Several days before
her baby was born, Sandra's membranes ruptured
prematurely. After investigating all of their options, Sandra and her
husband decided to wait for labour to start spontaneously with close
monitoring of her baby. Sandra also chose to have antibiotics to reduce
any risk of an infection harming the baby before he was born.
As the birth of our second baby drew nearer, I found myself thinking
repeatedly of how it would unfold and how I would cope with it. I
imagined the contractions, the positions I would adopt and I felt
increasingly confident and positive about it. I felt, on the one hand,
impatient for that special experience to come and, on the other, I was
enjoying my pregnancy, I did not want it to end.
Then five days before my due date, on a Thursday morning, I had a
suspicion that my membranes had ruptured. There had not been a
spectacular gush of water, so I did not know exactly when it had
happened, but I suspect it must have been around the time I got up and
became active after the night's rest. I was dismayed when my doctor
confirmed my suspicions. I had not wanted my labour to start this way,
and I had not contemplated this as a possibility. I was feeling only
occasional, mild contractions and I was advised that I should be
admitted to hospital for an induction. My doctor told me that another
school of thought was to treat the situation conservatively and wait for
the body to go into spontaneous labour, but there was a risk of
infection to the baby once the membranes had ruptured and his advice was
that I should be induced.
I was very opposed to being induced. I wanted to have a drug-free birth,
to be alert and mobile throughout the labour, the birth and immediately
afterwards, and I knew that induction would ruin the experience for me.
The thought of labouring with a drip in my arm had me in tears. I told
my doctor that I wanted to wait. I was given a CTG to monitor the baby
who seemed fine, his heartbeat was reactive, but I was warned that the
CTG only indicated the state of the baby's health at the time it was
done, it gave no information on how the baby would be later in the day.
Further, if a CTG indicated a problem, the problem was likely to be
serious; it would not pick up early signs of distress. I telephoned my
husband, Reinie, who arrived at the consultation rooms while I was being
monitored. He was supportive of my decision and we left with an
appointment for the next morning.
When I got home, I telephoned Sarah, my doula. She was also very
supportive and we discussed natural ways of trying to prompt labour. I
took some homeopathic tablets and tried to rest. I was aware of
contractions, these had also shown up on the CTG, but they were mild and
of short duration. They were also irregular, coming and going away
again. I did not sleep well that night; I was dreading waking up in the
morning and having to go for my appointment. I felt pressurized. I woke
up on the Friday morning with a heavy, depressed feeling; I was still
getting mild contractions but nothing more than that. I was again put on
the CTG and again, everything showed up as fine. Reinie asked some
questions about the risks to the baby, and was wonderfully calm. Our
doctor reiterated his advice about induction and asked us what we wanted
to do. Reinie told him without hesitation that we wanted to wait. I was
so grateful to have him with me, I was tearful and despondent and almost
unable to battle on. I wondered whether I was being selfish, whether I
was putting my own wishes for an active birth before the health of my
baby, something I did not want to do. I was prescribed antibiotics,
which were to try and combat any infection that might set in. For the
first time in my pregnancy I was agreeable to taking antibiotics.
Once home, I telephoned Sarah again. I remember telling her that I felt
my body was letting me down and not doing what it was meant to do. She
reassured me that apart from my membranes rupturing, which complicated
matters a little, it was absolutely normal for the body to get ready for
birth slowly with irregular, mild contractions. She suggested I drink
some cinnamon, clove, ginger and cumin tea, and rest in a quiet dark
room. By that afternoon I was having more definite contractions, and
they seemed to be quite regular but they were early labour contractions,
not the sort that closely precede a birth.
Reinie had taken the day off and was very encouraging. A friend took
Alexandra, almost three years old, for the afternoon. I continued
getting the contractions right into the evening, but they did not seem
to be moving on to the next phase. Then at about 9 o'clock that evening
they disappeared again. I was crying and felt distressed. I was almost
convinced that the drip was unavoidable, that I was going to have to
give in. I could not believe that things were developing this way. My
first labour had started, got stronger and about ten hours later
Alexandra was born. Reinie insisted our baby would be born soon and said
we should go to bed and get some rest. It was the last thing I wanted to
do. Of course, I was tired and needed to rest, but I felt too worked-up
and didn't think I could sleep.
I managed to drop off. Albeit not a deep sleep, it was sleep
nevertheless. I woke again at about 2 a.m. Saturday morning. The
contractions were back again but still only shallow first-phase
contractions. After a short while we went back to sleep again. Then at
about 4 a.m. I woke up with a strong contraction which I knew was in a
different league from the ones I had been having earlier. It had an
intensity and depth which the others had lacked. I lay very still hoping
for another, then another. I woke Reinie again and said I thought we
were moving on. I was nervous of getting too excited but I was thrilled,
and as each contraction came I felt that much closer to the sort of
birth I had planned. As one contraction ended I felt impatient for the
next one to start; to confirm that I was now entering labour proper. I
constantly reminded myself of the need to stay relaxed, not to tense up
as the pain started. I was determined not to "chase" the contractions
away. During contractions I visualized the dilation which was taking
place and focused on them. I was very quiet and felt very calm. At some
point Reinie telephoned Sarah, and a short while later she arrived. I
was pleased to see her, and she and Reinie inflated a ball for me to sit
on which was a lot more comfortable than the footstool I had been using.
Reinie was timing the contractions, and when one exceeded a minute, he
said it was time to go to hospital. He was very anxious not to be caught
with a birth at home or in the car. I didn't want that either, but nor
did I want to get to hospital too early, and then be told that I had not
progressed very much and really should be induced. I knew I would feel
pressurized to the point of not being able to refuse yet again. So I
protested that there was no hurry, but Sarah diplomatically agreed with
Reinie and off we went. I remember some very strong contractions as we
were getting into the car, clinging to a pillar before getting in, and
again in the car, very deep contractions. I was very sensitive to every
bump or jolt on the road. Orchard Road felt like a cross-country track.
In the hospital lift when we reached the delivery floor, I recall
holding onto the rail and the doors having to be held open while I got
through another very powerful contraction.
Thank goodness for Sarah, she knew where she was going. We were shown to
a room, and the midwife checked my dilation: 7cm! I was quietly ecstatic
and relieved. Now I knew I was going to have a drug-free birth. It then
seemed to go very quickly. The baby was monitored, he was fine. I got
off the bed, went to the loo, remembering Nikki's instructions to keep
the bladder empty, then I moved to the window where there were some more
contractions. They were very strong but I felt up to them. I thought I
probably had an hour or so of the most demanding contractions ahead of
me. In fact, I had already had them.
After a short while I seemed to enter a wonderfully calm and pain-free
state. I remember looking out of the window onto a garden and thinking
how pretty it was. I told Sarah. She said I was entering transition and
would probably get an urge to push with the next contraction. She
suggested that I move back into the centre of the room. She told me to
try and pant through that contraction and I asked her to show me how. I
was standing at the end of the bed when it came. I remember calling out
that I wanted to push. Sarah was very reassuring and took me through it.
The midwife then asked me to get onto the bed so that she could check my
dilation. The bottom half of the bed was lowered down for me to get on
and I sat on the edge of the top half, like sitting on a deep step. She
told me I was fully dilated and I could push with the next contraction.
Sarah suggested Reinie get onto the bed and support me from behind. He
put his arms in under mine, and Sarah stood next to me. With each
contraction I held her hand and squeezed her fingers so hard, they must
have been quite mangled by the end.
My doctor arrived, and more nursing staff. I was already pushing. Each
time I felt as if I was turning inside out and I experienced a strong
burning sensation. It had been the same the first time around, but the
urge to push was so strong I went with it. When the head became visible
the sister asked me if I wanted to watch in the mirror. I didn't but
Reinie said he would. So the mirror was pulled up and in fact I was
mesmerized, I could see everything and watched closely. I remember my
baby's head bursting through and hanging there for what seemed like
quite a while; then another hard push to get the shoulders out and the
rest of him followed easily and quickly.
It was wonderful to have his warm, round body in my arms, to hear his
little voice. He was well and showed no ill effects. It had been
probably 48 hours since my membranes had ruptured, possibly more. I
couldn't believe how well it had all worked out, I felt I had been
through a marathon; not the labour but the 48 hours before it with the
threat of an induction hanging over my head. I was elated. In retrospect
I realize that my desperation to avoid an induction carried me through
the labour. I was so relieved and grateful to have gone into labour
spontaneously, I felt I had come so close to a very different
experience, the pain seemed to be on the sideline. It took a few days,
but eventually we agreed to call him Nicholas. His birth is, and will
always be, one of my most treasured memories.
What's going on
here?
Sandra's waters released two full days
before her baby was born. If labour does not start immediately, some
women will choose to have an induction, while others will decide to wait
for labour to begin spontaneously. The great majority of women will find
themselves in labour within 48 hours if they decide to wait.
Meanwhile, there are many things that can be done to reduce the risk
of infection when membranes release before labour. Sandra's story shows
how she used a few of these strategies: she stayed out of hospital,
avoided internal examinations, and took antibiotics.
In ParentLink childbirth classes, you'll discuss this scenario
and many other common situations, and you'll discover ways to ensure
you're in control of your choices and feel prepared, even for the
unknown!
Click here
to learn more about how classes can make a difference for your
birth.
If you'd like to learn more about how a doula could help you and
your partner, as Sandra and Reinie's did,
click here for details.
To talk over your particular needs or concerns, you can:
call Tania at +65 9671-8428
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