The first sign that we had that Kaylee would be meeting us early was when at 35 weeks exactly that I started to lose my mucous plug. Up until this point I had been adamant that she would be late – how wrong I was!
I then made a conscious effort to rest and take it easy, as I didn’t want to bring on labour too soon. On July 23, when Kaylee was just 36 weeks and one day, I started to get signs that labour was imminent. Throughout the day I was having small leaks of amniotic fluid, and my bowels were clearing out. When I went to bed that night, I was having bad lower back pain. Somehow I still thought she wouldn’t come just yet.
At 3:15am on Thursday July 24, when Kaylee was 36 weeks plus 2 days, I woke up with a jump as my waters had well and truly broken. I went to the toilet and cleaned up, then woke Ben up before phoning Fiona, our midwife. Fiona told me to get to the hospital to get checked out, however at this stage I was not yet having contractions so there was no rush. As Kaylee was so early, we had not yet packed our hospital bag, so we ran around the house finding and packing our bags, during which time the contractions began. On the way to the hospital I phoned Laura Lee, our doula, who met us at the hospital soon after we arrived.
We arrived at the hospital at about 4:45am, and were taken up to a room just after 5am. My contractions by this time were quite strong, although irregular. A quick examination showed that I was already 5cm dilated. The hospital phoned our midwife, as we couldn’t go to a birthing suite until she got there. Because we were four weeks early, the hospital said I had to keep the foetal heart monitor (ctg) on, however we were left alone with no one checking on us for the majority of the time. I already knew that my hope of a water birth was over, due to being premature, and tried to move around the room as much as possible during contractions, mostly using our fitball. Our doula was fantastic. She turned off the lights, turned on electrical candles, massaged me, used aromatherapy and provided Ben and I with a great deal of support. I kept asking when we would be able to go to the birth suite, but we had to wait for our midwife to get there, which was taking what felt like forever. All I wanted to do was get in the shower, but with the ctg on it was impossible.
By the time our midwife Fiona arrived just before 7am my contractions were rather intense and we were moved to a birthing suite. I asked to be able to shower and Fiona explained that the portable heart monitor would need to be charged then I could use it in the shower. In the meantime the ctg was kept on, and the midwife became increasingly concerned about Kaylee’s heart rate as it was not stable. I continued to try to use the fit ball for my contractions. One thing that surprised me was how much blood there was, and how certain movements of Kaylee would cause further gushes of amniotic fluid. It was just so messy!
Kaylee’s heart rate continued to be unstable, and so an electrode was attached to Kaylee’s scalp through my vagina, to more accurately monitor her heart rate. Soon after I was made to lie down on my side on the bed to try to slow down the labour, as it was happening too quickly and Kaylee was distressed. The pain of contractions increased immediately once I was lying down, and a quick check showed that I was 8cm dilated. At this point I could no longer manage the pain of the contractions lying down, so asked for the gas. I felt a bit like a failure asking for the gas, but I’m glad I did. Being able to breathe in the gas and concentrate on my breathing helped a lot, although the pain was still intense. I did not want Kaylee to be affected by any drugs so was adamant that the gas was the only drug I would have.
Shortly after 8:30am, it seemed like the birthing suite filled suddenly with people, and we were told that we had to get Kaylee out of my body as her heart rate was not good. I was made to put my legs in stirrups, and the obstetrician directed me to push. Because the labour had been so fast, the obstetrician used a vacuum to turn Kaylee as she hadn’t turned like she was supposed to I only learnt this afterward, as everything I had was concentrated on pushing her out as I was so worried about her. The obstetrician cut an extended episiotomy and put in a catheter, and told me that they would have to use forceps to remove her. The pushing felt never ending and so painful, and our midwife said at one point that if I couldn’t push her out right now we would be rushed to theatre for an emergency caesarean. This was the last thing I wanted, and with some serious pushing finally she came out and the pressure immediately eased. I found out later that the forceps were only used to lift Kaylee slightly, and I pushed her out myself without them. As she was coming out Laura Lee told the doctors that I wanted delayed cord clamping. However the OB said that it wouldn’t be possible. Kaylee was immediately taken away to a nearby table where the paediatricians were waiting to work on her, and after a couple of minutes I heard her cry. We found out later that her first apgar score was only 3, and she needed 3 minutes of resuscitation to start breathing. At the time neither Ben nor I were aware of this, as it had all been such a whirlwind. I was feeling rather shocked that she wasn’t on my chest for skin-to-skin as we had planned. It all felt quite surreal.
Kaylee was born at 9:06am on July 24, weighing 3348 grams and measuring 49cm. Due to the concern for Kaylee’s well being and the need to get her to the special care nursery, we were unable to have any of the after birth practices that were planned, such as delayed cord clamping and immediate skin to skin. I was also haemorrhaging, so was unable to deliver the placenta naturally as I had hoped.
After the doctors had checked her over, they brought Kaylee over to me for a very quick cuddle. Having that cuddle with Kaylee was extremely special. We were both surprised with how much hair she had. Kaylee was then taken to the special care nursery and Ben went with her while I had the episiotomy cut stitched up. I think I was in shock at this point, that our birth had deviated so far from the “plan” and that Kaylee wasn’t with me. I phoned Mum and told her that she was a granny, as I wanted her to come, but she said she would have to come after work. I didn’t tell her any details, and my memory of this is quite blurry. I had three tears up high on the vaginal wall which I needed to go to theatre to get stitched up. I was taken to theatre and started getting really teary and emotional from the shock of it all. I remember the anaesthesiologists trying to comfort me. Once in theatre they got me to sit up for a spinal block, but I got dizzy and fainted. I woke up to find that I had vomited as well, and they were sucking it up with a small hose. They let me lie down from there on. They put the spinal block in and stitched up my tears as I dozed. All up I lost almost a litre and a half of blood. I really don’t remember much until I was wheeled to recovery, where I started getting emotional and teary again. I was feeling very much shocked at the way everything had happened. I had had a baby, but I was alone – not the way it is supposed to happen.
I was then taken to the High Dependency unit. I was told that I couldn’t go to Maternity due to the large amount of blood I had lost, as this meant I had to be closely monitored. By this time it was after 1pm, and Kaylee was over four hours old. Fiona and Laura Lee showed me how to hand express colostrum for Kaylee. It was a lot of work for about a millilitre of colostrum. Ben showed me the photos that he had taken of Kaylee, and I started asking the staff to be allowed to see her. Throughout the day I kept asking, but was told I was too unwell to go see her, as I was hooked up to a lot of drips and needed close monitoring. Being separated was horrible, it didn’t feel like we had had a baby. Ben was amazing, running back and forth between us, absolutely exhausted.
Over the next 12 or so hours my kidneys shut down and there were problems with my blood pressure and heart rate and liver. By about 1am they were monitoring me closely, and said that I might have to be transferred to the intensive care unit at Footscray Hospital, while Kaylee stayed in the special care nursery at Sunshine. I had many doctors coming in and out, and they said that I had HELLP Syndrome, which can be a form of severe preeclampsia. It was a couple of days before I fully realised how serious this was, and that it was life threatening. I was given a blood transfusion, and at 3am I was hooked up to a Magnesium drip, which would need to run for 24 hours. During this time I was hand expressing colostrum every 2-3 hours to be taken up to the nursery to feed Kaylee.
It took until 3am that first night for the nursery to bring Kaylee to visit me in her humidicrib. She was so tiny and sleepy, and it was so good to see her and have cuddles. I then didn’t get to see her again until they bought her to see me the following evening (Friday). Over the course of the next 24 hours I slowly recovered, and by Saturday morning I was able to get out of bed for the first time since the labour on Thursday morning. I was extremely dizzy and in a lot of pain from the stitches, and had to be taken places by wheelchair until Monday. After having a much needed shower on Saturday morning, we then spent the whole day with Kaylee in the special care nursery.
The nursery were monitoring Kaylee for potential brain haemorrhage, which thankfully didn’t occur. She was hooked up to a Dextrose (sugar) drip, as well as a lot of monitors. As my milk started to come in I was able to breast feed her, but the nursery staff and practices were mostly very non- breast feeding friendly, and went against everything recommended by the World Health Organisation and the Australian Breast Feeding Association. Luckily I had read a lot during pregnancy and I knew that a newborn’s stomach is tiny, and all it needs is colostrum until the mother’s milk comes in. The nursery staff however said that by day 3 of Kaylee’s life I had to be providing her with 300ml of milk (which I didn’t yet have, due to my blood loss) or she should be on formula. This went against everything that the hospital breast feeding policy said and everything that the research I had read recommended. We refused to feed her formula as it was not necessary, and I had read research about the harm that this could cause to Kaylee’s gut flora, not to mention the damage that would be done to our breastfeeding relationship which was so new and fragile. If Kaylee was drinking from a bottle (or in our case a syringe) rather than sucking at the breast, my body would not be getting the message that she needed me to make milk for her. Unfortunately, by refusing formula, this meant that the nursery kept her on the drip. All the midwives that I spoke to said that I was producing enough milk or colostrum for Kaylee, and that we were doing the best thing for her, but that wasn’t enough for the nursery staff. It got to the point where I was so filled with stress and anxiety and ready for battle whenever the nursery staff would come near us. The nursery staff told us on the Sunday night that the only reason that Kaylee was in the SCN was because we were refusing to feed her, which was extremely hurtful. We felt judged whenever we were in the nursery, and received no support from the nursery staff at all. On the Saturday we even bought in a private midwife as no one would help me to breastfeed, as a first time mum I had absolutely no idea what I was doing.
On Monday they said that Kaylee’s head was now fine, and it was only her feeding keeping her in the nursery. We were able to negotiate to use our sister-in-law Alice’s donor breastmilk to top up her feeds to get her out of the SCN, and bring her to my maternity room for the night. I don’t know what we would have done otherwise. We were so overjoyed at getting her out of the nursery and having her with us for constant cuddles. The SCN staff continued to check on her and they came down for every feed and would literally stand over me while I fed Kaylee, then topped her up with donor milk, which felt like force feeding as she wasn’t still hungry, and would then vomit most of it up. The SCN staff told us that she would have to stay in hospital until she had regained her birth weight, but on Tuesday morning a decision was made that she could be discharged with me that day. We went home on Tuesday afternoon, and were overjoyed to have our little girl to ourselves.
**I would like to add a note that I have nothing against using formula when it is medically necessary, however in our case it was completely unnecessary, and would have caused more harm than good.