gajumaru

Content note: Labour, childbirth, pain, genitals, sexual experiences, medical, hospital, blood, active birth, positive birth


I left you hanging on a tough bit last time! It was a bit unsatisfying putting the agony of my long labour out into the wild without the payoff that comes next - but on the other hand, there's something very honest about letting that part of the story stand alone. It's like a counter to the peak-end rule, which I've definitely experienced since the birth. During the labour I said on more than one occasion something along the lines of "I am never doing this again, and I don't understand why someone ever would", and since the birth I've already found myself looking back on the labour as a positive memory, if not a pleasant one, and thinking, "Next time..."

In case you missed them, here are the first two parts of my birth story:
Part 1 - Latent phase: Preparations
Part 2 - Established labour: Pain

My memories start to return clearly with the feeling of my baby descending through my pelvis. During the pregnancy, all my ligaments had loosened; now the bones of my pelvis were moving apart to make space for them to pass through. This was one of the reasons I'd spent the last 32 hours staying active - this moment where gravity assisted in the descent, and my upright position created space for my coccix to move back and my pelvis to open up. (I'm told there's up to a 30% difference between how much the pelvis can open between an upright position such as kneeling, standing or squatting, and a lying-back one.) All that work, and finally, here they came!

I'd started experiencing the urge to push some time ago, in the run up to transition, but had been told to wait. At some point, apparently Henny turned to Kesiah and said something like "External signs point to second stage of labour." (The first stage is where the cervix dilates to 10cm - that's what takes most of the time. The second stage is where the baby starts to move through the cervix, and you can start to push.)

The sensation of my baby moving through my cervix was indescribable. There was an intense pressure, like being hugely constipated and needing to do a massive poo (in fact due to the way my colon and rectum were being compressed, this almost certainly happened and was neatly scooped away by the midwives without my noticing). But there was also the feeling of my pelvic bones literally moving to make way for the huge, solid head that was moving between them.

It felt momentous. Like I was being broken open. It hurt, of course - nothing about this experience was painless. But I had my wits about me now. I knew something was happening, I could feel the sensations changing subtly with each contraction as my baby moved lower. I'd lost my fear and frustration that I would be stuck in this agony forever - instead, it was serving a purpose. I deliberately stopped using the gas so I could tune my attention more precisely into what was happening. The pethidine had worn off, and although I'd only had three and a half hours sleep in over 48 hours, I felt increasingly alert. For the last hour until Podling was born, I didn't need any pain relief.

The pelvic pathway during childbirth is shaped like a kind of twisted funnel, and the baby needs to rotate to move through it. I can't describe the shifting sensations of that journey, which took nearly an hour. I was on all fours throughout, occasionally kneeling upright but mostly leaning forward with my hands on the side of the tub. Leo was kneeling beside me in the pool with a hand on my shoulder, sharing every moment of the experience.

The strong uterine contractions - the whole centre of my body feeling like it was being squeezed to a pulp by a massive fist - did a lot of the work; but I was pushing too, now, participating actively in the process rather than just being tossed on the waves.

As the head passed through my cervix and into the birth canal I started to feel sexual sensations. The solid, round pressure of the back of my baby's head, the contours of their face, pressed and moved against my sensitive vaginal walls. It felt like being fisted from the inside out, only two or three times as intense.

I exactly remember the moment when the top of my baby's head started to crown. It was an extraordinary painful/pleasurable sensation of fullness and pressure. At this point the urge to push was overwhelming, but the midwives advised me to wait. This wasn't easy - it felt like my baby was ready to be born any moment! My pelvis felt impossibly full, the pressure was immense, and I was ready to meet them - but I had to wait just a bit longer.

With each contraction, my vaginal entrance stretched open a little more as the head crowned. Like the dilation of the cervix, this was a slow process. Somehow, with the midwives coaching me, I understood that if I pushed too hard at this point I was at risk of tearing. The midwives urged me to breathe rather than push: "Breathe your baby out."

This was a phrase I'd heard during pregnancy yoga, but I hadn't appreciated what it meant. It meant long, slow, patient exhales at the peak of the contraction, letting gravity ease the head a few millimetres lower, my sensitive membranes stretching a few millimetres more around it. There was an incredible, crushing pressure against my urethra and clitoris as the head pressed against them from the inside, and a burning sensation in my perineum. "Breathing my baby out" meant staying with those sensations, breathing into them as the contraction faded and I waited for the next one, staying present to the extraordinary intensity of the stretching while resisting the urge to push. I controlled my out breath, dizzied by the raw rush of input from every nerve ending in my vulva. I was nervous about injury to my sensitive parts, but concentrated on relaxing and trusting my body to do its thing. It did occur to me at one point that this was a silly thing to try and do without lube! I wouldn't make love under the water without some extra oil or silicone lube to make things slippery - so it seemed a bit foolish that I was expected to try and give birth that way!

Nonetheless, we made it work. Leo tells me that crowning only took 15 minutes or so, but it felt like forever. After the first few contractions I reached down between my legs and whimpered with delight as I felt the soft, velvety mound of our baby's head starting to emerge. I wanted to touch it almost continually, reassuring myself that more of it was out with each contraction, marvelling at the fact I was about to meet them for the first time, but the midwives cautioned me not to touch it too much. Apparently touch can stimulate the baby's breathing reflex, which is a bad idea when they're still in the water - never mind when they're still inside you.

As the head crowned to the widest point, every iota of my attention was focused on staying present and calm, on breathing not pushing - and then with the next contraction the head was born. It was an extraordinary sense of stretching followed by a massive release of pressure. I sobbed with delight. Maybe this was it? Was my baby born yet? But it took several more contractions for the rest of the body to follow. The shoulders felt surprisingly difficult - they took some serious pushing on my part, over a couple of contractions, and felt almost as solid and substantial as the head. And then the body was born in a great, slippery rush. The exquisite feeling of my baby's soft, creamy limbs slipping out of me.

"Can I lift them?" I asked, excited. I was desperate to meet them.

"Not quite yet, one more push", Henny said - I hadn't realised the legs and feet were still inside. I didn't realise it at the time, but Leo was behind me, holding their body under the water until they were fully out.

The next contraction did it. Leo passed our baby through my legs and I took them in my arms. "Slowly," Henny said, "you don't want to tug on the umbilical cord."

I gathered my baby up and leaned back into Leo's arms. They were creamy and covered in vernix. Hello, I thought, who are you? This little stranger had come into our lives, a small unfamiliar body. A whole new person. I held them against my chest, marvelling, all my pain gone for the first time in hours, flooded with relief and joy. Leo held us both. Henny wiped their face with a cloth to stimulate the breathing reflex, and they took their first breaths.

We lay in the pool for some time, our baby cradled on my chest. Henny tucked a towel around them to keep them warm, which of course immediately soaked through.

We'd asked for optimal cord clamping. This means waiting for the cord to stop pulsing of its own accord before clamping it, to allow time for the full transfer of blood from the placenta to the baby. If I recall correctly, there's no iron in breastmilk, so babies are born with all the iron they're going to have until they start eating food other than milk. If the placenta blood transfer isn't given the chance to fully complete, then the baby can be iron deficient for the first few months.

I reached down and felt the cord, wondering at its strong, firm, slippery texture. Henny pointed out that in warm water, it can continue pulsing long after the placental blood has all transferred, so after a while we climbed carefully out of the pool and I lay on the bed. Henny clamped the cord and Leo cut it.

In the birth plan we'd requested a physiological third stage, where we wait for the placenta to be pushed out by my body's natural contractions. However, Henny had noticed that I'd lost quite a lot of blood in the pool, and still seemed to be bleeding quite a bit. She recommended a managed third stage. I was happy to agree. They gave me a syntocin injection in my thigh to stimulate the uterus to contract, and pulled steadily on the cord until the placenta came out. This was a pretty intense experience - it felt absolutely huge, if not as solid as a baby's head.

We lay there, enjoying skin to skin with our newborn, for some time, I don't know how long. I was still bleeding, although it had slowed down, so the midwives gave me another shot to slow the bleeding - ergometrin. Once we'd had nearly an hour together, the baby was weighed - 3.75kg - and measured (head 36cm circumference) and given the Vitamin K shot we'd asked for.

I was still bleeding. I hadn't really noticed, I'd been totally high on having a baby, but Henny estimated that I'd lost 1.35l of blood - the human body only has about 5l of blood, so I'd lost between a fifth and a quarter of my blood. They didn't want to delay any longer, got me on a trolley and rushed me straight downstairs to obstetrics. I was feeling pretty out of it by this point. Leo and Shiri followed with our bags and Podling in a crib, and I was taken to a private room big enough for fifteen medical professionals to work in simultaneously, which is what happened next. A nice doctor gave me more gas and air while she removed a bunch of blood clots (enough to bring my blood loss up to 1.4l total), I was hooked up to a syntocin drip to encourage my uterus to continue contracting, a hemabate injection. I was feeling increasingly dizzy and nauseous, and had to vomit, so they added a pressurised saline drip in each arm to restore my fluids. They also catheterised me to drain my bladder and help my uterus contract.

Leo sat with our child on a chair in the corner of the room, having skin to skin with them. I felt a bit weird and disconnected being plucked away from them both so soon after the birth, and asked them to move so I could look at them. At some point during the afternoon, after being on shift for over thirty hours without any sleep or a proper meal, Shiri headed home. I can't believe how amazing she was - I feel so privileged to have had her for my doula.

Nurses and midwives took my blood pressure, my temperature and various bloods. A sequence of doctors came and talked to me. My blood pressure was high, and they weren't sure if I'd need to go to theatre to have more blood clots removed from my uterus. After an hour, I'd stopped bleeding, and I was feeling a bit better, so I was able to hold Podling again, which I'd desperately wanted. I didn't end up needing to go to theatre, but they wanted to keep me in overnight to continue monitoring my blood pressure, as the hypertension was possibly a symptom of pre-eclampsia.

So after a home birth labour and a gorgeously natural water birth in the birth centre, we spent our first hours with our child in the hospital. It was strange, holding them with tubes and canulas coming out of my elbows and the backs of my hands. I couldn't move my hands and arms freely, and I kept on having to drape a blanket over the canula in my left elbow to make it more comfortable while I held them to feed. I kept on thinking that their first experience of their boob parent was a bit unnatural and uncomfortable. The drips got unplugged that evening, but the canulas stayed in my arm and hand in case I needed anything else IV. I couldn't wait to lose all the tubes, tape and vials of blood so it would be nicer for them to be held by me.

I stayed in that room overnight, having my blood pressure and temperature checked and blood taken every few hours. After the drips were removed Kesiah helped me carry the catheter bag to the bathroom so I could sit down on the chair and rinse myself off with the shower. It felt really good to get the crusted blood off my thighs.

I was desperate to speak to my mum, but there was no signal in the room, so I had to content myself with Whatsapp messages.

Leo and I chose a name for our baby - we each had a favourite name from our shortlist, so we used one for their first name, one for their middle name.

I was starving, and ate a lot of homemade flapjack. I'm so glad I made that stuff, it stood us in really good stead. Leo ordered us some takeaway, but my hands were too shaky and bruised from the canulas to hold chopsticks, so they had to feed me. They put out the LED candles, closed the blinds and turned the overhead lights off.

Around 11pm, they drove home to get a few hours sleep, so that they'd be better rested for what was coming next than if they had to sleep in a hospital chair. It was hard saying goodbye, but I was exhausted, and fell asleep almost as soon as they'd left. We dressed Podling warmly and I put them down next to me, being careful to move my blanket and pillows well out of the way, cradling an arm around them. We slept side to side deeply until I was woken at 4am for more blood pressure checks etc, and then got another two hours sleep before they woke me in the early morning, wanting to feed. So I managed around 7 hours sleep in total, which was a massive boon - and so so necessary.

That time together in the early hours was incredibly precious. I spent hours gazing at their face, getting to know them. It was amazing watching their eyes start to open, making eye contact with them, stroking the incredibly soft, velvety skin of their arms and legs. I offered them a boob whenever they started making hungry faces - I'm indebted to the brilliant, free NHS antenatal classes for telling us what cues to look for - and they seemed to be latching on really well. Feeding them felt natural and effortless.

I borrowed a fork from the midwives and ate the rest of my takeaway. The catheter was removed, and I got up and moved around a bit, starting to feel more like myself again.

Leo rejoined us around 9.30am. By that point my blood pressure was back to normal, so I was moved out of the emergency obs room to the labour ward, although to my relief we still had a private room. (And it had a bidet! Very sensible, and greatly appreciated.) We spent the day in a tired, happy haze, snuggling our baby, gazing adoringly at each other, calling and messaging our families, and resting together on the bed. Podling was feeding well and we had our first wet nappies.

I was feeling much better, but my blood tests overnight had shown an abnormal platelet count, so I'd had more blood taken that morning and we were waiting for the results to come back.

Every time we tried to nap some medical professional or other would come in and interrupt us, so we didn't get any more sleep - there was a newborn hearing screener (which took ages, really upset Podling, and didn't get a clear result due to their being fluid in their ears. They were born in water a day ago, what did you expect? We've been booked back in for a scan at six weeks, and I kind of wish they'd just gone straight for that in the first place - attempting a first day screener seems a bit daft to me), the newborn head to toe test, orderlies popping in to take food orders and bring my meals, midwives coming to check on us, etc etc. Having tests done that made Podling cry was upsetting, but more bearable when they seemed sensible and necessary.

In the end, I had to self-discharge. The blood test results didn't come back until the evening - they were normal, so now I had all the info I needed to know that no further medical interventions were necessary. They wanted to keep me in until the doctor could review me before discharging me, and throughout the evening we were told the doctor was on their way, but then at 10pm found out they wouldn't be available until the morning. I didn't want to spend another night apart from Leo, and I just wanted to be at home in my own bed, eating proper food, rebuilding my strength. After some insistence, and further delays to look for my medical notes which one of the midwives had put down on the ward somewhere (Leo found them in the end!) and to fill out all the required paperwork, we finally signed the self discharge form, I got my last canula removed, and headed home sometime after 11pm, with a baby and a hefty ferrous sulphate prescription (400mg/day - the normal RDA for iron supplements is 20mg!).

So I lost a quarter of my blood, spent 36 hours on the ward, and got thoroughly poked and prodded - between the drips and the blood tests, I had bruising inside my veins in both arms from the canulas, and multiple bruises from different blood test sites that each got re-poked several times. I felt a bit dizzy for a couple of days, but ate well and got as much rest as I could around caring for a newborn (that first night at home was very fretful and sleep-deprived, but we've managed to sleep a bit better since then) and am now feeling as well as could be expected.

Although I wanted a natural home birth experience, I feel incredibly positive about how everything happened. Even at the time, I felt good about each medical intervention that I received, because I was able to make informed choices about what happened, and my consent and autonomy was respected throughout. I'm glad we transferred to the birth centre for the birth itself, given that I ended up haemorrhaging - I felt like it was a far safer place for me to be, able to be whisked downstairs to the ward on a trolley at zero notice, than if I'd started bleeding out at home and needed to wait for an emergency ambulance. I'm glad to have had the pethidine - even though it didn't help me sleep, if I hadn't had it, who knows how much more exhausting, and more intense, the strong contractions approaching transition would have been, and whether I'd have been in as good a place to give birth naturally when I reached the second stage? I'm glad to have had my waters broken - I was in no fit state to continue labouring for another twelve hours, and even though the very intense contractions and fast dilation that followed was incredibly hard on my body, I was glad to reach transition as quickly as I did after that.

Given the substantial bleed, I'm so grateful to have been in the hospital, and for the medical care I received. Every doctor who attended me was respectful, friendly, and communicative. I felt well informed, respected and involved in the decisions that were made. It's sobering to think that a few decades ago, or in a less wealthy country, I could easily have died. And that without a National Health Service, I'd now be facing enormous medical bills on top of caring for a newborn.

In the end, although I wasn't at home as I'd planned, I gave birth in a private, comfortable room with my birth partners and two very competent, respectful midwives, with soft lighting, in the pool. I had a natural vaginal birth with no pain relief during the second stage, and no tearing. That last point is incredibly valuable to me; I love my bits, I love sex, and I was really nervous about being injured or needing stitches, and possibly experiencing lasting injury after giving birth. Despite the long labour - which almost certainly contributed to the blood loss I experienced - and the feeling that the pain was too immense for me to manage during the last few hours, I think that all the preparation and reading I did, the pregnancy yoga, keeping active throughout the labour and birth, my experience with meditation, tantra and BDSM, my baseline fitness as a tai chi player, paid off when it came to actually birthing my baby. When it came to it, I found myself able to be with those extremely strong sensations, and I was able to actively steer the process, and have the patience - even while feeling intense pain - to bear with the experience long enough to give my body time to adapt to what was happening.

Although at one moment approaching transition I was so desperate for pain relief I said I wanted an epidural, I am so so glad that my birth partners had faith in the birth plan I'd made beforehand, and didn't take me seriously. That was definitely the right decision. It was too late to have one, by that point; and if I had, I'd have lost all the sensitivity and fine control that enabled me to birth Podling slowly, mindfully, intentionally, letting myself open gradually enough to avoid a tear. I'm incredibly proud of myself for that.

I'm also incredibly proud of my baby: not only are they perfect and wonderful, but they did such a great job during the birth! Every time their heartbeat was checked, it was strong and steady. They didn't freak out, didn't get distressed, but stayed calm and trusted me to birth them. They got themselves into the right position - head down, front to back - and they rotated perfectly as they were born. They knew how to be born, they knew instinctively how to feed, and they're doing really well and gaining weight. What a clever baby!

So it wasn't an easy labour (understatement of the century!) but it was a powerful experience. At various points, I felt that I wasn't "strong enough", but now that it's over I have a renewed appreciation for my own strength. I've learned that strength isn't just about being able to "overcome" the pain; it can be about enduring, too. I wasn't stoic, but I was strong.

In my naivete, before I experienced it, I thought strength was something like being able to encompass the pain. Being able to ride it out. Maybe even transmute it into ecstacy. Being able to manage it, to stay in some semblance of control. 

I don't know if any amount of strength would have been enough to do that. Now, I think labour is about balancing strength and surrender. I'd like to have surrendered more, because the times I was fighting the experience were when I suffered most. It's not possible to encompass pain that big - I think the best one can do is accept it, and accept whatever reactions go with it, even reactions like screaming and crying. I was attached to this idea of being "strong enough" to react a different way or have a different experience, but surrender can enable you to accept the reactions and experience you have, and be at peace with them. I think with childbirth, as with children themselves, there's chaos in the system. You get what you get, and it's not always possible to prepare or optimise or "do better next time". Each experience is different, and it is what it is.

I'm proud of myself for managing myself as well as I did. I laboured at home for 27 hours. That's pretty awesome. In the end, I had the birth experience I wanted - a vaginal water birth with no tearing - and I'm solidly pleased that I was so well placed to receive the medical care I needed. Overall, I had a really positive birth experience. I might even do it again.

I'm sitting at my kitchen table with a drowsy three day old tucked inside a nursing top and nestling against my tummy. This isn't quite the first time I've had both hands free and a spare moment to type something since the birth, but it's close. Our podling is indescribably precious and wonderful. I can't get over how perfect they are. It's Friday today, and I gave birth on Tuesday. I don't know how long it'll take me to finish writing this post - I suspect it'll happen in snatches here, snatches there, so it might come in a few parts!

Content note: Pregnancy, contractions, labour, home birth, active birth

About a week ago, my belly dropped. Suddenly the high, firm, rather sore mound of baby-filled uterus tenderising my internal organs was several inches lower. Podling (name redacted to protect their privacy) wasn't due for another week, but I started to wonder if it might be time soon. Around the same time my fatigue and heaviness seemed to lift away, and I spent four days on a nesting and baking bender. I made fruit and seed flapjack to eat during labour - two batches of it after the first one turned out too crumbly (I'd skipped the sugar in hopes of making it slightly more sustaining, but it seems sugar is necessary to get it to stick together), and did a bunch of batch cooking. I made granola. And cornbread! I never bake.

People talk about getting a "spurt of energy" before labour starts. In my case this was definitely a sign.

At 2am on Monday morning, I was woken up by cramps. Thinking it was gut pain, I went to the loo, but it continued in short bursts as I got back into bed. I hadn't had any Braxton Hicks contractions yet - maybe this was them? They didn't hurt enough to feel like real contractions - just sort of moderate period pain, each wave lasting less than a minute. I lay in bed and dozed, and eventually fell back asleep, only to be woken up from a dream by another wave. After lying there a bit longer, another one came. I looked up "signs of labour" on my phone and found myself unsure. They seemed to be coming every 15 minutes or so, still not super intense.

After the next one, I woke Leo up. That was at 4.30am on Monday morning. I wouldn't get proper sleep again for another 43 hours.

We lay in bed together, cuddling and experiencing the contractions. The previous night I'd been reading Active Birth - I hadn't quite got to the end of the chapter on labour and birth - which counsels upright postures during labour, to help the pelvis open and let gravity assist with the descent of the baby through the cervix. Squatting is ideal, standing and kneeling up also good, and kneeling on all fours and lying on your side are the recommended rest positions. Any leaning back, lying on your back or sitting in a semi-reclined position are described as actively unhelpful.

The period pain like sensations and a persistent ache in my lower back made it uncomfortable to lie down, so I was taking the book's advice. I was moving around on the bed, trying different positions, kneeling, moving on all fours, getting up and walking around. The contractions made me catch my breath and focus on my body sensations, but they were bearable. In between, Leo and I cuddled and talked softly. We both felt awake, excited.

At 5.30am I messaged our doula and sent her an update. I said it might still be Braxton Hicks - in my reading I'd learned they could be frequent and could go on for days, so I was cautious about raising a false alarm. She replied a couple of hours later. The pattern was the same: short 30 second contractions every 10-15 minutes, intense enough that I tended to stop talking and concentrate on them. Leo brought me a hot water bottle to press against my lower back to help ease the ache, but I soon abandoned it in favour of staying active. The pain was a slow wave I could feel building in my lower back, which then crested before fading away. I hadn't had a bloody show, and my waters hadn't broken.

Leo started setting up the birth pool. I was hoping both that this was the start of labour, and that it was a false alarm and would stop for a few hours so I could grab some more sleep. In between contractions I stayed still, leaning forward on a pile of cushions and focusing on my breathing, trying to have little micro-dozes. I'd had around 3 hours sleep and felt nervous about going into labour from a starting point of being already tired. If I was in labour, I wanted to make progress and give birth as soon as possible!

At 8am I timed the gap between contractions: they were around 7 minutes apart, but each one was still only 30 seconds long. Shiri, our doula, said she was on her way over. I was still thinking it might too early to be sure, but Leo seemed pretty convinced that today was the day. I was persuaded that they weren't Braxton Hicks - I was in the latent phase of labour - but I also knew that the latent phase could go on for hours or days. The contractions weren't completely regular - sometimes they came very 5 minutes, sometimes every 10. Some were more intense than others.

Shiri arrived around 10.30am with grapes, strawberries, snack bars, energy balls, massage oil and other goodies, and we settled in. As an experiment, I tried to talk through a contraction and could, just about, but I preferred not to try. Leo and Shiri sorted out the room, clearing out items that were in the way and filling the pool. There was a false start where the first attempt to fill the pool ran far too cold, so it got emptied and refilled. I hung out on my pile of cushions on the sofa, sometimes using the birth ball, sometimes getting up and leaning against the wall. Between contractions I messaged the friends who we'd been planning to see that day letting them know why I was unavailable, and sent messages to friends and family. I ate a bowl of granola, some flapjack and a banana and listened to drum and bass, wiggling my booty to try and ease the ache in my lower back.

Finally the pool was ready, and I got in. Leo got in and we had a cuddle in the warm water. We'd called the home birth team midwives and let them know what was happening, but we hadn't asked them to come over yet - the guidance was not to call the midwives until contractions were coming 3 every 10 minutes, and we were still at 1-2 every 10 minutes. I was impatient to progress, so I was doing what I could to keep things moving. I did a lot of squatting - which was much easier in the birth pool - to open my pelvis, and tried to keep moving and stay in all the upright active birth positions as much as possible. Squatting did intensify the contractions - and it intensified the pain too - so I did it as much as I could bear to. Being so tired wasn't a good basis for doing such a workout over so many hours!

Leo and I did what we could to get the oxytocin flowing: lots of making out, naked cuddles, heavy petting, and Shiri gave us some privacy for some sexual play. That definitely helped.

Mid afternoon, we'd managed to get the contractions from every 5 minutes to every 3 minutes. Shiri was excited. She suggested we call the midwives.

Miranda, our first midwife, arrived. Of course having a new person in the space, having conversations with her, having my blood pressure checked and temperature taken, having the fetal heartbeat checked, all inhibited the oxytocin release and the contractions slowed right down again. All the observations turned out good, however, and I used the longer breaks between contractions to drink tea and eat some food.

Being interrupted for observations every so often was a bit of a pain. Around 6pm I tried to check my own cervix to see how dilated I was. I could feel softness, but I couldn't reach in far enough around my bump to feel a gap. I asked Miranda to check it out. She said I was 3cm dilated.

I admit, I was a bit disappointed. The guidance is to call the midwife at 4cm dilation, so I felt like I'd jumped the gun a bit. I'd also been in labour for 16 hours at this point, so it felt like slow progress. Even if it speeded up towards the end, I didn't think I could manage labouring for another 16 hours!

Still, here we were. Miranda gave us some space and we did what we could to get things going again - squatting, make outs, moving around, etc. The downstairs room was a lovely space - the bunting friends and family had made at my birth blessing festooning the walls, and my birth playlist playing, which I'd been assembling for the last few months. I was really enjoying being at home, really enjoying sharing the experience with Leo.

Shiri was also being fantastic - I really appreciated having her there. I discovered she gave excellent lower back massages.

Run out of time to write more - will continue tomorrow.

Part 2 - Established labour: Pain »
Part 3 - Childbirth »

Another blog entry written in a hospital waiting room. I'm getting my glucose tolerance test done to check for gestational diabetes. You have to fast (nothing but water) for 12 hours, then have blood taken, then drink a glucose drink, sit still for two hours, and have more blood taken. The glucose drink delivered 75mg of glucose and tasted like very strongly mixed gatorade. It's the sort of thing you'd drink if you were running a marathon or building a burn camp in the desert, although with the latter you'd probably want to also add salt.

Me and the foetus both seem well! They are kicking as I write this. They are very wriggly. Sometimes the movements are intermittent, but sometimes it's a constant barrage of movement that lasts 15 or 20 minutes before it settles down. Super Rolling Attack Combo! According to the pregnancy websites, by 28 weeks the foetus is 14 inches long, which is frankly enormous, and sometimes I can feel punches and kicks at both ends simultaneously. When I don't notice any movements for a while I get a bit worried, and it's a relief to feel them kicking off again. But it's also pretty distracting when I'm trying to sleep or concentrate on something else.

I'm six months pregnant. Officially in the third trimester! That's a weird feeling: we're in the endgame now. I'm due three months today.

Symptoms:

- Nausea is less. Finally! The last time I vomited was 2-3 weeks ago. I've been taking my anti-emetics in the morning with my other meds and sticking to a breakfast routine. I've got the hang of what foods to eat when now - if I feel any hint of nausea I go for slightly more glycaemic foods (toast or a bagel) and save the muesli and porridge for days when I feel like it's less risky. I'm trying to eat lower GL food in the evenings, but also following my whim and being relaxed about it.

- Rib and back pain is still a thing, more so at the end of the day. It's worse if I'm sedentary and better if I'm spending most of the day standing, lying down, or being active.

- My insides feel very squeezed. My bump got big a month or so ago, but it still felt soft and squishy. The last couple of weeks, I've really noticed feeling fuller, my belly feeling firmer, and weird, tender, slightly sore internal sensations of various organs being squeezed. Sometimes I get random pain low down or in my side where the foetus has stuck a foot into my cervix or liver or spleen or something. And it's hard to eat a full meal: after about a half portion my stomach starts to feel painfully full, not because the stomach itself has shrunk, but because it has less space to expand into. I expect 5 or 6 small portions a day would be better than 3 normal sized ones, but it's hard to find time to stop and eat that often. I'm eating several pieces of fruit most days between meals but maybe I should start trying to split my meals up too.

- Weird ligament shit! All my muscles and ligaments are loosening, so a) I am now the most flexible I've ever been, which is cool when doing Tai Chi, although of course I lack stability at the edge of my range of movement because I haven't trained the stabilising muscles there, and b) I'm getting loads of random weirdness and pain as things move around. I went through a few weeks of neck and shoulder pain as my ligaments loosened and my muscles involuntarily tensed to try and keep things where they were, but Leo's been giving me loads of body work, and after a week on holiday that's eased off a bit and things feel a bit softer. As the surface muscles relax, I become present to deep tension in the ones underneath - I don't know if that's worse, or if I'm just able to notice it where before the surface tension was in the way. I'm also getting pains from old injuries - my right ankle, which I sprained a couple of years ago, has been playing up again, specifically a weird nerve pinch when I put weight on my foot from a certain angle, or rotate my ankle at a particular point. Leo reckons my tight calf muscle is pinching the nerve, but it hasn't been a problem for over a year so it's obviously related to soft tissue changes in pregnancy. I have some foot and ankle exercises to remember to do, and I'm going to try and book myself a pregnancy massage soon.

Other than that, I'm well! Feel like I have normal energy levels for the most part, although I slept a LOT on holiday - but then, I had a cold and some sleep debt from the previous week to catch up on, so I think that's standard. I've been getting intermittent pregnancy insomnia, waking up at 4 or 5am and taking 2 or 3 hours to get back to sleep. Surface from sleep, feel baby movements, suddenly feel hyper alert, realise I need to pee, go downstairs, and by the time I'm back in bed I'm awake and it takes ages to wind down again. The last few nights, though, it's not been so bad. I wake up around 8am, I've been so tired I've been falling asleep involuntarily at 11pm even if I'd intended to sit up and read for a bit.

Things that help with sleep maintenance: doing Tai Chi, cuddling a pillow at night to take the weight off my pelvis and shoulders when I sleep on my side, sticking hands and feet out of the duvet to regulate core body temperature, going to sleep at the same time each night, doing ana pana when I'm lying in bed, turning the nightlight on and sitting up and reading for a bit until I feel sleepy again, rather than lying there with my mind churning. Sometimes none of those work, though, and I'm just stuck with wakefulness until it goes away. It's fine when I don't have anywhere to be in the morning and can sleep later to make it up, but it's a real pain when I have morning appointments.

I function so badly when I'm sleep deprived I'm frankly terrified of how I'm going to survive with a newborn. Midwives keep saying to me that the pregnancy insomnia and night waking is "good practice", but that seems like bollocks to me - surely it would be better for me to be as well rested as possible before the birth.

I'm doing Tai Chi two or three times a week, and have just booked five sessions of pregnancy yoga. Initially I was like, oh, pregnancy yoga, I don't need that, I do Tai Chi, but although my instructor is super chill about it it's not special pregnancy Tai Chi. What I'm hoping for from the pregnancy yoga is preparation for labour, practising helpful movements etc, and doing pelvic floor stuff. As well as meeting other pregnant folks in my area.

Other preparations are going well: I've booked antenatal classes with the home birth centre, and apparently I get an all-day class with the hospital too, although I haven't been booked onto that yet. Need to chase that up. I've started meeting the home birth team, who seem nice, although it's a big team and I only have a handful of appointments, so there's no way I'll get to know them all before my due date. Plus, apparently only one out of two midwives will be from that team, and the other will be from a different team. Given the importance of continuity of care, I'm extra glad to have found a doula.

Oh yeah: I found a doula! I spent ages going through all the ones on Doula UK who serve North London back in the first trimester, and despaired of finding someone who met my requirements (queer friendly etc). The only mention of LGBT+ I found was one person who mentioned same-sex partners, which isn't exactly the same as being able to cope with two trans, non-binary parents, but when I contacted her she wasn't available on my dates. I needed to back to the drawing board and do a bunch of cold calls to sound people out about it, or maybe send out a bunch of emails getting people to answer questions about trans/non-binary gender, and I was busy with work and putting it off until Leo was available to help me with it. Then in March, I was at the press event for the Woman's Strike, and one of the other organisers asked me if I had a doula yet and it turns out she just qualified!

She's a member of my community - queer friendly, trans informed, a mum and activist, overlapping life experience, likeminded, politically radical in compatible ways. She's also tiny and sensible and full of hilarious snark about woo woo yummy doula culture. I like her, I can imagine her being with me while I'm all messy and in pain. She's coming to meet Leo next week.

Pregnancy news: I'm 19+2, and apparently this week the foetus is the size of a mango. A mango! Mangoes are huge! There are times when I look and feel seriously pregnant - especially after eating, everything seems to get pushed out in front of me all the way up to my ribs, not low like a pot belly but a big high curve. Then in the morning it all looks a bit more deflated.

Week 19 pregnancy symptoms:
- Itchy skin
- Achy muscles, particularly my shoulders, back and intercostals (my ribs start to kill me after I've been sitting still too long)
- Morning sickness (STILL!!)

No swollen feet yet, so I guess that's something. No kicks yet either! I am VERY SAD about this. They are the size of a MANGO how can I not feel them. My bump is big, and at my last scan they said the placenta was behind the baby so I should be able to feel something, but everyone tells me I'll know it when I feel it, and I haven't felt anything yet. I know feeling something for the first time around 18-20 weeks is normal for a first pregnancy, so there's still time, but in the middle of the night when I wake up and everything is still and dark and quiet and I think, surely I should be feeling SOMETHING, it's a bit tricky not to feel anxious. Maybe the foetus is only awake during the day when I'm distracted? Maybe it's died? Maybe I'm not pregnant? Maybe I've just been eating too much pasta?

I have a 20 week foetal anomaly scan booked in on the 27th, so I'll get to watch it wiggling around then and hopefully that should put my fears to rest. Meanwhile the NHS website tells me that 16-24 weeks is normal, so it seems there's over a month before I should start worrying.

I had my obstetrician appointment to talk about endocrine stuff. He said he's not at all worried about my thyroid levels because the supplements are obviously working, but he's referred me for a couple of glucose tests because the PCOS puts me at risk of gestational diabetes. I haven't booked the first one yet, although it was meant to be at 18 weeks, because my schedule just felt too full and I'm a bit sick of losing the whole morning to hospital appointments. Plus it's a fasting test, which means I won't be able to eat to suppress my morning nausea, which means I'll be sick and ... ugh. I'm not looking forward to it.

The good news is that he wrote me a prescription for an antiemetic to help with the morning sickness. I didn't realise I needed to go to the hospital pharmacy to get it, so I guess I'll pick it up next time I go in.

I have heaps of energy, and I also get tired easily. I keep volunteering for things. I've been working really hard on building one of my online income streams, which was super fun for a while, and then it got really boring (omg I hate doing promo), and then it got stressful that I wasn't seeing immediate results. Oh well. I'm enjoying the energy while it lasts.