This birth story is contributed by Dr. Amy Chin-Atkins, who founded Four Trimesters in December 2002 when she was still living in Singapore.

Preamble

That every pregnancy and birth is different is very clear to me, having had 3 of my own and seen many more. My first was a hospital birth, lots of interventions and drugs, everything short of a caesarian, typically traumatic. My second was with a midwife and doula, fantastically empowering and exhilarating. My third was a planned unassisted birth at home, deeply satisfying. As Debra Pascali-Bonaro, director/producer of the film “Orgasmic Birth” said to me: “It’s been quite a journey for you”.

This pregnancy was by far the easiest of the three, both physically and emotionally. I only gained 14 kg, instead of 20 kgs for my 2 previous pregnancies. Although my tummy felt bigger and more stretched this
time, the rest of my body was more normal.

I had forgotten how much I do enjoy being pregnant. The feeling of the baby moving inside is something that never ceases to amaze me, even though at times it feels like the baby is trying to escape Alien-style or tunnel through the birth canal.

This time around, we decided on no unnecessary testing for this pregnancy, including no ultrasounds or internal pelvic exams unless medically indicated. So, we weren’t sure of the sex, although I would have preferred knowing. But weighed against the risks against obtaining useless, or even distressing, knowledge, it was an easy decision to make.

Getting into an argument with my GP and the less than enviable state of the Danish health care system turned out to be a blessing in disguise, we decided to do our own prenantal care this pregnancy which was easy and wonderful. I had a much better record of my health, I could do my own check whenever I wanted (which I did each Thursday to celebrate another week of gestation, although urine checks I did less frequently) and I felt much more aware of how this pregnancy was progressing. It was also great fun listening to the baby’s heartbeat whenever we felt like it, especially for Liam and Kira. Thank you to Uncle Robert for the gift of a fetoscope and blood pressure monitor.

Pre-Labour

28 November 2007

I spent the entire pregnancy being deliberately vague about the due date (“it’s an arbitrary date, only 5% of babies are born on the EDD and I don’t want to be pinned down to a specific date”). And until about 2 hours before the birth, I was sure baby wouldn’t be born until December anyhow. So I was somewhat surprised when I had a show around 2300 the eve of my actual EDD.

29 November 2007, EDD

Baby had already engaged at 35 weeks, which is early for a multip, and I was carrying very low. However, this was the first time I started a labour with a show. Having had strong Braxton Hicks contractions since June, I continued to ignore them and went to bed around the usual time (after midnight). By 0200 (and already several visits to the toilet) the contractions had changed from BH to something slightly more, so I checked the position: ROA. Groan. (Having gone cephalic at 5 months and then spent most of the pregnancy in the preferred LOA position, baby had suddenly decided to go ROA with 2.5 weeks to go. After a panicked complaint to Ginny, upon her suggestion WE (baby and I) had had a talk, and agreed that baby could do whatever it wanted but it had to be back in LOA when labour started). I asked baby to turn and baby was very compliant. Back to LOA, I tried to doze between contractions. By 0500 the contractions were coming every 5 mins and lasting about a minute, and I found counting through them v helpful. The most uncomfortable thing so far was still the itching/burning of the stretched skin on my tummy. At 0600, I went to the toilet (for the nth time) and had another show. This time it was dark red, mucousy and with no sign of fresh bleeding – good. Since I had avoided all ultrasounds we didn’t know the exact position of the placenta, so this show was a good sign that it was not previa. At this time, I did a poo, at which point the contractions died down and not much happened for most of the day.

Come morning school run time, David and I talked over how to get him home and the kids out of school quickly if required. Typically, people’s concern at this point is where to put the kids for the birth. We had the opposite challenge of how to ensure they were at home for the birth. We had decided to have a family birth, and everyone had a job to do.

Liam wanted to be the first to touch the baby. David would receive Sian. Kira’s job was to announce the sex. In preparation, we had watched a few birth videos, done a birth rehearsal and everyone knew their roles. The kids understood how much blood would come (and what was considered abnormal), that Mummy would make noises, that it might be fast or take ages etc. Kira had even drawn a picture of the rehearsal at school – it was the most gorgeous thing.

David took the kids to school, putting on my favourite CD (the Chamber version of the Goldberg Variations – also my CD of choice for when I laboured with Kira) before leaving. I was full of energy, so did the nesting thing, clearing up the house. Hardly any contractions to speak of, so maybe we would make it to December after all, which I had started to doubt at 0500 this morning.

1500 – Toni dropped Liam and Kira home from school, we had apples, porridge and did homework and music practice. The contractions were starting to get a little stronger but still ignorable and 10 mins (?) apart.

Active Labour and Birth

1700 – David comes home from work. Kira and I are at the piano singing our favourite Christmas carols. For a while more, I practice the accompaniments I always play for my Mum (arriving in 4 days) to sing to, at which point my body decides that labour can start now that David has returned.

1720 – After updating David re the status of the kids and dinner (we need stuff from the shops), contractions get stronger.

1730 – Contractions now requiring my attention and focus, I go to the bathroom with Harry Potter and the Half Blood Prince. Contractions still 10 mins (?) apart.

1745 – David takes Liam to karate (then to get petrol, shopping and dinner). Kira is on the computer.

1800 – I decide that sitting on the toilet reading Harry is no longer working for me. I get out my yoga mat and turn up the heater in the bedroom.

1810 – Check my email, write a message to Rina in Singapore “Am in labour now. Talk about forgetting what it’s like and going through it again. groan. need distraction. David and Liam at karate. love amy”.

1815 – Get the birth ball into the bedroom from Liam’s room. Ring David saying “I might be pushing but I am not entirely sure”. He says he will come home straight away (too bad for shopping and dinner).

1820 – Ring Gentofte hospital, saying that things have started but no need for a midwife to come out to the house yet (implying I’m still at 3-4cm rather than the 6-7-8 cm I feel like I am at. I am trying to sound very casual with the nurse through a contraction, laughing as she jokes about not leaving the next telephone call too late. Thankfully, the midwife on the phone doesn’t seem to pick up I am further along than I am saying. David arrives home while I am still on the phone, and starts getting things out from the birth drawer. David also takes a photo. This turns out to be the one and only photo taken until after the baby is born. I remember also giving big cheesy grins around this stage with Kira.

1830 – We trundle out to the study to find Clare’s number from the computer (the joys of having the entire school’s contact details at my fingertips from doing the directory and moderating the parent chat group
8-) to ask if she can please drop Liam home from Karate. We order pizzas and fiskefillet for dinner. Go back into the bedroom, and take up position – knees on the yoga mat, leaning onto the birth ball. Kira decides to start watching Harry Potter on the TV (we were all in a Harry Potter phase).

Ask for the big cushions and a pillow to raise the level of the birth ball a little. Put on the hypnobirthing CD (thank goodness we had sorted out the MP4 player that morning) which immediately relaxes me. Trying to go back to basics and relax (not stimulating the neocortex, etc) while at the same time very aware regarding getting things in order (asking for the heat pack for the perineum, towels, mirror, etc ). David puts the waterproof sheet on the bed, sets out the stuff from the birth drawer. Contractions are now coming around 5 mins (?) apart.

1910 – Starting to feel really pushy, I alternate between asking David where Liam is and if he can see anything (such as a head emerging. David later said he thought we still had hours to go).

1920 – Liam arrives home from Karate, David runs to the door and grabs him (thanking Clare hurriedly). Liam comes into the bedroom and immediately becomes immersed in the whole scene, so much so that he starts echoing the sounds I am making. (Afterward Liam said I sounded like a Mummy during labour. ‘But I am a Mummy. Oh, you mean an Egyptian Mummy’). As calmly as I can, I say “Liam, please don’t make those noises, Mummy needs peace”. I ask for the perineum pack (specifying for it to be inside the little purple towel) and can hear David behind me trying to activate the heat – we have an expensive brand one which won’t snap on, so I suggest to David to try the cheap secondary one which fortunately works immediately.

1930 – Doorbell rings again – pizza delivery. David tells Liam where the wallet is so he can pay. Liam and Kira decide pizza in front of Harry Potter is more interesting. Looking back now, I think I went through transition for a couple of contractions, because it was SUCH a relief when the head finally moved down, which was in itself the most amazing sensation – feeling everything move out of the way for the baby.
Upon the head moving down, David calls the kids into the bedroom “It’s happening”. They run in to see the head emerge. Liam freaks out a bit and decides he no longer wants to touch the crowning head. “I don’t want to touch it”.

Me: “OK”.

Liam: “I don’t want to touch”.

“It’s OK”

“I don’t want to touch” (thinking I’m telling him it’s ok to touch).

“It’s OK Liam, you don’t have to touch it!” (said as calmly as I can considering it is through a contraction).

Without any pushing on my part, the head is born up to the eyebrows. I think to myself: “hmm, I guess this is the ring of fire everyone talks about that I never really felt with the other two. And I guess this is as stretched as it gets so I can either pant and wait for my body to do it or I could push a little… well, I guess I should let my body and the baby do their thing since I haven’t really done anything consciously myself so far.”

And I have a whole minute to think all this as the head just hangs there. It also means that Liam has time to un-freak and be the first to touch the baby as he had wished. There is also plenty of time for Kira to say repeatedly“I really think it’s going to be a boy”. For a moment it feels like someone is pushing the head back up, which they assure me they aren’t.

1940 – I feel the next contraction coming and give David a warning “Get ready, here it comes“. The whole body slides out easily.

1941 – Sian born into David’s waiting hands. Kira says in the clearest voice “It’s a GIRL” at which point I completely snap out of any labour-induced haze and respond with “You’re kidding?!” My inglorious first words to greet our new baby.

All the water also comes out in a huge gush once the head is clear. Liam and Kira later told me that the water was everywhere, including coming out of Sian’s ears and nose. I turn around and sit leaning against the ball, we place Sian on my thigh, cover her and then I hold her in my arms. We’re all just sitting there taking in the moment and watching her, when I remember we need to take photos.

1951 – The placenta is born (David catches it in a large bowl, it looks fine), accompanied this time by a huge gush of blood. David grabs more towels and throws them down. This is possibly the only negative about a home birth – the mess. Although for us it was all onto the yoga mat, a few blues and the wood floor which was easily cleaned.

2000 – We decide we probably shouldn’t put it off any longer and get around to calling the midwives to come to the house.

2010 – Sian decides to latch on, good motion.

2100 – The midwife and student midwife arrive “well, this is an easy job for us, ha ha” (imagine the Danish accent) and check everything – placenta (whole, quite big), perineum (fine), uterus (good, shrinking fast), and baby (fine). The first weighing gives us 4.9 kg – we all look at each other thinking that’s a little too big, so David grabs a tin from the kitchen to calibrate the scales with. The second weighing is a more realistic 3.7 kg, which was what both the midwives, and David and I had estimated. Length 51 cm. (Liam and Kira had both been a similar 3.6+ kg and 52 cm, this is the size I grow my babies). I have a quick shower and then we all settle down for the night. David and I discover the kids have eaten most of the pizza and all of the chips.

Wrap up

For Liam and Kira, I think the pivotal moment was when the head emerged and then just hung there. I guess that was the first they saw of the baby, and the moment when it became real for them, not just something moving or having a heart beat. Afterward, I asked them to draw a picture of the birth to help them process what they had experienced, and they each drew the head halfway out.

For both Kira and Sian – my active births – my favoured position for labouring and birthing was kneeling up, leaning slightly onto something solid, both in terms of comfort and ease of birthing. In both cases I came through with an intact perineum, no need for stitches. In fact, both labours and births were easy in terms of their speed, intensity and hence very little to recover from afterwards. If anything, Sian’s birth was more intense than Kira’s because it was faster (Kira’s was about 4.5 hours, Sian’s was 2.5 hours). With Kira’s I went much more deeply into ‘labourland’ as I had a doula to lean on, whereas this time I was kept in the present, as I was required to be there for the house, the kids, and the whole DIY thing.

We had wanted to try a Lotus birth but in the end we gave up, it was just too much of a hassle! The placenta was huge and sitting in a bowl full of blood – yes we could have drained it off, washed, dried, salted and wrapped it, but the other problem was the cord – it was cold and clammy and kept sticking to whatever it touched (yes we could have wrapped that too). In the end, we asked the midwives to cut it just before they left, so the placenta was left attached to Sian for about 2 hours after the birth. As opposed to several days as we had first intended 8-).

As with Kira, we started EC (Elimination Communication, AKA Natural Infant Hygeine, Infant Assisted Toilet Training) with Sian from the very start. It’s just great not having to deal with pooey nappies, particularly the meconium ones. While it is somewhat more tricky to EC a baby in the dark grey Danish winter as opposed to tropical Singapore, it is so very worth it. And as I was telling a friend, I cannot not EC, after EC’g one child, I can’t just sit back and ignore any signals or timing that I see and not take baby to the potty.

Interestingly, choosing to birth the baby at home raised a few eyebrows, even amongst the Danes, for whom homebirth is a feasible option. Quite a few people assumed we were talking about Singapore or Australia when we said we were having the baby at ‘home’ as opposed to ‘having the baby in the house rather than the hospital’. It was a very easy decision to make, for someone like me, with a low risk pregnancy, a home birth is easier, more pleasant, less risky, etc but the bottom line is that it is safer for the baby and mother. The bonuses were that we wanted it to be a family event, we thought it would be good for all three children both in terms of bonding, and good for them to see a natural birth. I remember Liam at 3 years old copying me giving birth classes, sitting there with a doll and demonstrating “the baby comes this way, then the head turns, one shoulder is born followed by the other”. And a few months ago I had mentioned to Kira that Mummy might make a certain amount of noise, and she had replied “that’s because it’s hard work”. I would have loved Ginny, my good friend and partner of Four Trimesters, being there but in the end she couldn’t make it to Denmark. The more difficult decision was how ‘unassisted’ we were going to go with this birth. I had complete confidence in David catching the baby, and in my own body to birth this baby. We had the midwife on-call and ready, I knew the various things to watch for and I was registered with the hospital which was 10 minutes away if required. By not exposing ourselves immediately to any strangers, it was healthier for the baby.

In the end we kept it flexible and ended up with our ideal situation – the most perfect birth for all of us.