Romina's Birth Story
A SUCCESSFUL VAGINAL BIRTH AFTER CAESAREAN.
“God I’m staaaarving!” wrote Romina to me at 5am, one peaceful Wednesday morning in May. She had texted to tell me she had woken with mild cramps and a raging hunger. Feeling restless and obviously excited, Romina decided to time the tightenings and cramping she was feeling. Sending me a snap shot of those times, it showed me she was having contractions every 5 mins but they varied in length throughout. Encouraging her to put the timer away, have something to eat and just enjoy this time with bub, I didn’t think too much more on it. Being a doula means you often will hear from mamas at the very beginnings of labour. And the very beginnings, could be minutes, hours, days and even weeks, before active labour actually starts. So you learn to not overreact and to guide women to try go about their day as usual. Have breakfast, go for a walk, feed your children, have a shower, brush your teeth, walk the dog. Do whatever you normally do, and act as if you aren’t heavily pregnant and desperately wanting to meet the baby that has been growing inside of you for 9 months or more.
That Wednesday, Romina had just reached the 38 week mark, which although is considered term, most women and care providers don’t expect a baby to arrive “so early”. But every baby, if left to decide on their own, will have a plan, and the little girl inside of Romina’s belly had a plan. Her plan was to arrive, quite un-expectantly at 38 weeks on the dot. So unexpected that Romina and Justo hadn’t even decided on a name yet, as they thought they had more time to think about it.
3 hours after her first message, I get a message from Romina’s husband, saying that he had confirmed with the hospital that I was allowed to be a support person and that the only requirement was I wear a mask the entire time. In a conversation post-birth with Romina, she explained how relieved that news made her feel. The relationship I build with my mothers and the journey I take with each couple, is unique and incredibly important. They don’t rely on me to have a positive birth, but I still am an integral part of their chosen support team, and the prospect of that being suddenly changed and taken away from them, is incredibly stressful and daunting. Luckily, the universe was on our side and Romina was to have her husband and her doula by her side.
Soon enough, Justo contacted me again saying Romina had lost some mucous and a spot of blood, and sent another screenshot of her contractions. Again, they looked irregular to me, but I reminded myself that contraction apps are often hard to navigate when you are in the middle of labour (for both the woman experiencing the contractions and the partner trying to determine when they start and stop). That’s why I often suggest to put away the timer as they are more of a distraction then a true indicator of labour. If a mother feels in her gut that she is in labour, then she is in labour. Trusting women is at the core of what I do. We don’t need to put all our trust in a machine or digital device. Your body and baby are giving you signs, you just have to be willing and open to listen to them.
By 2pm, Romina and her husband decided to head into hospital and by 5pm they called me in to support them.
Walking into the room I found Romina standing at the side of the bed, earphones in, TENS machine on, eyes covered by the eye mask I had gifted her, and her husband quietly standing beside her. The room, although unmistakably a hospital room, was perfectly set up for birth. It was quiet, peaceful, dark, with LED candles flickering and the sound of any hospital machinery turned off. Even the rooms clock had a towel hung over it to block any idea of time from its viewers. The midwife supporting Romina, was quiet, unassuming and gentle, to the point that you barely realised she was in the room. All attempts to make labour undisturbed were respected.
Romina was leaning over the bed with stretched legs and slowly rocking her hips from side to side. Placing my hand on her back when I arrived, I instantly realised she didn’t like to be touched in birth, as she shrugged me off very quickly. Although light touch massage is heaven to some women in birth, some find it more of a disturbance then a comfort. Romina wanted to have absolute focus on her baby and the contractions that brought her baby closer to her. So her Justo and I stood in front of her or beside her, letting her sense our presence. Sometimes this is all women need in labour – to know they are not alone. With every wave of contraction Romina would press the button on her TENS machine allowing its electric waves to vibrate through her body, giving her some pain relief. In between contractions her husband would offer her sips of orange flavoured Hydralyte. At times during her labour, I quietly reminded her to focus in on her baby. “Do the dance of labour with your baby” I repeated, “This is your special time with her”, “It is just you and her in this moment”. Since Romina had earphones in, I wasn’t sure if she could hear my words of encouragement, but there were little moments of reassurance when Romina would smile. About an hour after I arrived, Romina’s OB came in to check how things were going. Now I can admit, I always put my guard up when I encounter a doctor in the birth room. Obstetricians are trained professionals at medical birth, and there is definitely a stereotype surrounding them. Romina was trying for a VBAC (vaginal birth after caesarean) after her first child was born via C-section due to being breech. Doing her research, she enlisted one of the only VBAC supportive Obstetricians, Liza Fowler, in Perth to support her in her journey. Despite being considered VBAC supportive, I was still nervous that her OB would push a more medicalised agenda onto Romina, threatening her chances of a successful VBAC. But, like so many births I have attended before, all my preconceptions were thrown out the door. Romina’s OB was kind, gentle, quiet, and in no rush to push any type of medical agenda on Romina’s labour. When she arrived to check up on Romina, she kindly introduced herself and we both had a little laugh, as today was meant to be the day that I was going to meet her at an appointment Romina had booked. Liza asked Romina if she could check her dilation, and when Romina consented but asked for it to be performed standing up, I waited for Romina’s wishes to be ignored. To my surprise and utter delight, Liza took no time in accepting the request and bent down to perform a vaginal exam while Romina stood over the bed. At no other birth that I had been to, had a care provider done a vaginal exam in any other position but with the mother lying down with her legs spread wide. So after witnessing this anomaly, I began to trust that Liza really was as supportive of vaginal birth, as she said she was. The exam was quick and there was no mistaking the progress that Romina had made (dilation wise), from the look on Liza’s face. “Very happy”, she exclaimed to Justo, and whispered in his ear that Romina was now 9cm’s. With her eye mask on and her earphones in, Romina remained oblivious to the progress she had made in a number of hours.
A few moments later, after Liza had left the room, the midwife asked if Romina felt the need to wee, as she hadn’t gone in a while. Every time a question was asked, it usually was asked to Justo, as Romina wanted to be completely undisturbed. Then Justo would gently whisper, in Spanish, to Romina the request. This happened throughout the labour, and every whispered moment in their native tongue, left me speechless. There was something so romantic and magical and sacred, about the moment Romina and Justo shared. It was their own little way to drown out all the noise of birth. It may have not seemed much to them, but from an outsider looking in, it was the perfect complement to a truly undisturbed birth. Attempting to walk over to the bathroom, Romina was only able to make a few steps, before her body threw her down onto her knees. The baby was coming and going to the toilet was not on the agenda.
Still concerned that Romina hadn’t weed though, the midwife asked to insert a catheter to help relieve her bladder. Accepting this request, the midwife attempted to insert one while Romina laboured on all fours. With a few failed attempts, the midwife soon realised that it wasn’t going to happen as baby’s head was right there, blocking any pathway to the urinary tract. A full bladder can become a barrier to baby progressing in the birth canal, which is why it is so important to relieve yourself during labour. But Romina’s baby had a clear pathway and was ready to be born.
Romina’s moans begun to sound more guttural and she started to feel the urge to push. Liza had entered again and sat herself comfortable behind Romina and waited. With her gloved hands ready, she sat patiently and quietly. There was no rush. Both baby and mum were trusted to do exactly what was needed. Finding it hard to get a trace on baby’s heart rate as she got further down the birth canal, Liza suggested the midwife use a hand held Doppler to monitor baby. This was again another ground shaking moment for me as a doula. In all the hospital births I have attended, care providers seem almost obsessed with the CTG machine to monitor baby and mum. Despite the research saying that it doesn’t improve care in labour, I constantly witness CTG’s being used as the be all and end all of monitoring. But here I was, in a hospital with an OB suggesting the use of a Doppler, rather than playing around with the CTG machine. This quick and well considered decision, was again a testament to respecting Romina and her labour. There was no attempt to move her out of her position on the floor, just to make it easier for her care providers. There was no constant moving and prodding and poking. Instead it was a quick and painless decision that left Romina still completely undisturbed. Her care providers worked around her, rather than her working for them.
Soon enough, Romina was pushing harder and stronger. Throwing off her eye mask, earphones and T-shirt, she was listening to her body and getting down to business. With Justo at her side holding her hand and whispering encouragement, Romina’s amniotic sac began to show. Leaning up on a chair whilst still kneeling, Romina let out the roars of birth. Vuela Con el Viento (Fly with the wind) was playing from Romina’s phone, while she pushed further, bringing her baby closer and closer. Thinking the sac would break with each contraction, Liza, the midwife and I, all sat watching and waiting. But the sac continued to stay intact. Again, I felt my nerves and preconceptions get the better of me, just waiting for the moment that Liza would break the waters. But that moment never came. This birth truly made me rethink my preconceptions. My trust has never waived with the couples I support, but it takes a lot to trust a system that has so many flaws. Liza lightly caresses the sac as Romina slowly pushes it out. By 7pm, Romina gave the biggest push of her life and her baby’s head emerged. Reaching down to touch her baby, still in the sac, you could feel the awe and excitement rising in the room. As the first en caul birth I had witnessed, I was fascinated (and perhaps a little photo crazy) with what was unveiling in front of me. Then suddenly with one last roaring push, baby slid out and the sac broke around her. Passing baby up between her legs, it took a while for Romina to realise what had happened. “Open your eyes, your baby is here” we all repeated in ecstasy. And opening her eyes Romina lifted her baby girl into her arms and Justo showered them both with kisses. In shock and in love, Justo and Romina stared at their vernix covered girl. After 38 weeks of pregnancy, 16 hours of labour, Romina got her VBAC. But she did more than just that. She proved to me that an undisturbed, peaceful, awe-inspiring, untouched birth CAN be achieved in a hospital setting. Birth is truly and wholly unpredictable, and god-damn incredible.