If you’re still with me into this fourth blog post, cudos to you! This post is about my second birth.
There are a few things I would change about my first birth, but they’re mostly small and only really as a result of the information I now know. On the whole I felt empowered, respected and that the main elements went very smoothly. I had the low intervention, drug free vaginal birth I had always imagined.
The one thing I did want to change was the type of care I received. With my first pregnancy and birth, there was zero continuity of care from my midwives (although the care was always very good). I’d seen a different one at every appointment and on the day saw all new midwives again – I must have met at least 70% of the midwives working at the hospital for them not to have crossed over at all!
During one of the first hospital appointments with my first pregnancy, I’d been told about the Caseload Midwifery Practice that operated alongside the hospital. I had qualified to apply to them (low risk pregnancy, living within 30 minutes of the hospital) but at the time hadn’t been interested. After my disjointed care experience, one of my first questions at my first hospital appointment for my second pregnancy was, ‘how do I apply for the caseload group?’. I filled in the form then and there, asked a few more questions, and waited to hear whether I’d been accepted.
I few weeks later I got a call from Lisa, who would be my caseload midwife. I was so happy to have been accepted! I was going to be able to form a relationship with the person who would help me through labour! All of my appointments from 18 weeks to labour day were with Lisa. The added bonus was not having to go to the hospital for appointments, pay for parking, wait in a massive waiting room with heaps of other pregnant woman while trying to keep my toddler calm and contained. I met her at a small community centre not far from the hospital, we went through all the usual blood pressure checks and tummy measuring, but I was able to speak to her at length about the pros and cons of this and that. I initially decided I didn’t want to do the GBS swab test. Assuming I would be positive again, and knowing labour often goes faster the second time, I assumed I’d have the same problem of not getting the full antibiotic dose as had happened the first time. That would mean more time in the hospital than I wanted. This second time, I wanted to spend as little time there as possible, which was another thing attracting me to the midwifery group practice model of care. Because the midwife is your primary care provider, not the hospital, you have the option of home birth (I didn’t like the idea of cleaning up post-birth enough to go this way) or being discharged from hospital 4-6 hours post birth, assuming there’s no medical indication that you should stay. With a toddler at home this time and knowing that hospital is not the most relaxing place to be with a newborn, I wanted to get home as soon as possible. If I was knowingly GBS positive, that might not happen.
In the end I did end up doing the swab. I heard a story of a friend of a friend who’s baby died from a GBS infection, and me still not being the widely read, fully informed person I am today, that scared me into changing my mind. It was negative, so no need to worry anyway.
Because I’d gotten myself so convinced the first time that I wouldn’t make it to 40 weeks, this time I decided to plan like I would get to 42 weeks. I was starting to understand much more about the haphazard way we date pregnancies, and that every pregnancy and baby is an individual and need their own individual time to grow and be ready for life on the outside. Whenever anyone asked when I was due, I gave a vague ‘she’ll be here by mid-month’ rather than the exact date, and that also helped with my own mental preparation. But these kids, they’re put on this earth to mess with our plans. I was so convinced I’d go over my due date, that of course she decided to come a few days early instead. Turns out that because I had been due in the first few days of the August, I didn’t even have the right month in mind. I woke up to pee (AGAIN!!) around 1130pm one evening, and noticed that the panty liner I’d been wearing was soaked. I went to the toilet and weeing felt a little strange, and I wondered if my water had broken. I tried to go back to sleep, but my mind was racing. Instead I sat on the couch in dark silence for an hour or so, concentrating on my body. Was that a contraction, or was it nothing? I knew that if my waters had broken but labour didn’t start, I was at risk of having to be induced, and I still wanted to avoid that like the plague. I called Lisa to tell her I was pretty sure my water had broken. We had discussed during my appointments that my labour was likely to be quite fast, as it had gone from concentrating but comfortable to pushing within two hours during my first labour. Knowing I didn’t want to have bubs at home (or worse, on the side of the road on the way to the hospital) she suggested I go in and get checked over to confirm where I was at. I woke my husband and called my mother-in-law to come and stay with Miss 2yo. At this stage it was 1am. By the time MIL arrived and we drove to hospital it was 2am, and I could definitely feel some small contractions, but they were very slight. The hospital midwives did a test to confirm whether my waters had broken, and told me I was just 1cm dilated. This was actually a bit disappointing considering the first time I’d been through labour, I’d got to 2.5cm before it even began. We sat around in the observation room and I bounced on the birth ball, talked to my husband, and basically got bored. Part of me knew this was how it was last time until it ramped up at the end, and part of me was bored and wanted to go home.
The hospital midwife came in and assessed my contraction at around 530am and suggested we go home. I wasn’t contracting regularly (sometimes they were 7 mins apart, sometimes 5) and I wasn’t in the least bit of discomfort. I was told to come back at 6pm even if labour had started properly, to be induced as my waters would have been broken for 18 hours by then. Again, I wasn’t confident enough to push back on hospital policy. So off we went, back home.
My MIL was watching DVD (what is it with me and labour movies?) so we sat down and watched the rest with her. I was still timing my contractions, which still weren’t completely regular, but where getting stronger. Eventually I had to sit forward in the chair and rock, or stand up and rock through contractions, though still able to hold a conversation. My daughter woke up at 730am, and I decided I was uncomfortable enough and far enough along that we should go back to hospital. I rang Lisa to say as much as 747am. She said she’d wait until the hospital rang her with an assessment of me before coming in. I almost asked her to head in anyway, but didn’t back myself (lesson learned).
We got back in the car and I was pushing the trusty TENS machine button pretty forcefully with each contraction as we drove in, parked, and walked back to the maternity unit. When we got to the nurse’ station we were told there weren’t any observation rooms available and that I would need to wait in the waiting room. We walked in a there were a few other women already there. I was starting to go very ‘within’ so my husband made the following observations about the other women in the room. One was chatting away, happy as Larry to the person she had with her (I presume her mum) the other two were alone, uncomfortable but not enough to need to actively work with pain. Then there was me. In the space of the 15 mins we were there (though it felt a lot longer!), I went from sitting still and breathing through contractions with the TENS machine button firmly pressed, to forceful rocking and breathing to telling my husband to go get me a room cause I wanted to push. Admittedly I wasn’t quite there yet, but I could tell it was coming and I knew saying that would make a room appear quickly. The midwifes suddenly appeared and ushered me into an observation room. I was given an internal and told I was 7cm. Again, I was slightly disappointed, but didn’t have much time to think about it as the next contraction showed up. It was a double – it didn’t completely go away before the next one started. I’d gotten on the bed on my back for the internal and again, I hadn’t moved and it wasn’t suggested. The room was incredibly hot (in my opinion) I and told my husband I wanted help to take my jumper off after the next contraction. I never got the chance. The next contraction came and suddenly I really did want to push. My husband yelled for the midwives to come back – I think they had been ringing Louise to update her and trying to find me a birth suite to go to. In the small observation room equipment was hurriedly bought in, it was obvious bubs was going to be born in there. A resus station appeared from the hall, a lidded plastic box with birth supplies was bought in and suddenly a small room had a lot of people and equipment. Seven minutes later, my second child was born at 847am, exactly one hour after I rung Lisa to say we were heading back to the hospital. Needless to say, she didn’t make it to be there with me. The maternity unit midwife did say I’d made her weekend by giving birth in the obs room, apparently on average it happens once a week.
In the rush from waiting room to obs room to bubs being born, the midwife obviously didn’t get a chance to read our paperwork (again). In between contractions I tried to squeak out about delayed cord cutting, but it was lost in the moment and her cord did get cut quite quickly. Interestingly I also had an undiagnosed velamentous cord insertion. If this had been found during my ultrasounds, my pregnancy and labour would have been treated as high risk.
The midwife offered to take us up to a birth suite but I didn’t see the point. Lisa arrived and came into the room and we had a laugh that she hadn’t made it in time. Bubs had her first feed and then I had the second greatest shower of my life. This time I had no need for stitches, and after my shower felt pretty much normal. Such a short labour meant my muscles felt weak but not overly strained, and I hadn’t expended much energy. I had only had a few hours sleep that night, but other than that felt great (the oxytocin high probably helped!). The uterine contractions where a lot more noticeable this time than after number 1, and they continued to be a little eye watering and require some concentration as I breastfed in the first few days. I was discharged four hours after bubs was born, and we went home with our new baby as a family of four.
Rachel Angelone is the founder of Your Birth Your Baby and is a Lamaze Certified Childbirth Educator and Postpartum Doula based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. She is also a loving wife and mother to two young girls.