SARAH & CALE - POSITIVE INDUCTION

It can be hard to find positive induction stories, so when Sarah messaged me with the birth announcement of Theodore I knew this amazing story had to be shared. Sarah and Cale are honest with the events of the process through induction. Attending my birth class I knew from the beginning they were going to make one hell of a team. Sit down, grab a cuppa and enjoy this wonderful story.

Story features: Induction of labour - balloon catheter, membranes released, syntocinon. Nitrous gas, epidural, vaginal birth


Apart from horrendous "morning" sickness for the first 4 months, (I'm talking 24/7 nausea, daily vomiting and food aversions to everything) I had a great pregnancy and loved being pregnant. I still miss my baby bump! All scans showed the baby was perfectly healthy and thriving, which was very reassuring as I'd previously been through an ectopic pregnancy and a miscarriage. During one of my regular obstetrician appointments when I was 34 weeks, my OB noticed that my fundal height had not increased much since the last appointment. Due to the fact that I'm a small person, my fiance Cale is average size and we were both small babies at birth - me weighing 5lbs 5oz (2.4kg) and Cale 6lbs 15oz (3.1kg) - she wasn't concerned. However we decided to have a growth scan done for peace of mind. The growth scan showed that the baby was very small (in the first percentile) but appeared perfectly healthy. I then continued to have monitoring done twice a week for the remainder of my pregnancy, to ensure that the baby was still growing and the placenta still providing sufficient nutrients and blood flow. Because I was having such a small baby, my OB recommended that I be induced at 39 weeks (if spontaneous labour hadn't occurred by then).



Pelvic examinations at 37 and then 38 weeks told us that my cervix was still hard and closed. It was then that I learnt a balloon catheter would likely be used to ripen my cervix before my waters would be broken to commence induction of labour. As soon as I heard about the balloon catheter I was freaking out. I had a balloon catheter inserted previously for a tubal patency test and found that procedure a bit traumatic. I had found having a catheter inserted through a closed, hard cervix painful and very uncomfortable. I was also nervous about going into hospital for a procedure to induce labour as I had always anticipated going into spontaneous labour and this was my preference. I therefore tried all the natural remedies to bring on labour spontaneously and hoped this would occur before my induction date.

Monday 14th June rolled around and labour had not commenced spontaneously. I was 39+1 weeks and due to go into hospital that evening to have the balloon catheter inserted, with induction then scheduled for the following day. As excited as I was to meet our baby, I was so nervous about the induction and subsequent birth I could barely eat that day. My stomach was in a knot and full of butterflies. Cale and I packed our bags into the car, dropped our Cavoodle off with friends (I remember saying to them, "I'm absolutely shitting myself!") and drove into the hospital. The most surreal feeling knowing the next time I saw our dog and home we would have our baby with us. The most significant moment of my life, the birth of our baby and my transition to becoming a mother, was finally upon us.

We checked into the birth suite and Cale started setting the room up to make it a positive, calm environment - salt lamp, LED candles, an oil diffuser and music. While the midwife was hooking me up to the electronic monitoring device for the baby, I told her how scared I was about the balloon. She said I could use the nitrous oxide (gas) while it was being inserted, which would offer some pain relief, and I could also request a sedative. My obstetrician then arrived and did a pelvic examination, I crossed my fingers that my cervix would be slightly dilated and the balloon wouldn't be needed after all. She said my cervix had started to soften, however it was still closed, so the balloon was necessary to ripen my cervix prior to the induction. I asked if I could be sedated, and she said yes, however advised by the time she got that organised the procedure could be over and done with. So I agreed to proceed without it.

My OB then started getting set up for the procedure, meanwhile the midwife put a drip into my arm and put my legs up in stirrups. I then proceeded to inhale the gas. I actually loved the feeling of the gas as it made me super relaxed and giggle a bit, which was perfect for the anxiety I had around the procedure. I remember the insertion of the catheter being uncomfortable, but it wasn't nearly as bad as my previous experience, nor as bad as I had built up in my head! Once the catheter was inserted, my OB filled up the balloons with water and said the pressure would start to open my cervix overnight. I was then given panadeine forte, a sleeping tablet and told to get some rest as I had a big day coming up tomorrow.


Overnight the balloons put constant pressure on my cervix and therefore caused the regular braxton hicks contractions I was experiencing to become painful. What I experienced felt very similar to early labour contractions, enough to keep me awake but still manageable - especially with the gas. I also had an upset stomach and vomited at one point, I believe this was due to nerves as I'd built the procedure up so much in my head. Or maybe it was my body softening and getting ready for labour, or maybe a combination of both.

Despite the regular braxton hicks and having a midwife come in frequently to check the CTG monitoring for the baby, I did manage to fall into a light, broken sleep in the early hours of the morning. Next thing I knew I was being woken up at 6am and asked if I wanted to get up to have a shower and some breakfast before my Obstetrician was due to arrive at 7:30am. Such a crazy feeling knowing I was about to go into labour and meet our baby very soon! Upon arrival, my OB did another pelvic examination and said I was now 1-2cm dilated. The balloon catheter had done its job! She told me she would now deflate the water out of the balloons and remove the catheter. I was offered the gas again so started inhaling it to take the edge off. Shortly after the balloon catheter was removed, I felt a warm gush of fluid. I wondered if this was my waters breaking but also wasn't sure as I was tripping out a bit from the gas! My OB then told me that it was all done - my waters had been broken. As soon as the balloon catheter was removed my braxton hicks were no longer painful and I felt a lot more comfortable. Verdict on the balloon catheter: it was totally worth it!

Once my waters were broken, the midwife hooked me up to the syntocinon drip to commence contractions. Contractions commenced about half an hour later, very gradually and mild at first. The drip was dialled up from 40 to 60 after about 2 hours and remained at that level until around 11:30am when it was increased to 80. I told my amazing midwife we had for the day, Sarah, that I was open to getting an epidural later if things became too intense, but that I wanted to hold off as long as I could. I wanted to feel what true, active labour felt like. I also wanted to challenge myself to get as far as I could relying on the gas and TENS machine, combined with hypnobirthing techniques Cale and I had learnt in birthing classes. The midwife was very supportive of me holding off on the epidural, however let me know there were five girls being induced that day and that they often requested epidurals at a similar time, potentially resulting in longer wait times for the anaesthetist. While I could have put my hand up there and then for the epidural, I elected to hold off for as long as I could.

The TENS machine and the gas were my best friends in early labour. I was managing the building contractions really well with the assistance of these and was feeling proud of myself. Cale was an amazing birth partner too, reminding me each contraction to do my surge breathing and relax my jaw. The midwife commented a few times on how well prepared we were and what a great team we made. I walked around the room a bit in early labour and tried a few different positions during contractions - including standing up whilst leaning over the bed and sitting on a fitball. I found sitting on the fitball way too intense - I remember jumping up mid contraction and grabbing on to Cale for support. I believe it's such a personal thing finding what positions work best for you in labour. I'd been told that a downside to having an epidural was being confined to bed, but after trying out a variety of positions, the bed was actually where I wanted to be. In addition, the mobile CTG monitors that I used when moving around the room weren’t able to pick up the baby's heart rate as well. Due to being small, constant monitoring of the baby throughout my labour was necessary. The baby's wellbeing was my absolute priority, so at around 11:15am I got back into bed and was hooked back up to the wired CTG monitoring machine. Things were really starting to build in intensity, (breaks between contractions only about 40 seconds) the TENS machine boost button was getting a workout! Even though I wanted the epidural at this point, I set myself a target of midday to call the anaesthetist.



At approximately 11:30am our midwife increased the drip to 80 which intensified the contractions to an extreme level with minimal time in between which continued until midday where I asked Cale to request the epidural. The midwife realised that I was having minimal relief in between contractions and returned the drip to 60 which appeared to be the optimal level for me. She then left the birth suite to find the anaesthetist. She came back into the room telling us that he'd just gone in with another girl so he would be about 20-30 minutes. I gritted my teeth and told myself, right 20-30 minutes, I can do this! Things were ramping up very fast, to the point that the midwife thought I was in transition. She therefore called my OB to come into the hospital to do a pelvic examination prior to me getting the epidural. Basically she thought it may have been too late! My OB arrived at about 12:45 - 45 minutes after I'd asked for the anaesthetist. At this stage I was crying mid contraction while she did a pelvic examination. She said my cervix was now fully effaced but only 2cm dilated still. I couldn't believe it. As relieved as I was that it wasn't too late for the epidural, I was disappointed that I'd done all this hard work and was only 2cm. I remember thinking, I've probably got another 24 hours in labour at this rate! The anaesthetist finally came in around 1pm and ran through all the standard risks that accompany any type of procedure - I responded with yep, yep yep that's fine! Once I'd made the decision to have the epidural I'd never wanted something so badly, no risk could deter me.

I had to take my TENS machine off as the pads were in the spot where the needle needed to go, which I of course hated. Feeling the first contraction without the TENS was next level of intensity. The contractions really started ramping up while the anaesthetist was getting set up - they were coming every 30 seconds so I was getting minimal rest between them and they were intense enough to make me scream into the gas mouthpiece. After a very long 15 minutes or so getting set up, the anaesthetist was ready to insert the needle. I was tripping balls on the gas when I remember him saying, "now whatever you do, DON'T MOVE". Holding still mid contraction while he inserted the needle was one of the hardest things I've ever done. I went into some weird zen state, Cale had me in an iron grip and I feel like I left the room. But then it was done and I was relieved knowing that the intense contractions I'd been feeling would soon be over and I could then rest. Or at least I thought...

The anaesthetist told me I would feel another few contractions before I got relief, then he left the room. I did feel some relief after a few minutes, however I still needed the gas and could feel a strong pressure. The contractions then started building again and soon became more intense than they'd ever been. My midwife was baffled - she said, "at this point girls usually fall asleep!". I was as far from falling asleep as possible. Pushing the boost button for the epidural made zero difference. She then proclaimed that the epidural hadn't worked properly - I was numb in my legs but not from my pelvis upwards - so she went to find the anaesthetist. She came back telling us that he'd just gone into theatre for an emergency c-section, so she didn't know how long he would be. This was the toughest part of my labour - I'd mentally told myself that I was about to feel relief, then experienced the exact opposite. Also not knowing how long I had to wait for the anaesthetist to come back, and if he'd even be able to fix it, combined with the fact I thought I still had hours and hours ahead of me was mentally and physically tough. Cale said he actually started crying at this point (he hid it from me) from seeing how much pain I was in, especially since I had finally asked for the epidural and it hadn't worked. He continued to be my rock and helped me to breathe in for four and then out for four through each contraction.

I was quickly snapped back to reality when it became apparent that the midwife was unable to locate the baby's heart rate on the monitor. It had dropped off a couple of minutes prior and she was searching around my stomach with a doppler to locate the baby, but to no avail. It took me a while to realise this as I was too busy trying to work through each contraction, and Cale obviously didn't want to say anything to me as I had enough going on. When I came to and realised what was going on, and noticed that the midwife looked visibly rattled, I was worried. Nothing else mattered except the wellbeing of our precious baby. The midwife left the room, saying she needed a fresh set of eyes, and came back quickly with another midwife. Thankfully this new midwife was able to locate the baby's heart rate again and confirmed all was ok. The biggest relief. I didn't care how much more pain I had to endure, all that mattered was getting our baby out safely.

Soon after a new midwife, Belinda started her shift. Belinda was incredible. She looked furious at the fact that I was in so much distress with my epidural not working, and stormed into theatre to retrieve the anaesthetist. While she was gone I told Cale that I was feeling a whole new intense pressure with contractions, an overwhelming sensation to push / go to the toilet. Belinda came back and Cale relayed this to her, meanwhile the anaesthetist finally returned (it was around 2:30pm - over an hour since his last visit) and topped up the epidural enough to numb my midsection too. The relief I felt was something else - it was AMAZING! I could still move my legs and feel enough sensation to know when I was having contractions, but that intense pressure had subsided. I was physically exhausted at this point so the epidural was a god send.

As the anaesthetist was leaving the room, Belinda said she wanted to do a pelvic examination given the new intense pressure and urge to push that I had encountered. She told me later that in addition to how much things had obviously intensified, she had noticed a lot of bloody show. She did the examination and then said to me, "you’re about to have a baby". I was at 10cm - fully dilated! That was honestly one of the most profound moments of my life, the emotion I felt was overwhelming and I started crying. My active labour was very fast which is why I felt it so fucking intense - according to my hospital discharge report, active labour commenced at 12:20pm with this first stage lasting for a duration of 2:10 hours. Between the two pelvic examinations I had at approximately 1pm and 2:30pm, I'd gone from 2cm to 10cm dilated.

Despite the epidural not working properly at first, I’m so happy with how it all played out as now I can say I know what transition feels like. I had wanted to go as long as I could without pain relief, and as it turned out I literally couldn't have gone any longer - I got through the whole first stage of labour without it essentially. It was so empowering. The relief from having the epidural work just before I had to start pushing was amazing as I was able to relax and work with my OB and Midwife to push at the right times. Having the syntocinon drip in my arm from being induced was an advantage at this point as they dialled it up to make my contractions stronger and longer, helping each contraction to be more efficient in pushing out the baby. I was shaking uncontrollably from the epidural and adrenaline, stripped off, legs up in stirrups and told to curl into a ball (hello double chin) while pushing. All modesty out the window but zero fucks given at that point - we were about to meet our baby!

I pushed for a total of one hour. My OB (who had obviously arrived at this point) and Belinda guided me on when to push and were so encouraging. Saying things like, "yes amazing, great job, you're pushing SO well" was very helpful to keep me focused and positive. As per my birth preferences, Belinda used warm compresses on my perineum to help prevent tearing. At one stage they got me to reach down and feel the baby's head which had started crowning. It was incredible. Cale (who was up the Paris end) and I looked down as our baby's head fully emerged and twisted around to face upwards. We didn't know the gender of our baby up until this point as we had elected to have a surprise. Upon seeing our baby's face, we both proclaimed at the same time, "it's a BOY!". Shortly after his whole body slid out and they told me to reach down and pull him up to my chest. That was the moment - on 15 June 2021 at 3:35pm - we met our precious son, Theodore. The most incredible moment of our lives, that instant love we felt for him was indescribable. Theodore came out calm, alert and was (and is!) absolutely perfect. Weighing a tiny 2.55kg and 44cm in length, our perfectly healthy and happy boy.



Everything after that is a complete blur - I was well and truly in my baby bubble. On our birth preference sheet we had requested for delayed cord clamping. Once the umbilical cord had stopped pulsating, Cale cut it. I have no memory of this as I was focused on Theodore on my chest the whole time. I vaguely remember my OB saying they were giving me the syntocinon injection in my leg to birth the placenta, but I don't remember the placenta coming out, nor did I have a chance to look at it. Cale did though - he was accidentally splashed across the face and chest with placenta blood as it was yanked out, making for a hilarious story!

My OB and midwife finished cleaning up, then told me that I had minimal blood loss (300ml) and no tears! My perineum was completely intact. I couldn't believe it. I had been told at least some first degree tearing was common with first time mums, so was expecting possible stitches. They said it came down to really controlled pushing. I had also been open to any intervention that was necessary to get our baby out safely, but everything went smoothly and no intervention was required. After two hours of skin to skin bonding with Theodore and initiating breastfeeding, he was taken to the other side of the room to have his measurements done and Cale then dressed him in his first outfit. Soon after Belinda removed the catheter from my bladder - I hadn't even realised they'd put one in after the epidural - and helped me up to have a shower. We then transferred into our allocated room for the following four nights (which was huge and like a hotel room!) and FaceTimed our interstate families who couldn't visit us in hospital due to Melbourne lockdown. I was on the biggest high and couldn't believe how physically good I felt, no pain relief necessary.

I feel extremely lucky and grateful to have had such a beautiful birth, as well as having Cale, the most supportive and amazing birth partner. We put a lot of preparation in - attending birth classes together, practicing hypnobirthing techniques at home, and I attended weekly prenatal yoga classes and kept up weights sessions at the gym throughout my pregnancy. As Vanessa told us, labour is like running a marathon and you wouldn't turn up to a marathon unprepared. The knowledge we gained from the birthing classes was invaluable. Birth was the most intense thing I've ever been through, but also the best as it brought our beautiful Theodore into the world. Wouldn't change a thing! I can't wait to do it all again one day.










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