Tuesday, 24 December 2013

The Birth of Isla Wood: Hope & Honey Personal

Hi, I'm Karenna and I run Hope and Honey - offering HypnoBirthing, Childbirth Classes, Birth Pool Hire and much more in Perth, Western Australia. Every birth is a journey. Here is my journey through the home, hypnobirth of my first child – Isla.

Every birth is completely individual. I’m sharing my story as I am passionate about birth, not because I believe this is how birth should be for everyone. This is what was right and what worked for me. It’s important that we celebrate birth regardless of the ‘who, what, where and how’ and it’s important that we celebrate each other’s births even if we wouldn’t make the same choices ourselves. I hope this story may help just even one person to believe in their body’s ability to birth naturally and to promote home birth as an option for those that want it.

So this is my story. It’s a bit long, so you may want to grab a cuppa first! (Please note as per the HypnoBirthing philosophy contractions are referred to as ‘surges’ throughout)

I had been niggling for days, gasping at each little sensation and saying to myself – Is this it? Am I in labour? The day after my estimated due date, I had a fabulous day out doing all the things I love. Somehow I think I knew it was coming. That evening I started feeling more cramps. I woke up at midnight experiencing tightening sensations and couldn’t sleep, so I got up and spoke to my family abroad whilst monitoring to see if these potential surges were coming regularly. By 3am, they definitely were and so I woke up my husband Lee. The sensations were like period pain and I could happily talk through them but did start using my some deep breathing at this time. 

I tried to use a clock and an I-Phone app to monitor my surges as I knew we had to keep an eye on timings to be able to report to the midwives. In the end I actually found this incredibly off-putting as when a surge was starting I had to come out of my focus to check the time or press a button and the same at the end. Eventually I stopped doing this as I was finding it counterproductive.

As the surges were coming every 5 minutes, we called the midwife who came about 4.30am. She confirmed I was in labour and after a few checks (see below) asked us to keep in touch.

One option I always discuss with my clients is vaginal examinations – whether you would like to have them and if you do - if you want to find out how many cm dilated you are. It’s so easy to get hung up on those numbers when in labour and it can be incredibly demoralising if, for example, you have been labouring for a long time and then find out you haven’t made much progress.  Personally I didn’t have a strong opinion over it and knew it wouldn’t affect my mindset at that stage so was happy to find out. I was 3cm dilated and the head was SO low, the midwife thought things might happen quite fast…..Nope!

Lee and I spent the next few hours relaxing together. We went for a couple of walks around the neighbourhood, watered the garden, dozed a bit and tried lots of different positions and techniques to get comfortable. Walking and moving around was great, it really moved the surges forward. I also found I was comfiest on all fours. As they thought Isla was in the posterior position, being on all fours is the best position to assist the baby to turn into the easier anterior position. I somehow must have instinctively known this and naturally got into this position the most.

Lee continually reminded me to eat and drink, just small sips and small snacks. He was constantly there with a straw near my mouth without being asked. I wasn’t hungry, so in some ways I had to force a little bit of food down but man was I thirsty!

Surges were coming every 3-4 minutes at times and Lee was asking if we should fill the birth pool…Nope!

As it turned out both my named midwife and back up midwife from the CommunityMidwifery Program were on leave that day. So Angela came to check up on us next. I definitely think this was meant to be. Angela, like myself, is a trained HypnoBirthing Practitioner and we just bonded straight away. My labour hadn’t really progressed much and so she worked with Lee to use a HypnoBirthing script to relax me. Unfortunately it was a little too effective as my surges slowed considerably. She thought it was time for a rest so sent us off to bed for a few hours with surges only coming every 6-10 minutes now or even disappearing.

Refreshed from a nap, I found I was almost controlling the timing of the surges by how much I moved around or how relaxed I was. I needed to keep active and present to keep labour on track.

One of the most effective things for me during labour was kissing Lee and nipple stimulation. This is something people can be a bit funny about and I understand that. I can also imagine that I would feel more inhibited using this technique if I wasn’t at home. The hormone (oxytocin) that controls surges is the same hormone released through kissing, nipple stimulation and sex. It’s the hormone of love. By harnessing it and using it for my labour, the surges became much stronger and more frequent. I know it’s not for everyone, but I would strongly advocate giving it a go as it really moved me forwards. Whenever labour seemed to slow, the midwives would start making jokes about needing some ‘private time’!

By now my breath was my main focus. As I felt a surge coming I would inhale deeply and use several breaths to carry me through each surge.

Both Angela and I started to sense I had some sort of mental block that was stopping me progressing. I was using visualisation, especially going to my favourite Scottish island in my mind, and this assisted me through the surges but there was something more. I couldn’t for some reason visualise Isla – the end goal.

My mum suggested that instead of seeing my blockage as a large immoveable object, to think of it as something fluid. I started to visualise a long, flowing piece of fabric and on each surge was pulling myself along this fabric like a tug of war. My only opponent was myself however. I just wasn’t completely releasing, letting go and surrendering to my body and I wasn’t sure why. I knew the theory but couldn’t move it into practice.

Also I had always visualised giving birth at night, in the dark. The pool was set up in the back room with large windows overlooking the garden. I felt almost exposed being in there during the day, but knew at night it would be cosy and welcoming. That in itself could have slowed me down.

I’m not sure exactly what changed, I wish I could put my finger on it – but soon I started to will on each surge. Moving my hips around to bring them on, bringing my baby closer. I remember saying to myself and others – Bring it on! I was in the zone.

I spent a lot of time on all fours with my head planted into a pillow. By now, I instinctively felt that I needed to use noise to move through each surge so with each exhale I made a low moaning sound and found this incredibly helpful.

Angela asked if she could check progress as we needed to decide when to call for the second midwife. Again, I had no strong opinion about a vaginal examination and was happy to know how we were getting on. I remember knowing that regardless of how well progressed I was – this was my journey and the speed of progress would be what it was meant to be. Therefore I consented, knowing that it wasn’t going to affect my mindset, and was happily told I was 7cm, very stretchy and Isla was very low. Angela wouldn’t explicitly say what position Isla was in, so I took this to mean she could still be posterior. Knowing that this can in some cases cause longer and more painful labours, I was probably best making light assumptions than knowing for sure as that information could have set me back.

Our back up midwife, Katherine, and our student midwife, Dani, were here now – I was aware of their arrivals but needed to keep under, keep in my zone.

Again, I’m not sure what changed. I think I was tired and running out of energy but I started to doubt myself. It wasn’t fear of the surges as such – it’s hard to explain. In some ways I was thinking – I can do this now, but how much more intense will it get and can I handle that? But on the other hand, deep down I knew I could handle it so that wasn’t the blockage – I think it was just tiredness as I had been laboring for nearly 24 hours by this point.

The Community Midwifery Program midwives are typically more hands-off than you would find in a hospital. However, they of course have parameters in which they must work and with not much progress I was starting to get close to the ‘action line’. I was getting very tired and we needed to move things on so we chatted and decided to break my waters. I found this to be a horrible but yet fantastic release of pressure. Apparently tough as old boots, this would have been hard to break naturally and it did the trick – we got moving. Angela said she was sad that we had had to intervene – again I felt no disappointment; just that this was my journey and it was much more important to be able to keep labouring at home.

At this point, Lee filled the pool. I actually resisted getting in it for quite a while (preferring to plant my face in my pillow still!) as I knew it could slow me down by relaxing me too much. Eventually with the beautiful darkness making my birthing room cosy and inviting and by the flickering light of candles, I took a dip in the pool. Heaven! But I promptly started falling asleep in between surges! For the next hour or so we moved through lots of different positions – walking outside in the garden, sitting on the toilet, kissing Lee, on all fours and in the pool. The surges were intense but manageable and I was bringing them on through movement and slowing them down by relaxing in the pool.

Soon however I just couldn’t cope with the surges out of the pool, I had to stay immersed and this is when the heat and buoyancy of the water really come into their own. In the final stages of dilation, the pool was like a cocoon, giving me that layer of support and the darkness was that extra layer of privacy and comfort which I instinctively needed.

These last few hours are a bit of a blur – I was definitely in labour-land. I had my favourite music on but only remember hearing one song (tuning into the lyrics of a John Mayer song saying you can’t stop this train and smiling at that!) I had all the team around me but really could only tune into Lee and Angela’s voices. I moved positions in the pool, again sitting resuming the all fours position mainly and just enjoyed the warmth of the water and how effective it was making low moaning noises through each surge.

I can’t quite remember whether I felt a strong downwards urge, but I remember sensing a change. I refused to believe the midwives that Isla was there and ready so they made me check myself. I was astounded to feel the wrinkles of skin on her head and the ridge of her skulls as they were moulded ready for birth – it just didn’t feel real.

The next stage I remember is ‘getting Isla round the U-bend’- which is the best description of how it felt. It was incredibly frustrating – with each surge I would direct so much energy and feel her moving down, using several breaths for each surge – only for her to slip back. After a while, I started to panic and was saying to everyone – I’m failing, I can’t get her round. They reassured me this was completely normal and it is in fact a positive as each time she comes forward, she is gradually stretching the tissues. However mentally, this was incredibly difficult. I was using SO MUCH energy and felt like I was getting nowhere.

By now, I had been labouring for nearly 27 hours. I was aware of the midwives talking to Lee in the kitchen next door about progress – god knows how as I couldn’t tune into much but was hyper aware of this conversation. I remember Lee coming back into the room and being much tougher with me, not explicitly saying the ‘H’ word (hospital) but I knew this threat was looming. He said ‘you have to do this now’ and I remember feeling panicked as I just didn’t know how. Well he actually said – “Aisle 14, Bag of Concrete, Toughen the f**k up” – much to everyone’s shock and laughter. Cheeky sod!

My energy levels were so low by this point and I was flabbergasted by the amount of energy I needed during each surge to move her down. By now, noise and my breath were my absolute everything. As I felt each surge coming, I would breathe in and then exhale using all my energy and voice to move her downwards. I definitely wasn’t screaming – the noise was part of the energy and Angela could really tell how much progress I was making by the tone of my noises. It was primal – I needed that noise but afterwards I was so surprised and now joke I must be the loudest ‘Hypnobirther’ ever!

Originally I thought I would labour on all fours as I had done throughout, but I found myself almost horizontal in the pool with lee holding me under my shoulders and my legs pushing against the other edge of the pool. I also had an anchor strap – two handles attached to the birth pool, almost like water skiing, which were absolutely amazing and just what I needed.

With each movement, everyone could see the head except me. I started to feel like I was tearing but not where I expected to around the perineum, but up at the top and this was surprising and stung a lot (I actually didn't tear and just had a couple of grazes). In the end I had to just not care about that and once I decided that she came round the ‘u-bend’ for the final time and stayed there. It was time and I couldn’t believe it. I literally had to go past common sense, reason, what felt right and shut everything out. With lots of encouragement and one huge, monumental downward surge, the head was out.

Now this was one of the strangest parts of the labour for me. I remember looking up at Angela and saying ‘stop pushing her back in, what’s happening’ as there was this phenomenal amount of movement and pressure as little Isla turned her head from side to side. I honestly can’t fully describe that feeling of her moving like that – but nature is a wonderful thing as she positioned herself ready for the next surge. I will never forget that crazy feeling.

With the next surge, her whole body emerged and Dani lifted her up onto my chest. Looking down on this pink, wriggly, little thing – I couldn’t connect the last 27 hours and the last 9 months with that moment, it was surreal. Immediately alert, pink, moving and healthy – we all cooed and stared at her for about 20 minutes.  I think I was in a little bit of shock – only maybe 15 minutes before I was battling with myself thinking I couldn’t do it but here she was. Dani helped me to test whether her cord was still pulsating which was more difficult than I thought and our natural third stage unfolded really naturally.

Once the cord had stopped giving Isla all her blood from the placenta, Lee cut the cord and taking his shirt off had some skin-to-skin time with his new daughter.  After the birth, I had taken a small homeopathic remedy from my little childbirth kit. I’m not sure whether this did assist but I got out the pool and within a minute my placenta was out.

The midwives kindly set up our bedroom for us so we could take Isla straight to bed. For the next couple of hours, they checked on Isla and I and also assisted us with the first breastfeed. It was important for me to try get Isla to self-latch if possible. Lying in bed, we put Isla on my chest and within minutes her little head was bobbing up and down and she made her way to the breast. Hand expressing a drop of colostrum to help her find her way, with no assistance at all she latched on. I was ecstatic – this was just what I wanted.

After a quick shower and a gorgeous cup of tea, with all observations complete, we waved the midwives off and had a glorious six hours of sleep in our own bed. Waking up to the snuffles of our new daughter and our new life as parents, we felt so lucky to be at home and healthy.

Looking back on the experience now two weeks later, there are a few things that took me by surprise and that will alter my view and possibly my teaching about birth. As a birth professional, I knew the theory but until knowing this experience for myself there was always going to be a gap in knowledge.

I think the two main take-away learnings for me are the sheer importance of the power of the mind and the energy I needed during the second stage.  I couldn’t believe how much I could ‘control’ the surges through relaxation, movement and my state of mind. When I wasn’t in the zone, my labour slowed, and it was sometimes hard to keep in that zone. I felt so lucky to have been at home and been supported by such a great team. I can only imagine how much harder it would be to keep my mind on track in an unfamiliar setting and with the additional pressure of hospital policies.

For me the other main learning was about the second stage or pushing stage of labour. In HypnoBirthing, we teach people to breathe their babies down. I definitely did use my breath as my main tool in this phase, but it took me by surprise how much energy I needed with that breath. It was quite simply the hardest thing I have ever done. Speaking to Angela about this, she said that every woman and every labour is different but that some women need a huge amount of energy whereas others can more easily and quietly move their babies down. I will definitely bring this range of experiences into my practice from now on.

To sum up – a phenomenal experience. I’m so glad I had the support to do this at home and am eternally grateful to the midwives and the Community Midwifery Program, but mainly my husband Lee who was incredibly supportive of all the theory and plans leading up to the birth and was like a blanket of support, comfort and love throughout the birth.

Much love xxx

Visit the Hope and Honey website for more information on HypnoBirthing, Childbirth Classes, Birth Pool Hire and much more.

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