Type A and the Uncontrollable Pre-Labour

In my early twenties, I used to avoid making eye contact with the family planning section of the chemist but these days I had pregnancy tests in the second drawer of my bedside table for occasions such as these. The last time I had to do this, I had to drive over to my friend Katie’s apartment to use one from her emergency stash. I’m not even late, my tracker app says my period is due that day, but there’s a gut feeling I had been warned about. I pee on the stick, and there is only one line. With an insouciant shrug I throw the test away. And by four in the afternoon I sit upright on the couch and realised I, the perfectionist and rule follower, hadn’t waited the five or so minutes it says to on the box. I dig through the bin and in my shaking hands is a positive pregnancy test (note: those trying to conceive affectionately refer to this as a BFP). Ever the woman of science, I remind myself that this is probably just an “evap line”. I also know that pregnancy tests are most accurate when it’s the first urine of the day, but there’s no possible way I can wait until the next morning. So I test again, and again, and I race in my car to Victoria Park to my boyfriend of two years with three BFPs sitting in the cup holder. He knows before I even show him just from the look on my face and the harried message I’d sent.

And so begins the uncontrollable for the Type A. In a pandemic, there were already things I couldn’t control. I’d been redeployed to a different unit at my work and could no longer take potential COVID patients. I was anxious, exhausted and most of all – experiencing morning sickness that would turn into hyperemesis. Then, I had to take extended time off work. Despite all of this, holy shit did I love being pregnant. As I do with most things, I jumped straight into the deep end of pregnancy world and obsessively researched. I avoided the foods you’re meant to avoid and I bought all of the pre-baby accoutrements. Birthing ball, new yoga mat (and maternity yoga pants to boot), and the books. I did hypnobirthing classes online, and listened to birthing stories while hiking with my dogs. Being pregnant was simultaneously my new persona and hobby. I honestly still wouldn’t change a thing now in spite of what I know, because despite vomiting for 7/8 months straight I loved being pregnant with all my heart. By the third trimester my partner and I had the hospital bag meticulously packed, nursery ready, and the big waiting game to do. Ready for our little family to be complete.

At my 38 week appointment, our obstetrician informed us that baby wasn’t showing any signs of coming any time soon. I took that as a challenge and so came the sex, the daily 5km walks and bouncing on that godforsaken birthing ball day in day out. I told my partner Jack I was going to take a butcher’s knife to that ball once the baby was born. What the books and the classes didn’t prepare me for was that at 39 weeks, my baby was certainly showing signs of coming. I had my bloody show. And on the Friday, exactly a week before Christmas, the contractions started while we were watching a movie. I coquettishly timed them on my phone. After an hour I turned to Jack with an impish smile and told him I was having contractions that were 8 minutes apart. What would then follow was 9 days of latent, or prodromal, or “pre”, or my least favourite term of all – false – labour. And probably the most sleepless and stressful week of our lives (and we now have a 2 week old, go figure). On the Monday I went to hospital with contractions 3 minutes apart after the paracetamol and the shower they tell you to take. It was there I was told my uterus and cervix “weren’t agreeing”. Baby’s head wasn’t engaging and I wasn’t dilating. To get some relief from the round the clock contractions, over the next week I tried exercises from Spinning Babies hourly to get his head engaged, my partner gave me massages, we went for walks twice a day. I had a glass of red wine and a bath to relax because I’d read that stress and anxiety could cause stop start labour. On Christmas Eve, the contractions were stronger and in the end I couldn’t talk through them. We waited as long as possible, camped out on the fold out bed in the lounge room with the birthing playlist on quiet, lights dimmed and candles burning. I hypnobirthing mantra’d away to myself “relaaaax relaaaax relaaaax” and breathed through each contraction until we called the Family Birthing Unit at 3 in the morning in Christmas Day and it was then that the contractions abruptly stopped. And I cried. And it was a low keening, animalistic cry of hopelessness and desperation. I sobbed and asked my partner what the last 20 hours of contractions had been for. All I wanted was to meet our baby. We both spent Christmas Day feeling so low, and then eventually I crawled into bed with him to start the wailing and sobbing all over again.

Barely two days later, the contractions started up in the small hours of the morning and I shook my partner awake. My instincts were telling me something was wrong. After nine days of labour that wasn’t progressing, I was concerned. I was concerned I would be too tired to push when the time did come. I was worried for my baby. And so we called and went into the hospital to get checked out that morning. They put me on the CTG and I had a contraction. “Whoa!” Said the midwife. “That was a doozy.” Then she checked my cervix. “It’s moved forward a little, and you’re about 1-2cm.” She said she couldn’t see any decelerations on the CTG but hadn’t seen any accelerations – my baby was tired. I don’t blame him. And then I finally got asked the question I should’ve been asked days ago, “What do you want to get out of being in hospital today? Do you want to have a baby?” I nodded, because of course, and she phoned my obstetrician. My obstetrician offered to break my waters, if he could, to get things moving. He couldn’t, I was contracting too much, but he gave me a stretch and sweep. And offered to induce me the next day. My whole birthing plan was so quickly going out the window. They gave me a temazepam to make me sleep and the plan was to crack my bag, as the funky night shift midwife put it, and start the Syntocin drip at 7 in the morning. I didn’t sleep despite the temazepam and panadeine forte, because I was still having contractions, but the next morning we waddled to the birthing suite to start my induction. The midwife handing me over loudly announced to my labour midwife as we came up the corridor that I was having my baby today. After an examination, my obstetrician cracked my bag indeed, with a tool that looked like a crochet hook and with a gush, all that amniotic fluid keeping my baby safe and sound all these months came flooding out. He looked at me and told me it was meconium stained and now the paediatric RN in me was starting to panic but it was all systems go and as I raced from active labour to transition, I could only focus on the contractions. He offered the epidural I’d refused the day before again but I shook my head. Not in the birth plan. Gas and air only, please. Well, I ended up screaming into the entonox mouthpiece every 2 minutes and throwing up all over myself before I made the decision (one I’m proud of) to ask for the epidural. Once it was hooked up, my mum arrived in the hospital and I was finally feeling comfortable. I think the epidural must’ve worked for about fifteen minutes in total before I was a screaming mess again, I felt this intense pressure between my legs constantly and I couldn’t get comfortable. I was insisting to my partner and mother that the epidural wasn’t working. I exhaustedly asked my partner what time it was and it had only been a couple hours since they broke my waters. I remember crying and saying I couldn’t do this. And my mum told me I could, and I was going to. My mum, who on my birth plan was not meant to be in the birthing suite but waiting outside. My midwife told me she would come back at noon to check my cervix. I told my mum I felt like I needed to push and she assured me it was too soon. Just before 12, I made a noise I’m not proud of and reiterated very calmly that I had the urge to push. Before the MW assessed me I steeled myself to be told I was nowhere near, after a week of disappointment and being nowhere near. “Oh. You’re having a baby.” Everything happened so fast from there and there was no amount of hypnobirthing mantras, birthing balls or counter pressure massages from this baby’s father that could help me now. What did help, I will say, was the birthing playlist my boyfriend and I had lovingly compiled. I asked if we had to wait for the doctor when she told me she was calling my OB. No, she laughed, you don’t have to wait. But he arrived within 10 minutes regardless and so did the paediatrician. The paediatrician I had said I would refuse because I’m a paediatric RN and wouldn’t need his input. Oh right, I remembered- the meconium staining in my waters. I focused with everything I had on pushing and it wasn’t until the doctor looked me in the eyes and told me to stop pushing that I had any idea that things weren’t going according to plan. With my knees to my chest, I stopped. Afterwards, my partner would tell me that our beautiful son was getting distressed despite my best efforts to get him out and the OB was pulling back on the cord that was tight around his neck. And my poor tired baby’s heart rate dropped dangerously. I didn’t know these details at the time but I knew something wasn’t right. My doctor and I locked eyes again and I told him I couldn’t do it. He nodded and gave me the episiotomy and used the vacuum I had expressly verboten in my birthing plan in order to deliver my child safely into the world. I was handed a floppy, blood and guts covered baby, who I kissed and subsequently ended up with blood on my face. And he didn’t cry. The midwife took him off my chest and it was the longest 10 seconds of my life before he let out the best scream I’ve ever heard.

My mum looked at me. He’s beautiful, she mouthed. I asked if he was okay. He’s okay, she reassured me. Then my partner and I kissed. He got to cut the cord. Then I was handed my baby again and I don’t think I’ll ever feel anything like that feeling again. Not until the next one, at least. I made a joke about how everything went opposite to the birthing plan and truly everything did. But the most important thing was my baby was born safe and well. I had to let go of control. We went back to our room and nestled into the bubble we’d heard so much about. We excitedly changed his nappies, I breastfed him, and we settled down into the bed to sleep between feeds. The next day was much the same. And on my discharge day came the baby blues and my first exposure to what can only be referred to as mummy shaming. The midwife questioned why we wanted to go home early, told us he was jaundiced and that it would progress quickly and he had lost too much weight since birth (he had actually lost less than 10%). She told me the less selfish thing to do would be to stay in. I called in on my support network of nurse and mum friends and regained the confidence to go home but so began the guilt. I had given him jaundice. If I’d gone to the hospital earlier, if I’d tried harder to push…he wouldn’t have needed the Kiwi delivery and avoided the subsequent haematoma. I was made to feel like a terrible mother by a health professional who should’ve been reassuring me and not feeding my anxiety. Then I was sensitive to any comment my partner made and spent days crying at the drop of a hat. My partner told me he was worried about me. I was worried about me. I did a screening test of the PANDA website and it told me I was at risk of postnatal anxiety. Bloody oath – I was and am still a nervous wreck! My partner and I finally talked through the birth and I admitted the birth had been traumatic. I felt angry that nothing had prepared me for it and that I didn’t get to have the birth I had imagined. I imagined walking around the room, bouncing on the Bloody Ball and certainly not having an epidural, an episiotomy and a vac assisted delivery. Mantra-ing through contractions and breathing my baby out.

I felt like a failure. What I know now from calling on my network of amazing women is that this type of birth experience is ridiculously common and I did nothing wrong. This was out of my control and is just the beginning of a lifetime of the tiny human I created holding the reins. I’m still learning every day from him and second-guess myself a lot. But we all got him here safe. And he is beautiful, and well worth the wait.

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