 4cm at a stretch!” We were all amazed and excited. She said that because labour had begun we could hold off on breaking the waters and let things progress naturally. What a relief! I started walking the corridor with Cam, pausing as the contractions got stronger. We moved from a labour room into a delivery room which was exciting.
At about 18:00 we had another check and were about 6cm so the midwife said it would be a good time to break the waters. I knew she would be off duty soon and trusted her advice so I said she could go ahead. It was painless and I hoped it would really get things going. She also did a pelvic exam and told me that my pelvis was perfect and felt really good and she could feel the baby’s head. This was so encouraging after being treated like my body was a failure for the last few days.
The contractions continued getting stronger - by now I was having to really focus on breathing low deep breathes and needed Cam to squeeze my hand or my leg with each contraction. I couldn’t stand being rubbed or massaged but when a contraction hit, I desperately wanted to pressure of Cam’s hands on mine or on my leg. I battled to get through a contraction without it. By now my legs were hugely swollen - if I wanted to get off the bed, Cameron and Colleen had to move my legs for me because I couldn’t bend them. We tried a variety of positions for contractions because I had been adamant that I wanted to be able to move around during labour, however I really battled to have a contraction standing up - I needed to feel grounded, either on the bed or on a birthing ball. I was also suffering from really bad burps - the noises coming out of me would have made a teenage boy proud. I had been sipping on soup and apple sauce but at about 19:00 I threw up everything I had eaten so far. At this point I should mention that a hospital offers you a kidney bowl to vomit in - entirely impractical! What happened to a good old bucket?
The midwife went off duty and a new one came on - a lovely lady but much more of a stickler for policy and procedure. She continued to monitor the baby and the contractions every two hours. As the night went on and the baby slept, she kept buzzing the baby to wake her up and create some movement on the chart which made me really anxious because I knew that if they thought the baby was stressed or tiring, they would push for a c-section. After half an hour of monitoring, she would check my dilation. I wasn’t really aware but apparently it didn’t progress very far past 7cm for the next 6 or 7 hours. I dozed between contractions. What we were unaware of at the time, was that the midwife was filling in a chart with my progress, which should have been a centimetre an hour. Of course it wasn’t and so she wanted to intervene, either with drugs or a c-section. Colleen spent a lot of time out in the corridor convincing her that I was fine and baby was fine and so she should let us keep trying. Thank goodness she agreed.
Friday: The contractions kept coming and I had slipped into a bit of a labour trance, time seemed to become a blur - punctuated by bouts of pain. I threw up again but Colleen kept telling to Cam to keep me eating and drinking even though I didn’t want to. Coconut water was about the only thing that was staying down. Every hour or so she would encourage me to go to the toilet. I knew I needed to but it was awful - I would wait for a contraction to hit, they would quickly move my legs, I would have another contraction on the edge of the bed, and then it was a speed shuffle to get to the toilet before another one hit. I would have a few contractions there before the speed shuffle back to the bed. Poor Cam had to offer his stomach or chest for me to grind my head into if a contraction happened when I was mid-shuffle. At some point Colleen put the ball on the bed and Cam leaned on it to keep it there and we both snoozed between contractions. I knew contractions were good and what we wanted, but I also felt dread each time one arrived. I thought of what I had read about women who found labour and invigorating and ecstatic process and couldn’t understand it at all. Eventually Cam sat down on the chair in the corner for a power nap. Cam says that he soon realised that there wasn’t really much he could do and had to accept that, but I could not have got through that without him, especially that big firm hand that seemed to anchor me through each contraction. There were times when he really wanted to offer me pain relief but knew that I had asked not to be offered. For me that made all the difference - because no-one offered, I just got on with it, but if I had been offered it may have been tempting. My biggest motivation in not using any was that I wanted the baby to be as alert and healthy as possible when she finally came out.
Every two hours the midwife would come in to monitor me and the baby until I started to realise that the anxiety around the monitoring may be delaying the progress. I asked for them to check my dilation and then monitor the baby afterwards which she agreed to and from then on labour started to progress - 7, 8, 9cm until by about 6am we were fully dilated and the midwife was preparing the delivery table. I thought I would be excited but I was so exhausted and sore by then, all I could think was that pushing may still take hours and I just wanted it all to be over. Then I heard the midwife saying that she was going off duty. That meant it was 7am! I had no idea the whole night had gone by. She said that I should wait until I felt the need to “bear down” and everyone had told me I would feel like I needed to poo, so I waited and waited but didn’t feel that. I felt awfully uncomfortable and the contractions were worse than ever - I was screaming now, and feeling panicky because I didn’t know what to do.
It felt like 2 hours but apparently it wasn’t even one, and Colleen called in the midwife on duty to see what was going on. All of a sudden she said, “Ok Sophie you can start to push”! I probably could have started pushing sooner, I just never felt that ‘urge’. It took me a while to understand how to push because the breathing is very different to the rest of labour. Soon the on call gynae arrived, the big surgical light went on, and it was all action stations yelling at me to push. I looked down at one point and saw him preparing a large syringe. I thought he was going to do an episiotomy and he must have seen my concern because he reassured me that it was just there in case of a bad tear developing and needing to cut. In my birth plan I had been quite specific about wanting to push as I felt the urge to rather than being instructed. Most women tear because they push on instruction rather than as they feel however, to be honest, I was quite grateful at that point for someone telling me what to do.
They poked and prodded and shouted, telling me to wait for a contraction and then push but I had stopped feeling contractions so they had to tell me when I was having one. I pushed so hard I thought my eyes were going to pop out and couldn’t feel anything so I was very surprised when the gynae said that the next push the head would come out. I was too tired to be upset at the time but in retrospect, after realizing that I had been injected, I feel a little cheated that after a whole long, medication free labour, I would have liked to feel everything right to the end.
A few more pushes and the head was out, and then Cam says the baby turned completely and I remember them commenting about the baby’s big shoulders, and then she was out with a pop. After such a long labour it was all very loud and quick and all of a sudden there was a little grey baby and she was on my chest! I had also requested delayed chord clamping but before I knew it the gynae was telling Cam to cut the cord and I was too tired and too taken with our little girl to protest. Within a few minutes she was pink and very alert and after about 15 minutes she latched beautifully and started feeding. Her Apgar score was a 9 and then a 10/10.
In the meantime they injected me and poked and prodded to get the placenta out and then stitched up a tiny 1cm tear. I was really relieved to have not torn badly as I had no idea what was going on down there! After that we were finally given some time alone to take it all in. We did it!
After feeding Lexi for a while, she was weighed and measured - 4.020 and 54cm! I went to shower and Cam had some skin on skin time with her, but he did ask that we leave the door open so he could yell for a nurse if needs be.
The maternity ward was really lovely - we had a room that Cam could stay in so we stayed for two nights and really enjoyed the friendly nurses and tips and stories and advice. I was very weak and dizzy from not eating for such a long labour but otherwise had a relatively quick and pain-free recovery which I’m really grateful for.
Looking back, the labour was long and hard, but over so quickly and with such a wonderful reward at the end. However, the emotional turmoil of the week was much harder and definitely will take more time to heal. I don’t want the beautiful process of my daughter’s birth overshadowed by the hospital experience, but at the same time, it made me very angry and indignant for women in general and has motivated me to advocate for women learning more about their bodies, their births and their rights. I considered myself well educated and strong-willed and even I feel like I was bullied and scared into making decisions I wasn’t comfortable with and having to undergo processes I didn’t want to. I am incredibly grateful that we could have a natural birth to a healthy little girl and have no doubt that it would not have happened without the many people who were praying fervently and our doula Colleen. I really saw so much evidence of a lot of what I had read - that progress in labour is largely about feeling safe and positive and relaxed - it’s just as much psychological as physiological. If I can help it I will never give birth in a hospital under a gynae again, I will find a midwife who respects me and my body and give birth in a calm and safe space, surrounded by friendly and encouraging faces with all the time I need.
Once again, we are overwhelmed by this perfect little person who popped out and are loving getting to know her! I should also add that there are many wonderful mothers I know who have given birth to healthy babies using pain meds, or by c-section and I have so much respect for them too, because really, it only actually gets tough once you get home and your life changes forever. Our life is certainly changed forever!