Wednesday, 25 February 2015

The Currawongs Playground turns one!

We're one today! It's been a whole year since I posted this. Can you believe it? It's a little crazy.

It's also a little scary because it means that we are moving closer and closer to our departure date, unless Michael is offered another year here... I am looking forward to going home, it is just a little nerve-wracking to have no work lined up, and a little mouth with a big belly... Anyway...

The whole reason I started this blog was so that I could share our adventures (and misadventures) with family and friends back home, plus have a nice record of Jimmy's first year(s). I know I haven't shared absolutely every (this blogging thing takes time and energy), there is one story that needs to be here, but it just hasn't made it: Jimmy's birth story.

I've been thinking about sharing it for some time, but didn't manage to during the week of his birthday - I think I ran out of energy. Not long after he was born I wrote 2-3 versions of Jimmy's birth. Writing it was very theraputic at the time, sharing it was even more so, and hearing other birth stories also helped put things in perspective. I now have over 18 months of perspective and look back at those heady, hormonal days fondly, although I'll be the first to admit that birth hormones play tricks on birthing mothers minds...

Please be aware that I might get into some medical detail that will either a) gross you out or b) make you cranky because I've related some medical thingy wrong. If it's the latter, I should point out that I'm an ecologist, not a doctor, and this was my experience, my perception (with some details filled in by Michael and our midwife), and things might be different in your part of the world.

Oh and there may be a picture or two with blood in it - this is a birth story! And if you want a bit of a spoiler, check out this photo...

This is the birth story of Jimmy-bubba. 

My waters broke late one Monday night, 10 days before my due date, just as we were getting ready for bed, with a little trickle and a splat of the mucus plug onto the bathroom tiles. Michael paged our midwife, and then called my mum (she got out of bed and drove the 2 hours from Warwick to Brisbane). We went to the Birth Centre at the Royal Brisbane Women’s Hospital, with all our bags in the car, just in case, but were sent home to allow labour to establish. 

It didn't take long – labour started within an hour or two, but I was able to enjoy a cup of tea with my mum before the contractions became too much to handle at home: movement, fit ball and wheat pack no longer cut it. Our midwife suggested that I get in the shower for a bit, to allow for her travel time to the hospital but in my mind getting in the shower was not an option because getting out of it would have been too much, plus I really didn't want to go up and then down the stairs. Somehow it still took us 45 mins to get packed up and to the hospital... our midwife was there about 5 minutes later.

We were admitted ~5am Tuesday morning, and all I wanted was the bath. Michael was under strict instructions not to take any photos, so there are no photos of me in the bath - I was concerned that the sound of the camera would be distracting and make me feel self conscience. So there are no photos until the birth. It's something I slightly regret, but only very, very slightly... Anyway! 

At the Birth Centre they have these big baths, big enough for 3 people to be waist deep in water, and there are support bars to save husbands' hands. Oh the warm water was amazing. It did take a while for the bath to fill up, and then every so often the water needed refreshing because it was cooling down, so I spent a bit of time in the shower too. Funnily enough, I felt my contracts were less intense in the shower but apparently I made less noise in the bath (I was vocalising through each contraction... long, deep moans, as my yoga teacher had instructed us... hey! at least everyone knew I was still breathing through the contractions).

Every hour our midwife would check Jimmy for 2-3 contractions to make sure that he was still fine, which he was. I was also made to go to the toilet, because a full bladder can make it harder for the baby to come out, but I hated getting out of the bath. Hated it. Timing it between contractions kinda sucked and I'd have 1 or 2 on the way there and the way back. My contractions were steady and I felt good but a little drained. I was instructed to nibbled on toast, sip water and was allowed a little Up&Go, I also had plain and fruit juice ice cubes to help keep my fluids and sugars up. But I was too scared to have much else, just in case the pain made me throw up - in hindsight, I would have been fine.

I remember being really focused on each contraction and didn't appreciated the interruptions of toilet trips and internal exams to check how dilated I was. While in the water I was focused, I was in the zone. Unless I looked over at the clock, which was in my line of sight, above the door. Having a sense of time was just annoying. That was until I'd been dozing between contractions, somewhere after 9 am, and had had an internal that showed my cervix was fully dilated (go me!) at 10 am. I'm assuming that the dozing occurred during transition, because after 10 am I remember feeling the contractions change as my uterus started to push. Before allowing myself to get excited about getting ready to meet my baby, I remembered something about active pushing being something to help the uterus and to wait until it was 'asking' for the help. But I was think: it's almost time to push!!

Naturally, I informed Michael and our midwife of the change in contractions and that I didn't feel the urge to push. Our midwife was calm and cool about the whole thing. And when I was ready to push I told the whole room and at about 10.30 am I started pushing. But it wasn't going anywhere in the bath.

We weren't set on a water birth. We hoped for a water birth and I had hoped to labour in the water, so getting out of the water to push wasn't hard. I was going to meet my baby and it was going to happen somewhere in that room. Our midwife suggested that we try the toilet, because apparently it can help, and then a bunch of different positions. After half an hour of this, our midwife told me to rest while she went and had a chat to the registrars. Rest? My body wasn't letting up, but I managed to relax between pushes, although I was panicking a little on the inside, worrying about how to get her back if we needed her (and I'm not sure I've told anyone that before). When she came back we tried some more things, but nothing. Just pain. No watermelon between my legs. It just didn't feel like it is described - it just didn't feel right.

By 12 pm there was still no sign of the baby, so the registrars were called in and then we were transferred just down the hall to birth suite, where things started to pick up. And by that I mean the room filled with people, there was someone starting prep for surgery, there was an anesthetist talking to me informing me of the risks of epidurals (honestly, I don't remember a word he said but I remembered what we were told in the antenatal classes). Our midwife was doing a transfer with a theatre midwife and somehow, through all the chaos, I heard our midwife explaining that we wanted a lotus birth, if medically possible, and at this point I clearly remember asking for cord milking at the very least. Epidural form signed, transfer completed, all they had to do was get me from the bed on to a trolley and then to theatre. I was still unbelievably uncomfortable, I was still having contractions*, and somehow the big burly orderlies were able to transfer me without any fuss. 

Actually, the orderlies were really nice and calming. Actually, everyone was really nice, calm but efficient. And the only thing that made this all possible was that Jimmy was fine. He was still recovering from each and every contraction, he was still perfectly happy to keep doing what he was doing.

The doctors were ready, 15 more people entered the room (just a little like in The Meaning of Life), then I felt a shove, then a pull, then a weight off my back that I realised what had just happened: I was no longer pregnant, I was a new mum. The feeling of not having Jimmy's weight on my back took my breath away. And then they lowered the curtain and showed me our screaming, vernix covered baby boy, who had been sticking his chin out and was posterior. 

The minutes dragged by as the midwives milked his umbilical cord, rubbed the vernix off, tagged him, APGAR tested him, weighed him, measured his height and head circumference, put a nappy on him and covered his head with a pink beanie (because his head was too big for the blue one). Then he was there, still not happy, still attached to his placenta, and there was Michael. Poor Michael.

Poor, poor Michael. This was not what he had envisioned. There had been no doubt in his mind that our baby would be born without any intervention. And yet, there we were, in the operating room. I have never seen anyone so shattered, so tired, a little lost, a new dad. There I was, still open, needles in too many places, and there was our baby, still screaming and not getting cuddles, with his placenta in a bucket next to him. 

I looked from Michael to the placenta to Jimmy and back at Michael and told him that it was ok, he could cut the cord - the midwives had done such a great job milking it, that I couldn't see any benefit in keeping Jimmy attached to his placenta. And we really had no idea how to look after the placenta (and I had no idea what I wanted to do with it), we were going to have our hands full with our new baby and with me recovering from major abdominal surgery. So, Michael cut Jimmy's umbilical cord and then, then! I was able to cuddle my baby. Oh it was wonderful, a little awkward, but wonderful.
And fleeting.

Jimmy was breathing bubbles, so the pediatricians wanted to put him in a humidicrib so that he didn't get a chill from people coming and going, and so that they could keep a better eye on him. An hour after his birth, Jimmy was taken away to the Special Care Nursery (SCN) so that he could be put on antibiotics, and a glucose drip because his glucose levels were very low

Initially this was very stressful - it was actually a little heartbreaking but I didn't have it in me to argue or question the move. Michael did, and he was told this was fairly normal. Michael went with Jimmy while I was being stitched up. I told myself that it would be ok: Michael would know where Jimmy was, I was in no position to go with him and I was in good hands, it was our newborn baby being separated from us that concerned me.

Once Michael returned from the nursery, I was able to relax and I started getting excited. I was also exhausted and decided that having other people look after Jimmy was slightly relieving, because I'd been up all night, hadn't eaten and had laboured, so the reprieve was nice. In fact, we were all exhausted: Michael, Jimmy (hence the need for glucose), me and my uterus (it took two injections of synthetic oxytocin and a shot of something else to get it contracting**).

As soon as the nurses were able to take me down to the nursery they did, but in the meantime Michael and I milked some of my colostrum for Michael to give to Jimmy (he fed him first!). Nurses also milked my colostrum during the night when they came to check on me. The next morning, after a much needed shower and breakfast, the nurses found a wheelchair for me and took me to Jimmy. 
This happened a few times during the day (I had to go back to the ward for meals) and if I wasn't in the nursery and Jimmy was hungry, the nurses looking after him would call the ward and I would go down to him - all this was so that we had the best possible chance of establishing breastfeeding and I felt as though everyone was cheering us on. 
And we needed that cheer squad: because of the glucose drip, Jimmy wasn't registering that he was hungry, but he had this instinctive urge to suck, so the result was that he would latch for a bit, detach and scream, only to latch on again... But we got there.
It was just over 36 hours after his birth that Jimmy's glucose levels stabilised on my colostrum alone (they had to turn down the drip so that he would feed properly) and then my little boy was by my side in the ward. As you can imagine, I cried great big tears of joy and held him for 4 hours straight (and I've had trouble letting him go ever since!). 

Our Birth Centre midwife checked in on us every day we were in hospital, and continued to visit us at home for two weeks after Jimmy's birth. Having her visit, as well as visits from another midwife, and being able to chat with the on-duty midwife in the weeks that followed, was such a wonderful safety net. I cannot begin to describe how much that helped with our recovery from the shock of an emergency caesarean. We were so well looked after, and it was free.

Michael and I are a little sad that we will not be able to use the Birth Centre at the RBWH for baby #2, even if we are in Brisbane, because I will not be in the low risk category - my uterus now has a weak point that might rip open during labour, even after 2-3 years. We will explore our options when the time comes. I am at peace with how Jimmy's birth played out, and am not afraid of having another baby.

I should point out that I am NOT pregnant. I may have fears to address during the next pregnancy, so might Michael. Birth is unpredictable, even when doctors and midwives make it sound straight forward. And things that affect how the birth plays out are not always in our control. Take Jimmy's chin: he still sticks it out when he sleeps.

 Photo credits mostly go to Michael, although a few were taken by RBWH nurses, and the last one was taken by me.

* Labour is helped along by oxytocin (the love hormone), while adrenalin hinders it. Something as simple as the transfer from home to the hospital can interrupt labour, so I wasn't entirely surprised when my contractions went from frequent and regular pushing contractions to irregular contractions that alternated between pushing and non-pushing.
** In natural birth there is a rush of oxytocin as the baby is delivered and then the uterus starts contracting of its own accord, expelling the placenta in the early stages not long after birth. Sometimes an injection of synthetic oxytocin is used to kick start the process or to prevent excessive bleeding, and in the case of caesarean births there is no option but to inject synthetic oxytocin.

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