Bump&Taryn - 36 Weeks to Birth
Introducing Benji Cameron!
I am very excited to announce to those who haven’t seen it on social media – on the morning of October 10th, at 38 weeks and 5 days of pregnancy, I gave birth to the beautiful Benjamin Cameron Watson, AKA ‘Benji’! Although we ummed and aahed and considered many other names throughout the pregnancy, Benji was always our favourite. Therefore when we found out he was a boy, we christened him Button, as in Benjamin Button… did anyone guess that was why?! I’m surprised that no one seemed to! It is also very fitting that our little man has a distinctive button nose that is absolutely adorable. And Cameron is Byron’s brother’s name and it’s lovely to be able to continue a family tradition in that way.
The time since then has been a bit of a blur, and I look forward to writing about the whirlwind of new motherhood in my new blog ‘Benji&Me’ in the coming weeks, however this final Bump&Taryn blog reflects on those last three weeks of pregnancy and the much anticipated birth.
The last weeks were definitely filled with difficulties and most movements were accompanied by involuntary groans… it was hard to get onto the couch, it was hard to get off the couch, it was hard to put my shoes on, it was hard to get out of the car, etc etc etc. I was unable to go for my beloved walks due to lower abdominal discomfort, and I was living on liquorice, prunes and Benefibre, trying in vain to regulate my poor bowels. And I have seen enough heavily pregnant women through my career to realize that I was actually much luckier than most – no pelvic girdle or back pain, no swollen ankles and I was actually relatively mobile right to the end. But it still was not a phase that I would have liked to stay in for too much longer!
On that note, one thing that definitely helped these final weeks was that at approximately 36 weeks of pregnancy I had made the difficult decision to opt for an elective caesarean delivery, and this meant that I knew that I would give birth by 39 weeks. I have a newfound respect for those who deliver one or two weeks overdue – not only would they have had an extra two or three weeks of growth, discomfort and boredom to what I experienced, but would also have to deal with the uncertainty of not knowing how much longer they had to endure this whale-like state of being…
So, how did I finally come to the decision on how to birth my baby? Well, I’ve decided to tell the whole truth here about my past medical history, even though this might be a bit of an overshare in a public blog… My thoughts are that for most pregnant women in my situation (30 years old with an uncomplicated pregnancy), trying for a vaginal birth would usually make the most sense. I think it's best to plan for limited intervention, with a mindset that you trust the birth professionals if they decide that intervention is needed and accept that there may be many different outcomes to your 'ideal' one. However, I needed to take into consideration that I have suffered from bladder dysfunction for the past 10 years. At age 20, I had sudden onset urinary urgency and frequency, and started really struggling to make it to the toilet in time. I had some very invasive testing done and was diagnosed with ‘detrusor overactivity’. This means that while most people’s bladder wall muscle will only contract when they are at the toilet, mine contracts before that, and I need to have a very strong, well functioning pelvic floor muscle to control that pressure and get to the toilet. This was well managed with medication for most of the past decade, but I had to go off this medication when I started trying to conceive. Some of the symptoms returned, but were generally well managed with calming strategies, minimizing caffeine and keeping my pelvic floor muscles really optimal. It got me thinking though – and I’ve seen this first-hand with patients of mine – life could get really difficult if I endured a pelvic floor injury during birth. And if you work in Women’s Health Physiotherapy like I do (or if you read my recent blog post about vaginal birth!) you will realize that pelvic floor muscle injuries in vaginal births are actually relatively common. For most people, rehabilitating this muscle will usually get it back to a point where they are asymptomatic – but throw in something extra like the detrusor overactivity and it could be a different story.
So early in the pregnancy I started considering an elective caesarean birth. This worried me and I felt quite anxious about the decision – if I’m being honest, it was mainly about how other people would perceive my decision. Would it be assumed that I was ‘too posh to push’? Or that I was being selfish in saving myself from pelvic floor injury if caesarean births are more risky for the baby? I have experienced scathing comments about the high rates of caesarean sections at the private hospital that I delivered at (the same hospital that I have worked at) – mainly from midwives who don’t work in the private sector – and that has always played on my mind.
This is the point when I decided to do as much research as possible, the result of which was the blog post ‘The Great Debate – Vaginal Versus Caesarean Birth’. And my conclusion was that there is no wrong way to birth – the research seemed to show that a caesarean birth would not be detrimental to Button, and both choices for birth seemed to have fairly even pros and cons for different people in different situations.
So the Caesarean was booked for 38 weeks and 6 days, and a huge weight was lifted off my shoulders. In the end, looking back at the way the birth ended up panning out, I really feel like this was meant to be.
I had a check up with my midwife at exactly 38 weeks, and I mentioned to her that I had experienced a day recently where I hadn’t felt very many movements. She was quite definite in telling me that if that were to happen again, I must call the maternity ward and come in for a CTG (cardiotocography) as soon as possible to check that the baby was OK. So that night, when I noticed that Button wasn’t moving very much again, I took more notice – however I really thought that it was just that the midwife had put it in my head that day, and I was overthinking it. But the next morning, when the movements still weren’t as obvious as usual, I ended up calling and going in for a CTG.
Everything was fine, and I felt slightly embarrassed to have wasted their time. All the staff reassured me that it wasn’t a waste of time and to come again if it happened again. The following night, I was awake at 1:30am (my body clock getting used to motherhood…?) and started monitoring the movements again. Sure enough, even with cold water, sugary food, moving around etc, I could only feel very small, irregular movements over the next hour, and so I (reluctantly) called the maternity ward again. And I was told again – come straight in, better to be safe than sorry.
And again, after a couple of hours of monitoring, I was told that Button seemed fine and that I could go home. But the obstetrician on call (my obstetrician was overseas for another two days… doesn’t this always happen?) came and had a chat to me and said that if I was anxious about the decreased movements, he could definitely do the caesarean section that day – it was only 3 days before the booked caesarean date anyway. I decided that because the CTG was good, then I would wait, but agreed to the obstetrician’s suggestion to do daily CTG monitoring for the next two days before the caesarean date.
Sunday’s CTG was, again, fine. Therefore I nearly didn’t attend on Monday – I felt fine, Button was moving lots and I had that unnerving feeling that I was wasting everyone’s time. Thank goodness I did go in – Monday’s CTG showed two good accelerations (three are needed to give the all clear) but then I had a Braxton Hicks contraction that was very strong and went for about 3 minutes. These contractions had been happening since about 30 weeks, but this was a particularly big one, and afterwards the midwife told me that no matter what position she got me in, Button’s heart rate dropped dramatically to about 60, when normal is 110-160.
No one really acted like this was an emergency, and no one mentioned what this might actually mean and what the cause was. I was told to call Byron to come from work, because Button was going to be born today, but I pictured that we would be put on the end of the caesarean list in the afternoon. I actually thought Byron would catch the bus back home and pick up our bags… so when I was told that we were next on the caesarean list and would be in theatre within the hour, I was relieved to hear that Byron had the sense to catch a taxi instead of the bus and it was my Mum who was picking up our bags!
I was laughing and smiling and very relaxed. The whole cesarean process went very smoothly, I had already prepared myself for the fact that I was going to have a very large needle inserted into my lower back (I actually used all the relaxation techniques that I teach for preparation for labour, and the distraction and breathing worked wonders), a drip was going to go into my wrist, and a catheter would go into my bladder. To be honest, compared to some of the fertility procedures I had gone through, this was much less traumatic (and had a lovely reward at the end of it!). As I was going through all of this, I did spare a thought for what this potentially scary process would be like without the mental preparation, and what it would be like to have an emergency caesarean after many hours of labour, with the possible feeling of failure and being worried for the baby’s health.
As it turns out, perhaps I should have been more concerned than I was. Byron stood up and watched the caesarean, and told me that as they lifted Button out, the cord was wound very tightly around his neck, and the medical staff all looked knowingly at each other. In the days afterwards, I was told on multiple occasions that someone must have been looking out for me that I attended for that CTG on Monday, and that they happened to catch one of the large Braxton Hicks contractions before they discharged me again. Those unusually long and strong contractions were tightening the cord further around his neck and drastically lowering his heart rate and oxygen supply. The staff praised me for listening to my body and knowing that something wasn’t quite right with Button’s movements.
We will never know for sure, but the obstetrician said that the tightness of the cord and the drastic drop in heart rate very probably would have ended in an emergency caesarean if I was being monitored in labour, and he was very glad that we didn’t have to go through that. For someone who had been very concerned about making the right decision regarding mode of delivery, I have come away with a very satisfied feeling that my decision was the right one for Button and me.
For those who didn’t read it, here is a link again to the article that I spent so many hours researching and writing in the lead up to Button’s birth. Knowledge is power, and women need to embrace our inner power to make these tough birth decisions.
Since Button’s birth, I have been reading Constance Hall’s book that my wonderful sister (also a new mother) has given me, and her candid, empowering view of birth has brought tears to my eyes. I would like to finish this blog with a Constance Hall quote:
“One thing we all have in common is that we are women who want the absolute best for our little purple aliens, at whatever cost. We just want safe arrivals and I think that unites us all. There is only one piece of unasked-for advice that I like to shove down every pregnant woman’s throat: Do NOT ever let anyone else persuade you to give birth the way THEY think is right, this is your journey. I don’t care if all the hipsters are squeezing them out in the VIP section of a new bar on opening night. I’m not. You are entitled to feel disappointed in the way things happen but you’re not allowed to feel disappointed in yourself. Ever.”