Homebirth: A Midwife Mutiny

Brydda’s story

2010-07-29T21:24:21Z

I admire this woman for writing her birth story. A birth that she found difficult , when I read the story I feel the raw energy I felt on the day of the birth. I also feel the need to justify my actions in the story. Not because I was at another birth initially but because I actually manipulated the baby a little after being asked. It’s not something that I regret as I am happy that births are always decisions made by women and their midwives but because it is not something that I would advocate. Would I do it again? Of course I would if it were important to the woman.

Thanks for this amazing birth story.

The Birth of Brydda

Soon after Luke and I got together we knew we wanted to marry and have kids. We got pregnant sooner than expected, but were both cautiously happy.
Pregnancy wasn’t what I expected. I had moments of calm and peaceful expectation, but there were also moments of severe self doubt and something like despair. I liked the feel of my growing belly, but I didn’t like the lack of sleep or heartburn that it caused. And although I felt excited at the baby moving inside me, I often felt detached, even resentful. Looking back, I didn’t feel really comfortable with pregnancy until very late into it (about 38 weeks!), when I went to a second birthday party at the wonderful light-filled home of my friends in the hills. That day I was suddenly struck by the love they had created: by the patience and tenderness with which they held their little boy, and the way he shone just to be near them. I remember thinking, ‘I want this. I want to experience this love.’

I had been to the hospital early in the pregnancy on the urging of my mother and GP, but knew in my core all along that I wanted to birth at home, and Luke supported me wholeheartedly. After several unpleasant antenatal visits during which I was informed that I would be preventatively ‘treated’ with dangerous anticoagulants for a blood disorder I didn’t have (and their own tests proved it), patronised like a stubborn schoolgirl for declining routine ultrasounds and Dopplers, and told the birthing centre was simply full, I bit the bullet and left without making another appointment. We had already been in touch with Lisa and come to know her as a passionate, wise, experienced midwife, and I felt relieved to be in her care, which was amply more caring than that of the hospital.

The baby’s head descended fairly early on, and throughout the pregnancy both Luke and I had intuitively felt that she or he would come earlier than 40 weeks. I had prepared all my labour essentials: oils, altar, exercise balls, tambourine, placenta bag, birthing necklace, mental imagery and affirmations by 36 weeks. But it wasn’t to be. And in hindsight, as impatient as I was at the time, I wasn’t ready. Can one ever be ready?

When the birth did happen, it definitely wasn’t what I expected. I woke early on my birthday (the day before 41 weeks) with mild cramps, and a fervent hope that this would be ‘it’. I’d had very little sleep and was still resurfacing from a bad cold, but was buoyed by the idea that I would soon meet the precious soul inside me. Twelve hours later the excitement was starting to wear off; I knew I was in labour, but things were taking a long time. The contractions were painful but I could still breathe through them. Strangely, they were much stronger when I lay down, which I did as much as I could, hoping to speed things up. Luke had spoken to Lisa on the phone on and off, and she thought it would take a while, but told me that she would come whenever I felt I needed her.
I had been dodging birthday phone calls all day, with the excuse that we were ‘about to head out to a movie’, so we decided to do just that. We went to a nine o’clock session, but I found that it did little to distract me, and it was hard not being able to move much. We left halfway through, and were home by 11pm. After a long walk by the river, the contractions were still painful, but not strong enough for me to feel like I was close to birthing. When we arrived home something inside me gave way, and I remember standing in the back yard crying to the near-full moon, begging for her to help me because it was getting too much.
I lay down in the bedroom to try to get some rest, and that’s when the contractions really hit. They hit like a tsunami. I suddenly understood what women meant when they talked about the pain of labour. I needed Lisa. We called her, only to find that she had been called to another birth. I was intensely disappointed, but she assured us that she would be there soon. Meanwhile, she offered to send Rose, another midwife who lived nearby, around to sit with me.
Rose arrived shortly. She set about quietly and respectfully offering words of encouragement and filling the birth pool. By then the contractions were beginning to blow my mind. As each one hit, I fell to my hands and knees and roared. Luke had spent time learning acupressure points for pain relief, but I found I didn’t want any touch. It helped to have Rose there, but it was still very difficult not having Lisa, who had been with me for the whole pregnancy. I knew Rose socially though prenatal yoga (she was also very pregnant, poor thing!), but Lisa I knew and trusted as a woman knows and trusts her midwife.
Rose asked if I was feeling any ‘pressure’. I wasn’t sure what she meant, but I felt that perhaps by now I should be feeling the urge to push, so tentatively I tried to push. The more I pushed, the more I felt I needed to push. My body took over; I got in the pool and my body pushed for me, with every contraction. Between contractions I was so mentally and physically exhausted that I just sat back and fell asleep. I hated each contraction because it pulled me back to consciousness.
After a couple of hours of pushing in the pool, nothing much had happened. Luke was bucketing water out because he could see my head dipping towards the waterline. I remember hoping that I would pass out because it would give me some relief. I knew from all my research that the ‘pushing’ stage shouldn’t take this long; I could just feel the top of the baby’s head deep inside, but it didn’t seem to be moving any further down for all my pushing. I started to fear that something was wrong. I told Rose and Luke that I couldn’t do it anymore. I had the crazy idea that if I went to the hospital they could give me something to stop labour for a few hours so I could sleep. Of course I knew that hospital would probably mean a caesarean, but I honestly couldn’t see any other way to proceed. I felt completely hollowed out; I had nothing left.
Somewhere around sunrise, Lisa arrived. Every time I looked up she was there with a glass of water and rehydration salts, and a spoonful of honey. The day was heading towards 42 degrees, and apparently I was very dehydrated. Luke and Rose had offered me water, but they weren’t as forceful as Lisa, and I had mostly ignored them. Lisa suggested I get on the toilet to help move things along. I asked her to do an internal, and she found that there was a lip at the front of my cervix that wasn’t fully dilated. The baby was coming down at an angle, with one shoulder against my bowel—the reason I had felt like pushing—but the baby’s head was stuck against my cervix. I needed to lie on my side and ‘not push’, to relieve the pressure. For anyone who hasn’t experienced it, ‘not pushing’ is like holding back the tsunami with a sieve, and after an hour of it, I was back on the toilet. The lip was smaller, but it was still there.
I looked at Lisa. I said, ‘I can’t do this anymore,’ and I think she finally believed me.
‘There are a few things we can try before we go to hospital,’ she said.
I nodded. Anything.

So with the next contraction, Lisa reached into me and pushed as I did. When she told me the cervix was now out of the way and I could push my baby out, I was scared to believe her, so I asked her to check again. It was. Then she warned me that it could still take half an hour or more to push the baby out after this point. My most vivid memory of labour is sitting on the toilet gripping Luke’s arm, him omming, low and strong, to help me through the waves. It made me think of cherry blossoms.
About an hour later I was in the bedroom, squatting on a bolster, pushing pushing pushing with every skerrick of my being. She listened for the baby’s heartbeat, and couldn’t hear it. She reassured me, saying that it was most likely because the baby was too far down. To be honest I didn’t care. I just wanted the pain to end. All thought had gone from my mind.
Then I felt the head and it all changed. I said to the baby, ‘come on, beautiful boy, come on little man,’ and he came, alive and slippery into his daddy’s arms. He was covered in blood (mine) and poo (his) and his head was squashed but he was perfect, and tiny, and alive. I blew on his face to kick-start his breathing, and he began to wail. I was shocked that we were both alive.

It was about 11am and the day was well and truly heating up when I climbed up on the bed and pushed out a round, beautiful placenta, which we left attached until Brydda let go of it on day 5. Luke passed Brydda to me and we had our first attempt at breastfeeding, which was a bit of a muddle. Everything seemed surreal and hazy, we were all so exhausted. I had a second degree tear, but it was straight and held together well. I decided not to have it stitched because I couldn’t bear the thought of any more pain (and with the aid of seaweed and time it did heal very well). Lisa left the three of us in bed together.

I think I got about 20 minutes of sleep before being thrust onto the wonderful, rocky road of motherhood, which wasn’t what I expected, but that’s another story…
Looking back at labour, it was the most harrowing, shocking experience of my life. I honestly believed at the time that I could not do it, and that I would die. I’m sure that it was equally as difficult for Brydda, though I may never know for sure. On the tough days, looking back, I’m sometimes disappointed in myself, or resentful that the birth was so hard for us both, and so different from what I’d hoped. But most days I’m deeply grateful that I was able to stay at home, and that we have a healthy, beautiful baby boy. If you ask me, any day, would I do it again, at home, drug-free? The answer is, in a heartbeat. I can’t really describe why, but it has to do with love: love for my child, and myself, and my body. On this journey, the three of us are teaching each other so much about love. I’m looking forward to the day Brydda asks about that stain on the carpet in our bedroom.

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Maternity Coalition Update.

2010-07-26T21:30:27Z

I haven’t blogged these updates as the whole thing is very depressing, it’s also terrible some midwives would be willing to give up the right of women to birth with anyone or noone in the comfort of their own home,

IMPORTANT update from Maternity Coalition:
The medical veto over Medicare for midwives is now law.
Sun 25 July 2010

The Government’s $120 million national Maternity Reform Package is currently being implemented. From 1 November 2010 Medicare rebates will be payable for care from eligible private practice midwives, subject to certain conditions.
For the last nine months consumer and midwifery groups have been lobbying hard around the one crucial point of these reforms – how midwives and doctors will work together. The government stated from the outset that the midwife would be required under legislation to work in a “collaborative arrangement”. Consumers and midwives have argued for the definition of these arrangements to be one which supported women’s choice and access, and which did not give doctors control over women’s access to Medicare rebates.

After months of suspense, the Determination defining “collaborative arrangements” was quietly signed into law by the Governor General on 16 July, without notification to stakeholders. The Determination can be downloaded from this link: http://www.comlaw.gov.au/ComLaw/Legislation/LegislativeInstrument1.nsf/all/whatsnew/6A0EF93573665149CA257762000BBDEE?OpenDocument

Maternity Coalition is dismayed at the introduction of the Determination that provides 4 options for collaborative arrangements. Each option requires the midwife to have some form of permission from a doctor, before a woman can receive Medicare rebates.

The minimum form of permission is an “Arrangement – midwife’s written records” (section 7 in the Determination). This option requires a named doctor of a specific type to acknowledge “that the practitioner will be collaborating in the patient’s care”, and that the named doctor has received copies of a hospital booking letter and a maternity care plan.

These requirements will make it very difficult for women to access Medicare-funded care from midwives in private midwifery practice. We expect midwives in private midwifery practice (working for themselves, not a doctor) will rarely be able to find private doctors who are willing to enter collaborative arrangements with them. In some cases this may be possible under very specific conditions. However it is unrealistic to expect that private doctors will collaborate in the care of women planning homebirths.

Even for women planning births in public hospitals, these requirements for collaborative arrangements will make it extremely unlikely for them to be able to access Medicare-funded midwifery care. There is no reason to expect public hospital doctors to enter the required collaborative arrangements with private midwives. They have no incentive, and there is no sign that state governments are ready to implement to effective collaborative arrangements in State hospitals.

In March 2010 when the Senate was debating this legislation, the Government stated that “There is no intention to provide a right of veto over another health professional’s practice”. However, under intense pressure from the medical lobby, this is exactly what has occurred. Most importantly, it is women’s choices and access to care which are being vetoed, to protect medical control of the maternity marketplace.

If these reforms are to deliver the “choice and access” promised to Australian women by Government, the medical veto must be removed. Midwives must be accountable to the women they care for, and to their regulating body, not to another profession.

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Absurd Birth Scenes – Apocalypto

2010-07-14T05:09:40Z

When Mel Gibson made Apocalypto I don’t think women were his target audience. It’s a very barbaric movie. But those women who did endure its horrific violence were treated to a hidden gem of a birth scene – and a waterbirth no less.

In Maya A Safe Birth Is The Least Of Your Worries

If you don’t like bloody violence and brutal murder then Apocalypto is not the movie for you. Set during the 16th century Mayan civilization of central America, it tells the story of a group of assailants who capture and sell jungle tribes for city priests to use in blood sacrifices. The gods apparently wanted a lot of blood to arrest the rampant diseases introduced by the Europeans.

During one raid on a jungle village, a young hunter hides his son and pregnant wife in a deep, vertical cave prior to his capture. The movie focuses on the plight of this hunter and his efforts to be reunited with his family before the rains arrive and flood the cave. Actually drowning can be considered a joyous way to go when compared to the grim alternatives served up by Apocalypto.

But What About The Birth Scene?

The rains have started to fall and the cave is quickly filling with water. What a terrible time to go into labour. True to life it always happens at the most inconvenient moment. At least it makes for a great birth pool.

As the video clip shows, this movie birth scene is remarkably good. A small amount of blood is dispelled into the water, the cord is intact, the baby swims to the surface before being scooped up by the mother. Not sure how they did it – but Mel Gibson sets a great example. What a shame its tucked away in such a barbaric movie.

Room for improvement? Like most movie birth scenes labour is a very brief affair. I wish I could educate my clients to reliably pop them out this quickly. The birth of the placenta is omitted, which is forgivable in this movie as the birth is incidental. It’s not so forgivable in some of the movies where the birth is the climax.

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Traditional Midwifery Workshop

2010-07-20T14:33:10Z

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On yer bike says Homebirth dad

2010-07-11T13:16:14Z

This Appeared in the Mountain Bike Magazine Enduro written by a regular Contributor, I have reproduced it here for two reasons,

1. It’s a wonderful story by a lovely man, and not too many men write about birth in any magazine let alone a biking one.

2. I am made mention of so it definitely counts for my blog.

I am lucky enough to be have these people as great friends. I love all of my clients and one of the utter delights is that some of them become life long friends.

Biking home to birth.

It seems to me that bikes have been a major part of my life forever, but in reality I guess it has only been a relatively short number of years. But it never fails to amaze me how in the most important moments of my life, on those rare and amazing days that I know I will remember till my very last, a bicycle always seems to have a fundamental role to play.

On one such weekend a few short weeks ago, I was hanging out on my porch with a good buddy of mine. I was jumpy and nervous, trying to kill some time. Tim, being the busy bee that he is, was making use of my bike stand and my sunny deck to put a bike back together. For reasons that are not entirely clear to a simple mountain biker like me Tim’s bike, hereafter known as The Tiger, had been sent back from The States after a long stint in the repair shop and Timmy was determined to put it together and go for a ride. So despite the fact that my partner, hereafter known as Frawley, was in the early stages of labour, we went out for a ride.

To set the record straight, it was a long labour, the midwife was there and they were settling down in front of the telly to watch a chick flick. At least, they were as settled as a woman in labour can ever get, which means Frawley was fine for at least eight minutes out of every ten. The local MTB park is just down the road, and I figured I could be home in minutes if necessary. It was shaping up to be a long day, so while it was all relatively quiet, I went out for a ride with Tim.

I don’t need to tell you about that ride. You have all had one like it I am sure. On the cusp of momentous events, my mind was free and the body was willing. My riding was quick, tight and alive. Tricky uphill pinches I had never succeeded in making on previous attempts were flowing under my wheels with ease. Tim, usually a speedy whippet that tans my hide, was left to wallow in my wake that afternoon. We whipped it round a hot lap of the local park, and I was actually laughing out loud on the last corner when I turned around to say something to Tim. Just in time to see him wash out his front wheel and bang The Tiger hard into the dirt.

To be fair to the tough little nugget, Timmy got up immediately. Without so much as a grunt of pain, he announced calmly that he had broken at least one bone in his hand. A trip to the hospital was inevitable. I was concerned but also torn. Not only was Frawley intent on birthing a baby that afternoon, I also had a two year old daughter due to wake up from her nap that needed looking after. Clearly a calm and steady head was required at this moment. And so I panicked.

The next hour of my life, I have to admit, is a bit of a blur. In pretty much this order the following events occurred. I got a car, I dropped Tim off at the hospital. I got lost, I found my way home. I picked up my daughter, Molly. I bought her an ice cream. I received a call from Tim to come pick him back up from the hospital as he was done. When I got there I received a call from the midwife saying the waters had burst and I better scurry home. I called Tim to abandon him then found him again walking down the road so I picked him up anyway. When I got home Frawley was already pushing. She never bothers to wait for me. It occurred to me that I may well be the only mountain biker in the world who has had to make a mad dash from a hospital back to my home, as opposed to the other way around, to make it to the birth of my child.

Jarrah Daniel Partridge, or ‘second wheel’ as he is referred to by me and not that many others, was born on my lap in the lounge room of my house late that evening after a marathon push. I was still wearing my riding gear at the time, and the trail dust mingled freely with the blood, sweat and tears of a home birth. It was, without doubt, a defining moment in our life.

If you think that enduro mountain bikers do it hard, then go watch a woman give birth without so much as a Panadol. We got nothing on them. Frawley was incapable of walking for a few days after that ordeal. In toughness stakes that puts her in front of pretty much every enduro mountain biker I know, with the possible exception of Gordo.

For the record, Timmy’s hand and The Tiger are fine. Turns out the finger was merely dislocated and I could have saved myself a whole lot of angst simply by giving it a bit of a pull in the park. We are riding again and gearing up for a single speed crack at the inaugural Mawson MTB Marathon in June. Jarrah is going great guns and Molly is loud and oh so very proud to be a big sister. Frawley is fine; she is a tough old bird and is back in the saddle already, albeit with the help of gears. Just in case I never get another chance to do it in print, I need to tell her I love her very much.

It never fails to amaze me how much bikes play a pivotal role in my life. This particular yarn is by no means unique. But the others will have to be left for another time for yet again, I have run out of space. But with the wisdom of one who doesn’t know much but now knows a little more than he used to about being a bloke, let me leave you with this one piece of advice. If your lady chooses to have a homebirth, remember one thing. Somebody has to clean up the next day, so make sure you get your ride in early.

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Celebrity homebirth, a blessing and a curse

2010-07-10T04:19:23Z

Another week where homebirth has hit the headlines. Although I know lots of things have happened in hospitals all over Australia, 1 homebirth transfer has Obs out of the woodwork making up bizarre figures and generally pushing the line that homebirth is dangerous.

Here’s the deal; If you repeat over and over to the population, homebirth is dangerous and your baby is 4 ( read 2,5,7,27, all figures bandied around this week) times more likely to die, then after a while the message sinks in, no facts necessary, nobody asked for a balancing view, no midwives (who actually attend the births) questioned, just Obstetricians who openly hate homebirth. Why not ask a homebirth friendly Dr like Sarah Buckley? Or one of the many others who quietly support the homebirth community. I can tell you why, it doesn’t create headlines and it doesn’t scare the population into compliance. Why didn’t anyone say, this was a great success, the woman transferred her care as was best to do at the time. No drama no fuss, good care by midwife with joint decision making and collaboration between care provider and woman. Isn’t that what they want?

We did hear the line up to 50% of first time mothers transfer, they mean from birth centre to labour ward. this is because of the draconian rule structure. Homebirth midwives have a transfer rate of 10% and under in this country. Which ties in with the WHO estimate of those who would need help.

I could linkyou to some of the many articles that have been printed this week but the whole reason I have left it until now to blog is to respect a woman who has just given birth and not give them the satisfaction. I can link you back to the SA homebirth study and also to a great post in Midwifery today, it’s a reponse to the recent american study on homebirth.

To finish, Congratulations to Dannii Minogue on the safe arrival of her baby. How sad I feel that her birth has been used as a means to slam homebirth. I’m sure once she has recovered she will stand up and support us.

In the mean time, Nice one posting her stuff onto twitter and giving the bird to the journos waiting outside.

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Knight and Day, a fundraiser

2010-07-13T08:08:33Z

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Stateline

2010-07-03T22:51:23Z

Here is the stateline program where they talk about the coroner wanting more powers of investigation.

I am very sad for the loss of the woman in the clip, but I don’t think that she understands that it is very unlikely that they would ever find a reason for her loss, even if the coroner did a post mortem and investigation. She is only looking for something to blame for her baby’s death. The thought that no baby should ever die isn’t healthy for the continuation of the human race and just isn’t realistic.

Clutching his Large appendage.

Dr Lavender from the AMA had a small lobotomy before launching into yet another attack on homebirth, completely missing out the issue and ploughing over what could be a change with huge and devastating implications for Obstetricians.

Dr Lavender’s hatred of homebirth means he didn’t think about the implications. Very few deaths happen at home but almost 3000 babies were still born at hospitals last year. If every death in utero is investigated Obstetricians will have a nightmare. If the Coroners decision stands then GTOPS who are born alive will need to be kept alive, a PEA has to be present for an organ donation to happen right to life will have a field day.

I was surprised that a program about the coroner and the law on still birth could be so easily moved to a debate on homebirth where Lavender drops in that stupid stat from the editorial of the SA homebirth study. There are so many important issues he could have talked about but didn’t.

he has made it totally clear that his prejudice of homebirth (and I have no illusion that getting me along the way is important)means that he can’t see the wood for the trees. I also feel it is the agenda of the state coroners office making it a state government issue with homebirth too.

shoulder dystocia is an emergency that bricks and mortar don’t control, just last week in SA there was a Shoulder dyctocia at a private hospital in this state where a baby died.

I can’t imagine his Obstetric colleagues thanking him for the lack of support. It’ll probably be good for the coroners office though, can you imagine how many people they will have to employ…..

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Virtual international day of the midwife.

2010-06-30T06:33:58Z

Setting up communication for my talk

I am finally putting this up here. It’s an interactive talk that took place on international day of the midwife. The title is

Midwife Elite professional or birth servant. The history of registration and regulation is very interesting. Lots of us don’t understand that to put your hand up and go on a register is very different to being regulated in the name of public safety.

Click to play

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Absurd Birth Scenes – Knocked Up

2010-06-16T14:40:53Z

I first saw knocked up at the cinema and enjoyed watching it again for this blog post. As far as movie birth scenes go it’s actually not that absurd. However it is memorable for lots of reasons, primarily the uncommon sight of a baby crowning from the vagina.

Knocked Up or Knocked Out?

In summary knocked up is a comedy about a successful woman who becomes pregnant after a drunken one night stand with a slob. She decides to keep the baby and endeavours to build a relationship with the father. This is where most of the comedy originates as they are so dissimilar. She has an ascending career at a TV station whilst he is unemployed and living with a group of other slobs who spend most of their time smoking dope and watching porn. It generally portrays the women as uptight bitches and the men as hapless contributors.

Well I enjoyed the movie (obviously not in the class of The Jazz Singer but no where near as appalling as The Back-Up Plan), it has funny scenes that will appeal to both sexes. If you have experienced pregnancy & birth there are plenty of moments to identify with. The Ob reneging on his promise to be available for the birth, relaxing in a candle lit bath, having pregnant sex, buying books to educate the partner and many, many more. By the way, What to expect when you are expecting seems to be awful book of choice in every movie although she did buy a copy of Penny Simkins The Birth Partner too.

But What About The Birth Scene?

Firstly I must say they did a pretty good job on making the actress look pregnant. They flaunted plenty of convincing belly shots to make you wonder if the actress really was pregnant. Perhaps they used a belly double? As for the birth scene it was a standard (caesareans excluded) hospital affair, sadly more realistic than it aught to be. They went in to the hospital wanting a natural birth, but as soon as she was hooked up to the monitors and for some reason a drip, then had her resolve broken by a tyrannical ob she soon capitulated. “Whatever, do what you have to do“, she says defeated. All too a familiar story I’m afraid. I only wish it was absurd. The writers must have met an ob or two to think of nicely encapsulating the dead baby card with the who’s in charge card.

So I think knocked up delivers one of the better hospital birth scenes in any Hollywood chick flick. And showing the vagina was pretty unusual don’t you think? I’m sure it was eye opener for anyone viewing for the first time.

In the birth scene clip I’ve prefixed the moment where the Ob is demanding compliance as it is so pertinent to the birth scene that soon follows.

Have you seen the movie? What did you think? Did you enjoy the birth scene?

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