Share

Homebirth Of Aquilo, Cholestasis

Aquilo is two months old. Nine weeks have passed in a blur of milky nights and sunny days. Even the rainy days have been sunny. Two months of happy, sleepless delirium and never ending washing lines of nappies. Two months are all that separate Aquilo then from Aquilo now. Aquilo the idea, the rolling waves behind my taut drum belly and Aquilo himself, the real, whole, beautiful boy.

Our first son, Zephyr, was born at a birthing suite in a public hospital. Zephyr’s was a normal birth, at least normal in the hospital context, yet through the whole process I struggled to feel in control of what was happening. Some of this feeling of disempowerment might be due to the newness of the experience. The midwife who led the prenatal classes made us all pull our mouths wide open with our fingers and said “This is what birth feels like.” A somewhat inadequate description!

Labour was only 12 hours but felt like forever, especially when upon examination the midwife said – “Oh you are ONLY 4cm dilated.” After Zephyr was born in a sudden rush and gush and tear, and his father had to sit down and his grandmother cradled him to my breast and a handsome young doctor had stitched me up (crookedly, it seems) I had a hot shower and fainted. Maybe it was when I woke up on the beige tiles of the hospital bathroom, or while I was eating the mashed potato and cabbage hospital dinner the next night (vegetarian option) that I realised there must be another way to bring one’s baby into this world.

When we next became pregnant, some four years later, I had no doubt that a homebirth was what I wanted. This caused some raised eyebrows from family members (“have you got ambulance insurance?”) but ultimately they supported our decision. I think my husband, Marty, felt a little anxious about the choice as he felt he would be responsible in an emergency before the midwife arrived. We talked about this later with Lisa who pointed out that if the baby’s coming, just catch it! The pregnancy felt much like my first – three months of all day nausea and vomiting, a couple of months of that “glowing feeling” and the rest of the time when it was just plain hard work.. At 35 weeks I developed Cholestasis – at least we think I did, I never actually had a blood test to prove it as that may have triggered a spiralling process of medicalised care.

Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones.

This causes a build up of bile acids in the liver which can spill into the bloodstream

According to the American Pregnancy Association, ‘Cholestasis may increase the risks for foetal distress, preterm birth, or stillbirth.’ The website says: ‘A developing baby relies on the mother’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on the baby’s liver. Women with cholestasis should be monitored closely and serious consideration should be given to inducing labor once the baby’s lungs have reached maturity.’ So when I told Lisa that “I’ve been a bit itchy,” she rolled her eyes and must have known we were in for a bumpy few weeks.

I was pretty uncomfortable, itchy during the day but mostly at night, not sleeping very much but spending a lot of time in a cool bath. At this stage my focus shifted to that looking-inward of a woman all awash with birthy hormones and the weeks are a bit of a blur. Lisa continued to monitor my condition very closely. At 37 weeks, as the cholestasis seemed worse, she set out my options. She always allowed me to feel in control of the situation and to make the decisions, which is very selfless of her as in the end she has to deal with the consequences! In the end the best thing seemed to be to try to get the baby moving with a “stretch and sweep” of my cervix. This seemed to me to be the least interventionist option. Turns out I was already 2cm dilated at this point, which explains why I had been waddling like an old duck for the last week or so. After the ‘stretch’ I felt the baby might just slide on out every time I stood up. I had a mucous show that afternoon and even some quite strong contractions. But the next day, contractions stopped. Lisa visited and suggested I keep active. Lots of sex. Husby, Marty, was very obliging. I reminded him to make the most of it.

Then followed about five days of on and off contractions. This coincided with Adelaide’s record heat wave – two weeks of temperatures above 400C. I did lots of walking but whenever I got home everything would stop. Lisa visited every day, the level of care I received was fantastic but we were all frustrated and worried Baby would be stressed out by my ‘elevated levels of maternal bile’. Lisa joked that if I continued to have a contraction every two hours it would take five days to have this baby. And that’s what happened! Labour finally started for real on Sunday night, after a day of washing the windows, the floors, the car (utter desperation!) and more walking up and down hills. Until then I had been so worried contractions would stop again I forgot to think about how much they would hurt when they really did come. I remember talking to my baby: OK Baby, the pain is good, give me pain. Ride the waves little one, little seal pup. Little wet, slippery seal, out you come, surfing on those beautiful waves of pain (wacky!).

p3100210

We called Lisa at about midnight. Labour at home was an altogether different experience to labour in the birth suite at hospital. The funny little things stick in my mind now, like having my own favourite glass to drink from, my own shower (now spotless due to manic cleaning spree, pity about the water saving shower head!). Candles all around, soft glow in my little birth nest, our home, our baby’s home. Our favourite CDs on high rotation, the soundtrack to our birth – songs layered with a new meaning when I listen to them now. Time goes all gooey as I focus on getting through each wave and talk to our baby, while still disbelieving we’ll meet him so soon. Lisa and Marty make a wonderful support team, massaging my back, keeping my wheat bag warm and my spirits up. Reminding me to drink lots of water – it was still 300C in the middle of the night! Labour was about eight hours. At one point I was so tired, I just wanted to go to bed. Lisa suggested I lie on the couch and try to sleep between contractions. Incredibly, I would drift off, waking to moan and groan and breathe through each one. Eventually, as the moans became more and more melodramatic, Lisa said it sounded like I was about to say “I CAN’T DO IT.” I said I had been thinking it! I guess that was transition to second stage.

Then things changed. I welcomed the change, a difference in sensation. Then I realised that pushing hurts just as much – more?- than contracting. Lisa gently suggested I use the energy in my noises, bring the noise down, push it through my body and use it to move the baby down. It worked, and all the mooing also woke our 4 ½ year old son, who came out rubbing his sleepy eyes. He was great, not upset by my pain, not grossed out by the blood. He sat by my side and patted my shoulder, my back.

zoe-cropped

Pushing. Feel his head moving down through my body. Pushing, his shoulders twisting, turning, descent from his heaving pink world into ours. Pushing, burning (oh yeah, just like stretching your mouth as wide as you can, ha bloody ha!) And then I am stretching, miraculously opening, and there is his head. There he is, pink and white and bluish, there’s our baby. Lisa tells me to reach my hands through to catch him and then with a push he is born in a rush, slippery, bony, amazing little creature bursting from me and into my arms. That is how I met my new boy. With his dad and his big brother there to meet him too. To welcome him home.

p3100220

I remember he cried a lot at first. But I was so proud of what we’d done as Lisa took me through third stage and delivered a lovely healthy placenta. No stitches. Aquilo’s funny bluish face turned perfect pink as he finally started to suckle, like life itself was rushing into him. Lisa tucked me up with blankets on the couch and stayed to do all the checks on the baby, fill in the paper work. The sun came up and the morning was hot and golden on Aquilo’s first day. Marty made us toast and tea and everything was perfect.

p3100224

6 responses to “Homebirth Of Aquilo, Cholestasis”

  1. Alicia

    Wow, what anamazing experience. im so glad that you did it your way and well done to Marty for supporting you! What a women you are!

  2. Anonymous

    Hi zeddy,
    Balled my eyes out reading your story even though I have already heard it. So beautiful. Love Nic

  3. greendraggon

    Wonderful story.
    Lisa will you be writing your views on the management of choleostasis anytime soon?

  4. Lisa Barrett

    Greendraggon, what were you wanting to know?

  5. Alex ross

    I have a question for you! I’m “high risk” because of a rare anti-body and because of a sugically placed badder mesh. I’m a student home birth midwife and I want a home birth! My state doesn’t allow a CPM to attend my birth because I’m “high risk”. I don’t want to just submit and have a hospital birth. I would really love to hear your opionion on this! Thank you!