Life and birth with HIV.

By Melinda Susanto
Sep 2015

The diagnosis and life before children

I’m Melinda; a wife, a mother of two beautiful and perfect young children, and I also happen to be living with the HIV virus.

In 2006 I was living in Indonesia, in Jogjakarta (Java), when the city was struck by a devastating earthquake. My Javanese partner Dali and I were unfortunately right in the middle of it, and after helping as much as I could manage, as well as contracting dengue fever and being hospitalised soon after, the trauma and emotions I was experiencing were reason enough for me to come home to New Zealand for a short time where I could be near my family and begin the recovery process. Whilst in New Zealand, I wanted to make the most of the healthcare system, as I knew that when I returned to Jogja I wouldn’t have the same options. I said to the GP “I want a full check-up please, test me for everything, tick every box.”  To which he responded, “Even HIV”? “Yes” I said, “Do it all,” unaware of what HIV really was.

My phone rang a couple of hours later, a nurse on the other end tells me that I need to get back to the office asap. With my body, riddled with fear and anxiety about what could be wrong, and my Mum reassuring me that everything would be fine and that it was probably just low iron, we returned to the health centre. “I’m afraid one of your tests has come back positive” said the doctor, pausing for a very brief moment, “You have HIV.”  This was followed by “I don’t know” answers to all of my questions including whether I would die soon, whether I could have a family, and what did it all mean…” You will have to wait until you see the specialist in two more weeks.”  The longest two weeks of my life!

During this time, I spent a lot of time ‘googling’ for information, much of it incorrect which I now know. I found a lot of alternative therapies, thinking I could cure myself and so that I wouldn’t die young after all, if that was going to be the case. I also made the very difficult phone call to Dali, telling him the bad news and asking him to get an HIV test ASAP. I was almost certain he would leave me, but he did not, and he was very supportive. He got tested straight away. A very scary wait, turned into a very happy outcome when his test came back negative! Unprotected sex, one time, is all it takes to contract HIV from an infected person, and thanks to the universe I had not given it to him, he had not given it to me, and he did not have the burden of carrying this virus for the rest of his life. But where had I contracted HIV from? That was the constant thought in my head that kept me awake at night.

Finally, the specialist appointment day had arrived! I learned I could still live a long and productive life, one day I would need medications and I would be on them permanently but right now the virus was still in small numbers in my body so didn’t need it yet; I could have a family, and with the virus under control (meds making the virus undetectable when viral load is tested through blood tests- in NZ, less than 50 copies of virus per millilitre of blood, when it actually gets up in the thousands and millions without meds) with medications, my babies would have a less than 1% chance of contracting HIV – there are many other illnesses and disabilities that have a much higher risk factor than that! HIV is in breast milk so I couldn’t breastfeed (although advised that in developing countries where the alternative of using unsanitary equipment and dirty water to formula feed causing serious health risks, greatly outweighed the risks of passing on HIV through breast milk); and finally we discussed where I had contracted HIV from…to which he finally put it in the ‘unknown’ category.

So where did I contract it? I put it down to one of several options, one being my ex-partner in Bali who had told me after the breakup that he had used heroin before, intravenously! That’s high risk right there as through needle sharing the virus is passed on easily sending the infected blood directly into the blood stream of the other. Option two, had I contracted it from getting a tattoo whilst living in Indonesia? Possible but less likely, especially since the virus dies quickly once leaving the body, and any tattoos I had were always using new needles. Option three, while in hospital on the drip following the earthquake, was the needle sterile, was it new? My head was full of information, of crazy thoughts and anxieties, it was not easy not knowing, but I got on with it.

I returned to Indonesia with a suitcase full of supplements and other alternative health products and therapies, ready to continue life as I used to. It was a relief to be in Dali’s arms again, but challenging being in the same place where I had seen so much heartbreak and devastation only 6 weeks earlier. I returned to work (teaching English as a second language) and tried to continue with life as usual. It wasn’t easy. We eventually relocated to New Zealand. Life went on, although I was still going through the grieving process…. on several occasions I became very depressed. Fortunately, I met another woman living with HIV, and from there I learned of an organisation called Positive Women Inc., who exist for the purpose of supporting women living with HIV and their families, and for education and helping to break the stigma around HIV. They helped me through the hard times and have supported me until this very day. I don’t know what I would have done without them.

One holiday back to Jogja, Dali and I got married…although quite spontaneous (Just a fortnight before going back to NZ), it was a beautiful and traditional Javanese wedding. It took us four years after our marriage to finally come to the decision that we would have children. We wanted kids so badly, more than anything but for me I couldn’t get the ‘what ifs’ out of my head even though I knew it would be fine. At that time there had been over four hundred children born to HIV positive mothers in New Zealand while on the highly successful medication regime for pregnancy, with the mothers having an undetectable virus (well under 50 copies of virus per millilitre of blood), and not one had contracted HIV.  I was more concerned about the lack of studies done on the effects of the medications on children since they are exposed to them in the womb, however any children of Mummies living with HIV I knew seemed perfectly fine and gorgeous to me, just like any other happy families. We wanted to have a family like anyone else and decided there was no reason why not. I let go of the buts and ifs, and we conceived via artificial insemination, using a plastic syringe! My virus was undetectable, as I was on medications at that point, so the chances of passing it on to Dali was around 1 in 10,000, however I just didn’t want to take the chance and the hospital had advised we do it with a syringe.

My First Pregnancy and Hospital Birth

To know how huge my positive experiences are, it is important to tell you about the not so great ones too, so please bear with me while I tell this first pregnancy and birthing journey.

In my pre pregnancy appointment I was told I had to give birth in a hospital, and reminded of the no breastfeeding rule, and advised that formula feeding was the only option. Immediately I was under secondary care in the hospital, where I had no choices around who my midwife was, and I was to have different midwives throughout my pregnancy as there was no guarantee the same midwife I saw the previous appointment would be available. Just to be fair, the midwife I saw the most did try to schedule my appointments so I could see her, but that didn’t always happen.

Although I was a healthy pregnant woman, I had to have regular scans (I’m not sure quite what they were looking for!), obstetrician appointments, and midwife appointments. At one point a registrar almost fell over backwards when she learned that the pregnancy was planned, as she presumed I had been diagnosed during pregnancy through antenatal screening. I was monitored constantly for weight and asked about my eating habits on a regular basis even though I repeated numerous times that I had the healthiest diet ever and that I cared greatly about the health of my child. I also did a lot of walking! It was almost like they were expecting something to be wrong, because of course I had the big HIV, and I was pregnant! It was my first pregnancy, and I learnt to search ‘outwards’ for information about my baby…I looked up to everyone else who were in charge of my pregnancy, to a degree it felt like I didn’t own it, they did. One thing I did own was the HIVand I had to educate health professionals on several occasions; it was tiring but I had to do it, and it was something I did feel empowered to do and could do with the knowledge I had.

At around 30 weeks pregnant, the combination of the medications I was on, and pregnancy itself, caused one liver enzyme to elevate (ALT), which they labelled as a hepatic reaction. There was nothing else wrong and I had no other symptoms, but baby and I were in for daily monitoring and I, daily blood tests. One training nurse put double gloves on and took half an hour to take blood from me because she was shaking so much. I had to tell her that my virus was undetectable, and I questioned her about the double gloves! How are double gloves going to protect someone from an accidental needle incident, and what if the person didn’t know they had HIV…did she use double gloves and shake for every test?

I was informed that if the ALT didn’t stop elevating, then baby would be born via C-section early and be in SCBU. One weekend, an obstetrician who had flown in from Christchurch and was just on temporarily came to see me. Since he was not my regular obstetrician, and had obviously had no training around HIV, he came across as very unsure about the whole thing. “So…you have HIV…hmmmm…this case blah blah.”  Unbelievably he proceeded to say, and I quote, “Well, for your sake and for mine, let’s hope I don’t have to do it”! Having a possible C-section just around the corner was scary enough, but the chance of an incompetent and ill-educated obstetrician cutting open my body and taking my baby out scared the crap out of me! I had nightmares of him coming in with a big knife with some kind of music from a horror movie playing in the background! While in the room each day I could also constantly hear my name being said aloud and ‘HIV Positive’ up and down the corridor outside and behind the desk…you may be able to imagine how I felt being a pregnant woman in a small town, with a sensitive health issue, and having my confidentiality compromised. Luckily, I had experience in being public about my status as I shared my story on several occasions to groups and some media, so I knew what to expect.

Monday came. Thank you universe! My liver had improved, and I was back seeing my regular obstetrician. She informed me that he (the locum obstetrician) had called her over the weekend in a bit of a panic, and she had told him to get a grip and if he had to do the C-section to treat me like any other women….no difference! I was now able to have a vaginal birth, in the hospital, and the pregnancy was to continue as usual. For some reason I still had to have constant scans of all sorts, not to mention more and more regular hospital midwife and obstetrician appointments. After the C-section scare, I decided to get my birth plan sorted and following antenatal classes I decided I wanted to have a waterbirth and have a drug free birth. My obstetrician agreed that even though she didn’t agree with waterbirths herself, I could safely have one if that’s what I wanted. Finally, I had some choice, some control.

When the first contraction came (on the due date!), as instructed, I was straight on the phone to call a taxi. I was told to go in immediately, at the first sign of labour. Dali and I didn’t have a car at that point and my Mum had gone to do some training for her new job as we’d decided that babies don’t come on due dates and she would be back in plenty of time! We arrived at the hospital, and I was so pleased to have a room with a birthing pool! But wait, I couldn’t birth in the pool? The nurse on said that because I would be given an AZT drug intravenously (as a precautionary measure to reduce risk of transmission even further), then there was a risk of electric shock if I was in the water. I was gutted. There was no space in my mind to make it an issue and I proceeded with the labour, in the most uncomfortable environment- hard floors, no cushions, plastic bed, and to the sound of other birthing screams and ‘AAAHHHH’s’ – and all with a drip my arm which continuously slipped to squirt out blood across me and the floor.

Through the entire birth I was visited by countless unfamiliar faces, both midwives and doctors, and whatever else you call them. Why? I don’t know! What I do know is that when I became comfortable with one midwife, her shift was over and in came another! After 10 or so hours I was so stressed and in so much pain because of being so stressed (VS normal birthing sensations, pain, whatever you want to call it, but in a more relaxed state and comfortable space around people you choose to birth around), I demanded an epidural…I didn’t care anymore, I just wanted to hold my baby.  I birthed on my back, among strange faces, with hands doing this and that to me (a man had pumped my tummy for a long time and very hard to loosen the clots. The pain was unbearable). My beautiful baby boy was placed on my tummy, and he made his way up to find my breast. That was the hardest part, denying this to him, his birth right, but I was just so happy to have my angel in my arms…and I was never going to let him go. Teposeliro, or simply Liro, so precious and perfect.

After two nights in hospital, and being given the milk blocker medication, we took our sweet, strong, and extremely inquisitive little boy home. And of course, over the first few weeks there were numerous community midwives visiting us, all giving slightly different and sometimes conflicting advice about how to take care of a baby, when to feed, not feed, and so on. It was quite invasive of my space, and Liro’s, and very confusing hearing so much conflicting information and even personal opinions and advice. Again, like during pregnancy, I felt my natural maternal instincts and motherly abilities were taken away from me and invaded. Being a first time Mum, it was far too easy to listen to everyone else, but even more so in the predicament we were all in and what we had been throughI would also often get “I hear you had a natural birth, well done!”  To which I would reply following a long pause, “ummm, yes, I had a vaginal birth, but I had an epidural.”  It didn’t feel right saying I had a natural birth (even though my understanding at the time was that it was quite a normal experience), and I now know it was far from ‘natural’ for many reasons, so no wonder I always felt uncomfortable hearing that!

Once we were through a three day supply of donated breastmilk from a lovely woman, Liro went straight onto formula, as we were told to do. I was uninformed about there being other options, or that breast milk could be donated for long term feeding, or even about the full benefits of breastmilk. However, towards the end of the pregnancy after one of the midwives kept accidentally forgetting I wasn’t breastfeeding and talking about all the benefits, we got on to the conversation about the possibility of finding some milk from another Mum. It was all new to me, but that was all the hospital could do…the policy didn’t allow for assisting families to source donor milk. Fortunately, I was given a piece of paper with a number on it andwas told “It’s up to you to contact this person, but we can’t assist any further“.This is how we were able to source 3 days’ worth of milk, including some colostrum. As I became more educated about donor milk over the following year or two, I was able to give him more small amounts here and there but didn’t realise I could actively search for it. His main source of nutrition before solids came from commercial formula.

As I had already known, Liro was going to need several blood tests over the first year or so of his life, just until he was no longer carrying my antibodies and therefore get an all clear test result. He had to have twice the number of blood tests that he was meant to have, all due to error. Not enough blood taken, lost blood, missed courier, etc. [arrghhhh!]  It was heart breaking putting him through one test, let alone many more and unnecessarily too! Over the first 6 weeks he also needed to have an AZT syrup for babies, every 12 hours again as an extra precaution. It wasn’t nice, but we knew that would be part of the journey of having children for us.

Making Informed Choices and My Home Birth.

I think it’s pretty obvious how this whole experience of pregnancy and birth, and even the weeks after made me feel, as a new mother. I made the decision that when we decided to have another child, this would not happen again. The next time it would be my choice; just as it’s my body, my birth, and my baby. I was thankful to be surrounded by so many wonderful gentle parents, who believed in breastfeeding and knew of the benefits of breastmilk, who strived to always be informed about natural birth and home birth. Some of these friends were aware that I was HIV positive and were understanding of my situation. I didn’t want to be different to other women when it came to having birthing choices and having choices around feeding my baby. This got me thinking…am I really different (besides the fact that we all are!)? My virus is undetectable, I can have healthy HIV negative children with a less than 1% chance of transmission, why can’t I have a homebirth? Why am I put into the ‘high risk’ category, automatically, with no choice?

I talked to as many people as I could who I knew had a lot of knowledge or had contacts they could discuss this possibility with. This included Jane Bruning, a friend, and the National Coordinator from Positive Women Inc. One of their roles, is to ‘support’ women living with HIV and their families. The feedback I got was generally positive, although it was all a bit new for everyone and it wasn’t something they knew of as happening before for any HIV positive women in New Zealand. Jane said to me that I would first need to find a midwife who would support my homebirth, and as I already knew, this could be a little difficult especially since HIV is quite misunderstood and many are uneducated fully about HIV here. OK, step one. Step two, tell my specialist. His first reaction was a little unsupportive and he said, “You would have to be Michael Jackson to do something like that!” I questioned this and he was basically saying that to have the intravenous drip in my home was going to cost at least $10,000, and he also said he didn’t think midwives were able to administer it. Lucky, because I was informed, I now knew that this AZT drug through the drip was no longer a requirement as New Zealand was finally following the lead of other leading countries in the treatment of pregnant HIV positive women. After some looking into it, he agreed that I didn’t need it, and I could go ahead with whatever…he knew I was a determined mama who was going to do what I wanted anyway! Ok, that box was ticked!

I spoke to some friends about midwives in the area who support homebirths and wanted to know if the ones they recommended would be likely to support my decision to have a homebirth being HIV positive. “If anyone is going to support you, it would be Julie Kinloch,’ a friend said. I was on the phone to her straight away, and as usual (from experience) I was all ready for either some confrontation or some serious question answering, educating. Instead, I got “You’re HIV positive, that’s fine, I don’t see that as being an issue and I am happy to support you for a homebirth,” followed by “call me back when you are pregnant, and we’ll go from there.”  Wow! Can you imagine how I felt??  Do you know what I did when I got off the phone? I jumped around like a crazy lady in front of Liro, who thought it was hilarious, and I got straight on the phone to Dali. I was over the moon!

When the time was right, when Liro was around one and a half, we began to try for a baby, naturally. Yes, no artificial insemination this time! After all, me having an undetectable viral load meant that Dali had a one in ten thousand chance of contracting HIV from me. It happened, I became pregnant soon after! I was in control this pregnancy, I owned it, it was mine. Julie respected all my decisions, including staying away from the hospital unless there was an important reason to go there. She supported my choice to have little or no scans too, and she also supported everything I wrote in my birthing plan, even if it was quite detailed and specific! She did everything she could to ensure that my pregnancy and birthing experience was better than the first…she gave me back my evolutionary rights as a pregnant woman. I only ended up needing a scan or two, and even though I was disappointed, it was my choice and compared to the last pregnancy it made a massive difference to my emotional wellbeing and pregnancy stress levels having that choice. Julie visited me at home since I didn’t have the means to go to Napier to see her. I didn’t step foot in the hospital for obstetrician appointments or anything else for the entire pregnancy, except for my half yearly specialist appointment. Julie attended this one with me, and we were quite ready to stand up for my choice to homebirth, but my specialist knew I was going to do what I wanted to do, and he respected that and supported us.

My diet was another thing that was vastly different from the first pregnancy. I had nobody breathing down my neck telling me what to eat and what not to eat (even though my first pregnancy consisted of a lot of organic foods, extremely minimal of what some would class as ‘unhealthy foods,’ no takeaways, and nothing on the ‘do not eat if you are pregnant list’). Because this pregnancy was so relaxed, I was able to look inwards and listen to my body. If I needed a certain kind of food, I would eat it, to a certain degree. I still preferred to eat organic and not have takeaways, however I wasn’t strict about this, and I did have takeaways sometimes, and I also had a cake or two when my body asked for it.

The journey was life changing, due to the nature of the pregnancy – calm, undisturbed, relaxed; no words can really explain it, I went into a deep spiritual place within myself. I suppose you could say I rediscovered my spiritual self. I felt so connected to the universe, and I felt the presence of angels most days. Coincidences began to happen more often, and I was living in a very high vibration. When I asked, I was able to influence the events and outcomes of each day. I was also able to protect myself from negative influences, simply by circling myself in a protective light or bubble, but also by, to a certain degree, avoiding the things that were likely to take me away from my sacred space such as Facebook, and others bad experiences and anti-homebirth talk. I felt so awakened, and I know why. Everything spiritual was there in the first pregnancy but everything that happened was so ‘loud,’ invasive, and I didn’t believe in myself but rather looked up to others. It was like I was not the pregnant women doing the work, but ‘they were.’  So, I was so distracted from all of this that I couldn’t hear, see, or feel it. I had faith in the higher beings that surrounded me and baby, and I left the rest up to them. My body would do the work, and they would guide me and my body to do whatever it needed to do. I wasn’t stressed. I was in another non-physical world, though I still carried on being Mum to Liro and being wife to Dali…perhaps a little spaced out!

My cravings were not food! I became obsessed with crystals, and by the end of the pregnancy, the entire house was surrounded by them. All kinds, shapes, and sizes, they were beautiful and made my birthing space feel lovely and positive. They filled our home with the most amazing energies, and helped me to feel connected and content, even if it was only me who felt it. Even though while having all these amazing feelings and experiences I wasn’t able to fully communicate with my baby, the presence I felt may well have been her. She was my crystal child.

After learning all ‘the facts’ in antenatal class in the first pregnancy, which didn’t really help with the labour and birth itself, I found the perfect alternative for this one. I did a class with Diane Reefman which was all about going inwards to yourself and grounding yourself throughout labour and birth, as well as practical tips on helpful breathing exercises, positions for labour and birth, and natural alternative pain relief options. It was full of exercises both for me to use, and for me and Dali to use in partnership as needed during the labour. It was wonderful feeling empowered to be able to birth my baby myself without the need for any interventions. My body was made to birth! I could do this! This class fit well with the spiritual journey I was going through, as I was able to feel and breathe the presence of my guides and connect with my higher self throughout the grounding exercises each class and outside of class when practising.

I read the book ‘hypnobirthing’ and surrounded myself with the affirmations from the book. I made large copies and hung them on the walls, in every room of the house. I then began to prepare my birthing space. I purchased three large Himalayan salt lamps, and an aromatherapy diffuser that also had changing lights…it all added to my calm and peaceful pregnancy, and nothing was going to compromise my need to have the pregnancy I wanted, unless it was out of my control. I re-arranged the lounge and made a little corner for myself where I could have privacy if needed, although I knew I could end up birthing anywhere, and I remained open to that and OK with that. I knew I wanted the cord to be tied, and I wanted delayed cord cutting too. I wanted to learn the sex myself, and not have someone telling me first. I wanted to be given the chance to just listen to my body and have my primitive birthing sounds and actions allowed to take place naturally, without being given instructions like ‘push’ during the birth, to be free to do what I liked birthing my child…as my evolutionary right as a woman. I also wanted Liro, Dali and my Mum to all be a part of it. I didn’t want Liro to see me with another baby in my arms only for him to wonder where on earth she came from, or how she came out, when it happened, and why didn’t he see too? I wanted him to see for himself, and be supported through this experience, to welcome his sister (or brother) into the world together as a family. The plan was for my Mum to be there to guide him away from the situation if that was needed, if he was too upset or traumatised by it, or of something went wrong. Most importantly, I wanted to use my intuition at all times, and follow it, as I was doing throughout my pregnancy.

During the final two months of pregnancy, I was going to have to make a final decision about feeding my baby. The decision was by far from easy, or simple. I had spent many days, months even, spinning options around in circles in my head. I did the research, and weighed everything up…advantages of this, disadvantages of that…and do you know what the hardest part was? Having to go against my natural maternal instincts to breastfeed. Had I considered it? Of course, but there was still a chance of transmitting the virus to baby. I learned I could have a very low risk of something like 1.2 % of passing it to baby if I were to exclusively breastfeed my own milk to baby (because my viral load was undetectable while on meds), no mixed feeding, but what if for some reason I couldn’t complete the full 6 months? These what-ifs really are a challenge in life right? ‘What if…when crossing a road??,’ I just couldn’t bear the thought of anything happening. Formula feeding was out of the question, I knew this wasn’t a healthy choice, and I would only do this again if it was THE ONLY option. I searched and I searched for information, studies, and the like, and I was disappointed to find very little information besides the Ministry of Health’s recommendations, and the recommendations for women in developing countries.

I couldn’t find anything I needed, until I stumbled across a presentation on the Positive Women Inc website from last year’s annual HIV seminar, by a lactation consultant in Wellington. On it, I found not a lot of detail, but some simple facts about ‘flash heating,’ and then I found a video on the Eats on Feet’s website. By flash heating milk from an HIV positive mother, the HIV could be killed, and many of the beneficial bacteria could remain, unlike pasteurisation. That’s what I’ll do, I decided! I will express my milk, flash heat it, then give it to baby! Hang on, that sounds like a lot of work when I have two young ones to care for…what will I do after that? Donor milk – I decided I would express and flash heat as much as I could, but I wouldn’t put pressure on myself, and as long as I had been able to achieve my goal of providing both children with at least one feed, then that was ok…then I would feed her donor milk. I started collecting milk, without mentioning that I was HIV positive (the stigma and lack of understanding about HIV is that huge), but that I had a medical condition and breastfeeding wasn’t advised. Never did I tell anyone about expressing then flash heating as then things would have become complicated and then questions would have started coming. I had an amazing response, from generous and selfless women from all around New Zealand. The response was overwhelming, and no longer did we need to worry about the first months of feeding.

I was prepared for the birth, but I wasn’t prepared. I know that sounds strange, but I was so relaxed, and spaced out that although ‘things’ were all organised, I wasn’t mentally prepared. I was focussing on being calm and content, and just letting whatever happened happen…whenever that may have been. For all I knew it could have been two weeks after the so called ‘due date,’ so I didn’t want to get in a panic about ‘when’ it was going to happen, so I let it be. I also very much doubted it would be on the due date, since Liro had come on his…I mean what were the chances of that

While in the bath on the evening of December 15th, 2014, the due date, the first surge went through my body. I wasn’t certain at the time because it could have been Braxton Hicks, so I just kept quiet and kept on enjoying my moment. The surges quickly became more frequent and just walking down the hallway became somewhat a challenge, so I quietly said to Dali who was asleep next to Liro, “Don’t make a deal, but I’m having surges.”  He did answer me but since I had said not to make a deal, he drifted off to sleep again! By this time, I was leaning on the kitchen bench and the surges were extremely intense and getting closer together fast. I managed to wake Dali, then I text Mum to say, ‘don’t rush but I’m pretty sure I’m in labour.’ I phoned Julie who said to call when the contractions were 2-3 minutes apart, which they almost were, and it wasn’t long before I was straight back on the phone to her! It was all very casual, and I was slightly in shock that I was having another baby and fast too! Mum arrived and was quite surprised to see how far on I was, because I had said not to rush and come when ready, but she had come as fast as she could anyway.

The empty birthing pool was in the lounge with Mum and Dali frantically trying to fill it up and care for Liro who was at once excited yet quite tired after being woken by all the commotion late at night. And me, after finally making it from the kitchen bench to the carpet right next to me over a waterproof picnic mat (I couldn’t go any further), doing my ‘AHHHHHH’s’ in as I relaxed but as naturally toned as my mind would allow…I tried to remember the things I had learnt in Diane’s classes and I kept re-grounding myself so I could allow my body to take over, rather than my mind.  Liro knew the ‘AHH’ sound as he had heard me practicing and seen a couple of nice home birthing videos. While my primitive sounds kicked in, I could hear Liro’s sweet little sound of laughter as he copied my noises.

Dali was in a bit of a panic now while trying to fill the pool, but also trying to rush back to support me through each surge as well, managed to fill a bucket of hot water and do some hot stone and oil compressions on my back…it was such a lovely feeling of relief, for a moment, with the hot gentle pressure on my back and the aroma of a pregnancy oil blend filling the air.  On other occasions, as he rubbed my back, I could feel his stress…and asked him to please rub softly just as I could feel another one beginning. As each surge came to an end, Mum, and sometimes Liro would hand me a drink through a straw, although on several occasions I remember it being shoved in my mouth when surges were at their peak (and it wasn’t my Mum!). I had time to gently say “thanks for helping Mummy” in between, and on the next breath reminded him to give me space when I was making noise! Shortly afterwards, I had to slip in a “forget the pool” when I had the chance, “just be with me” after the following surge, and a “I need you here, the head’s coming out” after the one following that. It’s a little funny looking back, as the water pressure was so slow, I’m not sure it would have filled up in a week! Finally, I had Dali with me, and he was able to forget the pool on focus on the birth and gentle massage and back rubs on me, and to his surprise (although I had already mentioned it!) he said excitedly “I can see the head!!”

I could feel the pressure of baby’s head starting to push its way through, and it was then that I remembered the string going from my head straight up to my angels/guides who were holding it…holding my body in the right posture, grounding me, as we had practiced in Di’s class. With each short break I would remind myself to loosen my jaw, relax my body, and stay focused. Julie arrived andwas perhaps also a little surprised about how far along I was, and she sat behind Dali and supported him to support me and baby. Her head would push out a little, then pop back in again…push out, and pop back in, and so on. My body and my baby were doing the work, not me…I wasn’t forcing myself to push, I was listening to my body the whole time. I reached down and I felt her tiny head, so moist and warm and I could feel hair…I was touching my baby for the first time! She came out a little further each time and I was slowly opening up, allowing her to come into the world at her own pace, and mine. The feeling was incredible, and even though I had given birth before, I had not experienced this before. It felt so natural. My body was really doing it, I was trusting and allowing it to do it with no interference.

Each time her head would emerge, I wondered if this would be it, but then she would slip back in again. Even though I was in another world, a place that felt far way, I could hear Dali say, ‘she’s coming…Oh no…, she’s gone back in’…’Here she’s comes again, oh…nope.’  I could feel Liro next to me, while on my hands and knees, he was quiet and would every so often ask ‘where is the baby?’ that was until my body made a final push. At twenty past midnight, out she came, like jelly – an amazing feeling that words cannot explain…it was powerful, emotional, surreal; and in that beautiful moment, Liro quite clearly says “look, poop coming out.” Liro had been there watching every moment of the birth and he only felt the need to inform everyone about that particular part. Everyone laughed, and although I wanted to as well, I could only think about baby and wanted to make sure Dali was catching her in his arms safely. I could hear Julie gently instructing Dali to turn her around so that the cord would come untangled from her neck, but it wasn’t around her neck fully, and all was well. Dali, with baby in arms (not that I could see anything) was unsure quite what to do now, and Julie softly told him to hand me the baby through my legs. I reached down and pulled her as high as the cord would allow, and just knelt there, exhausted, overwhelmed, happy, and ecstatic, for probably longer than I realised. She was so mellow and content, and hardly made a sound. I hadn’t experienced the full sensation of birthing a placenta before, and I only remembered it was still to come out just before my body worked it out by itself, and it just slid out with ease and so fast, another amazing and ‘so natural’ feeling.

After the cord being cut by Dali and then tied with flax closer to her body, we sat on the sofa, me with a blanket draped over, while holding our precious daughter, Sasikirana (Kirana for short). She was so calm, content, and quiet. It was just so magical having her in my arms after such an amazing pregnancy experience; seeing her and feeling her warmth, after the spiritual experience I had had during the pregnancy. I could not stop gazing into the eyes of my beautiful daughter. Liro sat beside us and wanted to hold her too at which point she thought it would be a nice greeting to poop all over him. He wasn’t too happy about that, and he spoke about it for weeks afterwards. “Kirana come out Mummy’s tummy, and poop too”! To this day he still re-enacts babies coming out from tummies, so I guess I never have to explain where babies come from to him, besides the “How do you…?”

Dali prepared Kirana’s first feed of colostrum, and I held her close, as if I were breastfeeding. I fed her while she gazed up into my eyes, and mine hers, and I longed to breastfeed her so badly, but I knew I had made the best choice for her and I…and the overwhelming intention of love from all around New Zealand coming from Mums donating milk to her was beyond amazing, and it was enough. When I began to express my own milk, and flash heat it, it lasted only two weeks before I gave up. My time was taken away from Liro and Kirana, and I became stressed and exhausted. I had to make the choice, and I had already decided that so long as both Kirana and Liro had been given a feed of MY OWN, then that was adequate, and I would be happy and OK with that. And they did, they both tried my milk, I was able to give them some of my milk!!  It was amazing. Please never ever take breastfeeding for granted.

The birthing pool didn’t completely go to waste, I was able to make use of it to wash my body while Julie and Dali cleaned and dressed Kirana on the floor beside me. I had not one tear. I put this down to not being forced into pushing when my body wasn’t ready, but I remember huge clumps of clotted blood slipping out. Such a strange feeling. After a little gentle help from Julie, it came out by itself, even a day later. Julie was able to pick up the low dose AZT medication from the hospital and drop it off to us. Kirana had the syrup for four weeks this time whereas it was only for six with Liro, things change fast! Julie also went out of her way to write on the back of Kirana’s blood test forms to ensure there would be no mistakes and repeat blood tests this time, which was really helpful, however, her very first bloods were rejected once they reached Auckland because her details stated she was the ‘baby of Melinda…’ rather than her actual name.  You just can’t win. Thankfully Kirana didn’t seem so disturbed by blood tests, and remained calm and content, so we all just did what we had to do. Over the first few weeks, Julie would visit weekly to see how everything was, and came into our home just as family would…it was very casual and comfortable. It was lovely having a familiar face, and not a series of different and unknown ones.

So as of today, our girl is now eight months, and our boy, now three years…these two smiling happy little children with no HIV in their bodies whatsoever; Kirana still on donor breastmilk (it was all donor milk up until 7 1/2 months!) and a homemade formula as backup for when we are low on breastmilk, and Liro still enjoying his bottle of anything but breastmilk (he turns his nose up at it!).    Both children fulfil my life and make my world go around. To think it took four years to choose to have a family, now, if I could turn back time, I wouldn’t have hesitated. And that’s my story, a long one, but without the full picture you would not see how powerful my second pregnancy and homebirth really was for me…how life changing both were. I wouldn’t change a thing about either pregnancy because we live and learn from all experiences, and I value mine and each has its purpose. I have no regrets.

We are not a mainstream family, so we are different in that respect, but besides that we are just like most other families living their lives and bringing up their children. My virus is invisible so nobody would know unless I told them. Living with HIV does not mean that any person (or family) should have little or no choice, as I had to learn for myself. In fact, we all have a choice of some kind, wherever you choose to birth, but if we don’t stand up and claim it for it ourselves or research it ourselves and make informed choices, then we are often left to be led by others. If you trust your maternal instincts, gut feelings, and listen to your body, you can’t go wrong.

Melinda and her family

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