So today two years ago I was midway through the most excruciating labour.

Yeah I know birth stories usually start out ‘oh I was woken up by a gush of water and we had to change the sheets I thought I’d peed my pants!’ (Well in the movies anyway) but actually I didn’t go into natural labour at all.

But I digress.

Somewhere between 25-30 weeks of pregnancy (can’t remember exactly) I started getting wildly itchy hands and feet. Like intolerably itchy. Scratching didn’t help, I scratched all night while I slept. No other symptoms (apart from normal growing-a-human stuff). Luckily I knew it was something to look out for though I couldn’t remember why so I told my OB and she was like.

After some bloods she diagnosed me with cholestasis of pregnancy (liver-stop-while-pregnant, basically) and the itch is caused by rising bile acid levels in your blood (because the liver isn’t filtering it properly). And so I immediately became a ‘high risk’ pregnancy (I think, technically, IVF pregnancies are already ‘high risk’ just because it’s IVF, but I’m not 100% sure on that).

And thus began weekly bloods to follow the bile acid and liver function trends. It was slowly going up and it was fine but the main issue was that I lived in Tasmania and the only labs that process tests for bile acid are on the mainland, so results took over a week to get back. I was also having extra ultrasounds and frequent foetal monitoring to keep a closer eye on the baby.

Fast forward a few weeks and I went and had coffee with my friend down the road, had some missed calls from a private number - no voicemail left, casually drove home and continued knitting and sitting on my gym ball, then the phone rang with the private number AGAIN and I could answer it - it was one of the OB’s at the hospital in a bit of a panic telling me to come in now - my latest (the previous week - remember it had to be sent away) bile acid test had come back and it had SKYROCKETED.

Dumbass me was like should I bring my hospital bag.

Anyway before we left we washed all my new pump parts and stuck them in the steriliser lol. Wasn’t expecting to need them so soon!

I’d known from the moment I was diagnosed my labour would need to be induced which I was disappointed about (first thing on my birth plan was ‘no inductions’) but I’m pretty rational and go-with-the-flow and my baby was high risk of miscarrying because of the cholestasis so of course I agreed to it.

It went like this:

a person sitting up in a hospital bed with foetal monitoring on — I pretty much looked like this the whole time.

Day 1: arrive at triage, get horrifically painful cervix check, (the second thing on my birth plan was no cervix checks), a nice midwife puts a balloon between my cervix and uterus (0/10)

Day 2: balloon is removed. Dilated a tiny bit. Prostaglandin gets put all up in there.

Day 3: Dilated a bit more. Midwife calls in sick so needed to wait for relief midwife. She turns up and physically breaks my amniotic sac with a long sharp crochet hook, felt like I was peeing an entire ocean but out of the wrong hole (yep like the movies) and 30 seconds later (literally) I finally went into labour.

After my waters broke followed the worst 7 hours of my wife’s life (I’d say mine, but I was delirious).

The third thing on my birth plan was ‘unmedicated’ by which I meant no opioid pain meds or an epidural, because I’m a stubborn b. And obviously nothing had gone to plan thus far so I really dug my heels in on this one. The midwife had fully explained all the kinds of pain relief I had access to. I’d brought a tens machine (I hated it and took it off instantly), a wooden comb to squeeze (surprised it didn’t pierce my hand), and I was hoping for warm water but due to the type of monitoring I needed that wasn’t really an option. I could've pushed for it but I decided not to.

I sucked on a lot of gas - didn’t do much except make me light headed and feel like I’d licked a permanent marker. About half way through I agreed to a PCA - patient controlled analgesia - containing remifentanil. I’d heard the midwife talking to the anaesthetist on the phone saying ‘I don’t think she’ll be able to sit still for an epidural’. But you didn’t want opioids, you say, and no I didn’t, but this one is an extremely short acting opioid that wears off very quickly. I was supposed to press the button when I felt a contraction coming on, I’d get the medication, and it would offer relief for the duration of the contraction.

But the whole time felt like one big contraction.

I didn’t feel any ups or downs, really (no, I did, it’s just the ‘down’ part was really bad too) so I kept missing the ‘start’ and not pressing it in time. It did work a little bit though, I definitely noticed on the times I completely missed pressing it.

Fast forward a few hours and my wife crying (yes, I heard, and I remember it) and feeding me sips of Solo, the midwife suggested I get up and walk to the bathroom hoping it would shift the baby down my birth canal a bit more. And then half way to the bathroom (idk like 4m away) out she plopped and I managed to catch her before she hit the floor!

Yeah, those are broken blood vessels all over my face. From the screaming.

And it was like being in the eye of a cyclone - suddenly the pain just, stopped? We just hobbled back to the bed and we were surrounded by like 7 midwives because at some point between me going toward the bathroom and the baby falling out someone had pressed The Button, and someone else was on the phone to the paeds registrar because she was born at 36 weeks and 6 days and any baby born before 37 weeks needs a review by that doctor. They did do APGARs etc while she was on my chest but there was something up with her breathing so they did take her off me but I think it was only for like, 2 minutes, and they checked whatever it was right there beside my bed.

Anyway, THEN the OB inspected my nether regions for damage (midwife had already looked and said it looked like a 2nd degree tear - in hindsight she absolutely knew the truth and just didn’t tell me out loud) and told me I had a fourth degree tear.

A lot of different things contributed to me getting a fourth degree tear and I’m not going to go through it all but basically - it happened. It was mostly unavoidable. I’d been seeing a pelvic floor physio throughout my whole pregnancy, mostly doing all the exercises she gave me -

a pregnant person and a dog doing pelvic floor exercises on a yoga mat — I remembered I posted this on my Instagram stories and yes I’m dedicated to the bit so I scrolled all the way back through my archives just to include it here.

But essentially my baby came out with her hands up over her face and I did indeed tear from arsehole to breakfast.

Now the following bit is probably confronting - I’m a nurse who loves gross stuff and even though this was my own body and I cried every time I showered or went to the toilet for a few months I’m still ok with it. If you are not, the baby came and she is still a perfect angel. I have fully healed with no lifelong pain or continence issues (apart from some ‘giggle’ incontinence that most people who birth get - will work on that because it doesn’t have to be this way!).

Here goes:

Content warning I guess? You’ve read this far.

I tore the outer anal sphincter all the way up to and including the internal anal sphincter and also the perineum all the way from butt hole to vagina and some of the vaginal wall. It was a surgical repair, that is, in the operating theatre (so hey, I got an epidural in the end!). The surgery took over 2 hours and the on call surgeon JUST HAPPENED to be a uro-genital specialist surgeon and had God’s chunky hands (legit sausage fingers, I was like, oh no - sorry for doubting you Dr Wolf). The stitches were innumerable. He very firmly told me my poop had to be like toothpaste or I would need a stoma and he also very firmly told me no more babies were coming out that way (don’t worry, I’d already decided that the second the OB said ‘fourth’). He estimated 6 months to heal. I healed to the point of being able to ski again in about four months :)

a person on a paramedic sled on a snowy mountain — Then I broke my knee while skiing at that four months but that’s a whole ‘nother saga.

(Yes that’s me and the mountain paramedics. One of them used to do wilderness stuff in Tasmania!)

But you said this wasn’t a negative birth story, you say.

And yes I did say that and to me it isn’t. Yeah obviously it would’ve been preferable to not be induced, to not tear so badly - BUT.

Now I promise none of this is meant to be a flex, and I do actually have a bit of trauma from the birth but overall I’ve decided to think of it as a positive experience;

My midwives were great
I was listened to (do I regret not taking the epidural when it was offered? Maybe, but it’s done now so…)
My wife was there the whole time (and just happened to have 5 months long service leave to take after)
I caught my own baby (literally)
Even though Baby was early, she was ok and didn’t require NICU or special care

a photo on a canon camera of a placenta — I got to cut my own umbilical cord (Jas is squeamish hahahaha)
I got to stick my hands in my own placenta and have a good look at it (highly recommend doing this)

I got skin to skin for over an hour before my surgical repair (then jas took over)

My feeding desires were respected and Jas got to do the very first colostrum feed (speaking of, I’d just started to antenatally express it when I got called in!)
And then…my feeding journey (ex pumping by choice) went how I wanted it to, bar a bit of formula for a couple of days in hospital.

There you have it. My birth story.

Don’t let it put you off if a baby is something you want. Poke your placenta. Probably don’t ski in a whiteout too soon post birth.