An Icelandic Summer Birth

Photo Credit - Rachel Potter Greenley

Birth Story Shared by Rachel Potter Greenley - January 19, 2023

Growing up, I remember hearing a lot about how awful childbirth was. Not only was I continuously shown the dramatized version of labor and childbirth on TV, but I also grew up hearing my dad say that women walked through the valley of death to bring a child into the world. It was his way of acknowledging what women endured, but it put the idea in my head that it was the pain that caused all of the maternal deaths that occurred during childbirth. I had no clue that there were other complications that would cause a woman to die during the birthing process. As a result I remember having panic attacks in my teens at the thought of eventually giving birth some day. I feared childbirth almost as much as I feared death and I knew that I would definitely want to get all of the pain medications possible.

In an unexpected turn of events I gave birth to my first two children in Dubai. My husband, a foreign service officer, was working at the US consulate there. The medical system was very westernized and I was even able to find an American OBGYN to deliver my first child. It was normal to assume that I would get an epidural and go through what is thought of as a routine birth. Last minute I decided to take a prenatal course with my husband. We snuck it in just in time (I ended up giving birth the day after the course ended). The course was given by a British midwife. I remember she explained that we shouldn’t fear childbirth and that some of us might want to consider an unmedicated birth. One of the reasons she gave for this was that unmedicated mothers in labor are able to stand and move around. This would make it possible for gravity to help bring the baby down through the birthing canal and potentially speed the process along. What really struck me was when she described that if a woman is upright or in any other position then on her back, her tailbone could flair out and create more room for the baby to move through the birthing canal. It was then that I heard that women started laboring on their backs only in recent times and that it was to facilitate the doctor’s comfort and ease. While for the women, laboring on their backs meant they would have added difficulties as they would have to push their baby up and over a tailbone that was held in place by the bed below her.

What this midwife taught me, opened my mind to the idea that an unmedicated birth was actually practical and maybe a great way to consider giving birth. When my water broke the next night I found myself testing out my curiosity and decided that I would labor as long as I could before getting an epidural. My early contractions felt more like Braxton hicks contractions and were easily managed. However, the second I felt my first real contraction, I panicked and immediately asked for an epidural. I had not prepared myself to endure any pain. My curiosity disappeared and I reverted back to the girl who was terrified of the pain associated with birth. When it came time to push, my baby’s heart rate was dropping and the doctor decided to perform an episiotomy and use a vacuum assist to get him out. He arrived healthy and sweet. I, on the other hand, had a bit of a longer road to recovery. The healing of my episiotomy did not go as smoothly as hoped. There was an excess of scar tissue that had to be removed twice (which entails cutting it off and then sealing the scar tissue by burning it with silver nitrate). Yes - it is as painful and uncomfortable as it sounds.To this day I still have hypersensitivity on the scar.

My second birth was also pretty routine for the western system. I was induced a few days early so that we could ensure my mom would be in the country for the birth of my daughter. I was heavily medicated and had a difficult time knowing when my body was telling me to push her out. At one point my doctor started laughing because my daughter’s head would almost crown and then when I would stop pushing she would slide back in. I obviously did not appreciate that she was laughing at my efforts to give birth while the bottom half of my body was completely numb. After 30 minutes of almost crowning, the doctor threatened to “go in and help”. I feared she would give me another episiotomy and pushed with all the strength I could muster and got her out on my next try. I tore and needed stitches that time around as well. Though the wound was not as severe as the last time and recovery was a bit quicker, it was still not fun.

Four years later, we had moved on to another assignment in Iceland and I was pregnant with my third and final child. Iceland has a midwife based system and I was directed to call to set up an appointment with the midwife at my community clinic. I was immediately struck by how differently the midwife model of Iceland approached pregnancy and childbirth. Icelanders view pregnancy as a natural part of life and therefore care is much more relaxed. While they do basic screenings such as fetal heart rates after 12 weeks and the dreaded gestational diabetes glucose test (only if you have a family history of diabetes), the midwives are happy to let things progress naturally. I was only weighed once and even though I was 37 (an age where pregnancy is labelled geriatric and high risk in the United States), I only went in for check ups every other month until I hit 35 weeks.  

In contrast, in Dubai, I was under the over-watchful care of a  doctor (a person who is trained to look for illness and diagnose it). In hindsight it was obvious that doctors were always looking for problems to be solved whether it be my weight, exercise, water intake or other aspects of my body during pregnancy. It was all very stress inducing and I was constantly worried that I was doing something that would negatively affect fetal development. As I would later learn, stress dramatically affects the birthing process. The mental state of the mother can help labor progress naturally and in good time if she is calm and empowered, or it can stall labor if she is under stress. Now that I have experienced both the midwife model and the western, doctor model, I can see clearly that one was the source of stress and anxiety while the other was empowering. In Iceland the fact that they trusted me and my body to perform the natural function of pregnancy and birth, helped me feel strong and capable. Iceland’s approach seems to work too. They are ranked among the   counties with the world’s lowest rates of maternal and infant mortality.  

After my midwife learned that this would be my third child, she suggested that I do an unmedicated birth at a birthing center. My immediate reaction was “no way - I had an epidural with my other two births, I want all the pain killers please!”  She said that would be fine and that I could prepare to give birth at the hospital. However, over the next few weeks the idea of doing an unmedicated birth kept on coming back. As I was not working, I had more than enough time to dive in and do all of the research and prepare myself for the mental endurance I had lacked before. My prenatal yoga teacher leant me the book Ina May’s Guide to Childbirth and after reading the first section of the book, I decided to go for it.

As luck would have it, I was also connected to a wonderful midwife who was able to offer a hypno-birthing course in English for my husband and I. Not only did I learn so much about how my body functions during pregnancy and childbirth, but I also learned how important mental preparation was. With the help of my husband, I was able to practice methods of meditation and breathing to help me stay relaxed as I experienced the contractions of labor. I loved that my husband was able to take a more active role in preparing for the actual birth of our son. When the time came, he was my coach and was there with me every second. It was so much more beautiful and intimate because we had prepared together.

The day of my 39 week check up, I decided to take a bath. I stayed in the bath for a couple of hours and around 11 pm, I started to feel the initial contractions of labor. I was so grateful for the knowledge I had gained throughout the pregnancy. I knew exactly what was happening and how the contractions were helping open my cervix. Armed with knowledge I felt so much more calm and happy to observe my body do what it was built to do. I had a feeling that I could wait a bit before heading to the birthing center. Around 1 am, my husband started timing the contractions. They were about five minutes apart but they did not feel as intense as I had expected. So we waited to call the birthing center. At 2:30 am my water broke. We called the midwife on duty and she said to give her twenty minutes to get to the birthing center and set things up and then head over.

It was a bit surreal to head to the birthing center at 3 am during an Icelandic summer. The sun was up as if it were in the middle of the day, but the city was asleep and there were no cars on the road. We made it to the center in about ten minutes. The facility was small and only had two birthing rooms. I felt fortunate that we had the entire place to ourselves. This added to my comfort, I knew I might be more vocal than I had been with the other births and I didn’t want to have to feel self conscious. In the room there was a bed, a birthing pool and any other tools typically used in an unmedicated birth.

Initially I sat on a big exercise ball and wrapped my arms around my husband as I breathed through the initial contractions. I felt calm and was able to rely on some of the breathing techniques I had learned through my hypnobirthing course. After about 20 minutes the midwife asked if I would like to get in the bath. I said yes and immediately felt soothed once I got in. As pre-transition contractions continued I went back and forth between sitting on my knees and floating on my back. During this time we listened to one of the guided relaxations that I had been practicing with for several months. My husband sat on the exercise ball next to the tub and held my hand. As we listened to some of the birthing affirmations, I started to transition and the contractions became more intense in my lower back. At this point I only felt comfortable on my knees, leaning against the side of the pool and holding my husband’s hand. As the transition contractions started to get into a rhythm I was able to tell my husband to count up to thirty and then back down. If I could breathe through to thirty, I knew the worst of the pain was over. The midwife was very helpful and messaged my lower back during each of the contractions. It didn’t stop the pain but did offer some relief. I remember reading in Ina May’s book that if I tried to do a low moan while doing my “J Breathing”, it could help the transition go more quickly. So that is what I did. I must say that I was a bit shocked at the sounds that came out of me. I did not know I was capable of making such noises. The best way I can describe it is that the transition contractions were using the expulsive reflex, similar (but on a much bigger scale) to the reflex you have when you vomit during food poisoning. My body was just working on expelling a baby on the other end. I would be moaning and J Breathing through the contraction and then all of a sudden the expulsion reflex would kick in and I sounded like an alley cat.

I had to laugh. I feel like I should create a “Expectation vs reality meme”. I had pictured myself breathing in a zen state through my final contractions and bringing my child into a peaceful and quiet world. That did not end up being the case. Thankfully, my hypnobirthing teacher was able to help me reframe the loud moans I was making as my battle cry.  

Towards the end of the transition phase I was on my hands and my knees and my arms were shaking and about to give out. During a pause in contractions, my midwife did a fetal heart rate check and said that my son’s heart rate was going down and that I should probably get out of the tub and onto the bed so that they could monitor him easily. From there I had a few more contractions to push him through the birth canal. It was such a different experience feeling his body move through mine and knowing that he was now mostly out of the womb and in the birthing canal. At this point there was a bit more pain and pressure (I may have shouted ‘is his head out yet?!?!? Get him out! Get him out!). I pushed once to get him to crown and one more time to get his shoulders out. From there he slid out and his birth was marked at 6:48 am, just four hours and 18 minutes after my water broke. We later found out that the umbilical cord was around his neck but fortunately did not cause him harm.

The first image I have of my little Leif was a calm little person with his eyes open but not crying. We did not cut the umbilical cord for a few minutes to ensure that all the excess blood in the placenta was passed to him. After I delivered the placenta, my midwife showed me the intricate maze of veins forking off of the umbilical chord. “They call it the tree of life” she said. It was beautiful. As a person who loves nature and particularly trees, this only added to the sacredness of the experience of building and delivering another human.

His coloring was a bit pale and the midwives explained that my labor and delivery had happened so quickly that he was not able to get all of the amniotic fluid out of his lungs before entering the world. This meant that he was panting and unable to nurse. After about thirty minutes of observation, my midwives were worried that he may need help clearing his lungs. So they called an ambulance and sent us to the hospital. Fortunately, our little man was able to clear his own lungs after a few hours and we were able to go home a few hours later without any interventions taken.

My recovery from pregnancy and labor was significantly quicker the third time around. I was up and walking the next morning, for which I was grateful. Another lovely aspect of the Icelandic midwife system was that the midwife who helped deliver my baby came to do checkups for us both in our home. She came around six times in the first two weeks. I didn’t have to worry about leaving the house to go to a doctor appointment. It was also lovely to talk through the labor with the woman who was there helping. I knew we were in good hands and that she was ensuring that the baby was breastfeeding and gaining weight as he should, that I was healing as I should and that I was not suffering from postpartum depression.

I am immensely grateful that I was able to have the experience that I did. I wholeheartedly recommend that anyone hoping to conceive soon or is currently pregnant to read books such as Ina May’s Guide to Childbirth and other guidebooks on meditative birthing. Arming yourselves with a thorough knowledge of what your body is going through and what options are, will help you feel empowered and ultimately help you make the right decisions for you when creating your birth plan.

Birthing another human truly is miraculous but not easy. Preparation through study and mental training will go far in giving you the mental fortitude to not fear  but surrender to the pain that comes with labor. As I learned to step into the power of my female body, I gained a deeper love and trust in it. As my midwife helped me see, I was empowered and ready to face what my dad would call ‘ the valley of death’ without fear and be ready to breathe through it with calmness, confidence and with my battle cry.

Rachel Potter Greenley lives in Reykjavík, Iceland and is the mother of 3 children. She is well traveled, well read, and loves adventures.

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Sarah Ziroll

Sarah Ziroll