"I'm a homebirth midwife, I am doing my PhD on birth outside the system and this was my first pregnancy. At 2.30am I started contracting. I was planning a homebirth and felt fine about birthing a slightly preterm baby at home because deep down I knew he was ready. I contracted regularly through the night and as the sun came up it continued and I felt sure that labour was progressing well and normally." This article originally published in 'Midwifery Matters' tells a story of acupuncture and stalled pregnancy.
I'm a homebirth midwife, I am doing my PhD on birth outside the system and this was my first pregnancy. At 2.30am I started contracting. I was planning a homebirth and felt fine about birthing a slightly preterm baby at home because deep down I knew he was ready. I contracted regularly through the night and as the sun came up it continued and I felt sure that labour was progressing well and normally.
By 1.30am in the afternoon I felt a change - the contractions felt like they were coming on top of each other and getting more intense.
I suspected I might be getting close to birthing and asked my husband, 'How close are these contractions?' He very proudly replied, 'A minute and a half apart and my app tells me you are in transition'. I had no idea he was actually timing or that there was an app involved! I felt that it was time to call my midwives.
At about 3.00pm my midwife arrived and told me I was doing great and later told me she thought I was in transition at this stage.
The details are a blur - but, as the sun went down on the day, contractions seemed to slow and at some time in the early morning of the next day, they virtually stopped and I fell asleep on the floor of my bedroom on a pile of pillows. I was woken a few hours later by returning contractions and felt a new sense of purpose to get up and start labouring again. I decided to start my day like every other – having breakfast with my husband. I had a big breakfast in preparation for my task and just as I was finishing I felt that my contractions were returning with some regularity and intensity.
At this point I had been in 'established' labour for about 16 hours (but it felt longer than that). Frustrated with the progress, I asked my midwife to do a vaginal exam to assess my dilation. My midwife tried to talk me out of it but the midwife in me wanted to know what was going on.
At 7.00am my midwife checked me and I was 9cm dilated with a thin stretchy cervix! This was great news to me - I wasn't too bothered by the fact that I didn't have many contractions because what I was getting was working! It occurred to me at that stage that I had never really worried that my body wouldn't dilate … but I was worried about what would happen to me if I didn't start contracting some more. I mentally went through the scenarios in my head; if these contractions didn't pick up - I thought through what might happen at hospital. The best case scenario was that they would gladly agree to augment me with a little bit of syntocinon and soon after that I would push my baby out and go home. But then I took myself to the worst case scenario - when I get there they will probably freak out because I didn't do a GBS swab or a glucose tolerance test; they will give me grief over the vaginal exam and admission CTG that I would most certainly decline when I get there. They may be somewhat concerned with the length of time I had been labouring with a preterm baby and may or may not decline to give me an augment and suggest a caesarean section instead ... Nope, I most certainly was not going to hospital. I knew he would be born small and they would whisk him away from me immediately for observation in special care. He would have a nasogastric tube and blood sugar tests; they would give him vitamin K and not allow me to cuddle him through fear it might make him cold or tired and mess up the readings on their heart rate and oxygen monitors.
Nope, I was not going to hospital! I couldn't, it felt the wrong thing for my baby - I had other plans, better plans. I was going to push him out of my vagina, feed him regularly, have uninterrupted skin-to-skin and kangaroo care for at least a week and he would be sleeping with me.
So, what was I going to do - I had virtually no contractions. By midday I was fully dilated with no contractions or urge to push. My little baby was doing fine, I was doing fine, my membranes were intact and all our observations were perfect. There was no need for a hospital transfer but my midwife told me, 'You need to have this baby soon, Mel'. I knew I did too. My midwife suggested a walk so I reluctantly allowed my support people to get me dressed and do my hair ... I climbed the 25 stairs to get to the road from my house and walked for an hour through the lovely sunny streets of the Blue Mountains but didn't get one contraction! What was going on!
My midwife suggested I rest - NO! I didn't want to rest; I wanted to push my baby out. It was at about 2.00pm, some 24 hours into 'established' labour when my midwife asked if I wanted to call in an acupuncturist. I said, 'Yes, I would pay her anything to come to the house and get things moving'. I am also a qualified naturopath so wholeheartedly I believe in the effect natural medicines can have on the body and I was filled with hope with this new development.
At about 3.00pm the amazing, magical Anada arrived and got to work right away. She birthed at home too so she slotted beautifully into my birth team and hummed along with me as her needle work quickly got my contractions going. She seemed to know exactly what I needed. She put needles in my hands and feet and tweaked them to bring on contractions. From the time of her arrival to the birth of our baby, I contracted every three minutes. Once the contractions got going she worked on my back to bring Charlie down to birth. Before she had arrived I didn't feel him moving lower, but as soon as she put the needles in my back I remember calling out, 'Oh he's in my bum!' and felt a dramatic shift in his position. She continued to move her needles down my back until they could go no further and then made the (shocking at the time) request to put a needle in my perineum.
I was hesitant but a holler from my midwife ('Do it Mel!') convinced me to say 'Yes'. What other choice did I have - it was this or hospital in my mind. Through the course of my treatment I also had needles to my symphysis pubis - I was up for anything at this stage. Anada stayed for about 3 to 4 hours until my baby was born at home. I just birthed a baby out of my vagina at home! After 37 hours of contracting and 27 hours of established labour! My midwife reminded me that I still needed to birth my placenta and it was then I told her, 'I don't want another contraction'. It was about this time that they made me a raspberry leaf tea to encourage my uterus to contract and Anada stuck another needle in to encourage the placenta ... it was soon after that I birthed my placenta with 400-500 ml of blood loss. I thought back to the births I had attended and felt sad that I hadn't thought to call an acupuncturist to some of those; I want to take Anada to every birth with me now!
Thousands of years ago when the ancient thinkers in China were developing the first rudiments of traditional Chinese medicine, their traditions were deeply rooted in ancestor worship and followed the philosophy of the Tao. The understanding and basis of Chinese medicine still adheres to the philosophy and principles of the Tao. When treating a person with Chinese medicine, we do not only treat symptoms, but also work to balance and harmonise yin and yang in a person. Yin and yang cycle in a perpetual natural dance that is not just opposites, as they exist within each other and cannot exist without each other. My favourite analogy is night and day: night is yin, day is yang.
When the sun is rising into dawn there is always a period where there is light on the horizon, even a peak of sun, but also in the sky there is darkness and the last dying twinkles of stars. This is yang blossoming into the yin, the white dot in the black. The Chinese adopt this philosophy and understanding of existence to medicine, where night and day, body and mind, human and animal, animal and earth, earth and heaven (sky and beyond) are not separated, but fundamentally entwined. In the philosophy of the Tao, we are all bound together in a cosmic dance, a rhythmical swing of life and death, yin and yang.
When a woman is in labour she is in the full swing and rhythm of life and death; with life - the birth of the baby, and death - the absence of the baby inside her and the placenta ceasing to support the baby. To do this she needs to stay focused and balanced in her body, her mind and her environment, as one is not separate from the other.
One of the biggest issues stalling labour is the mind. When having a baby for the first time or sixth time, women delve into a very primal state so, no matter how well researched a woman may be, one cannot anticipate the intensity of labour and birth.
As a Chinese medicine practitioner attending a stalled labour, I check a woman's pulse to ascertain where she is mentally, and balance the mind. By reinstating a sense of calm through removing thoughts and emotions such as disappointment, urgency, worry, fear, anxiety, despair, fatigue, grief, despondency or depression she can reconnect with her labour. I then work on the physical body and purposely stimulate the body to remind the uterus and cervix to regain its rhythm and small muscle movement. By invigorating her body, calming her mind and supporting yin and yang, I can help a woman to re-establish labour quite quickly, resulting in a successful natural birth without excessive bleeding, an intact placenta, reduced placenta retention and calm control of her body.
First appeared in Midwifery Matters December 2013