An Account of Labor and Birth Following a High-Risk Pregnancy That Ended in Induction of Labor at 37 Weeks: An Acknowledgment of When Option B Can Still Lead to a Positive Birth Experience

Abstract

After two textbook pregnancies, I was not expecting my third to be any different. However, despite feeling well and exercising regularly, at 29 weeks, I was diagnosed with gestational diabetes. After taking insulin, I developed pregnancy-induced hypertension and oligohydramnios. Having studied to become a Lamaze Certified Childbirth Educator in 2017, I was keen to utilize all my learning and follow the six Healthy Birth Practices to avoid repeating the birth experiences I had had in 2012 and 2014. This is an account of when option B is presented as the best option for the safest end to pregnancy and the ways I tried to gain control of what I could the Lamaze way.

I’m Lesley, a full-time mom to three children and a recent newbie to the world of childbirth education. From a clinical psychology background, I was keen to pursue a different path in 2017 and couldn’t have made a better decision than to complete the Lamaze Childbirth Educator training with Tanya Strusberg in Melbourne. Little did I know at the time of signing up for the Lamaze Educator course that my learning among some of the most inspiring women I have come across in my life would put me in a great place to give birth to my third child on November 22, a daughter after our two sons in 2012 and 2014.

This pregnancy was not straightforward like my first two experiences. Despite feeling “healthy,” exercising regularly, and gaining minimal weight this time, at 29 weeks, I was diagnosed with gestational diabetes. This was a bit of a surprise to me. I had always thought this condition was related to diet choices in pregnancy. How wrong I was. What followed in the coming weeks was a lot of education about the science of the body and a strict low glycemic index (GI) diet to try and manage the blood glucose levels without medication. Despite my best efforts, I began taking insulin at 35 weeks. As easy as I found the daily injections, what I did struggle with was the daily judgment of people toward my condition. I found support through online forums and this seemed a common experience for a lot of pregnant women—diabetes of pregnancy was a condition we had brought on ourselves through neglect of our body. Following episodes of pregnancy-induced hypertension, I had a well-being scan at 37 weeks and I was then diagnosed with oligohydramnios—low amniotic fluid levels. How many more boxes of the high-risk factors I was now going to be ticking!

Despite feeling “healthy,” exercising regularly, and gaining minimal weight this time, at 29 weeks, I was diagnosed with gestational diabetes.

This diagnosis led me to the birth suite that afternoon for the oxytocin drip to bring my baby into my arms 3 weeks early—an experience I know too well. Both my sons were induced at 41 weeks, but in retrospect, their inductions were not for medical reasons but for the convenience of my service providers at those times. I was perhaps naïve in my past birth experiences, but not now, I thought. I am not going to lie, after the year of Lamaze learning I had, I was keen to follow the Lamaze Six Healthy Birth Practices and I was determined to have a birth experience that at least my baby had decided it was time to start.

However, very quickly, my mind had to catch up with my body. It was time for option B. My baby had to be delivered that day. After an artificial rupture of my membranes at 2 p.m., I began climbing stairs in an attempt to start labor naturally. During this time my thoughts turned to what was about to happen, inevitably with the hormone drip looming. My midwife asked me what my birth plan was. Honestly, I didn’t have one. I was meant to be at the hairdresser’s at 2 p.m., then Christmas shopping, I told her. But I knew what I didn’t want, and my midwife was happy to know that lying down on the bed, immobile, and medicated for pain was not in my mind as the birth I wanted to aim for. So I began a list in my head of what I knew would support me. Having hired a TENS machine in my second labor, I had this ready to strap on when things got going. My midwife was able to locate me a birth ball and mobile cardiotocography (CTG) sensors so I didn’t need to be hooked up to another machine. I refreshed my husband’s memory of the acupressure points I had learned to utilize in labor as well as making sure he had food and drink close by. I would have liked to have had more comfort measures in my bag, but again I didn’t think I would be giving birth that day!

I knew what I didn’t want, and my midwife was happy to know that lying down on the bed, immobile, and medicated for pain was not in my mind as the birth I wanted to aim for.

As things progressed, it was 3 hours before I was in established labor and another 3 before my daughter arrived. My husband asked me why the TENS was helping me and this allowed me to remember the science of the drug-free pain-relieving methods Lamaze promotes. This gave me confidence, so I just turned up my machine as the midwife turned up the oxytocin once more! During the last hour, I knew I was struggling, not with the pain, but with my self-talk. My confidence in myself was low; I didn’t believe I could keep going and achieve the outcome I wanted for myself and my baby. In hindsight, I think it was actually the overwhelming reality that I was going to meet my baby imminently, not 3 weeks later like I had thought for so long.

At 9.19 p.m. on November 22, 2017, Juliette Francesca Ann Pascuzzi arrived with us. Having birthed on all fours, I was helped by the midwife using hot towels to have my first birth without any tearing. At a modest 3.3 kg, our daughter changed our lives forever with her first cry.

I look forward now to 2018, completing the final chapter of my Lamaze journey as a childbirth education student and immersing myself in the world of women keen to learn that knowledge is power. I hope to encourage women who may have found themselves on a path that hasn’t been a textbook pregnancy to understand that with the right knowledge and skills behind you, you can take control of your body and work your way toward a birth experience that will stay with you for life.

With the right knowledge and skills behind you, you can take control of your body and work your way toward a birth experience that will stay with you for life.

Biography

LESLEY ANN PASCUZZI is a full-time mom on a break from a clinical psychology career. This is her first publication.