Tension due to shoulder dystocia and a placenta that doesn’t want to come out| Birth photography the Netherlands

Geboortefotografie Reusel

Lindsey is the youngest Mum that I’ve been involved with. When she mailed me in May, she was 22 years old and pregnant with her second and, she wrote; “I just really want to capture this birth on film!” I remember that when I mailed back, I thought that it was great that she was about to have her second one so young (because you don’t hear that very often anymore) and especially as she really wanted it to be photographed.

In June, she came to see me with her husband Tijmen (they got married when she was 18) and their little boy Tygo who was three and an half at the time. It was a beautiful, sunny day, so we sat in the garden to get to know each other. Tygo’s birth went really quickly, he arrived in six hours flat. It was a home birth and everything had gone well. He was born at 39 weeks and 2 days. Given this history and the quick birth, it will be important that I set off in the car straight away when it comes to it, otherwise, there’s a chance I could miss everything of course.

When Lindsey’s 39th week and 2nd day goes by, it’s a bit of a downer because secretly you hope that if the first one is born on time then the second one will be too. The next downer came when the due date passed…no baby. The last weeks had been though because of a kidney infection and a double ear infection. That, combined with looking after Tygo wasn’t easy. Luckily, Tijmen could take some leave from work to help out at home, but now it’s really time for the baby to arrive!

On November 7th (three days after the due date) Lindsey sent me a message to say that the midwife had done a sweep and that she was already 4cms dilated.  So, that’s a gift. There are some cramps but other than that not much is happened. We decide to keep each other posted via whatsapp, but this isn’t necessary, the baby is comfy where he is. Nothing happens. Even a second sweep later in the week fails to have the desired effect.

On Wednesday the 13th of November, when another birth has begun in Oss (an hour from Reusel), Tijmen calls me to tell how things stand.  In the meantime, Lindsey has dilated to 5cms (without contractions) and if nothing happens tonight then her waters will be broken at 8am tomorrow. The question is whether I’ll make it, because the midwife expects that it could all go quite quickly. I’m honest with him and say that there’s another birth underway in Oss and that I hope I’ll make it.

In the end everything works out perfectly and at 3 o’clock in the night between Wednesday and Thursday, I crawl into a bed in Oss so that I can drive from there to Reusel three hours later. Amazingly I’m on time, arriving 8 o’clock. The midwife is there already and Tijmen is waiting for me.  Lindsey is lying on the bed, ready to have her waters broken and Tygo is walking backwards and forwards before he goes off to school. In between he lets me look at his lovely collection of Angry Birds, they’re a bit more interesting at the moment than the little brother that’s arrivingJ. When the waters are broken the amniotic fluid is clear so they can stay home for the birth. The contractions should start by themselves and if that doesn’t happen before 2pm then they’ll have to go to the hospital after all to get the contractions started. 2pm seems a very long time away, to my sleepy head and I ask myself why I’m here so early 🙂 At the same time, I think it’s a good decision because if it happens it could be over very quickly. The midwife leaves and we go downstairs for a cup of tea.

I notice that Lindsey has Braxton Hicks, so I’m hopeful that she won’t have to wait too long for the contractions either. While we’re discussing the idea of getting a matrass for me to have a sleep on and prevent them getting the impression that we’re all waiting for the contractions, Lindsey says: “I have to go upstairs and lie down.”  At that moment it’s 9.10am.

I don’t want to race after her straight away but, when I hear Tijmen talking to the midwife five minutes later I go and have a look after all. It’s hard to take in what I see; Lindsey is lying on the bed with strong contractions. From nothing, to this! It even looks like the baby will be there any minute. I don’t know why, but just in case I give my hands a wash, because I don’t know how long the midwives (there are two of them) are going to be.

It’s a worry for nothing because at 9.30 they are already back. In the meantime, Lindsey’s contractions have got really strong and there is sweat on her forehead. An internal examination is done and she has 7 cms dilation. It’s going quickly. In the three quarters on an hour that follow so much happens that I don’t realise I ought to take note of the times. Very soon after she wants to push but, because the dilation is not quite complete, she not allow to push yet. Just before half eleven, the urge to push can’t be fought anymore and exactly an hour and a quarter after the first contraction the little head is born! Tijmen stands ready to deliver his son, because he really wants to. Un-bel-iev-able that it’s this quick. I actually can’t process it.

But then….then the shoulder won’t come out. In about 1% of births the baby’s shoulder can stay stuck behind the mother’s pubis. This is called shoulder dystocia and it can be very dangerous. Once the head is born, it mustn’t take too long before the rest of the body comes out. I notice that I find it really tense and that the tension in the room also increases, but the midwives react quickly. Lindsey has to get on her hands and knees and I don’t know where that woman gets the strength but, without a trifle, without question, she turns in one go from her back, with the little head between her legs to her hands and knees. The seriousness of the midwife is clear. In this position there is more space in the pelvis and there are various manoeuvres that the midwives can try. I realise that I’ve stopped taking photographs, it’s too tense for me and I don’t want to make the midwives nervous by taking too many photos. In my head all I can think, like a mantra, is; come out, come out, come out, COME OUT!!!! Tijmen, has gone back to the head end to support Lindsey. Ooooh come out, out!

After what seems an eternity, but later turns out to have been a minute and an half, Jace is eventually born! He needs some time to get over the shock, but starts crying quickly. Phew. I’m shaking.  He’s here!!!!! It seems to me like everyone needs a moment and then the midwife says: “turn yourself over Lindsey” and she lays their baby in her arms. Wow.

He is called Jace! I walk over to Tijmen to ask how he’s doing, but he’s okay, he’s proud. I have the feeling that he didn’t realise how serious the situation was, and that’s a good thing. Everything has turned out okay, he’s here! Lindsey is in tears and Tijmen is standing next to her with a grin from ear to ear! He looks like a big lad and he is given the name Jace.

Shortly after the umbilical cord is cut because the placenta still needs to come. Unfortunately there seems to be little movement in it. Jace is put to the breast again, but that doesn’t help either. After half an hour the plancenta still isn’t there and because the hospital is quite a drive, the decision is made to call an ambulance. This too goes pretty quickly. Jace is weighed (he weighs 4540 grams!) and dressed. Lindsey is freshened up a bit and dressed and Tijmen has to get some things together and get the car seat ready. Shortly after the ambulance is there. In the meantime there’s been one more check on the placenta and I have the same mantra – come out, come out – I tried it again, but alas it didn’t work. Lindsey has to go in the ambulance and Tijmen drives behind with Jace and the midwife. Then, the other midwife, and then me. On the way to the hospital in Veldhoven.

As we arrive in the room it’s already busy. With the four of us there too there are now nine people in the room. Lindsey is lying partly behind a curtain and Tijmen goes to her. I don’t go too straight away because that might me too many people behind one curtain.  I can see her face, however, and she’s looking a little bit distraught and frightened. They try everything, a drip is put in and they’re still trying to remove the placenta by hand. If that doesn’t work then they’ll have to go to theatre and remove the placenta there under a mild anaesthetic. I understand that it’s a lot for Lindsey. Only four hours ago her waters were broken and she thought she thought she was having a calm home birth. If you think what has happened in the last four hours…..

Eventually, the gynaecologist manages to remove the placenta by hand after all! That’s great! When they weigh it, it’s more than 800grams, that’s a heck of a placenta! It’s a relief for everyone that it’s out. In the meantime Jace has also had some checks because he’s such a big baby. In the hospital it is the protocol to check sugar levels and that’s done now for the first time.

Now I dare to have a peek behind the curtain and to say to Lindsey that she’s done a great job and that her son is gorgeous. She says herself that she can’t quite take it all in. The tears come when she hears that she has a small wound that needs a stitch. Beforehand, she said that she found it scary and didn’t want that (with the first one it wasn’t necessary) and that’s the last straw after everything that has happened. What happens after that is actually funny because the stitch is made (it really is only one), without hurting her and the surprise and relief is written all over her face 🙂 .

Once this is done, everything is tidied up and everyone goes out of the room. Peace. Jace is placed with his Daddy and then his Mummy, finally the three of them can come round together. After that, Jace is checked again by the hospital, the traditional Dutch crisp breads with sugar covered aniseed are brought in and Jace is put to the breast again, which goes really well! That’s great because with Tygo that was more difficult and Lindsey is pleased that Jace latches on so well.

Soon after that Tygo arrives with his grandma. Grandma had said that Mummy and Daddy had a surprise for him and Tygo had said that he thought that he was getting a new Angry Bird. He comes into the room, full of expectation and when he hears and sees that the surprise is a baby brother, he is a bit shy at first. He certainly has to adjust, because a brother is certainly different to an Angry Bird 🙂 . The shyness doesn’t last long and then he is curious and proud! He wants to look close up straight away and hold his little brother. It’s touching to see. So sweet! He actually doesn’t want to let go, but I have to make a few more photos for the birth announcement card, so with pain in his heart he has to give him over to me. After that he gets his little brother straight back. When I ask him if his little brother isn’t much nicer than an angry bird, he has to think about it for so long that we all burst into laughter!

I make some more great photos from the little family and then go home feeling very thankful. Grateful that everything had turned out all right and that the world was a healthy little person richer.

Dear Lindsey, Tijmen en Tygo: enjoy!

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