birth, home birth, homebirth, induced labour, induction, natural labour, pregnancy, pregnancy and birth, premature rupture of membranes, PROM, ruptured membranes, waters breaking
This day two weeks ago my life was changed forever when we welcomed our precious little man Harley Jay Hinschen into the world. But like all good stories we must go back to the beginning to truly understand the journey.
Anyone who has been following my pregnancy journey knows that we were hoping for a home birth. We had done all our research, we were prepared, secretly our team was in place and we were ready to go. I say secretly because in the current political climate of the obstetric world, home birth is frowned upon to say the least. We had to cocoon our birth plans and as much as I wanted to shout their existence and my belief to all that would listen I felt it necessary to protect them for fear of recrimination of our team. Even though home birth is legal here the fear that surrounds it makes it very hard for anyone to actually practice it.
The nine months of pregnancy preparation focusing on homebirth had steered us well – as I said, we were ready. I had been having niggling cramping pains from about 35 weeks. I feared that bub would come early and Todd and I spent much time talking to him and asking him to wait a little longer. My relief when I made it to 37 weeks was immense. Not only that bub had waited and developed long enough but that now we had hit the magic mark that said yes, a birth at home was on the cards.
On Monday night at week 37 + 2 I felt three mild contraction-like pains. They weren’t unlike what I had been having but different enough for me to notice. I went to bed early and remember telling Todd that we had better get some rest just in case. I woke at 1030pm with a gush of water. I knew instantly that my waters had broken. I called this to Todd as I made a mad dash for the shower. I stood in the shower in shock and disbelief. Our baby was on the way. I cried tears of joy and shock, all the while looking like I was peeing myself. Todd was an instant rush of exhilaration and adrenaline.
‘What do I need to do?’
We looked blankly at each other for a minute or two. Then logic (or so we thought) kicked in.
‘The birth pool.’
Right off Todd set blowing up the birth pool, and air mattress. He kept checking in on me. I was taking my time trying to calm myself and enjoying the moment of pure anticipation. I washed my hair and shaved my legs – much to Todd’s bewilderment.
‘I think we should call the ladies (our midwife and doula) I eventually reasoned.’
We did and with no labour pains we were assured that the best medicine was to calm down, go back to bed and wait for labour to start. This was like telling a kid on Christmas Eve who just saw a big guy in a red suit walking through the house to go back to bed and wait till the morning. As hard as it was we listened and snuggled up whispering all our excitement to each other, eventually we fell asleep.
We woke in the morning without labour. That’s ok we reasoned, the excitement was still there. We were probably going to have our baby today! As it turns out roughly 95% of women go into spontaneous labour within 24-48 hours of their membranes rupturing prematurely (rupture at full term prior to the onset of labour). Odds were in our favour. We knew the advice, no baths, no VE’s. Just sit tight and wait. We did, but we couldn’t help but make plans. Todd went in to work to tidy up a few things, I pottered around the house putting last minute preparations in place. I actually remember thinking how nice it was that I had a little bit of warning and could get some food made ahead of time. We called our families. In hindsight this was probably not the best thing to do, but we were so excited we wanted to share it with those closest to us.
The day came and went without labour. My midwife came and listed to bub’s heart rate and advised me to monitor my temperature regularly. I’m pretty sure here is the time we started to become aware of a slightly increased risk of infection with a prolonged rupture of membranes. We weren’t worried though we were only 18 or so hours in. Even though time was creeping up and we were starting to overtake most of the stats I thought bub was just waiting for the hormone surge that night.
We kept in constant contact with our midwife and doula. Again we went to bed excited. Again in the morning we woke without labour. This was starting to get a little frustrating. I lay in bed questioning whether there was some mental block from me which was holding up the birth. Deep down though I doubted this – I was so ready to meet our baby. On Wednesday morning at roughly 33 hours post rupture I was on the way to a Bowen Therapy session to try to coax bub out, when I received the dreaded phone call from our midwife. Her backup was no longer comfortable with the home birth – we had timed out. This left us with no choice, we could not birth without backup, and the pressure on our midwife was building. She suggested I come into the midwife-lead hospital for a chat and to see where we were at. Once we talked I agreed to talk to the doctor in charge. I knew he was going to recommend induction and antibiotics and I knew I wanted none of it at this stage. I truly felt I was fine, bub was fine and that he was just not ready yet. I remember thinking to myself. I just need more time. I was in a pretty fragile state with the rollercoaster of emotions floating around. I called Todd (I wasn’t making any decision without him) and our doula (who I knew would be invaluable in helping us to remember questions and take the time to weigh our options) to come to the hospital with me.
I was put on CTG monitoring (just to check) while we waited for the doctor. Again bub was absolutely fine according to the monitoring. My vitals were perfect. I did a GBS swab (which later came back negative). Todd arrived and after a bit of a wait we saw the doctor. He advised us of the recommendations which were, as expected. We wanted to wait. By now the pressure was building. Pressure on us and on our midwife. I know she was torn. Thankfully the option of induction today was ruled out as there were staffing issues. The option of induction at the midwife-lead hospital the next day was floated. If induced here the chance of a natural birth was, in my mind, far higher than at the city hospital. Here they would be prepared to give us a little more time and they knew our wishes. To say it was a tough decision would be the understatement of the century. We had to weigh up inducing (what I still considered early) here and the better chance of a natural birth or waiting another day with only the city hospital available if we needed to induce later. I knew how much an induction increased the chances of intervention in labour, including a caesarean, which I wanted to avoid as much as possible. Again I caught myself wishing that we could have just a little more time.
I believe someone heard. We had decided (after much talking and heartache) to go into the midwife hospital the next morning to be induced, but it was not to be. We got a phone call that afternoon from our midwife who had to tell us that they were now no longer an option for induction, as they didn’t have surgical cover in the event of needing a caesarean. It was too much. Somehow, somewhere I think I just pushed it all away. I decided not to think about what would happen in the morning. Our options were slowly being reduced. I decided the only thing to concentrate on was having this baby spontaneously go into labour. We recruited Todd’s sister for acupuncture, I called the homeopath. I spent the entire day doing everything I could possibly think of to go into labour.
Again I went to bed hopeful. I think it was this night that I woke at 1am and sobbed my heart out into the blanket. Todd could do nothing but hold me. Everything I had tried had failed. Eventually I fell asleep.
I am struggling to explain the extent of the emotional rollercoater that we were on. Add to this the need to try to keep our family informed. A difficult task when we didn’t know what was happening from one hour to the next. I was confused, frustrated, upset, hopeful, listening for every niggle, and prodding my body constantly for four days, with no relief. The thought that kept recurring was ‘we just need more time’. I believed bub and I were both healthy. This never changed. But the weighing pressure was taking its toll. We knew we had to make a decision. Do we give up on a natural birth and face the very real risk of increased (potentially harmful but medically accepted) intervention as opposed to waiting and facing the very small increased risk of infection.
On Friday I woke with increased pain. It seemed to follow this pattern. Just as we were feeling hopeless the pains would increase, just enough to keep us hoping. We waited all day. Our doula came up to the house; again we tried everything to increase the niggling labour. One of the funniest times was watching a show with talking animals. I got fits of laughter. Even thought this was a deliberate attempt to induce labour (we had discovered earlier that laughter seemed to set off my pains) it was nice just to sit and laugh for a while. But I could not relax. I was pressing acupressure points, tears not far away and I knew that in a few hours we were going to need to give up.
Our midwife called around lunchtime. She said she would come to monitor bub after her shift and that perhaps we needed to make plans to go to the city hospital. I was devastated but I knew I had to change my mindset to be able to deal with what was to come. Our doula went home and we agreed I needed to just sleep for a while. Of course I was hoping that I would miraculously wake in labour, but again it was not meant to be. Our midwife called and said that she had spoken to the midwife on duty in the city and of sorts, paved the way for us coming in. She reassured me that if I put my mind to I could get through an induced labour naturally and she was going to come with us.
I strapped on my brave pants and we all headed into yet another hospital. Again I said goodbye to the house promising a baby in arms on next our return. I steeled myself for what was to come in the next few hours. Todd text our family again. We were on the way to the ‘big’ hospital – this was going to happen.
Arriving at the hospital and my fears were allayed somewhat. The midwife was lovely. I felt as comfortable as I could. I was strapped to CTG while we waited for the doctors and midwives to come explain and start induction. The ladies dimmed the lights; Todd played my yoga music in the background and we tried not to watch the CTG monitor. My midwife massaged my feet and I physically felt her pour her energy into me. Contractions on the monitor concurred.
The hospital midwife returned to tell us that they did not have the staff to start inducing me. There were three other women being induced and I was going to have to wait until a couple of babies were born. I was ok with this. I liked it when people told us we had to wait. The ladies went to get some dinner and Todd and I actually spent some lovely time in the hospital together. The contractions continued but never intensified or regulated. They were just there, reminding us.
The midwife took the CTG strip away to talk to the doctor. Three hours of continuous monitoring and bub had not missed a beat. Again my obs remained stable. Again we waited.
Eventually the doctor came in. Brusquely we were told we could do this now or in the morning. That was our window. As our midwife pointed out, if they were worried we would be getting induced now. I looked at Todd and he said straight out.
‘I want to wait’.
That was all I needed. And it made sense. We were waiting one more night for bub, giving every chance we could, but also I was not in a state to start induced labour at 10 pm at night. Our midwife had worked all day, our doula had waited with us all day and the last week was beginning to take its toll on Todd. Much to the dismay of the staff I asked to go home. I needed to be in my bed, alone with Todd.
Todd suggested I stay in the hospital and he go home. I just don’t think he wanted to face another drive home empty handed only to have to come back in the morning. There was a barrier there somewhere for him, but I wasn’t having a bar of it. We laughed it off. I don’t know if delirium was starting to set in but the giggles were coming thick and fast. Passing the doctor in the hall I felt like our renegade team was again bucking the system. To hell with it, I thought, we weren’t making stupid decisions and after all it is my baby, my choice. Our little group erupted in the lift, and a big contraction came. I waddled through it to the car, to head back up the hill.
I went into spontaneous labour within an hour of climbing into bed that night.