What a night…
My experience of assisting Kate with the birth of my daughter.
What a night!
It started at midnight. Pains, but nothing more then that, and she could still sleep well. Then at 1:50 when I was overseas in my dreams, Kate woke me up. Frank, water! I jumped up out of bed, and yes, Kate went to the bathroom, and water was leaking out of her. Some mucus type of stuff also came out. The water was clear. So, obviously I go to the internet, and then see that my normal calm has changed a bit, and as I google for water, first signs of labor, in various languages I start to read. The pages come up slow, much to slow for this kind of situation. I immediately contact my mother who is happy for me, but I am actually more like seeking advice, then I msn with a friend who asks me all kind of details. Contractions. I start to clock them. They come every 10 min, and then less, and I still start to clock. I am now at every 5 min, and really don t remember any more what it was I was supposed to do. Previously I had bought a pair of scisors with some rope, for in the car. But, we had it in the room, and Kate thought it might be a good idea to have it ready. But of course at this particular time, I could not find it. After a while I did find it, and we boiled water, put the scisors in, and for some time now there was calm. Kate walked up and down, felt more like walking then lying down. So I was on the internet and Kate was walking around in our room. Her mother was also around, and that was very useful, as she had so much more experience then me with my internet knowledge. Contractions every 5 minutes, then I decided to go to the hospital. Kate thought it was not yet necessary. But I wanted to be in the car, close to the hospital, just in case. I left Kate and her mother off at the emergency entrance (this was the only entrance available at 3 in the morning) and parked my car. I joined them at the ward. There I was surprised that we woke up the staff, who came out sleeping and clearly not in a good mood. I was to fill in forms and after that they wanted me out. But we had just been practicing active birth where the husband participates, so their attitude was clearly contradictory to what we had learned. Come back at 8 they said, these are the rules of the hospital. At that moment I thought…Did I choose the wrong hospital? Weeks of training, and then all goes wrong because of some rule. I clearly wanted to stay with Kate. But we went back, and Kate called at 6 in the morning saying that they measured 5 centimeters opening, and she was clearly in big pain. I called her back after 20 minutes, and all I could hear was her saying my name and for the rest, pain. A nurse then took the phone and told me that this was not a good time to call, and hung up on me. At that time I thought…wait a minute. We take a course, we believe in active birth, we trained, and then when the time comes for it, it is like this? Active birth where participation is essential is just not possible? At this time I got up, took a bath, and prepared myself to go. I would be earlier then 8 o’clock, but I was going to get in. And I did get in, explaining the staff how I thought about their attitude to active birth. Clearly it was not practiced a lot at this hospital. I came at the hospital and went to see Kate, who was now shouting and screaming from the pain. 6 centimeters opening of her womb, they measured. But then there was the problem, this guy –me- wanted active birth. And, no room was ready, and nobody really knew what to do. A mattress was found, a room was found, the mattress on the ground and people were asking me what to do. I was surprised. Neither the nurse who trained us, nor the doctor who we had been seeing, were present, and while Kate was lying down on her back on the mattress, with her head towards me, the staff told her to push. I had seen this in the movies so I could understand this. But I remembered what I had learned, to use gravity to make the baby go down. But here we didn’t t do this. I understood that neither the nurses, nor the very young doctors who had just finished university, had really any notion about this, or at least this was my judgment. It seemed that we were going to do this without the doctor and the nurse who I knew. But Kate pushed and pushed, and nothing really happened. It was about 8 in the morning. At this time the doctor I knew came in, and shortly after the nurse that had given us the training on active birth. The situation changed, and all of a sudden their was guidance. Kate was lifted up, and now she was in a squatting position, and I was kneeled behind her on a mat. She felt clearly more comfortable like this. She labored, and then rested putting her head forward with her hips up. Now I could massage her coxes (the last bone of her spine) as I had learned and practiced. We actually continued like this for 1 hour. When the pains came she leaned backwards in a squatting position and as I kneeled behind her and supported her with my arms under her arms. She squatted and leaned backwards against me. We continued like this and made progress, and although she was exhausted this routine was clearly beneficial. At 8:58 the baby came out. Immediately after the baby came out it was placed at the breast of Kate. But it did not start to suck on the breast. The umbilical cord was cut some time after 9:00. Then the baby was put under a hot light and the measurements were taken. Net weight: 4210 grams. A big baby. Kate was sewed up. After that we went to another area, where Kate was monitored, and the baby was oxygenized. The baby was then later put at the breast of Kate, and both were monitored for about 3 hours. At 12:00 we moved to another section, where one stays for about 2-3 days. And this is where I am now, writing this report.
How we got in contact with Active Birth?
Well, actually it was more or less by accident. When we went to the hospital about 1 month ago, we queued up, just like everybody else in an overcrowded room. All big bellies lined up, some accompanied by husbands who clearly were thinking of how to get out of this place as fast as possible. I guess to keep the crowd busy a nurse said something like “all the mothers interested in active birth, follow me”. Not really knowing what this was all about, I felt that a walk would do us well, so I followed the crowd with Kate. We went to the second floor, and we all put on green protection suits. The panic in the eyes of nurses was visible when they saw me, thinking they might have to switch to English with me, but then relieve came when I spoke Thai to them. We then got to know Khun Jim (unfortunately I do not know her real name). She explained about active birth, saying that it was a drug version of giving birth, resembling that traditional way of giving birth, but in an assisted environment. In this assisted environment, the hospital, intervention was possible at any time if needed. I really did not know anything about this all before coming here. All kind of positions were reviewed and practiced. I practiced along not really knowing what all this was for. Later I went on the internet and checked about active birth or natural birth. This is when we got more and more convinced that it was this way we would like things to happen. No drugs, and standing positions, and as natural as possible. It made sense to us. We went to the second training of Khun Jim. Now we were listening more carefully then the first time. But these sessions with Khun Jim were just part of the job. We now also had to find a doctor who was also convinced of this practice, active birth, so that when the delivery would come, an “active birth doctor” would be present. Khun Jim recommended Dr. Witun. We went to his practice, and we talked to him about it, where he said it was a good way to give birth, but not many people practice it. Most Thais are happy they have just gotten a few steps away from natural birth, and medication against pain seems a solution in fashion. A week later he took us in as his patients (this plural in “patients” is not a mistake: Active birth is clearly a participatory way of giving birth so it always involves the pregnant woman and another party, be it a mother, a husband or a good friend). From then off we have been coming to the hospital for weekly trainings, and also got a very good and clear lecture on breast milk feeding Nurse Porn Pen. So we were both very motivated to go this way, and we did. We are both very happy with the results. Giving birth to a child of 4.2 kilos is not easy, specially not if the mother is a Thai woman, not big like a foreigner. Where everybody said (if not thought) that this would probably turn out to be a caesarean birth, as Kate was very very big bellied, we managed, I believe through the guidance of Khun Jim, to give birth naturally to our child. I can not thank her enough for her lectures and clear explanation. She did a great job! And, of course, so did Kate who persisted even though she was in terrible pain.
So, is there anything to improve?
It seems that pain is not in fashion these days. Understandable of course, but it could very well be that the advantages of active birth are considerable. Yes, pain, it is true, but once birth is given, most pain is gone, and a child is all awake, as is the mother, ready for their new life together. Also, the advantages of gravity are gone once birth is given in a lying down position. Added to that, the lower end of the spine can not move out well in a lying down position, and the exit for the baby is actually a bit blocked by it. It was made clear to me that if Kate would have tried to give birth in a lying down position she would not have been able to, and a caesarean would have been necessary. All these experiences in such a short time make you think a lot. Of what went right, of what went wrong, of what might have been better. Here are some of my conclusions that I would like to make available for people to read. Clearly, I am a first-experience father and may be completely wrong with my conclusions. They should be observed in that light.
Explain about different ways of giving birth: When a woman comes to a hospital to “fak thong” (lets a hospital take care of her pregnancy) she should already be notified of the different ways of giving birth, that is, if that applies to the hospital or clinic she enters. I think only few hospitals give this possibility, but the hospitals that do give this possibility should spend time with the patient(s) in explaining about the different procedures possible.
Start practice soon, and know with who: If Active birth is chosen, the patient should start to come with her partner in birth (this can be her husband, a good friend, a parent) to training sessions. They should do this as much as possible on a weekly basis from week 30 off. There should be some exam, so that the people who will perform this are committed to practice, and feel confident going into birth.
The room where to practice should resemble the room where active birth is supposed to take place. The cussions, and other equipment should be clearly numbered, so that when the time comes to give birth, the same equipment is available as when it was practiced.
An “Active Birth” Sticker should be put on the “fak thong” booklet, so that when a woman comes in with this sticker, the staff know about this.
If an Active Birth is to take place, there should be no rule to prevent the helper to come in and participate.
My experience was that doctors (mostly very young graduates) did not know anything about how to organize things for active birth. I conclude this from the fact that they were asking me how to do things. I have an MSc in Sociology but Active Birth was not a subject in the curriculum. I expected the doctors to know about this.
A utensil that may be useful is something where the woman giving birth can hold on to over her head. I understand that in some Hospitals have an artificial tree with a rope hanging down from it, so the woman can hold on to this. A tree seems a bit far fetched, but a metal system seems a possibility.
My comment ends here. I would especially like to thank Khun Jim, Dr. Witun and Nurse Pornpen for their assistance.
