A GentleBirth – however and wherever it happens

As my baby boy was due just before the legendary Ina May Gaskin’s appearance at the Home Birth Association conference in 2012, I was hoping he would be four or more days late.  My daughter was born 6 days after her EDD, so I fully expected to reach 41 weeks or so of pregnancy.  Although her birth had been a positive and empowering experience in hospital, helped by using the GentleBirth programme, I knew I wanted a home birth next time. I had found the transfer to hospital the most difficult part of the whole thing, particularly the admissions process.

When I found out I was pregnant again, I rang and booked in with a Self Employed Community Midwife.  From 11 weeks into my pregnancy, she visited every 3 weeks or so, long visits during which we discussed every aspect of pregnancy, labour and birth.  Over these many, many hours, my midwife and I built a relationship and I was so happy i would be sharing my birth experience with her.   I used the GentleBirth programme both to prepare for birth and to cope with any worries that arose along the way.   I found great support at Home Birth Association meetings and through a breastfeeding support Facebook group. My “mind movie” of how I hoped the birth would go involved me going into labour in the afternoon, nursing my daughter to sleep at bedtime, then going downstairs, getting into the birth pool and giving birth around midnight.  I gave no thought to the possibility of being transferred to hospital as I felt this was remote and I have a personal philosophy of not worrying about things that might never happen.

My EDD came and went, and I was at the HBA conference to hear Ina May’s words of wisdom.  It was a wonderful day and the perfect note on which to go into labour. I felt sure labour would start in the next few days.  But by 41 weeks, the home birth deadline of 42 weeks loomed.  I tried all the usual methods to encourage labour to start – walking, sex, hot curry, hot bath, reflexology, acupuncture and more.

By 12 days over, I was anxious and upset.  I was to be scanned in the Rotunda the next day and expected to come under some pressure to set a date for induction.  Having had such relaxed antenatal care, I dreaded going into hospital and dealing with obstetricians who would likely not be supportive of my decision to wait for the onset of spontaneous labour.  My midwife called to me and her presence was an amazing comfort and calmed me.  She performed a sweep and said my cervix was soft and favourable so labour could be imminent.  I used my GentleBirth to stay as relaxed as possible and managed a good night’s sleep.

I found myself amazingly calm going to hospital to be scanned the next day.  All was well with the baby although the obstetrician who saw me was shocked to see someone 13 days past their EDD!  We discussed options with a consultant and I agreed to come in again 2 days later to be reassessed but refused an induction appointment.

Day term + 14 dawned – the last day on which I could have my homebirth.  My midwife visited and again performed a sweep.  We spent the day quietly at home.  By the evening, it seemed certain that I would not have my longed-for home birth.  I decided to focus on having a positive birth experience, wherever it happened and let go of any upset about not having a home birth for the moment.

Day term + 15.   I attended the follow up appointment at the hospital, knowing more pressure to be induced would be applied this time.    A consultant performed a scan and was happy with what he saw but still advised induction. We smiled politely and refused an induction appointment.  He noted that the date on my booking form for the hospital was 27th April which made me 13 days over.  When I rang my midwife that evening to tell her how things had gone, we realised that this meant that her insurance covered us till the following day when I would be, by these dates, term + 14.  Surely my baby would arrive before then?  I felt like I’d been granted a reprieve.  I got a sudden burst of energy and ran around the house tidying, then bounced on my birth ball for a while and got up and danced to a song with my two year old.

Suddenly, I felt a gush – the waters had released!  I was ecstatic.  My home birth was going to happen after all!  I rang my midwife to let her know and went for a walk to deal with the excitement.  The regular Braxton Hicks I’d had for weeks intensified and I could feel more water releasing.  I went home, put my daughter to bed and waited for labour to kick in, texting Krysia from the HBA for advice on homeopathic remedies to get things moving.  I stuck on Dirty Dancing for a bit of nostalgia and for music to gyrate on the ball to.  But by 11pm, nothing had happened.  I was disappointed but went to bed, listened to my hypno tracks and fell asleep.

My midwife called the next afternoon and we decided we had to make a plan.  As the waters had now gone, there was a risk of infection to the baby so induction the following day seemed the sensible option.  We rang the Rotunda and I was booked in for the following morning.  It was a scary proposition. I spent the day in communication with Krysia from the HBA and Tracy from GentleBirth for moral support and encouragement. I focused on the belief that, by having the rest of the waters released, my labour would kick off and I tried not to think beyond that.  I packed my bag and went to bed early.  In the middle of the night, my daughter woke, and I brought her into our bed so we spent our last night as a family of three snuggled up together.

Next morning, my parents arrived early and we set off for the hospital.  It was a beautiful sunny day.  As second timers are expected to progress quickly, I was brought straight to a delivery room on admission. I was put on a trace while we waited for the obstetrician, and myself and my midwife chatted.  Immediately, I could tell that she understood what sort of birth I wanted.  There was no issue with any of the birth preferences we discussed.  The doctor came at 8.50 am and examined me, then released the rest of the waters, which were copious. By 9.20 am, I had had my first surge. The midwife in charge came in and told me that, in the event that I had to go on the syntocinon drip and continuous monitoring, that they would do everything they could to let me be in whatever position was comfortable. I wouldn’t be confined to bed, so not to worry about that.

We decided on a walk outside, with the idea to go for a coffee.  I really wanted a chocolate twist from the Paris bakery. I also wanted to buy some underwear and slippers, as my hospital bag had had to be so hastily packed, and some Lego for my daughter.  In the toy shop, I had to breathe through a surge for the first time.  I was delighted that things were ramping up and labour was finally here!  We went across to Penney’s and after paying for my undies, I got a massive surge and realised coffee was definitely off the agenda and we should get back to the delivery room quickly.

We arrived back at 10am and within a very short time, surges were coming every two minutes and lasting around 90 seconds. They were strong and the thought of the epidural crossed my mind as I leaned over the ball and gyrated and moaned through them, amazed at how quickly labour had intensified.  I knew that if I was thinking about the epidural, then I was almost there, but couldn’t believe that could be the case after about half an hour of real labour! My husband was behind me using the double hip squeeze technique we had learned in the GentleBirth workshop although he kept taking his hands off between surges which meant he wasn’t getting started right at the beginning of a surge, making it less effective (I later learned this was because he was eating a sandwich to keep his strength up!).   I was using the affirmation “I can do this” between surges as I was finding the lack of recovery time in between them very challenging.  On my first birth, at it’s most intense, I still had at least 1 minutes rest time to flake out between surges and flake out I did. This time, there was no flaking, just pure hard work. The most difficult part was that I couldn’t speak during surges and in between there was not enough time to think and communicate with my husband as to what comfort measures would be helpful.  But he was amazing, and thanks to our preparation, had a few ideas up his sleeve.

After some time, I decided I needed the gas and air but went to the loo first.   I managed to get there, but once there, had no idea how I was ever going to be able to get off!  My husband started doing acupressure, as it had just occurred to him, and pressed my shoulders – but he was pushing me down into the toilet. So although it gave immense relief from the surges, it actually hurt the backs of my thighs! I didn’t have time to think that he should just choose a different point. I could barely think at all. The surges were changing and in this upright position were pushing down.  The midwife came in and encouraged me to move as she didn’t want me to have the baby on the toilet!   I asked her if she wanted to check me and she said there was no need, that I’d be pushing the baby out in no time. I was not examined at all which was fantastic. At this point, she was carrying my ball and the midwife in charge had the mat as they were going to let me set up where I was. Talk about being woman-led!!

So I managed to get back to the room and I knelt on the bed, dangling my arms over the bedstead and using the gas and air, which made all well with the world.  I no longer thought about the previous or the next surge – I no longer thought at all! After about 15 minutes, I felt the baby move down and told the midwife who had to take off my pyjamas.  It had happened so quickly that I was still fully dressed!  Half an hour later, baby began to crown.  The midwife did a fantastic job of warning me when it was going to happen and then coaching me to hold back which took a superhuman effort.  My husband was also telling me to relax my jaw as he had forgotten to do this the first time.  My baby emerged slowly and gently, with no tear, at 12.06pm, just 2 hours after we had arrived back from our excursion. He weighed 4kg (8lb 14oz)  and came out roaring, marking his territory by weeing all over me! Welcome to the world of little boys!

The cord was clamped and cut after about 15 minutes and I put my baby on to my chest, where he stayed for the day.   I had wanted a natural third stage, but lost quite a bit of blood and after 50 minutes was fed up and agreed with the midwife that I should have drugs to help deliver it. She gave me syntocinon, not the dreaded syntometrine that had contributed to me having a retained placenta on my first baby. The placenta came about 3 minutes after the drug was administered, so she reckoned the placenta had already separated anyway. She asked me if I wanted to take it home, and I had planned to, but after all of that, I was glad to see the back of it! I could not be happier with the care I received in the Rotunda. They were all genuinely sorry for me that I had been transferred and did everything they could to give me the closest possible experience to my home birth. It was amazing!!!

After two hours, we transferred to the postnatal ward which was thankfully very peaceful. It was actually lovely to be with my husband and new son and no distractions. However, I was desperate to be home and have all my family together.  I had a bit of wrangling with the hospital as they said I had had a Post Partum Haemhorrage (it was just above the borderline). But my home birth midwife was fine when I told her the estimated blood loss so I told them I was discharging myself. I got “the talk” from an obs and then they rang my midwife to make sure she was taking over my care, which was lovely of them. We eventually left at around 9pm and brought our boy home to meet his sister and grandparents.  My midwife called on us as soon as we got home and then every day for a few days after so I still had all of that wonderful postnatal care.

I feel that I have come to terms with the turn of events, although I will always be sad I didn’t have the birth in my mind movie and be slightly envious when I hear of others who had similar births. But, at the same time, I’m happy with the birth I had. There will always be the regret that the amazing midwife I built up such a relationship with over the course of my pregnancy was not with me when I delivered my baby.  It would have been wonderful had she been allowed to accompany me for support during my labour.   How much I relied on her during my pregnancy was brought home to me after her last visit when my baby was 2 weeks old. I cried on and off for the next two days, so sad that someone who had become such an important figure in my life was now leaving it.   I even irrationally wondered how quickly I could become pregnant again so I could get her back!

So, not the home birth I hoped and planned for, and yet it was a good birth.   While I didn’t birth at home, I feel I still had a “home birth experience”.   The antenatal and postnatal care count for so much. To feel nurtured and listened to during and after pregnancy is something all women should experience.  I’m thankful I did, and who knows – I may have the beautiful home water birth of my mind movie one day.