In March 2009, I gave birth at a baby friendly hospital(1, 2) - since 1998, all hospitals in Sweden but one was baby friendly. I remember leaving the maternity ward and having an ice-cream and a cup of coffee in cafe of the woman’s clinic with my family and seeing the plaque:
“This is a baby friendly hospital and at this café everyone is welcome to eat! Please respect breastfeeding mothers!”
It felt good. I sat down and nursed. A few people passed. They smiled. Another mother complimented my grip, saying she wasn't able to do "that" (eat and nurse at the same time) until her first baby had been much older. My BB was 2 days old and beautiful.
But I'm fast tracking.
I had a medicated birth, I'm the first to admit.
My baby had been in breach position to and fro in the last weeks before she was born in week 41 +2 and my blood pressure had been a tad high during those last weeks. I'm also overweight. I had planned on working until week 38, but after an intensely stressful day in week 36 I called my boss and said I'd take my maternity leave from then on and went home to wait. And wait. And wait. February the 28:th came and went. My mother had her first four children about two weeks earlier than her due date, and my grandmother said it was the same for her, but pointed out the last two were twins and therefore didn’t count. So I had expected not to make it to my due date.
It was Sunday evening around 6 pm that I felt my first contraction. I never had one before. I never felt any of my Braxton Hicks contractions so this was my first feel for labor. We waited, and they didn’t die down. We timed them online and they were irregular. So we called in to the labor ward. “It’s not very busy here said the midwife. You can come in if you want to.” Me and my partner got into a cab and had a smooth ride over. Somewhere between 10 pm and 11 pm the same midwife I talked to on the phone said “If these contractions has actually dilated you, you are in for an easy ride.” I nodded. She asked if I wanted her to check. “Yes please”
She had big hands.
Almost nothing had happened. We went home, a bit giddy. When I stepped through the door at home the world rocked. I wanted to pee so BAD but my body just locked in a contraction that made me laugh, jump around and be in agony at the same time. “Ineedtopee!!!”
We spent some time at home, I think my partner had a nap between 1 am and 3 am, then we had some fish fingers and pasta and I spent some time in the bath while my partner timed my contraction from when I screamed “NOW!” and put my head under water until the next “NOW!” It just kept coming, wave after wave of intense pain, starting in my back, reaching around my belly. We called in again before 6 am. Said I wanted to come in again, that I wanted pain relief. “Eat breakfast and come.” Was the answer. We were there at 6.43 am Monday. My first Midwife was named Solveig Jansson.
At 7.20 am the cervix was 2 cm long and I was dilated 1 cm. I was hooked up to the fetal monitor. I had actually thought about not using one but now I was absolutely fascinated by it. My contractions came with about 3-6 minutes intervalls. My baby's heartbeat was 130, and my own was 80. They informed me that I was in the latent phase but that I could stay for the doctors round. I don't remember meeting the doctor and I actually think they just let me stay because me contractions were so painfull.
I came of fetal monitor and most of the time I spent walking around, saying YESsssss…..in a low husky voice whenever contractions would grip me. At 11.20 am I was open 3 cm, and the cervix was 1 cm.
At some point I was asked if I wanted my membranes ruptured and have my babies heartbeat tracked with a scalp electron instead and to my surprise I yelled “YES!” and just gave this BIG SMILE. I was alone with the nurse, don’t remember why since my partner almost never left my side. It was such a great relief to have my membranes ruptured and the water come out. I told her thank you. She looked surpriced. After the scalp electron was placed I wasn’t hooked up anymore but roamed freely.
For pain relief I used:
- Nitrous Oxide inhalations: I started with a 50/50 mix with oxygen at 11:40 am monday. At first it helped, but I have mixed feelings about it. It made me funny in the head and I think some of my weird thought was because of it. Midwife said I spoke of chipmunks and Danish people. I overdosed quite a lot and have bouts of amnesia that went on for hours. Had I been able to control myself I would have less side effects.
- Acupuncture: It worked, but not a lot. I liked it.
- Bath: I took a bath 5 pm but it was HORRIBLE! Hated it. Hated getting naked, hated getting in, tried to drown myself in it, hated getting up, being wet. Not doing it again during labor this bad. Don’t know why I insisted on trying it. I was desperate.
- I had sterile water injections placed under the muscle in my back to alleviate the back pain. I liked this too. The time was 10:30 pm monday.
- Positive thinking helped a lot, thinking how the pain was leading up to something, getting results.
- I also had a epidural(3), more about that below.
At 3 pm I had my next midwife, Christina Johansson, since Solveig had to go home. My contractions came at 4-5 minutes intervalls. She has written in the journal that the head was somewhat jammed (but in medical speak) and above spinae.
Then, at 6.30pm I had given up and had the epidural. I had written in my birth-letter that I was open to having the Epidural but I wanted to be the first one mentioning it. And I did. I begged for it as soon as I was open enough. Swedish midwifes has to have a doctor order the epidural and an anestheisiologist come down and place the cathether. It took a while to get into effect. At first it took away all of my pain. This kind of epidural is called a Sufenta-Eda 5ml/h, a "stand-up-Epidural" designed to allow the mother to be able to move around. The drugs used are typically bupivacain(4) and fentanyl (5) One of the nurses asked me to pee and I headed for the toilet. I couldn’t so she gave me a cathether. With the pain subsided I had a hospital dinner, I think it was fish and potatoes.
Well, you can guess what happened. Contractions slowed down & I was put on a ocytocindrip at 8 pm. We started 10 units of Syntocinon in 1000NaCl at 20ml/h at 8pm and cranked it up to 60ml/h at 9.15pm (the midwife told me we could “back down” if it became to intense). I met my next midwife, Magdalena Göthberg, at this time. She brought a student, Annika Strand.
And there was the PAIN again! All the Epidural gave me was time to eat. My back labour was back with a vengeance. I think this was around 10 pm monday so at 10:30 I had the student, supervised by the midwife, place the sterile water injections. They told me it would feel like bee stings, a fitting description.
At 11.05 it was noted that my epidural cathether was causing a bleed. Maybe this was the reason it no longer helped? It was fixed by the anestheisiologist at 11.50pm but he said it was working. He also gave me an extra shot of painkillers into the epidural pump but I never felt any effect.
I inhaled my Nitrous Oxide, screamed for a birthing chair and was gone. When I returned several hours had passed. I tried asking people what was going on, they didn’t understand that I had NO MEMORY of the last few hours. It was time to push, it took me 25-35 minutes of pure POWER, but I was too weak to change position so I gave birth lying on my back with my legs in the scaffolds.
And when I pushed one last time, my baby girl came out and the world turned NORMAL in the blink of an eye. It was ok. I threw away the breathing mask and reached for my child. We had asked for them to wait with severing the cord until after it stopped pulsating and they respected this. Delaying the cutting of the cord is new in Sweden but has spread rather quickly. You can also donate blood in the cord to the umbillical vord blood bank but then you often cut it immediately.
- http://en.wikipedia.org/wiki/Baby_Friendly_Hospital_Initiative
- http://www.who.int/nutrition/topics/bfhi/en/index.html
- http://en.wikipedia.org/wiki/Epidural
- http://en.wikipedia.org/wiki/Bupivacaine
- http://en.wikipedia.org/wiki/Fentanyl