Woman Fucking Power

Natural childbirth in an unnatural world.

Maia Star Assad

It was 6:01 on a warm July day. The sun was peaking through the shades as my wife crawled into bed to wake me up.

“Good news!”, she said with a grin, “it’s starting!”

Sabrina was at 40 weeks and 5 days. We were getting anxious because we wanted a natural childbirth and that gets harder after the typical 40 weeks of pregnancy.

I was ecstatic! It was our first pregnancy and probably our last. We were both so ready to meet our little one.

When we first got pregnant we debated whether we should go through the medical system or do it the natural way. Sabrina’s twin sister had a straightforward home birth about a year before and we didn’t like how the hospitals treated the baby afterwards.

On the other hand, my uncle was an OB and our moms were both nurses. Medicine was in the family and I’m not one for taking risks when it comes to health.

Sabrina did some research and found Dr. Howard Berger at St. Michael’s Hospital in Toronto. He was highly regarded and the hospital had my name on it. How could we go wrong?

We went to visit Dr. Berger and we both liked him right away. We asked about natural childbirth and he said tongue-in-cheek that vaginal birth is the preferred method and they always did everything to ensure that the birth was attended with minimal intervention.

We asked about having the baby at the Toronto Birth Centre, a posh new facility for natural childbirth, rather than the hospital. He said that would out of the question unless we signed out of his care and went into the care of midwives.

He proceeded to scare us with a story of how a young couple came into St. Mike’s earlier that week in shock from a Birth Centre birth gone awry.

To me, the decision was easy. We’ll go through the system at one of the best hospitals in the city. We’ll get the best care that modern medicine has to offer without paying a dime.

To offset the risks of intervention at the hospital, we decided to hire a doula. Our friend recommended someone from King City north of Toronto.

We drove up to meet Jessica on a snowy winter morning. Her office in a converted century home in the woods was inviting, friendly and cosy.

Jessica was great. She offered advice on natural prenatal supplements and described her services during the birth, including natural pain relieving techniques. She would act as a gateway between us and the doctors to ease the temptation when drugs or interventions were offered.

We made an easy decision to fork over the cash for her services. We figured it was the best way to give us the highest chance of a natural birth at the hospital.

I woke up quickly and was excited about how the day would unfold.

Sabrina was up since 3:00 when her mucus plug came out — a clear sign that labour had started. She had a few mild contractions between 3:00 and 6:00 AM that were around 10–15 minutes apart.

As they got more frequent, I started timing them with an app on my phone. By 8:00 AM they had became unusually frequent and were ramping up in intensity.

We decided to call Jessica and let her know that Sabrina was in labour. She was excited and she agreed to come down.

As the due date drew near, Sabrina visited Dr. Berger alone for one of her scheduled appointments. At this stage, the topic of birthing became more urgent.

She had heard about water births and asked Dr. Berger if this was an option at the hospital. “No”, he said, “we’re not equipped for that — we’re no Birth Centre!”

He told us that the C-section rate is around 30% at St. Mike’s, “depending on who’s working that day”. Apparently it’s the highest rate in the city.

When you have your baby at St. Michael’s, the attending doctor gets the job. The rapport that you build with your doctor during prenatal visits is mooted by a one in thirteen chance he or she will be on duty for your birth.

C-sections are an amazing feat of science. With the fear around the pain of childbirth, it sounds like a high-tech work-around to a whole lot of agony. But it’s easy to forget that major surgery requires weeks to recover from. Given that Sabrina and I run a business together, this wasn’t an attractive proposition.

Sabrina was discouraged. She liked having the option of a water birth and the thought of a random doctor attending the birth caused a bit of anxiety. We discussed it and she scheduled an appointment at Community Midwives to get their side of the story, despite my protests.

I went along to the appointment with no expectation of going this route. When we arrived, I was immediately skeptical. Compared to the newly renovated prenatal centre at St. Mike’s, the waiting room was a tad shoddy. The vibe was a little too hippy for my taste.

A midwife named Jennifer called us in for the consultation. Despite my skepticism, I went in with an open mind.

Jennifer was confident, professional and inspiring. Their patients often choose to birth in the hospital with midwives attending, rather than doctors. Since her group was registered with St. Michael’s as their primary hospital, She knew Dr. Berger and had nothing bad to say about him. In fact, she said she was grateful that the OB’s were there to intervene when needed.

She calmly described how the midwife approach compared to the medical methods and joked at how her and Dr. Berger often traded barbs about which was better.

I was inspired. It sounded like we could have all of the benefits of the hospital without any of the drawbacks. Sabrina and I discussed over dinner and decided to switch over to midwife care.

The frequency and intensity of the contractions continued to increase so we paged the midwives at around 9:30. Jennifer was on duty. It was still early labour, so she told us to chill out and try to take your mind off them. “Page us when they’re 3 or 4 minutes apart and about 1 minute long”.

Jessica arrived and decided that the baby was probably positioned oblique posterior or “sunny side up” because Sabrina was having strong pain in her back with each contraction. This less common orientation of the baby tends to cause these symptoms and usually meant labour was harder.

Jessica had a few tricks up her sleeve to get the baby to spin around in the belly. Sabrina worked through them with the contractions.

We paged the midwives back in the early afternoon. By this time, Dione was on duty. Sabrina wasn’t sure she’d be able to make the trip to the birth centre in her state, so we asked her to bring the home birth equipment.

Dione came over. She assessed Sabrina’s progress and determined she was about 3cm dialated. There was a long way to go.

I was a little discouraged. The pain seemed so intense already and it was hard to imagine it getting worse. Sabrina was taking it in stride and not showing much of a burden.

But she was getting tired. Dione offered to give her a Gravol shot which we declined at first because we didn’t see the benefit. After 30 minutes of intensifying contractions, Sabrina changed her mind and Dione administered the shot.

For the next hour, Sabrina dosed in and out of sleep between contractions which was great because she had been up early and there was a long evening ahead.

The effects wore off pretty quickly and the pain continued to intensify, especially in Sabrina’s back. Dione agreed that the baby was probably positioned posterior and that techniques to spin the baby around were warranted.

Jessica suggested Sabrina get in the shower. She showed her some techniques using a bosu ball to try to flip the baby’s position while the warm water eased the pain in the small of her back. Sabrina made her self at home and continued to impress with her coping.

From then on, Sabrina moved between the shower and tub, using the warm water to ease the pain as much as possible. I could tell that it was getting really intense now, but she wasn’t letting it get to her.

After labouring in the shower for a couple of hours, Dione checked the dilation again. “7cm and I can stretch it to 10!”

We were thrilled! Dilation was progressing quickly, and we just needed the baby to drop more to put pressure in the cervix and help it to open the rest of the way.

Dione suggested standing and walking because the gravity would help bring the baby down. Sabrina was getting weak by then so she had trouble walking on her own. She put her arms around my shoulders and we shuffled back and forth in the bedroom facing each other. I called it the ‘labour waltz’. It must have looked hilarious, but it was a great bonding experience and I was happy to be engaged in the process.

It worked! Sabrina felt the urge to push and Dione decided she was starting the final phase of labour.

We never did make it to the birth centre.

Sabrina and I got onto our bed to prepare for the pushing contractions. Jessica and Dione coached Sabrina on how and when to push.

It was slow going at first and Sabrina was getting frustrated. After 18 hours of labour with intense pain and only a single dose of Gravol, she was exhausted.

She asked Dione to break the water to help speed things up. Dione did so and announced that there was meconium (baby poo) in the water.

Protocol for this case is to take the mother to the hospital. It means that the baby is probably in distress and there is a risk of the baby inhaling the meconium when they take their first breath. This situation also calls for continuous monitoring of the baby’s heart rate.

Dione asked if we wanted to decline the hospital since Sabrina was so far along and the head was starting to come down. She suggested that if we can get the baby out quickly, the hospital would not be necessary.

The decision fell to me because Sabrina was loopy from the intense labour and pushing. I declined.

By this point, a second midwife, Mary, had come to help with the final stages of birth. Mary was put in charge of monitoring the heart rate between contractions.

Whereas the hospital would have hooked Sabrina up to a continuous baby monitor, the midwives used a simple device that presses against the mother’s abdomen to listen for the heartbeat.

With each round of monitoring, my heart leapt to my throat as she searched around for it, and finally found it. Sometimes it was a little slow and sometimes okay. The topic of hospital came up again, but we decided to wait for a couple more contractions.

Two or three rounds of intense pushing came and went and still no baby. Mary checked again and the heart rate was slowing — signs that the baby was in distress.

The midwives made the decision to call the ambulance and Mary handed me the phone as I was supporting Sabrina for another round of pushing.

The 911 attendant asked me questions as Sabrina grunted and Jessica, Dione and Mary shouted words of encouragement. Somehow the information came out after stumbling over our address and suite number.

We informed Sabrina that the ambulance was coming to take us to hospital.

The baby was crowning at this point and the midwives were still optimistic that we would be able to get her out.

A touch of divine primal instinct set in and Sabrina beared down for the effort of a lifetime. I’m certain that no other motivation but a mother’s love for her baby would be able to muster this kind of strength and courage from someone so exhausted.

With one leg on my chest and the other held back by Mary, Sabrina made the supreme push that finally birthed our baby’s head.

She had done it!

But no. The head was out, but the rest wasn’t coming. Dione calmly diagnosed that there was a shoulder dystocia which means that the baby’s shoulder is caught under the pubic bone.

Without wasting a moment, the midwives flipped Sabrina over on her hands and knees to try to release the shoulder. I jumped from the bed to get out of the way.

It didn’t work. The baby was still stuck!

While contemplating the decision to try for a natural childbirth, Sabrina and I read several books including Childbirth Without Fear and Ina May’s Guide to Childbirth. Both books mentioned the shoulder dystocia complication and how flipping the mother from the hands and knees position and back could release it.

The books cautioned that this technique would not be possible in most hospital births. Hospitals hook the mother up to an IV drip and baby heart monitor. These connections make it difficult to move the mother around into different positions. When a shoulder dystocia event is diagnosed in a hospital, a cascade of interventions is initiated.

Sabrina’s mom told us about her friend who had a should dystocia in the hospital. They had to break her pubic bone to release the baby. Ouch!

One more flip and the baby came lose.

Wow, that was impressive!

The baby’s limp, silent form was placed on her back next to Sabrina’s exhausted limp form. Mary grabbed a ventilator and started pumping air into her mouth. She started grunting, but no crying.

I was petrified.

Crucial seconds passed and the baby finally started making louder grunts and short cry’s. She was struggling to breath, but she started to move around and ‘pink up’.

Just as she struggled her first breaths, the fire department came in, followed closely by the ambulance team.

The midwives and medical team decided it would be a good idea to bring the baby to the hospital. There was a risk of meconium inhalation and the equipment needed to properly diagnose and remedy this problem could only be found at the hospital.

One of the firefighters looked me in the eye and said “Get your wallet and shoes. You’re going to the hospital”. I was happy to oblige. Better safe than sorry!

By the time I got my shit together, the baby was on a stretcher and being wheeled down the hallway of our condo building. I ran to catch up and found our newborn baby on a stretcher with an oxygen mask.

Holy fuck!

Mary came with us in the ambulance. She was cheery and optimistic, reiterating how good the baby looked, how well she was breathing and that her oxygen saturation level was a perfect 100%.

The ambulance had to call around to find a hospital that would take us at 12:30 AM on a Saturday morning. We finally get the confirmation from emergency at Sick Kids.

We brought her into the Sick Kids ER and they had a room available immediately. A senior doctor checked in and she was optimistic after looking at the baby and listening to her breathing. Additional doctors and nurses came in and they were all uplifting. Her temperature was low, but they agreed that it was probably from the transport in the air conditioned ambulance.

The baby looked great to me too and I started to settle down. I asked the doctor if I could remove her from under the heat lamp and put her against my skin to keep her warm. She agreed.

Mary kept in touch with Dione who was still with Sabrina to deliver the placenta and clean things up. She waited with the baby and me as I sat in admiration of our tiny bundle of joy sleeping soundly on my chest.

A couple of hours passed and I heard the unmistakable laugh of the day’s mighty hero. Dione pushed Sabrina’s wheel chair into the room where she met our beautiful baby for the first time. She took my chair and Dione helped the baby to latch onto her breast.

I started to cry.

When we were contemplating birthing methods, we were concerned about the side effects of medical intervention. From our reading, we concluded that the short term relief from the natural discomfort of birth wasn’t worth the long term recovery time which sometimes accompanies the medical procedures required to get the baby out.

We read about the sense of accomplishment that mothers feel when they give birth naturally — an enduring sense of euphoria that drugs and surgery will never match.

I did not expect that the euphoria would transfer to the dad.

I looked around the room — Two incredible midwives, two doctors, my amazing wife and our brave little daughter all together with big smiles.

I felt immensely proud at the world we were bringing our daughter into.

A world where women are far more than equal. Where woman are revered for their unique strength, courage, empathy and determination.

A world of women with superhuman fucking power.