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Ocean View Verandah
The birth of Liam
Liam Christopher was born on 21 March 2002 at 7:15am.
The birth was both harder, more painful and more wonderful than I expected. There are many moments when I think it will be a long time before I put myself through all this again - the labour and birth and the sleep deprivation and sore nipples. But then there are other moments when I think I'd start again right now just to experience again that first moment when Liam was born and in my arms.
The hardest part of the labour was not, as it's generally made out to be, the pain. It was the constantness. By 4 in the morning I was so tired I just wanted it to stop for a while so I could sleep. I'd had amniotic fluid start leaking at about 1:30 the night before (which turned out to be a hind water leak, not the actual breaking of the membrane below Liam's head), and consequently I'd been awake for most of that night as well, too excited to sleep. And I was tired of the contractions too. By that time I was actually sleeping for the couple of minutes between contractions (even in the water), which was good but also made it seem a bit like there was no time between them. I was really unprepared for how much work they were - because the muscle action is involuntary it kinda seems like it shouldn't be tiring, but it is.
Julia and Chris were both absolutely wonderful during the labour. It is not true that I couldn't have done it without them (what choice would I have had?) but it would have been a darn sight harder. Also there was a moment at around 4:30 in the morning when the midwife suggested breaking the membrane to speed things up. I decided against that both because things tend to speed up and get more intense if you do that (and frankly more intensity was the last thing I needed) and because once the waters aren't there to cushion the baby's head there is a greater risk that he will be become stressed, leading to the probability of more and more intervention (eg forceps, which also means probably episiotomy, local anesthetic etc). If I had been there alone with the midwife, with no-one to talk that over with, there is a much higher chance I think that I would have just let her do it. But even aside from that, having Chris and Julia there to lean on (literally) and encourage me was incredibly important.
Lots of people have congratulated me on a 'good birth', and each new midwife who came to see us at home mentioned the 'good birth'. I'm sure that's in their script. The truth is, it was good. Good in the most important ways. Liam was born, completely healthy and unstressed. His Apgar scores were 9 at one minute and then 10 at five. Excellent in other words. And at no point during the labour did his heart rate suggest he was stressed. He was also born in the water, which is what we were planning, and came up straight onto my chest. And the birth and labour were completely 'natural' ie no drugs or intervention. So neither he nor I had any drugs to overcome when he was born.
Nonetheless it was also disappointing in some ways. Not the birth itself, but the labour. We had planned on a hypnobirth. We did some preparation for it with a midwife Julia brought down from Bowral, listened to the affirmations tape and practiced relaxing and breathing (though not as much as we could have). We had a birth plan which said we wanted a calm, quiet atmosphere with minimum monitoring, coaching or talking. But the midwife we had (who we hadn't met before) was not trained in hypnobirthing, and although she read the birth plan and said it sounded great, I really don't think she got it.
The first part of the labour was good. I spent about 6 hours at home, during which time the contractions went from being mildly uncomfortable to something I had to stop and breath through. The breathing in hypnobirthing isn't like Lamaze breathing though. It's more like yoga or meditative breathing. So the focus was on relaxing through the contraction, so that I wasn't tensing against it and creating pain. Once it got to that point where I felt that I needed to really focus we decided to go into the birthing centre. I wanted to be in the water, and also I didn't want to have to interrupt my relaxation by going in when the contractions were any more intense. We called Julia who arranged to meet us there, as well as the midwife of course. We got there at about 8:30pm and I headed pretty much straight for the lovely large bath.
Until about midnight I coped pretty well, able to breath and relax through the contractions as I had practiced. But the thing that made it difficult was the midwife's constant interruptions to check his heart rate or (more irritatingly) stick her fingers into my belly to check the uterine tone during and between contractions. Sometimes she'd be there through a whole contraction and then the break until the next one. In fact, Chris said sometimes she was there doing that for about a 1/2 hour, but I wasn't really that aware of time. Also questioning me all the time - where is the pain worst, was that different to the last one, are they getting more intense? All this made it awfully hard to relax, both because sticking things into me (fingers or Doppler) hurt and tended to make the contractions hurt more, and because I had to focus on answering her questions rather than on relaxing. And because it was so irritating.
Basically, I got the impression that because I was relaxing through the contractions as I'd trained to do, and therefore not feeling as much pain as she expected, and showing even less, she didn't think I was really in labour. Eventually I think I just answered her questions the way I figured she expected, and I was aware of myself actually tensing during contractions sort of on purpose sometimes, because she didn't seem to get that I was having one otherwise. Of course, as soon as I started doing that I started experiencing a lot more pain, which led to more tensing and the vicious cycle of fear/expectation (of pain)-tension-pain had begun. So by about 12, 1am I started to lose it - tensing up and not being able to relax properly during contractions at all. And so then she pronounced me in labour (meaning, she didn't start charting me on her little labour chart until 12:45am). So by her count the total labour was 6 hours 51 minutes, whereas by all the books I was definitely in 'established labour' by about 6pm at the latest. Making the total labour about 13 &1/2 hours, which is of course far more typical for a first labour (the average first labour is apparently 12-16 hours).
Later on when I was in 2nd stage (ie the pushing the baby out stage) she still didn't seem to get it. Perhaps I was doing better with the hypnobirthing even then than I thought. Or perhaps it was just that she had checked the dilation of my cervix not that long before and found that it was only about 4-5cm, so she didn't expect me to have moved along that quickly, I don't know.
Before she even checked my cervix I felt like I was perhaps in the 'transition' stage, which comes at the end of the first stage when the cervix is almost fully dilated. So I was surprised when she said I was only 4-5cm, but then I'd never done this before so of course I didn't really know what to expect.
She had me on my back on the bed to check the cervix of course, so after that I stayed on the bed (on my side) for the next couple of hours, because the contractions were so intense by then that I couldn't think about moving. At some point between 4:30 and 6:30 I moved into second stage. In discussions with Chris since then we reckoned that it was around 5:30. I said maybe I was doing better with the hypnobirthing still than I thought, and maybe that's why she didn't get it, but in fact it seems to me that there were contractions in which I was thrashing around on the bed, and I was making a hell of a lot of noise, from basically yelling to sort of chanting: just breathing out a very loud "ahhhhhhh" all in one tone. Chris says I wasn't thrashing, so I guess that's just how it felt, but how it felt was that I needed to push but I couldn't (I was lying on my side with my legs together) so I thrashed instead. Of course, the pressure felt all in my anus, which is supposedly quite typical, but didn't make me feel like I was wanting to push a baby out. Also because she said I was only 4-5 centimetres dilated I figured I shouldn't be pushing - if you push before the cervix is ready you can tear the cervix - and that she would let me know when I should be.
Then around 6:30am Julia suggested getting back in the water. That was what I needed - someone else to suggest things. If she hadn't done, goodness knows how much longer I might have lain there thrashing about unable to push. So I got back in the water, and the next contraction I had the midwife said -'That was a push! - did that feel like a push to you?' I just said yes, although I wanted to say 'what do you think the past hour's been then?' And 45 minutes later Liam popped his head out. Man that hurt. That last perhaps 10 minutes ( I have no idea really) was incredible. The midwife drove me crazy - for goodness sake she told me to be quiet (though not rudely). I guess she read on my birth plan that I wanted to breath him out gently and felt she should remind me of that or something, since I was yelling at the top of my voice. Some of the contractions - or for part of them - I was still able to focus on breathing him down instead of pushing and tensing and writhing around. I would try to hold eye contact with Julia and listen to what she was saying and ignore the midwife.
Oh, I remember also, the midwife kept telling me I was safe, nothing was going to happen to me blah blah blah. I think she was saying that while I was still on the bed. I knew what she was trying to do - to get me to relax and not fight the contractions. But I kept thinking 'Yeah, you said that already. But since it's obviously not helping me, just shut up already!' I just wanted her to go away, so I could get on with it.
For the last part of second stage the midwife got me into a not very helpful position, but one where she could see what was going on - see his head as it came out. The baths they have there really aren't big enough for water births - I would have liked to be upright, maybe sitting on a birth stool in the water, or ideally (in deeper water) squatting, holding onto the edge of the pool. But instead I was virtually on my back- my head and shoulders up against one corner of the bath and my feet on the opposite site down the bottom. So no gravity to help me, but not as bad as being on my back on a bed or anything. Chris was in the bath too at that point, and he was pushing up on my lower back during contractions, because that was where the pain that made me tense up was. Funny, because Liam wasn't posterior or anything, but it was more uncomfortable in my back than anywhere else the whole time. And I guess it was good that she could see what was going on, because Chris told me afterwards that she did have to unloop the cord from his neck.
I remember feeling down with my hand to feel his head coming out. After one contraction the midwife asked me if I'd felt his head and I said no, but the next time I realised that I had - it had just felt so weird, all pointy from the way the skull molds to come through, that I didn't think it was his head. I thought it was some weird part of me that I was feeling through the opening of the vagina - some part that had swelled or that I couldn't usually feel or something. But then with the next surge I felt down again and realised it was his head.
The amazing part was that last contraction. First his head popped out and then seconds later his shoulders and the rest of him followed. In one swift movement the midwife caught him and lifted him to me. I was stunned and awed. 'Oh my god!' I think I said 'It's a baby!' I was so involved in the labour and the birth, the fact that not only was it over, but there was a baby to show for it was stunning. The relief at it being over was entirely eclipsed by the shock at their being a baby on my chest. A real one. Liam had just been a theory until then. A hypothetical baby. I think especially because we didn't know his sex, so we didn't know if he was going to be Liam or Mikaela, he hadn't seemed so real. I mean, I thought he'd seemed real, I talked to him all the time while he was in the womb, but not this real. Up until then he had just been 'the baby'. Now he was an actual baby. A person. A son.
It was good that Chris was in the bath with me then. So that he was immediately involved, able to put his hand on Liam's head as he lay on my chest, instead of just watching from outside the bath. And I hadn't thought about it before, but in a way the bath made the whole thing much more intimate for us: Chris, Liam and I were in the bath, while Julia and the two midwifes (they always have two there for the actual moment of birth) were outside looking in - a physical boundary to protect and surround our new little family.
It was a moment of shock and awe and wonder, mingled with relief that the labour was over (except for the placenta, but that was nothing) and perhaps a tiny bit of regret at the loss of Mikaela. Not that I regretted Liam - not for a second. But up until that moment Liam and Mikaela had both existed in my mind. With the birth of one, the other one was gone. That was slightly sad, but only slightly. The wonder at the one who was real - Liam - was too great for any other feelings to get much of a look in.