This week the tables have turned, we have a midwife and two-time award winning blogger Lisa Roddy sharing her birth story. Here’s what really happens when the midwife is in labour.
What happens when the midwife is in labour?
Being a midwife is a privilege and a vocation, I love my job. I don’t always love the where I do my job; a lack of resources and investment in the HSE make it far from ideal. All we can do is our best with what we have to try to make maternity care a positive experience for women. So what happens when the midwife is in labour?
I had a fairly big bump, it always measured 2 weeks bigger than my gestation, and I was 10 days past my due date. I didn’t have a written birth plan, it’s not that I disagree with them but I’ve seen so many perfect birth plans go out the window as soon as the first contraction happens. I did know exactly what I wanted. I wanted to stay mobile, to eat and drink as I liked and to keep options open around pain relief but avoid an epidural, if possible. I wanted skin to skin with my baby and to be home 6 hours after delivery. I didn’t want an induction of labour unless I got to 42 weeks (unlikely given the size of me), CTG monitor unless clinically indicated or IV cannulas. I didn’t want to be lying down on my back or ARM (breaking my waters). This was all in my head and my husband had heard it all on a few occasions.
I agreed to a membrane sweep at 41 weeks which I didn’t find uncomfortable. I had expressed colostrum (breastmilk) antenatally from around 38 weeks so I believe this helped make my cervix favourable. The obstetrician wanted to bring me in for induction of labour in 3 days but I declined so after some negotiation I was to have daily scans from 10 days over and come in at 42 weeks gestation for induction. Not that it was likely I’d be still hanging around that long.
At 9 days past my due date (2 days after my membrane sweep), things started in the early afternoon. Just a few niggles but I knew this was it. The tightenings were only about every 30 minutes and very mild so I ignored them as best I could. I walked and had lunch with my mother – I didn’t mention what was happening, the excitement would have been too much for her! I then went home for a rest as I knew it might be a long night. When my husband came home around 6pm, we had a visitor so I couldn’t say anything even though the tightenings were now every 15 minutes and enough to make me feel uncomfortable.
Around 7pm, we had the place to ourselves and I said maybe just have everything ready at the door for later. Mini panic on his part but all was well, I stayed focused. I went between the birthing ball, standing over the bed and the bath. It was all good, I felt in control and felt that things were moving along as they should. In my head, I wasn’t going near the hospital until absolutely necessary.
Around 11.30pm, I checked my own cervix (I know, I know but there was no way I was going to the hospital until I was at least 4cm). I was 3-4cm dilated in my estimation but I could feel bulging membranes and couldn’t feel the baby’s head. This may have been because it was difficult to stretch to do the examination, especially with my huge bump to negotiate around. Anyway, I didn’t want to take the chance of my waters breaking and a cord prolapse if the head was high. So I gave the midwives (my colleagues) on labour ward a call to tell them I was coming in.
The half hour car journey was uncomfortable but I encouraged himself to take it easy. It helped that it was after midnight on a Wednesday night so the roads were empty. We landed in and had the whole labour ward to ourselves which was fantastic. My colleagues were brilliant, they just let me do my own thing. I was examined at 1am and found to be 4cm with regular contractions (3-4 in 10 minutes) and bulging membranes so they offered to break my waters but I declined. Things were going well, I wanted to keep things normal, no interventions. I started on the Entonox (gas and air), it was so strange to be standing there in my nightdress in front of my colleagues puffing on the Entonox. Surreal. I didn’t feel the Entonox made any difference to the pain but I couldn’t put it down just in case it was helping and it was worse without it.
The time flew, I couldn’t chat, I was in my own little world. I stayed mobile as much as possible to try to get the baby’s head down. Plenty of hip swaying. I decided that I needed more pain relief at 4am so I got a pethidine injection. I always thought pethidine would be something I’d avoid when working as a midwife, I felt it made people really “out of it”. But personally, I found it fantastic. I don’t know if I just took it at the right time for me but I really got a great rest, I lay down on my side and dozed between pains. I still couldn’t let go of the Entonox.
I had another examination at 5am and this time, I was 7cm dilated and fully effaced. Again, they offered to break my waters so I agreed – maybe it was the pethidine. Things really ramped up then, I felt I had to get out of the bed immediately, the pressure was unbelievable. In hindsight, I think it was a combination of the waters going and the head coming down quickly. And the sensation of the warm liquor leaking out continuously is very strange. It feels like you are wetting yourself and it feels like there’s about 10 litres of it in there! The urge to push at every contraction was overwhelming. I could feel myself pushing without ever deciding to.
This is when my birth plan went out the window! “Get me an epidural now” actually came out of my mouth. After some wise words from my midwife, I carried on without an epidural and stuck with the plan in my head. I could do it. I was walking and swaying and doing my own little dance with each pain and I felt I was getting close. I could hear the midwife saying the stuff I say to women that I know are in transition (coming up to 10cm and nearly ready to push – this is when most people lose control). I worked through each pain telling myself that’s another one off the list and I can do anything for one minute (about the length of each contraction). I let each one build and fade away, I was in my own world. I shouted that I was going to split in two any minute – to which the midwife calmly replied: “well I’ve never seen that happen to anyone before”. It even made me laugh.
At around 6.30am, I decided if I wasn’t fully dilated I was getting an epidural so I asked the midwife to examine me and I was fully dilated. At this stage, they would have liked me to stay on the bed while pushing to see what was happening but I just couldn’t get comfortable on my back or even my side. So up I got, I stood up beside the bed, leaning on my husband, still feeling like I was about to split in two as I pushed with every pain. I could hear myself moaning but it was like it was someone else.
After about half an hour of this, my legs got tired so I kneeled up on the bed. The pressure with each push was so intense, I felt myself trying to hold back but my body just got on with it despite my brain saying “just STOP for a minute”. The next thing I heard was “I can see the head”, yeah right I thought, imagining the tiniest bit visible and then disappearing as soon as each contraction finished. I’d seen that happen all the time. I was waiting for the scary crowning sensation but it all happened so quick, at 7.12am he was out in one big push. I was still up on my knees so the midwife handed him straight to me through my legs. I remember thinking “where did you come from?” and “he doesn’t look as big as I thought he would be” and “wow, I have just had a baby”. I turned myself around and took him all in, every perfect little bit of him. He cried for a few seconds then settled in skin to skin.
When they put him on the scales later, he weighed 10lb 3oz. That was a shock! I know my bump was fairly big and I thought he would be big – but more like 8lb or 9lb.
I don’t remember the placenta coming out, I do remember a bit of a panic over me bleeding, a few unsuccessful attempts to get an IV line into one of my hands, a doctor coming to do suturing, bloods being taken but I didn’t care what they had to do. I had my perfect baby right there, the rest was just background noise. The blood loss was from a second-degree tear so once the suturing was done, everything settled.
So as far as my birth plan in my head went, I was really happy that things went so well! I couldn’t get my 6-hour discharge home because of the blood loss but I did get home the next day after pretty much refusing to stay. As far as I’m concerned, I got my dream delivery and an insight into what it’s like to be on the other side of labour ward. I would like to think it will make me a better midwife too.
Find Lisa over on her blog The Irish Baby Fairy where she writes about fertility, pregnancy, and childbirth or you can also find her on Facebook, Twitter or Instagram.
There are a whole collection of birth stories on the blog if you would like to read more. Birth stories go live every Sunday at 9pm. If you would like to feature your birth story email at firstname.lastname@example.org.