Birthing From Within

I have had such an interesting journey in just the last few days that I am curious about what is unfolding for me this time around.

I mentioned in my last blog that I was about to start work with a doula. And work we did. I have chosen to have a doula present at this birth for many reasons, but primarily because I need there to be one person there intimately familiar with birth and able to support both my hubble and myself as we journey this next precious little soul into being. My choice was made easy by finding a woman who is deeply spiritual, strong and earthy, like a tree with muddy roots, and with a mothering energy that easily moves into warrior when the need arises. I need that and I trust that. She has already taken me to some deep places and I am grateful for the work that we are doing together, even when every atom of my being tries to shut down and run in the opposite direction rather than face the anger and the sadness that run so deep in me.

In addition to this work, the hubble and I had an almost child-free weekend as we embarked on our Calmbirthing journey with the gorgeous people from About Birth. The lovely Lael has been a friend for a good few years now and I am always amazed at how deep she can take me with just a few intuitive comments. Our calmbirthing classes were amazing and in just those few hours spent with lael, something deep within me shifted. I finally allowed myself to see that not all of Lily's birth was a failure, which is how I have most often viewed it and where much of the grief around motherhood stemmed from. Some tiny prompt from Lael sat with me all that first night as I practised the calmbreath and somewhere, in the depths of the night, an amazing insight arose. My birth with Lily was difficult. My waters broke at 11.30pm at night and I went straight into the most intense and excruciating pain I had ever experienced. And no, I'm not exaggerating. The problem was an undiagnosed posterior baby and so I was sure that something was 'wrong' with me, which sent me spinning into fear. Fear is not a good labour companion. However, in the next 6 hours, I managed (without any professional support and with only two beloved but equally bewildered loved ones present), and deep in the grip of both terror and pain, to dilate to 5 cm. Basically, the hardest centimetres to dilate are the first 5 and I did it whilst fighting tooth and nail instead of surrendering to the process of birth, which I might have been able to do had anyone told me that what was happening was normal and not a potential disaster. Now, this might not sound like much but what occurred to me was that if my amazing body was powerful enough to still dilate to 5cm, while flooded with adrenalin and with me unconsciously working against it's every physical need, then what might it have done if I had felt safe and had been able to surrender? It might not have made a difference to the amount of dilation, but it would most definitely have made a difference to the amount of pain I experienced and to the fear and worry I journeyed with. And so, with some astonishment, I finally realised that I had done amazingly well to get so far without help and without guidance regardless of all the interventions that followed. If there had been one person there who could have told me to change positions, to try and breathe with the contractions, to stay calm - I may have been able to do it all without intervention. However, that was not mine and Lily's birth journey. But it reassured me that no matter what state I am in mentally, my body still knows what to do and how to do the work of birthing. If I can simply show up and try to remain calm and not let the fear take me, then this birth can be everything I want it to be, even if I end up having to take a different route to the one I planned. As Lael put it, "it's not where you birth your baby, but how you do it that counts." If you are present and calm, then that baby will have the best entry into the world, even if your choices are limited by unforseen circumstances, and she should know. She's had it all in birth - a forceps delivery like mine, a beautiful home waterbirth and a last minute caesarean with a footling breech in severe distress. It gives me hope and with hope comes a feeling of anticipation. A feeling of almost looking forward to the journey of labour and birthing as an opportunity to complete the journey.

It's also interesting that this past week, in the lead up to my calmbirthing work with Lael, has been an exercise in facing many of my fears for this pregnancy head on. During my last midwifery appointment, while they were measuring my belly, the midwife got that look on her face that every woman dreads. It's a mixture of confusion, worry and tension that leads them to say, 'I'd just like to get a second opinion on this...' before returning with a second midwife. The reason for the concern, as it turned out, was that the first midwife couldn't get an accurate reading on the bump due to, what she thought, was an excess amount of fluid around the baby. The second midwife, whose hands were soft and warm and gentle compared to the hard poking hands of the first, measured with ease and gave her opinion. There was some discussion about the amount of fluid and whether it was 'too much' and the second midwife seemed unperturbed but said come back in two weeks rather than four and we'll see how we are doing then. Now the upshot of all of this is that I then confronted the first midwife with a few questions designed to get to what the problem was. Reluctant though she was to share. It turns out that there is a condition called 'hydramnios' or 'polyhydramnios' which is an excess of amniotic fluid in the third trimester. Apparently, amniotic fluid increases until around 34 weeks and then slowly decreases towards birth. The worry with excess amniotic fluid after this time is that it 'can' cause some birthing issues such as a cord prolapse during labour or placental abruption. The baby is not in any danger due to the excess fluid in pregnancy but there is also a risk that the excess fluid indicates a problem with the baby - such as chromosomal difficulties or a gastrointenstinal blockage causing the baby to be unable to swallow the fluid as they normal do. I wasn't sure what to do with this information so late in the pregnancy, so I left it at that and went home. If there is still excess fluid next week, then I will be referred for a sonogram to measure the amount of fluid and check the babies development. Once that has been done the results will dictate what sort of 'risk' I present to the birthing centre and I may be referred over to the main hospital for the birth, reducing drastically my risk of having a waterbirth.

It's a lot to take in. Possible birth defects with my child, the risk of another highly interventionist birth and of being potentially encouraged towards a ceasarean to prevent calamity. All of my fears - BANG! - right there in my face at 32 weeks pregnant. And I didn't spin out. I'm quite proud of that. This is not to say that there is not niggling worry but I simply chose to remain focused on the outcome I want for this baby - a gentle birth - and allowed myself to recognise that, as I have no control over the ultimate outcome at this point, there is no sense in worrying myself to death about it. What I feel instinctively is that I am being given an opportunity to face these fears, deal with them and let them go, come what may at the conclusion. I can only be present with the 'what is' and allow the journey to unfold with as little stress from me as I can manage. What I can do is remain present with this little one, realise that the medical profession, including the midwives that work in the birthing centres, are educated in a culture of fear regarding birth and that any possibility of risk, no matter how remote, will cause them to take appropriate steps to prevent danger to mother or baby. That is their job. It does not mean that what they fear WILL happen, just that they must take precautions against the 'what if's'. I can live with that. I have to. What I don't have to do is take on their fear. My feeling at the moment is that the baby is fine. I am fine. I carry a lot of water in pregnancy, just like I did with Lily and, as I had a private midwife then, it may be that this is what it was like with Lily but no-one noticed or it didn't concern them enough to mention it. I do remember having a very late scan (due to choleostatis in late pregnancy with Beanie) and it showing that she had an olympic sized swimming pool to play in even though she was overdue.

So, what else can I do but trust that this is part of the journey, a gift of fear to move through and an opportunity to shift yet more uneccessary silt before the real work of labour and birthing this child comes into play. I am learning the uncomfortable art of sitting with all that is unknown in my life and learning that all I can do is breathe, trust, pray and wait. What will be, will be and I cannot know why, or where this path will lead me until I arrive.