Sarah’s story
of Noah’s birth


Excerpt from Midwife Wisdom, Mother Love

Out of my four birth stories, Noah’s is probably my favourite. His birth was my magical one, the one that took me to that special place you sometimes hear women talk about just after they’ve given birth. Maybe his birth wouldn’t have been so special if it didn’t follow the very difficult delivery of our first baby, Jack. Maybe it wouldn’t have been so special, if I hadn’t reached the point where I was able to let go of all the expectations I’d clung on to so tightly about natural birth. I don’t know. All I do know is that as soon as he was born I was ready to do it all over again.

In my book Midwife Wisdom, Mother Love I tell the stories of all four of my births, simply and straight from the heart. In the telling, these stories help to illustrate how every birth, even when it is the same woman giving birth, is unique and individual and often unpredictable. Midwife Wisdom, Mother Love is a combination of both my professional and personal experience. It’s a journey into truth, not only my truth, but the truth of pregnant and labouring women everywhere.

When I fell pregnant with Noah two years after the birth of Jack my mind was a lot more open. Jack had weighed eight pounds, thirteen ounces (almost four kilograms) and had been hard to push out. I knew in most cases that the more babies you have the bigger your babies get, so I wasn’t expecting a small baby.

But I doubted that a baby any bigger than Jack would be able to fit through my pelvis. Natural birth without any drugs or medical intervention was still really important to me. It was something I wanted to have another go at, but I had managed to let go of it as my all-consuming goal. I knew the most important thing would be holding my baby in my arms and rubbing his warm cheek up against mine.

After seeing the relief the epidural had offered me during Jack’s birth, Pete was amazed that I was still considering natural childbirth. He was, however, prepared to support me in whatever birth choice I made.

This time I decided, if at all possible, I wanted a midwife to deliver my baby. I also wanted to have my baby in the hospital where I worked, where I knew the staff well and felt comfortable and relaxed.

I was working at a private hospital where obstetricians delivered the babies and I was happy to have the reassurance of an obstetrician on call in case he was needed. There was an English doctor working at the hospital at the time who was more than happy to let the midwife do the delivery if everything was going okay. So we had our absent English doctor, and a queue of colleagues putting their hands up to be at the birth. All we needed was a calm, natural birth.

Noah was due four days before my birthday (babies in our family have a bad habit of trying to steal birthdays already taken). Even though I wasn’t keen to share my birthday with one of my own children, I was not prepared to give the castor oil another go. It hadn’t worked the first time. So it was down to as much sex as my big, pregnant body could handle and lots of long walks to encourage Noah to arrive early.

The day before my birthday, at three in the morning, I woke with a pain in my lower back. Half asleep, I thought the pain might be the beginning of labour but I was too tired to think too hard. I rolled myself out of bed for my third toilet stop that night and then sank back into bed again on my side. I pushed a pillow under my belly to try and make my back more comfortable. For the rest of that early morning sleep I woke about every half an hour with a niggling back. I would wriggle and squirm to find a more comfortable position and then doze off to sleep again.

When daylight finally came and Pete was off to work, nothing much had changed – there was still a niggle in my back every twenty minutes to half an hour. My morning ahead was packed with laps to do at the local pool and grocery shopping after that. I was trying not to assume the niggles in my back were the start of early labour. I hugged Pete goodbye and gave him a kiss.
“Better keep your mobile close today.”
“You never know.”

Pete went off to work not really expecting labour, there had been too much wishful thinking when Jack was overdue. Now that Noah’s pregnancy was heading the same way, neither of us really wanted to start guessing when he might arrive.

That morning at nine, Mum, Jack and I headed down to the local pool. Jack went into the crèche, Mum plodded up and down her own swim lane, and I slid in to the slowest lane of the swim squad as I had been doing right through the pregnancy. The water was cold and soothing on my body. The familiar smell of the chlorine and the splash and bubbles of the pool helped me to drift off into my own little world. The comfort from the water I knew so well was like meditation.

Towards the end of my ninety-minute swim I was having a contraction every second to third lap. This meant they were probably coming every five minutes or so (I wasn’t swimming too fast at this stage of the pregnancy). My arms kept moving during the contractions but my kick slowed down, almost to a stop.

While I was in water having to think about the two kilometres I was swimming, the contractions were fine. But as soon as I got out of the pool and the water no longer supported the weight of my belly, the grip of the contractions tightened. I was still able to laugh and talk and smile through them and nobody I chatted to after the squad session knew that I was in labour. So the contractions were by no means intense, but they were definitely contractions and they weren’t going away. They seemed intent that I meet my baby the day before my birthday.

The groceries had to be done on the way home from the pool. My mother was not keen. I’d told her I was having contractions and she wanted to get me home, call Pete and then bundle me off to the hospital. Remembering Jack’s birth, I wanted to stay away from the hospital and pretend there was nothing going on for as long as possible.

We were sitting at a red traffic light, waiting to turn into the shopping centre car park when I had a contraction that felt like two large hands with claws squeezing my lower belly tighter and tighter. I gasped, my fingernails dug into the steering wheel and I leant forward over it. My mother had the panicky look of a woman who thought she would have to deliver a baby in a car. There was a loud pop. It sounded like a paper bag, blown up with air, had been clapped between two hands. Warm water pooled between my legs on the towel and seat below me.

“My waters have broken,” I said to my mum, watching the traffic lights turn green.
“Good. We’re going home and you are going to hospital.” It was eleven o’ clock.

Pete arrived home grinning. He was thrilled to be called out of work. “Just like in the movies,” he said.

The experience of walking into the hospital was so different from the first time. I knew everybody. I knew where everything was and how everything worked. The tension that gripped me when I walked into the hospital pregnant with Jack was nowhere. I was greeted with smiles and lots of jokes,

“Finally! We thought you must have forgotten you were having a baby,” and “We thought you’d snuck off and had that baby without us.”
I felt like the long lost daughter being welcomed back to her family for a special celebration. It was wonderful and I was glowing. Pete could feel the peace in me and was so much more at ease than he was at Jack’s birth.

By then, contractions were coming about every five to seven minutes and lasting forty to fifty seconds. They were less frequent than they had been at the pool, but more powerful. Memories of the contractions I had during Jack’s labour started to race back to me. The midwife who was looking after me did my temperature, pulse and blood pressure, she listened to the baby’s heart beat and felt how Noah was lying in my belly. Everything was fine. She went off to run the spa even though I had no idea if I would want to use it.

“Doesn’t matter if you use it or not,” she said. “At least if you decide to then it will be waiting for you full of warm water. And if you don’t, someone else is always ready to hop in. You know what this place is like, always a new baby arriving.”

I spent the first hour pacing up and down the birth suite floor just like I had with Jack at home. I was starting to have to concentrate through the contractions but in their absence I was chatty and excited.

Unlike Jack’s birth, the midwife popped in to see how we were going every half hour or so. And we hardly knew she was there: she was very quiet, offering words of reassurance and comfort when we needed it. And when it was obvious we didn’t need her she would do what she had to and then leave. This was comforting for Pete. He felt that if he needed help or was worried about anything, he could ask. At the same time he felt he was being trusted to support and look after me.

As the contractions intensified, pacing the birth suite floor no longer offered relief. I became a lot quieter and found that I wanted to rest between contractions instead of talk. I leant over the back of a couch and rocked while Pete massaged my lower back. He couldn’t rub hard enough to rub the pain away. I kept saying, “harder, harder.” We had brought oil for massage but forgot to use it. So not only did Pete have sore fingers from all the massaging, but I had a red-raw mark on my lower back for days after Noah’s birth where the skin had been rubbed away.

I started to wish for the lightness of the swimming pool from the morning’s laps, for water to hold my heavy body up; the midwife suggested the spa.

It was so good to be naked, to feel the warm water around my body and the lightness of my bulging belly. I leant forward on the rubber ring floating in the spa, with my knees on the spa floor. Without getting into the spa, Pete was able to reach my lower back and massage through the contractions. There was a smell of chlorine from the heated town water in the small dimly lit spa room. The comfort of the pool started to come back to me: I started to slip back towards that meditative state the splashing laps had induced earlier that morning. Everything was soft and hazy and warm.

The midwife whispered when she came into the room. I was never sure if she was there or not. She whispered something to Pete who then leant over and whispered to me, “She wants you to get out, Sar, so she can have a listen to the baby and see how dilated you are.”

My thoughts were slow and foggy, “Probably not a bad idea to get out, I need to do a pee anyway.” My body was heavy and pink when I stood up, letting the water drip off me. Pete and the midwife helped me onto my back on a beanbag, my feet resting on the cold tiles of the spa room floor, my wet body covered in towels.

As soon as I lay down on the bean bag a contraction made me clutch at my belly and roll to my side; it was almost unbearable. I needed water. There was no way I could do this without the help of water. My breath rushed in and out, I tried not to hold onto any tension, I tired to let everything go. Not easy. When the contraction was finished I rolled back onto my back with my knees up and feet apart.

The midwife listened to the beautiful galloping of my baby’s heartbeat and then she asked me in a voice that reflected the haze of the room, “Sarah do you mind if I examine you to see how dilated you are?”
“Fine,” I said with a closed lip smile.

Another contraction started while her fingers were inside me. My teeth gritted and my breath snorted through my nose. When she was finished I couldn’t get off the bean bag fast enough. It seemed like some medieval torture apparatus.
“Six centimetres and thin,” the midwife smiled at me.
“Uh huh.”

I couldn’t stop smiling I squeezed Pete’s hand. “We’re over half way, can you believe it?” We’d only got half that far with Jack before I’d screamed for an epidural.

Pete pushed my hair back out of my face and kissed me on my forehead, “Sar, you’re doing so well. I’m so impressed.” But there wasn’t much time for marvelling at our cleverness: another contraction took hold. I grabbed Pete, pushed my head into his chest with my arms around his neck and leaned on him while he rubbed my back.

The contractions started to come a lot closer together – every two to three minutes – and lasted for a good minute. I wanted the spa. It seemed like the one place I could really let my body flow with the contractions. My brain started calculating. Get to the toilet before a contraction. Sit there, pee for one contraction, and then race back to the spa before the next.

After going to the toilet I got stuck in the bathroom not wanting to move. The contractions seemed to be coming one after the other. I was leaning over the sink, with Pete still rubbing my lower back. When there was a rest between contractions my eyes would close. I felt like I was in a half sleep. The last thing I wanted to do was walk back to the spa. Besides, I wasn’t sure I wanted the spa anymore.

That was where the midwife found us, stuck in the bathroom. I was leaning over the sink rocking and breathing, still thinking about relaxing my body so my cervix had the best possible chance of dilating, with Pete behind me massaging my lower back harder and harder.

She said softly, “How about you come out here and lean over a bean bag? Your legs must be getting tired?”

I was open to any suggestions at that stage. As soon as the next contraction finished I followed the midwife into the birth suite area where there was a beanbag on the floor covered with a white sheet. A spongy mat had been placed in front of it. I collapsed onto the floor kneeling on the mat, my head and chest resting forward into the beanbag. Pete sat in front of me on the floor. His forehead rested up against mine.

“Is there anything you want Sarah?” The midwife’s voice was a whisper in the dim room.
My words were distant and low, like a rumbling moan, “I don’t know, it hurts, I don’t know.” I no longer opened my eyes, I was starting to feel like my body was separate from me; it seemed to be taking over and all I could do was go along for the ride.
“How about some gas, do you think some gas might help?”
“Mmmm.” At that stage in the labour I trusted the midwife with my life. Anything she suggested sounded good.

The gas was hooked up and a black rubber mask put in my hand. I knew how to use it. Even in my labour haze I could remember the words I had said to so many labouring women. “Push the mask on to your face, make sure it’s sealed, and then breathe deeply as soon as you feel a contraction starting. If you’ve got the seal right you’ll hear the machine clicking over. Keep breathing the gas in until the contraction starts to ease, then take the mask away.”

I clutched the gas mask in my white knuckled hand as if it were a piece of rope thrown over a cliff to me. Pushing the mask onto my face I sucked the gas in as though it was the only oxygen left in the birth suite.  Pete’s forehead was still pushed up against mine and he was talking to me through the contractions, soft murmurings that I could hardly hear but I knew he was there. I could hear his voice and feel his fingers stroking my hair, but I felt like I was kilometres away from him. I felt as if I was at the end of a very long tunnel near a bright light. My body was with him but I wasn’t, I was at the end of this tunnel watching everything from a distance.

I heard the midwife say, “She’s gone, she’s not with us just now.”
I thought to myself, “Don’t be so sure about that, I’m only staying here because it’s warm and bright, but I can hear you, I can come back if I want.”

A deep, guttural groan had started in the birth suite; I didn’t know where it was coming from or what was making it. It sounded like an animal stuck somewhere, trying to push its way out. Pete was still there in front of me with his forehead resting on mine. I couldn’t understand why he hadn’t gone to free the animal.

The contraction I was having had started to ease. I took the gas away from my face letting my head flop into the bean bag. I felt Pete’s fingers running through my hair. The groaning had stopped.

“Sarah,” the midwife was again whispering close to my ear. “It’s time to start pushing. You need to give the gas to me so you can use all your energy to push.”

My eyes fluttered open and then closed again. “Do I have to? I’ll still push with the gas.” Without gas I was sure I couldn’t get through labour and finally meet this little baby.

“Sarah, you know you can’t push while you’re breathing in gas. You can’t get enough power in your push. You want to meet your baby don’t you?” Gently she unwound my fingers from the black gas mask handle and took it away. I looked for Pete’s hand instead.

The next contraction started, building and building. My fingers crushed Pete’s. I wasn’t at the end of the bright tunnel anymore. I was back close to my body, watching it rock and moan. I again heard the groan I thought was an animal; it wasn’t an animal, it was me. The groan built with the contraction until it was so low down in my body that I wanted to push it out. I needed to push the groan and the baby out.

“That’s it, give this baby a big push, it’s time to meet this little one.”
Pete was there, his forehead pushing against mine. He was letting me squeeze the blood out of his fingers. “You’re doing so well, Sar, keep going.”

Then the groan turned to a squeal and I was pulling back from the huge push I knew my body wanted. “Ow! Ow! Oh, it hurts, please, please it hurts.”

The contraction eased and my body sank into the bean bag.

“Where did it hurt Sarah?” The midwife had come around to my face and was pushing my damp hair out of my eyes.
“My bottom, my bottom.” I hadn’t felt anything in the vagina or on the perineum – everything was in my anus. It was as if a large stick with flames was inside me trying to push its way out. The sting was so intense that I couldn’t push against it.
“I’ll get a warm face washer for you and put some pressure on it,” the midwife said, leaving Pete and me in the room.

A warm face washer seemed like the last thing that would help, but I was prepared to try anything. I knew there was no way I could push with that pain there.

While the midwife was away, another contraction came. This time I puffed and panted and did my best to ignore the groan and ‘push!’ that wanted to take over my body. I knew I was resisting, but that burning feeling was too scary.

The midwife came back with the warm washer. She put it over my anus and left her hand there. Even in the middle of the labour haze it felt strange to have a woman crouched behind my naked body with her hand over my anus. I was way past the caring stage. If it was going to stop the burning in my anus while I was pushing, then ten people could stand there with their hands and warm washers on my butt, I didn’t care.

The next contraction started building. I tried to think about my breath and relax so that I didn’t tense up with fear. I felt the groan rumbling in my chest and moving lower, the urge to push taking over. My first push was tentative, testing for burning, stinging or ripping apart. It wasn’t there. The midwife had increased the pressure of the warm washer on my anus and was massaging slightly.

I took a deep breath and this time really let my body take over and push as hard as it wanted. It felt fantastic. After all of the struggle of the previous hours I could finally do something with the contractions. My body felt strong and powerful. As the contraction eased I was surprised to find a tired smile on my face.

My eyes stayed closed in between contractions. I was gathering every bit of energy I had left so I could push my baby into the world. Every contraction seemed to last a bit longer than the last, or maybe I was pushing more effectively with every contraction. When I first started pushing I only managed to get one good push out of a contraction. Just before Noah was born I was getting three to four good pushes out of every contraction.

Pete and I had talked about the birth during my pregnancy, and we both thought it would be special if Pete could put his hands on Noah and help to guide him into the world. As I pushed I couldn’t let Pete go anywhere. It was so important to me that he stay up near my head. He needed to be touching me, I wanted his forehead on my forehead, I wanted to hear his voice. I needed to know that we were doing this together, that it wasn’t just me.

The more Noah’s head pushed out, the more orgasmic the pushes became. As Noah’s head pushed through the opening of my vagina and swept over my perineum I felt a faint stretching and burning. It was masked by the orgasmic sensation and the joy of having pushed my baby’s head out without anyone’s help. I was laughing and smiling while Noah’s head sat there on my perineum.

By then two midwives were in the room. The other midwife had snuck in with her rubber-soled shoes when it became obvious the birth was close. I didn’t know she was there until after the birth of Noah’s head. His little head sat on my perineum for longer than our midwife liked. I heard her worried whispers about shoulders getting stuck and whether or not they should move me onto my side to make more room for the shoulders to come through.

I was on all fours over my beanbag, quite comfortable and high on the endorphins. I wasn’t in a hurry to do anything, but when the next contraction came and the urge to push started to build, I let the worried whispers seep into me, and scare me just a little. Then I gave a grunt from the deepest part of me.

Noah’s shoulders were tight as they came through, I could feel the bone of his little body rocking against the bone of my pelvis and all the blood and wetness that followed him. Five and a half hours after my waters had broken, Noah had arrived. He was there on the mat between my legs all shiny with black matted hair. He was blinking one eye in the light, which was bright for him, but dim for us. His other eye was stuck closed and took a bit longer to open.

I turned over and lay back in the bean bag cradling him in my arms, kissing his wet cheeks. The cord was clamped and Pete cut it.
“He’s so beautiful,” I whispered to Pete not taking my eyes off Noah.
Pete didn’t say anything. His arm was wrapped around me, his head resting on mine.

It was only then that I realised Pete hadn’t been able to help deliver Noah like we had hoped. “Oh honey, I’m so sorry that I couldn’t let you go, I needed you so bad.”
He squeezed me and there were tears in his eyes. “There is nowhere I would rather have been than there with you. Besides, I got to see him open his eyes first, he looked straight into my eyes and didn’t blink. Straight at me.”
“Mmm, really.”

The placenta came away easily and was warm and soothing over my torn and bruised perineum. Noah’s big shoulders had caused my perineum to tear in the same place I’d had the episiotomy with Jack. The doctor who had been sitting patiently at the nurse’s station while I was giving birth came in and stitched up my perineum. He was another good seamstress; I was able to sit on my bottom immediately after the birth. By making sure I used lots of ice and had lots of showers to keep the stitches clean and dry in those first two days after birth, I had no problems and the wound healed well.

I don’t remember the midwives cleaning up or putting a blanket around me and around Noah. I don’t remember their congratulations or accolades.

What I remember is Pete, Noah and me in our own bubble. It was the bubble Pete and I had used to float up to where Noah was, to gently put our hands out and reach for him. We’d brought him into our bubble so we could all float back to earth together.

We were still in that bubble, everything was warm, the lights were dim and no one was making a noise, not even Noah. I knew I could stay there forever without a needing anything. And we did, for an hour – Pete, Noah and I.

Then the visitors started to arrive and I had to get up and have a shower. Someone took Noah out of my arms and bathed him, someone turned the lights on, and Jack arrived with all his two year old excitement. The birth bubble had burst, Pete and I were back in the real world, but now Noah was with us.

That night, tucked up in bed breastfeeding Noah and with Pete on the edge of the bed I said, “You know we will have to have another one. That was too fantastic not to do again.”

Pete rolled his eyes, smiled and stroked the pure pink of Noah’s cheeks.

I stared at our beautiful Noah. I was in awe of him and what my body had done. I had managed to push him out all by myself – all ten pounds, one ounce of him (about four and a half kilograms). He was a whole pound and a quarter heavier than Jack.


© Sarah James
Reprinted with permission from Sarah James and Lothian Books, from Midwife Wisdom, Mother Love

“A gender-equal society would be one where the word ‘gender’ does not exist: where everyone can be themselves.”*

I’ve always been aware of gender conditioning and actively tried to combat any lingering prejudices or stereotypes in my own parenting, even down to encouraging dolls with my boys when they were little. It’s great to read people writing about gender issues they’re experiencing with their kids. For too long these subjects have been discouraged or silenced. I’d love to publish some more creative writing on this topic, especially if you are struggling with a child who actively tries to move away from gender normative preferences. A society where everyone can be themselves thanks Gloria for those aspirational words.

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* Gloria Steinem