One Born Every Minute: Conception

Steady now, there are none of those photos in this post.

I knew I was ready to start a family about ten years ago when I had an unexplainably powerful urge to have a baby. I have never found the words to describe how it felt. Hormones have a lot to answer for.

Luckily for me and the Husband, we’ve never really had a problem with conceiving babies.

Of course, from the moment we decided that we would be ‘trying’ (I hate that expression), I was on tenterhooks. Would this month be the month? Your mind can play so many tricks on you, especially if you have a somewhat erratic cycle, like me. Mother Nature can be very cruel. The very same symptoms can mean either PMT or pregnancy.

When the magic finally happened, I was beyond excited. Imagine my disappointment when the Husband responded in his usual laid back way. In the movies, women announce their pregnant state to enraptured partners, who then sweep them up and cosset them for the next nine months. It wasn’t like that in our house. At five months pregnant I was still helping him shift concrete fence posts onto a trolley in B&Q.

I got used to him treating my pregnancy as a run of the mill event. In hindsight, I should have realised what a bonus it was that he wasn’t fazed by the whole thing.

Next time around and my heart thumped and fingers shook just as much as I took the pregnancy test.

There was something about this baby that felt right somehow. My first pregnancy had ended in a strange ‘missed miscarriage’ and my second resulted in Son Number One. For some reason I never felt secure in either of those pregnancies but I was completely confident about the one that gave me the Middle Miss. Strange.

By the time Babykins was conceived, I had acquired an iPhone. They say an iPhone will change your life.

It changed mine, I’ve never been pregnant so quickly. There’s an app for it you know….

I was using the ‘Period Tracker’ app on my phone to chart my cycle, mainly to work out when my hormone related migraines were going to hit. After a few months of this, the app got better at making predictions about when my fertile period would be.

It even told me the ‘Most Fertile Day’.

Bingo.

Result? Babykins is the only one of the three that I have any idea about when conception occured.

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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

One Born Every Minute: Pain

I have found this post very difficult to write. Labour pain is such a personal thing. My experience will have been different to yours in some way or other. I don’t want to be preachy and say “This is how you should have your baby” because, clearly, that would be stupid.  On the other hand, I would like it if my words made someone think differently about how birth can be, and why.

When I decided to have a home birth and therefore restrict myself to only gas and air for pain relief, quite a few people told me I was ‘brave’. It didn’t seem that way to me. I didn’t make this choice because I had a terrible fear of hospitals or had any major political views about how birth is controlled (that came later).  I just never really had any fear of labour or labour pain. I figured I would be able to deal with it. Maybe it was the reading material I had around me during pregnancy. Maybe it was because my Mother never made a big deal of it (despite having what I would consider to be a grotty 1970’s birth). Maybe I rationalised that if it WAS that bad, I could get help, I could transfer to hospital and scream for an epidural.

Do I look fed up? This was just before we called the midwives at my second birth. Three hours later I had the Middle Miss in my arms.

Luckily for me, that was never necessary. I think these are some of the reasons why:

1. My first two babies were in the best position possible before birth. If your’s isn’t, see here.

2. I wasn’t fearful. Fear increases pain. This theory has been around for years. If you are fearful about birth, you can bet your system will be swimming in adrenaline. Adrenaline is generally the enemy of progress in birth. You can read more about this here and here. It is possible to overcome the fear of birth (tocophobia). Some women find talking to a trained counsellor helps, some find hypnotherapy is the answer. If you want more information on this, click here. May I also recommend reading Ina May’s Guide to Childbirth. Yes, she’s an old hippy, but she’s funny too and makes a lot of sense.

3. I had good midwives (I wish I could post a picture here but I don’t think they would thank me for it) and a great husband supporting me. I didn’t know the midwives but they had an air of confidence that told me ‘everything is going well’. That contributed to my lack of fear (see above).

4. I was able to use my yoga experience to breathe deeply through labour and I wasn’t inhibited when it came to using sound. If you want to learn yoga while you are pregnant, find a teacher by clicking here.

5. I had a beautiful, deep, warm pool of water available. Although water will not take away the pain of labour, it does provide comfort. It’s buoyancy allowed me to stay in an upright, kneeling position for far longer than I could maintain on ‘land’. Upright positions generally aid progress in labour and can be less painful.

It’s not obligatory to move house between each birth, but it does make siting your pool more interesting.

6. My labours went at the ‘right’ pace. Very fast labours can be a shock for both mother and baby, whilst slow labours are undoubtedly tiring. Labours that are induced or augmented artificially in hospital can be harder to deal with. It’s not as easy for your body’s natural pain killers to keep up with the progress of the birth. Think carefully before you agree to induction. The NICE guidelines say that induction should be offered if you are overdue. There is little evidence to suggest that it is necessary.

It saddens me that so many women fear labour and the pain it brings. I get fed up of people saying “Well, you wouldn’t have your tooth out without anaesthetic so why have a baby”. The answer is that these two types of pain are NOT comparable. I think you could compare being stitched up after giving birth with having your tooth out, but I’m only guessing, from what other people have told me.

Having a baby can be one of the most exciting, exhilarating and empowering things you can ever do. Ask anyone who’s had a good birth.

I was lucky enough to hear Davina McCall speak about her birth experiences a couple of years ago. She too has had three home births. This is what she said, more or less – sorry Davina, wish I’d recorded you:

“Have you seen the Lion King? You know the bit where they take the baby lion up to Pride Rock and show him to all the other animals? That was what I wanted to do after my births. I felt so strong and a bit wild. I wanted to hold up my baby and shout, ‘Look what I did'”. (I can’t find the exact clip of her saying that but if you want to see her interview childbirth expert, midwife and author Ina May Gaskin, click here, Ina May is well worth it)

Wouldn’t it be lovely if all mothers felt like Davina did, because in a good birth, that is the bit you remember, not the pain.

Oh dear, all that house moving. I can’t find pictures of baby one after his birth.

Baby Two

Baby Three

One Born Every Minute: Fathers

The theme of this week’s episode is ‘Fathers’ so I am going to share the experience of the Husband in this post. Before I use his words, I would like to use a few of my own…Be warned, I have strong views on birth. Don’t worry though, I haven’t had the macro setting on the camera in use when preparing this post!

I really feel for fathers at births. I’m sure there are quite a few of them who have very mixed feelings about being present. I’m sure there are quite a few of them who really should not be present for all sorts of reasons. These days, it is expected that a father will be with the mother of his child when their baby is born. I’m not sure that this is a better situation than when the opposite was expected. However, I suspect there are also many ‘converted’ fathers out there who were initially dubious about being at the birth of their child. My father was one of those back in 1974….I wish I had a digital picture of him holding me after I was born. This is the best I can do.

At the start of the programme, the midwife being interviewed said that men are used to being ‘in control’ and acting as the ‘protector’. How does a man square these roles with being an effective birth partner. For birth to progress well a woman really needs to be comfortable with feeling ‘out of control’. It’s not easy to witness the primal instincts that come with being out of control during a birth. It’s a side of ourselves that is normally hidden and repressed. An ideal birth partner takes control by allowing space for a woman to do the opposite. By this I mean that they can field questions from midwives or other medical staff, keep the lights low, provide food and drink as needed. In short, the partner can be the ‘thinking’ brain in the partnership and allow the mother to stay in her ‘instinctive’ brain. How many men are really prepared for this? For that matter, how many women understand that this is the way to give themselves the best chance of a peaceful birth?

As I watched the programme I couldn’t help but feel that the men featured had no chance of fulfilling this role for their partners.

For a start, births occur in a complex system that most people don’t have any understanding of. On top of that, we are all products of the culture we live in. In our culture, birth is frequently portrayed as something to fear, something to be medically managed.

When I watch One Born Every Minute I’m generally resisting the urge to shout “Get Off The Bed”. How many people have any idea that getting up and off the bed is one of the single most effective things you can do to have a good birth? Not many I guess, because that is the way we usually see birth portrayed. How many people realise that as soon as they have an epidural, they are at much higher risk of needing a caesarean birth? How many people realise the true risk factors in a caesarean?

See, there are so many questions that most of us never even know about before we have our first babies. And we expect men to support women in labour? Heck, the system doesn’t even truly support most women. If it did, we would have a midwife who cared for us throughout our pregnancies and births, who had time to discuss all these issues. The only way to get this kind of care in the UK is to pay for it. Don’t get me wrong, I’ve had brilliant care with fantastic NHS midwives but it was not the gold standard that independent midwives are able to provide. They are able to prepare the men in the relationship more effectively too.

I’ve read a lot about birth in the last seven years. I’ve had the privilege of working with midwives in my antenatal yoga classes. I’ve been active in the NCT and spent time discussing birth with doulas and antenatal teachers. All this experience has helped us get the births that we wanted, within an imperfect system.

Rant over…… Do you want to hear the Husbands side of things now?

Me: How would you say you felt about the idea of us having a home water birth for our first baby?

Husband:  Fairly calm and  relaxed about it. I got good feelings about it from you. I didn’t really think about the birth itself, I left that to you. I was more concerned with practicalities. If we had been going to hospital I would have been thinking about how long it would take to drive there and what we needed to take. As it was, I was responsible for getting the pool ready and helping the midwives with anything they needed, mainly food and tea. I suppose initially the idea of a baby being born under water seemed pretty bizarre but I suppose I just trusted your judgement. I never really read up on the subject and never really thought about what could go wrong so I didn’t stress about it. (Did I mention that the Husband is a very laid back type of guy?)

Me: Would you say that going to antenatal classes prepared you adequately?

Husband: Well, the mechanics of birth were well covered. I felt that antenatal classes were like a refresher class from what I had learned in biology. I suppose they were good in giving information about other positions for birth and stuff like that. I had a bit of experience in handling babies from when our nephews were born.

Me: What about being a witness to the primal nature of birth? Did antenatal classes prepare you for that?

Husband: That’s the one thing you already expect! You know that there is going to be a certain amount of shouting, screaming, swearing and name calling (for the record there was only load groaning and some screeching).  You do begin to wonder “How much pain is she going through?” “How long will this go on for?” “Is she going to get too fatigued?” but you were pretty calm through most of it so I didn’t worry too much.

Me: Second time around you were happy to have the same experience again, despite the complications I had with bleeding after the birth. A lot of people would find that quite strange I suppose?

Husband: I was very comfortable with the first experience. I couldn’t visualise doing it in hospital and feeling the same level of involvement. I was confident in your judgement again. I knew you had researched the risks and wouldn’t put yourself or the baby in danger.

Me: Obviously you would recommend home birth.

Husband: You know that I already have. You know my colleague at work has had two.

Me: Yes, we know a few home birth babies these days. Our antenatal class of five couples has now produced 13 children, seven of which were born at home. That’s not a bad percentage (gets out calculator): 54%, waaaaay above the national average. You know, I think you were so relaxed about birth because despite not having witnessed a human birth, you had assisted at the births of lambs and calves. All the blood and mess and stuff wasn’t really a shock.

Husband: Maybe. At least I didn’t have to pull our baby out though.

Now there’s a thought. A friend of mine did recently catch his third child. Notice, CATCH, not DELIVER. The mother did all the work. Just remember that any journalists out there. I’m fed up of the fathers getting all the credit in these stories!

Both the dads in the programme said the same thing, “I want the best for my baby”. Dads come to delivery suites (or go along with their hippy, home birthing wives) these days because they know that in order to do the best for their babies, they have to do the best for the mother. For that, I take my hat off to them. I salute all Dads who try as hard as they can to do the right thing for the women and babies in their lives. Goodness knows, we need them.

Just after the birth of The Middle Miss, August 2007