When planning my 3rd birth, this time after a 9 year gap, the issue of my last PPH came up when talking with my midwife, but we assumed that this was due to the third stage being managed and therefore there was a good chance another PPH would not occur. I also placed hope in the fact that I had chosen a home birth would negate the possibility of negative outcomes. I enjoyed a lovely pregnancy and birthed my baby in 6 hours. However, I again started to bleed slowly after birth, but this time my midwife monitored me closely and made the decision to give me a shot of Syntometrine an hour after the birth. This managed to stop the blood loss, but my blood pressure was still abnormal due to the bleed being more than a litre. Given that I was still feeling very sick and not really ‘with it’ the decision was made to transfer me to hospital 2 hours after the birth. The hospital experience wasn’t fantastic but the blood transfusion I consented to made me feel much better than after my 2nd birth with no transfusion.
Discussing the possibility of another home birth with my midwife, I was told that it was possible, but that her desire would be that we manage the third stage from the start. This was not something I was keen to do, as after experiencing PND with my first baby, I was aware of the importance of not interrupting the high natural oxytocin levels that are present in the first hours after birth. When I fell pregnant with my 4th baby, I looked at my choices of midwives in my area, but found that the best option was the same midwife I had in my last home birth. I really respected my midwife and was happy with how she handed the situation with my PPH, but wasn’t keen to have a managed third stage. I also just had a feeling that I needed something different for this birth, but wasn’t sure exactly what that was. When I met with my midwife at 5 weeks, I expressed my wishes for a natural third stage and that I felt my confidence had grown in relation to childbirth and that if it turned out my pregnancy was multiple or with a breech position then I may need to look for another midwife. My midwife was happy with this and we started out on the journey for my fourth baby.
As the weeks continued I became more and more uneasy about my midwife and still felt I needed something different for this birth. Around 14 weeks into the pregnancy I was feeling very stressed and confused and I still hadn’t had my official first appointment with my midwife due to the busy time of the year. I contacted another midwife from Melbourne and discussed possible alternative midwives who might travel to support me in my birth. I was informed of another midwife that lived an hour from us who might consider travelling and who was worth contacting. The next day I phoned the ‘possible midwife’ and straight away I felt a peace coming from her that felt ‘right’. She agreed to meet me two weeks later and have a chat about my ideas around this pregnancy and birth. From the start of the meeting with the ‘possible midwife’ we ‘clicked’ and after two hours of debriefing my births and discussing my desires, her philosophies and how that all fitted together, I knew she was the right midwife for this pregnancy and birth.
By this time it was mid December and due to my new midwife going away in January, we made our first appointment for the start of February when I would be 24 weeks. I felt good about this timeframe as I felt a desire to have fewer appointments in this pregnancy and at this stage I still did not feel ready to fully ‘enter into’ the pregnancy. This was not in a disconnected way, rather I had a peace with where I currently was and I needed to sit in this place for a while.
When February came around I was feeling ready and was excited to finally be starting the journey. At our first appointment the PPH’s were at the top of the agenda and we started the discussion of what we could do to reduce my chances of experiencing another one. My midwife knew my wishes for a natural third stage and supported that unless I bled quickly or the bleeding would not stop. I agreed that I would definitely want her to take what steps she needed to if I had a quick bleed (which was not in my history) or if my bleeding did not stop like my last birth. We also discussed other alternatives to stop the bleeding such as using certain herbs, breastfeeding quicker after birth (I did not feed my 3rd baby until 1.5 hours after birth), making sure my birth space was quiet, dim and uninterrupted and that I could quickly access the toilet to empty my bladder and also get onto the bed quickly to get comfortable after birth (again all things that were missing from my 3rd birth). My midwife also suggested exploring possible emotional/psychological reasons for the bleeds as I continued on in the pregnancy.
We continued our appointments every few weeks and by 31 weeks I was feeling very tired and not very well within myself. My midwife challenged me about my overall health and suggested I start to see an acupuncturist to work on my blood and energy levels and also a chiropractor to work on my back, which had been sore for the last few weeks. We were also aware that I needed to be conscious of the diagnosis of pregnancy induced osteoporosis that had occurred 4 months after the birth of my 3rd baby after experiencing 2 spinal fractures. This had resulted in losing 4cms of my height going from 157cms to 153cm. It dawned on me that I only had 9 weeks until I was ‘due’ and that I needed really step up and take control of my health and not see out the rest of my pregnancy being in pain and feeling out of control. Over the next few weeks I made an appointment for the acupuncturist for 33 weeks and the chiropractor for 35 weeks. The chiropractor was local but the acupuncturist was personally recommended to me as a specialist for pregnancy so I ended up travelling an hour to see her. At 32 weeks my midwife found the baby in a transverse position, which again gave me motivation to get on top of my health. I knew it was still early and transverse at this time was quite normal in subsequent pregnancies but again knowing I had lost 4cms in my height since my last birth put some ‘unknowns’ around positioning and the room for baby to move.
Things from that stage changed very quickly, after seeing the acupuncturist for the first time my energy started to increase, she said it was clear my blood was not looking good and she needed to work on balancing it out so was could reduce the chance of bleeding at the birth. She also noted the transverse position and did some work on encouraging bubs into a head down position. I continued to see her fortnightly right up until the birth. By the time I went to the chiropractor at 35 weeks bubs had already turned head down and the chiro just worked on my pelvis which she said was restricted by 3cms and she was surprised I had not had any pelvis pain as yet and only the back pain. She adjusted it gently and then made another appointment for 2 weeks time with another appointment 3 weeks later around the time I was ‘due’. When I went back two weeks later I was still without back pain and feeling great, the chiro confirmed that my pelvis had stayed in the right position and there was no need for me to come back unless I had pain again.
The next week I finished work and was still feeling great. This was so different to my last pregnancy where I actually was due to finish 4 weeks before I was due but ended up taking some sick leave and finishing 6 weeks early as I was so tired and in pain. This all was making me feel more confident about the changes that were happening with my health and giving me more hope that this time we would be able to birth at home without a transfer again, being able to enjoy the time after birth for the first time since my first birth 13 years ago.
Having a bit more time after finishing work I started reading a book called “Lotus Birth” by Shivam Rachana. It really spoke to me and helped me to start exploring the possible emotional/psychological aspects of my two PPH’s. I thought about the PND I had experienced after the birth of my 1st child which was still there after the birth of my 2nd and wondered whether my PPH was a way of trying to stop the pregnancy ending so I didn’t have to move into the next step of being a mother which I had felt such a failure as to begin with. Even though it had been years since my PND and I had done a lot of work to find healing from it, I acknowledged that my body could still be reacting in the same way. I also wondered about whether I could feel the same way with my 4th baby as even though I did not experience any PND with my 3rd baby, I still experienced the back fractures when she was 4 months old which resulted in me being in chronic pain for a long time afterwards. I wondered if choosing a Lotus Birth was a way of slowing the ‘birth’ and a way of embracing the placenta and not feeling thrown into the next stage of the birth being over so quickly. I discussed this with my midwife at my next appointments and she agreed that it was a good idea and was very familiar with Lotus Births and had supported many over the years. My husband was not as comfortable with the idea but when I explained the reasons behind it he soon agreed that it was a decision I needed to make as I felt so strongly about it in our plan to reduce the chances of another PPH.
At 37 weeks I was blessed with a beautiful Blessing Way organised by a dear friend of mine. The time was so special with candles lit, prayers expressed, births shared and my friends and family sent home with their own personal prayer request for my birth, which included prayer asking for a normal birth with a minimal bleeding. At 39 weeks I went back to my acupuncturist who commented that I actually had ‘too much’ energy and she needed to balance me out the other way a bit more. I was getting up every morning at 8am and going non-stop until 11pm at night before I dropped into bed. This was unheard of for me who usually crashed in the last trimester needing afternoon sleeps most days. That night I felt so exhausted much quicker than usual and the next few days I was so tired and needing to sleep in the afternoon again. This had me worried and so I emailed the acupuncturist to make another appointment for the following week. A few days later I was feeling much better and seemed to have a better balance of my energy levels so decided to cancel the appointment.
By the Wednesday of the next week I finally felt ‘ready’ to have the baby. I knew I had done everything in the pre-natal period that I needed to do to fully prepare for the birth and was very confident that we had a great chance at not experiencing another PPH … now it was time to wait until bubs was ready to come … it turned out we did not have to wait long. On the Friday night I went into labour and our fourth baby was born early Saturday morning with only a 550 ml loss after birth.
I am so thankful that I trusted my instincts and continued to look for another midwife who really helped me to prepare physically, emotionally and even spiritually for a normal birth. I am also thankful for my beautiful husband who supported me at every turn even when I didn’t make much sense to him and he wasn’t sure exactly why I needed a different midwife or needed to choose a Lotus Birth. He now understands why and has expressed his admiration for my decisions and is in awe of the way I birthed, finally birthing completely my way.
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