
Cayleigh’s Birth Story
11th June, 2009
11th June, 2009
I remember very vividly the day that we were studying breech birth at university and the lecturer discussed the mechanisms and went through Mary Cronk’s “Hands off the Breech” theories and presented us with many pictorial books. The books that stuck in my mind the most were those by Maggie Banks and I stared at the pictures in awe as I glanced across the pages and watched little bottoms and feet emerge from their mothers, followed by arms and finally a head. I was immediately fascinated by breech birth, but all I had seen (or heard about) was caesarean after caesarean for breech presentation, regardless of how many babies the Mum had birthed before, or any other relevant obstetric history. Despite this I found myself reading articles, listening to older mothers’ stories of their breech births, and speaking to very experienced colleagues; midwives who had been delivering breech babies before I was born.
About two years later I found myself on a night shift in a small maternity unit and the only “labour ward competent” midwife on a two midwife shift. A first time Mum had broken her waters and was coming in for assessment. Her baby was breech and she had already discussed with her obstetrician the possibility of having a vaginal birth as she did not feel comfortable with the idea of a caesarean section. A vaginal breech labour was completely foreign to me and I was terrified. I did, however, have support from the obstetrician who was well aware of my level of experience, and a senior midwife who decided to stay after an afternoon shift and sleep in an empty bed to provide me with some close at hand, experienced midwifery support. I dutifully cared for that woman all night, remembering to keep her mobile, keep her bladder empty, keep a close check on the foetal monitor for potential problems, all the things my lecturer had talked to us about in the few years prior. My first breech VE, “Oh, it’s definitely a boy!” (they already knew), “wow, this is really different”.
Despite my best efforts, and the woman’s, there was little decent and at 7:30am an emergency caesarean was organised. To this day I am still unsure if there was something more I could have done to help that woman with her unusual labour, or if the obstetrician was giving this woman a genuine chance to deliver vaginally, or just bailing out when she felt that the parents were satisfied with the efforts so far. The woman had laboured very well and as a first time Mum, it would be expected for decent to be a little slower, maybe she needed more time, or maybe a caesarean was the best option? Still, I was keen to learn more about breech birth.
When I was twenty eight weeks pregnant with my second child, a night shift started with a couple of births and some additional chaos. I had been feeling very tired and experienced several episodes of strong Braxton hicks type contractions the past week so when things quietened down I asked the midwife I was working with to do an additional antenatal assessment on me. My first pregnancy ended abruptly at 32 weeks after spontaneous rupture of membranes and subsequent delivery so my anxieties were not completely unfounded. The baby was fine, head first with the back on the left, heart rate around 140bpm and my BP etc were all normal. “Fine, only four more weeks of work and I can just relax.” I lay down on the sofa in an unused birth suite, just long enough to revive a little before the long drive home in a couple of hours, when I felt large movement, all the way around the right side of my tummy. “Alright baby, Mummy is tired”. I closed my eyes briefly and forgot all about it.
During the week I had my scheduled 28 week check with my doctor. Great, gestational diabetes again, we have to go through all that again, despite that I am still vomiting everyday and eating next to nothing. A quick feel of the tummy, he is obviously confused and asks me if I mind if he uses the scanner. I don’t, the baby seems really quiet, I go days without feeling it and sometimes I wonder if something is wrong. My placenta is at the front so many movements are not felt by me so it will be reassuring to see it for myself. “Oh look, your baby is sucking on it’s toes, the head is up here.” He gestures to my left side under my ribs. I am surprised “Oh, it was head down on Friday?”, “Yes, it probably was” he replies, “plenty of time, no need to worry”. I hope he is right.
Due to my obstetric history, they decide to perform an ultrasound at 32 weeks to rule out placental and foetal problems. Apart from being preterm with unconfirmed excess fluid, I had elevated BP, swelling, a retained placenta with a 3000ml postpartum haemorrhage. I am sure the baby has turned by now, it has been four weeks and only 5% are still breech by 34 weeks. The Doctor immediately notices that my baby is breech. “Oh, your baby is breech!” She continues the scan, taking measurements are reassuring me about my baby’s condition. “It all looks well and healthy but with your history we cannot rule out preterm delivery. Your doctor is only a GP, so who will do a caesarean if you need it? There’s a bit of fluid around the baby, it could turn.” There was such a strong sense of doubt in her voice about the baby turning, I felt she was trying to reassure me, but she was not at all convinced, instantly suggesting that a caesarean birth might be necessary in view of a breech baby (who is still sucking on it’s toes).
By 34 weeks I’m starting to get very nervous. I’m still pregnant, but the baby is still breech. In the midwives clinic I discuss options with one of the Midwives. She is surprised when I tell her the baby is breech, she asks me many times if I am sure. The baby has extended legs and is tucked in very tight, without ultrasound technology, it would have been likely to go undiagnosed until labour. The baby is not moving much at all, I cannot see how it is going to go anywhere. So, the desperate measures to get the baby to turn begin.
I order some moxibustion sticks from an online acupuncture supply centre. I have searched everywhere locally and cannot find a qualified technician to perform the moxibustion for me, so I use my midwifery research links, contacts and experience and grasp an understanding of the techniques and perform the procedure myself; how, where, when and for how long to do it for (etc). I find some information from Andrea Robertson’s Birth International website and various midwifery and obstetric journal articles, it looks promising. So I find myself sitting out in the cold, every night, just before bed “smoking my toes”. It really does increase the baby’s activity; it kicks a lot during the procedure and seems much more active afterwards than during the rest of the day. Despite continuing the procedure for nearly three weeks I get nothing more than a few jabs in the side. The baby is stuck fast.
Homeopathy has been reported to be helpful too. So once again I research, search for information and discuss this option with a homoeopathist. It does not seem like true science to me, but at this point I’m willing to try anything. I try the homeopathic remedy of pulsatilla, twice; it might not help, but there us zero evidence it will do harm. I don’t feel any different and there does not seem to be any effect, but there was no harm done.
So I find myself, every night hanging upside down from the couch, trying to lift my pelvis high. I even resort to my sister’s tilt bench on occasion (you can hang yourself completely upside down if you are strong enough to hold it), but I just feel nauseous and giddy and the baby does not move. I’m trying the hot on my lower abdomen and cold behind the baby’s head, the baby kicks a little but there is no movement significant enough to think that it has turned around. I play music using my husband’s iPod and direct it to my lower abdomen. I now know the baby likes “The Panics”, but generally there is little response.
This is getting ridiculous. This baby is wedged in my pelvis, without ultrasound technology it is unlikely that anyone would have realised this baby was breech. It’s legs are extended and there is little room to move. I am making myself sick doing acrobatics to try to get postural turning, and taking desperate measures to try to get this baby to move. “I just want to be normal”, I hear myself say it over and over again as I talk to family, friends and begin to beg the universe “You’ve made your point!”. The thought of lying on a theatre table, as they cut me open and surgically extract my child, makes me sick to my stomach. I don’t believe that I am “in need” of a caesarean section but I am not the one that needs convincing.
At around 36 weeks I again see the doctor for a routine check. By this time I have studied a lot, old texts and new along with a detailed pouring over the Term Breech Trial and related articles, reviewed WA’s only tertiary hospital’s policies and guidelines related to External Cephalic Version and Vaginal Breech Delivery. I know exactly what is required, but I need referral to the tertiary hospital.
I have all the usual checks with the doctor. He asks if the baby is still breech, I tell him “it is not going anywhere”. We briefly discuss ECV but he insists that I need referral closer to term. “What if I go into labour?” I ask him, with desperation and concern, as I have had several episodes of strong Braxton hicks’ contractions in recent weeks which have stopped me in my tracks. I remember his response so very vividly.
“If you go into labour you come in and we’ll just section you.”
“But I don’t want a section, that’s why I need referral to KEMH for an ECV.”
“No, we do that closer to term, if you labour prior and the baby is still breech you will have a section.”
By this stage, I am getting anxious, frustrated and very upset. My blood pressure is through the roof so he now starts to talk about preeclampsia and tells me I look a little puffy and sends me for another urine check while he writes forms for blood work. This makes me even more upset as I am wearing all my rings on my fingers, all of which I usually need to take off in the heat during summer because they get too tight when I’m hot. I think he realises that I am quite upset, we are colleagues and usually get along really well. He sends me up to see the Midwives on the ward (my colleagues and friends) to give me further BP checks in “a more relaxed environment”. Once on the ward I am greeted by the midwifery student, who I have worked with for four years on nights as she was a RN on the neighbouring Med-Surg ward. I promptly burst into tears and desperately explain to her that the doctor will not refer me to the tertiary hospital despite their clinical guidelines stating ECV should be at 36weeks and 6 days gestation. She reassures me and lets me vent while seeking assistance from the more experienced midwives.
Normally, I am a very strong advocate for my patients. I would stand up for what they want, provided it were safe, and explain very clearly why things may be better to deviate from their wishes should the need arise. As a pregnant woman, I felt powerless, helpless and extremely timid. Every day I thank the universe for my wonderful colleagues and friends, amazing midwives who stood by me and supported my decision. When the team leader made that call to the Maternal-Foetal Assessment Unit at the tertiary hospital to discuss what they could do for me, she immediately had me booked in for an ECV for six days time, at a gestation of 36 weeks and 6 days, exactly what the policy had stated.
I arrived at the tertiary hospital at around 8am on the 20th May, 2009. I was very anxious. I felt this was my last opportunity to get a “normal” birth. There was a lot of waiting, moving between departments for admission, consent, ultrasound, CTG foetal monitoring, medication and finally the procedure itself. The registrar was lovely, very kind, considerate and forthright.
“I don’t want to be pessimistic, but I just want a clear understanding. If this doesn’t work, what is your plan?”
“I was hoping that I could book in here for a vaginal breech birth”
The look on his face would be best described as impressed surprise. I don’t think he realised at this time that I was a midwife myself and had a fairly good understanding of breech; the problems, the research, the current “management” (caesarean) for most cases.
The procedure of ECV itself was something I would never try to describe to anyone. It was something that I have never felt before and find it very difficult to try to explain. I wouldn’t describe it as painful, but it was certainly uncomfortable and a very unnatural feeling. Getting my little baby’s bottom out of my pelvis was challenge enough, but as the registrar would finally dislodge it and get it lifted and start rotating it didn’t budge more than 45 degrees. He tried one way twice, then the other way twice. It was all I could do to try and relax during the procedure, keep my muscles from tensing and provide as little resistance as possible to give the best opportunity for a version to occur. Those little legs were extended, the head was tucked and the breech was deep in the pelvis, Left Sacral Anterior (LSA) perfect positioning for a vaginal breech delivery. That is the way my baby was going to be born.
There was little resistance from the obstetric team at the tertiary hospital for me to transfer my care for a vaginal breech delivery. The first step was for me to receive counselling from the Medical Director, “Dr A” in regards to vaginal breech delivery; it was no surprise that the first thing she wrote down was “Hannah (2000)” and began discussing the ins and outs of the Term Breech Trial. I sat there and listened politely, after all she has a duty of care to ensure I completely understood the risks and benefits of both caesarean section and vaginal breech birth. What I saw was that there was a 95% chance that everything would be absolutely fine with the baby, whereas if I underwent a caesarean section there was a 100% chance that I would have major surgery, a uterine scar, and never have the opportunity to be considered to have a “normal” pregnancy and birth again. It is also mentioned that “some believe and epidural is desirable” to prevent premature pushing, reduce the risk of head entrapment and be ready in case emergency intervention is required. I very quickly inform her that I am not keen for an epidural and that I do not feel comfortable with that idea, she seems immediately supportive of my decision and states “they are not absolute”. I am relieved, that is one thing I was not keen to negotiate on. After discussions with my husband we were both convinced that a “normal breech birth” is what we desired.
At 39 weeks I was sent for an ultrasound scan, just to check foetal size and positioning, in my opinion, to ensure that I met the “criteria for a vaginal breech delivery”. The ultrasound estimated a child of around 3.6kgs with a head circumference of 36cms. This did not concern me at all, even if the scan had estimated a child of closer to 4000gms I would have felt this to be appropriate for my size, especially when considering my mother and grandmothers’ obstetric histories; none of them had ever had difficulty delivering their sometimes large (>4000gm) babies despite none of them being overly tall women, much smaller than I.
My next appointment, 39weeks and 6 days I sat in the antenatal clinic, niggling. Sometimes the tightening would stop me in my tracks but they were still irregular so while I suspected labour was imminent, I just hoped that I could get in and out of my appointment quickly. I still had things to sort out and I needed to go food shopping. During my appointment Dr A asked permission to perform a VE to examine my pelvis. She discovered I was 3-4cms dilated and expected that I would labour within 24 hours (a membrane sweep in a niggling woman will do that!!!). She then sat me down as she “wanted to have a little chat”. “Uh-oh, that doesn’t sound good” I thought to myself. The Obstetrician then wanted to discuss the predicted size of my baby’s head.
“I have your ultrasound report here; your baby’s head is estimated at about 36cms.”
“I wouldn’t have expected anything else.”
“This is in the 90th percentile.”
“Everyone in my family has had big heads and nowhere in my family tree has had difficulty giving birth; I would be surprised if you told me otherwise.”
“Ok.”
Dr A seemed satisfied that I was quite comfortable to continue with the planned vaginal delivery. I believe that she was satisfied after assessing my pelvis and knowing that I felt confident in my own ability to birth my baby. I had no doubts that I could do it, but still felt like everyone else needed to be convinced.
I continued to niggle all day, worse for about four hours after the internal exam, which is not at all surprising. My new washing machine arrived and I headed off to the shops with my Mum where I bought a very large trolley full of food. I started to think about what my 3 year old son and husband would eat if I needed to be in hospital for a while (i.e. I ended up needing a caesarean), I ended up spending about $400 on a week’s shopping, but it was proving too challenging to concentrate. We headed home and I had some lunch and things settled down significantly. I had a large show but knew this was likely to occur anyway due to the VE. I was still experiencing the odd tightening but nothing regular. I informed my husband that I suspected he would not be working the next day, although I had already had a false alarm the previous week!
I didn’t eat much for dinner that night. I had difficulty getting to sleep, I felt unsettled and agitated. My three year old son was very clingy and he was up in the night around 1:30am. I lay with him for a while and told him that I thought Mummy was going to have the baby but if Mummy and Daddy were not here when he woke up in the morning then Grandma would be here. He was very matter of fact about it all and told me that Grandma would be getting his breakfast. He went back to sleep quite well, but I had difficulty resettling myself. The contractions were much more regular, still fairly mild, around 15-20 minutely, I tried to relax in between and doze. By 3am I was up, trying a hot pack and pacing around the house a little. I didn’t feel like I was in labour but I just couldn’t get comfortable so I watched some television.
At 4am, almost by the stroke of the clock the contractions started coming every 5 minutes and I was having trouble staying quiet. They were coming hard and fast. I was expecting a much slower and more relaxed warm up to labour but I felt like it just hit, hard and fast. I knew I was in labour but didn’t want to rush off to the hospital. I wanted to be sure I was established and didn’t want to wake people earlier than necessary.
By 4:30am, I was unable to get comfortable. I hopped in the shower to try and relax and calm myself down. All the things that worked with my son’s labour 3 years earlier were not helping me at all this time around. The shower was fantastic, I felt more relaxed and more in control. I’d been in there for about 5 minutes and my husband rolled over from his slumber and said “What are you doing?”. The height of a contraction, he got no immediate response. Then he asked “are we on?”. I nodded, I have never seen anyone move so fast!!! After about 20 minutes he dragged me out of the shower. The contractions were fairly strong and I think he was very nervous about this labour, the last one was rather frightening for him as I was wheeled off for emergency surgery, in and out of consciousness soon after the birth of our son.
I got dried and dressed and put the final things I needed into my hospital bag. Ben called my mum and she came around to sit with William. I made the calls to the Maternal Foetal Assessment Unit (MFAU) at the hospital to inform them I was in labour. I then called my midwife, friend and colleague, Rosemarie, who had agreed to act as support and attend my birth. I trusted her immensely and the original plan was for her to deliver my baby at our place of work. I called Dr A on her mobile phone, as instructed, and she informed me she would be in to see me soon. I felt like my mother and husband could not get me in the car quick enough, I was becoming quite vocal with my contractions and starting to feel nauseous.
For the entire labour with my son, I sat, cross legged yoga style on the bed and I was comfortable. This labour was completely different, trying to sit in the car for the 20 minute drive to the hospital was excruciating. My husband’s favourite story is what he refers to as my “labour induced turrets’ syndrome” as it seems every single filthy word I had ever heard came out of my mouth during the drive to hospital in no coherent order. Stepping out of the car was the biggest relief I have ever had. Thank goodness it was 5:30am and not peak hour traffic. I step out of the car, the air is crisp and there is very fine shower of rain falling on my face, I find it incredibly refreshing. Another contraction hits, I’m being very vocal (the swearing has stopped now I’m out of the car) and my dear husband desperately escorts me into the hospital (I could’ve stayed outside quite happily).
I went through to emergency to get access to the rest of the hospital. Rosemarie was already waiting for us. I was starting to vomit. We went up to MFAU and were greeted at the door by the same midwife that I had spoken to on the phone. She was about to show me into MFAU when I had a contraction. We went straight through to labour ward (I hope I didn’t scare anyone). The midwife did all the necessary admission assessments, I handed her my birth plan and she organised the paperwork. Before long the obstetrician arrived, just after 6am. A VE revealed that I was about 5cm dilated, I couldn’t believe it “Is that all?”. I shouldn’t really have expected anything else but the pain coming so hard and fast I hoped the rest would follow. My membranes were still intact and I was vomiting, with every contraction.
As agreed I had a large bore IV cannula inserted in my arm in view of my previous PPH. It is also decided that CTG monitoring needs to be commenced in view of my well established labour. I am thankful that a good trace is obtainable while I stand, I am upright and mobile the whole time, I cannot sit without screaming, even to sit on the toilet is excruciating. This labour is so different, except for, the vomiting. It is relentless and I am finding it harder to cope with than the labour pains themselves. I feel like I am getting no break, I start vomiting at the height of the contraction and don’t stop until well after the contraction has stopped, just in time for the next contraction to start. I am finding it all very overwhelming and frustrating as I don’t feel like I can get into the rhythm of things like I did when I was labouring with William. The obstetrician reminds me that the “menu is open” and I can have whatever I like for pain relief. I have requested in my birth plan that pain relief not be suggested or recommended, that I will ask for it if I want it. All my caregivers are respectful and supportive of this and I am very grateful. At 7am shift change I got a student midwife, and a clinical midwife, as my new caregivers. They could not have been more caring and respectful.
By 9am I have immense pressure in my backside. I do not have an urge to push but this pressure is really bothering me. I suspect if I had been in a primitive setting, birthing as a cave woman without all this attention from strangers in a clinical setting I would have done something to relive that pressure myself. My birthplan very clearly stated “prefer no ARM or augmentation” but at this point, I was experiencing something that I could not “plan” for. They called Dr A back.
Another VE revealed that I was 7cm dilated. I couldn’t believe it, I was labouring so hard. I was also still vomiting and I was finding it really distressing. The resident doctors and senior midwives kept knocking on the labour ward door asking if I’d had any antiemetics (drugs to stop the vomiting), there was a chorus of “yes” from everyone in the room, I think they were about as sick of watching me as much as I was doing it. They had given me all the usual antiemetics and none had really helped. I now have IV hydration running (at my request) as I feel so thirsty and just cannot quench my thirst, all sips of water bounce right back. At around 9:30am, Dr A. starts to gently broach the subject of ARM with me. She has obviously read my birth plan and possibly feels that I will agree. I give my consent immediately; the pressure is so intense, not painful, but the discomfort is distressing. I have instant relief, followed by a reasonable trickle of warm amniotic fluid. She says to me “we’ll see how that goes, at 11am we’ll see how you’re going and we might have to have a little chat”. There are those words again, I feel myself cringe and then think “no caesarean necessary!”.
The next few contractions are really intense. I expect this after the ARM but I am still retching and vomiting. I just want to lie down, I’m tired. I cannot sit, it hurts. Nothing works, if only I could stop vomiting. I eventually request morphine. I don’t know what else to do. I think it is too late but everyone in the room assures me that it is not and that if I really want it I can have it. Vomit again, I yell out in frustration. Yes, I’ll have some morphine. I am given morphine with promethazine IMI. Within about 20 minutes the vomiting stops, that is so much better. I feel that I can get through things now. I regret the morphine and wish I had thought of the phenergan earlier. I am feeling much more in control now, until the morphine hits. At least I can lie down now, I don’t think I am able to do anything else.
I breathe through contractions really well now, I feel so much better. Except the twilight sleep, I am having weird dreams and I am talking in my sleep. I am drifting from reality to my dreams. Somebody says something and I respond with “Will, wash your hands”, I am seeing my son with grubby hands sitting in our lounge room. I also dream about a homeless man crossing Thomas st and Bagot road intersection. Someone in the room says “oh, she’s having a show” and I respond “don’t worry, it’s just a homeless hobo”. I know this is completely wrong and I apologise to everyone, I know what I’m doing but I cannot stop! They all see the funny side of it.
Dr A. returns around 11-11:30am. A VE reveals I am fully dilated. I am instructed not to push until I have a really strong urge. I felt with my first labour that I was forced to push, despite not feeling like I needed to or feeling ready. I am grateful that this time it will be in my own time. There is no more mention about “the little chat” and I know that I’m nearly there. I continue to breathe through contractions, it is easy, I don’t have any urge to push, there is no more vomiting, the dreaming has stopped. I finally feel like I am in some sort of control of my labour. Just before midday I have a big contraction, at the end of it I feel myself give a little grunt, the result of a small push. “Oh, sorry, I just pushed a bit”. That seems like such a silly thing to say now, but they were all very encouraging “that’s good, are you starting to feel like you need to”. “Yes, just a little, towards the end of the contraction” I explain. I can hear them “fluffing around”, getting things ready for what they expect to be imminent birth. I have a few more contractions like that and the pushing gets longer and more forceful. Soon after, just before midday, they page Dr A.
Dr A arrives, she is very pleased with my progress. The midwives and my support people help to roll me from my left lateral a little so they can see what is going on. Dr A does a quick VE to see what is where. I have a contraction, I am pushing and I can feel her pulling and poking around, trying to determine baby’s position. The contraction is finished and I feel a terrible burning, I am not looking “what is she doing to me?” I ask with desperation in my voice. I am feeling an amount of pain in my vagina and I want it to stop. One of the midwives leans over and whispers “they are not doing anything to you, that’s your baby’s bottom”. I ask “is it on view?”, she grins and nods. I can’t believe it... so far that was fairly easy. Suddenly that “horrible pain in my vagina” is the greatest feeling and my discomfort quickly turns to indescribable excitement.
There is a lot of fluffing and buzzing around. Everyone is getting ready for the birth. I ask the midwife “has the paed been paged?”, I remembered them talking about it earlier and I didn’t hear anyone do it, so I was just checking. She laughs, “yes honey, it’s all done, just concentrate on what you are doing, we’re fine!”. You can’t take the midwife out of the mother! They insert local anaesthetic into my perineum, the senior midwife whispers to the registrar “you are going to ask permission before you do that? She doesn’t want an episiotomy”. The Registrar is surprised by this and Dr A says “we’ll see how we go Danielle, I am not sure if we will get away without one”. At this point, I don’t really care.
I am pushing really well with each contraction. Dr A helps with the delivery of one leg, then the other. It is an absolute moment of relief with each little limb being delivered. I want Ben to tell me the sex of the baby, they all ask him if he can see. I watch him tilt is head sideways in total confusion “is that a... scrotum???”. They all smile, “ah, just wait until you can see some more of it”, I instantly think “girl”, Ben is the only male in the room, I have Rosemarie, the midwifery team, Dr A and her two female registrars, a paediatrician and neonatal nurse – 9 people in total, all of them are female. I manage to say briefly as I catch my breath “I wish I had a camera so I could take photos of all of your faces”, they were all around me, smiling, “pushing” with me with excited eyes.
Dr A splints and supports one little arm out, then the other, each provides instant relief as they are birthed. I take a breather briefly, I am not contracting. As Dr A hangs my baby over her arm I am instructed to push. “Even though I’m not contracting?”, yes, “PUSH!” the chorus instructs me. At this moment, I feel like I want to “pant” more than “push”, but I am determined to do this “right”. I give one almighty push and my baby is born. (Rosemarie tells me later that “If it was a cephalic birth it would’ve been one push and the baby would have landed in the bucket on the other side of the room”). It is placed on my chest, eyes wide, looking a little stunned, it is 12:25pm. I pull it’s little legs apart, “what have you got?” someone asks me “A girl!” (I knew it!).
About two years later I found myself on a night shift in a small maternity unit and the only “labour ward competent” midwife on a two midwife shift. A first time Mum had broken her waters and was coming in for assessment. Her baby was breech and she had already discussed with her obstetrician the possibility of having a vaginal birth as she did not feel comfortable with the idea of a caesarean section. A vaginal breech labour was completely foreign to me and I was terrified. I did, however, have support from the obstetrician who was well aware of my level of experience, and a senior midwife who decided to stay after an afternoon shift and sleep in an empty bed to provide me with some close at hand, experienced midwifery support. I dutifully cared for that woman all night, remembering to keep her mobile, keep her bladder empty, keep a close check on the foetal monitor for potential problems, all the things my lecturer had talked to us about in the few years prior. My first breech VE, “Oh, it’s definitely a boy!” (they already knew), “wow, this is really different”.
Despite my best efforts, and the woman’s, there was little decent and at 7:30am an emergency caesarean was organised. To this day I am still unsure if there was something more I could have done to help that woman with her unusual labour, or if the obstetrician was giving this woman a genuine chance to deliver vaginally, or just bailing out when she felt that the parents were satisfied with the efforts so far. The woman had laboured very well and as a first time Mum, it would be expected for decent to be a little slower, maybe she needed more time, or maybe a caesarean was the best option? Still, I was keen to learn more about breech birth.
When I was twenty eight weeks pregnant with my second child, a night shift started with a couple of births and some additional chaos. I had been feeling very tired and experienced several episodes of strong Braxton hicks type contractions the past week so when things quietened down I asked the midwife I was working with to do an additional antenatal assessment on me. My first pregnancy ended abruptly at 32 weeks after spontaneous rupture of membranes and subsequent delivery so my anxieties were not completely unfounded. The baby was fine, head first with the back on the left, heart rate around 140bpm and my BP etc were all normal. “Fine, only four more weeks of work and I can just relax.” I lay down on the sofa in an unused birth suite, just long enough to revive a little before the long drive home in a couple of hours, when I felt large movement, all the way around the right side of my tummy. “Alright baby, Mummy is tired”. I closed my eyes briefly and forgot all about it.
During the week I had my scheduled 28 week check with my doctor. Great, gestational diabetes again, we have to go through all that again, despite that I am still vomiting everyday and eating next to nothing. A quick feel of the tummy, he is obviously confused and asks me if I mind if he uses the scanner. I don’t, the baby seems really quiet, I go days without feeling it and sometimes I wonder if something is wrong. My placenta is at the front so many movements are not felt by me so it will be reassuring to see it for myself. “Oh look, your baby is sucking on it’s toes, the head is up here.” He gestures to my left side under my ribs. I am surprised “Oh, it was head down on Friday?”, “Yes, it probably was” he replies, “plenty of time, no need to worry”. I hope he is right.
Due to my obstetric history, they decide to perform an ultrasound at 32 weeks to rule out placental and foetal problems. Apart from being preterm with unconfirmed excess fluid, I had elevated BP, swelling, a retained placenta with a 3000ml postpartum haemorrhage. I am sure the baby has turned by now, it has been four weeks and only 5% are still breech by 34 weeks. The Doctor immediately notices that my baby is breech. “Oh, your baby is breech!” She continues the scan, taking measurements are reassuring me about my baby’s condition. “It all looks well and healthy but with your history we cannot rule out preterm delivery. Your doctor is only a GP, so who will do a caesarean if you need it? There’s a bit of fluid around the baby, it could turn.” There was such a strong sense of doubt in her voice about the baby turning, I felt she was trying to reassure me, but she was not at all convinced, instantly suggesting that a caesarean birth might be necessary in view of a breech baby (who is still sucking on it’s toes).
By 34 weeks I’m starting to get very nervous. I’m still pregnant, but the baby is still breech. In the midwives clinic I discuss options with one of the Midwives. She is surprised when I tell her the baby is breech, she asks me many times if I am sure. The baby has extended legs and is tucked in very tight, without ultrasound technology, it would have been likely to go undiagnosed until labour. The baby is not moving much at all, I cannot see how it is going to go anywhere. So, the desperate measures to get the baby to turn begin.
I order some moxibustion sticks from an online acupuncture supply centre. I have searched everywhere locally and cannot find a qualified technician to perform the moxibustion for me, so I use my midwifery research links, contacts and experience and grasp an understanding of the techniques and perform the procedure myself; how, where, when and for how long to do it for (etc). I find some information from Andrea Robertson’s Birth International website and various midwifery and obstetric journal articles, it looks promising. So I find myself sitting out in the cold, every night, just before bed “smoking my toes”. It really does increase the baby’s activity; it kicks a lot during the procedure and seems much more active afterwards than during the rest of the day. Despite continuing the procedure for nearly three weeks I get nothing more than a few jabs in the side. The baby is stuck fast.
Homeopathy has been reported to be helpful too. So once again I research, search for information and discuss this option with a homoeopathist. It does not seem like true science to me, but at this point I’m willing to try anything. I try the homeopathic remedy of pulsatilla, twice; it might not help, but there us zero evidence it will do harm. I don’t feel any different and there does not seem to be any effect, but there was no harm done.
So I find myself, every night hanging upside down from the couch, trying to lift my pelvis high. I even resort to my sister’s tilt bench on occasion (you can hang yourself completely upside down if you are strong enough to hold it), but I just feel nauseous and giddy and the baby does not move. I’m trying the hot on my lower abdomen and cold behind the baby’s head, the baby kicks a little but there is no movement significant enough to think that it has turned around. I play music using my husband’s iPod and direct it to my lower abdomen. I now know the baby likes “The Panics”, but generally there is little response.
This is getting ridiculous. This baby is wedged in my pelvis, without ultrasound technology it is unlikely that anyone would have realised this baby was breech. It’s legs are extended and there is little room to move. I am making myself sick doing acrobatics to try to get postural turning, and taking desperate measures to try to get this baby to move. “I just want to be normal”, I hear myself say it over and over again as I talk to family, friends and begin to beg the universe “You’ve made your point!”. The thought of lying on a theatre table, as they cut me open and surgically extract my child, makes me sick to my stomach. I don’t believe that I am “in need” of a caesarean section but I am not the one that needs convincing.
At around 36 weeks I again see the doctor for a routine check. By this time I have studied a lot, old texts and new along with a detailed pouring over the Term Breech Trial and related articles, reviewed WA’s only tertiary hospital’s policies and guidelines related to External Cephalic Version and Vaginal Breech Delivery. I know exactly what is required, but I need referral to the tertiary hospital.
I have all the usual checks with the doctor. He asks if the baby is still breech, I tell him “it is not going anywhere”. We briefly discuss ECV but he insists that I need referral closer to term. “What if I go into labour?” I ask him, with desperation and concern, as I have had several episodes of strong Braxton hicks’ contractions in recent weeks which have stopped me in my tracks. I remember his response so very vividly.
“If you go into labour you come in and we’ll just section you.”
“But I don’t want a section, that’s why I need referral to KEMH for an ECV.”
“No, we do that closer to term, if you labour prior and the baby is still breech you will have a section.”
By this stage, I am getting anxious, frustrated and very upset. My blood pressure is through the roof so he now starts to talk about preeclampsia and tells me I look a little puffy and sends me for another urine check while he writes forms for blood work. This makes me even more upset as I am wearing all my rings on my fingers, all of which I usually need to take off in the heat during summer because they get too tight when I’m hot. I think he realises that I am quite upset, we are colleagues and usually get along really well. He sends me up to see the Midwives on the ward (my colleagues and friends) to give me further BP checks in “a more relaxed environment”. Once on the ward I am greeted by the midwifery student, who I have worked with for four years on nights as she was a RN on the neighbouring Med-Surg ward. I promptly burst into tears and desperately explain to her that the doctor will not refer me to the tertiary hospital despite their clinical guidelines stating ECV should be at 36weeks and 6 days gestation. She reassures me and lets me vent while seeking assistance from the more experienced midwives.
Normally, I am a very strong advocate for my patients. I would stand up for what they want, provided it were safe, and explain very clearly why things may be better to deviate from their wishes should the need arise. As a pregnant woman, I felt powerless, helpless and extremely timid. Every day I thank the universe for my wonderful colleagues and friends, amazing midwives who stood by me and supported my decision. When the team leader made that call to the Maternal-Foetal Assessment Unit at the tertiary hospital to discuss what they could do for me, she immediately had me booked in for an ECV for six days time, at a gestation of 36 weeks and 6 days, exactly what the policy had stated.
I arrived at the tertiary hospital at around 8am on the 20th May, 2009. I was very anxious. I felt this was my last opportunity to get a “normal” birth. There was a lot of waiting, moving between departments for admission, consent, ultrasound, CTG foetal monitoring, medication and finally the procedure itself. The registrar was lovely, very kind, considerate and forthright.
“I don’t want to be pessimistic, but I just want a clear understanding. If this doesn’t work, what is your plan?”
“I was hoping that I could book in here for a vaginal breech birth”
The look on his face would be best described as impressed surprise. I don’t think he realised at this time that I was a midwife myself and had a fairly good understanding of breech; the problems, the research, the current “management” (caesarean) for most cases.
The procedure of ECV itself was something I would never try to describe to anyone. It was something that I have never felt before and find it very difficult to try to explain. I wouldn’t describe it as painful, but it was certainly uncomfortable and a very unnatural feeling. Getting my little baby’s bottom out of my pelvis was challenge enough, but as the registrar would finally dislodge it and get it lifted and start rotating it didn’t budge more than 45 degrees. He tried one way twice, then the other way twice. It was all I could do to try and relax during the procedure, keep my muscles from tensing and provide as little resistance as possible to give the best opportunity for a version to occur. Those little legs were extended, the head was tucked and the breech was deep in the pelvis, Left Sacral Anterior (LSA) perfect positioning for a vaginal breech delivery. That is the way my baby was going to be born.
There was little resistance from the obstetric team at the tertiary hospital for me to transfer my care for a vaginal breech delivery. The first step was for me to receive counselling from the Medical Director, “Dr A” in regards to vaginal breech delivery; it was no surprise that the first thing she wrote down was “Hannah (2000)” and began discussing the ins and outs of the Term Breech Trial. I sat there and listened politely, after all she has a duty of care to ensure I completely understood the risks and benefits of both caesarean section and vaginal breech birth. What I saw was that there was a 95% chance that everything would be absolutely fine with the baby, whereas if I underwent a caesarean section there was a 100% chance that I would have major surgery, a uterine scar, and never have the opportunity to be considered to have a “normal” pregnancy and birth again. It is also mentioned that “some believe and epidural is desirable” to prevent premature pushing, reduce the risk of head entrapment and be ready in case emergency intervention is required. I very quickly inform her that I am not keen for an epidural and that I do not feel comfortable with that idea, she seems immediately supportive of my decision and states “they are not absolute”. I am relieved, that is one thing I was not keen to negotiate on. After discussions with my husband we were both convinced that a “normal breech birth” is what we desired.
At 39 weeks I was sent for an ultrasound scan, just to check foetal size and positioning, in my opinion, to ensure that I met the “criteria for a vaginal breech delivery”. The ultrasound estimated a child of around 3.6kgs with a head circumference of 36cms. This did not concern me at all, even if the scan had estimated a child of closer to 4000gms I would have felt this to be appropriate for my size, especially when considering my mother and grandmothers’ obstetric histories; none of them had ever had difficulty delivering their sometimes large (>4000gm) babies despite none of them being overly tall women, much smaller than I.
My next appointment, 39weeks and 6 days I sat in the antenatal clinic, niggling. Sometimes the tightening would stop me in my tracks but they were still irregular so while I suspected labour was imminent, I just hoped that I could get in and out of my appointment quickly. I still had things to sort out and I needed to go food shopping. During my appointment Dr A asked permission to perform a VE to examine my pelvis. She discovered I was 3-4cms dilated and expected that I would labour within 24 hours (a membrane sweep in a niggling woman will do that!!!). She then sat me down as she “wanted to have a little chat”. “Uh-oh, that doesn’t sound good” I thought to myself. The Obstetrician then wanted to discuss the predicted size of my baby’s head.
“I have your ultrasound report here; your baby’s head is estimated at about 36cms.”
“I wouldn’t have expected anything else.”
“This is in the 90th percentile.”
“Everyone in my family has had big heads and nowhere in my family tree has had difficulty giving birth; I would be surprised if you told me otherwise.”
“Ok.”
Dr A seemed satisfied that I was quite comfortable to continue with the planned vaginal delivery. I believe that she was satisfied after assessing my pelvis and knowing that I felt confident in my own ability to birth my baby. I had no doubts that I could do it, but still felt like everyone else needed to be convinced.
I continued to niggle all day, worse for about four hours after the internal exam, which is not at all surprising. My new washing machine arrived and I headed off to the shops with my Mum where I bought a very large trolley full of food. I started to think about what my 3 year old son and husband would eat if I needed to be in hospital for a while (i.e. I ended up needing a caesarean), I ended up spending about $400 on a week’s shopping, but it was proving too challenging to concentrate. We headed home and I had some lunch and things settled down significantly. I had a large show but knew this was likely to occur anyway due to the VE. I was still experiencing the odd tightening but nothing regular. I informed my husband that I suspected he would not be working the next day, although I had already had a false alarm the previous week!
I didn’t eat much for dinner that night. I had difficulty getting to sleep, I felt unsettled and agitated. My three year old son was very clingy and he was up in the night around 1:30am. I lay with him for a while and told him that I thought Mummy was going to have the baby but if Mummy and Daddy were not here when he woke up in the morning then Grandma would be here. He was very matter of fact about it all and told me that Grandma would be getting his breakfast. He went back to sleep quite well, but I had difficulty resettling myself. The contractions were much more regular, still fairly mild, around 15-20 minutely, I tried to relax in between and doze. By 3am I was up, trying a hot pack and pacing around the house a little. I didn’t feel like I was in labour but I just couldn’t get comfortable so I watched some television.
At 4am, almost by the stroke of the clock the contractions started coming every 5 minutes and I was having trouble staying quiet. They were coming hard and fast. I was expecting a much slower and more relaxed warm up to labour but I felt like it just hit, hard and fast. I knew I was in labour but didn’t want to rush off to the hospital. I wanted to be sure I was established and didn’t want to wake people earlier than necessary.
By 4:30am, I was unable to get comfortable. I hopped in the shower to try and relax and calm myself down. All the things that worked with my son’s labour 3 years earlier were not helping me at all this time around. The shower was fantastic, I felt more relaxed and more in control. I’d been in there for about 5 minutes and my husband rolled over from his slumber and said “What are you doing?”. The height of a contraction, he got no immediate response. Then he asked “are we on?”. I nodded, I have never seen anyone move so fast!!! After about 20 minutes he dragged me out of the shower. The contractions were fairly strong and I think he was very nervous about this labour, the last one was rather frightening for him as I was wheeled off for emergency surgery, in and out of consciousness soon after the birth of our son.
I got dried and dressed and put the final things I needed into my hospital bag. Ben called my mum and she came around to sit with William. I made the calls to the Maternal Foetal Assessment Unit (MFAU) at the hospital to inform them I was in labour. I then called my midwife, friend and colleague, Rosemarie, who had agreed to act as support and attend my birth. I trusted her immensely and the original plan was for her to deliver my baby at our place of work. I called Dr A on her mobile phone, as instructed, and she informed me she would be in to see me soon. I felt like my mother and husband could not get me in the car quick enough, I was becoming quite vocal with my contractions and starting to feel nauseous.
For the entire labour with my son, I sat, cross legged yoga style on the bed and I was comfortable. This labour was completely different, trying to sit in the car for the 20 minute drive to the hospital was excruciating. My husband’s favourite story is what he refers to as my “labour induced turrets’ syndrome” as it seems every single filthy word I had ever heard came out of my mouth during the drive to hospital in no coherent order. Stepping out of the car was the biggest relief I have ever had. Thank goodness it was 5:30am and not peak hour traffic. I step out of the car, the air is crisp and there is very fine shower of rain falling on my face, I find it incredibly refreshing. Another contraction hits, I’m being very vocal (the swearing has stopped now I’m out of the car) and my dear husband desperately escorts me into the hospital (I could’ve stayed outside quite happily).
I went through to emergency to get access to the rest of the hospital. Rosemarie was already waiting for us. I was starting to vomit. We went up to MFAU and were greeted at the door by the same midwife that I had spoken to on the phone. She was about to show me into MFAU when I had a contraction. We went straight through to labour ward (I hope I didn’t scare anyone). The midwife did all the necessary admission assessments, I handed her my birth plan and she organised the paperwork. Before long the obstetrician arrived, just after 6am. A VE revealed that I was about 5cm dilated, I couldn’t believe it “Is that all?”. I shouldn’t really have expected anything else but the pain coming so hard and fast I hoped the rest would follow. My membranes were still intact and I was vomiting, with every contraction.
As agreed I had a large bore IV cannula inserted in my arm in view of my previous PPH. It is also decided that CTG monitoring needs to be commenced in view of my well established labour. I am thankful that a good trace is obtainable while I stand, I am upright and mobile the whole time, I cannot sit without screaming, even to sit on the toilet is excruciating. This labour is so different, except for, the vomiting. It is relentless and I am finding it harder to cope with than the labour pains themselves. I feel like I am getting no break, I start vomiting at the height of the contraction and don’t stop until well after the contraction has stopped, just in time for the next contraction to start. I am finding it all very overwhelming and frustrating as I don’t feel like I can get into the rhythm of things like I did when I was labouring with William. The obstetrician reminds me that the “menu is open” and I can have whatever I like for pain relief. I have requested in my birth plan that pain relief not be suggested or recommended, that I will ask for it if I want it. All my caregivers are respectful and supportive of this and I am very grateful. At 7am shift change I got a student midwife, and a clinical midwife, as my new caregivers. They could not have been more caring and respectful.
By 9am I have immense pressure in my backside. I do not have an urge to push but this pressure is really bothering me. I suspect if I had been in a primitive setting, birthing as a cave woman without all this attention from strangers in a clinical setting I would have done something to relive that pressure myself. My birthplan very clearly stated “prefer no ARM or augmentation” but at this point, I was experiencing something that I could not “plan” for. They called Dr A back.
Another VE revealed that I was 7cm dilated. I couldn’t believe it, I was labouring so hard. I was also still vomiting and I was finding it really distressing. The resident doctors and senior midwives kept knocking on the labour ward door asking if I’d had any antiemetics (drugs to stop the vomiting), there was a chorus of “yes” from everyone in the room, I think they were about as sick of watching me as much as I was doing it. They had given me all the usual antiemetics and none had really helped. I now have IV hydration running (at my request) as I feel so thirsty and just cannot quench my thirst, all sips of water bounce right back. At around 9:30am, Dr A. starts to gently broach the subject of ARM with me. She has obviously read my birth plan and possibly feels that I will agree. I give my consent immediately; the pressure is so intense, not painful, but the discomfort is distressing. I have instant relief, followed by a reasonable trickle of warm amniotic fluid. She says to me “we’ll see how that goes, at 11am we’ll see how you’re going and we might have to have a little chat”. There are those words again, I feel myself cringe and then think “no caesarean necessary!”.
The next few contractions are really intense. I expect this after the ARM but I am still retching and vomiting. I just want to lie down, I’m tired. I cannot sit, it hurts. Nothing works, if only I could stop vomiting. I eventually request morphine. I don’t know what else to do. I think it is too late but everyone in the room assures me that it is not and that if I really want it I can have it. Vomit again, I yell out in frustration. Yes, I’ll have some morphine. I am given morphine with promethazine IMI. Within about 20 minutes the vomiting stops, that is so much better. I feel that I can get through things now. I regret the morphine and wish I had thought of the phenergan earlier. I am feeling much more in control now, until the morphine hits. At least I can lie down now, I don’t think I am able to do anything else.
I breathe through contractions really well now, I feel so much better. Except the twilight sleep, I am having weird dreams and I am talking in my sleep. I am drifting from reality to my dreams. Somebody says something and I respond with “Will, wash your hands”, I am seeing my son with grubby hands sitting in our lounge room. I also dream about a homeless man crossing Thomas st and Bagot road intersection. Someone in the room says “oh, she’s having a show” and I respond “don’t worry, it’s just a homeless hobo”. I know this is completely wrong and I apologise to everyone, I know what I’m doing but I cannot stop! They all see the funny side of it.
Dr A. returns around 11-11:30am. A VE reveals I am fully dilated. I am instructed not to push until I have a really strong urge. I felt with my first labour that I was forced to push, despite not feeling like I needed to or feeling ready. I am grateful that this time it will be in my own time. There is no more mention about “the little chat” and I know that I’m nearly there. I continue to breathe through contractions, it is easy, I don’t have any urge to push, there is no more vomiting, the dreaming has stopped. I finally feel like I am in some sort of control of my labour. Just before midday I have a big contraction, at the end of it I feel myself give a little grunt, the result of a small push. “Oh, sorry, I just pushed a bit”. That seems like such a silly thing to say now, but they were all very encouraging “that’s good, are you starting to feel like you need to”. “Yes, just a little, towards the end of the contraction” I explain. I can hear them “fluffing around”, getting things ready for what they expect to be imminent birth. I have a few more contractions like that and the pushing gets longer and more forceful. Soon after, just before midday, they page Dr A.
Dr A arrives, she is very pleased with my progress. The midwives and my support people help to roll me from my left lateral a little so they can see what is going on. Dr A does a quick VE to see what is where. I have a contraction, I am pushing and I can feel her pulling and poking around, trying to determine baby’s position. The contraction is finished and I feel a terrible burning, I am not looking “what is she doing to me?” I ask with desperation in my voice. I am feeling an amount of pain in my vagina and I want it to stop. One of the midwives leans over and whispers “they are not doing anything to you, that’s your baby’s bottom”. I ask “is it on view?”, she grins and nods. I can’t believe it... so far that was fairly easy. Suddenly that “horrible pain in my vagina” is the greatest feeling and my discomfort quickly turns to indescribable excitement.
There is a lot of fluffing and buzzing around. Everyone is getting ready for the birth. I ask the midwife “has the paed been paged?”, I remembered them talking about it earlier and I didn’t hear anyone do it, so I was just checking. She laughs, “yes honey, it’s all done, just concentrate on what you are doing, we’re fine!”. You can’t take the midwife out of the mother! They insert local anaesthetic into my perineum, the senior midwife whispers to the registrar “you are going to ask permission before you do that? She doesn’t want an episiotomy”. The Registrar is surprised by this and Dr A says “we’ll see how we go Danielle, I am not sure if we will get away without one”. At this point, I don’t really care.
I am pushing really well with each contraction. Dr A helps with the delivery of one leg, then the other. It is an absolute moment of relief with each little limb being delivered. I want Ben to tell me the sex of the baby, they all ask him if he can see. I watch him tilt is head sideways in total confusion “is that a... scrotum???”. They all smile, “ah, just wait until you can see some more of it”, I instantly think “girl”, Ben is the only male in the room, I have Rosemarie, the midwifery team, Dr A and her two female registrars, a paediatrician and neonatal nurse – 9 people in total, all of them are female. I manage to say briefly as I catch my breath “I wish I had a camera so I could take photos of all of your faces”, they were all around me, smiling, “pushing” with me with excited eyes.
Dr A splints and supports one little arm out, then the other, each provides instant relief as they are birthed. I take a breather briefly, I am not contracting. As Dr A hangs my baby over her arm I am instructed to push. “Even though I’m not contracting?”, yes, “PUSH!” the chorus instructs me. At this moment, I feel like I want to “pant” more than “push”, but I am determined to do this “right”. I give one almighty push and my baby is born. (Rosemarie tells me later that “If it was a cephalic birth it would’ve been one push and the baby would have landed in the bucket on the other side of the room”). It is placed on my chest, eyes wide, looking a little stunned, it is 12:25pm. I pull it’s little legs apart, “what have you got?” someone asks me “A girl!” (I knew it!).

I blow on her face, she reacts but is still not crying and showing little respiratory effort. She is a little flat. I am disappointed as I believe this is due to the morphine but I worry that it will be blamed on the breech presentation. She is doing really well, but not really wanting to breathe. I have tears streaming down my face, I am so grateful that I have just had the opportunity to birth my baby but I am feeling a little worried about the lack of noise coming from the resuscitation cot. The paediatrician is encouraging Ben to come around and see the baby and take photos. I feel another contraction and instinctively begin to push. I look over at the resuscitation cot and have a moment of confusion and think “hang on, the baby is out”. It is then that I look up at Dr A and say “placenta?”, she nods and smiles. I am delighted that I am also able to complete third stage, rather than be rushed off to theatre in and out of consciousness as I had done with my previous birth. I ask “what’s the damage?”, the midwife replies “You’re intact!”. I cannot believe it, everything has gone so well. I am exhilarated!
It seems like an eternity but eventually my baby begins to cry, very very loudly (and continues to do so for at least the next three months). She is in pretty good condition with Apgars of 6 at 1 minute, 7 at 5 minutes and 8 by 10 minutes. They take her to the special care nursery for further assessment and monitoring as per the hospital policy. By the time they take her I am feeling a little sad, I know she is fine and the paediatrician seems to be thinking the same but due to her slow start they need to be sure. “You’ll get her back soon”, it just reminds me when they took my son, struggling for breath at 32weeks, that was the last time I saw him for over 24hours after my serious third stage complications.
Before long I am hungrily making light work of a chicken roast lunch and I am handed a note from the neonatal nursery staff. My baby girl is 3470gms, 50 long (as best as they can “straighten her out” I am told) with a head circumference of 38cms. I question the head circumference immediately, it seems huge! I am bleeding “heavily”, but it seems fairly normal for me, the midwives are being extra cautious in light of my previous history. I am barely out of the shower and combing my hair to go down to the nursery to see my baby girl that she is brought back to me from the nursery. They have assessed her and she is fine. Dr A finalises some paperwork so I can transfer to my hospital, my place of work and where I have originally booked. She assures me that my baby girl’s blood gases were perfectly fine and agrees that the morphine was the most likely cause of her slow start.
It seems like an eternity but eventually my baby begins to cry, very very loudly (and continues to do so for at least the next three months). She is in pretty good condition with Apgars of 6 at 1 minute, 7 at 5 minutes and 8 by 10 minutes. They take her to the special care nursery for further assessment and monitoring as per the hospital policy. By the time they take her I am feeling a little sad, I know she is fine and the paediatrician seems to be thinking the same but due to her slow start they need to be sure. “You’ll get her back soon”, it just reminds me when they took my son, struggling for breath at 32weeks, that was the last time I saw him for over 24hours after my serious third stage complications.
Before long I am hungrily making light work of a chicken roast lunch and I am handed a note from the neonatal nursery staff. My baby girl is 3470gms, 50 long (as best as they can “straighten her out” I am told) with a head circumference of 38cms. I question the head circumference immediately, it seems huge! I am bleeding “heavily”, but it seems fairly normal for me, the midwives are being extra cautious in light of my previous history. I am barely out of the shower and combing my hair to go down to the nursery to see my baby girl that she is brought back to me from the nursery. They have assessed her and she is fine. Dr A finalises some paperwork so I can transfer to my hospital, my place of work and where I have originally booked. She assures me that my baby girl’s blood gases were perfectly fine and agrees that the morphine was the most likely cause of her slow start.

Around 11 hours after arriving at the hospital, at 4:30pm the midwife helps me to our car in a wheelchair, clutching my baby girl. We name her Cayleigh. We were already prepared for this and the baby seat is secure in the back.
It is lightly raining; it has been a really rainy day, but not inside my heart, I am elated. We make the trek from Subiaco to Armadale. I call my work colleagues on my mobile phone and let them know we are finally on the road. They are ecstatic, but no one is prouder than me.
It is lightly raining; it has been a really rainy day, but not inside my heart, I am elated. We make the trek from Subiaco to Armadale. I call my work colleagues on my mobile phone and let them know we are finally on the road. They are ecstatic, but no one is prouder than me.