Lennart's Birth Story - an induction of labour
This is my firstborn Lennart's birth story. I share it with you as it is a piece of me and my story as a doula - his birth is the beginning of who I am and what I do today. But I also share it as it reflects the reality of what can be involved in an induction of labour which every woman who is considering this process should be aware of. I also think it is a helpful example of how lonely, lost and unsupported a birth without a doula can be. I have no doubt in my mind that a doula would have improved my overall birth experience. But it is also a story of strength, the strength of a mother who was ready to embrace anything thrown at her with a positive mindset to birth her baby. My baby boy.
4 years and 2 days ago Lennart’s birth story began. I was admitted early in the morning at the Royal Hospital for Women in Randwick to begin my induction process as I was 9 days ‘overdue’ and had one elevated blood pressure reading at the end of an appointment with a doctor that had annoyed me. I remember feeling excited and totally trusting towards the process - I went into birth completely fearless, not for one second did I doubt that I would be having my baby in the most natural way. I had done a lot of pregnancy yoga, attended hospital antenatal classes and had the approach of ‘going with the flow’. Lennart was born some 58 hours later - we were under informed and naive.
After admission to the prenatal ward a doctor examined me and administered the first dose of Prostaglandin gel with the aim to soften my cervix. I was given 12 hours and if my cervix was not dilated enough at that point to be able to break my waters (about 3cm) they’d offer me another dose. Fairly soon I began to have intermittent contractions which made us feel excited and we went for a walk around the hospital carpark where Ben was timing them and I joyfully embraced every contraction at about 3 minute intervals. This was going well! They were manageable but I remember at some point during the day that when walking I had to stop and breathe with focus. 12 hours later I had my next vaginal examination and was told there was ‘little to no progress’ to my cervix. Oh well! I still felt positive and completely at peace with whatever the medical professionals suggested that had to be done to have my baby. A second dose of Prostaglandin was administered and by then the skin of my vaginal wall was irritated and burning strongly. Contractions still about every 3 minutes but not necessarily intensifying. I was given pain medication and told to sleep overnight. At every shift change a doctor would come in and ask me to do a vaginal exam to see where I was at and if they could ’stretch me’. It seemed like a little competition amongst doctors and I did not know that I was allowed to decline vaginal exams. The next morning arrived and after another check there was still no progress. Another dose of Prostaglandins was administered. My insides burnt like hell without labour having started. We walked around, stayed positive and in the afternoon a doctor suggested to insert a Foley catheter. This is a balloon which is inserted through your cervix, then inflated with the aim that the additional pressure will dilate the cervix and fall out at about 3cm. I was transferred into a small theatre onto a gynaecological chair with stirrups and the doctor attempted to insert the catheter several times without success. I remember it being extremely uncomfortable and for the first time thinking ’this is a lot different to how I pictured my baby to be born’. My cervix was at 2cm at this stage and the doctor suggested to leave it until the next morning and with a bit of stretching she was confident to be able to break my waters. Again, I was given strong pain killers and a sleeping tablet to get some rest as ‘I would be having my baby the next day’. I remember lying in my hospital bed late in the evening, trying to relax, be joyful whilst next to me was a sobbing woman who had started to miscarry at 20 weeks. I put my earplugs in and eventually fell asleep.
The next morning we were transferred to the birth suite bright and early and things started to feel real. I decided to have a shower before the doctor would break my waters and told Ben to get some coffees. I was on my own in the bathroom of my delivery suite under the shower when I realised I needed something out of my washbag. As I waddled over the wet bathroom floor I slipped…and fell with full impact right on my belly. I will never forget the horror of that moment in my whole life. I immediately felt amniotic fluid gushing down my legs as I had broken my waters during the fall. I don’t quite remember how I got up but I somehow managed to run to the door, open it and scream ‘I had a fall, I had a fall!’. The room immediately filled with about 6 people asking me to lie on the bed, a doppler monitor used to find my baby’s heartbeat but to no avail. At that stage someone started inserting a cannula into my right hand whilst a doctor inserted a fetal scalp monitor to Lennart’s head and someone else began to ultrasound my belly. It was hectic and I do not remember anyone telling me what they were doing. Once the ultrasound was on they identified Lennart’s heartbeat and things began to calm. Poor Ben appeared in the door with two coffees in his hand seeing his naked wife on the bed surrounded by doctors and midwifes all hooked up to the monitors. It’s safe to say my zen was gone by that point. I was monitored for about an hour and since Lennart’s trace was reassuring the next stage of the induction began by hooking me up to the synto drip to get my labour going. They told me I was the first woman who had broken her waters in the birth suite the way I had done.
I remember lying on the bed with my contractions slowly intensifying but I was still chatting to Ben and we had somewhat calmed our nerves. The midwife kept coming in every half hour to increase the dose and said she’d know we’re in business if I wanted to be up on my feet and stopped talking. I still couldn’t really imagine at that point what would feel like but this changed very quickly. After about 2 hours on the drip my contractions were on top of each other and I was on the floor, on a ball, doing everything I could to somehow manage the fast increasing intensity. My midwife was friendly but sat in a corner on a chair and took notes. I do not remember her coming close to me, perhaps put a hand on my shoulder and telling me I was doing well or giving me any form of reassurance. My husband felt increasingly lost, not knowing how to help me or what to do and I remember feeling so very alone in this whole situation. The contractions did not stop, I remember staring at the clock thinking ‘it’s just 60 seconds, you’ll get a break then’ but they just did not stop. I did not know in what position to be in and was lying on a mat on the floor at that stage unable to move. I asked for gas. This made things even worse, I hated how dizzy it made me feel, even more out of control and began to vomit. I was lost. I had wanted to birth my baby drug free, intervention free and here I was, lying on the floor, staring at the clock, unable to move and thinking ‘I’m going to lose my mind’ any second now. I asked for an epidural.
The anaesthetist came after about 45 minutes and I still to this day do not know how I managed to sit still on the bed whilst he administered the epidural, contractions still on top of one another. Before the anaesthetist started checking the effectiveness with an ice cube I remember feeling a strong pressure to push which I told them but they said it was best to give my body an hour and so they left us. The epidural did its thing and so Ben and I sat on the bed chatting, I had no sensation whatsoever anymore knowing in about an hour or so we’d meet our baby. We chose some music we wanted to play and it was the most surreal contrast to what had taken place less than an hour before.
After an hour the midwife came back in and said ‘Right, it’s time to have a baby!’ and told me to do a bit of a ’trial push’. As soon as I began pushing Lennart’s heart rate went down, drastically to around 50 and didn’t recover afterwards. I remember once looking over to the monitor, seeing ’54’ and hearing beeps with a VERY long pause in between. Once again in what seemed like seconds the room filled with people, lots of them, and I remember Dr Andrew Bisits came into the room and put a hand on my shoulder (he was the first and only one to do that to me on this day) and said to me ‘Your baby is struggling, we need to make sure it is born as soon as possible’. He was very calm. A forceps was prepared and he stood behind a female doctor who used the forceps and quietly gave instructions to her. I was told to push and without feeling anything I pushed with all my might - Ben said he saw the veins in my eyes exploding. An
episiotomy was performed and I would end up with two further long second degree tears. As his head appeared they said his cord was wrapped around his neck and they cut it there and then before he was fully born. Anyhow, in less than five minutes they pulled Lennart out of me and I remember as the doctor held him up I bursted out ‘Oh my god is he big!’ (he was 4.5kg). He was placed on my chest but taken away again to be looked at by the paediatrician as his colour was a little blue. I immediately felt joyful, happy, elated…throughout of this I never for a second had thought that my baby could not make it. I smelt his head and thought it was the sweetest, best smell in the world…like strawberry fields or something. I felt my mother instinct for the first time in my life and it was the strongest instinctual experience I’ve ever had. I felt like a lioness and protected my cub fiercely from that moment and forever.
It was about six months after my birth experience when I started to look into becoming a doula. The need for support, education and care during pregnancy and birth was so evident to me and I began to learn and inform myself about birth, hospital protocols,
options - something I should have done before my birth. I struggled with guilt for having agreed to an induction with so little knowledge about its risks and what is involved and it was during my training when I fully understood what had happened and what perhaps should have happened instead. The choices I had which were not necessarily presented to me.
Today I know that my birth experiences make me the strong and passionate support for women and their partners that I am. I have seen the realities of birth and my desire for others to have the most empowered, informed and supported birth experience is what will always drive me. Despite or probably because of my highly medicalised births I believe and have trust in the natural process that birth is.