One Born Every Minute: Rule Breakers

When I saw the theme for this week’s One Born Every Minute I thought ‘Ha, now here’s something I can relate to!’. I’ve been pretty good at ‘breaking the rules’ when it comes to birth. Three home births has seen to that. The funny thing is, the first one was the only one that didn’t get me into trouble with the birthing powers that be. Despite it being my first baby, my midwife was all for the idea of home birth.

The birth went really well. I used the pool and the gas and air. I requested a natural third stage of labour, meaning no drugs to be given to hasten the delivery of the placenta. I still maintain that the process of the third stage was messed up at my first birth. The result being that I bled quite badly and transferred to hospital for observation. I didn’t required any further treatment at that time but then I was readmitted two weeks later with a secondary post-partum haemorrhage. A few doses of IV antibiotics sorted me out and that was that. Or so I thought. Of course, I didn’t realise that this had put me into the ‘high risk’ category.

When I booked in for my second pregnancy, I honestly didn’t think anyone would bat an eyelid at the thought of me having another home birth. How wrong can you be? An appointment was made for me with the consultant at the local hospital and for a change, I took the husband with me. I wanted to make sure that someone else heard what was said. I didn’t trust myself to hear it impartially. I also really wanted him to be there as the only real ‘witness’ to the first birth.

Of course, the consultant said she couldn’t recommend a home birth (she had to cover herself, professionally speaking) but she did understand why I wanted one. She knew the decision wasn’t up to her and she couldn’t really argue with my reasons. To her credit, she decided to make a stronger drug (misoprostol) available to the home birth midwives, to be used as a last resort in the case of another haemorrhage. I never expected to need this drug. The midwives had brought my bleeding under control very effectively with their standard drugs at my first birth. In fact, I think they could probably have stopped me bleeding more quickly but they were under the impression that I didn’t want the drugs at all and tried everything else first.

I really searched myself when preparing for my second birth. Was I being selfish or stupid. Was I putting myself at unnecessary risk. I talked to a lot of people and read a lot of information (albeit, most of it was probably a bit biased). I shed tears while asking the husband all the difficult questions I was asking myself. I will always be grateful that he supported my decision wholeheartedly.

We were visited by two midwives to discuss our plans and it was even stranger than talking to the hospital consultant. Their opening gambit was along the lines of “high risk, bleed to death, etc etc” but then, when it became clear that we weren’t changing our mind, it was as if two new women had entered the room. “Yes”, they said “If you want a home birth, you should definitely have one”. After they had left, I turned to the husband and said “Was that conversation as weird for you as it was for me?”. I really felt it had been an exercise in box ticking. They weren’t dead against me having a home birth, but their guidelines had to be met.

So we broke the rules and surprise, surprise; my second birth was the easiest of the three. My daughter was born after approximately three hours of active labour, with only a pool for pain relief. I had no bleeding and no tearing. I was at the park with my-sister in-law and her family forty eight hours later. This time, I opted for the more usual ‘managed’ third stage. There was a big part of me that still wanted an all natural birth. I couldn’t quite believe that I could have two trouble free pregnancies and not be able to finish the job without help. However, I didn’t trust the midwives to be able to give me what I wanted. I knew they would feel more confident in the managed route. Most of all, I didn’t fancy having anaemia for a month with a two year old and a new born to deal with.

I booked my third pregnancy in with the same NHS midwife (how lucky am I?) that I had with the other two. She hardly lifted her pen from the paper when it came to asking about ‘place of birth’. “You’ll be having another home birth, then?” She said, knowing it wasn’t really a question that was worth asking. Of course I was.

Fast forward about six months and my labour started with my waters breaking, ten days before my due date. This came as a bit of surprise as the other two were more or less exactly ‘on time’. This labour was where the ‘rule breaking’ really began.

I called the delivery suite as I was fully expecting things to move fast. In my previous births, it was a matter of hours between my waters breaking and a baby being born.

Unfortunately I got the response that all people planning a homebirth dread. There was only one midwife available so they wanted me to attend Hospital or the birth centre to “Confirm that my waters had broken”. I wasn’t very inclined to go along with this plan. I certainly didn’t think I needed anyone to tell me what I already knew. I couldn’t see the point in going for that kind of assessment and then coming home again. Also I wasn’t ready to give up on my home birth that quickly. I told them I would consider my options and ring them back. Before I had a chance to call back, my phone rang. The delivery suite must have got my notes and they were ringing to say that I couldn’t go to the birth centre due to the post partum haemorrhage after my first birth. They wanted to know what I was going to do. I took a deep breath and told them I wouldn’t be coming to hospital. I was sorry to be giving a busy midwife a problem to deal with but at the same time I knew that a home birth was my choice and if anyone had rung me asking for advice in this situation I would have told them to stick to their guns.

A while later the delivery suite called me back to say that Jane, a local midwife, who I knew, was going to visit me to assess the situation. I was extremely pleased about this news. I knew that Jane was a very experienced midwife who prefers to avoid the medical model of care.

When Jane arrived there was the inevitable examination. I was only 2-3 cm dilated. We got chatting, had some breakfast together and all the while, my husband was busying himself. We really weren’t prepared for our baby to arrive. He was up and down ladders to the loft getting out our Moses basket, baby clothes, car seat etc. Since I wasn’t making fast progress, we decided to get the inflatable birth pool out. I say ‘we’, but yet again, the Husband was doing all the work. As I chatted to Jane, he was getting busy inflating and filling. I didn’t realise until much later that he had had to use the garden hosepipe to fill the pool and that before he could do this, he had had to defrost the pipe in the shower upstairs. All the cold weather had totally frozen it.

Jane spent a while re-arranging all the house calls for the day but it was becoming clear that I wasn’t going to have this baby as quickly as I had first thought. She decided to pop out and do some calls herself. As the day went on, Jane came and went a few times. I was having regular contractions every 10 minutes but they certainly weren’t strong or ‘effective’ in midwife speak. The funny thing was, they felt much stronger when I lay on my side and seemed to subside as I pottered around. I actually spent quite a large part of the day dozing on the sofa. Even the Husband went back to bed for a few hours in the morning.

By 8.30 in the evening we had been fed turkey casserole by our extended family, the children were still settled at their Grandma’s and Jane had gone off shift after calling in around 5 o’clock. I spent a really peaceful time, in a meditative kind of state, listening to the hypnobirthing CD that our local practitioner had loaned me. At last, it seemed that the contractions were coming more regularly. We called the midwives again and the evening shift team came out. They were already starting to talk about approaching the 24-hour mark since my waters had broken. The current guidelines (rules?) in my area suggest going in to hospital for induction at this stage. I didn’t fancy that idea either. I would have gone if there was any sign on infection but I was fine and as far as the midwives could tell, so was our baby. When I was examined, I was still 2-3 cm dilated. I was not very happy about this state of affairs. It was turning out to be a completely different experience to my two previous births.

The midwives disappeared fairly quickly and we were left with the post Christmas TV viewing. Around midnight the Husband went up to bed but I stayed dozing on the sofa, hitting the timer on my ‘contraction companion’  iphone app every 10 minutes or so. At some point I realised that I was feeling the need to make a bit of noise with each contraction. Bizarrely I could sleep quite deeply between each tightening. Eventually I thought I’d better let the Husband know that things were beginning to move on. I laid on my bed and kept on dozing and groaning, hoping he’d take the hint and ring the midwives again like I’d asked him to. This must have gone on for a couple of hours, by which time I was getting pretty frustrated. I must have started to sound a bit more desperate because eventually when I said “I want some Gas and Air now” he got up and started faffing with the pool and ringing the delivery suite. At that point I became very emotional, had a good cry and told the baby I wanted it to get a move on and come NOW. “Is this transition” I thought? If only….

The night shift midwives arrived back again at about 7.30, by which time they had successfully attended a mother in an unplanned home birth and I was on my hands and knees next to the pool, starting to make a lot of noise. Their thermometer was rubbish and it took about 3 contractions before it worked. I was thinking “Sod the thermometer, get the gas and air on the go” I was actually feeling a bit scared by then. I felt as if I was never going to get this baby out. I was examined again and was pronounced to be 4cm. I could hardly believe it.

It was around this stage that I started to loose track of time and really get into ‘labour land’. I was aware that the evening midwives went off shift and Jane arrived back for the day shift with her colleague, Margaret. It seemed that in no time I was feeling that familiar sensation of pressure in the bottom and lower back. “Are you having sneaky pushes?” someone asked me and I realised that yes, I was. I was a bit worried that I might be pushing against a cervix that wasn’t fully dilated but no one seemed concerned. I don’t remember anyone suggesting getting in the pool and by that point, I had no intention of moving anywhere from my all fours position next to my sofa. All I could think about was getting a good pull on the gas and air.

Somewhere in my mind, I was aware that things were moving on. I was aware that the midwives were getting geared up for a baby arriving and before long, the crowing sensation happened. I think I must have experienced it about five times and each time my baby seemed to slip back in. I was wishing someone could pull as I pushed! I did not want the baby to disappear again. The midwives helped me to focus on my pushing. It was a completely different experience to my previous birth when I didn’t feel that I had consciously done anything but my body had just ‘taken over’. This time I definitely did the work. I knew I was going to have to change positions, I just didn’t relish the thought of it. Finally, when I heard them say “Husband, I think we’re going to have to get her over onto her back” I thought I’d better make an effort. My (very vocal) response to being on my back had been “Not bloody likely”, so over two contractions I got into a deep squat, facing my sofa and that did the trick. The relief of birthing my baby was immense.

I don’t know who caught the baby but I do remember asking what the sex was and not being surprised it was a boy. I think the cord was cut pretty fast, the Husband wasn’t even invited to do it, as had happened previously. I got up onto the sofa, got my first look at Margaret, the second midwife (I’d had my eyes shut the whole time up until then) and somehow, Jane jumped up onto the back of the sofa to deliver the placenta. She was in a bit of a rush to get this all done and dusted. With my history and having had a fairly long labour, she wasn’t in the mood to hang around and see if my uterus was up to it! I didn’t really care; I just didn’t want to haemorrhage. Finally, I got hold of my lovely boy and got him to the breast. He took to feeding immediately. When that was done, I conked out while Jane and the Husband between them got our boy cleaned up and dressed. About 10 minutes after the birth, our neighbour (we live in a semi) knocked on the door concerned that our curtains were still shut, and had been shut all day previously. I think she was a little surprised to be met by the Husband holding a baby, though we had warned her a home birth was planned. He was surprised that she hadn’t heard all the commotion I had been making!

I perked up a little while later when I heard someone suggest a bath. I can’t tell you how luxurious it felt to have two midwives fussing over me, running my bath and finding scented oils etc to go in it. It was bliss to bathe lying on my tummy! It turned out that I had a tear, another first for me. Although the midwives assured me it wasn’t bad, it seemed terrible to me. I chatted to them about what had happened. Jane thought that Babykins had had his head slightly de-flexed. In other words, his chin wasn’t tucked down properly so the smallest part of his head was not the presenting part. It explained why my contractions hadn’t been effective for so long and also why I’d had to really work to get him out. The diameter of the presenting part of his head was bigger than it should ideally have been. He had quite a bruise in that area too. I was amazed at Jane’s good judgement. I wondered at what point she would have advised me to transfer to hospital for something like a ventouse or forceps delivery. She said it would have been right at the end. Thank goodness I didn’t need to go. I don’t know how I could have moved.

I wonder what would have happened if I had played by ‘The Rules’ and gone into hospital for an induction/augmentation, 24 hours after my waters broke? Personally I think I would have had a very painful experience due to the presentation of baby’s head. Would I have succumbed to the epidural at that point? Maybe? Would I have been able to move around and push him out as I did? Probably not. Would I have ended up with a caesarean birth? Fairly likely I think. Of course, I’ll never really know but in my experience, sometimes it pays to break the rules.

N.B. The names of the midwives have been changed

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s