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Delayed Cord Clamping, Hospital birth, Physiological birth

Planned hospital waterbirth and natural third stage

Jess gave birth to her second baby Arya Ruby, followed by a physiological third stage in a planned hospital waterbirth.

 

The hospital where Jess gave birth is located in the north-east region of Victoria in Australia. It has a maternity service that facilitates approximately 1200 births per annum with a level 2 special care nursery. This hospital recently began a Midwifery Group Practice, where eligible women are assigned a primary midwife (and secondary as back up) to provide public patients continuity of care from a known midwife.

(See this link for a summary of 2012 research by La Trobe University in Melbourne regarding effect of continuity of care by known midwife)

As part of her preparations for birth, Jess was seeking support to have a physiological birth, delayed cord clamping and physiological placental birth.

Jess says the ‘third stage of labour’ was “discussed at length with my midwives because it was important to me. Both of them were completely supportive of my aim to stay in the bath to deliver the placenta and to wait to cut the cord for as long as it took.”

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Birth story with images of cord and placenta

Jess shares her birth story and images captured by friend and photographer Kellie Crosier Photography

Arya Ruby came into the world at 3.59am on Tuesday, September 4th 2012, which was her estimated due date!

I had been having pre-labour pains and contractions since 37 weeks, so by the time Arya’s due date rolled around, I was well and truly ready to have her.

On the Monday morning I was having some sharp pelvic pain and some semi-consistent contractions so I went in and saw my midwife – Leila – so she could check me out. As soon as she had a feel for Arya’s head, she told me that her head wasn’t even engaged despite the fact that it had been the week before, so the pain I was feeling was Arya trying to get her head back in position!

I nearly cried!! I was soooo over being pregnant and running around after my sick 15 month old, I just wanted to have my baby!!

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So I went home and told my husband (who had stayed home that day, as he works an hour away and we thought something might be happening) that I was going to try castor oil.

We went and bought some castor oil and I took it at 3.00pm. I had no action until 7.00pm, when I had to go to the bathroom once and that was it, so we sat and watched TV for a while and by 9.00pm I started to have some consistent, strong contractions!

I live 2 minutes from the hospital, and I was always wary of going in too early, and wanted to labour at home for as long as possible anyway, so I went and took a shower then went to bed, because I wanted to make absolutely sure I was in labour (as I’d had so many false alarms!).

By midnight I was about 98% sure I was genuinely in labour, so we called my midwife and let her know (she lived 45 minutes away from the hospital) and I also called my Mum to come and stay with our daughter, Evie.

Mum arrived not long after I called her and by 1.15am my contractions were only a few minutes apart and getting stronger. I was happy to stay home but Mum was anxious for me to go, so we left for hospital!!

Leila arrived at about 2.00am and things were still very calm, I was just breathing through my contractions using the Hypnobirthing breathing techniques, so the room was pretty quiet! Leila ran the bath but asked if she could check me, given that I was still doing pretty well and Arya’s head had not been engaged earlier in the day (she didn’t want me to get into the water too early).

When she checked me, I was surprised to find I was only 4cms, given that I was already 2-3cms a week before and my contractions were feeling quite strong!

When she was checking me, Leila gave me a quick sweep and said she would leave us for a while before I hopped in the bath. I was happy with that because I still felt like I was probably a while off having Arya. Well, within a short period of time (not sure exactly how long) I said to my husband that we needed to get into the bath because things amped up very quickly!!

I was still able to breathe through my contractions , but they were beginning to really hurt, and Leila could tell things were getting a move on rather quickly.

At this stage it was about 3.00am, and Leila told Dave he should probably call our photographer because it seemed like Arya was not too far away. Kellie, our lovely friend and photographer arrived within about 20 minutes and not long after that, I had a great big, involuntary push!

I told Dave and he called out for Leila, saying I wanted to push, to which I apparently replied ” No, my body wants to push, I don’t!!”

 

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After that, things happened very quickly, I had a 9 minute second stage!!

I had maybe one or two more involuntary pushes and Leila got the mirror underneath me and said she could see Arya’s head, and that she had hair! (I was happy!)

I could no longer really breathe through the contractions, I was quite uncomfortable by this stage and was waiting for the ‘ring of fire’ but it never came! I asked Leila if I could push and she said if I felt another contraction, I could breathe her down gently, so I immediately started because it felt like I was having continuous contractions by that stage and she came out almost all in one go, straight after my waters- no one was quite ready for her! My husband was supposed to catch her but it happened so quickly that I caught her myself :)

 

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After I had caught her, we waited to birth the placenta naturally-which happened very easily after about 15 minutes, and then we just waited for the cord to go white and floppy so my husband could cut it.

One of the coolest things was at one stage I thought the cord was looking quite empty, Leila actually got me to feel the cord so I could see it was still pulsing and suggested we could leave it longer, which was fantastic! It was such a cool thing to feel while it was still connected to Arya.

 

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It was important to me that we waited until the cord had stopped pulsing and was clearly empty of cord blood because I had done quite a bit of research this time around on delayed cord clamping and decided that it was something I really wanted to do.

 

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My midwife also believed in delayed cord clamping so she put the placenta in a dish and sat it on the edge of the bath, above Arya and I so that it had the best effect possible.

I was very happy to have got through the whole labour and birth without any drugs or interventions and it has given me a lot of confidence going into any future births which I hope are all water births with physiological third stage with delayed cord clamping.

All in all, I feel very lucky to have had the birth that I did, not only did it give me a beautiful, healthy little girl but it went exactly how I wished it would and I felt absolutely amazing afterwards.

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From the midwife

Leila, a midwife with experience from the UK and Australia, had this to say about her clients birth experience:

It was recently my privilege to attend Jess and Arya’s beautiful, natural birth. Jess had researched her options to have the best possible birth experience, and I was extremely happy to support her in her choices. A birth through water is a very calm entry for a baby, and the only way to further enhance this, is to have a physiological 3rd stage where the cord ceases to pulsate in its own time, and the placenta is birthed by the woman naturally. This ensured that Arya received oxygen continuously whilst she made the transition to breathing for herself, and also received her complete blood supply. It is now widely known, through research, that babies who do not receive their total blood volume are more likely to be anaemic within the first 6 months of life.

I am so pleased that Jess had the birth exactly as she had wanted, and hope that her story encourages more women to realise that they too can have their dream births.

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Images of cord and placenta

The following images of Arya’s birth placenta and cord were also taken by Kellie Crosier Photography.

“My midwife was so into it, she was absolutely fantastic, she laid [the placenta] out for Kellie so you can see everything- it looks just like the tree of life and the cord is so nice and clear! The midwife also showed Kellie the inside of the cord and the arteries/vein are clearly visible too.”

Placenta cord baby intact

Placenta fetal side

Two arteries one vein umbilical cord

About Kate Emerson

Kate Emerson is a clinical student pursuing her interest in neonatal transitional physiology and clinical cord clamping practices. Please visit www.cord-clamping.com to read more.

Discussion

7 thoughts on “Planned hospital waterbirth and natural third stage

  1. Awesome article Kate, so lovely to read about Jess and Arya’s birth again. My sincerest thanks to Leila for allowing us to photograph this most wonderful moment and for being so amazing at explaining everything and showing us the placenta in detail. Of course to Jess and your husband Dave, thanks so much for allowing me to attend this most intimate moment in your lives, what an experience, one I will never forget!

    Posted by Kellie Crosier | January 30, 2013, 9:16 pm
  2. Thank you Kate for taking such an interest in Arya’s birth and publishing this article and thank you to Kellie for being a wonderful friend and beautiful photographer! Thanks must also go to Leila for her support during the pregnancy and birth- it was so lovely to have someone be so understanding and supportive of doing things the way we wanted to. I hope that everyone who reads this article will enjoy the story, the beautiful photos and that they will take away a greater understanding of drug free birthing, physiological third stage and delayed cord clamping :)

    Posted by jessandbaby1 | January 30, 2013, 10:39 pm
  3. Any woman who wants to have a birth like this can come to GV Health. The midwifery group practice accepts women who live in the city of Greater Shepparton. My Midwives Shepparton accepts women from both within and outside this area.

    Posted by Andrea Quanchi | January 31, 2013, 8:04 am
  4. What a GREAT story! Congrats and Thanks!!!

    Posted by greendoula | February 13, 2013, 2:50 am
  5. Your birth sounds like it was what you wanted! Congrats for having such a birth in the hospital. That must have taken alot of work for you, well done!

    You used some words in your article to describe your birth that I belive to be inaccurate. You say, ” I was very happy to have got through the whole labour and birth without any drugs or interventions.” But you state that you had multiple vaginal exams and your membranes were swept. Those are both interventions. I belive it would be more accurate to change your wording here to something like “I was very happy to have got through the whole labour and birth without any drugs and only minimal interventions that I chose to have.”

    You also refer to your birth as a physiological birth. I disagee with you about this for several reasons. Although for a hospital setting, your birth was very close to physiological one, and I commend you for that. According to http://naturalfamilytoday.com/pregnancy-birth/physiological-childbirth/#axzz2NC7BHph9,
    “Physiological childbirth simply means birth in it’s most natural form, without intervention or medications. The mother is allowed to labor how and where she wants, and birth is left to happen naturally. The definition can also be extended to the postpartum time. A physiological birth is spontaneous in onset; The mother chooses her location, is given freedom of movement throughout labor, and chooses the birthing position. There are no routine interventions, and no separation of mother and baby after the birth.”
    #1 You used castor oil, which may or may not have started your labor. So it is inaccurate to say that your birth started spontaneously. #2 You had some interventions (very minimal, but still there). They may or may not have been routine, you do not say, could you have turned the vaginal exams down or did you choose them? I believe you should reword your article to remove the word physiological and use a more accurate word to describe your beautiful birth experience.

    Posted by Jennifer | March 11, 2013, 1:51 pm
    • Thank you Jennifer for acknowledging the work it can take for some women to achieve a waterbirth and natural third stage in hospital.

      The first few sentences of the article are mine, where I describe Jess, the type of care she was seeking (physiological), and the research demonstrating the benefits of a known midwife. The birth story then begins in Jess’s own words, where she also describes how she chose or accepted some low-tech interventions during labour.

      The description of a physiological third stage remains accurate and reflects the appropriate psychophysiological care given by the midwife in a hospital setting (no cord clamping, no uterotonic, no cord traction, no separation from infant, mother supported to remain comfortable and relaxed in the warm bath).

      Although I fully understand the importance of recognising the difference between physiology and intervention, I do not wish to define another woman’s birth experience when sharing her story on this website. It feels wrong to me, to critique a woman’s birth experience and the words she chooses to describe it.

      Posted by Kate Emerson | March 11, 2013, 9:08 pm
  6. Thanks Kate, I think you’ve addressed Jennifer’s concerns well :) as far as I’m concerned, I had a physiological third stage because I chose not to have the injection, I chose to birth the placenta in the bath which occured in my own time, without being touched by anyone else while I was breastfeeding my daughter. Pretty sure that IS a physiological third stage?

    I had one vaginal exam once my labour had already begun, which I was more than happy to have, because I don’t believe that purely checking my dilation is an intervention. When Leila asked if I was happy to have a sweep, at that stage I definitely was because I already knew my labour was well underway, especially given that it was not my first, I kind of knew what was going on. I do understand how technically that is considered an intervention, but probably the most minor one possible, especially given the hospital setting.

    As far as the castor oil is concerned, I don’t believe it started my labour, because as I stated, I was in hospital having a pelvic exam earlier on the day labour began because I was having sharp, labour like pains and to be honest, the castor oil was taken as a bit of a joke between my husband and I, we never expected it to make a difference.

    I am not a Dr, Nurse or Midwife, and the birth story featured here was written down less than 24 hours post birth so it would be as accurate as possible so perhaps my medical terminology is not 100% accurate, so forgive me, please.

    Kate, if I am genuinely incorrect in any of my language or terminology please feel free to edit the birth story :)

    Posted by themamabare | March 11, 2013, 10:02 pm

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