My birth project
Last week, exactly at 00:13 on 20.05.20, our daughter Lucia was born. I have had transformational experiences in my life before, but this experience was different. I knew as it was happening that it was changing me and my life forever and in a meaningful way, unlike any other experiences I've had which required hindsight.
I have shared a lot of my fertility journey in this blog before, but thought it would be good to contextualize some things.
For most of my adult life I thought I was not fertile. When I was 22 years old, I was told by a doctor in Brazil that I had a bicornuate uterus and I tried to operate without success. He told me I would likely have trouble carrying a pregnancy successfully. It was devastating news to a 22 years me old who didn't even know what she wanted out of her own life, and then see her choices limited at a fundamental level. Not fit for reproduction: what was nature trying to tell me?
I was surprised, at age of 29, to learn that I was pregnant despite using birth control. It was a very hard decision for me to make at the time, but I decided I wasn't ready to be a mother, and decided to have an abortion even if that meant I would perhaps throw away my one and only lottery ticket to maternity. Ever since the unsuccessful surgery to fix my uterus, I thought of maternity as something I had to be flexible about and considered adoption and other means vs getting pregnant as possible ways to achieve it.
Check these posts if you're interested in learning about my fertility journey from the moment Mark and I decided to try to have kids, up to the moment when I learned I was pregnant:
This post isn't about pregnancy, it is about birth, decisions, preparation and reality. There will be a lot of bodily details, so be aware of that if you're considering reading on. I will also share my opinion on what things I think I influenced vs just got lucky with.
As a way to prepare for birth, I decided I had to inform myself about my choices. I read some books:
If you're considering pregnancy, and evaluating your choices, I recommend you to inform yourself. Birthing is way too big to go into it blind. The more information you have, the better decision you'll make for yourself, independently of what your choice is.
Mark, my husband and birthing partner also was doing his homework. He read Expecting Better, by Emily Oster, and also The Birthing Partner. He highly recommends birthing partners to read those books (as well as the second book by Oster, Cribsheet).
To make my decision, I took into consideration how I felt about my body and what I wanted for myself after birth. My conclusion? I wanted to get back to being myself as soon as possible. As far as I knew at the start, I didn't even think I would like the experience of being pregnant. I thought I would feel enormous, not mobile, and not in charge. But I did enjoy being pregnant a lot in the end, and witness my body making another human being and changing so rapidly.
My conclusion from reading in particular the three first books in the list, is that I wanted a vaginal birth. And if possible, without an epidural, which makes it a natural birth.
According to research and wisdom from midwives, once you start having "interventions" for birthing, the likelihood of cascade interventions with less predictable outcomes becomes larger, and with that, recovery becomes less predictable. I wanted to bounce back fast. I still do want, but since I am 8 days after birth writing this, it is a work in progress.
Given that I opted for a natural birth, there were questions I had to find answers to:
a) What am I afraid of?
b) What can I do beforehand to address those fears?
c) What are my options for the birth itself?
d) What if things do not go according to plan?
Section 1: What am I afraid of?
One of the things which I thought would be important as I prepared for my birth experience was to be honest with myself about things I was afraid of. So I thought about what those things would be for me and what I would have to do in order to prepare myself.
I am afraid of harming my baby or myself.
Natural birth meant less interventions, which sounded good. At the same time, when you let nature take its own paths you have unpredictability which is very uncomfortable. I was very afraid that not wanting medical intervention would somehow be close to being negligent. And I didn’t want to be negligent. I remember looking at the wardrobe with all clothes of the baby washed and ironed inside just weeks before birth, and showing Mark where everything was “just in case I wouldn’t come home from hospital with them”. As this thought crossed my mind, tears filled my eyes. I had this fear of not coming back home.
This fear was also true towards the baby. Of course, as any pregnant woman, I was afraid that any decision I made (or did not make) could result in harming my precious little girl. Just the thought of it was very scary.
I am afraid of the pain during the contractions.
Everything you see in movies, and most of the things you hear from others are about how painful birth and contractions are. I was afraid of that, of course. Who’s not afraid of being in pain? I also know it was a pain I wasn’t used to, and have never felt before.
I am afraid of having a big tear and the long term consequences of it.
Any woman that goes through birthing a child and tells you she doesn’t think about their vagina being stretched to pass an (average) 36cm circumference head through it is probably a liar. There’s no way to not think about it, and think it is an impossible task. My body functions are something extremely important to me, I did fear that birth itself would “damage” me in a permanent way. Quite a few women need cuts to help with their births. I didn’t want either a tear or a cut, but thanks for offering.
I am afraid of the unpredictability of the process.
Some women have 3 hours labours, others have over 30 hours labours. Some have traumatic experiences, some have wonderful experiences. For some the birth of their child starts fine and ends up in an emergency. How would I know what my process would look like? We already established I was afraid to die, but that’s an extreme. There’s a whole rainbow of other possibilities which are unpredictable, and being on a path that you know the destination, but not what you’ll encounter on the way is very scary. Let alone that most of the birth experiences you will hear from others are not the “I had the time of my life” stories. Perhaps because women go through such hardship to birth their child, they want their stories told as a way to process what happened to them?
I am afraid of giving birth amongst strangers.
Mark has always been very supportive and would stand by me no matter what I decided. He read books about pregnancy and birth and also educated himself on how to be helpful to me during labour. We had an agreement for a postpartum setup on who takes care of what (basically: I take care of the baby, Mark takes care of Nanda). Closer to the birth we also agreed on a safe word I would call at the hospital in case I wanted an epidural (the word was caipirinha, in case you’re curious).
Since we live in Switzerland, I also familiarized myself on how the healthcare system worked and how I could ensure that I knew the people who would support me for labour. I found out that here you have the choice to hire a private midwife who works in a particular hospital. So instead of going to the hospital and working with the people on shift when labour starts, you call your midwife and with her you determine whether she would come to your home to help you, or meet you at the hospital. She will also stay the whole labour with you and the hospital staff (the strangers) would only be called in if I had complications or if she called them in the room. For delivering the baby, a second midwife is required to be in the room.
I found Eva Kaderli through recommendations from a friend’s midwife (thanks Amy!). She has been absolutely fantastic. She has been my main care provider since week 30 of pregnancy and was a calm voice to my “please give me all the data” inner paranoia. She has assisted women to deliver hundreds of babies in her career, and when I mentioned her name to doctors (by Ob-Gyn and a Ob-Gyn who’s neighbors with a friend) I would hear “the is amazing” and “she’s the best”. They were right. Eva is amazing.
With the pandemic though, I had this fear that Eva could be called into the frontline, and also that Mark for some reason wouldn’t be allowed in the labour room. The restriction on birthing partners (fathers, or otherwise) has been put in France, for instance. That would have been a major bump in the road. Fortunately it didn’t become true here.
Section 2: What can I do beforehand to address those fears?
Research less intrusive pain management.
If you’re not taking opioids or an epidural, you’re basically left with massages, breathing, meditation, being immersed in water and (thank god!) gas and air. I read about all of those things, their risks, benefits, how they help with pain management, and decided that, unless necessary (or I used a safe word Mark and I established before labour) I would not take opioids or an epidural.
Epidurals are great, don’t take me wrong. For the babies, there isn’t any reason not to do it. Epidurals aren’t associated with bad outcomes for the baby as far as my research went.
For the mom though, the picture isn’t as good. On the plus side, epidurals provide great pain relief. But that’s with caveats. Epidurals do not always work, they take mobility away from the birthing mom and you cannot go into a birthing pool if you have one. Epidurals increase the likelihood of other interventions too, such as ventouse and forceps births, and those come, most of the time, with the need of episiotomy which was in my no no list. Epidurals are also connected to higher C-section rates for fetal distress, and longer pushing time. There are other issues I could list here, but in my head I just decided to remind myself that epidural equals the possibility of cascade of interventions, and those wouldn’t be bad for the baby in terms of outcomes, but for me they could be bad in terms of recovery and long-term issues.
Opioids is a whole different game. I definitely did not want to have opioids for my labour. I had very strong opioids for some fertility procedures in the US, and the whole thing is scary, besides being addictive, there’s evidence that opioids aren’t very effective on labour pain. Also there’s no research on longer term effects of their use in labour. Ok, I have to admit I am also biased against the whole opioids industry and how they turned opioids into an epidemic in the US.
I learned that a lot of women who labour without epidurals and birth in water use gas and air (also known as laughing gas) as a way to relieve pain. Gas and air isn’t a painkiller itself, but it takes away the edge of the pain from the contractions (in theory). It is supposed to feel like having two or three glasses of wine, and that for sure makes you relax. I miss having two or three glasses of wine (not the morning after)! I decided I would have gas and air in case I need help with pain management in labour.
From the time I was researching, water seemed to be the birth of choice for most moms opting to birth their babies naturally. Water provides good relief of the pain, and also relaxation which is much needed in between contractions. I was totally sold on it. Water was in my plans and one cannot argue much against water :-)
I have been practicing yoga for almost two years now, so I knew that meditation would be a good thing to practice during labour, and I was definitely planning to use that, in addition to breathing exercises to help with labour. I had not heard of hypnobirthing, but the idea also sounded good, so I signed up to that too: I decided I would continue breathing, I would meditate and why not would also check this hypnobirthing thing for my labour.
One thing I repeated to myself a lot of times thinking about the pain was: women die because of complications, not because of the pain. I knew the pain wouldn’t kill me.
I can read birth stories to familiarize myself with possible outcomes.
As part of preparing for birth, I read a lot of birthing stories. For the birthing stories the book from Ina May is a great resource, as it starts with a lot of stories with different outcomes. In addition, I would search for stories in websites that speak about things such as hypnobirthing or natural birth websites. I read a lot of birthing stories which were happy stories, and I also read some that had adverse outcomes. For me, having information was crucial and I felt more empowered the more familiar with the process I was.
I can watch natural birth videos and check if I think it could be for me.
If you want to put a picture on your mind about how a childbirth looks like, do not watch movies or TV series. Most of the time they treat birth as a medical emergency and nobody seems to be having any fun. I did want to put some images in my mind, so I went to good and old Youtube and searched for natural birth videos and I was positively surprised with what I found.
In addition, I received the recommendation to look at this website and Mark and I watched several of the videos there: https://www.monetnicole.com/birth-videos.
I can prepare myself through books, classes and physical activity.
The reading list is at the start of this post. I recommend you read all of them, except Hypnobirthing by Marie Mongan. I did not like the style of the writing, and did not find the reading super useful. The most useful thing about that particular book was the story about her watching her cat giving birth. It is useful to pay attention how animals cope with birthing, because as I said to a friend of mine, birthing a baby is a lot more like “Animal Planet” than a romantic comedy.
I practiced prenatal yoga the whole pregnancy (from week 12), about twice per week. I took classes first at Birthlight, a pre and post natal yoga studio in Zurich (highly recommend), and after the pandemic closed the studios, I continued with a private yoga instructor, Gisela Collazo (who’s also our postpartum doula) and in addition I did some online classes through MyYogaWorks (thanks Dana for the recommendation!).
I also took a Hypnobirthing class, which I have mixed feelings about. The instructor was very nice, but I did not click with the method itself, because I found it to be too much about feelings, emotions and nature and a lot less about tools I could have in my toolbox to use in labour. For Mark, since he had read less about the subject than I, it was very interesting to understand how contractions worked and other basics of childbirth. If you want to learn more about Hypnobirthing, there are classes pretty much everywhere. I recommend reading the book by Katherine Graves. I took thing my class with Awital from My Gentle Born in Wettingen. One important tool I got from from the classes and used throughout the pregnancy were the affirmations for birth. I found those useful to remind myself of having confidence in the process and I listened to them quite often.
Because all of this process was happening during the largest pandemic in our lifetime, all in person classes, including birth preparation classes in Zurich, were cancelled. As a result, I did not have in person classes for birth preparation and I did not get any tour of the maternity beforehand. My Hypnobirthing class was also interrupted, and I had to do the fear release session via Zoom. Not ideal, and I wouldn't recommend for someone who's not used to meditation. I did enjoy the session a lot.
I asked friends for recommendations for online classes on birth preparation and ended up taking several classes with Jo Everatt, a British midwife living in Brussels who really cares about moms and babies and did a great job quickly adapting to the situation of the pandemic, moving a lot of her classes to be delivered online. Mark and I ended up taking several classes with her (Breastfeeding class, Surviving the labour ward, Baby Skills and a refresher of infant and child CPR training). If you need to take those classes online, consider doing with Jo (thanks Ilana for the recommendation!).
I also tried to remain active. I did some short runs at the start of the pregnancy, but after week 16 it got very hard as the belly bouncing felt uncomfortable to me (also, I could write a whole blog post on pregnancy sports gear that suck, and I could not feel comfortable on anything to do a proper run). I then started taking walks instead, I even went snowshoeing, and in general (as much as the pandemic allowed me) I did move around. I spent probably at least an hour per day on my pilates ball bouncing and making pelvic movements in circles, side to side, front to back. In the last month, I used to go downstairs to the ground floor of our building and come up the stairs to our apartment at least a couple times per week. We live on the 5th floor, and they start counting floors at zero in Switzerland.
Last, and not well spoken about… I mentioned I was afraid of tears from birthing vaginally. So I researched what I could do about it. I found two devices in the market that help you to prepare your perineum for birth, and you can use them as a way to also familiarize yourself with the pressure you’ll feel at birth when the baby is passing through the cervix. Those are EPI-no and Aniball. I picked Aniball because I read the reviews and some people reported Aniball was easier to place in the vagina and it would stay, while some of the reviews for the EPI-no mentioned being hard to keep it inside.
I started practicing with Aniball every day. By week 40 I could pass the balloon at 28.5cm circumference through my vagina only using breathing. Amazing I know. They have a video about how the exercises work here. Aniball gave me the confidence that my body could birth a baby vaginally. The start was very frustrating and I even cried a bit in silence trying to use the device and making everything work. But I persisted, asked Mark to leave me alone to exercise and then whenbirth got closer, he joined me to support me through the exercises, which also got more intense.
After the exercises with Aniball, Mark would do a perineal massage using a special oil from Weleda. I found the massages, more than anything else, very relaxing after the exercise with the balloon.
Section 3: What are my options for the birth itself?
I can give birth at home.
I did not like the idea of giving birth at home because I was afraid of not having the necessary medical support in case things went not according to plan. The hospital in my case was assurance and safety. I am 38 years old and this is my first child. By the book, I am already advanced age pregnancy and therefore risks are higher.
As the pandemic aggravated though, not having to be at a hospital with possibly loads of sick people with covid-19 became more appealing. Also, the restrictions on hospital access meant that Mark would only be able to attend the birth, but not stay with us in the postnatal ward. I contacted a home birth midwife and had a chat with her. A couple of weeks after that, I called her back and gave up on that option because I liked working with Eva so much, and I didn’t want to change that.
I can give birth at a birthing center.
The birthing center was never very appealing to me. If you’re doing somewhere that has no facilities to escalate your case within, then you might as well be at home? Not sure. I looked at a very traditional birthing center in Zurich, Delphys but the possibility never really crossed my mind in a serious way.
I can give birth at a hospital.
I researched statistics on C-Section from the various hospitals in Zurich. Some have rates as high as 58%, while others are close to 20%. Besides the C-section rates, another thing that was important to me was that the hospital where the birth happened had a neonatal intensive care unit. That particular pre-requisite narrowed down the list to two options: Triemli Hospital or University Hospital.
I went for Triemli because they had the possibility of a private midwife arrangement, they were near home, and in hindsight I also liked the fact their maternity building was separate from the rest of the hospital. In times of pandemic, not being in the same building as people sick with covid-19 was definitely a feature. Being able to walk to the hospital for my appointments from week 30 was a nice way to avoid taking public transportation.
When Mark and I went to meet Eva, our midwife, for the first time at 16 weeks pregnancy, she showed us around the Triemli maternity ward, and the place seemed fine. Not fancy by any means, but most labour rooms had pilates balls, ropes, showers and a birthing pool. That was all I needed, and I was happy with that.
In Switzerland, usually after an uncomplicated vaginal birth the mom and the baby are discharged in 3 days. Because of the pandemic, though, the hospitals were not allowing birthing partners to access the postnatal ward for more than 1 hour per day.
My goal was not only to give birth at the hospital. I wanted to give birth at the hospital and I wanted it be smooth so I could come home within hours, which is a possibility and is specially encouraged because of the pandemic. I could be at home as fast as 6 hours after labour if the baby was born during the day, or I would have to stay overnight if birth was in the evening or night and then come back home in the afternoon of the same day. I called this “drive-through” birth.
Section 4: What if things do not go according to plan?
Not always things go according to plan. For this one, what I decided to do was to ensure I had all the information about the possible outcomes (which reading the birth stories helped a lot) and I had to grow a bit of faith in the universe.
One thing that I learned being pregnant is that it does sometimes feel like when you're in an amusement park and a friend convinces you to go on the rollercoaster. You hate rollercoasters (I do!) but you end up agreeing. As the seatbelts lock, you feel terrified. But as the cars go up the first slope, you accept that you're in it for the whole ride, and you cannot control much at this point. Baby was in, was growing and healthy and had to come out. I would trust the advice of my care team in case things didn't just happen as I imagined.
My birth plan
A lot of the books on birth talk about the importance of having a birth plan. This is a written list of your preferences that you can share with your care provider to ensure that, as possible, they follow your preferences when the big day arrives. It is also pretty important because it will allow you to discuss each item with your birthing partner, and this way they can be an advocate for you in the day of the birth. Last, you should not count on your own ability to make important decisions while in active labour. You'll be in a different mind space.
I did not write a birth plan itself, but I had a list of bullet points I checked with Eva, our midwife, as part of the birth preparation. What I had in my list is this:
I will be practicing Hypnobirthing/meditation/breathing exercises during labour.
If water breaks before labour, wait for 12 hours and avoid vaginal examinations in this period.
I will be drinking water, juice and eating small quantities to stay well nourished (pineapple, orange, mango).
Stay home for as long as possible.
Quiet and calm environment, no active coaching.
Dimmed lights please.
I would like to stay mobile.
Encouragement is welcome.
Gas and air for pain management if necessary.
No induction unless the baby is in distress or if I reach 42 weeks of pregnancy.
In the case of induction, I would like to get anesthesia -- the minimum possible so I can stay mobile for as long as possible.
No routine episiotomy.
Water birth if possible and available.
Delayed cord clamping. Mark does not think he wants to cut the cord, but ask again just in case.
Skin to skin contact with mom and dad immediately after birth.
We would like as much family time as possible after the birth.
We would like mom and baby to go home as soon as possible after birth.
My birth story
As the “due date” approaches, besides people asking you all the time whether the baby is here yet, I started to wonder whether every new sensation was the start of labour. Most of the time they weren’t. One tip I got from a book I read (I believe was the Oster book) is to tell people, when they ask about the due date, something like “end of June” instead of a precise date. I also told many people the due date was June 2nd, when I would be actually closing my 42nd week.
Differently than what is portrayed in the movies, labour doesn’t start all of a sudden. Your body slowly gets prepared for it, and gives you clues it is about to happen. Since this was my first pregnancy, I had no idea what those clues could be though.
Reading about it, I was aware that my “pre-labour” contractions would become more regular. They did on Sunday, May 17th. Mark and I timed the contractions and I was having contractions every 8ish minutes.
The pre-labour contractions feel like your belly is going really hard, and that creates discomfort on your abdomen, because it stretches all the muscles in a weird way. It can be painful, but the pain there is what I called “stretchy pain”. You feel muscles being stretched to the point of discomfort to cope with the contraction of the uterus. Those contractions aren’t painful.
During the day on May 18th I didn’t feel much, but I noticed the contractions continued. At around 3pm, I lost my mucus plug, or at least part of it. The mucus plug is an egg white like blob that comes out of your vagina. The volume is about a large tablespoon worth of mucus (at least it was like that for me). Sometimes it can be stained with a bit of blood. Mine was just transparent. For a lot of women, losing the plug means the start of labour, but not for all. Not for me, anyway.
My toilet trips were all followed with much anticipation from that moment. Am I going to bleed? Is this pee or my waters? I felt nothing but the same pre-labour contractions every 7 to 8 minutes.
I went to bed as usual. In those last days of pregnancy, it was always unclear whether I would have a full night of sleep or not. I had not slept well from Sunday to Monday, so I didn’t expect much success from Monday to Tuesday either.
Worth mentioning that, during pregnancy and for me from month 7th or so, there hasn’t been a single night that I slept all the way from evening to morning. I always woke up in the middle of the night to pee, at least once.
Tuesday May 18th 3am. I go to the toilet but before I get there, I feel a lot of water coming down my legs. It was obviously not pee. My waters broke. Much excitement came with that so I could not go back to sleep for a while, but that wasn’t the start of active labour just yet.
From the time my waters broke, every time I went to the toilet there was “something weird” in the paper when I wiped. It looked maybe like the same consistency as the mucus plug, but yellow-ish in color.
We spoke to Eva on the phone early in the morning and she assured us that everything was normal. That was probably around 8am. She asked us to come to the hospital at 4pm to check on the baby’s heart rate -- or we’d meet earlier if labour had started.
After the call, I went to the toilet and noticed that the yellow-ish color was more green-yellow color, so I messaged Eva asking about that. At this point I of course had checked the internet and I had a good clue of what was happening: the baby had passed meconium (pooped while inside the belly). This can potentially mean the baby is in distress, and also there’s a risk of Meconium Aspiration Syndrome at birth, which can be very dangerous to the baby.
Eva told me that, since I had meconium in the waters, I should come to the hospital at 10:30am for an ECG. There I went and she monitored the baby’s heart rate. Everything seemed normal. She suggested that I came back to the hospital at 4pm to have a cocktail that could help onset active labour.
The cocktail was something I’ve read about in some of the books: castor oil. It works about 50% of the time. Castor oil upsets the mother’s stomach and that can start contractions naturally. The contractions are not more intense than regular contractions (unlike the contractions one has when induced with Pitocin, for example). Castor oil is also known to taste terrible.
I went back home hoping labour would start because at 4pm when I went back to the hospital for the cocktail, Mark wouldn’t be able to be with me until active labour started, and that would take about 4 to 6 hours from the time I had the cocktail. Active labour did not start, so we closed our bags and headed to the hospital.
If labour doesn’t start within 24 hours of the waters breaking, then you need to do a medical induction. To cut it short, women who have inductions are more likely to have epidurals because the contractions are much stronger than natural contractions, and once you have an epidural there’s the risk of that cascade of interventions as I mentioned before.
At this point, the control freak in me was already thinking “oh fuck this is nothing like I planned. I just want to have this baby safely”. I wasn’t very happy but was committed to bring our little human safely to this side of the world, regardless of the cost to me at this point.
When I arrived at the hospital at 4pm, I was put into a pre-labour room with a bed, a desk, a cabinet and a chair. Eva did another ECG to check on the baby’s heart rate, and was also possible to see the frequency of my contractions, still painless contractions. Everything was fine. She prepared my “smoothie”. A mix of almond cream, apricot juice and castor oil -- do not do it at home without medical supervision. It tasted better than I expected. I had that at 5pm. Eva said goodbye and went home to rest and promised to be back by 10pm, when she expected me to be in active labour.
|Castor oil "smoothie"|
I felt a bit sad to be alone, tried to talk to people for a while over WhatsApp, and started watching an interview on Youtube. At some point I got more uncomfortable, and more, and the discomfort became a very strong pain. I was very sad and upset to be suffering on my own alone. I pressed the “please midwife come check on me” button and I said I needed my husband to be there. I felt like I was going to go crazy on my own. The midwife said she was going to check if that was possible. I pinged Mark and said labour would start and he should be ready to come to hospital. The midwife came back and said “your husband can come”. At that point Mark had already messaged me saying he was on his way. The hospital staff also called Eva, and they told me they were preparing the labour room for me.
Mark arrived around 8pm, and they quickly moved us to the labour room, where a never before so appealing bathtub was waiting for me. I got there and I asked whether I could get into the water, and so I did. They put a wireless monitor around my waist. Contractions were very intense, but it was much easier to cope with them in water. Eva arrived probably around 8:30pm. For those who know nothing about labour, the contractions at this point at dilation contractions, or first phase of labour. The goal of those contractions is to help your body dilate to 10cm opening in your cervix. Ok, back to the story.
Before Eva arrived, I was already talking Mark down the “I want an epidural” path. I did not call our safe word though. When Eva arrived, I made the same “please feel sorry for me” speech about the epidural. Eva was supportive but firm. She said this wasn’t what I had planned for myself but that I could have an epidural if I wanted, she asked me to try a bit more. I begrudgingly agreed. I “tried” a bit more and asked for gas and air. She measured my cervix and I was 5-6cm dilated.
I asked Mark to play some music. He used my phone and our travel speaker which we took with us to the hospital. I wanted to listen to the album from Caetano Veloso and Gilberto Gil, entitled “Dois amigos, um século de música” (Two friends, a century of music). After that album was over, I asked him to play Cara B, from Jorge Drexler. At some point a very busy song started playing and it felt a bit overwhelming to me. I asked Mark to skip that song. Before he got to do it I asked “is this playing from my phone?” and he answered yes, so I went “ok google next song”. And the phone miraculously did what I asked for. At last!
The magic tube of gas and air arrived at 9pm. So far, Mark was helping me with encouraging words, offering me water, and also giving me a bucket because I started feeling nauseous and felt I was going to throw up. I never really did. From that point on, Mark was also the gas and air operator, so he would place the valve and press it for me to take it in. He might or might not have tried a bit of gas and air when Eva left the room. It was important he would know first hand how much he needed to press that button!
I worked through a few more very intense contractions using gas and air, or at least trying to figure out the timing with it and something really weird started happening. I felt an urge to push. At that point my head started to think “omg, this is where I fuck up, I cannot be pushing at 5-6cm dilation”. I went back to the “please feel sorry for me epidural conversation”, without mentioning the safe word again. I told Eva that I didn’t think it was working for me because I wasn’t fully dilated and I felt an urge to push. She said “really? Can I check your cervix?”.
Checking your cervix means the midwife will insert two fingers inside your vagina as far inside as she can reach, then she will open her fingers to estimate how open the cervix is.
She did that and her face changed. She said “Fernanda, you are fully dilated. This is fantastic” or something like that. This was 9:30pm. Those contractions were VERY intense. In plain English they hurt like a motherfucker. Going from 5-6cm to 10cm dilated in 30 minutes probably is what made those contractions so very intense. Did I mention they were VERY intense?
So my urge to push wasn’t misplaced. I was actually ready! The contractions at this point felt different. They felt less painful and more like pressure towards the lower part of the pelvis. More or less as if you really needed to poop and there was nothing you could do about it. These contractions are known as “push contractions” or “second phase of labour”.
Since I am mentioning poop, let me also tell you there will be poop. Some women have diarrhea just before birth. I did not have that. I did poop inside the birthing pool, though. Quite a few times according to Mark. I cannot remember much besides one image of Eva “fishing” my poop from inside the water at some point. To be honest, I had no fucks to give about the poop. I knew my body could expel poop, as I’ve done that my whole life. The feeling I had at this point, which was terrifying, is that I would have to poop a pineapple with skin. The push contractions felt like my orifices would explode if I put any more strength to push anything out.
Eva was patient as I cheated those contracting with mouthfuls of gas and air. I felt super relaxed in between contractions and I would push “the minimum necessary” to get by with them. Knowing I was going nowhere, but I honestly needed a break from the first phase of labour.
I was offered to put my finger inside my own vagina to feel how close the baby was, and I did that a few times and could feel progress. It felt amazing to be able to feel the baby hair with the tip of my finger. She was perhaps about 4cm inside and then 3cm. I would check on her between contractions. I knew I was making very little progress to be honest. Mark also felt the baby with his finger after I offered him to do so.
At some point, it was already 11:30pm and Eva told me something like “Fernanda, you know you need to push harder than this. The baby isn’t going to come out like that”. I surely knew. She told me to take a deep breath and hold the air inside me and push as hard as I could, and the baby would come out. I said “ok, let me build the courage”. I remember looking at the clock and it was almost midnight. Once it passed midnight would be 20.05.20, my due date, and something in my head just clicked saying “ok, its time”.
I started the strongest pushes I could find strength to perform, and 4 contractions later, Lucia was born. In the first contraction her head crowned, but went back in. In the second contraction her head was half way out, and Eva asked me to hold. In the third contraction her head was out and last but not least the whole body came out. Mark said he saw the whole thing happening, and he thought it was fascinating to see what my body was doing (albeit also a bit scary).
The baby’s head passing through the perineum felt like a very powerful stretch and I also felt that sensation familiar to what I practiced with Aniball earlier. I wouldn’t describe it as painful.
The push for the baby to come out feels like a relief. I felt physically empty. Eva asked whether I wanted to take the baby myself and I said “no, please just hand her to me”. She did. And I took Lucia in my arms. As I brought her towards my chest I felt a painful pull in my uterus. Eva then told me “don’t bring her too high, your cord is very short”. I placed her on me, and Mark took my favorite photo of the experience. As you can see in the photo, the water is clear. Not pink, not red. Mark said he saw a little splash of blood into the water as Lucia came out, but it was just a tiny bit.
|The happy face seconds after Lucia was outside my body|
After that a pile of warm towels and blankets landed on top of the two of us, still inside the birthing pool. A few minutes later Eva announced the cord had stopped pulsing, and asked Mark if he wanted to cut it. Mark did not feel like cutting it, so Eva did it.
She told me they would pass Lucia on to Mark and take me out of the pool. So they did that and brought me to bed to deliver the placenta, also known as the third stage of labour. As I laid down in bed, my whole body started shaking. Not as you would shake when you get out of the swimming pool and it is windy. Shaking like in an earthquake. It was a mixture of feeling so cold with feeling so exhausted. A thousand warm blankets later, I stopped shaking. One more job to do, and birth would be over: birthing the placenta.
At this point you don’t feel any painful contractions. I did not feel any contractions to be honest. I was on my back in bed, and Eva asked me to push. I did push twice and the placenta was out. There was some more blood to be seen at this time, and since I was in bed it was a bit more obvious, but nothing scary.
Eva then checked my vagina and made the best postpartum announcement: no damage to the perineum (no tears, therefore no stitches!).
Minutes later, Lucia Josephine Drayton, the cutest baby in the whole world, was melting my heart and latching on my breast. Her head had a 36cm circumference, she weighed 3.520kg and was 48 cm long. What I had just accomplished was just the most powerful, bare bones experience of my life. I am pretty sure that’s how superheroes feel like after saving the world. I was a superhero.
Eva took me to have a shower while Mark cuddled with Lucia. At around 3:30am Mark left the hospital and I was moved into the postnatal ward to sleep. I spent most of the night just looking at the magic baby I had by my side. Never had such a feeling of being so content in my whole life. I needed nothing else.
The next morning I woke up and went to the bathroom to pee. I took Lucia with me in her wheeled crib. I was afraid to pee because some people report a stingy sensation peeing after birth. I did not feel that at all. I had no pain. I was feeling pretty good. I had breakfast and lunch at the hospital, and they also brought me a sandwich snack for the afternoon. I ate all of it, I felt very hungry. I definitely ran a marathon.
Since everything seemed fine with us, I asked whether I could leave the hospital that same day. The hospital organized a pediatrician to check on Lucia, and we were free to go as long as I had a pediatrician appointment for Lucia to be seen when she completed a week of life. Mark organized that and at 5pm, just 17 hours after Lucia’s birth, we were home, the three of us.
|First family photo, outside Triemli Hospital|
How do I feel about the experience, you might be wondering? I feel very positive. Mark also feels very positive. The investment we made in terms of preparation paid off. Mark also prepared very well and I honestly could not have asked for a better partner to go through this experience with. He was fantastic support for me, and continues to be in the postpartum period. He is taking care of me so I can take care of Lucia.
Both of us feel that the more we informed ourselves about the process, the less scared we were and more prepared we felt.
Of course there are things I think I got lucky with. First, my labour was 4.5 hours long. For a first child, this is considered VERY fast. Besides trying to be as relaxed as you can, you cannot control the length of labour as each woman is different. I wonder how much the exercises and massages helped with having my perineum intact. I don’t think I would like to A/B test that. I will take that some of this was luck, and a good part was preparation.
I do think though that all the training, preparation and persistence even when things got hard (as with the Aniball exercises) made a huge difference.
Do I recommend this experience to everyone? Absolutely not. I do recommend though that you inform yourself as much as possible, and plan an experience that works for you based on your own goals, fears, limits and priorities.
Would I do it again? At the moment I am not sure if we’ll have a second child, but if we do, I am going to prepare myself for a natural birth again, yes.