A Labour of Love: Jack Anthony Cyril Kelly
Tuesday 06 December 2011
It has been nine months since I gave birth to our son, Jack. Just as he took nine months in my belly to form and become fully grown, ready to enter the world as a newborn, it has taken me these nine months to grow into being a mother, and this daily process of slow unfolding and developing continues.
As a new member of the motherhood club, a club that has its own vocabulary, inside jokes and common understanding, I have noticed that many members tend to gloss over their birth experience. In what I’ve come to know as the style of conversation that mothers have, one that happens in fragments, fits and starts, in between rocking babies, feeding, changing nappies, burping, playing with and distracting their children, the women I’ve spoken with tend to paint their story with quick brush strokes and conclude with, ‘But at least my child is fine’.
I haven’t been able or willing to gloss similarly over what this experience has meant for me. I think our birth experiences are important milestones in our lives as women, and probably one of the strongest physical, spiritual, emotional and mental experiences we will ever have.
I have often found myself reliving the events, replaying the process in my mind and wondering whether I could have or should have done anything differently.
For the most part of these nine months, my birth experience has sat like a hastily swallowed over-spiced meal in my belly, a solid uncomfortable lump. I’ve needed to chew it over, to work to digest it and absorb it in all its lumpy fullness, because I feel that it holds nutrients and richness which I want to claim for myself as a woman, a mother, a writer.
So this story is my way of digesting this experience, rolling it around in my mouth until finally it can settle within me as a precious part of who I am now.
A home birth
From the early months of my pregnancy, Joel and I had decided that we were keen to have a home birth. Birthing is a natural process that women have been doing for centuries, and if all was well medically with the pregnancy, and I was healthy, we could see no strong reasons for having to be in a hospital setting in which the woman in labour is treated as a patient – with all the possible medical interventions that entails – rather than someone who simply needs to be supported in doing what comes naturally.
As the weeks passed and my belly grew and ripened, I felt a sense of relief and comfort at the thought of giving birth in our home. ‘You’re very brave’ was often the comment passed when we told people that we were planning to have a home birth. Yet, rather than a choice of courage, it felt like a nurturing, cosy option.
When we went to the gynae for our 24-week developmental scan, she questioned us about our home birth choice, as I was an older mother, (42-years old) and in her words, ‘Personally, I wouldn’t take the risk.’ Joel and I discussed this when we had left her consulting rooms. We still felt strongly about choosing a home birth and believed that we had the necessary back-up plans in place should things not go as we were hoping.
In preparation for our home birth, I read a pile of books on birthing and home births, talked to many different mothers and did hours of internet research. We attended two birthing preparation workshops and obviously had regular consultations with our midwife. As a result of our research, our midwife’s advice and my conversations with other mothers, we decided to get a doula (a childbirth assistant) to support Joel and I on the day of my labour, and we booked a birth pool.
We also prepared for Plan B: if there were any difficulties with the birth or any foetal distress whatsoever, we would go to the Active Birthing Unit at Mowbray Maternity Hospital. And as a last resort, Plan C would be to move next door to the labour ward should an emergency C-section be necessary.
On the night before our son was born (one day after his due date), as I was stepping clumsily into my pyjama pants and preparing to ease my bloated belly between the sheets, I noticed a dragonfly-like insect perched on the shade of my bedside lamp. I wondered whether it was a sign and pictured myself telling our child about the strange creature that came to visit on the night he / she came into our world. At that stage, we didn’t know the gender of the little life that had been growing inside me.
That morning, around 3, I woke up with contractions and woke Joel. I said in as understated a way as I could, ‘I’m having some contractions but I’m not sure if they’re Braxton Hicks or not.’ We’d had a false alarm a few nights before so I didn’t want to cry wolf too soon.
Joel went downstairs to get his notebook and I lay and waited for him to come back, feeling quite important, excited and scared at the same time. He began noting each contraction, using his cell phone to time them, and stressing me out by asking ‘How long did that one last? Has this one ended yet?’ At that stage, they still felt like the Braxton Hicks contractions I’d had a few days before. They’d fade quite subtly so it was difficult to say exactly when one ended and the next began. Joel wanted to call the midwife straight away but I wanted to wait till I was sure they were the real thing. So we compromised and agreed to call her in an hour if the contractions became stronger and more regular.
By this stage, we’d gone downstairs, switched lights on in our sleepy lounge and Joel had got the kettle boiling for coffee. There was expectation and quiet excitement in the air. Now each contraction began to feel unmistakably real and I slowly let go of the small hope that it was just another false alarm. I finally agreed to call the midwife. She answered sleepily and I remember saying politely, “Hi it’s Cathy, how are you?” as though I was just calling for a chat. She didn’t answer me but asked how I was. She listened for a bit then told us to keep monitoring the contractions and to call her again in an hour.
My body began to shiver so I curled up on the couch with a blanket but each time a contraction came, I felt the need to stand and move around, to let it move through me, so I soon shrugged off the blanket. As each contraction squeezed its grip on my body, I breathed into it. Each breath brought me more into my body and into the present moment. A little later I rushed to the bathroom and vomited. I could feel that my body was preparing itself for something big. I had the impression of getting strapped into a rollercoaster as I mentally gripped the sides of the carriage and gathered myself for that first ka-klunk when the engine started up.
The midwife came round at about 6:30am to check my blood pressure and to see how much I’d dilated. She seemed pleased with my progress and I took courage from this, telling myself it was going well so far. She left and said she’d be back just after eight, as she had to drop her kids off at school. She advised us to call the doula.
Joel began filling up the birth pool. Because I’d just had a shower before coming downstairs, it took a while for the hot water to fill up. I began to feel helplessly impatient, as the contractions were getting stronger and I was hoping for some relief. Finally the birth pool was full enough for me to get in. I took off my tracksuit pants and stepped into the warm circle of water. All I was wearing was my bikini top. There was a brief moment of delicate indecision about whether I should take off my underpants but then I thought of all the birth videos I’d watched with women completely in the buff and I stepped out of them with a feeling of reckless daring.
I felt flooded with gratitude that we’d decided to use a birth pool, because the warm water took the edge off my contractions, which had started to feel unmanageably intense. I sat in the pool, feeling sweat begin to bead on my forehead, and wondered how I would’ve managed without the pool.
At around 7 the doorbell rang and the doula arrived. We hadn’t called her ourselves so the midwife must have. I remember feeling a twinge of disappointment that she’d arrived so early, as I was enjoying the quiet close unit that Joel and I were creating. She walked into our house and I said hello (ever the polite one!) from where I sat in the birth pool. She replied with a quiet smile and went to sit in the leather armchair in our lounge. I was facing the wall on one side of the birth pool and had my back to the lounge. There was a beat or two of silence and then a polite attempt from Joel to make some small talk. This made me smile to myself, and I could hear from her quiet monosyllabic responses that she was trying to discourage this. Then a long silence. I turned my head around to see what she and Joel were doing. She was sitting on the big leather armchair with her eyes closed and Joel was sitting on the couch sipping coffee. I assumed that she was possibly centring, getting herself in tune with us and what we needed.
Then the next contraction began and I called Joel to come and hold my hand.
The midwife came back around eight with all her equipment. She brought a breeze of competence and a feeling of ‘let’s get down to business’ with her. She asked me to go and wee so that she could check my urine, then she took my blood pressure and did a vaginal check while I was back in the birth pool. She said I was dilating well, and I felt a rush of pride and relief at her words. I could feel that I was going with the flow of my body, and through my breath, surrendering to each contraction and letting each lead my body to where it needed to go. As each contraction laid its grip on my body, and as I breathed deeply into the bone-moving strength of it, I could feel myself turning more and more inward, becoming more dreamlike. I felt fully in my body and committed to the process – there were a few jagged edges of fear at the intensity of it but I would breathe and dive deeper than the fear.
There was a part of my rational brain that was still switched on, and it’s this part that occasionally made sardonic comments to myself, and thought of witty things to say to the others in the room. I chose not to verbalise these (they probably weren’t that funny anyway!) as the two birthing workshops we’d attended stressed the importance of not talking, of rather staying with the wordless physicality of one’s body. Between each contraction I watched the midwife and the doula to see what they were doing. I thought of asking what the time was then quickly discarded that idea and likened it to being stuck on a plane in economy class on a long flight and realising that clock-watching was only going to make me feel more desperate and uncomfortable.
At 9am the midwife came to check me in the birth pool again and used her Doppler to check the baby’s heartbeat. She listened intently for a while then said calmly that there seemed to be some foetal heartbeat distress. She said we’d give it another 30 minutes before checking the heartbeat again and added that we might need to go to Mowbray. My heart sank and I wondered how I’d manage contractions while sitting in the car, but I stayed silent because I was willing to do whatever it took to get the baby out safely. Thirty minutes later, the baby’s heartbeat had calmed down. The midwife said she wasn’t sure why there had been distress and the doula said it could have been the warmth of the birth pool. I felt a rush of grateful relief that the baby’s distress seemed to have passed.
Though I’d stocked up with little fruit juice packs and healthy energy food beforehand and Joel was standing by to feed me, I didn’t once think of food – which is very unusual for me. I asked Joel for a glass of water, which he brought and put on the floor beside the pool and which was difficult for me to reach. The doula brought a small stool and put the glass on top of it so that I could easily get to it. She rubbed some sweet smelling oil into her hands and massaged my neck and shoulders. A bit later she went to get a towel and suggested that Joel mop my forehead, as I was sweating a lot from the exertion and the warmth of the birth pool. I remember the lovely relief this cool towel offered.
Every time a contraction began to build, part of me swore to myself ‘I’ll never do this again’. Having watched birth stories on TV since then, it seems many women either wail ‘I don’t want to do this anymore’ or we promise ourselves we’ll never do it again. Perhaps this is our mind’s way of attempting some degree of (illusory) control over this shift of earthquake-like proportions that erupts in our bodies and sweeps us along into a space where we have to call on our deepest strength and will.
As my labour progressed, I was in a dreamlike space, where I faced inward and surrendered to what was going on inside me, yet I was also aware of Joel’s comforting presence, the midwife and the doula around me, their occasional comments etc. The voices of the three of them (when they spoke, which was rare) felt far away. I had a similar feeling to drifting off to sleep while watching TV, when the wakeful world around becomes fuzzy and distanced.
At one stage, the midwife put the kettle on to boil and asked me where the rooibos tea was. I was in a deep non-verbal zone and had to make a superhuman effort to locate the tea container in my mind and express verbally where she could find it.
Having Joel there and squeezing his hand every time a contraction came felt absolutely essential to me. I think I endured one contraction without him, while he’d rushed off to the bathroom. I couldn’t wait for him to get back. When he did, he gave me his hand once more to squeeze but the grip felt different and ‘off’ so I wriggled my fingers and changed the grip till it felt just right. This felt almost like a superstitious need to have everything just the same as for the previous contraction. As the contraction began to build, I’d grip the side of the birth pool with one hand and reach for Joel’s hand with the other. I felt that my survival through each contraction was dependent on having his warm strong hand to squeeze, and his familiar silent presence at the edge of the birth pool. This helped me not to feel so alone with the intensity of what was happening in my body.
Some time later the midwife said she was going to try to break my waters. She came to me in the birth pool with a long pointed instrument and inserted it inside me to try to nick open the amniotic sac. I felt a slight discomfort, a pricking sensation but then she took her arm out of the water and said she wasn’t able to do it because the baby’s head was too close to the surface of the sac.
A while later, the midwife checked me again and said in a decisive tone, ‘It’s time to push now, Cathy. The next time you feel a contraction, give a good long push.’
As I began to push, she explained the kind of pushing I needed to be doing: long and strong and lasting. I gave each push my all but often ran out of strength towards the end. I felt from the beginning of the pushing stage that she was communicating to me that somehow I wasn’t getting it right. After what felt like hours of pushing with all my might, the midwife said in a stern voice, ‘You’re resisting it Cathy. The next time the urge comes, just go with it.’
I couldn’t find where in myself I was resisting the urges to push. I felt that as each urge arose, like the swell of a wave, I rode it for as long as I could.
What I understand now, as I look back, is that my body was still ripening, I was still at the beginning stages of the pushing phase and that the midwife’s instructions were not useful. I believe that I would have responded better to encouragement. The last two surges I felt were bigger than me, and that’s when the process turned a corner. The readiness is all…
Afterwards, the midwife said that I struggled so much during the pushing stage because my pelvis was narrow and Jack’s head was unusually big, which helped me to feel better as it made it a simple case of measurements.
With each push, I began to suffer from excruciating lower back pain. It felt like my pelvic girdle had developed blades and was cutting through the muscles and skin of my lower back. As each contraction began, I asked the doula to rub my lower back.
Then the midwife said I needed to get out of the pool to be able to push more effectively. She invited me to stand outside of the pool and lean on the rim to push. By this stage I felt I had no strength left and began to feel a creeping sense of doubt about whether I could do this.
She then instructed Joel and the doula to leave me for a while so that I could try to do it on my own. I heard them go outside into the garden and I stood, legs wide apart and bent at the edge of the birth pool, holding on to the rim and staring into the water. My gaze felt dreamy and glazed and so I tried to shake out of it by shaking my head. I gave myself a talking to and told myself to stop resisting and to just do it. My mind kicked in at that stage and began to tell an old familiar story of how I often don’t finish things, how I often can’t go through with things on my own…..looking back now I see that it was a whole lot of drivel, fuelled by self doubt and fear that I wasn’t going to be able to do it.
The midwife came back in then and I felt like a failure because I hadn’t managed to do it. She tried me in different positions: Joel sitting on the edge of the bed and me squatting between his legs, him holding me up under my arms – that felt good but still the pushing yielded no visible result. Then we moved to the toilet, while the midwife knelt beside me and told me to push, Joel crouched in the bath and the doula sat on the tiled floor. I remember wanting to ask jokingly if everyone was comfortable. Every time the urge to push came, I’d push with all the might I had, my voice guttural and squeezed out with each effort. The tops of my thighs were red from my hands gripping them each time I bore down. At one stage I gripped the midwife’s forearm and pressed my forehead against it in the effort. I remember feeling connected to her then, feeling like I was drawing some strength from her, but that was the only time.
Then we went back to the bed and I lay supported by Joel and pushed again. I dug my fingers into the skin of my thighs and my legs shook from the effort.
The midwife’s voice then got urgent and she said ‘Come on now, Cathy, you’ve got to give a really good push, the baby’s had enough.’ And I tried, and it wasn’t enough. Then in a decisive tone she said, ‘Ok, we need to get to Mowbray NOW.’
There was a general rush as she packed up the equipment and they began loading the car in preparation for the journey. The doula helped me put one shaky leg, then the other, into my tracksuit pants. I leant one hand on her shoulder as she knelt to help me, as though I were a child. As I began slipping into the second pants leg, I felt a sudden urge to go to the toilet (as though I needed to have a big bowel movement) so I mumbled this to her, and hobbled to the bathroom. I gave one immense push once I was in the bathroom, but nothing happened so I came back out.
The doula helped me on with my pants again. I stood ready by the door then realized I was barefoot and asked Joel to get my sandals in our bedroom. He rushed upstairs and for a moment, I stood alone at the threshold of our house, while the midwife and the doula packed the car. At that moment, I felt an indescribable urge to push that felt greater than my own body, larger than my own will, and so I hobbled-ran to the bathroom. I squatted over the toilet bowl and heard a guttural growl emanate from my throat as I bore down in submission to this overwhelming push that came from deep inside me.
Now I can see that my body had been building up to this intensity of pushing, the last two surges I felt were quintessentially different from the previous ones: resisting them would have been impossible.
I reached down between my legs and felt a warm, hair-covered head crowning. I called out, ‘I can feel the head!’ And no one came, no one heard. I called out again for Joel and he came running, stuck his head into the bathroom and I said again, ‘I can feel the head!’ He shouted for the midwife and she came running and they helped me back to the bed.
I felt like my body had turned a corner and could feel that we were nearly there. I lay back against Joel’s shoulder and pushed for another ten minutes or so. By this stage, Joel was cheering me on and saying, ‘Come on, you’re a star, you can do it!’ and there was an excited focus in the room. The midwife said, ‘Come on, one more push’ and I gave one more push and felt a burning sensation at the edges of my vagina and almost simultaneously, blissful relief as I felt a warm slimy body slither fish-like out in a gush of liquid.
I looked down and saw a mop of wet black hair and as the midwife grabbed his head and shoulders (Joel tells me she had to take the umbilical cord from around his neck) I saw a pair of large red testicles! This was unexpected as I’d been convinced we were having a girl.
She turned this little creature around onto his back and placed him on the sheet between my legs. She rapidly suctioned his nose and mouth. He lay there, not moving, not making a sound. I remember lying against Joel’s shoulder, watching, with Joel squeezing my hand. The midwife began to milk the umbilical cord so that it fed him oxygen-rich blood. As the nutrient rich liquid tailed off, Joel and I watched soundlessly as the midwife gave short sharp instructions to the doula to assemble the oxygen tank (which the midwife had disassembled as she packed the car), and she put it to his nose.
He lay there silent and still. I reached forward with my index finger (I didn’t have the strength to sit up) and all I could reach was his little belly. I rubbed my finger along his warm bellyskin and said, hey sweet thing. I kept softly saying these little words of love as we watched and waited.
As he lay there, not moving, not making a sound, I wondered which way it would fall. The midwife began to pump his heart with two fingers and she said, ‘Come on little guy’. I remember watching in a detached yet hopeful way. I felt strangely at peace with whichever way he chose. My thoughts fast forwarded a few seconds, a few minutes and I felt an acceptance if his little body never breathed or moved. Yet there was a bated hopeful feeling in me too: a silent prayer, please, please, please as we watched and waited. As the minutes lengthened, I felt him moving further away from us and my heart became one big, pulsing please. The room held its breath and none of us spoke. And then, into that silence, muted raspy kittenish sounds as he began to draw breath. Joel and I looked at each other in mute relief. I felt a wordless thank you flood my heart.
Our baby boy Jack was rushed to Mowbray ICU where he spent the first four days of his life, with various health issues ranging from hypoxia and renal failure to thrombocytopenia (a low platelet count: platelets are the clotting agents in the blood). He recovered quickly from most of the adverse effects of his birth asphyxia except for the thrombocytopenia, so the doctors kept us in the Kangaroo Mother Care ward in Mowbray for another ten days. He received a platelet transfusion while at Mowbray and since then he’s had regular blood tests. His platelet count, while still lower than normal, seems to have stabilised and the doctors are not overly concerned. He has also had regular developmental assessments and the doctors are happy that his progress is perfectly normal.
He is alert, bright and cheerful and doesn’t seem to have suffered any ill effects from his difficult birth. Strangers often stop us in the shops to comment on what a happy baby he seems!
So to end off, I’ve racked my brain for a well thought-out and carefully weighed conclusion that will wrap it all up. But the truth is I’m not sure what my conclusion is. I’m not sure whether now I’m for or against home birth. I’ve looked up various statistics and there are pros and cons for both home births and hospital births. I know that for months after the birth, because of the way it almost ended, I cried every time someone asked if we regretted having a home birth. I know that if we were to do it again, we wouldn’t do it at home but would rather choose to use a facility such as the Mowbray Active Birthing Unit, which would feel like a wise compromise between the comfort of my own space, and the proximity of medical help.
I also know that in preparing for the birth, it was comforting to be able to visualise myself in our home, with Joel alongside me. On the other hand, during my actual labour I was in such a deeply internal space that I don’t know if it would have mattered where I was, as I was wrapped up in the process my body was undergoing. Yet again, perhaps the reason I was able to surrender so fully to this process was because I was in my own space, and the people who were around me respected and supported my process, without any outside medical agenda of induction, drips, epidurals etc.
If we’d been in a hospital and I had reached the point when I began to struggle with the pushing stage, I would probably have been given an episiotomy and Jack would have been delivered by forceps or vacuum. This might have relieved him of some of the distress he experienced, yet it might also have caused other trauma. And at the eleventh hour, my body was somehow able to push through (literally!) so that Jack could emerge naturally.
So my mind see-saws from one side of the perspective to the other but most of all, we are so grateful that it ended well. Through having written this, I feel more at peace with how our birth story unfolded. Something in me has grown to trust that it all happened as it was meant to, for reasons that are larger than my thoughts and fears. Maybe babies choose their birth path into this world and Jack somehow needed to take a bit of time to make his choice. Eventually, he chose to stay with us and he chose this world. And we give thanks every day that he did!