I went to my last yoga class at noon on Thursday 15 August, exactly 40 weeks along, forty years old, with my fourth baby. I always carry long, so I fully expected to come to yoga for at least another week, maybe even two. I have always gone into labor with my water breaking, so I couldn't imagine starting any other way this time. That Thursday evening my husband went out and I fed the children. I had a certain feeling and could do little more than rock on my yoga ball at the dinner table. I was overjoyed when I saw that the mucus plug was coming away, so there was something behind that feeling of mine. I messaged Kristbjörg, my midwife, and tried to get to sleep early. In the night I woke up to go to the bathroom and felt a current through my whole body, out into my fingers and toes, and knew something more was happening. In the morning, as I stirred, I thought: Now maybe my water has broken. I took a deep breath and held on to this last moment of the pregnancy in my mind. I rolled out of bed and yes, the water dripped onto the floor and my husband woke to the drops.

No baby of mine has ever engaged before labor, so I just lay back down in bed and messaged the midwife. I planned to give birth at home, like all the other times. School hadn't started yet, and that Friday was even a staff day at the preschool. That meant the whole family was home and awake. That was a certain kind of pressure. Kristbjörg came and listened to the heartbeat and felt my belly. The baby was not engaged and in an odd position, probably face up. But I made it to the bathroom, amniotic fluid leaked everywhere, and then I lay back down in bed. My four-year-old daughter proudly whispered to me that the pool was set up in the living room.

In all my other births the waves started about 1-2 hours after my water broke, but that didn't happen this time. Instead I spent the day lying on my left side to encourage the baby to turn, and was honestly getting bored. I tried rest, meditation, an oxytocin high with my youngest, nipple stimulation, and the essential oils and herbs the midwife had with her. Nothing happening except water everywhere. At 6 pm all the children went to their grandfather's, and I tried to watch a movie with my husband and we ordered food. Almost at once I felt the first wave come. I ate a few bites and then my husband went out, as I had asked to be alone as much as possible. By then the baby had turned into a better position but was still not engaged. I breathed the ocean breath and welcomed each wave, grateful for every single one. I listened to my Hypnobirthing relaxation and imagined I was inflating my belly like a giant balloon and relaxing down into my pelvic floor. I felt incredibly good. Truly wonderful. By 9 the waves were really strong and I messaged the midwife that she could come now. She had said goodbye in the late afternoon after spending almost the whole day at my home. I heard my husband putting our 4-year-old to sleep. I lay alone in the dark, probably until midnight, with hypnobirthing on repeat, so content and happy. Then I decided that if I was going to get into the pool, it was now. I had noise-cancelling headphones and an eye mask, and my two boys stroked my back in the pool while I kept listening to the relaxation with my eyes closed. After a while the waves changed, and my body began to push on its own. I knew I was fully dilated, because the urge to push wasn't just at the peak of the waves, the whole wave was pushing.

Something was still a little off, because I felt no sensation of a head or pressure down in my pelvis, so I got out of the pool and tried the toilet. Then I met the waves on a mattress on the floor, but rose up and hung from my husband's shoulders and neck during the waves. I tried all kinds of positions, went back to the toilet, but everything stayed the same. Nothing changed. After 3 hours of this I was very tired. I had declined internal exams in advance, and the midwife knew I preferred not to be disturbed. She listened to the little one's heartbeat with a doppler now and then, but otherwise I was alone, working undisturbed with my body, which felt good. But I was very tired and had tried everything I could think of. I was pushing with every wave, but I simply couldn't feel a head in my pelvis, no pressure like I had always felt before. Maybe she was still not engaged. I was becoming fairly sure the baby wouldn't be born unless something changed, and I felt a certain surrender.

Then I told the midwife I was tired. She suggested holding and lifting my belly through a few pushes. She stood behind me, held my belly and lifted while I hung on my husband. We did maybe 3 pushes like that, it was very intense. Then I needed some rest. I sat on the floor leaning my back against the sofa and tried to rest and ease the pushing so I could gather some strength. I deliberately lay reclined like that, because I wanted to keep the baby as close to my spine as possible, so the head would hopefully find the right way and press correctly on the cervix and down into the pelvis.

Next the midwife wanted me to try a deep squat by the door handle. I had to walk a whole 5 m to the nearest door handle and had a few pushes on the way, I walked so slowly! But I felt something had changed now, there was pressure back towards my bottom, and I tried to say so with limited success. I also tried to drink well to keep my energy up. It took me a good while to get into a deep squat with a curve in my spine, but it wasn't nearly as uncomfortable as I had expected. By the door handle there was some bleeding, so Kristbjörg wanted to do an internal exam. I was very happy with that at this point, as I was completely puzzled myself about why there wasn't more progress.

Kristbjörg said she could clearly feel the head and confirmed I was fully dilated, which I believed had happened quite a while before. But the head was a little crooked, and the little one was lying all on the left side of my belly. With pure midwifery artistry, Kristbjörg managed to nudge the head so it lay right and held my belly from the outside so the little one moved to the middle and would hopefully now find the right way out. I was like a turtle stuck on its back and couldn't move at all, and had to ask my husband to simply lift me up, as I didn't want to meet the waves on my back, the most uncomfortable position of all for me. He lifted me to my feet in one go, and I felt the next wave crash over me. Kristbjörg asked what position I wanted, but I couldn't think of anything, and it was so hard to move. So I stood like a Valkyrie through that wave, with my arms around my husband's neck, and the head simply dropped through the pelvis and down onto the perineum. The midwife was so pleased, and so was I, but I would never have imagined I would give birth standing! I was in no way able to change position, so I met the crowning contraction standing too. It felt strange to be standing like that, and it flashed through my mind that this baby would simply tumble onto the wooden floor. I put all my trust in Kristbjörg, who would certainly need to "catch" this baby. Looking back, I find it incredibly remarkable and empowering that I gave birth standing, we can do so much more than we think.

At this point in birth I have learned to relax and go slowly. There's no rush now. Of course you want to finish the birth and hold your baby as soon as possible, but with a little calm at the right moment I have always managed to give birth with an intact perineum, and I intended to do it again. So I think it took 2-3 contractions for the head to come out. I let my body lead. And gravity. Kristbjörg asked if I wanted her to support the perineum, and I just said yes, because then at least I would feel her there and know the baby wouldn't just drop to the floor. The crowning itself is only a few seconds of blind, unshakable faith in your own body and complete surrender. Once the head was out, I felt so strongly as the baby turned inside me so the shoulders could come out with the next contraction. Gravity surely made me feel it so strongly. A very special feeling.

I was so happy when the baby came. Covered in vernix, with a short cord wrapped around the neck. The baby started crying straight away while Kristbjörg, my husband and I held the baby against my thighs, and it took a moment to loosen the cord so I could take the baby in my arms. All my children have been born with the cord around their neck, so I know very well it is completely normal and nothing to worry about. Only 17 minutes had passed since the internal exam.

My eldest boy, 12, had fallen asleep exhausted on the living room floor behind the birth pool (I didn't know he was there), and his dad woke him, laughing, with hands white from vernix, and then the other children were woken and rushed downstairs. It was such a fun moment when the whole family looked at the little one to find out whether it was a little sister or a little brother. A little girl it turned out to be 😉 Our little daughter went straight to the breast. There was hardly any bleeding, but I had strong contractions as my uterus was contracting quickly. The placenta was born 1 hour and 30 minutes later. By then my boys had fallen asleep again, but my 4-year-old daughter watched and got to cut the umbilical cord. It was so wonderful to experience this birth with the whole family, but oh, how tired everyone was after that long night.

So my fourth birth became my longest and most demanding. It would have been even longer if I hadn't had such a skilled and experienced midwife on hand when I wanted her support and help. Still, I'm so grateful to have had that time in dilation alone and undisturbed in bed, and that she didn't disturb me all that time I was hanging on my husband and the mattress. It is so empowering to own your birth.

My twelve-year-old boy, who stayed awake through almost all of it with me, sadly didn't get to witness the birth at the very end as planned. I loved having him with me this time, as he himself had asked again and again. The next day he said to me: Mom, that was an absolutely perfect birth. And he's right.

Rósa Stefánsdóttir, daughter born 17 August 2024