Week 20 – Birth

Week 20 – Birth

My apologies to anyone who has been waiting for this blog, frankly – for entirely positive reasons – I have struggled to write it. This week I really did have a dream come true and describing this in a non-clichéd way while respecting the privacy of my wonderful brave, strong client (who has asked me to call her Mariam in this blog) has proved difficult. So I’ve decided to just get on and describe some of what happened and as long as Mariam is happy I will publish.

On Wednesday 20th (a week after her expected date of delivery) Mariam called me in the morning because she had had a “show” and was having a lot of what she thought were Braxton Hicks contractions. Mariam did not have another birth partner and I wanted to be there as early as possible so I went over to see her. We went to a pre-planned ante-natal appointment together and the midwife confirmed that Mariam was in the “latent” stage of labour and warned us (as we knew) that this could go on for a long time – potentially days. We spent the rest of the day together in Mariam’s home with her contractions increasing in frequency, length and intensity. I reminded her to eat and drink, and reassured her from time to time, but mostly I was just an observer while she managed by moving round the room and mainly sitting on the floor when the contractions came.

Birth professionals generally advise that for contractions to be effective – to dilate the cervix – they need to be coming every 2/3 minutes and be lasting over a minute. By around 9.30pm Mariam’s contractions were coming roughly every 4 minutes and most were over a minute in length. We decided to go into hospital. Mariam was found to be 3cm dilated – whereas “active labour” is defined as 4cm+ which meant that we could not go into either the delivery suite or birth centre – in fact we were told that at that point they were both completely full. (September is a notoriously busy month for maternity wards.) However we stayed in the hospital and were taken to the general labour ward.

This was a noisy, busy place with little privacy apart from that provided by a paper curtain around a booth. Not surprisingly Mariam’s contractions slowed down for a while. Over the next few hours Mariam spent a lot of time walking around the ward and leaning against walls when her contractions came. She also managed to rest on the bed from time to time. I did very little during this time and occasionally wondered if it was useful for Mariam having me there. Then sometime in the early hours Mariam was sick and she began to ask for my support through the contractions – I pressed her lower back and pelvis during contractions and she rested on me between surges. Mariam began to want some other relief from the pain – the midwife we asked felt it was too early for gas and air, but agreed to Mariam getting into a warm bath. She stayed there for a long time, managing brilliantly through increasingly frequent and intense contractions while I held her hand and rubbed her shoulders. We both felt that labour was really progressing (though were also a bit scared that we might be wrong). Mariam was examined again and was 8cm dilated. Wonderful!! A huge boost. Midwifery staff who had more or less left us alone until this point started to pay attention. They also agreed that Mariam could give birth in the birthing centre. There was now space and Mariam would be able to use a birthing pool.

We transferred to the birthing centre and now had one midwife with us in a large quiet room. A huge change from the ward. Mariam was soon pushing. She started in the pool, but her contractions slowed down. So despite being exhausted Mariam came out of the pool and between contractions walked around the room. Sometimes I supported her while she squatted to push. At other times she sat up on the bed and pushed against me and the midwife Sue. This “second stage” took a long time (over 2 hours), but at the end of it all Mariam gave one huge roaring push and her son (Hassan) was born. He was placed on her stomach and within 10 minutes was rooting for his first feed. The wonderful Mariam had managed the whole labour without any drugs. She also delivered the placenta without medical assistance.

I still cannot get over how lucky I am that my first birth as a doula was such a wonderful, intimate and positive one. This was without any doubt, and far and away the happiest and most satisfying day of work I have ever had. Doulas talk a lot about the oxytocin high which can envelope all those involved in a labour – I am still feeling it. This last 5 months since I left Acas have had their ups and downs – though far more ups. Whatever happens now 20th-21st September 2017 is the proof to me that my decision to change career at this advanced age was absolutely the right thing.