I’ve never documented my births before and I regret that now as there are lots of little details that I can’t remember. For my fourth, all I remember is my waters breaking at home and my 4 year old asking me to have sword fights with him when I was finished in the bathroom. I don’t know why I can’t remember anything from that birth but I regret not writing things down when they were fresh.
This pregnancy and birth was a really different experience from the others, in that I questioned everything and said no to a lot of things that I previously didn’t even think to question. Turns out much of what I had been told was “necessary” or “policy” wasn’t necessary for me and the fact that it was hospital policy didn’t mean I had to agree to it. We’re in control of our birth experience and whether we’re planning a c-section, a hospital VBAC or a freebirth at home, we can and should ask for more information, decline to make decisions on the spot and seek alternative options/opinions.
This pregnancy and birth has taught me that the hospital system doesn’t always do what is current best practice and that you won’t always be asked for consent or be fully informed by those who are providing your pregnancy care. According to the Journal of the Royal Society of Medicine, it takes an average of 17 years for research evidence to reach clinical practice, so we have to inform ourselves. We can’t take it for granted that someone else will do that for us.
Pregnancy
As far as the pregnancy itself, I was honestly expecting it to be tough. I’m 38, a full 16.5 years older than the first time I was pregnant, I’ve had a big gap since my previous baby who is now 6.5, and have always had uncomfortable pregnancies. I’m not overweight but I’m not fit by any stretch of the imagination and after multiple miscarriages over the past 2 years, falling pregnant again came as a beautiful surprise, so I hadn’t really prepped my body for the marathon that is pregnancy.
I am beyond grateful that the pregnancy was truly so easy compared to my others. I certainly had some discomforts, but nothing like the debilitating lower back pain, awful sciatica and prolonged morning sickness of earlier years. Morning sickness for this pregnancy faded early in the second trimester and my main physical discomfort was some right ankle oedema in the last couple of months (more on how I dealt with that HERE).
I couldn’t believe my luck!
The main things I did differently were:
- Fortnightly remedial massage – this basically eliminated sciatic nerve pain (until the final weeks when it reappeared every so often) and kept on top of my lower back issues.
- NingXia – this is the first pregnancy I’ve had access to NingXia and I’ve enjoyed it daily (with the exception of a 2 week stint when I ran out – my sleep took a crazy hit that fortnight!). CLICK HERE to learn more about NingXia.
- Beef organ supplements – pretty much the only supplement I took during pregnancy (in addition to NingXia, which could be considered a liquid supplement) and it helped immensely to keep my energy levels high and I dramatically upped the dosage at 28 weeks to turn my ferritin levels around in less than 4 weeks. Ferritin went from <8 to 33!
My head was also in a great place and I am so grateful to have experienced such a peaceful pregnancy.
Then came my hardest labour of all…
It began 1 am on a Friday. I was 39+2 gestation and I knew it straight away. An intense tightening woke me and the mucous plug came away. My husband asked if I wanted to go to the hospital, but I knew to give it time as I’d gone to hospital too early with some of the others and that just invited more intervention so I was determined to labour at home for as long as I was comfortable doing so. I knew this was where mindset work would come in to play. Contractions were 15 minutes apart and I said we should wait until the contractions were 5 minutes apart or my waters broke.
By 8 am, the contractions had slowed down to about 20-30 minutes apart. We rolled through the day, sleeping when I could, plodding around quietly doing jobs and hanging with the kids, waiting for things to kick up a notch.
Friday night came and that notch kicked up and we were back to contractions 10 minutes apart. But the same things happened again on Saturday. By 8 am, the contractions had slowed right back down. Oh well, I knew this was part of the process and any work that my body did now was work it didn’t have to do later so I embraced every contraction for what it was: a necessary part of the journey to meeting our baby. I was experiencing lower back pain by this stage, but my back pain oil blend worked incredibly well to help relieve the tension and numb the area a little. I finished an embroidery project, did some low-impact gardening and watched a movie.
Saturday night was rough, with contractions down to 10 minutes apart again and I felt for sure we’d be heading in to hospital, but by Sunday morning we were back to the daytime lull. Sunday night… you guessed it. I was getting used to it by now, although not enjoying it. The contractions were intense and I hadn’t slept much for a few days now and in the early hours of Monday morning, my headspace shifted and I started to worry about the baby. Maybe he had flipped and was no longer head down and that was stalling progress? By 7:30 am, I was quite upset with worry so we headed in to the hospital to check that everything was ok.
A check with the midwife confirmed baby’s heart rate was great, he was still head down and my waters had not yet broken. The midwife assured me that this was perfectly normal and that some women are in early labour for weeks prior to birth. So back home we went to wait it out again. Previously, I would have begged to have my waters broken, but I’d done enough research this time to know not to try and fix something that wasn’t broken. My body wasn’t broken. It just needed more time. Knowing the baby was ok, I was happy to give it more time.
Monday night was out of control. The contractions were steady again at 10 minutes apart, and they weren’t getting any closer but they were getting a lot more intense. I knew now that I wanted to be in hospital so we arrived at 9:30 am Tuesday morning and met the most amazing midwife I have ever had. She was calm, joyful, supportive and knowledgeable. Everything I had prayed for in a midwife.
I’d felt nauseous since about midnight so hadn’t eaten anything, but by the time we got to the hospital, it was bad enough that I threw up (nasty experience while having contractions!). I knew this was a normal part of labour for many women though, so I wasn’t worried. I basically just swayed my way through the next 2 hours. I was able to have some time in the bath and used gas for pain relief, but by 11:30 am, the contractions were on top of one another, I was throwing up again (possibly exacerbated by the gas, but I was nauseous prior so it’s hard to know) and begging for some stronger pain relief.
Birth
My midwife advised that for pain relief to be administered, she’d need to do an internal exam (which I had expressly said in my birth plan that I would not consent to), but I was so desperate by this point, I said ok. It was the least invasive internal exam I’ve ever had (didn’t feel a thing), as baby was right there, ready to come. Definitely no time or necessity for pain relief at that point! I had grand plans of giving birth in a better position than all previous births which had been on my back, but once I was down on the bed (for the internal exam), I couldn’t change position. My midwife asked if I’d like to change position and she and James certainly would have assisted me to do that, but I honestly couldn’t move. Everything I had was going into the final few contractions and now it was time to push.
Right at this moment, I random doctor was doing the rounds and decided to step into the room and asked me if she could “just do a check.” If you’ve ever been in labour, you might remember that you can barely speak at this point in the birth journey and I couldn’t speak to decline what I considered to be invasive and unnecessary. A mild panic started to come over me as I looked to my husband and midwife. My zone had been interrupted and I was in shock. They both turned to the doctor, gave an emphatic “no”, the doctor removed her gloves and left the room. What a relief to have people around who understood me, had my back and took the reins when I couldn’t.
Seven minutes of pushing and I was holding our beautiful little boy.
Thank God that part was over!
Third Stage
I did an enormous amount of research during this pregnancy and went into the birth knowing that I was in charge and my body and baby knew what to do.
For previous births, I was very much the compliant patient. The woman who, when told something was necessary, just went along for the ride. I rarely questioned any of the processes and procedures that the medical system has in place around pregnancy and birth, but something I saw early in this latest pregnancy set off a whole cascade of questioning, researching and ultimately making lots of decisions that departed from the status quo.
That something I saw was that synthetic oxytocin has been linked with over 30% increased risk of developing post-partum depression. I wanted to know: is it really necessary to routinely administer something to women that puts them at significantly higher risk of post-partum depression and anxiety? In particular, was this necessary for me? I’d had synthetic oxytocin administered at birth with all of my previous babies so I had no idea if my body actually needed it or if it could complete the process without this intervention.
Now, I’d never had synthetic oxytocin as part of labour – I’ve had a caesarean and 5 VBACs, some of which were augmented, but have never been properly induced using IV oxytocin, so my experience with this synthetic hormone was purely from the perspective of someone who’s had it administered (usually without it even being mentioned or my consent sought by medical staff) for the active management of third stage (delivery of the placenta).
What’s interesting to me is that I had never previously been asked for consent to administer the drug. It is such a routine part of birth in Australia now, that many women are hardly aware they even have it or if they do, are often not asked if they want it. The approach seems to be more like, “We’re just going to…” rather than, “Would you like us to…?”
When I handed my birth plan in at my 38 week appointment, the midwife said the doctors would need to “sign off” on my refusal of synthetic oxytocin and said I’d need to come in for an appointment with them the following week. This made me wonder: was it just a given that it would be administered? Would they not have sought my consent or mentioned the administration of the drug if I didn’t first bring it up? My previous experience suggests they wouldn’t have.
As it happens, labour started 12 hours before that appointment and as I expected that the baby would come that day and I’d be heading into hospital anyway, I canceled the appointment so never had to “sign off” on anything.
My research led me to question why and how synthetic oxytocin went from being a medication that was administered to stop post-partum haemorrhage (PPH) to being routinely given to all women in order to prevent PPH. Why were we assuming that no woman’s body works the way it should to release it’s own oxytocin to safely and effectively deliver the placenta?
Information produced by the pharmaceutical companies themselves state that synthetic oxytocin shouldn’t be used in the case of previous abdominal surgery (that was me – c-section for my first baby who was breech), who was grand multiparity (also me – more than 5 births), and – this was the kicker for me – one of the known and listed side affects is post-partum haemorrhage.
Come again? The very thing that’s supposed to prevent PPH can cause it?
I’d had a PPH after my 3rd baby (2nd VBAC), approximately 30 minutes after administration of the synthetic oxytocin. Turns out that having a previous PPH puts a giant red X against your name that the doctors struggle to look past. They want to micro-manage your birth and most certainly to actively manage the third stage.
But could the drug have caused the PPH? Who knows. The pharmaceutical company that produces the drug says that it can… and this study of over 33,000 women found that active management (which includes administering synthetic oxytocin) of the third stage of labour significantly increases rates of postpartum haemorrhage (by a whopping 2.7 times).
Knowing all that I now knew about birth, I just wasn’t willing to take the risk again and I wanted to give my body the chance to do what it was designed to do. There was literally no reason to believe my body couldn’t do this. It had successfully pushed out 5 babies without synthetic oxytocin – why couldn’t it push out another, followed by the placenta?
Turns out, it could. Within 20 minutes of birthing my beautiful baby boy, the placenta was delivered without fuss and without fundal massage or controlled cord traction. My post birth bleeding was recorded as being substantially lower than previous births and afterbirth pains were significantly reduced. I remember those afterbith pains as being all-consuming following my previous births, but this time they were nowhere near as intense, as long-lasting nor did they last for as many days.
In addition, blood loss in the ensuing weeks was significantly reduced compared with previous births. Was this all a coincidence? Who knows. All I know is, if we’re blessed with another baby, I won’t be consenting to “just in case” synthetic oxytocin.
What you can do to prepare for birth
Preparing for birth is so incredibly important. Far more important than which nappies you’ll use or what colour the nursery is. I’ve learned that you HAVE to advocate for yourself and that mindset is almost everything in labour and birth. Being physically well and having a great support team is of course super important as well, but nothing replaces your own head and heart.
If you’re in the process of preparing to welcome a new baby, I highly recommend the following:
- Follow some natural birthing pages on social media. Not so that you can expect a pain-free-breathe-your-baby-out kinda birth (definitely wasn’t my experience!), but just to normalise intervention-free labour and birth. Fill your feed with positive birth stories and with women who know and love birth.
- Understand that you can say no to anything. I had so many dear friends tell me this over and over again. It took a long time for me to really believe this.
- This experience has taught me that the medical system doesn’t always do what is current best practice and that you won’t always be asked for consent or be fully informed by those caring for you. You have to inform yourself. Don’t expect someone else to do that for you.
- Find your support crew. I had a great session early in the pregnancy with my friend, Sally, who is a postpartum birthkeeper and doula. In the session, we went through my previous births and what I had envisioned for this baby, pros and cons of different options and she really helped to empower me to take the reigns and make the right choices for me and my baby. I highly recommend a session with Sally.
- Grab my free labour, birth and post-partum guide. In it, you’ll find safety notes and dilution ratios, plus essential oil blend recipes for relaxation, labour, back pain, physiological third stage, after-birth pains, perineal and wound care and anxiety/stress.
