Ruby – Midwife, low-lying placenta, Royal Women’s homebirth program, positive induction experience

Conception and Early Pregnancy

After marriage and some strategic timing around celebrations, Ruby and her husband Daniel were fortunate to conceive quickly. “The first month I was convinced, I was like, yep, this is it. We were pregnant… And I was so devastated when I got my period,” Ruby recalls. The knowledge that comes with her profession created anxiety: “I really spiralled after that first month… I was like, oh my gosh, like what if my uterus is funny shaped? What if I’m not ovulating?”

Her second cycle brought success, discovered in typical fashion whilst rushing to Pilates: “I looked at it and I was like my goodness that can it was positive. And yeah, was just like, I was so excited. It was such a shock.”

Early pregnancy brought significant nausea and vomiting. “I loved a good vomit, especially every morning. You know, it was like literally opened my eyes and I was like running to the toilet,” Ruby describes. The symptoms persisted longer than the typical 12-week mark, finally subsiding around 16-17 weeks.

Choosing Care and Navigating the System

Ruby knew she wanted a homebirth if possible, viewing it as the best way to avoid the cascade of interventions. However, choosing between private midwifery care and the hospital homebirth program proved challenging. “I remember thinking, oh my gosh, navigating this with the knowledge that I have was difficult. Like how are other people doing this?”

She ultimately secured a place in the Cosmos program (the MGP program at the Royal Women’s Hospital) at 19 weeks. Meeting her midwife was transformative: “I just was like, this is where we’re supposed to be… I felt like very comfortable and I was in very, very good hands.”

The Placenta Scare

At 20 weeks, Ruby’s morphology scan revealed a low-lying placenta touching her internal cervix. This news was devastating for someone preparing for homebirth: “I was like, oh my gosh, I’m prepping for a home birth and now I could be prepping for a caesarean… It was just like such, you know, so different ends of the spectrum.”

The wait until her 34-week rescan was emotionally challenging: “I had from that, you know, 21 weeks to 34 weeks of just not knowing… It was out of my control, which that was, and that was also a really hard thing as well. I had to surrender.”

Ruby advocated strongly for her preferences during the rescan, declining growth scans and requesting only placental assessment. When the sonographer delivered the good news – “four centimetres away” – Ruby’s relief was overwhelming: “I was just there crying and she was like oh my gosh like are you okay like is it hurting and I was like no I’m just so happy.”

Birth Preparation

Ruby invested heavily in birth education, attending classes at Mama in Kensington, completing hypnobirthing training, and listening extensively to birth stories and The Birth Class podcast. She also pursued physical preparation including spinning babies techniques, pelvic floor work, and sessions at The Pelvic Space for internal release work.

“It was pretty intense like the feeling of you know they’re releasing but it like it made such I felt like it just created so much space in my pelvis,” she describes of the pelvic work, which also served as valuable labour preparation for breathing and coping techniques.

Labour Begins

At 38 weeks and 5 days, Ruby experienced what she suspected was her waters breaking – just a small trickle that left her uncertain. Knowing the hospital’s 18-hour policy for labour to commence after membrane rupture, she initially chose to wait at home. “I was just like, oh, I’m just gonna sit on it for a little bit. And I felt well, I was checking my temperature, the waters were clear, she was moving beautifully.”

After 24 hours with no labour progression, a hospital check confirmed her waters had indeed broken. This meant her homebirth was no longer possible under the program’s guidelines. “I remember calling one of my good friends and just being like, hey, my waters have broken. I’ve just gone the 18 hours. I’m not having home birth… I had a really big cry and just was, you know, I said goodbye to all that prep and planning.”

Pivoting to Hospital Birth

Ruby’s ability to adapt and reframe her expectations proved crucial. She spent time grieving the loss of her planned homebirth whilst preparing mentally for an induction. Fortunately, the stars aligned when her primary midwife returned from leave just as Ruby needed to begin the induction process.

The syntocinon drip began at 10:30 AM, and Ruby appreciated her team’s approach of covering monitors and screens so she couldn’t see the technical details. “I needed to sort of get out of my brain,” she reflects.

Active Labour and Birth

Labour progressed steadily with Ruby using various comfort measures including TENS machine, birth ball, and eventually water immersion. A brief concerning moment occurred when baby’s heart rate dropped, requiring internal monitoring, but this resolved quickly.

Ruby’s midwife brain remained active throughout labour: “I often think back to my labor and think like I was a bit of a toddler. Like I was very much like, I don’t want to do this. I don’t like this… I was very vocal about it.”

The transition from 3 to 7 centimetres happened rapidly within an hour, explaining the intensity Ruby experienced. When involuntary pushing began, her midwife’s guidance to “get out of your head” and trust her body proved essential.

“I just can’t believe that feeling… that involuntary pushing, like it’s like… You just you cannot stop it,” Ruby describes. “Once I sort of relaxed into a little bit more, I think that really helped.”

Meeting Clementine

After about an hour and 10 minutes of pushing, Clementine was born at 10:45 PM, weighing 3.3kg. The moment of discovery was magical: “I looked down and I was like, oh my god, it’s a girl. Like I just couldn’t believe it… it’s just that weird, see them for the first time, you’re like, oh my gosh, it’s you. Like, of course it’s you.”

The placenta proved challenging to birth, requiring Ruby to push it out after the cord appeared to shear. Interestingly, examination revealed a velamentous cord insertion that hadn’t been detected during pregnancy.

Breastfeeding Journey

Having had breast reduction surgery in 2012, Ruby was uncertain about breastfeeding success. Initial challenges included nipple damage and Clementine’s static weight gain, leading to an intensive triple-feeding routine for seven weeks.

“It was so grim,” Ruby admits of the triple feeding period, but her determination paid off. With support from lactation consultants and an experimental approach, they eventually achieved exclusive breastfeeding. “We’re four months now we’re exclusively breastfeeding and it’s just yeah it’s just incredible… it’s been the most rewarding thing to do with her.”

Reflections

Ruby’s story demonstrates how birth can unfold very differently from our plans whilst still being positive and empowering. Her ability to adapt, advocate for herself, and trust her body – even whilst battling her “midwife brain” – resulted in a beautiful birth experience.

“I just could not believe that it had happened. I’d done it you know,” she reflects. Her journey from planned homebirth to hospital induction illustrates that positive birth experiences aren’t defined by location or interventions, but by feeling supported, informed, and respected throughout the process.

Now working as a maternal child health nurse whilst continuing casual midwifery work, Ruby has found she can switch off her professional brain and simply be a mum – a gift many healthcare professionals struggle to achieve.