Wednesday, 17 December 2014

Birth story part 2

...continued from Part 1

My midwife tried to insert the catheter, but was unable to due to bub's head pressing on my bladder. No wonder i couldn't empty it myself! So we decided to focus on getting bub out and then the catheter in.

This is where my easy birth turned into hard work. I pushed on my side. I pushed on my back. I tried a few contractions on my knees but very quickly realised my back was the most comfortable and effective. I pushed with each contraction until bub's head was about 5cm visible across, but at this point i wasn't stretching any further. My midwife tried perineal massage, but there was a tight band of skin/muscle that just wasn't thinning and stretching any further. Bub was doing well, heart rate dipping as i pushed and recovering to baseline as the contraction finished.

After around 3 hours pushing out of the pool, my team were getting very concerned about possible bladder damage and a fourth degree tear - my perineum was getting shorter and thinner but the rest of the area was not stretching. There was a lot of discussion going on according to hubby - i was unaware of most of it other than i was starting to tire - from 5 or so surges per contraction i was now only getting about 2 and the rest of the time i was just pushing myself rather than with contractions. My midwife told me i could do this - but that if it didn't happen within the next 20 minutes she'd like me to consider an episiotomy.

Our toddler had woken up by this point (5am) and was downstairs with us. He wasn't the least bit scared, just gave me a kiss and sat down to his breakfast.

I pushed as hard as i could for the next few contractions. There was no change at all, so i told her to go right ahead and cut me. This was apparently only the second one she'd had to do during a homebirth, and it was clear to me that she didn't want to do it but rather thought it safer than a fourth degree tear. So she numbed the area (small sting) and then cut, and waited for me to push, and then cut a little more and my team all told me to push as hard as i could. Hubby distracted our toddler while this was done. One push and i could feel the difference - baby was crowning! Another push and his head was out!! Our toddler was leaning over my shoulder, fascinated that he could see 'his baby'.

At this point my birth team were all excited and told me to push again, then suddenly the atmosphere changed to one of urgency and i was told to push as hard as i could and to keep pushing. I was calm and pushed as hard as i could - i had an idea what was wrong. Baby's shoulder was stuck under my pubic bone. My midwife held his head (i think) and tried to hook a finger under his armpit to rotate the shoulder, my backup midwife helped by pushing on my stomach. It didn't take long and all of a sudden his shoulder popped free and i pushed again and out he shot in a rush of body and the rest of the amniotic fluid!

Hubby had him round the chest and as my midwife unwrapped the cord from his neck he lifted him up and onto my belly for me to see. "My baby!", said our toddler.

I did it!

It seemed the most normal thing in the world, to finish off a pregnancy by pushing out a baby. It was as though i'd always known i could and would do it. There was no huge sense of achievement with my HBAC - just a kind of 'of course you did' feeling :) Still pretty awesome though and i feel great about it even now, three weeks later.

I feel i chose my birth place and team well - there is no way i'd have been 'allowed' to push that long in a hospital without a fight, or several interventions along the way, possibly too early and resulting in foetal distress and then a c section. My team never faltered, always encouraging me, and kept all discussion of complications in whispers away from my earshot. The one time i said, "I can't," (in regards to i couldn't keep pushing as my contractions were running out of steam) the entire team chimed in, "Yes you can!" which almost made me giggle had i not been so tired at that point.

Continued in Part 3...

Wednesday, 3 December 2014

Birth story part 1

I woke up at 6am when i was 40+3 days into my pregnancy with some mild infrequent contractions and some more show. I didn't know if this was it, or just more ramping up towards labour, so i continued my day as normal - took our toddler to daycare, chatted with the girls there about the xmas party later that day (where they joked again there might be a baby by that time - unlikely, i thought!), and headed back home. The contractions were regular and more frequent by this time - maybe 8-10 minutes apart to my estimation, but easily able to breathe through. I tidied a few things away, but was pretty pleased with my housework in the last few days to have everything ready and looking nice for a homebirth and the resulting photos. I cooked myself some eggs for breakfast and started drinking (water and coconut water) to stay hydrated.

Hubby came home from work at lunchtime after texting me all that morning and announced he was off to pick up the toddler immediately. No, i pleaded, let him stay for his xmas party. I was already at the stage where i wasn't going to be able to drive there and back, but i knew there wasn't going to be a baby anytime soon - he was worried he'd go to pick up the toddler and miss the birth. In the end i had to call my doula and she told him i wasn't in established labour yet and not to panic. She said to call her back when my contractions were about 4 minutes apart lasting a minute. I estimated probably just under 8 minutes apart now and lasting 30 seconds, so that's what i'd told her. Hubby timed two of them - 2 1/2 minutes apart lasting a minute. Oops. Still shows you the power of hypnobirthing - i was still quite fine, up and walking, just leaning on the counter or wall each time a surge began. No pain, just discomfort/pressure. However i had started feeling slightly nauseous and wasn't able to eat any more, just kept trying to keep water down.

He called her back and she arrived about 3pm at which point he left to get the toddler. I laboured nicely while chatting with my doula. The nausea kicked in and i threw up twice. At this point i could only manage a sip of water at a time without feeling sick. I was still going to the toilet fine. Hubby arrived home and started the toddler's nighttime routine early, while getting the pool out and pumping it up. By this stage the contractions were quite strong and i found i preferred lying on my left on the couch and breathing nice and slow through each one. Toddler was very interested in the pool! He gave me a kiss and went to bed early (around 6:30pm i was told instead of 8pm) and slept well all through the night. He wasn't the least bit concerned about why mummy appeared to be sleeping on the couch, or why my doula was there (he'd met her before).

Hubby and doula started filling the pool at this stage. At some point before i got in, i asked them to call my midwife and birth photographer. My doula had been timing my surges and asked hubby to relay to my midwife that they had been 4 minutes apart, then 2-3 minutes apart lasting for a minute and a half, now coming 1-2 mins apart. They both arrived around 9pm i was told. (Was well into labour land at this point and deliberately not paying attention to time). Still not in pain, just working hard.

I could hear people talking quietly around me. My doula was bringing me cool flannels for my forehead and hubby had a glass of water with a straw to offer me. My midwife checked baby's position and heart rate, and said my bladder was quite full and asked if i could empty it, which i did with a little difficulty. I then took my pants off and got into the lovely warm pool and continued labouring there.

Time and progression are hazy to me, but i was asked to try to empty my bladder again. Took me a while to get to the toilet as contractions were now very close together. I remember it was really cold getting out of the pool, even though it was a warm stormy summer night. This time though, i couldn't empty my bladder. I tried through three contractions on the toilet but nothing. I let my midwife know and got back in the pool. Somewhere here i had started pushing, and i did so for about an hour i think. I didn't feel baby descend, but his head started to become visible - just a little patch of dark hair. But, it wasn't getting any more visible even though i was working quite hard. So i was asked how i felt about getting out of the pool, both to try some coached pushing to see if we could bring him to crowning and get me back in, and so they could try to put a catheter in - there was some concern about bladder damage due to me being unable to empty it. Apparently it looked very big on my belly with baby's head behind it. So out i got with some help, and lay on my back on the couch (which my doula had cleverly covered with a shower curtain and a dark sheet).

Continued in Part 2...

Tuesday, 25 November 2014

Labour watch

39+5: Really don't know if this is the start of anything or not, but i'll note it down anyway in the same way i did with my last pregnancy. Today i've almost constantly had Braxton Hicks. I think my belly has been rock hard more often today than not. Yesterday i had 2 cups of raspberry leaf tea, but i've done that most days so can't think that it can only be caused by that. Also, around 10pm i had discomfort like a cramp, but that went away fairly quickly.

Throughout that night, i had a stomach-ache level discomfort, no contractions. It stopped as soon as i got up the next morning.

39+6: Lots of BH and lightning crotch.

40: Nothing. Even the BH have eased up.

40+1: Just BH and lightning crotch. Feeling very heavy and as though my stomach is lower. However while driving home from daycare in the evening i was hit with very bad lightning crotch, sharp pains in my cervix and symphysis pubis, for the half hour drive home. Could barely answer the toddler's chattering at times. Thankfully as soon as i got home and was able to pull myself to a standing position the pain disappeared, but left me feeling really weak and tired all evening while i got him his dinner and put him in the shower.

40+2: Woke to find my show :) A small amount of clear mucus with very fine pinkish veins. I think some of the pain from yesterday has started my cervix dilating. Still feeling heavy in my pelvis but thankfully only a few sharp twinges. Just a general very mild discomfort low down which i barely notice except when thinking about it. Emailed my birth team, who have been checking in with me recently, to let them know i expect things to start happening within the next 2-3 days.

40+3: Woke with mild infrequent contractions and more show. Labour had started!

Sunday, 23 November 2014

Week 40

Week 40 pregnant belly side view

Week 40 pregnant belly side viewWeek 40 pregnant belly front view

STATS:

How far along: 40 weeks - the big 4-0! Wonder how much longer now?

How big is baby: a small pumpkin.

What is baby doing this week: After months of anticipation, your due date has been and gone, and... you're still pregnant. It's frustrating, but lots of women find themselves in this situation.

Rest assured your baby is quite cosy where she is. She is getting a little heavier and may grow a bit more in length. The average baby is about 51cm long from head to toe and weighs about 3.4kg at birth. But if your baby is anywhere between 2.5kg and 3.8kg, that's a healthy weight.

Your baby continues to shed the greasy, white substance (vernix caseosa) which has been protecting her skin. If she shows no sign of making an appearance after another week, she may have slightly dry skin when she arrives.

Your baby has mastered all the skills she'll need after she's born. She can instinctively search for her thumb and suck it, just as she will search for your breast for a feed soon after birth.

In TV dramas, labour always begins with the waters breaking – in the middle of a crowded room, of course – just before contractions start. The reality is that, even if your membranes do rupture, your baby's head will tend to act like a cork at the opening of your uterus (womb). If you lie down, however, you may notice fluid leaking. Your body will continue to produce amniotic fluid until your baby is born.

Try to stay calm if your waters break or you start to feel contractions, but do call your doctor or midwife straight away. You may be advised to wait at home until contractions are really under way. Find out how to tell when you're in labour.

http://www.babycentre.co.uk/40-weeks-pregnant

Total weight gain: 57.9kg, 300g more than last week and 11kg since the start of pregnancy.

Maternity clothes: Pretty much all maternity.

Sleep: Fairly good this week. I'm well aware of the fact that labour could start any night so am making sure i'm not too tired.

Best moment of the week: 

Food cravings/aversions: None.

Symptoms: 

Nausea: None.

Fatigue: Taking Ferro Grad-C every weekday.

Other: Very strong Braxton Hicks the last two days - i think i have one more often than not now. Sudden sharp pains down low, which i've heard called 'lightning crotch' are becoming more and more frequent.

Movement: Head down, left occiput lateral (LOL/LOT), 3/5ths above brim and non-ballotable (slightly engaged). Lots of kicks and stretches - more stretches now as he starts to get quite cramped in there.

Gender: Boy.

What i'm looking forward to: a peaceful, quick, healing home waterbirth!

What i miss: Being able to walk easily. Also my patience! I've got quite a short temper lately.

Next appt: 27 November.

What else i've done this week: 

Friday, 21 November 2014

Salted pistachio Nutella cookies

Salted Nutella pistachio cookies

Saw these on Pinterest and they looked so good i pinned them into my future baking board. It's taken me a few months to get around to making them though, but happily they use ingredients i always have in my cupboard so i didn't need to make a special trip out to the shops to get anything. I like recipes like that.

Original recipe is from Food Mouth, but their recipe is gluten free. As i don't have an intolerance (and also don't have all the flours they use) i've made mine full of gluten.

Ingredients:

115g butter, melted
1/2 cup dark brown sugar
1/4 cup sugar (i used raw caster)
2 eggs
1 tsp vanilla essence
1 cup Nutella
2 1/2 cups self-raising flour
1/4 tsp salt
220g dark chocolate
1/3 cup pistachios, shelled (about 3 handfuls unshelled)
Salt to sprinkle

Method:

Mix butter and sugars together in a large bowl, then beat in the eggs and vanilla (using a spoon is fine). Melt Nutella in a bowl in the microwave for about 20 seconds then pour into the bowl and mix thoroughly. Add the flour and salt and stir until fully combined (will be a fairly stiff dough). Place the bowl in the fridge for about 20-30 minutes.

Preheat the oven to 175C and line your trays with baking paper. When the dough is cooled place scoops onto the trays and flatten slightly with your hand. The recipe says to use a 2 tablespoon cookie scoop, so i used a soup spoon and scooped up what i thought was about 2 tablespoons. As you can see from the pictures i think it was much more than that! My cookies turned out huge. But, that's an option if you want large Subway-size cookies.

Salted Nutella pistachio cookies

Bake the cookies for 8-10 minutes until the edges begin to firm up, don't worry if the centres are still underdone. I found the giant cookies needed about 15 minutes. Cool on the tray for a minute or two then remove to a cooling rack to cool completely.

Grind pistachios using a food processor - not too much, some large chunks should remain. Melt the chocolate and let it cool slightly, then dip each cookie halfway into the chocolate. Remove any excess off the bottom and place the cookie on some waxed or coated baking paper.

Salted Nutella pistachio cookies

Immediately sprinkle a pinch of salt over each chocolate half, followed by the pistachios. Let chocolate cool and set completely before serving.

Makes 17 giant cookies.

I found that the chocolate wasn't enough to cover all the giant cookies - it covered about 13 of the 17. It also stayed quite soft for some reason... was a new brand i was using, so that may have contributed.

Sunday, 16 November 2014

Week 39

Week 39 pregnant belly side view

Week 39 pregnant belly side viewWeek 39 pregnant belly front view

It looks like my belly is all mottled around the navel from the front view photo here - but doesn't look like it in the mirror or looking down. What it mostly is is the lines from my elastic Tubigrip, darkened by the more obvious veins on my belly.

And, here's the comparison pic from 9 months pregnant, last pregnancy on the left and current on the right.

pregnant belly comparison pregnancy 1 2 9 months


STATS:

How far along: 39 weeks.

How big is baby: mini watermelon (eep!)

What is baby doing this week: It's all about watching and waiting now, as your baby could arrive any day. Your baby could be up to 50cm long, and weigh about 3kg. But that's only an average figure. As soon as your baby is born, your midwife will weigh him, and it's only then you'll know for sure how much he weighs.

Your baby is shedding the greasy, white substance (vernix caseosa) which has been protecting his skin. This turns the amniotic fluid, which was once clear, pale and milky. The outer layers of your baby's skin are also sloughing off as new skin forms underneath.

The hair on your baby's head may now be thick, and his fingernails extend beyond his fingertips. They may look long when he's born. Your baby's skull bones are not yet fused, which allows them to overlap as he passes through the birth canal during labour. This is the reason your baby's head may look cone-shaped after birth.

And if the week passes and there's still no baby? Try not to worry – babies have a habit of not arriving on their scheduled due date. Most doctors wait another two weeks before considering a pregnancy overdue. Check out how to cope with being overdue.

http://www.babycentre.co.uk/39-weeks-pregnant

Total weight gain: 57.6kg, 900g more than last week (eep!) and 10.7kg since the start of pregnancy.

Maternity clothes: Pretty much all maternity.

Sleep: I'm well aware of the fact that labour could start any night so am making sure i'm not too tired.

Best moment of the week: I've been on maternity leave all week! Also, my aunt and uncle are coming to visit today. My aunt gave me a huge amount of support after our toddler was born, checking in on me by phone each day to see how i was going in my recovery. She had both her babies vaginally (and very quickly) and fully believes in my ability to do so also :)

Food cravings/aversions: None.

Symptoms: 

Nausea: None.

Fatigue: Taking Ferro Grad-C every weekday.

Other: Lot of pinching/pushing sort of feeling down in my pelvis, towards the front, that only seems to happen in the evening. Makes it difficult to walk. The only thing that relieves it is laying down (temporary) and a heat pack on the back of my hips (fixes it). I think it's my symphysis pubis stretching to fit bub's head, which is getting lower each week.

My single stretch mark along the skin that marks my belly piercing has reappeared. You can see it's slightly red above my navel. No sign at all of the linea nigra i got last pregnancy, and the rest of my pigmentation (face, arms etc) has got darker in the last few months, but nothing like what it was the first pregnancy when it got bad enough to form brown patches on my face.

Movement: Head down, left occiput lateral (LOL/LOT), 3-4/5ths above brim and non-ballotable (slightly engaged). Lots of kicks and stretches - more stretches now as he starts to get quite cramped in there.

Gender: Boy.

What i'm looking forward to: an ecstatic, healing home waterbirth!

What i miss: Being able to bend over easily.

Next appt: 21 November.

What else i've done this week: Lots of cleaning of the house in preparation for the birth and photos. Except, it doesn't seem to last long with a toddler about! Particularly on the weekend as he's home with us. I've also packed my labour box and we've got the fittings for the hose so we can fill the pool.

Sunday, 9 November 2014

Week 38

Week 38 pregnant belly side view

Week 38 pregnant belly side viewWeek 38 pregnant belly front view

Edit: forgot to add the weekly montage!

pregnant belly side view weeks 35-38

STATS:

How far along: 38 weeks

How big is baby: a leek.

What is baby doing this week: If you don't know already, can you tell if you're carrying a boy or a girl? One hint may come from the size of your baby – boys tend to be slightly heavier than girls. Babies at week 39 weigh between 3kg and 3.2kg and continue to build the fat stores that will help regulate body temperature after birth.

Your baby's organ systems are fully developed and in place, but his lungs will be last to reach maturity. Even after your baby is born, it may take a few hours before he establishes a normal breathing pattern. After he's born, he'll have a series of brief tests which will measure his health on what's called the Apgar scale.

Wondering what colour your baby's eyes will be? Most white European babies are born with dark blue eyes and their true eye colour – be it brown, green, grey or blue – may not reveal itself for weeks or months. The colour of your baby's eyes in the first minutes after birth won't last – exposure to light changes a baby's initial eye colour. Most babies of African and Asian descent have dark grey or brown eyes at birth, but it won't be clear what precise shade their eyes will be until after the first six months or year.

If you go into labour this week, find out how to cope in the early stages. Have a look at our newborn section to learn all about the precious load you are carrying.

http://www.babycentre.co.uk/38-weeks-pregnant

Total weight gain: 56.7kg, 400g less than last week and 9.8kg since the start of pregnancy.

Maternity clothes: Pretty much all maternity.

Sleep: Fairly good this week.

Best moment of the week: I've finished up work on Friday! Still have to drive there each day to drop out toddler off at daycare, but i get the rest of the day to myself :)

Food cravings/aversions: Waiting patiently for double brie on water thins, champagne and sashimi salmon after the birth.

Symptoms: 

Nausea: None.

Fatigue: Taking Ferro Grad-C every weekday. Don't feel excessively tired.

Other: Red raspberry leaf tea twice a day. It strengthens and tones the muscles of the uterus, to help with an effective faster labour. I'm getting almost constant Braxton Hicks contractions, but that happens whether or not i drink the tea.

Movement: Head down, left occiput lateral (LOL/LOT), 4/5ths above brim (not yet engaged but getting there). Lots of kicks and stretches - more stretches now as he starts to get quite cramped in there.

Gender: Boy.

What i'm looking forward to: birthing my baby at home! And my birth photographer just emailed me to say she's now on call for me - this is getting real! I feel so much more positive and relaxed than this stage last pregnancy with my focus being on trying to turn my breechling and the birth being up in the air as to how it would proceed... now i have a head-down baby and a homebirth plan :)

Still waiting though for my midwife to bring over the birth pool. She was supposed to bring it to my appointment yesterday, but forgot, so then said she'd drop it by that afternoon (she's only two suburbs away, about 10 mins at most). She didn't show, so around 8pm i messaged her and suggested it was too late to drop it by that day and would she be able to do it the next day (today)? She said yes, in the afternoon - i'm still waiting and i've just messaged her again. She says she'll be here before 5pm. Plan is once it's here, to test the hose connections, fill it a little way so as to estimate how long it will take to be full, and then empty it and dry it ready for labour.

Edit: have the pool now! So excited!

What i miss: Being able to bend over easily - it takes me a long time now to reach the floor.

Next appt: 14 November

What else i've done this week: Had my hospital appointment where i saw a doctor to sign off on my VBAC plan (which involved declining pretty much all their usual procedures of IV, CFM, no food/drink except clear liquids and VEs every 3 hours). (I'm planning an HBAC but the hospital is my backup and they believe i'm having a VBAC there). She said she'd have to get the consultant (who i usually see) to sign off on the plan. I wasn't worried - none of what i'd declined was putting me or baby in danger, and even if they don't sign off, i know the magic phrase - "I do not consent".

The doctor was concerned about my fundal height. They seem to think it should be exactly the same on all women, regardless of their weight or height. I measured 34cm at 37+3, with a baby that was now 4/5 above the pelvic brim (where i had measured 35 with my midwife the week before with a 'free' head). Probably at least a cm of baby's head was now below their measurements. I'm currently measuring again at 35cm with my midwife - exactly the same as my previous pregnancy at this gestation (and fits with about a cm of growth since last visit, if you keep in mind his lower head position). However, the hospital wanted to book me in for a growth ultrasound, and added a check of placental location onto the form. I allowed them to book it with the proviso that i would discuss with my midwife on Saturday and decide whether to proceed with it.

I then saw the consultant who said she signed off on all my requests, but added, "until mother changes her mind". Fine by me. I've had 2 1/2 years to decide what i really want - i'm unlikely to change my mind at the last minute! She also mentioned she called my midwife to discuss my appointment.

So at my midwife appointment on Saturday, almost the first thing she said was to ask how i felt about getting a growth ultrasound. She said that the consultant had called her and stated that she'd be happy if baby was as low as the 10th percentile, as that was what my toddler was on when he was born (funnily enough a scan at 35 weeks showed him on 50th percentile for AC and HC - but he was quite thin at birth 6 weeks later (weighed just over 3kg)). Clearly not IUGR, just thin with an average size head and tummy. I explained that i wanted to discuss the fh measurement with her first, but i felt he was not at risk of IUGR, because the fh was the same as with my first baby who was born healthy, but small, and because he did not show any signs of placental insufficiency such as decreased movement. I measure small on fundal height because my babies are small, i am small, and i carry very little fat on my stomach (i tend to put it on my thighs). She was able to see just how active he was when she was measuring as he kicked to the side several times, as though to reassure her, 'i'm fine!'. You can almost make out the shape of a foot when he does this! And so based on continued activity from baby and only measuring -3cm from the average fh, and my research, i told her i planned to cancel the u/s. I think she'd have preferred me to do it, but it's my call. And i've seen so many mums pushed into interventions past 37 weeks (and i do consider an unwanted u/s an intervention), it's almost like the medical profession has to find something out of the thin line of 'normal' to look into and act upon, often starting the birth process too early because of it... can't they just wait til baby is ready like the rest of us do?

The consultant was more concerned about my refusal of vaginal exams, and asked my midwife to talk to me about considering one every 3 hours as they worry about obstruction of labour in the scarred lower uterine segment. Right, cos a baby kicking and pushing with their head and hands on it during 9 months of pregnancy isn't nearly as intensive on it as being on the non-contracting part of the uterus during labour? And that i'm not planning on having any pain medication during labour (so warning signs of uterine rupture (pain between contractions, shoulder tip pain, or just generally a feeling of something not being right - or the later signs such as excessive bleeding, contractions stopping or changing drastically) would be quite clear to me before it showed with heart rate changes in baby) or induction (known to increase risk of UR) - and a baby doing absolutely fine, just a plateau or slower labour than their plotted 1cm an hour suddenly means increased risk of UR? None of the research i've read shows that. (http://www.bellybelly.com.au/birth/vbac-sabotage-is-your-doctor-really-vbac-friendly#.VF6vOL7lk20 - number 3 and number 6 state there is no evidence that long first and second stages cause an increased risk of uterine rupture. That's also what my looking for an article on it found - absolutely nothing). So, i do not consent. She also asked my midwife if i would be ok with the CTG monitor being put on if i lay down on the bed (i had asked for intermittent only) and then taken off when i got up (yeah right) - oh yes, i said with a smirk. 1) i'm not planning on being in hospital and 2) if i were i wouldn't be lying down! Active labour for me thank you very much! Probably out waddling round the gardens and leaning on benches, if i had my way! Although if i had to go in due to concerning symptoms at home and it was quite long, i'd have hubby and my doula supporting me and i'd be repeating, 'I do not consent'.

So on Monday i will call to cancel the u/s and the clinic follow-up appointment after the u/s. I will only see them again if i go past 41 weeks.

I still find it amazing that you have to fight for every aspect of the birth you want.