A honest story about an induced and painful birth that didn't go as planned, ending up with forceps and a 3b perineal tear. Nevertheless - it's a story ending on a positive note as the right help can mean full recovery and no long term complications.
Astrid was due end of November 2019 but she was one of those babies who wanted to a late check out from mummy’s tummy. The due date came and went, no sign of a baby and no contractions. We lived in Norway at that time, in the very hilly Bergen - which literally means mountain in Norwegian. I walked up and down the hills every day trying to stimulate the contractions but with no success. So after many sleepless weeks I was finally welcome to the hospital at 42 weeks to get induced on a Tuesday morning. The doctor examined me and I was barely open 1 cm. They decided to use a Foley catheter to induce me, which essentially is a balloon inserted into the cervix filled with water. It puts pressure on the cervix and can naturally stimulate the uterus to contract and cervix to open. After the insertion we could go home and wait for the contractions to start or the catheter to fall out, meaning I would be open 3 cm. So we went home and we were so very excited. It was difficult to rest, but I knew I needed it. We played boardgames all day and I’m very proud to say while I could feel the pain increasing in my lower belly, like a very vague but painful period cramp, I beat my husband in a game of Trivial Pursuit. He still hasn’t admitted whether or not he lost intentionally so I’m still blissfully unaware if that’s the case.
Six hours after the balloon was inserted I gently pulled the tube connected to the tube it fell out. I was so excited - I was finally in labor. We went to the hospital for an examination. My husband is a terrible driver, so I actually drove myself to the hospital to give birth, which I think is quite funny. The doctor examined me and I was open 3 cm, so they decided to admit me.
We got a beautiful room facing the mountains. I had an enema because it’s standard practice in Norway. Although in hindsight I wish I wouldn’t have done it because I think it upset my natural bowel movement and made it much harder for me to poo after the birth. After the enema a doctor came to brake my water and for many hours the contractions were very manageable and I only had some paracetamol painkillers to help with the pain. At this point I thought birth was a lot easier than everyone had made it out to be, probably a very common mistake for someone giving birth the first time.
Later in the evening I was examined again and I was open 5 cm. To stimulate the contractions the midwife suggested giving me Pitocin, a synthetic version of Oxytocin which is very common and stimulates contractions. The contractions got much more painful, but I could manage by breathing and focusing. I couldn’t sleep at all during the night because of the painful contractions, and I was beginning to get very exhausted. I hadn’t slept at all the night before the induction because I was nervous, so I was now facing the hardest part of the labor after two sleepless nights.
In the early morning I was examined again I had barely opened any more during the night and this was a huge disappointment for me. If felt as if all the contractions and the sleepless night had all been for nothing and instead of being excited, strong and ready for the last phase of the labour I felt I had no control, I was exhausted and I was generally just very sad and weak.
They decided to increase the Pitocin so I would open faster. And this stimulated extremely painful contractions, I couldn’t handle them and I asked for Epidural to ease the pain. The anaesthesiologist came after only half an hour and it was quick and easy to give the Epidural. I sat on the bed hunched and he managed to place it in between two contractions so I could sit completely still. The epidural helped to relieve the pain in my belly, but not at all below my hip bones. It was like a numb waistband all around my belly but beneath the band it was as painful as before - or possibly even worse because the pain was kind of emphasised in relation to the numb area above. The contractions got much worse and I didn’t know how to handle the pain. It was beyond my imagination. I felt almost unconscious during the peak of the contractions. They came closer and more intense. I threw up, I lost all control and I didn’t know how to handle the pain. The contractions at this point came so close so I had no rest at all in between them. This also put too much pressure on Astrid and her heart rate increased to an unhealthy level. It felt like I had hit rock bottom. I couldn’t cope with the extreme pain, and on top of that my baby wasn’t well. I was very worried.
The midwife decided to reduce the dosage of the Pitocin and my contractions immediately decreased in intensity and Astrid’s heart rate came back to normal healthy levels. It felt as if I had been to hell and back. And although it had almost pushed me over the edge, I could again start coping with the pain.
I was examined again and the extremely painful few hours had been very effective - I was now open 10 cm. This made me very motivated and I knew the end was near. When the I have a sensation of needing to poo, a strong pressure on my bottom I tell the midwife and she says it’s time to start pushing. I am completely exhausted. I don’t have any energy left in me to change position. I can only lie down and push. I need to preserve the little energy I have left for the pushing and I can’t use it to hold my body in any other position than lying on my back. I push, and push and push. I try as hard as I can, but not much is happening. I push for a very long time, push push push. But still not much progress. The midwife asks her supervisor to help and she examines me to determine the position of Astrid’s head. When she puts her hands inside me it feels like knives are stabbing me or cutting my body in half. It’s excruciating. The head midwife is also unsure about what position Astrid’s head is in so they decide to call on a doctor. When the doctor arrives it has been two hours since I started pushing. It is much too long and it puts Astrid at risk of being deprived of oxygen. Astrid’s heart rate in once again unhealthy and the doctor decides she needs to be delivered now. They inform me that they will use forceps to get Astrid out. In most countries it is unusual to use forceps because it increases the risk of severe tearing for the mother, but it is still a rather common practice in Norway. They give me a Pundendal block, which is an injection in the vagina/perineum. During all of this I feel as if I have surrendered. I am so exhausted and in so much pain I feel that they can do whatever they want to me, I am completely passive. The room is packed with people. The midwife, a midwife student, the head midwife, the junior doctor and the consultant doctor. They get her out in just one or two contraction, and I can’t feel anything because the injection of the Pudendal block is so effective.
Astrid comes out and she has been so very strong during all of this, she is breathing, she is screaming, her skin is red and she gets a high Apgar score. They put her in my chest skin to skin and I start crying. I cry of relief that it’s over. No more pain, I cry because I’m exhausted. I cry because I feel immediate love for this little baby on my chest. She is the most beautiful lump I’ve ever seen. Astrid was born on the 11th of December at 16:38, she was 51 cm long and weighed 3380 grams.
The doctor tells me that unfortunately I have had a large tear in my perineum, meaning the area between the vaginal and the anus. They want to take me to the operating theatre to stitch the tear and it means I have to leave Astrid with my husband. I get to stay with Astrid skin to skin for one hour before they take me to the operation. The nurses are so very kind and comforting. They understand it is very stressful for me to leave Astrid after a difficult birth. But in this moment I am most of all just so exhausted, I need to rest. I lie down with my hands stretched out on each side and my legs are placed some type of gynaecological leg holders. They give me something to calm my nerves and anaesthesia which blocks everything from my waist and down. I cant feel my legs, I can’t move them. I see that they’re there but it feels as if I’m looking at someone else’s legs. I am so tired, and I fall asleep. When the stitching is done I’m moved to the post-op ward to be monitored. The nurse tells me I have to stay there until I can feel and move my legs again, and she can’t say how long it will take. I have a room of my own and I am all alone. I ask the nurse where my husband and baby Astrid is but she doesn’t know. She says she will try to contact the maternity ward to find out. But then I am left alone again, and suddenly it feels like I’m drown in the memories of the birth experience. All feelings, worries, the pain and the exhaustion comes back to me. I feel so lonely without Astrid, who’s been in my belly for 9 months. Where is she - is she well? I cry and I worry, I feel so very lonely. I was away from Astrid and Will for a total of 4 hours, and it felt like the longest hours of my life. And when finally my husband opens the door to my room, pushing Astrid in a plastic hospital bassinet. She’s comfortably swaddled and sleeping calmly. And finally I feel whole again.
We stay in the hospital for three more days, and I am in a lot of pain because of the tear. I can’t sit at all and I can barely transition from lying down to standing up because I then have to put a little pressure on the wound. I can’t carry Astrid because it feels too heavy in the wound. My husband gives Astrid to me for breastfeeding and snuggles and he changes all her nappies.
We go home from the hospital and everything feels very scary and new. I’m very handicapped by the tear and I am told I can only lie down for two weeks. I’m not allowed to sit or walk. So I just lie in the sofa and mu husband and my mum helps me with Astrid and everything else. When I stand up it feels very heavy in my perineum, and the wound and stitches hurt a lot. One week after the birth suddenly I don’t feel the stitches as much any more. It feels less stretched in a way, and I use a mirror trying to see what it looks like. Something looks very strange, the stitches has come open - and the wound is completely open. I am also bleeding a lot more than before, which is strange one week after birth as it should calm down gradually.
We go to the hospital and the bleeding increases even more as we arrive there. In the waiting room big lumps are coming out, not just blood. I’ve never seen so much blood and I get very worried. When the doctor comes and examines me she confirms that the stitches have come undone. But the reason for the bleeding is actually cased by a big tear in the vaginal wall, which is bleeding heavily. She also does an ultrasound and sees that parts of the placenta is left in the uterus, and this is causing the lumps.
When they examine the wound in the perineum they decide to not close it because there’s a risk it’s infected. So they stitch up the tear in the vaginal wall and they scrape the uterus to get the last bits of the placenta out. I stay in the hospital for another four days before they can close the tear in the perineum again. The wound is cleaned and examined every day and I had intravenous antibiotics. And then finally, on the day before Christmas the wound was finally stitched up again and I could go home. This time around I felt a lot better at the post-op recovery ward, my husband and Astrid came rather quickly to meet me and I shared a room with others so I didn’t feel lonely.
The happy ending to this story is that I recovered very well. For a couple of months I couldn’t stand up for a long period or walk very far, because my pelvic area felt too heavy and weak. I did pelvic floor muscle exercises every day and I went to a physical therapist specialised in women's health a few times. Slowly after two to three months I could start going for longer walks or very short jogs. And after six months my only complication was leaking urine when running downhill or jumping. This is very common after childbirth, and strengthening the pelvic floor muscles further helps. A lot of women are afraid of what it would feel like having sex again after a large vaginal tear. The problem some women can have is pain because the scar tissue from the wound is less supple and stretchy. It was daunting for me as well, but luckily it didn't hurt much and after only a few times the scar tissue must have stretched and it felt normal again. My physical therapist gave the very good advise to not endure sex if it's painful. Sex should be enjoyable and not associated anxiety or fear of pain. If you feel pain, rather wait a few more weeks and massage the scar tissue with oil every day to stretch it.
I want to send hope and inspiration to everyone who’s had a perineal tear, or is worried about getting one. I got the right help from professionals and I recovered very well. I have also since given birth 18 months later to Astrid’s younger sister Hilma. That birth was a wonderful experience, and I didn’t tear even a millimetre. Read all about it here.