THIS IS A GREAT STORY IF YOU ARE FEELING PRESSURE TO INDUCE YOUR BABY AFTER 40 WEEKS – But still don’t want to but are willing to explore “Natural” Ways of Inducing your baby.
What must carry the most weight in Scout’s birth story is not the birth itself, as that was quite short and incredibly sweet, but rather the story of the wait for her to decide when she would come into the world. From the start, the pregnancy progressed perfectly. We had planned a home birth, with Jane and Robyn the attending midwives. Our rather traumatic experiences with the birth of our first child Eddie, which had been planned as a Birth Centre delivery, but had ended 20 hours later, after a botched episiotomy, in the labour ward of King George with suction and an unnecessary three day stay in the nursery for our son, had convinced us of the risks of giving birth anywhere near a hospital.
We were in no doubt of the healthy female body’s innate ability to successfully give birth, and we were all too aware of the medical establishments predilection to interference and overkill, and their disdain for the natural (after all, they want to be needed). This time we were determined to have nothing whatsoever to do with the hospital, and up until week 41 we were completely successful. That was when we approached the danger zone of being ‘overdue’. If we had been in the hospital system, at that time there would already have been intense pressure for an induction. Eddie had also been overdue by about 12 days, and labour had actually started the night before a hospital induction was planned.
This time the midwives were aware of Pernille’s tendency to go over, and our due date was thus calculated, using the dates of a positive and negative pregnancy test, as well as the highly probable day of conception. This date was 10 days later than the hospital’s rigid and totally inaccurate method based on the last menstrual date, and was to become a major factor of contention later on. As we approached 41 weeks by our reckoning, our midwives recommended that we begin regular ctgs and scanning at the hospital. We were apprehensive to say the least, but caution (or was it fear?) got the better of us, and we decided it was wise. A big problem for us was to keep an objective distance to our own decisions, as we were heavily influenced by our previous experiences.
On the Thursday after, at 41+5 days we found ourselves at KGV. The nurse at the hospital, to our surprise, was supportive and friendly. The results were perfect, showing a healthy, reactive baby and a deep pool of amniotic fluid. There was simply no reason not to continue waiting.
We left the hospital a little disappointed that we had needed to be ‘monitored’ but relieved that all was as it should be. The next day at the midwife we were made aware of the statistical risks of going overdue, but to my ear they sounded very small compared to the risks and complications associated with inductions. An induction as well, we realised, would mean the end of any chance for a home birth. Robyn spoke of deciding where our ‘line in the sand’ was, but we were having trouble drawing such a line. We just wanted to wait. We couldn’t imagine at this point that we’d ever get to that point. Over the weekend we began using natural methods of induction, but only in a half-hearted way. We began with the usual. Walking, sex, aromatherapy with Clary sage, massage.
Pernille could sense that labour was close, but not imminent. But the weekend came and went, and still there was no movement. We rang to make an appointment for another scan on the Monday morning, but decided to make it for late Wednesday to give ourselves a few days breathing room and to avoid the pressure we felt was coming our way. A birth we had not at all envisaged was beginning to seem more of likelihood than a mere possibility, and this sudden, disturbing realisation spurred us into immediate action. We began to get serious about ‘natural’ induction. Despite this term being a complete oxymoron, we saw these methods being very natural as opposed to the chemical methods available in the labour ward. All in all it seemed to be the best way forward to achieve our desired outcome.
We arranged for an acupuncture appointment that afternoon. After that and a long walk, Pernille got mild contractions that evening, but after a few hours they subsided and disappeared. Pernille was starting to feel the stress as well, and her emotional state took a sharp dive. The fears of ending up with interventions and dubious medical outcomes began to plague her. I tried to reassure her but I was just as worried. Tuesday rolled around and we began to leave the phone off the hook, to avoid family and friends too impatient to wait for news. We had an appointment with Jane that day. We were 42+3. There was more talk of statistics and lines in the sand, and she recommended we book an induction for Friday, even though she was confident we would go before. We were forever trying to push things into the future, and wanted to book for the Monday if an induction was to become necessary. Jane massaged evening primrose oil on Pernille’s cervix and found that it was already 2cm dilated.
I still felt at this time that we should not go over 43 weeks, which was on the Saturday, but Pernille was not so sure. Her deepest instincts told her that the baby was fine, and she told me she could not be sure she would even agree to an induction on the Monday. I was quite emotional that afternoon, as my deepest fears were uncovered. While Pernille rested I went on the Internet and began to do my own research, so I could form a more balanced opinion; one not based on fear. Slowly that afternoon my fear receded, and in its place grew a trust in Pernille’s instincts, a trust in the female body, and a renewed scepticism of the motives and validity of hospital methods and arguments. I found well-researched reports that completely contradicted the statistics I had been given. I found food for thought that slowly, subconsciously was turning my attitude 180 degrees. That evening everything was on the menu. We began to worry we might be overdoing it. Acupuncture, walking, sex, aromatherapy, massage with Clary Sage… The poor baby was being bombarded with pressure to come out, despite our own deepest wishes.
That night we went to sleep that night worrying about the next day at the hospital. Wednesday morning was for more acupuncture, which again had Pernille feeling something was happening. We arrived at the hospital that afternoon in a tense state of mind, and the attitude we received was also notably colder. Again the ctg showed an active, happy baby, and the scan had also positive results, despite the fact it took them nearly an hour to get what they wanted (because our baby was moving so much :)). But good results were not enough for the hospital. It was obvious to me by the demeanour of the hospital staff alone, that a positive ctg and scan had no influence on their attitude. We had suddenly landed in a war zone.
I thought immediately of the report I had read the day before. A Scandinavian researcher Bergsjø had written: By introducing routine intervention, we tend to dismiss our clinical watchfulness . . . Our most common sin is that we do not pay attention to clinical detail … We were made to wait almost an hour for a registrar to come and talk to us. By this time, after three hours in the hospital with a tiring toddler, I began to feel very stubborn and hardened my mind to what I knew was coming. Then the doctor came and opened his mouth and set my stubbornness in stone. He started by saying we were 44 weeks. We corrected him to our due date on the papers, and much to our surprise and disgust, he tried to attack our midwives credibility saying they were not accredited at the hospital and that we were in fact 44 weeks. After arguing with him on this issue, he changed tack. Even if you are 42+4 he said, we still want to induce you. Tonight.
Using his best authoritarian medical voice he spoke of grave dangers without citing any statistics and intimated we were being totally irresponsible about our baby’s welfare. In the end he told us we were taking the responsibility in our own hands (where we wanted it all along) and that it would be noted on our file that we were going against his best medical advice. I was furious. To be talked to like idiots was one thing. To be subjected to their invasive tests and them have them totally ignore the outcomes of those tests was insufferable. He even admitted that induction at 42 weeks was a “convention”.
Pernille was quite distraught and found her resolve weakening by his tough talk, but by this time, I would have none of it. I reassured her in Danish that I would support her 100%. We told the doctor we would not be inducing our child today, thank you very much. To placate the head midwife in the birth centre, who was very friendly and was aware that we wanted a home birth, we booked an induction for the following Monday. It was arranged that even in the event of induction, it was likely the birth could still take place in the Birth Centre. We fled the hospital upset and angry.
Little Eddie was also very upset by this time, feeding as he was off our palpable tensions. I spent the evening on the Internet, continuing to voraciously reading scientific reports, birthing web sites and anything else I could find on the topic. I found a wealth of material, some very supportive of our position, some not so. The end result of my research though, led me to the firm conclusion that if there were no indications to suggest the baby was in distress, the best option was still to wait. After a long discussion with Pernille, we decided that even if we went to Monday we would not induce unless the tests showed there was a reason for it.
Pernille rang Jane to talk about their line in the sand. Her response was that she needed to think about it, talk to Robyn and get back to us. Being professional private midwives practising homebirths in the currently ‘somewhat hostile’ climate must be a balancing act of supreme skill and caution, and we were aware of the tightening corner they found themselves in. That they must have a line in the sand was therefore perfectly understandable to us, but it left us with the increasingly real possibility of being stranded without support. Chances were we had only 4 days left of support. What the hell, I thought jokingly. Unassisted Childbirth always appealed to me… Before bed I massaged Pernille’s belly with Clary sage, but we couldn’t muster up the mood needed for sex. Again we had trouble sleeping but eventually drifted off into a disturbed slumber.
As fate would have it (or Scout in any case), Pernille woke me at 3.30am the next morning to tell me ‘we were away’. A wave of relief swept over me. In some corner of my mind though, I was upset that it had come to this. Deep down we wanted Scout to come on the day of her own choosing, and I felt that our stress and induction attempts had definitely contributed to her choosing this day. On the other hand I was deliriously happy to have avoided the hospital’s somewhat brutal methods.
Natural induction was what it had come down to, to avoid the hospital’s interference, but I was inwardly seething that we had to do anything to avoid their meddling. I started to prepare to fill the birthing pool we had sitting in our lounge room, but Eddie woke up, and so I dressed him and took him to his ‘support person’, our neighbour Samantha. Upon returning, labour had progressed rapidly and considerably, and I abandoned my efforts to fill the birthing pool. Instead I quickly rang the midwife. To labour at home was very calming, despite the intensity, and the wash of relief we had both experienced left us full of energy for the task. I held Pernille’s weight as she hung off me, and between contractions she rested on the lounge. The contractions were coming fast and furious.
It was a pain a lot more intense than Pernille had experienced with Eddie, and already after an hour or so said she had the urge to push. As our only previous experience of childbirth was a twenty hour labour, we were very surprised, and I suggested she try and hold it a while, but then Jane arrived and told her to ‘go for it’. It was first then I realised the birth of our second child was imminent.
Robyn walked in the door as the head was crowning, and I relocated to take delivery of our baby myself. As the head came out I cradled it in my left hand. Then, while Jane slipped the cord over the head, I positioned my other hand for the arrival of the body. With the next contraction, in an incredible gush of blood, vernix, and heat – with a rush of life itself – our little daughter slid out into my waiting arms. ‘It’s a girl’ I cried, amazed. All the time we had been expecting another boy. I passed her up to Pernille. She cradled the little girl gently at her breast. At first she was not breathing, but no one panicked. We wafted oxygen under her nose to encourage her to come into herself. After less than a minute, her colour came in and her dainty cry filled the room. Of course, we could not control our tears of joy.
The placenta arrived quickly, ten minutes later, perfectly intact and totally free of calcification (a sign of post maturity). The baby, likewise, was well covered in vernix and the amount of wrinkles on the soles of her feet did not indicate post maturity at all. She was perfect, and not a day overdue. Born on the 4th of July I thought with a laugh. We did not weigh her that morning, choosing to let her rest peacefully in her mother’s arms, but the next day she clocked in at 3.820kg. A healthy size, but certainly not overly large. Particularly in respect to her mother being from Denmark, where newborn babies are regularly up around 4kg. Pernille bled quite a bit with the placenta, but again the professionalism of our midwives shone through. There was no panic whatsoever, and within a minute the bleeding had stopped. Shortly after the baby decided it was time to feed, which she did contentedly for over 30 minutes. I went and collected Eddie and brought him to meet his little sister. ‘Baby’ he cried when he saw her, and raced over and gently touched her on the nose. ‘Nose’ he said. With much obvious affection he placed a very sloppy kiss on her head. Everyone smiled.
Between then and now I have had much time to reflect and be thankful that we avoided that which we feared the most. Of course, it is not to say that a hospital outcome would have necessarily been a disaster, and if there was an emergency you couldn’t get us there quick enough. But a natural home birth was what we were after; confident as we were that natural childbirth, if left to its own pace, would deliver us a beautiful and healthy child. The only trouble was avoiding the ‘inductionists’ long enough to let it happen. Scout was born at 6.44am on the 4th of July 2002. By the hospital method of calculation, she was 44 weeks and 1 day. By our calculations she was 42 weeks and 5 days.
Waiting for Scout by Geoff Powell