Respect, Informed Consent and a Beautiful Birth

Benjamin’s unanticipated Birthvillage Birth

Sonia, a powerful young mum shares:

“Throughout my pregnancy, I had prepared to give birth at an institution at Bangalore, where Iive. But as it happened, my younger sister’s wedding was fixed quite unexpectedly, and I found myself in Ernakulam when I was getting close to my due date.
My first child, my daughter was born at an institution at Ernakulam. It was an experience that was far from satisfactory to me. But since it was the only one that I was familiar with, and maybe I hope somehow that things would be different this time around, I went back to that institution. But when I was there, I realized clearly that this was not how I wanted to experience birth all over again.

For the first birth, there was this feeling of being rushed all the time – rushed into taking decisions, rushed through the whole experience – when I was at the institution. I couldn’t understand it – there was absolutely no rush for anything till 37 weeks – and what happens suddenly that there needs to be this big rush into things?
In my first pregnancy, when the baby was 35 weeks, the care providers told me that the baby’s heartbeat was too high. I had just come from Bangalore to Ernakulam at week 35. And before I knew it, I was admitted in the institution! I remember thinking – what’s happening – how can things be done like this? I am a fully aware human being, and without any consent or information given, I am admitted! And then the careprovider was saying – ‘there is some danger to the baby. We have to take it out.’ No reports were shown to me, because the patient is not allowed to see their own reports! It’s my body, I pay for the tests and the reports, and I am not allowed to even see them. In addition to the heartbeat issue that they were bringing up, they also said there is a loose cord around the baby’s neck.

I was not convinced that these reasons were sufficient to have a Caesarean. And I took what everyone called a risk – I begged and Ii pleaded and somehow I managed to come back home. That was week 37. At week 39, I came in for a consultation again, given a vaginal examination and was told that my cervix was not ready. They told me that they wanted to induce me, and if I had no pains, then I would be taken to a C-section. Again, I was sure that this was not how I wanted things to go, and said no to all this. I wanted to wait. My family was worried by what the careproviders were saying, and in order to pacify them, I said that I would get admitted and wait for things to start on their own in the institution.
And so, a week went by of me living in the institution. The day before my due date, I lost the mucus plug, and began to feel initial mild contractions. I didn’t mention this to anyone, because I didn’t want to be interfered with unnecessarily. On the morning of the due date, the inevitable induction process began. Early in the morning 6 of us pregnant women were induced. By 9 a.m I could see that 2 of them had gone for a c-section. As time passed, one by one, all of them except me were wheeled in for the procedure.

It was really hard experience to be in the institution, constantly being pressured to go for a C-section, constantly refusing through the pain of the induction, being repeatedly examined internally by various strangers, never once any of them even informing me about the exams, or taking consent. There were never any words exchanged. I didn’t like any of it one bit.
Then the careprovider announced ‘’This isn’t going to happen, let’s go for a C-Section’. At the back of my mind I remembered someone telling me that if they give you an epidural, they have to wait for some more time. And so I said ‘I want an epidural’. Meanwhile, outside – my husband was being pressured to give consent for a C-section. But I got the epidural, and so got another 4 hours to labour. I drifted off to sleep. When I woke, I was hearing voices telling me to push, which I did. I found it very hard to breathe when the pitocin was going into my body, and had to repeatedly ask them to turn it down so that I could take a breath.
My membranes were ruptured without any prior information, or consent. I was constantly battling with all of the staff in there, just to let them allow me to have a normal labour. There was not a single source of any bit of support throughout that time. On top of it all I was made to feel extremely guilty – like it was my fault that labour was not progressing.

When they woke me up telling me to push, they asked if I was feeling the urge to push. I wasn’t and said so. Then they began to talk about the C-section again, and so lied and said I was feeling the urge. So, with a combination of me pushing when I was instructed, and some of the staff using fundal pressure, the baby came out. I remember the feeling of a whoosh when she came out of my body. But the thing I found most funny was that as soon as the careprovider had handed the baby over to the pediatric nurses, she had her hand on her chest and said ‘Thank God, that’s over’…and I remember thinking ‘has she never seen a normal birth before…?’

For the second birth, as I mentioned before, at week 37 when I went back to this same place, I was reminded about everything that I didn’t want in birth. Also, they found out that I had just developed Gestational Diabetes, and the careprovider advised me to take insulin and that the institution’s policy was to not wait for labour to start after week 38 if the mother had GD. It would inevitably be a C-Section. I decided I would wait till my due date before going to the institution again. There was a lot of pressure from my family about not going for weekly checkups.

One day, I tried my luck and called Birthvillage – I really wanted to have an alternate solution to my dilemma. I came across their name while I was searching online about unassisted birth. Much to my delight, they had a vacancy at that time! When I went to BV, they gave me a strict diet plan, and agreed to support me as long as I followed the diet and the exercises. Most importantly, they took the time and clarified all my doubts.

Six days before the birth happened, I began to have sharp shooting pains from my hips to my feet, and occasionally my legs bending involuntarily. I had Braxton Hicks contractions, and a feeling of being high.

Two days before the birth, I lost the mucus plug, and my hips felt loose, making it difficult to turn from side to side on the bed, or to get in and out of bed. I had an overwhelming tiredness constantly and that was when I abandoned the diet plan just that one time – and ate rice, which I was craving, till my stomach was full.

The day before the birth, the bloody show continued and my contractions also continued. I called my midwife, and she suggested that I call my husband and ask him to get from Bangalore to Ernakulam right away. That evening and later that night I continued to have regular painless contractions happening every ten minutes. They got a lot more intense late at night with a mild back pain setting in. I could not sleep in bed, but continued to have an occasional feeling of a ‘high’. By early morning, my contractions were painful if I was lying in bed, but painless when I would stand up or was in a kneeling position. In a while, they progressed, and were painful in any position I was in, and coming much closer together too. When I called my midwife, she asked me to come in to the centre. At dawn, I reached the centre, where my 4-year-old daughter and me were welcomed with big warm smile. My parents went to pick up my husband.

I talked to my midwife and doula off and on, in between the contractions. They gave me back massages, and a hot water bag for my back pain, which gave me much relief. I feel like I dozed off for a bit. When I woke, they offered me a hot coffee – the magic midwives coffee! I could feel that the contractions were more intense. From this point till the moment that I was in the final pushing stage, everything is a bit of a blur to me. I so wish that I had recorded my labour!

By this time, my husband arrived – just in time. I tried several positions to see which worked best with my body – the birth stool, squatting – but my favourite was the rope. Soon, I found myself having extremely intense contractions that made me make sounds similar to a howling. And no one complained about it – not even my husband, even though I was howling right into his ear! This really helped me cope better with the pain. I marvel at the strength that my midwife and doula had as they supported me throughout. The next thing I felt was that I had an intense burning sensation – and I remember that I felt the urge to push only twice. All other pushes that happened, happened without me doing it consciously – my body did it! And all the time, throughout my labour I got constant and continuous reassurance and support from the Birthvillage team.

At one point of time I felt that I did everything I could to push this baby out – I felt that I was about to close, and that the baby was stuck. Just after this point, my midwife had the baby out and had cut the cord. I heard the baby cry, and felt a wave of relief. My baby had his cord around one of his legs and around his shoulder.

It was a huge difference for me – the time after this second birth and what I felt like after my first birth. I was not exhausted after this birth. I didn’t feel that the muscles in my body had to strain for the birth. When my daughter was born, I felt pain in almost all my muscles for 2 or 3 days. Even lifting a finger brought intense pain to me. But at this birth, I only had the pain of my uterus shrinking and in my hip joints.

For my second birth, I had a wonderful time. I felt at every stage… that the midwives have the time to attend to me, and to them everything around this event was a normal sequence. There was no hurrying along, they were ready to wait if mother and baby were fine. At every point of time, I had the space to exercise my informed consent. Even for a simple thing like feeling my abdomen, my consent was asked! And this time, I did not have a PV done. At all times, mother and baby are treated as unique human beings, which was wonderful. They were ready to wait for labour to start on its own. Exercise and nutrition were important, and I had no medicines or chemicals used, except a local anesthetic that was used when they had to suture the natural tear that I had. There was full transparency at all times. My body got to handle early labour at the pace that it thought best, with no interference. What really amazed me was that I could breathe throughout, unlike when I was on Pitocin at my first birth; I always had time between each contraction to breathe and recoup my energy. I saw no terror in anyone’s eyes, only support, encouragement, skilled advice and help. The only intervention I had was a manouever that the baby needed.

And I got an unforgettable experience. I am so thankful to the BV team for the continuous support they gave me and my baby!

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