Overcoming language barriers and cultural differences birth story

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Victoria McFarlane 3

A birth story from Victoria. She did the Full Online Course as she was living in Vietnam at the time. Read about her birthing experience, through difficult times with language barriers and cultural differences with the midwives and OB. How she had the amazing support from her partner and doula. How her confidence with all of the tools she learnt throughout the course helped her ‘I didn’t expect to feel so calm in that setting but I felt in my core that I knew what I was doing. A deep trust between my baby and my body’.

Describe your birth experience in 3 words:
Empowering, amazing, bonding
When was your birth?
Dec 2019
Was it your first?
second
How did you prepare for birth?
SheBirths Online, yoga, reflection on first birth, acupuncture
How did you bring your baby into the world?
vaginally, naturally within a hospital setting
Who supported you throughout the birth?
my amazing husband Jeff and doula Severine
What was the most challenging part of the birth?
Language barriers and cultural differences with the midwives and OB
What most helped you through the birth experience?
Our education and empowerment garnered through the SheBirths course
Was there anything that surprised you on the day?
Our confidence…I didn’t expect to feel so calm in that setting but I felt in my core that I knew what I was doing. A deep trust between my baby and my body.
What has been the best post-birth care for you?
We created a ‘nest’, a sacred space in our bedroom which I didn’t need to leave, people brought me meals, cared for me and I rested. It was a game-changer for me.

How did She Births help you?
SheBirths fundamentally altered our trajectory. It gave us the knowledge to feel we were in control of our own birth. We felt so confident in our decision making. I could truly trust my body and our baby without fear.

We had been living overseas in Vietnam for 4 years when we were excited to discover I was pregnant with our second child. I was apprehensive about giving birth in what was known to be a pretty abysmal health system with limited options for care. My first son was born in a private hospital in Melbourne, induced, epidural, then fortunately little intervention from there but later postnatal depression and many years recovery. Facing my second birth I felt so much hinged on the birth as the ultimate beginning, the foundation for the years to come and I was determined for it to be different. I immediately enrolled in the online SheBirths course and my husband and I would spend our evenings making our way through the modules, often pausing to reflect on our first birth experience. We would discuss how we would change things, how our expectations had shifted. It became apparent to me as I moved through the course that during my first birth I had had the wool pulled over my eyes. I distinctly remember the moment my mindset shifted, I watched “The Business of Being Born” as recommended in the course and as it finished I had this overwhelming sense of empowerment. Holy s#$% it was MY body, MY baby. I was in control. This empowerment and education helped me to commit to birthing in Vietnam although we had many hurdles to overcome. My OB was aloof and dismissive, had a track record of ‘routine episiotomies’

Victoria McFarlane 2

without permission and disregarding birth preferences. As our due date approached I discussed many birth preferences but most were waved away with his hand and I started to feel very unheard and stressed. I considered changing OBs but options were so slim and in the end, I decided I should persevere and navigate what was most important to us and try my best to release the rest. My biggest wish was for spontaneous labour because, above all, I wished to avoid Pitocin. I didn’t feel confident to face induction with Pitocin without pain relief and I wanted, more than anything, to experience my natural birth hormones and connect with my baby as best I could, something I felt I was robbed of the first time around. So we hired a doula, we finished our course, I practised the breathing techniques, the visualisations, the rebozo, the yoga…we were ready. The due date then came and went and things started to feel more stressful.

On Friday we arrived at the clinic for their routine ctg as I was now 40+6. It showed ‘some things’ the doctor doesn’t like so he advises us to go home and collect our bags and head to the hospital that day for induction. Initially, we were swept up in the concern for the baby so we diligently returned home and prepped ourselves to leave for the hospital. We did not want to be induced but of course, we were concerned about the baby. In addition to this, my husband, Jeff, had been on leave for 2 weeks and only had a week remaining, I was hugely concerned of the initial postpartum period and how much support I would need. He is a pilot and I did not want him to be suddenly gone a week when the baby was days old so induction became a balance between needs.

We had agreed Saturday If there were no real indications of labour and I’d been having daily acupuncture and using the breast pump an hour a day without any changes. So ok, we get our head in the game and head into the hospital. My biggest concern about induction is Pitocin, we’d discussed this with the doctor, I’d asked for gel/tape and broken waters as a possible alternative, he’s agreeable but doesn’t seem convinced. The first tape goes in at about 1 pm, heaps of monitoring. Small contractions I can’t feel but no change to the cervix, after 5hrs I’m still only 1cm and he says there is basically no response to the tape. All the monitoring says the baby is fine so he agrees to leave it overnight and start again the next morning with another tape. We also have a great midwife friend who is at the end of WhatsApp reviewing all the monitoring. She agrees that the baby seems completely fine and thinks even the CTG that started this whole thing was fine. This gives us peace of mind and to be honest, I am still ever hopeful of spontaneous labour at this point and we have managed to avoid Pitocin so far.

We have to stay in the hospital but that’s ok. Next morning we get the tape at about 9 am and we’re moved into the delivery suite. I’m bouncing away on the fitball but don’t feel anything, not even cramps and I was 1cm at the start that morning so no change. I’m starting to think Pitocin is inevitable so I start to mentally prepare for that. I reached out to the SheBirths community on Facebook and am met by a multitude of positive responses and my mindset shifts in the right direction. I remember the lessons from the course, all births can be beautiful, it’s about empowered decisions. At about 12:30 they hook me back up on the stage and it shows contractions 2 in 10 but I can’t feel them even though they’re the strongest we’ve registered so far. We’ve had a lot of monitoring by this point so we’re getting good at interpreting! The midwife wants to check my cervix, I reluctantly agree as the midwives struggle with English and also have limited training so it’s difficult for them to come up with alternative ideas. They’re also under a lot of pressure from the doctors – our doctor has not been at the hospital all morning so I am waiting for her reports via the phone. She then takes out the tape/gel. She says I’m only 2cm. Our OB is brought in on speakerphone and says he’s instructing them to get the Pitocin drip set up.

This is where our SheBirths training really kicks in, we have many questions using the BRAND method. It seems to us at the end of the conversation that we are perhaps being coerced into moving things along when it isn’t necessary so we insist on a 3-hour delay before reassessment. This upsets the doctor and staff but I felt so confident in our training, it didn’t bother me at all. Jeff is so confident at this point that labour is starting he is sure a good walk will confirm it. They instruct us to leave the delivery suite. We noticed on the ctg that contractions became 3 in 10 in the last 30 minutes. I feel light cramping so we pack our things and make our way back to the ward we stayed in overnight. I’m happy to go back to our room where we won’t be bothered, I am starting to feel the need to nest and be left alone so it feels very right to head out of sight at this point.

We now use all our birthVictoria McFarlane 1 prep training and Jeff nests, he sets up the electric candles, the aromatherapy, the music, the blankets, the cards my eldest has made for me to take to the hospital. It looks amazing and feels surprisingly homely and safe. Above all, no one thinks we’re in labour so we get left completely to ourselves which helps me relax. I do squats and walk and sway and move as much as I can and now I feel the contractions. Within an hour I’m having trouble getting through them and needing to stay a lot more focused. Jeff has been supporting me through them with massage and I’m using the breathing techniques we learned. In between Jeff is using acupressure and also light touch massage. Jeff’s starts timing the contractions and they’re 2.5mins apart and about a minute long. I tell him I want to call the doula because she’s 40 mins away. Initially, he calms me and reminds me labour takes time and there is no rush, after all, it’s only been just over an hour since I was 2cm and not feeling contractions so we have time but about 5 minutes later I am sure I need her so we text her to come in.

Before long I am thinking about hot water and baths for pain relief. I want to ask to go back to delivery because there is only one room with a bath and I really feel I need it! The midwife comes in and she won’t take our word for it with the contraction timing or assess me visually working through them, she insists the only way is to do a CT to see the contractions before deciding if we can go back. So I lie on the bed and it’s so much more painful lying down! I get through about 15-20 mins and I said ‘Jeff go tell her I can’t do it anymore get them off!’ So he does and then she says she needs doctor approval for the delivery room. She rings the doctor and I go sit on the toilet which made things feel so much easier to manage.

At this point the doula arrives and is straight by my side talking and massaging me through contractions, she feels a welcome relief and I am so glad we hired her. The OB is now on the phone to Jeff and Jeff explains the contractions are now 4 in 10 and that I am in a lot of pain and wish to use the bath for pain relief. The OB surprisingly says ‘We can’t use the bath like a swimming pool, it’s not a hotel, other women might need the room, if you go in there you’ll have to be on Pitocin to get things moving’ Jeff is trying to explain that things ARE moving but he doesn’t seem to understand and says we can’t go back. He offered a spinal tap, which Jeff declines. Language is a barrier and also the expectations were that labour hadn’t begun since I had only left the delivery suite 2hrs before without visible signs. Jeff gets off the phone, the nurse asks him if it’s ok and at that point, he has a decision to make, he hears me moaning from the bathroom and he looks her in the eye and says… ‘Yep! The doctor says it’s fine we can go to the room now!’ So she gets a wheelchair and we go straight away.

The bath is running, I hop straight in, it’s so hot the doula can’t put her hand in to massage me but I don’t even feel it, it’s bliss and I usually hate hot baths! For about 10 minutes my contractions completely ease, I can talk again in between and everything feels manageable again, my body grants me a small rest. Again, Jeff busies himself around the room and I have a lovely memory of sitting in the bath, the doula is massaging my feet and pressing acupressure points for endorphins and Jeff in my periphery setting up electric candles and putting the aromatherapy and music on. Then, that bit was over and things get going, I’m starting to really struggle through contractions and starting to yell! I feel really nauseous during the contractions and hanging my head out the bath with a sick bag and Jeff massaging my head. Suddenly I’m sure I’m going to poo so I ask to get out and sit on the toilet and I can’t help but kind of bear down in the contraction but it feels like I’m fighting against them so I’m trying to stay calm but I’m losing it a little and the pain is pretty intense.

At this point, the doula knows what is happening and gently suggests we should do a vaginal exam now because she thinks the baby is coming and they won’t call the doctor because they don’t realise how far along I am. I initially refused. I remember thinking I felt close but also petrified of being only 4cm and the effect that would have on me mentally. The doula insists, the midwives are getting agitated and uncomfortable and the doctor lives 40 mins away so they want to know. I agree and hop on the bed…7cm and the midwife suddenly seems very panicked! She instructs me to stay on the bed and runs to call the doctor. I’m a bit panicky now for two reasons. One, I can’t help but push during the peak of the contraction, the contractions are very intense, I think I was tensing against it at its peak and it resulted in pushing but it also felt completely out of my control. I was trying really hard to breath through it and stay calm but it was getting harder and harder. Two, 3cm felt like a long way to go and I know transition 8-10cm is the hardest part and I don’t want to be stuck on the bed. I’m beginning to think I can’t do it and I’m saying this out loud, ‘I can’t do this! I don’t want to do this’ – classic transition. I feel more comfortable sitting up but leaning back so the doula gets Jeff to get up behind me and that feels like the perfect position, I can still hear his calm voice coaching me through every contraction. The doula stands at my side and more massaging etc.

Thankfully, the transition is so quick. I think maybe it was over in less than 10 mins. Somewhere in there my waters break with force during a contraction and scare the living daylights out of the doula who thought the baby was coming with them! Now the midwife is back and suddenly I know, I say ‘THE BABY IS COMING’ She looks and announces I’m 10 cm but is insistent I don’t push because the doctor isn’t here!!! I never actively pushed the entire labour, my body did everything on its own so regardless of the instructions it didn’t matter. Again, the SheBirths training is so valuable, nothing about this scared me, I didn’t worry about the doctor or who was in the room, I felt so confident in my body and my baby. The next contraction comes and I swear I feel him almost crown. Now I’m trying to tell people ‘IT’S COMING NOW!’ The room was full of people but they’re all standing as far away as possible, it’s only Jeff behind me and the doula by my side but because I’m on the edge of the bed I just worry that someone needs to catch the baby! I feel the baby retract a little. The midwife says 6 minutes till the doctor gets here and everyone relaxes, there are now about 5 midwives in the room but all standing about 3 metres or more away and it’s clear they don’t feel confident without the doctor present.

The next contraction…he crowns! All I remember in those last moments was having my eyes shut and so many people yelling NOT to push which is hilariously opposite to my first experience. Of course, I could not care less at this point who was there to deliver or not because I could not fight my body. I felt the next contraction starting and I opened my eyes to see a young Vietnamese man in scrubs between my legs yelling ‘NO NO NO NO NO’ I assume telling me not to push so he can try and keep my perineum intact. At this point, I’m yelling ‘What’s happening? Is it coming? Has it been born????’ The doula tells me to open my eyes and look and I see as he’s delivered straight onto my chest! The doctor then checks and I’m all intact then takes his gloves off and goes to leave! I yelled out ‘WAIT! What’s your name???’ He says ‘Dr Tien’ And we thank him in Vietnamese and he smiles and walks out! I vaguely remember the paediatrician giving him a quick check while he’s on my chest and then everyone slowly leaves. I’m yet to deliver the placenta but about 10 minutes later our doctor arrives and he delivers the placenta without oxytocin which is what we wanted and Jeff hops down and cuts the cord which was also great because we got some really good delayed cord clamping! Then our OB just says ‘see you in a month for a checkup’ and leaves along with almost everyone and we get 2hrs of amazing skin on skin, the doula leaves once we’d established breastfeeding and it’s this really lovely quiet time with just the three of us.

The whole birth was strangely exactly as we wanted given the circumstances. I’ve never felt so empowered and so surprised at what I could achieve. I would genuinely describe it as ‘amazing’ and the pain was intense but manageable. We are so glad we did so much prep before the birth because we were confident to advocate for what we wanted and ask for time when the hospital wanted to push. I would never have done that my first birth. We are also so grateful for the doula and our midwife friend on WhatsApp because a lot of confidence came from them too. In the end, I’m really glad the doctor didn’t make it because we would have most likely had to fight for our preferences. If we had been in Australia, a home birth would have been our preference but I think our experience goes to show with the right education a beautiful birth is possible in the most trying of circumstances.