segunda-feira, 12 de março de 2018

Relato de Parto da Quarta :)

Desculpem estar em Inglês mas ainda estou a trabalhar na versão em Português :)

Birth Story - Laura (12 Feb'18, 40+3wks, Homebirth After Cesarean) [Sorry it's a bit long]

Our 4th girl – first pregnancy&birth in the UK – came Earthside on the 12th February 2018. It was at the same time an easy and challenging pregnancy. I had been through 2 miscarriages and knew I would probably need to take daily medication in order to prevent losing her. I already had an 8yo and 3yo twins daughters, that in spite being the sweetest, cutest, loving creatures are very demanding on a daily basis. With a husband working long hours and no family around, I could only count on myself and occasionally on a few friends and neighbours to help out in hard times. The first and second trimesters were also very emotionally troubled times for us as a couple as we had to face our darkest hour yet since our 20 year commitment to each other. Putting all of that aside, this was the easiest pregnancy yet: almost no morning sickness, no discomforts until the 3rd trimester and only a nasty cold and an UTI in the middle of it that were inconvenient. The last month my pelvic girdle started to harass me but I tried a local chiropractor that worked wonders on me. 

Since my 2nd trimester I also started Pregnancy Yoga classes locally which were a bliss as they allowed me to have 2h per week to focus on me and my baby and this pregnancy. I especially enjoyed the positive-of-the-week moment, in which we had to share one positive thing that had happened that week. At first this was very hard for me as I was in a really dark place. But it made me look harder and appreciate the positive things that happened and suddenly I found myself saying more than one positive thing each week and not dwelling on the negative ones as much. It was also very important to feel part of a class and having other women around to share exercises, touch and stories. I also started to look into hypnobirthing as I’ve had very positive feedback from friends and thought as I was in a more fragile emotional state than ever before, it would help. And so it did! 

It helped me get more in tune with my body and its tensions and make time and methods to release this stress and unwind. I listened to hypno podcasts and printed and hand decorated some positive affirmations to place around the house.

As I had had a caesarean section 3 years prior with my twins (because twin A was breech and I couldn’t find a health provider that would assist me in a vaginal birth in that situation), this was the first “stone” I had to go around when dealing with consultants in the UK. I was already 38 yo, I had had 2 PPH after my 2 retained miscarriages and was taking blood thinners to carry my pregnancy safely to term. So, when I first expressed my wish to have a homebirth, the midwife I was talking to couldn’t help but laugh. I couldn’t stay on midwifery care alone and was attributed a consultant (a very nice one in fact, although his assistants were the ones that saw me most of the times), and soon I was being told I shouldn’t “risk” a homebirth because of the risk of uterine scar rupture (calculated at around 0,5%). I eventually could, if I could get my consultants approval, go for a birth centre experience, but it wouldn’t be certain I’d get it and even if I could, my daughters wouldn’t be allowed to be there and my husband wouldn’t be allowed to stay the night after the birth, two major factors for me.
As I am part of a childbirth rights association in my home country (and I’m a pregnancy & birth aficionada), I have access to a lot of evidence based information on birth. I knew as I was healthy and had had a previous vaginal birth, that the chances of achieving another one were very high. I researched on blood thinners and found out the dosages I was taking wouldn’t increase the chances of PPH in a physiological delivery, and I did have a previous homebirth with my first so I knew what was coming. 
I contacted several doulas (as I’ve always had them in previous pregnancies) and through them I found out about the NHS Windsor Homebirth Midwifery Team (Wexham Park Hospital), and went to some of their Positive Birth Meetings. I met several team members and listened to the wonderful birth stories shared by newly moms. They said they could help me figure out my options and assist me if it came to be the case.

 I always felt respected and supported in my decisions. Things were presented to me as options, not as rules, which made me feel more in control of the whole process. I continued to listen to consultants state it would be highly unrecommended to go for a home birth, but in the end, it was my choice, and they ended up accepting it. I came to 40 weeks and 2 days, the same gestation day I birthed my eldest, and went to bed knowing that it might happen any time soon. I had put all my affairs in order, my mother had arrived to stay with us and the last baby things I was expecting to arrive had come. My daughters were on half term holidays and my husband would start his parental leave the next day.

The Birth
I woke up that night around 4:30 am (as usual) to go for a wee, and felt somewhat different. I was having Braxton-Hicks surges since 20 weeks pregnant, and more and more frequently in the 3rd trimester, especially at night, when Lady Laura decided to dance around in my belly, but this tightening was different as I could feel it smoothly expanding towards my back. I decided to take one last selfie with my pregnant belly and went back to bed. Around 4:50am I knew that was it. I woke up husband and told him and he timed me: they were coming every 10 minutes. We phoned the midwife (ours was on leave but there is always someone on call) and she told us to keep monitoring and to call her again if there were any worrying signs or when the surges came every 5min. This happened around 9am, one strong and one mild surge at a time. During this time I went to the toilet, took a shower (to see if the contractions eased up or intensified), set up the pool (which husband started to fill up), had the talk with my mum (for her to know that positive reinforcement was ok but to refrain from talking to me during surges: any concerns she had she’d talk to my husband or the midwives). 

I used a bed sheet stuck on a door to hang from in a vertical position, pilates balls to sit and roll around my hips or to lean on to while kneeling on the floor. When the surges came I felt most comfortable leaning forward and rotating my hips. I had lavender and clary sage essential oils to smell, lavender candles lit and my birthing playlist on with tunes I had chosen and listened to during the previous weeks/months. I walked, sang, danced, and husband massaged my back (although this time I preferred smooth touch as I was being able to breathe through the surges and relax the stressed muscles until the surge subsided, and pressure touch seemed to throw me off of it). 

Eventually my girls woke up and came downstairs for breakfast. My eldest massaged me through a couple of surges and they were very curious about the pool and the baby coming. I ate some dates and cashews and drank sips of the famous Naoli Vinaver birthing tea (with chocolate and avocado tree leaves) and felt fine. My husband took them upstairs to my mother that stayed playing with them until I was in the pushing stage. I was losing some blood (a few drops) with each contraction but the midwives told me it was normal.
Around 10:30 am I was having surges every 3 min and I was starting to feel the urge to bear down. The surges were getting more intense and the midwives told us they were on their way, and that I could go in the pool if I wanted to. I decided to wait as I knew that it would bring relief but also efficacy to my surges and things would probably speed up rapidly. Once they arrived, very calmly set their material, they checked my temperature, my blood pressure and the baby’s heartbeat. Everything was fine and I went into the pool. I got to relax for a while as the water allowed me to lie back but soon I was feeling the urge to lean forward. 
Around 11:30 am I was feeling a slight urge to poop and soon after that I was feeling a burning sensation on my perineum… I tried not to freak out but the surges were becoming painful and burning and I asked for the gas&air. They set it up and I used it to breathe through contractions, which felt nice (although I dropped the mouthpiece into the pool several times during the surges!! LOL). At one point I felt like I was losing control of my breathing and the midwives reminded me: “long breaths”. I shouted that I couldn’t do it anymore and heard them say: “you’re doing fine, almost there, well done”. I felt something bulging out and felt it with my hand: it was a soft round thing, probably the bag of waters. Then I went back to “birth-o-land” and started pushing a little bit with each contraction. I was groaning and screaming but it felt impossible to do it without it. It felt strange to wait for the surges to push (as I felt the head go out a little bit and in again), but it allowed me to rest in between them and have more time to stretch without damage to my perineum. Suddenly the head popped out and the following surge the rest of the body. 

I looked down and there she was in the water under me, eyes wide open. I picked her up and held her to my breast. She cried almost immediately and we cuddled in the water. My mother and the girls came down precisely in time to see me catch her and were in total awe!
As I wanted to encapsulate my placenta, but baby had pooped a bit when birthed, the midwives suggested I might want to birth the placenta outside the pool to prevent contamination. I was offered the oxytocin shot for 3rd stage but decided to wait and declined as I wasn't loosing a lot of blood. I sat on my sofa and had a few after surges as I breastfed baby. I squatted down on the floor and birthed a big clot and a few surges later, the whole placenta, 30 min after the birth.
We took a few pictures and then when the cord turned white, we clamped it with a handmade crochet string I had made, and daddy cut it. The midwife examined me and saw a little internal graze that was bleeding and asked me if she could stich me. I agreed and while she was tending to the local anaesthesia, the other one was packing the placenta up for encapsulation. I had a raw placenta fruit smoothie and ate some more dates and cashews. Baby was happily on the breast for another 30 min until they weighed her (3,140kg) and measured her (53cm). She popped a diaper on her and back to my lap she came. The midwives checked my pulse and blood pressure and explained how to give baby the vitamin K orally (we decided to administer it due to her exposure to blood thinners throughout pregnancy). They left around 2 hours after the birth and big sisters had a cuddle with baby.
It was a perfect experience and I wouldn’t have changed a thing… Except maybe having more footage and pictures… there was no one available to cover the birth 

Homebirth isn't just for low risk pregnancies. Risk can be assessed and options may be found in order to allow women the experiences they desire 

Sem comentários: