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Birthing the teeny human

My first birth was traumatic. I don’t say that lightly. It took me six months to be able to talk about it without bursting into tears and three years later, sat in the same ward for monitoring I had to fight back yet more tears. I mention this here because my first birth played a huge part in my determination for things to be different this time. There can be a tendency in some birth circles to only talk about positive experiences, however often there is much to be learned from the more negative ones. I absolutely will write up the tiny human’s birth story at some point, but for some context I had a horrendous first midwife that made huge issues out of choices I had made in pregnancy (telling me I was putting my baby and risk and refusing to care for me as I had declined being weighed in pregnancy). I then had my waters broken, setting off a cascade of interventions and ending in an assisted delivery.

My birth plan this time was extensive and informed by my first experience. For example I wrote out preferences for all scenarios, as I had learnt that things do not always go the way you expect them to. I also did an online hypnobirthing course, asked to speak to the consultant midwife about my birth choices right at the start of my pregnancy as wanted to be very clear on the plans and expectations for my birth and insisted on being under the same consultant as last time as had found him helpful. This time round I was determined to advocate for myself right from the beginning.

We decided on a home birth as our local stand alone birth centre was closed and I didn’t want to go back to the hospital. I was warned there would be a slight increase in risk of a postpartum haemorrhage (PPH) as I had previously lost 700ml. I wasn’t concerned as forceps, an episiotomy and a long labour are all risk factors for PPH so considering all that it’s not surprising I lost a fair amount and I felt sure it wouldn’t happen again if I didn’t have interventions. I agreed to active management of the third stage (where you have an injection to help birth the placenta) to help reduce the risk as well.

Pregnancy went smoothly until the third trimester when my platelets started falling. They also felt I was having a ‘big baby’ based on growth scans, although I was unconcerned as scans can be so inaccurate and I was told the tiny human would be over 9lbs at 40 weeks - he wasn’t! My platelets hit 92 and they wanted them over 100 for home birth. I did my research and decided that if they fell below 80 I would birth in hospital, but that I was comfortable with the risk if they remained above that and I agreed to take tranexamic acid in labour just in case (totally forgot to take it when the time came!). They actually went back up to 112 the week before I gave birth - woohoo.

There was an interesting day when the teeny human decided to turn upside down, but he was head down the next day. I did then spend the last few weeks of pregnancy paranoid he would switch back as he was mega wriggly. They also told me I had polyhydramnios, which is extra amniotic fluid. It can increase the risk of cord prolapse if waters go before labour is well established. At various points towards the end I was starting to get quite stressed as it felt like it was one thing after another and I was worried my home birth would become more of a risk than I was willing to take.

We plodded on getting ready though, patching holes in our second hand pool (you use a fresh liner for each use, don’t worry!) and putting up fairy lights. I was convinced the teeny human would come early as had Braxton Hicks all the way through, often quite intensely...but 40 weeks came and went.

At 40+6 I went in to get him checked as he hadn’t done cartwheels for a couple of days, although he was still moving plenty. He often had quieter days so it wasn’t that unusual, but being so close to the end and struggling a bit with anxiety I just wanted to be sure. I knew they would want to induce me, but after his monitoring showed no issues I didn’t feel it was necessary. Enter the registrar...

“Right, so we practice evidence based medicine. That is to say medicine based on years of evidence” (patronising much?).

“Yes I understand that”.

“Well the evidence is that you should be induced”.

“I am happy to accept scans and monitoring, but I will not be induced.”

“You won’t be induced? Do you know the risks”.

“I am well aware of the risk, but I will not be induced, thank you”.

“Seriously? But you will have a scan?”.

“Yes I said I would have a scan.”

“What if you get to 40+12?”

“My plan with my consultant is to watch and wait.”

“Watch and wait? You know the risks?”.

“Yes I know the risks, thank you”.

“What if the scan shows problems”.

“I’ll deal with that when and if it happens.”

“You’ll have a sweep today though” (what that form of induction with little evidence...Mr ‘evidence based medicine?!).

“No, I won’t be having a sweep today”.

“Do you know what a sweep is?”

“Yes, this is my second baby”.

End scene.

The midwives shared a smile with me and told me he wasn’t used to women not doing as he said (I couldn’t tell!).

The next day, affectionately named ‘stressful Thursday’ was somewhat hellish. My scan showed a potential problem (for which there was little evidence, but it was still a concern) and a really helpful (heavy sarcasm) sonographer diagnosed meconium in my amniotic fluid (this should not have happened - they can’t diagnose what they can’t see, they can only query it). This meant that I was asked to speak to a doctor - I refused to see the reg from the day before and instead got my lovely consultant who came and talked through all the options and drew graphs on the paper on the bed in green felt tip. I declined a c-section and said I would consider induction or continuing to watch and wait and needed to talk to my husband. It all felt rather at odds with how I felt baby was - he was back to doing epic somersaults and his monitoring on the CTG was perfect. I’m writing all of this rather calmly, but I was far from calm at the time. I was alone somewhere I had experienced a horrendous birth before, I was worried about my baby, I was trying to work out what on Earth I should do. I was thinking about the tiny human and how he would cope with me being away from him for several days...I was tearful and very stressed. Unsurprisingly my blood pressure was raised and despite me explaining it was the stress, the midwife told me it could be a sign of a failing placenta and said I needed blood tests. I agreed to a blood test as also knew my platelets needed double checking and I thought the results overall would help me decide what to do. It took three doctors six attempts to get my blood - eventually it was an anaesthetist who succeeded after finding a vein with an ultrasound machine. I have a phobia of needles and in particular blood tests, so to say I was a snotty hysterical mess by the end of it was an understatement. Four and a half hours later and I was heading home. Both my mum and husband thought I should have said yes to the c-section, but after talking it through for a while we agreed that I would have a repeat scan the next day and if the result was the same or worse, would have an induction.

The scan the next day was significantly better and again I spoke to a consultant who agreed with me that there was no immediate rush. I agreed to book induction for the Tuesday and to have daily monitoring and a repeat scan on the Monday. Monday came and the scan was better yet again. Monitoring was perfect and my gut was strongly telling me that baby just needed more time. The pressure was immense. Every time I went in I was asked if I knew the risks I was taking. It does start to get to you when you feel like people think you’re putting your baby’s life at risk. My gut feeling was so strongly that the teeny human was fine and I researched the risks thoroughly - there are studies that show stillbirth risks increasing at 42 weeks, but there are also studies showing the opposite and the absolute risk remains incredibly low. I spoke to my consultant midwife who agreed with my assessment of the risks and I decided to just take things one day at a time.

On Wednesday the 11th of November I went in for monitoring and then went for a walk with the husband. I could feel the teeny human low down and felt like walking was putting pressure on my cervix. The pressure felt really positive, albeit slightly uncomfy, so we decided to go for another walk in the afternoon and took the tiny human for chips by the sea. When we got home I noticed that my Braxton Hicks were more frequent than usual and there was a sharp intensity to them...they also didn’t stop. No matter what I did I would get one every 10 to 20 minutes. They were quite intense, far more than the period cramp style contractions I had in early labour with the tiny human. I put him to bed and then was breathing through them and just chilling. I messaged my midwife who was on call, hoping she might be attending my birth that evening, we were both quite excited. They didn’t progress in frequency or regularity, but I was losing bits of plug so was thrilled to finally know I was dilating after being told my cervix was unfavourable on Monday - always what you want to hear!

I tried to sleep and managed about three hours in one hour chunks, but would wake with a strong contraction and head downstairs to see if they picked up. I alternated between snacking and watching rom coms, and trying to stay in bed and doze. They carried on the same the next day and my gut was that they would pick up in the evening. I blocked out as much light as I could, popped the diffuser on and spent the day watching easy TV, trying to doze on the sofa and eating what I wanted. I felt very much in a bubble - thankfully the tiny human was at nursery which deffo helped and I cancelled my monitoring as felt it would only cause me more stress and slow things down.

That evening I put the tiny human to bed as usual, but when he had boob the contractions intensified and I was humming through them. I asked him if I was making funny noises and if he knew why...he said “because of brother, can you neigh?”, so I told him brother might come soon and neighed for him!

I went downstairs at around 6.45pm and started timing the contractions, they were about every five minutes, I kept track of them while eating my dinner, pausing to hum. I slightly regretted dinner afterwards as felt a bit nauseous, but eating between contractions felt ok at the time, so I rolled with it.

After dinner I asked my husband to start filling the pool and call the midwives as I noticed the timing of the contractions was changing quite quickly and they were coming every 3-4 mins. At that point I wasn’t sure I needed them, but while waiting for them to arrive and the pool to fill my contractions were every three mins or just under and increasingly strong and I wondered if I’d left both things too late.

The midwives arrived, asked a few questions and did my blood pressure. My pulse was lower than it had ever been on any of my trips to hospital! They were very respectful about me not wanting to be on my back and so I sort of reclined, but not flat down, while they had a feel for the teeny human’s position and a good listen and they reassured me they wouldn’t ask to do it again as I progressed. I didn’t have any vaginal exams at all, they just trusted from my behaviour that I was in established labour.

I decided I wanted to wee and get in the pool, so I did. The warmth and ease of movement felt good, but it didn’t take the intensity away. I hung over the side and hummed away with my husband rubbing the top of my back. I didn’t know how I felt about that really, sometimes it helped and sometimes it didn’t, but I was in my zone and didn’t feel much like communicating, so just did my thing and largely ignored what others were doing. My mama tried to make some suggestions and questioned where I was birthing (pool or not) and I basically said just leave me to it and carried on as I was - questions were more than I could manage. I could hear her chatting to the midwives and saying she would be a terrible midwife as didn’t have enough patience. I internally laughed - we are close and I can always tell her how it is. The midwives were again really good at just leaving me alone. I had agreed to intermittent monitoring and found it a bit annoying at times as 15 mins goes so quickly, but it was also reassuring to hear he was coping well (the tiny human struggled a bit in labour) so I kept letting them do it. I did however delay requests to get more upright until I felt able to and listened to my body, again they were really good and just worked around me (I was just staying in my zone and only sitting back for them to listen when I knew I had time).

After a while I started to feel real downward pressure and stopped feeling as in control of myself during each contraction - it felt more wild and primal. I then started to bear down and was really groaning, mooing and oohing and throwing my head back or pressing it into the top of the pool. I remember thinking the pool smelled like plastic and wishing it didn’t. I never noticed transition, although I did make everyone laugh when I said “why was I so keen to experience this?!” at a point I really felt like I needed a break.

At some point I said that I felt the pushing was doing nothing and I could feel no progress, but sometimes it was so intense it was like trying to do the biggest most constipated poo ever and I really felt it in my bum and felt like I was turning purple with the effort. My gut feeling was that something wasn’t quite right, but I wasn’t sure what and it didn’t feel dangerous, so I carried on. The midwife said it was probably my waters making me feel like that and it would improve once they went. I asked if they should break them in that case as it was frustrating and she reassured me that it would happen when the time was right. I made them laugh again as I muttered “how on earth does anyone breathe a baby down”! I’m well aware that people do, but my body was pushing with everything and I couldn’t imagine how it would ever be possible! I had my eyes closed pretty much the entire time and was panting, trying to return to some level of calm between contractions and just keeping on. I found this stage of pushing a little triggering as it reminded me of pushing on a closed cervix in my last labour due to them putting me on my back and I started to worry I wasn’t dilated enough. They suggested I try reclining, so I did, screamed and turned straight back over (moral, do what feels best). After an hour they asked if I wanted to get out so they could have a look and see if there was a reason it was taking a while as they were surprised his head wasn’t descending. They were clear it was my choice and that I could continue on for as long as I wanted, but it was an option if I was too frustrated. After several more contractions that felt like they were doing nothing I stood up, immediately sank back down and after a couple more decided to try again. At that point I wished so hard for my waters to just go so I didn’t have to decide whether to get out or not and on the next contraction I felt a pop and suddenly felt his head between my legs. Little side note - my waters were totally clear!

The urge to bear down was incredibly intense and I was convinced his head would be out swiftly as could feel it right there. I reached between my legs to feel and it felt very jelly like and bumpy and not like a hard head at all. I figured that must be normal. This was one of the only times I felt a bit annoyed as they asked me to move my hand so they could see what was happening. I understood why, but was also not prepared to move my hand totally as I wanted the motivation so I moved it a bit higher up, but kept feeling when I felt it was helpful. At this point it felt like there was little let up and I could feel stinging and stretching and my body pushing with everything in me. I abandoned all intention of letting him descend gently as my body took over and I put everything into pushing. I was done and ready to meet him. The midwives were reminding me to try and take breaths between pushes and being encouraging. I didn’t mind as I still felt very much in the driving seat and still had my eyes closed in my own world. Suddenly I felt someone touch his head and it push back in me a little, which was agonising and I screamed out and then suddenly they told me not to panic but that his position wasn’t right and I needed to get out immediately. They had been so hands off up to that point and so I didn’t question them for a second. If they were telling me something wasn’t right, I trusted them. My first thought was actually cord prolapse and adrenaline took over. I quickly stood and climbed out with their help while contracting and basically screaming, but doing exactly what they asked. Once out they said he was face down (which I have since found out happens in less than 1% of births) which was why it was so hard and to really go for it with the next contraction. I did really go for it, well aware I might tear, and he shot out, head and body in one slippery go and they passed him between my legs to me.

They checked I was ok to have the injection, did it and then helped me to my sofa. Once settled they clamped the cord and I held him skin-to-skin while birthing the placenta. The midwives explained that they had thought he might be breech at one point as his face had looked and felt like testicles!

It wasn’t the calm water birth greeting I had envisaged and in the moment was quite scary, but it didn’t feel out of control and it was amazing to feel him being born, even though it was rather quick at the end! They explained he would have swelling and bruising and that the pushing had taken so long because of his presentation. They also said he may have been later term because the top of his head wasn’t pushing on the cervix and helping it dilate. We stayed skin-to-skin for an hour and he fed and passed meconium (several times, all over my tummy and legs!) then he was weighed. He was only 1 oz more than the tiny human had been, who was born a week earlier in terms of gestation - so definitely not gigantic. I always said he was smaller, yet another example of mother’s intuition!

One of the midwives tied the cord tie for me and the husband held him skin-to-skin while they checked me for tears. I had a small second degree tear and two labial tears, one side quite superficial and one deeper. They gave me the option to leave the labial tears or stitch the deeper side and I opted for stitching as didn’t want to be remembering to separate it each day.

I ate some toast and had a drink as was feeling a bit sick and exhausted and it really helped, even though I didn’t feel much like eating. I got my mum to take a picture of me as felt very much like that moment summed up birth and the moments afterwards. I looked manky but felt totally chilled and powerful. Still working up the confidence to share it totally publicly though!

After they’d cleaned up and checked we had no concerns, the midwives left, I felt so sorry for them as they weren’t allowed to accept food or drink at all during the birth, but we did send them off with a bar of chocolate each so they could snack in the car!

I showered, had something else to eat and some more cuddles before heading to bed, where I realised that all newborns are the same in their refusal to be put I sat up and waited for the tiny human to wake. He woke just after 5am and had boob while baby slept on my chest. I then popped the lamp on and introduced him and he was so excited and immediately woke up my mama and the husband to announce his brother had arrived. It was such a lovely moment as he stroked him so gently and kept pulling the blanket over him. I finally got to have a little sleep at 9am! So far the teeny human has been pretty chilled and I’m sure his birth experience has made a difference.

I’ve been left feeling triumphant - it’s the word that comes to mind most often. My faith in my body has been restored and trusting my gut and labouring and birthing on my terms has really boosted my confidence and been incredibly healing.

Here’s to the next chapter, life with two mini humans...bring it on!


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