By Kat Walker
Disclaimer: this blog post details a traumatic birth experience and may be triggering to some people.
During my first pregnancy I never really had a birth plan as such, but I had the hope of birthing in water with minimal interventions. As a pelvic floor physio, my general plan was “let’s just try to avoid forceps and a third or fourth degree perineal tear”.
At 39 weeks, I was induced because I had developed preeclampsia and I had a big baby on board. So unfortunately, a water birth was out of the question.
It started out great. I laboured for 12 hours in the shower and on the yoga ball using all of the hypnobirthing techniques I had learned. Then the contractions started coming really hard and fast for two hours straight. Our midwife at the time was convinced my son’s arrival was close, and she was getting everything ready for pushing. I remember being so excited and proud that I had made it and was going to meet my son soon.
But then on vaginal examination I was only 4cm dilated – I was not progressing. I had no choice but to accept the epidural I had been refusing up until this point. My blood pressure was really high, and they needed to increase the syntocinon to help me dilate. An epidural was going to help with this.
At 11pm the epidural went in. At around 1am, I had fully dilated, and it was time to push.
I couldn’t push in the pelvic floor friendly positions I had hoped for, it was either too uncomfortable or not an option with the epidural. I pushed for two hours, and then my son started showing signs of distress. They called the obstetrician in to take me down for emergency caesarean.
I was okay with the prospect of an emergency caesarean. I knew I had given everything my best effort and my pelvic floor would be spared at least. It would be over soon, and I could hold my baby in my arms.
However, once we were in theatre, they informed me that my baby was already too far down the birth canal, and that instrumental delivery would be safest – my worst fear realised.
They tried vacuum first and it failed. They then discussed using forceps.
I knew that having an episiotomy before forceps would lower my chances of a third or fourth degree tear. I was surprised to find that I had to aggressively advocate for an episiotomy, which was difficult to reconcile with later. It was 4am, and I was quoting the Third and Fourth Degree Perineal Tears Clinical Care Standard to the obstetrician. In the end I begged him to make the cut.
It was at this point that I realised I had lost the perceived control I had over my birth and lost a lot of trust in the people who were looking after me. Not to mention I was now completely paralysed from the waist down. I had gone from feeling in control, to feeling like birth was just something that was happening to me. It was a very vulnerable position to find myself in.
Then my son came out, and he didn’t breathe for what felt like ages.
We later found out he had the cord wrapped twice around his neck, he was severely hypoglycaemic, and he had facial injuries from the forceps.
He needed resuscitation, and once he was stable, there was barely any time to hold him. Both he and my husband were quickly taken up to the special care nursery while I was stitched up.
I later found out that my husband had also found the whole experience very traumatic. I think we often forget about the partner’s birth experience. The poor man felt so helpless in those early hours of the morning. Hours of no food or rest. A cascade of unfortunate events. He passed out when I had the epidural. He had seen the obstetrician covered in blood from postpartum haemorrhage. After this harrowing experience, he then found himself sitting beside his new baby in a humidicrib, worried if his wife and his baby were even going to survive.
The anticipation of this happy moment of our son’s arrival was replaced with worry and isolation.
Special Care Nursery
What I had not been prepared for at all, and what still affects me somewhat to this day, was the journey in the special care nursery.
It was COVID-19 times, no visitors were allowed, only partners for very restricted periods of time.
One of the moments that still haunts me after my birth, was waiting until the feeling in my legs had returned and walking to the special care nursery alone. Buzzing the door and saying to the person on the other side “I am here to meet my son”.
It is so unnatural to have your baby taken away from you the moment they are born, there was no opportunity for skin to skin and we weren’t reunited for hours.
He looked like he had been in a fight. He was in a humidicrib, with a nasogastric tube in his nose, a huge paddle on his arm to stop his drip from falling out. He was hooked up to lots of monitoring, so it was tricky to move him anywhere without setting off an alarm, let alone cuddle him.
I was really jealous of the mothers on the ward that got to have their baby next to their bed without any attachments.
There was a recliner chair next to him in the special care nursery, but I still had a bed on the ward. It felt like tug-o-war from both the ward and the special care nursery. I felt like both places needed me and I didn’t get the time to really care for myself or my son properly.
I had to pump every 2-3 hours and feed my son through his nasogastric tube. It was gruelling and I didn’t know my self-worth could be measured in millilitres.
The most depressing thing was having to leave the hospital without my son once I was discharged. Getting up every 3 hours to pump alone in a room with a towel that smelt like him.
Post Traumatic Growth
For some individuals who have experienced a traumatic event, there can be a positive legacy called post traumatic growth.
Murphy’s law had got me, but I had met many women in my job that had gone through similar birth stories with similar birth injuries, and I knew I would eventually be okay.
I did wrestle with thoughts about what I could have done differently for months. At the end of the day, he was a big baby and he needed to come out quickly and there was nothing I could do about that.
Little did I know my pelvic floor was in a worse state than I had initially thought, and I had a long recovery ahead. Losing control of the entire contents of bladder on the special care nursery floor was a particularly low moment.
In the end I can reconcile with my experience now knowing that I have been able to offer genuine reassurance and support to women who have gone through a similar experience. To experience and recover from my own symptoms of incontinence, urgency, pelvic pain and prolapse has been invaluable to my practice and made me a better physio.
I have gone through a grieving process, and had to learn to accept and appreciate the body I have found myself in. I believe that journey has been extremely humbling and empowering, making me a better person to date.
We eventually got home, and I can’t thank the people who work in the special care nursery enough. Granted it is not the best start in life, but the silver lining is you get the most incredible introduction to being a parent. By the time we got home, my husband and I were so confident in the basics after all the advice and support we had been given.
My Second Birth
My second birth I opted for an elective caesarean. I thought about the idea of having a “redemption birth” but ultimately, I was worried about further injury to my pelvic floor muscles.
The most triggering thing for me was being prepped for theatre and worrying about if my daughter would need resuscitation or if she would end up in special care like her brother. Everyone was so kind and reassuring and really made me feel like I was in control and prepared for everything and anything that could happen.
She came out screaming at the top of her lungs and straight into our arms which was very healing.
Where to go if you or your partner need help
Alarmingly, 1 in 3 women consider their birth traumatic.
If this is you, I am so sorry.
We are here to support you on your journey to healing. A pelvic floor physio can help you recover from the physical injuries sustained in birth. We can also help you make sense of your birth and provide reassurance.
Counselling helps. Both my husband and I found discussing the experience over and over until the powerful emotions became less intense really helpful.
Organisations like PANDA, Australian Birth Trauma Association and BirthTalk offer free resources to new parents, including evidence-based information on birth trauma recovery and healing. There are helplines, facebook groups and face to face support to help you. You are not alone.
I have listed their websites below:
https://panda.org.au
https://birthtrauma.org.au
https://birthtalk.org