After a few months of ovulation induction fertility treatment with a private obstetrician/gynaecologist specialist, my husband and I were so excited to learn we were pregnant. We counted down until the 6 week scan, and I had to fight concerns that there would be a problem. I’ve always been a cautious, anxious and sometimes ‘negative’ thinker – but we had a heartbeat and everything was going smoothly.
Unfortunately, just a few days later I had some bleeding and cramping and at a scan that day, the heartrate had slowed. Despite progesterone pessaries which seemed to perk up the heartrate, we lost that pregnancy.
I had nicknamed him/her ‘Baby Popcorn’ and was so devastated even though it was only 9 weeks when we discovered the heartbeat had stopped. I remember the unbearable sadness and crying in the waiting room at the specialist ultrasonographer, and grasping for ways to try to grieve for what I thought was a relatively “minor” loss in the context of fertility and trying to conceive: an early term pregnancy after only a few months of trying: I didn’t “deserve” to be so sad.
A colleague at work who had been through something similar shared how she had written a letter to her lost baby, which worked well as a way to process the grief for me also. It took us many more months of ovulation induction treatments to fall pregnant again after that, and I was starting to fatigue from the intensity of the routine of daily injections, waiting, frequent (every 2-3 day) scans to monitor the growth of the follicle and then the trigger injection to stimulate ovulation, before trying to conceive and then the notorious two week wait.
We were initiating IVF the month after our last ovulation induction when we got lucky and fell pregnant around New Years 2018. I found it very difficult to remain calm and wait for each of the milestones, trying to manage my negative thinking and anxiety that something would “go wrong” with this pregnancy too. However, joyfully, we made it to each milestone with relative ease: 6 weeks, 12 weeks (my favourite scan, where I finally felt I could begin to bond with the now quite clear image of a proper little baby I could see was definitely growing well inside me and where we learned he was a ‘he’) and 20 weeks.
At around this time we switched from private care with our fertility doctor to the public system and I engaged Marita as a private midwife to assist with the birth at the Royal Women’s. The first minor drama was concern at my 27 week appointment at the hospital that my fundal height was measuring weeks behind, which meant they were concerned about baby’s growth. However, a growth scan showed he was actually in the 99th percentile, so, he was hiding in there somewhere!
I awoke in the middle of the night when I was 31 weeks to discover my waters seemed to have ruptured. A hospital visit confirmed as much, but I was showing no signs of labour. After a 4 day stay on the antenatal ward and a lot (a LOT) of antibiotics, I was discharged, to return every second day for monitoring, until either I went into labour myself, or was induced at around 36 weeks.
It was a strange time, in ‘limbo’, knowing I could go into labour at any time but also being concerned I was continuing to leak fluid but not showing any signs of the action starting to kick off! At 35 weeks I felt reduced movements from my little bub who had previously been so active. We ummed and ahhed but finally decided to go into Emergency at the Women’s and get things checked out. They admitted me again, being concerned about the context of 3+ weeks of ruptured membranes. The next morning on rounds, the doctors said they’d recommend induction that day.
My husband was in surgery as a vet all day, as I waited for a bed to become available in the birth suite so induction could commence. It was another strange day of waiting, knowing things were about to really start happening, but having no sign of any action, and being alone, waiting for my Mum to drive from Shepparton and my husband to finish at work and arrive. I used my hypnobirth affirmations track and ‘Headspace’ meditation app to try to stay calm and focused and rest on the antenatal ward as I killed time.
It wasn’t until about 4pm that a suite became available and I was transferred. Mum arrived and Dylan too by the time the drip started. We had a ‘picnic’ dinner and chatted and laughed with the lovely midwife. Marita arrived and I still felt completely fine. My mum headed back to our house and hoped to hear overnight when our baby arrived. A few hours passed with the senstation of a contraction that was still quite bearable with the use of the breath and TENS machine.
However, after about 5 hours of contracting, I was really starting to lose my capacity to breathe and tolerate what were now very intense contractions, one on top of the other. I had read all the classic books about wanting to be strong and work with the functional pain using the breath and active birthing strategies and visualisations and so I was disappointed to find I was barely able to be upright, managing only by being curled in a ball on my side, clutching my TENS, with Marita rubbing my hips and thighs which felt in a vice grip and would seize up with every contraction.
I had also become very nauseous by this point and started asking for something to help with that. There was no way I was sitting on any birth ball – I couldn’t sit up! He had napped and awoken to find me dramatically different from earlier in the evening: he says ”it was like you were possessed”.
The week before, upon finishing Rhea Dempsey’s book, I had sat my husband down and told him how I hoped to try to manage the labour without pain medication, and how it wasn’t disimiliar to the pain of the half marathon I’d run the year before: ‘functional pain’. I said I needed him to be strong and support me mentally, even when I faltered, which I explained might happen during transition when I may have a “crisis of confidence”. Being a medical practitioner himself, albeit a vet, he maintained that drugs such as an epidural have their place and he thought we should remain open to the possibility I might need or benefit from one, so we came up with a “code word” I could use if I started asking for one and he wasn’t sure how seriously I needed it. Fast forward to the early AM of Saturday 18 August when I had been labouring for about 8 hours, and I was pleading for the epidural. The midwives and nurses must have thought we were nuts when Dylan is saying “But what’s the code word?” and I’m saying our dog’s name “Ollie! It’s Ollie!!”
After the epidural was finally administered I was able to have some relief from what had felt like a never ending single contraction. We all had a rest, and I remember vaguely pressing the button as the pain relief is patient-administered and I was adamant I only wanted it to be ‘light’ so I could still feel my legs and be sense how to push when the time came. Luckily I was really happy to manage this level of relief and the epidural worked really well for me. With hindsight, I don’t regret it. Even though I had hoped to do it without needing one, I suppose I’ll not know until/unless I ever labour without being induced whether the intensity of the induction drugs was what tipped me over the edge and made me unable to cope without pain relief, or whether that’s what I would have needed regardless.
I do believe the epidural did help me relax enough to allow my body to continue to dilate, as the intensity prior to that had left my entire body so tense and seized up that at my check I was only 3 cm.
By 10:30am the next morning I was finally fully dilated and it was time to start thinking about pushing. By this stage my Mum had returned and Marita had headed home so Jan, her backup, had arrived. I was so incredibly tensed up and shaking uncontrollably. It was the most unexpected and least tolerable symptom of the whole labour experience because I felt very disconnected from the sensation: it was completely out of my control and no amount of focus or breath helped.
Jan stroked and talked to me, helping me try as best I could to relax my muscles to minimise the fairly violent shaking. Apparently this is a side effect of an epidural, which I hadn’t read or been told about. When it came time to push, whilst I could sense my pelvis and legs, I did find it quite difficult to direct my energy and effort where I was being coached to. I tried JuJu Sundin’s tip in her book ‘Birth Skills’ to think of the effort required to push as being like a coffee plunger with the breath and effort pushing down, down, down, but I felt so exhausted and weak from surviving the labour that I didn’t feel strong enough to recruit the effort and strength required to push very hard. This was psychologically the toughest part of labour for me, as Jan was really dishing out the ‘tough love’ and I was trying to push with every single ounce of my being but mentally I felt it was going to be impossible to actually push hard enough to get him out and there were certainly times in between contractions and pushing where I was saying (and thinking) “I literally can’t do this. I will either die here, or they will have to cut him out. I have nothing left in me to do what I have to do.”
The midwife from the Women’s, Jan and Dylan kept encouraging me, saying ‘it’s so close now Em’ but I didn’t feel convinced until it was finally actually the moment and I felt his head crowning.
Jan recorded the moment I helped pull him up onto my chest and greeted him for the first time. As he was a 35 week-er, paediatric doctors from the NICU were there at that stage, appearing as if by magic to assess him and assist if required.
I couldn’t feel joy or relief yet as he looked quite purple and floppy to me and hadn’t cried yet but I was assured he was breathing by himself. He was rubbed down and then taken to the re-sus table to be given oxygen but he was deemed totally fine.
I barely recall Jan helping push him onto my breast to try feeding and can’t remember how well he did. He was shortly thereafter taken in an open air cot to the special care nursery with my husband. By the time I showered and could meet him there, though, he was in a humidicrib with a heartrate that kept dropping much too low. He was rushed to the NICU where he spent the next four days with a one on one nurse 24/7, having every test you could possibly imagine to try and ascertain what was ‘wrong’, if anything, with his heart.
He stabilised eventually and was moved back down the corridor to a less intensive room. He slowly ticked off other milestones, such as being able to regulate his own temperature, being able to suck all his feeds and therefore no longer needing his nasogastric tube, and beating his jaundice, before finally being discharged 12 days after birth.
Having a premature baby, going home 48 hours after delivery without him, expressing each night every 3 hours at home alone with a pump looking at the photos of him I’d taken that day…none of these are things I ever imagined when I was pregnant with Eden.
However, they are now all I know. The nurses and doctors at the NICU were absolutely incredible and the silver lining to our experience is how much we learnt from spending all day every day around them, watching how they cared for Eden and the other babies. I also had help on hand from Lactation Consultants who specialise in pre-term babies. Marita’s support and visits were another key part of making the early period feel as ‘normal’ as possible.
Eden has since gained plenty of weight, is a great little feeder and celebrated his ‘due date’ by going into his Mum’s work to say hi to everyone as a healthy gorgeous little 5 week old bub!
Thank you to everyone at MAMA, especially Marita, Jan and Sandra, for their support during our pregnancy, labour, birth and postpartum period.