29/07/2024
My maternal Slavic grandmother was a hard woman. The type who would turn a hoard of Chechen rebels about face once they realised they were heading towards 'Vesela'. She always warned me about sinister things like whistling (which was only for boys), or adorning myself with jewellery like an anklet, lest I become confused with a Gypsy. Maybe she knew more than she cared to explain, because it turns out that clairvoyance might just be in our blood.
My first pregnancy was absolute chaos. A Placenta praevia which politely migrated alongside a million concordant ED presentations, gestational diabetes requiring insulin, a 32-hour labour with hypertonic contractions, and extensive medical management during my birth. I'd say the experience was relatively comparable to an excited tourist biting into a crunchy piece of toast, slathered with enough vegemite to fill a Baldivis sink hole. My birth plan would have been more useful as a bluey placed on the floor of the birth suite. I had to fight like a born and bred Midland local to have my wishes accommodated but had some life changing midwives in my corner which resulted in a healthy baby, and happy mum.
I decided that if another baby was on the cards, I'd be applying for Family Birth Centre.
I fell pregnant again. And then I wasn’t. Then I fell pregnant again. And it stuck.
As the universe would have it, things were boring. I prepared myself for every issue under the sun. But at each appointment, everything remained within normal limits. Beyond the halfway mark, I questioned my Oral Glucose Tolerance Test results because I was convinced that I was marinating this parasite in maple syrup. My lately appointed but perfect birth centre midwife told me to chill out. It was sage advice.
Prodromal labour started at around 36 weeks. I kept my legs shut and showed up to work every day, even with a few questionable runs of excitement that never quite established. Just as well nobody checked my boss' blood pressure because I'm sure she would have earned herself a ride to the nearest Emergency Department with access to a cath lab. At the end of 38 weeks, I walked out the door and commenced parental leave. I floundered around at home, waiting for the party to start.
The day before my due date, I attended a routine antenatal appointment. My husband accompanied me as I waddled through the beckoning purple door. I joked that it was time to stumble at the finish line because all had been going so well. After my book was handed over at reception, I took a nervous breath and headed to the bathroom to check my urine with a test strip. And what would you know? Positive for protein. And leucs! After giving the test strip the bombastic side eye and placing it in a sample container for inspection, I exited the bathroom and sat down next to my husband.
"I knew it. I'm going to meet the clinical indications for pre-eclampsia." I stared down and the two pork knuckles jammed into my Birkenstocks that had replaced my once svelte ankles. My husband looked concerned and asked what I was talking about. I explained that my placenta was being a diva, and we were about to get booted from Family Birth Centre. We might not be able to leave the hospital until baby arrived, which meant we would miss our son's second birthday... which was tomorrow.
Our midwife looked at the test strip in the sample jar and agreed with my observation. Miraculously my blood pressure was normotensive, but phone calls were made, and I was advised to attend MFAU for assessment. On arrival, the triaging midwife looked unconvinced as my blood pressure remained within normal limits. I got triaged as a 4, and waited until I could go through for assessment.
My best friend who is a doctor and has delivered more babies than packets of Tim Tams that I have consumed across my lifetime, was following along at the sidelines. I felt like we were in the middle of an unfolding K-drama, holding our breaths to see what would happen next.
CTG fine. Obs still within normal limits. But my bloods came back deranged. Elevated ALT. And some mild hyperreflexia. I asked the doc if he was going to slap me with the Pre-Eclampsia label, and he said, "yes". I asked if this means I was officially excluded from FBC, and he again told me, “Yes".
This was it! Just as predicted, we'd stumbled just before the finish line. Damn.
I was messaging my midwife to see what the heck happened now?! She was poring over hospital guidelines as we worked on a game plan. The next step was to have an ultrasound to determine the size of baby, as my last scan was at 20 weeks.
My husband accompanied me into the dark room where we were met by the jovial sonographer and lovely senior reg who was learning the ropes. I watched as numbers were entered into boxes, and percentiles calculated. Baby was estimated to be 4,700g and showed all the signs of a robust maple glazed ham - humongous torso with average limbs. I had a hunch that my OGTT results were a false negative.
Upon returning to the assessment area, I explained to my husband that the only way to fix pre-eclampsia is to deliver baby and placenta. And that leaving things too long can lead to catastrophic consequences. We waited for the consultant to arrive and advise what they felt was the best course of action to take. They said it was advisable to book a caesarean section.
We negotiated.
I explained that I wanted to be home to celebrate my oldest boy's second birthday tomorrow. I mentioned that I would like to come back tomorrow for an induction, and that I was aware of the risks associated with birthing a large for gestational age baby. We talked about variances in actual size following a late term ultrasound, and that I would be in reverse McRoberts independently faster than you could say 'turtle sign' if things went awry. I was aware of morbidity and mortality factors and stood firmly by my decision.
They agreed to let me go home, but not before I requested a stretch and sweep. The veteran midwife told me I was already at 3-4cm, and by all accounts we'd be meeting our baby soon.
After a nervous night, my husband and I awoke to shower my eldest with love before opening birthday presents. We left him in the care of my parents as we departed for hospital. I felt so guilty that I cried - all whilst attempted to express breast milk with my Spectra in the passenger seat of the car during the journey. That would have been an interesting story for our Finest in Blue if we had been pulled over.
Around 10am, we presented to MFAU.
We hung around the waiting room for a few hours until a birth suite became available. I sent my husband home to spend time with our son for his special day. I walked up and down stairs in an attempt to get labour established and set up the room with a digital radio and electric scented wax burner. I was joking with my best friend and asked if she would sneak in and perform Artificial Rupture of Membranes because the hospital was very short staffed. It was approaching 16:00 and I felt sad that I had abandoned my birthday boy to sit around and twiddle my thumbs in hospital.
Shortly afterwards, the labour ward midwife who was looking after me said she would be free to perform the ARM! She discussed establishing labour with IV syntocinon, and I flat out told her to keep that away from me. She talked about hospital guidelines in the event of failure to establish labour within an hour, and I regaled her with tales of my last horrific dalliance with the Baxter pump. My uterus was irritable enough sans synto, and it was downright furious with it. I told the midwife that I'd take my chances, and I knew the odds were stacked in favour of a c-section.
The ARM went swimmingly, and I called my husband and told him to slowly make his way back to hospital. The contractions ramped up and established quickly, but between the gym ball, breathing exercises and some bangers on SBS Chill, I was dealing with them solidly. I walked past the nurses station to refill my water bottle, and the same midwife asked me if labour had established. It was only 15 minutes since the ARM, and I told her the contractions would be kicking my arse soon and requested help to get my TENS machine on.
The TOCO showed that my uterus was fired up. Contractions were strong and rhythmic. My husband walked into the room just as the scales tipped from, "I can manage this," to "this is bu****it". The labour ward midwife gave our birth centre midwife a call, and I requested gas. I considered asking for an epidural, but everything was progressing rapidly.
It was the most incredible thing, feeling my body prepare for imminent birth. I rocked and swayed, paced, and shook, vocalised and cussed. I focused my energy on unclenching my jaw, loosening my hands, and relaxing my limbs. At some point, I stripped off my clothing and threw my TENS machine away.
As I entered transition, I became FERAL. My midwife arrived to support me in the birth suite around this time. The gas became useless, and I declared, "I can't do this!" She sweetly reminded me that I was, in fact, doing it, and I'd be meeting my baby soon. I'm pretty sure for some period of time, I threw the gas away in defeat.
Nothing mattered because I had transcended to another dimension. There, I met Jesus himself, my exuberant friend's recently departed Bichon Frisé, a greenhouse full of plants that I had lethally loved with excessive water, and every birthing predecessor in a multibillion-year line up.
Then I became quiet. I communicated in whispers. The contractions changed, and my baby began to descend rapidly. I recall whispering, "pressure," whilst my eyes remained gently closed. My midwife and the labour ward midwife immediately knew what was up, and directed me into a kneeling position on the bed. The back of the bed was inclined into a full upright seated position, and I rested my arms and head on the top. My husband stood before me and was holding my hand and encouraging me.
Shortly after, I birthed my baby's head. She cried immediately. My husband sobbed, "You did it!" This should have been such an incredible moment, but I was exhausted and ready to rocket that baby straight to her 21st birthday.
My midwife took control and directed the pace. She redirected my focus and helped me to help her deliver my baby safely. My husband recalls a glance being passed between the two midwives, and suddenly it was both midwives on deck. The ultrasound was right. My baby was big and needed Olympian level Jenga skills to manoeuvre her through her descent safely. But safely (and skilfully) she was delivered.
After labouring for 3.5 hours, I cuddled my newborn whilst my eldest would have been getting tucked into bed for the night. It felt surreal.
I was in such an exhausted haze post birth that holding my baby felt like such a feat. I cuddled her during assisted 3rd stage and daydreamed about having the most amazing shower of my life.
After golden hour, it was time to weigh my meatball baby. I knew there must have been something special about her size because the feeling in the room was electric. I was asked to guess how much she weighed.
"4.2kg?" I asked hopefully. I knew a baby that size or smaller meant we could go home tonight pending assessment by the doctors.
"Higher." said my midwife.
"4.5kg?" I guessed again. 4.5 kgs was big for a newborn, so I couldn’t be far off.
"Higher."
Oh dear! My third and final guess was 4.8kg.
Wrong again.
My midwife read out the figure. "5.090kg." Or 11lb 3oz in old timey numbers...
There was excited laughter whilst I quietly connected the dots between gestating a parasite that size without diabetes. It seemed crazy.
The ward was busy and finding a doc to assess me post 2nd degree tear proved tricky. Eventually, my two midwives nabbed a doc and lead them into the birth suite where congratulations were exchanged, and general chit chat ensued. The doctor commented that trauma was minimal, and their job was very uncomplicated as a result. I was glad to hear that during the stitches because I was looking forward to being as minimally inconvenienced as possible. I watched an excited grin cross my midwife’s face as she asked the doc to look over at the crib as meatball was presented. I think the doc's eyes nearly popped out their head as they asked, "Is that your baby?!" as the 'over 5kg' announcement clicked.
My placenta weighed in at over a kilo. It didn't fit in the receptacle that was designated to hold it and was a sight to behold. I think it did the rounds between the nurses before finding its forever home in the incinerator. I kind of wish that I had a photo of it.
Meatball was very sleepy and not interested in feeding. The plan was to transfer us to the ward, but not before my sister and her partner showed up wearing matching sailor outfits after hosting the 'Western Australian Seabird Rescue' charity quiz and auction night.
Meatball and I remained in hospital for a couple of nights until she was able to regulate her blood sugar well. I was in such fine form that I happily drove home after my mum arrived to help me lug bags and a newborn into the car.
A+++++ 5 stars. Highly recommend this seller.
*** For you beautiful birthing people who have been told your baby may be large for gestational age, take some time to learn about common complications, and ask your midwife for advice. Make an educated plan and go with the flow. Don’t feel terrified into booking a C-section. My pelvic floor was in excellent condition after a controlled, slow birth, and I had less stitches than fingers on both of my hands. This is a stark contrast to my first birth which included an epidural and episiotomy – I was doubly incontinent for 6 weeks! I hope that every birthing person can walk away from their experience feeling as elated and supported as I was, even given the crazy unfolding of events. Your birthing preferences are valid, and you deserve support and education to make an informed decision. ***
