... Hana's story continued
On Wednesday (Jan 9th) late morning, John and I went for a walk to
a local park. Before leaving the house, I realised there is some sort of clear
fluid trickling from my vagina. I wasnít sure what is going on, but I was
suspicious this may suggest amniotic water is leaking. I called Marijn to
discuss this question. She agreed to drop by, to check me before a planned visit
at the Queen Charlotteís hospital antenatal clinic in the afternoon. It appeared
to me, leaking had been going on since the early morning but it was rather
little earlier on, so I interpreted it as being cervical discharge following a
membrane sweep from the previous day.
During our walk to the park, trickling of fluid started to be more obvious. I
also started to perceive mild period-like contractions. Contractions were having
a different pattern than the Braxton-Hicks ones, occurring most of the previous
nights; these contractions were quite short and more intense and more resembling
my "normal" period pains but, at least from my perspective, of very low
After the walk, we had a lunch and almost immediately after that Marijn came
to see us. We agreed that the leak is indeed most likely a spontaneous rupture
of membranes; fluid trickling rather than gushing is related to the hind water
leak. We also decided, there is no need to go to the hospital as Iíd rather
await any further development at home. I was concerned travelling around may
interrupt any pre-labour process. Subsequently, I cancelled the hospital
After Marijn left, we went to shop to Morrisonís. Contractions were slowly
building up and were getting stronger. From time to time, I felt sharp pain at
the bottom of my womb. John and I had an evening meal and then John put together
a birth pool. Contractions started to feel more as my "usual" period pains, but
still not at the level of maximum intensity. Today, it is difficult for me to
describe the evening development, because I forgot most of it. I remember
observing prodromal signs similar to those appearing close to the start of my
period pains. But, as I canít pinpoint these prodromal signs, which are feelings
of "something" is going on rather than specific symptoms, it is also difficult
to describe what was happening. We went to bed at around 11PM, but I got up
after less than 15 min of rest, unable to cope with contractions. As I laid in
bed, contractions immediately increased in intensity and felt approximately as
half as strong as my "usual" period pains. They were perfectly manageable when I
got up and started to move around. I also started to feel intense dull backache
in lower spine, and developed extreme chills. I walked downstairs, leaving John
sleeping upstairs, and put an electric fire on and attached a TENS machine.
It was tricky to put on the TENS machine on my own, but I managed. I was
rolling on a gym ball and, at the height of contractions, using the TENS
machineís high burst option. Contractions were appearing every 3-5 minutes. The
TENS machine was helping to take my mind of contractions and backache.
Hypnobirthing breathing techniques also helped between and during contractions.
I was coping without any issue, even though aware of discomfort. Suddenly, I
started to feel quite heated. I measured my temperature as 38 degrees Celsius. I
called Marijn between 1:30 and 2:00AM. She agreed to drop in and assess my
feverish episode. I woke up John few minutes after calling Marijn. I measured
temperature several times again; it first dropped to 37.3įC, but shortly later
it increased to 38.4įC. Marijn came at about 3AM. We agreed that high
temperature is perhaps a result of dehydratation and overheating. We decided to
observe the temperature development over a period of time and then make a
decision if there is a case to worry about amniotic fluid infection. I took two
paracetamol tablets, after a laughable and desperate search for some at my home,
where all meds are available but not pure paracetamol without a combination with
other ingredients....:) I was even searching on Internet an exact composition of
some Beachemís products as I donít keep product inserts. (But, one week later, I
actually found a package of paracetamol in our medicine cupboardÖ.) Shortly
after that my ability to perceive time significantly diminished. I can read in
my notes that, at 4AM, I went to the toilet and started to vocalize
contractions. This was one of the break points during my labour. Up to this
point, contractions were getting more intense, with certain regularity, but were
manageable using Hypnobirthing breathing techniques, TENS machine and
positioning. Then, I went to the toilet to pass urine but, sitting on the
toilet, I was unable to. Instead of it, I was hit by very strong contractions. I
remember trying to lean back as this seemed to help coping with pain. I also
recall not being able to get off the toilet seat with body convulsing arched
backwards and supported by John. Finally, I managed somehow to get myself
together and walk downstairs and even to refuse help with walking. From that
point, contractions changed their pattern; they didnít seem to Ąstop". The
restive period disappeared. Contractions, usually described in books as ĄÖthe
pain will usually start slowly, rise to a peak lasting about 30 seconds and then
subside....", changed in to a following pattern: with each contraction pain shot
up as an elevator without much warning, remained in a peak for some time and
then quickly subsided, but not to a restive period as before, but to a level of
constant pain in a lower tummy segment. The whole tummy felt hard constantly and
due to that I wasnít able to use Hypnobirthing breathing techniques any more.
Specifically, I wasnít able to inflate my tummy; it felt rock hard and resisting
breathing techniques. The "restive period" pain felt like having an open wound,
i.e. as having an incision deep inside in a lower abdominal area just above the
pubic bone. Maximum pain level, at the height of contractions, seemed to be
similar to my premenstrual period pains. What was challenging an requiring all
my attention was the lack of any restive period. I had to fight to relax in what
remained from it and it felt, I had no real time to prepare for the next
contraction. From this point things go hazy for me and I remember very little
until 8AM when, according to notes, I started to push.
What I recall from this part o my labour is that, downstairs, I couldnít get
comfortable on a ball any more and finished sitting on a carpet, on a sanitary
pad, my back propped against a sofa. I stayed in this position until getting in
a birth pool. I lost my modesty and was happy to leak on a sanitary pad. I
changed breathing pattern and remember breathing instinctively, as it felt
appropriate. I remember long deep breaths in and out going through my throat. As
I was unable to feel relaxation in my tummy, I was using throat as a guide to
keep slow deep breathing. It perhaps wasnít ideal for relaxation, but the best I
could manage. Further, I recollect breathing through my lips as a horse and
occasionally panting as well. I forgot all about the TENS machine, I had to
fully focus to survive through contractions. I got totally to myself, withdrawn,
losing all inhibitions, but one and that was making too much fuss and cause
distress to both John and Marijn. I vomited on one occasion. I felt I need to be
talked through each contraction. I also have knowledge of John being behind my
back and supporting me and Marijn talking to me whilst facing me. I tried to
take each contraction separately and not to think about the next one. I was also
swaying my neck and rotating my feet during contractions to relieve enormous
tension I felt building up in my body. Further, I was using positive and
negative thoughts to brace myself. Consciousness of the labour process being
temporary and working towards having my baby, were the positive thoughts, I was
repeating to myself. Negative stimuli included knowledge of reducing oxygen
intake and thus of potential harm to my baby, if I wonít be relaxed and stop
breathing deeply. I also had a fixed idea that a decision for a transfer for an
epidural will mean Iíd need to endure a transfer to a hospital, continuous
monitoring and a wait for an anaesthesiologist, who may never come. The second
option was in my opinion as good as slow death and helped me to keep firmly
gripped with an option of staying home, where nothing was really missing.
After a certain period of time, I felt I canít cope any more. Hoping for more
relaxation, I asked Marijn if it is possible to use a bath or a birth pool.
Later, I went to the pool hoping for some relief. I assumed a similar semi-prone
position as sitting on a floor. But contractions got much worse! I felt a bit
cheated. To my comment about feeling much worse, Marijn responded that water can
relax, but also intensify the labour. I eventually put together myself, but I
remember moaning about pain. In truth, I was indeed more relaxed during restive
periods, even though contractions intensified.
Again after a certain period of time, I felt I canít cope any more with the
level of pain and started to beg for gas&air. I remember being politely refused
several or rather many times. Finally, I got to use Entonox. But, I used it
perhaps only once or twice, didnít feel any relief and pushed the device away.
Then, with the next contraction, I shouted: "Iím pushing". I recollect Marijn
asking me at least once before if I feel like pushing. I answered "No", but
actually, I sensed something going on and could have been pushing involuntarily.
Even though the approximate start of transition is recorded in my notes, I
didnít experience any real difference between the transition and stages previous
to it. Contractions felt present all the time, but my ability to cope with them
declined over time. The only difference between early and later dilatation
stages was feeling, in the later stage, as if tearing inside. I felt sharp pain,
similar to tearing of a thin tissue or material, deep inside my lower abdomen.
Further, later in dilatation, I kept touching my labia. I sensed a lot of
discharge coming through, but I was mainly touching because of feeling strong
pressure on pubic bone. Throughout the dilatation phase, the baby was
occasionally strongly moving. Her moves at the height of contractions were
specially difficult to manage.
In the pushing phase, pain during contractions immediately intensified, but
the pattern changed. There was a real restive period between them, when I was
feeling almost "normal". "I got on with it". To my surprise, I wasnít able to
use the special pushing Hypnobirthing breathing technique at all, even though I
tried to compose myself to use it. However, at the height of contractions, I was
totally overtaken by my body and I pushed with all the might. Pushing was not
directed by my thinking at all; I was doing what instinctively felt right to me
without thinking. It occurred to me, I need to push as if I need to pass through
back passage; however, the same time I felt the pressure is Ąsomewhere else" and
pushed towards perineum in general. And I pushed and pushed, but nothing was
happening. I was aware of an increasing intense pressure inside my pelvis, but I
didnít feel extreme pain, I even felt sort of "anaesthetised". I had an extreme
desire to get the Ąthing" out. It was mentally challenging. The urge was so
strong, but I felt, there is little going on.
I had a perception as if a balloon got stucked internally between my hips.
Again, I didnít have a sense of time, but was more lucid than during dilatation
and was aware of pushing for several hours. But, I would never say I had been
pushing for 4 hours! Later on, I started to feel a pressure on coccyx. On advice
of midwives, I changed my position from kneeling to semi-kneeling with one knee
bend and was alternating knees. Changing the position was very hard and, at
first, I refused to do it due to feeling of an extreme pressure on my pelvis.
Strangely this feeling was not associated with pain, but perhaps there was some
mental blockage in my head refusing to move. Between contractions I was praying
to God a lot, calling God and Jesus, perhaps even quite shouting. I was
experiencing enormous pressure, which wasnít acutely painful, more numbing, but
extremely alerting my brain something wrong is happening to my body. At the
height of contractions I was biting a cloth and was bearing down, mostly with my
eyes closed, as much as I could down. I usually managed 3-4 pushes per
contraction accompanied with deep guttural sounds. I actually didnít feel
uncomfortable at all even after 4 hours of pushing; I got cramp only once in my
left calf. John was helping me so much and I was aware he was in tears, because
he couldnít help me directly. I felt very touched by that. Again, in this phase,
some positive and negative mental reminders were of help, for example, knowledge
of the labour process to be finite at some point. Further, I was hugely
motivated by being aware of surgical delivery as the only alternative to my
spontaneous efforts. Additionally, I had perception that if I start to give up
or be panicky, I reduce blood flow to my baby.
Finally, I managed to push baby up to where it felt like soft parts of vagina
and then it took perhaps only 30 min to the babyís birth. I was facing clock
during this phase and thus having recollection of time. This part felt very
easy. Crowning was causing strange sensations, but on advice of midwives and
using my instinct as well, I combined pushing and quick relaxed painting. When
it happened (crowning), my body took over and knew instinctively what to do.
When her head came through, I felt so relieved. I expected the rest of the body
to slide through easily, but it was not so easy and now it was really
challenging to find strength and motivation to push shoulders. I believe, even
the rest of the body required an extra push. Iím not sure what happened around
delivery of shoulders, but I sensed some alert in the room.
I felt so relieved that our baby is well and here with us and was totally
exhausted, elated and tearful. I also immediately Ąforgot all difficulties" and
remember saying, Iíd do it again without hesitation, but perhaps not tomorrow.
I had time to bond with the baby in the pool, then we cut the cord and there
was time for the third stage. As placenta wasnít appearing, there was a need for
an intervention. I was told it was high-lying and I got catheterized to empty my
bladder. It didnít help, so an oxytocin derivate was administered to get it out
with a gentle manual guidance. Pushing it out was quite uncomfortable, but
knowing this is likely the last bit of discomfort helped. And this was it. I had
lots of time to test breastfeeding and to get gently introduced to our daughter.
John had time to bond as well. At times, I canít believe, Iíve done it.
I feel grateful and indebted to John and Marijn and Viv. Without them, this
miracle of birth wouldnít be possible.
My take-away messages
- Expect unexpected.....Sometimes complicated plans will never get used and
improvisation will take place instead.....
- Supportive environment is crucial. Patient and positive support focused on
relaxation and breathing is incredibly valuable.
- Focus and determination are indispensable.
- Knowledge of what is available, e.g. medical care, and when is helpful.
- Selection of health-care providers and a partner (who wonít run away,
collapse, or start to lecture) is essential.
- An option of water birth is excellent.
- Home environment is very important if you need to relax from conventional
In summary, two things are essential: (1) partnerís support, (2) health-care