Monday, June 18, 2012

The Story of Ruben's Birth, with all the gory details!

Warning! This post is loooong... I have written it over the last month with one hand, often on my mobile, as I now have a bubba that is usually in the other arm :) I have done this mainly for myself, as I don't want to forget anything that happened. But if you are interested, feel free to peruse. Be aware that I didn't leave anything out!

The summary
Our gorgeous little boy, Ruben James Viggo Sargeant, was born on May 16th at 4.15pm. The labour lasted 27 hours  and I managed to get through it with nothing more than natural suppositories, a saline drip at the end to keep me hydrated, and the occasional homeopathic injection to relieve my seemingly constant need to throw up. It was a tough labour - Ruben was a 'sterngucker', or 'stargazer' (he'd come out face first, looking up), meaning he was in a posterior position with his back to my back, giving me what is known as a 'back labour'. This kind of labour is renowned for being extremely tough because, besides the incredible back pain it causes, it doesn't give you a nice rest in between contractions. This also made our hypnobirthing preparation very difficult, as you rely on these rest periods to bring yourself back into relaxation. It was, however, hugely beneficial through the earlier stages of labour, and perhaps I would not have been able to make it through the birth medication-free without it. Near the end, it turned out that I had a 'cervical lip', where part of my cervix did not totally recede until the absolute final stage, meaning that while I had the intense urge to push, I had to do everything in my power not to, for otherwise I'd tear my cervix. It's really impossible to explain how strong the urge to push is, and how it completely takes over your entire body, and so trying not to do this was... yes, hard. But the moment that he popped out? The love was overwhelming. And in hindsight, I love that my birth was difficult - A baby this beautiful is something that has to be worked for. :)


The lead-up
Duncan and I had spent three weeks glued to the weather forecast, after hearing that the dramatic drop in pressure during a storm can often break a woman's waters. Two storms came and went, we walked everywhere, ate lots of curry, pineapple and eggplant, had lots of sex, spent my days doing squats and visualising opening rosebuds,  everything. And while I went into labour only one day after my due date, it felt like an eternity. You see, Ruben had been pressing down and ready to pop for months, so I'd been instructed to take it very easy, avoid walking, avoid my pregnancy yoga, avoid stairs and even  standing, as much as possible. So we had to prepare for a possible premature birth and so I had been very much ready for this baby for a long time!  Then of course when it came to the week before my due date, his little head popped back up, still with his head down, but now completely disengaged. Gah!

I knew that things were really gearing up, though, because for four nights before my waters broke, I had contractions that were stopping me from sleeping. They always stopped by the time the sun rose the next morning though... so it was just a matter of waiting. Impatiently.

First signs of an imminent baby - waters breaking

And then on Tuesday the 15th of May, one day after Ruben's due date, the lake turned a little green and unexpected clouds started rolling in. I was in the bath listening to my relaxation CDs and positive birth affirmations ("my birth will be easy because i am so relaxed and confident") and keeping an eye out for any more traces of my mucous plug, which I had begun to lose two days earlier. When I got out of the bath, it seemed as if I was leaking a little bath water. Hmm. Nothing dramatic, no great gush like in the movies, but whenever I moved position, I leaked. I put in a pad and tried to calm my beating heart... was this my waters that had broken? And then the flow just became heavier and heavier, and I was going through one pad every five minutes, destroying my clothes and underwear in the process... So yes, this was it! It was around 6.30pm so I checked Google latitude to see if Dunc was still at work or already on his bike heading home. It didn't seem to be working, so I sent him a chat,which he'd get if he was at work, saying, "You still there, lovely? Coming home soon?" I certainly didn't want to tell him via chat that I think my waters had broken! But no answer... so I called him. Six times over twenty minutes. No answer. All of these things - the unanswered calls, the fact his latitude wasn't working... this all lead to the obvious conclusion that his phone had been destroyed in the horrific accident he'd had on the way home, and that he'd never get to meet our little bean!

Of course he was fine. He trundled upstairs and I told him my news -- I thought he'd get into a bit of a tizz, but you have never seen anyone more calm in their life. 'Oo, awesome! Better have a shave then,' was his response. We then had dinner (Thanks to my grocery deliveries for throwing in a free microwave dinner - perfect for my husband at that time! I just had some pureed apple and a rice cake... I was starting to feel pretty jittery), talked through some positive affirmations, and rang the hospital. They said we could come in now or come in a few hours. We decided to wait. But then  I became unsure about the colour of the waters, and my contractions, though not painful, were getting much closer together, so we called again and they told us to head in. I hadn't expected my waters to break before big contractions began, so all of my earlier plans for the first stages of labour -- bake a cake, watch The Sound of Music, play a board game, sleep -- went out the window.

It was a quiet taxi ride to the hospital, and I tried not to get overly stressed by the fact our driver kept checking his phone and swerving into the bike lane... he ended up giving us a discount -- in Zurich!!-- because he went past the turn off. Or perhaps because he knew we'd be broke pretty soon.

The first few hours - hypnobirthing and remaining at 1cm dilated

When we entered the geburtsabteilung, the midwife hooked me up to the monitor, and we watched my small, relatively painless, contractions for around 45min. I had an internal exam and was totally bummed to discover that I was only 1cm dilated (you need to get to 10cm) and only around half-way through the thinning phase. Seems I wasn't in for a speedy and relatively painless three hour birth after all. I was holding out hope! We were left alone during this time, and I made sure I followed my friend Vanessa's advice and worked on my breathing and relaxation even that early. She told me not to wait until i felt i needed the relaxation, as its better not to get yourself to that point in the first place. Eventually, around 10pm, another midwife, Melanie, came to speak to us. She asked me to wipe myself with some litmus paper, which turned bright blue, showing that yes, that was definitely amniotic fluid, and said, "looks like you'll be having a baby in the next 24 hours then!" Yikes! She then asked us what we'd like to do, whether we wanted to stay or head home. She was pretty blunt and said that she would head home, as there was nothing to worry about, the contractions weren't painful and it might take a while for them to get that way. Once she realised we were carless and would have to taxi, she sorted out a room for us. Meanwhile, I went to the toilet and noticed the waters had changed colour and it seemed our little bean had been a bit stressed and had done a poo in there in the last few hours. I knew that this was meant to complicate things, and I became a little worried for our bub. When I told Melanie, though, she seemed to think it wasn't a big deal and that we couldn't do anything about it anyway, so no need to be stressed. But this went against all my research -- shouldn't this be some kind of an issue? But no, we should just try to get some sleep.

As if! Of course, Dunc slept with no problem at all. I was having what my mum calls ‘monkey brain’... along with all those contractions. I took the midwife up on her offer and called at 12.30 to ask for something herbal to help me sleep. After this, my contractions started to become pretty intense. At 1.30 I woke Dunc and said I wanted to move to the birthing room, as I needed to cling onto things, roll around on the balls, etc, just not lie here in bed. So off we went.
My contractions at this point were really getting to be strong, but we practiced all our hypnobirthing techniques, particularly the breathing, and Dunc walking me through the relaxation and visualisations of my special nature place (a lake in Sweden where we camped and skinny dipped). The midwife left us on our own to do our thing, leaving us with what she called the 'boom box' so I could play my yoga music, and lighting the oil burner for my rose oil. After a couple of hours we asked to use the bath and Dunc jumped in too, but I just couldn't find a place where the pain was feeling relieved, and I just got kind of annoyed with the situation, so got out. Awkwardly. And painfully. The contractions were coming pretty hard and fast by now and I was beginning to feel myself go into that strange zone that people mentioned women often go to during birth, where all time and space becomes a bit warped.

The midwife came in again and asked if I'd like to have an internal assessment to see how much progress I'd made, and I was eager, as I felt it had been quite a few hours of pretty intense pain by that point. I nearly broke down when she said that now I was still only 1cm dilated, but at least my cervix had almost totally thinned now. I mean, really! She saw how dejected I looked and tried to explain to me what a big deal that cervix-thinning phase is, but whatever - I had spent the last three months on forums reading about women who spend weeks at 4cm dilated before even going into labour. I was bummed.

Enter Anja - my incredible midwife.

But, let the games continue. Pretty soon, at 7am, my wonderful midwife Anja arrived for work and came to help us out. I had met her a few times during the past week when I'd had to visit the hospital every second day to keep my blood pressure, fluid retention and Beanie's stress levels in check. She is an amazing woman who had spent the past six years working as a midwife in Darwin, Northern Australia, and had just returned recently to Switzerland, so it was great to have someone with a semi-familiar accent, where I didn't have to remotely worry about whether I could be understood. I can confidently say that without Anja, I feel as if my birth story would be a very different one, perhaps even resulting in a c-section.I hold this woman up with so much praise!

I had told Anja during our past meetings about some of my friends in Australia and their amazing birth experiences, particularly with hypnobirthing, and with home births. We also chatted a lot about Dunc and our big six-month cycling tour... and while this may seem a little irrelevant, it all came to play very important roles during the birth. During particularly difficult periods, for instance, she would say to me 'Joh, you spent six months of your life cold. You can do this!', and later on when she came to visit after the birth, she referred to the fact that she knew how important having a great birth story was to me, and how much I love my friends' stories, and so she was determined to give me one of those stories to tell too. Which is amazing, I think.

From this point on, I remember only snippets, and a lot of it is what Duncan has reminded me of. The thing I remember most is the strange place that I was in for the rest of the labour. I remember times when Anja and I were having a very serious conversation, and as much as I tried, I could not focus my eyes on her, and I kept feeling them roll back in my head. And her voice sounded as if it was coming to me from across a valley... and all of the hypnobirthing practices that Dunc was attempting to use with me were completely in the background - I was barely aware of them. Until he stopped, and then it was obvious something had changed and I didn't like it. At some point, I remember having a lucid moment where I thought about how incredibly awful this must be for my husband, watching me for so many hours, moaning and yelling like a wild animal, and feeling so helpless. I am really grateful to hypnobirthing for at least being able to give him an important role to play.

The bath - the fight for medication and becoming an animal
We went back to the bath, and the contractions were much worse now. Also, II was at the point where I was not getting any relief between the contractions. I remember being in the bath and moving my body around with the pain, wiggling backwards and forwards, and moaning. Anja had to leave the room at some point, and I remember beginning to sob to Duncan, telling him that I just can't do this anymore, it is too hard, and I'm done. Hearing myself say these words, though, I remembered that in our birthing class, this often happens right near the end, so I actually had a moment of elation in there too. When Anja returned and asked if I'd like an examination to see how far I'd progressed, I was eager. But I was only at 4cm. Not even half way. I can't tell you how soul destroying this was.

The pain at this point had become something that I could never have imagined. It was totally all-encompassing in a way that I just cannot describe, and knowing that I still had so far to go, I broke. I told Anja that I needed medication for the pain.  It was time to push that red button. Screw the homeopathics, I want the hard-core stuff. Now.
Here’s how it went:
“I need something more. Something for the pain. I can’t do this any more.”
“Well, Joh, I’ve spent a lot of time reading your birth plan, and you say in there that you want to exhaust all other options before reverting to that. So that is what we are doing.”
(Insert enormous contraction)
“Yes okay but now I’m done. I need something else.”  
“Look, you also said very clearly that you don’t want to be offered any medication and that you have to specifically ask for it. So I’m not going to offer you anything. You need to tell me exactly what you want.”
I’m pretty sure this is where I would have said something along the lines of “that fucking birth plan!” So after the next contraction I said very clearly (though I was unable to look her in the eye..) “I would like an epidural now please.”
She replied, “You’d like an epidural? You’d like  one? Well lots of people would like lots of things in their lives...” and she continued this way until my next contraction. After this, I looked at her incredulously, asking what more did she need me to say. She explained that she was sceptical to give me one because I was moving in the bath in exactly the perfect way for this kind of labour, to help bring the baby down (I was rocking my whole bottom half left and right with quite a bit of force), and she didn’t want to give me something that would stop that movement. I think this was when I pretty much broke down, so she told me she needed to leave the room for a moment to check on a few things, and when she returned she was very straight with me, which I really appreciate. She told me that, considering Ruben’s position and the fact that I would need to be able to have a lot of power and strength to push him out, asking for an epidural is tantamount to asking for a Cesarean Section. She reiterated that it wasn’t guaranteed that this would happen, but it was very likely. So from that point on it was just put out of my mind as something that wasn’t an option anymore.

Water injections as pain relief
Somehow I managed to plough on. We tried a bunch of different positions in the bath, and at one time Dunc became worried I was going to inhale too much water... But I didn’t drown, so everything was okay. :) As the pain continued to intensify, Anja offered me what she warned as being a very painful procedure, where they would inject water underneath the skin of my lower back, which would put a lot of pressure at the particular points that she and Dunc kept pressing into with absolutely all of their might. She continued to warn me that it would be very painful, but it would relieve the back pain a little... so I agreed. She said that she’d count me down and I would have to cling onto Duncan, who would count up to twenty while she injected the water, and then she would do it again for the other side. WOW that hurt, but it was a different pain - an intense stinging, so I could deal with it. And I am pretty sure that it did take away some of the pain... but from here on, I remember very little until we got to the point where I felt the need to push.

Dunc tells me that at some point here they needed to give me an IV drip to keep me hydrated, as I was sweating profusely and refusing water, as I continually felt the need to throw up with every strong contraction. I actually only did throw up once, but it felt like a threat throughout.

The last centimetre - trying not to tear my cervix

I remember my friend telling me about the fact that, during her labour, she felt the need to do a poo, and it was actually the feeling of wanting to push out her baby. The time came when I really felt the need to do a poo... Anja said that she could take me out of the bath and to the toilet, but the contractions were coming very fast then and each time I tried to attempt to get out, a huge contraction would put me back in the bath again. So she said don’t worry about it - if it happens, it happens. Turns out it also wasn’t a poo - it was a baby. But in my situation, I wasn’t allowed to push yet. My cervix was almost totally dilated (it should have been right from the start), but there was a ‘cervical lip’, where part of it hadn’t totally retracted, so if I went with my body’s intense urge to push, then my cervix would tear -- a pretty big drama. So Anja told me that every time I had the desire to push, I would have to pant as hard and heavily as I could, but only just until the point where I felt the urge pass, because if I continued for even a few seconds more than necessary, I could very easily hyperventilate, which could cause a bunch of other problems...

For me, this was the hardest part of the whole labour. It is impossible to explain to anyone who hasn’t done it how strong this urge to push is. It takes hold of your entire body, in an enormous wave from the top of your head, all the way through your body, as if a steam roller inside of you is squishing everything down. It seemed almost impossible to stop this feeling, but most of the time I managed it. There were times when it just took over completely and I was entirely unable to stop it, and I would end up doing an enormous push, all the while being very scared of the damage this was doing...
At this point, I moved out of the bath and back into the birthing room, where I knelt on the bed, which was tilted up, and clung to the back of the bed. Dunc was standing behind the bed doing light touch massage of my back and arms the entire time, which I wasn’t even aware of until he stopped it for a split second - and then everything became so much worse. The panting and occasional accidental pushing continued for the next two or three hours, with Anja often doing internal checks to see if it was okay for me to push yet. Finally I was told that I could go with it the next time, and the urge disappeared. I couldn’t believe it! But just that one time... from then on, the fun part started.

Time to ‘breathe the baby down’!
In all of our hypnobirthing preparation, we were told to not refer to ‘pushing’, and that we should just use a particular kind of breathing to bring the baby down. I also stated this in my birth plan that I didn’t want to be told to push, and that I would ‘breathe the baby down’ in my own way. Anja said later on that she couldn’t help but laugh at this, and that perhaps after a person has had five babies this is how it works... and now, I believe her. This pushing business is not an option - it is something that your body just takes over and does, whether you want it to or not!

Each time I had the urge to push, Anja would encourage me loudly to push harder, harder, and longer. And then to take a quick breath and try again before that contraction ended. Sometimes I would manage three huge pushes with one contraction, and I remember feeling really proud with all of the praise she was giving me. She would often tell Duncan to come around her side and see the head begin to come out. She would grab my hand at times and I could feel Ruben’s head, so soft and wet and covered in hair! “You’ve got a blondey!” she said at some point, though Dunc says the head looked more like a big tennis ball, all hairy and green with the meconium-filled amniotic fluid.
This phase went really quickly for me, I suppose because it felt so productive. Apparently it took one and a half hours, which I was told is really fast for a posterior birth, and therefore evidence of my crazily powerful pushing. Yay me! Dunc has said in the meantime that the power I had at this stage just totally blew him away. I would always feel that I could stop after one huge push, but at that stage I just wanted this baby out of me, so I totally went for it!

The point where his head popped out was amazing - it really felt like a ‘pop’, and then with the next push, in the same contraction, the rest of him slid out and immediately they put him onto my chest. What a completely overwhelming feeling. Duncan and I were both in tears immediately, and I kept rubbing this soft, warm, wet creature on top of me... He was incredible. I remember that immediately I was amazed at the fact that this little baby had just come out of me, and that just seconds before, it was inside of me!  It took a few minutes for me to realise we still didn’t know if it was a boy or a girl, so I asked Anja, and she told us to find out ourselves. Dunc went exploring and, through laughter and tears, told me that we had ourselves a little boy!

The aftermath
It took about fifteen minutes for Ruben to start breathing properly. He was doing very shallow little gasps only, and they placed a small tube that was pumping out oxygen underneath his nose, holding it there. They also gave him some homeopathics, but it wasn’t really a worry because the cord was still attached and pulsating. Only when they took away the towel that was keeping him warm and comfortable did he do a big hearty cry, much to my relief. I had wanted him to lie on my chest and then find his own way to my breast for the first breast-feed, which newborns amazingly do, but he was too tuckered out from the whole experience, the poor little bubba.

It took over forty-five minutes for the umbilical cord to stop pulsating, which was incredible. From then, it took another hour for the placenta to come out. The doctors and midwives were doing a variety of things to make it happen that I remained completely oblivious to, until I got told that I had to hand the baby to my husband and I had to focus on getting the placenta out, because it was beginning to take a little too long. Eventually, after trying a whole bunch of things, the trick that worked was for me to blow into a bottle pretending that I was blowing up a balloon. And then out it popped, no problem at all.

I discovered afterwards that Ruben had been born with the cord around his neck, but they managed to untangle him quickly before it became a problem. Also, he came out face first (which happens with the posterior birth), with a hand pressed to the side of his head, making it a MUCH wider area to have to push out, so the fact that I needed only one stitch (though the doctors and midwives argued about whether even this was necessary) is a real tribute to the benefits of being vigilant with perineal massage for the month leading up to birth!

And now my gorgeous boy is lying asleep on the couch next to me, one month old and one kilogram heavier, having no problems with producing hearty cries, and beginning to smile. I had always said that no matter what happens during the birth, it will surely be one hell of a thing to experience, and that was right! I look at my little boy and am so amazed and perplexed by the fact that my body grew him and my body managed to push him out. He is so perfect.


  1. Thanks for sharing the story. Congratulations on your experience.

  2. johanna, you inspire me so much but this is tops. no medicine, and all your preparations and mantras... it really seems to have worked well for you. i especially like the part about you asking so politely for an epidural and then realizing you had the major woman power to deliver him without! i am so glad you wrote this, and that you shared all the details^^