Malik’s Arrival. 08/04/2021

Mine was a relatively straightforward, even enjoyable pregnancy. It was tough, therefore, to make sense of the unexpected complications that arose on the day before and the day of Malik’s birth. Fortunately, Colleen’s excellent hypnobirthing course, which my husband and I took part in online, equipped us with the knowledge and confidence to make informed decisions about the interventions proposed. The reality of Malik’s arrival was a far cry from my birth plan. Even so, I have precious, sparkling memories of those hours in labour – breathing deeply, laughing, joking, swaying, moaning, sighing, at one with my body and utterly transported in my mind from the beige hospital room in which he was born.  

At 41 weeks and 6 days, and after two at-home sweeps by our brilliant community midwife, I reluctantly agreed to an induction. It just seemed as though our wee boy was never going to be ready for the world ex utero. I felt disappointed that he had not come of his own accord, but pleased, too, that the induction process, as I understood it, seemed gentle; I would be fitted with a pessary, which would release synthetic hormones designed to prompt labour, and sent home to relax and await my baby. It was likely, our midwife reassured me, that I would still be able to have my hoped-for waterbirth in the birth centre.

On arrival at the hospital that morning, however, a routine scan revealed that I had oligohydramnios; there was very little fluid remaining in my baby’s amniotic sac. I would need to remain under supervision in the hospital for the induction and labour. This discovery sent me into something of a panic. Had my waters gone without me realising? Had there been a leak that went unnoticed? Was this baby, ‘overdue’ by almost two weeks, alright in his dry sac?!

Once I was assigned a ward, my husband was permitted to join me. He kept me calm with jokes and crosswords and a lot of chocolate-covered pretzels that afternoon, but he was unable to stay with me overnight. That evening and the early hours of the next morning on the ward were among the toughest of my life – despite reassurances from various midwives, who monitored the baby’s heart rate periodically through the night, I felt terrified that he was in trouble. On reflection, the surprise complication had plunged me into a fierce state of anxiety. There was also a weight of guilt around the unexplained lack of fluid. I was in touch with some pretty powerful life-or-death feelings, and slept very little on the bright, noisy ward. Calm was out of reach but I used lots of deep breathing to try to suppress my panic, attempting to focus on protecting the baby from too much of his mumma’s cortisol!

When my husband was readmitted the next morning, I was shattered and afraid. Upon examination, my cervix had, despite the influence of the pessary, become less favourable for birth – a cautionary lesson in the power of the mind! My overnight terror had primed the baby for a dangerous world – he was staying put. Our wonderful community midwife arrived in the afternoon and explained her recommended course of action – that we enter the delivery suite and begin the synthetic oxytocin drip to get the baby out quickly. This plan was a long way from my hopes for a natural water birth, but I was very willing to be guided by her gentle expertise. I asked whether, given these circumstances, she would recommend an epidural, and she cautiously said that she would.

Once on the delivery suite, I was able to make peace with the plan. A nap in my husband’s presence and a hospital omelette gave me a bit more energy and calm. As we awaited an anaesthetist and I signed the paperwork consenting to an epidural, I felt disappointed but also relieved that I had been able to abandon my idealised vision and submit to being a patient. The synthetic oxytocin drip was administered via a canula as we waited for an anaesthetist to become available.

An hour or so later, some confusion arose around whether or not my waters had in fact fully broken; I was unable to feel any contractions, even as we could see them surge and subside on the monitor. I was examined by a different midwife, who told us she could feel the baby’s hair – so it was clear that the sac was no longer in tact! The two midwives suggested jokily that perhaps I just had a high pain threshold. Flippant though this suggestion may have been, it gave me an injection of confidence, reminding me that I still had some power and agency in this process, allowing me to consider that I could still have something close to the birth I had envisaged. I said that I would like to hold off on the epidural and see how things progressed with just gas and air.

Once labour got underway and I began feel the contractions more strongly, I entered a dream-like state. Despite the extreme worry of the previous day and night, I was able to withdraw into this animal part of myself, to stifle my awareness of any medical conversations taking place in the room and focus on myself, my breathing, my body and my baby, to the exclusion of everything else. All was timeless and blurry. My husband and birth partner, who was wonderfully supportive, helpful and even humorous, controlled a TENS machine attached to my lower back. I could prepare for each contraction with deep, long breaths of gas and air to better tolerate the peak. The room was dimly lit and I was able to move about freely while wearing a wireless monitor.

Affirmations – the cards from Colleen’s class and some silly reminders I had written on the back – were spread out on the bed as I paced around and swayed to my husband’s trip hop tracks, totally abandoning the painstakingly curated classical birthing playlist I had made! I kept my face and hands relaxed as each contraction intensified, experiencing it all as far less painful than I had been expecting. Not exactly pleasant… but manageable – and a happy, expectant sort of pain. Just as I began to find the contractions somewhat hard to bear, and wondered whether some pain relief might be helpful, my body began involuntarily to push. The midwife seemed wary, commenting that I was not very far dilated, but in the next 20 minutes I dilated to 9 cm and was clearly ready to birth my son.

My husband’s memories of the labour are far sharper than mine. He was more aware, for example, of concerns expressed about the baby’s heartrate, the equipment, the exchanges between the various people in the room. By contrast, I was able to blur all of that noise out and just be in my body. Owing to the absence of amniotic fluid, Malik’s cord was compressing in the birth canal, which was constricting his flow of oxygen. It was explained to me that his heart rate was periodically dropping while I pushed and they would like to quicken his exit. Lying flat, my legs in stirrups, I listened to an obstetrician instruct me in pushing. This was not at all how I had wanted to labour but somehow I still felt in control, empowered, at the centre of things.

The pushing stage was short and sore. I was given an episiotomy and some assistance from the ventouse. These developments were most definitely not part of my vision for my birth. But because I was able to remain in a calm, focussed, almost trance-like state, because I had such enormous trust in my birth partner, midwife, and body, and because the medical staff were all so considerate and good, none of this was distressing or even especially painful.

When my son arrived – without a cry, smaller than anticipated, just six hours after they had started the drip – he was quickly checked over and then placed on my chest to be close and to breastfeed for over an hour. I barely noticed them stitch me up or administer an injection to deliver the afterbirth. I was a little stunned by the overwhelming nature of the birth and did not experience an immediate surge of love, owing, I later learned, to the inhibition of natural oxytocin by the drip. After a shower, we were taken on to the ward at just after midnight on 8^th April. My husband had to go home, leaving me with several snacks which I gobbled up. The overnight midwives drew the blue curtain around me and my son and I could hear tiny newborn cries from the many beds around me. My baby was placed in the cot beside me, hat still on. Once the midwife left us, I took him out to lie beside me on the narrow bed and fell in love.