by Nathalie Boobis.
I fell pregnant with my first child in August 2020, just before my 36th birthday. I’m autistic and I have ADHD. The thought of giving birth terrified me but as soon as I was pregnant the one thing I kept fixating on was being interrupted during labour in order to get to a hospital or birth centre. My partner can’t drive and I hated the idea of having to be in a taxi during such an intense and vulnerable experience. The logical conclusion to this was a home birth but I thought I wouldn’t be allowed.
I was pregnant in 2020 - 2021, during the lockdowns. This gave me time to research everything I could find about birth; it became my special interest. I learned everything about physiological birth, reading Ina May Gaskin, Adrienne Rich, Milli Hill, Dr Gowri Motha, and more. I learned hypnobirthing ‘up’ breathing and I used a hypnobirthing script to dispel my fear of birth. By 24 weeks I knew two things: One was the optimal conditions for physiological birth (dark, safe, uninterrupted) and two was that I needed to have a home birth. As a neurodivergent person, I knew with certainty that the uncontrolled environments of a birthing centre or hospital would work against birth physiology for me. Not only in the obvious ways – bright lights, general hospital or birth centre noise, the taxi situation, social interactions – but also in small ways such as the potential for a buzzing light or beeping machine, chit chat of staff, unfamiliar smells, too hot rooms.
I asked for a homebirth and towards the end of my second trimester I was transferred to the homebirth team. My one regret is that I didn’t do this from the start; it was so ideal for a neurodivergent person as I was assigned one midwife who come to my home for all the appointments. Previously, I had been travelling to the birth centre and seeing a different midwife every time.
My waters broke at 2am on the day before my due date but contractions didn’t start then. I called the midwifery team to let them know and one of them came out at 6am to see me and check my waters. I didn’t like her vibe and I remember she checked my dilation without telling me what she was going to do and it hurt. I was 1cm. She casually told me I had premature rupture of membranes and would need to be induced. I was not happy about this idea and I was anxious and couldn’t get back to sleep. Another midwife called me about 9am and told me that there is an increased risk to the baby of infection once the waters have broken and they need to be born pretty soon. I was determined not to be induced but also to find out what the absolute risk was so that I could make an informed decision. I asked to speak to the consultant midwife who told me that the risk of neonatal infection doubled but only from 0.5% to 1% and that most women go into labour within 48 hours of their waters breaking. I was happy to take this risk and signed a waiver but I was still told that I would need to have my baby within 24 hours.
My contractions began at 7pm that same evening. I hadn’t slept since 2am. I had spent the day walking, bouncing on my birth ball, and tidying the house, hoping to induce labour. I put some clary sage in the diffuser at 6.45pm and lay down for a nap. 15 minutes later and I was contracting quite strongly every 5 minutes. I had hired a TENs machine and birthing pool for pain management, as well as asking the midwives to bring gas and air. I put the TENs machine on and tried to work with that for a couple of hours but I found it distracting. I need to sit with pain and discomfort in order to handle it. The up breathing worked for me. I breathed my way to 4cm dilated, mainly in the lounge with my cat, Elmo and my husband. As the contractions got more intense, I moved to my bedroom. Two midwives came to the flat around this point.
Time became a bit of a blur throughout labour but I remember sometimes kneeling down with my head on my bed and my husband holding my hands, and quite a lot of time standing up, either leaning against the wardrobe (with my cat on top looking down at me!) or against the wall by the door. The lights were low and it was quiet. I like music but I’m sound sensitive and prefer silence for coping with things. I was taking rescue remedy when I felt overwhelmed and diffusing lavender oil. I had a lot of back pain and found it hard to lie or sit down. Every now and then the midwife, Natalia, would come in and take my pulse and the baby’s heartbeat. She did internal exams too and I remember feeling disheartened at a couple of points when after what seemed like hours, I was ‘only’ X cms. I kept wanting to get in the birth pool that, at some point while I was labouring, my husband had set up with the midwives in the lounge. But I was told that I couldn’t because it might slow things down and I was against the clock because of the early rupture of membranes. Retrospectively I felt annoyed about this but I was accepting of it at the time and I was mainly able to tune out the time pressure. I felt rushy and high from all the oxytocin and it made me feel nauseous and like I couldn’t eat. My husband was bringing me coconut water to sip from a straw and trying to get me to eat dates and smoothies for energy.
I was exhausted from no sleep and standing up and at one point my legs started to shake and it got really intense. My lower back was very painful and I wanted to be in the birthing pool but was still being told not to. At this point I got in the shower, I think for ages. I had my husband aim hot water at my lower back and remember the bathroom being drenched. I remember when I got out the shower, Natalia gave me an internal examination and declared I was fully dilated and able to go into the birthing pool. That must have been the transition phase. I didn’t know until this point that Natalia been rooting for me to be fully dilated by 7am when her shift ended, and when the pressure would have started to kick in for medical interventions if I wasn’t. I’m forever grateful to her for safeguarding this for me.
The birthing pool was entirely the second phase of labour and although the first phase had been intense, it was manageable with the breathing and I had found a rhythm of how to handle it. I didn’t know what to do in the second phase, I felt out of touch with my body and I didn’t feel any urge to push. It marked a change in labour stage, a change in physical environment, and a change in midwives as the shifts changed. My regular midwife, Jade, was there for this part along with another called Tilly. I’d gone from being left to it, with some discreet observations, to being very much guided through the next part. I couldn’t find a good position in the water and I probably didn’t really want to be in the water at this point but I was exhausted and I followed the path laid out for me. I was being told when to push and how and I remember it just didn’t feel right. I felt like I was going to break in two; it was agony. I’d felt too nauseous for gas and air earlier and by now it seemed too late. The midwives were very much managing this situation and trying to keep me focussed on the task at hand. My up breathing technique that worked so well for me for 17 hours of contractions was no longer working and I couldn’t remember or work out how to breathe at this point, so I abandoned that idea. I tried making noises instead but nothing seemed to work so I gave in to pushing when Jade told me to. Apparently this stage of labour was 2.5 hours. Through everyone’s encouragement and instruction, I gave a final, huge, painful, push and my baby crowned and at the same time shot out of me in the water, tearing me as he emerged. I was in shock, I think from the pain and the speed of his arrival. My baby was born in water at 1.23pm on Tuesday 25th May 2021, his due date.
I was given him to hold in the pool and I remember the pain still. I was trying to be in the moment of holding my baby but I was very shaky. I wanted to get out of the pool with him and to lie on the sofa. I was helped to climb out and taken to the sofa and I can still remember the realisation that my husband had put a Wilko dust sheet on the sofa, with an old bed sheet on top of it, instead of the non-slip polythene sheets from the birth supply shop that I’d bought especially. So actually this memory of holding my new baby and trying to feed and relax with him wasn’t great; I was shocked and in pain, I was slipping around on the dust sheet, I was shaking, and I was struggling to breastfeed. My baby was crying – the midwives said he was cold. I think unfortunately my husband had also forgotten to put the heating on.
My husband cut the cord while I was on the sofa and I hobbled to the toilet with Jade where she coached me to push further to birth the placenta, and then put it in a cardboard dish in the bath. I wish I’d had more of a look at it but it was the least of my worries at this point and she didn’t offer. I was stitched up on my bed while my husband gave our baby skin to skin in bed and warmed him up. I took some paracetamol and went and had a shower then got into bed in clean clothes, with some toast and tea, and this is the moment when I remember properly holding and feeding my baby. I have pictures and my pupils are hugely dilated. I can remember feeling ‘high’ still from all the oxytocin. It was not until months after birth that I stopped getting oxytocin rushes every time I fed, held or wore my baby. The midwives left at about 7pm and despite being absolutely shattered and sleep deprived, neither my husband or I could sleep. I was wired and we were both shocked and in awe, staring at out little son, who was wide eyed and staring back at us. I remember feeling immensely proud and powerful!
My experience of a birth was hugely impactful for me. I self advocated for a homebirth and was able to have an unmedicated physiological birth. I know that as a neurodivergent person, being in my own environment was crucial for my body to be able to effectively birth my baby. I am sure that if I had been cajoled into an induction, my story would be very different. As it is, I hyper fixated on things that happened during labour and birth that with hindsight I know that I could have exercised control over – not being allowed in the birthing pool in the first stage of labour, disheartening internal examinations, coached pushing, not being in the birthing pool during the second stage of labour. (As well as my poor husband’s panicked mistake of putting the wrong sheeting on the sofa – which I will forever feel annoyed by!). I am currently training as a doula because I want to contribute to more women and birthing people learning about and trusting their bodies’ physiological abilities to birth their babies. I hope to specifically work with other neurodivergent people in their labours and births as I know first-hand the positive impact it can have to be able to have control over the environment you are birthing in, and how this can be improved even further with the right knowledge and support.
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