When nat met mateo
Natalie, a nurse and midwife, had hoped for a home birth supported by private midwives. However, at the end of her pregnancy she was deemed high risk with an intrauterine growth restricted baby and preeclampsia, so was taken to hospital and booked in for induction - which ultimately all led to a cesarean and a NICU stay for baby Mateo.
NAT tells her birth story in her own words…
CW: This story includes reference to NICU.
My birth story really starts from the preconception and pregnancy period. My partner and I before deciding to try for a baby would often talk about birth and our ideas around it. These discussions may have been a bit more common in our household because birth is often at the forefront of my mind working in the business as a midwife. In these discussions we had, we discussed whether Birthing on Country was important for my partner. From our research and these discussions, we decided that one day if I was to fall pregnant, a homebirth supported by Private Midwives was something that we wanted to do if the pregnancy allowed it.
Mid 2022 my partner and I decided we were ready to try for a family. On 29th July 2022 we found out that we were pregnant. This was on the year anniversary of my grandfather’s passing. I found the occurrence to be sad yet healing in so many ways and throughout my pregnancy have really come to appreciate the spiritual side of midwifery. I was well and the pregnancy progressed, however at the five and half week mark I started to begin to become sick daily sometimes vomiting up to 20 times in a day. At first, I was dismissed by GPs with having general morning sickness, however I struggled to keep food and water down, despite following the advice I was given. By a miracle I was still managing to work fulltime shift work whilst vomiting. However, I couldn’t balance much else in my life due to the absolute fatigue that came with what I now know was Hyperemesis Gravidarum. HG had an impact on my physical and mental wellbeing- I was exhausted and depleted. Despite remaining on medication throughout my pregnancy, I vomited every day and lost a total of 16 kg.
Despite HG, I remained having a low risk pregnancy and continued down the pathway of a planned homebirth. I equipped my partner and I with knowledge through reading books, chatting to friends, and attending a Calmbirth course. This was probably the greatest thing we did throughout the pregnancy as shared knowledge attainment and preparation really brought my partner and I closer together working as a team. I was mentally able to prepare for birth and labour by becoming more physically active joining both prenatal yoga and aqua aerobics.
Towards the end of my pregnancy there was some question over baby’s size. Scans returned that bub was on the smaller side. As the blood flows were okay, it was viewed that baby was happy and not compromised. Bub was also super active in utero, so I never once had any concerns about fetal movement which is also an indicator of fetal welfare. I am a 5 ft woman and my partner is not super tall, so I questioned that I may be a woman that may just simply grow smaller babies. Further monitoring of bub’s growth was needed. On my due date at 40 weeks, I did a repeat growth ultrasound. That night I was lying in bed and saw the results come through via email link from CFAC. I clicked on the link hopeful, but when I opened the report, I was devastated to see that bub’s abdominal circumference had dropped to below the 1st percentile. As a health professional I knew that this meant my chance to labour and birth at home was now over and that the days of my pregnancy was now limited as clinically I now was deemed at higher risk with an IUGR (intrauterine growth restricted) baby.
The next morning at 40+1 weeks I woke up with uterine pains and felt ‘crappy’, I spent the early hours of the morning under a hot shower. I felt like I needed to go back to bed and so I slept until the midwives attended for my antenatal appointment later that day. At the visit, I told my midwife that I felt ‘off’, she asked if I could describe it, I said “no not really, I just feel off and like I should go back to bed for a nap”. The appointment continued and when it was time to do my observations, my blood pressure was found to be high at 160/95. I was diagnosed with preeclampsia and was admitted to hospital for induction of labour that evening. Despite now being in the hospital system, I felt cared for by the doctors and midwives. They were great in giving me time to think and ask questions about the processes. Unfortunately or fortunately, I knew the process too well of what I was about to go through. I received the balloon catheter as a form of induction process. I found the process of the balloon catheter simple and not too painful. However, two hours later I began to get contractions and become more uncomfortable and was unable to sit down or stand up. I was given my blood pressure medication along with some pain medication. The pains went away, and I was able to get some rest and sleep.
The next day in the morning I found that I felt very ‘groggy’ and felt like I couldn’t keep my eyes open for long periods of time. The CTG showed signs of slow fetal compromise, and this was without active labour. Decision was put forth to me by the medical and midwifery team to opt for a caesarean whilst bub wasn’t at great compromise or to keep pushing the induction and risk greater compromise and a real emergency. I spent a few hours discussing with my partner what would be best. Physically, I felt unwell with the preeclampsia and could barely keep my eyes open. Emotionally I was worried about the welfare of my baby. I decided not to push the induction, an opt for a caesarean that would be done in a ‘calmer’ manner.
Even though I was having a caesarean, I requested a vaginal examination so that if there is a next time, I know that my body can achieve a vaginal birth. With the facilitation of a couple of amazing midwives in the birthing unit, I put together a wish list for my caesarean. I made a few requests, most requests including the vaginal examination were respected by both midwifery, medical and nursing teams in the theatre at my birth. I do wish that I had advocated for a maternal assisted caesarean a bit harder as that was important to me, and I wish the team would have been a little more flexible in providing that for me as I understand the importance of sterile procedures. However, I found it very therapeutic having the team listen to my wishes even though the birth had not gone to plan.
The birth was calm. Every clinician in the theatre that night in the early hours of the morning met me with a smile, they were delightful and professional. They were all excited for me to meet my little bubba. Their excitement helped me relax as my baby and my health depended on them. On went my 90s and 2000s R&B playlist, with my partner by my side chatting to me. I remember the needle in the back, the numbness down my body, then being cut open and the pulling sensations. I was happy and calm, but also felt numb and maybe in shock due to the adrenaline rush.
After a while, the drape came down, and bub appeared over the drape. My partner announced that we had a baby boy! It was so great to finally meet the little human that had been inside me. Our baby needed some minor resus to stimulate his breathing and then was back with me on the table.
As we went to recovery, I held him close, but noticed that he seemed drowsier compared to when he was born. On arrival at recovery, I attempted a breastfeed, however bub was too drowsy to latch. The midwife did the newborn check and the weigh. He was a healthy baby born born at 2.5kg. Due to his weight, the midwives did blood sugar levels. Bub had low BSLs that were unable to be corrected with 20mls of antenatally expressed breastmilk or glucose gel.
At that point, he was transferred to NICU whilst I went to postnatal ward, and I had to consent to the use of formula as I simply could not hand express enough to meet his needs.
In the morning I visited bub and found him lying in the humidicrib with IV cannula for fluids and Nasogastric tube for feeding. We had our first real proper cuddle without interruption, however it felt very awkward with all the tubes.
I was in awe of my precious baby, but at the same time felt so numb seeing him like this. Within 4 days he was able to wean of NG Tube feeds to both the breast and bottle and stay with me in the postnatal ward.
On day 4, I felt unwell with a significant increase in my blood pressure and tachycardia. We were to go on to stay in the postnatal ward for another 5 days and received great support from the midwives. I felt amazed that on the day of discharge I was able to establish lactation and breastfeed with bottle top ups to ensure he was gaining wait. After being discharged from hospital, I was able to wean from the bottle top ups completely with the support of midwives within the week following, and from then exclusively breastfeed. Breastfeeding was something I worked hard at, and perhaps it was my silver lining of hope amongst my birth story.
Recounting my birth story, I feel mixed emotions. I feel so happy to have grown a precious baby yet felt so depleted from pregnancy. I feel sad that I did not have a vaginal birth or real active labour, but content that caesarean was the right decision given the clinical picture. I feel a sense of grief and sadness for the birth that I lost, yet feel happy and joyous for the beautiful baby boy that I have gained.
Let me rephrase my birth story. I had a successful homebirth. My pregnancy, labour or birth may not have been how we wished but it turned out how it needed to with the right escalation, detection and referral into hospital. And that’s exactly how a homebirth should go and how the hospital system should be- a place for intervention. I still believe in physiological birth, vaginal birth and homebirth. And I do also believe in the necessary of medical intervention. This is part of our s
What do you wish you knew before birth?
Look to be really honest, I probably wish I would have known how my pregnancy would have gone and perhaps I wouldn’t have invested money into private midwifery and instead invested money in private midwifery for the postpartum period as that’s where I really felt like it made a great difference in my breastfeeding journey.
I also wish even though I should know this, even if the birth is ‘calm’ or it’s a ‘calm caesarean’, things can still go wrong. I wish I truly realised the impact on a mother’s mental health and bonding that separation of mum and bub has. I also wish I wasn’t as afraid for c-section recovery as I felt so great and pain free.
If you could, would you do anything differently?
I believe the path of my birth was predetermined when I conceived. As closer the due date got my body was giving all the right signals to myself and the care providers that I needed to be in the hospital system and birthing via caesarean. If I was to choose to become pregnant again in the future- I would aim for the vaginal birth that I wished for, but I know that any future pregnancies may still take this same path.
What did your partner do that really helped during labour/birth?
During my pregnancy my partner attended appointments, scans and calmbirth class. That really was beneficial going into the labour and birth as he was aware of what his role was and also up-to-date with medical concerns in the pregnancy. My partner stayed by my side the whole time. He listened carefully to what the doctors were saying. He listened to how I felt in the decision-making process and never once inflicted his own opinions into the decision. He kept a straight face and remained brave when deep down I know he was worried about my health.
What advice/honest truth would give a mama-to-be about birth?
If you are reading my birth story through CBRMAMAS- I would like to share my hopes for you. I hope you have access to the type of maternity care that you want and need. Do your research if you are unsure. If you experience hyperemesis know you are not alone. Advocate for yourself- it is more than morning sickness! Get to know your body mama, I hope you really listen to your body and speak up if you are feeling not quite right. I was diagnosed with preeclampsia with none of the typical symptoms apart from feeling ‘off’. I hope you aren’t afraid to challenge the system- ask questions, ask for evidence, decline if interventions don’t sit right with you. This is your pregnancy, body, and baby. I hope that even when things don’t go to plan you can ride the waves that are ever changing with grace and courage.