Janet's story - Rebecca's birth

Rebecca’s birth was the most beautiful thing imaginable; if I had to dream up my fantasy birth scenario I can’t think of any way it could have been improved. This was all the more precious because at 32 weeks a routine antenatal appointment identified that the baby had developed an irregular heartbeat. As it was a Friday night and all the cardiologists had gone home, the duty obstetrician on the antenatal day centre wanted to deliver the baby straight away by crash caesarian "to be on the safe side". I was by this stage in a surgical gown being prepped for theatre, absolutely terrified and in floods of tears, while my husband was at home trying to sort out childcare for our elder daughter Catherine. I spoke to our (independent) midwife Andrea who reassured me that although the heartbeat was unusual it didn't sound to her like the baby was in distress, and she came out to the hospital to help me explore what other options might be available. The obstetrician finally managed to reach a cardiologist on the phone, who told her not to do anything drastic but keep me in for monitoring over the weekend. 

When we finally saw a cardiologist he told us that delivering the baby early would have been absolutely the worst thing to do, and the baby's heart would probably right itself with time. However the obstetrician was still pushing for me to agree to an elective section, due to the expected difficulty of monitoring the baby's heartrate during labour. After many long discussions with Andrea we reached the point that we couldn’t think of any risks that could not be adequately addressed during a home birth (in most cases, they wouldn’t be able to do anything more in hospital than we could at home). Moreover I knew that I would be more likely to have a successful birth at home with the very experienced midwife who knew me and my baby intimately rather than in hospital surrounded by the panicking midwives whose only training was "odd heartbeat = immediate caesarean". Andrea had many years more experience, including monitoring babies with irregular heartbeats, whereas most of the hospital midwives couldn’t hide the look of horror on their faces when they heard the heartbeat for the first time, and I could see they were uncomfortable that I was being allowed to just watch and wait rather than doing anything to intervene.

Andrea agreed to come with me to the obstetrician appointment, and I found the strength to go against the obstetrician's advice and instead plan to go ahead with the home birth. In the event the baby's heartbeat righted itself before the due date as the cardiologist had suggested, so I discharged myself from the obstetrician's care.

I had been convinced that this baby was going to be early – I had been expecting it to be born any day right from 37 weeks. So when the due date came and went I already felt several weeks overdue. I had been experiencing increasingly uncomfortable Braxton Hicks contractions for around the last week, so it was with some relief that I woke up at 6.45am on 13thApril 2012 (four days late) with what felt like it might be something a bit more. I thought I would wait and see before saying anything to John, but then at 6.57 it came again. When it happened again at 7.09 I thought I’d better tell him I thought we were on. Exactly the same start as with Catherine – straight into regular contractions, no faffing about!

Catherine came rampaging into our room at 7, when Mr Sunshine appeared on her clock, and we all went downstairs where we put the kettle on and broke the news to my Mum. I also texted Andrea, who had asked me to let me know as soon as I thought things might be starting. We all sat and had breakfast together, and discussed what Mum and Catherine might do for the day. The nice lady from the shoe shop had rung the day before to say that the shoes we had ordered for Catherine had come in, so we suggested that Mum might go into East Grinstead to get those, have the obligatory tea and a cake in Caffe Nero, and then maybe go onto Wyevale for some lunch and then some soft play. After breakfast, John nipped out to buy a pump to use to empty the pool, Andrea’s one being missing a vital connector, and the rest of us got dressed and ready for the day.

As soon as they had set off, John and I set about preparing the room and building the pool. I then got another text from Andrea asking for an update, so I gave her a call saying that I was coping fine and didn’t even have the TENS machine on yet, although we had started filling the pool as I was worried about how long it would take. However by about 11 the contractions were getting a bit more serious, I could no longer talk through them, although they were still only around every 12 minutes. Andrea asked if she could come over anyway, since she would only be pacing about at home anyway, and she was worried about how long it would take her to get there if things suddenly accelerated. 

When she arrived about an hour later I was mostly sitting on my birth ball, however whenever a contraction came I would leap up and find something to lean on, as I couldn’t bear to sit down for them. After some experimentation I found that the handle of Catherine’s trampoline was the perfect height, although if I wasn’t nearby it I would use whatever was to hand, from tables to doors to John! We all had a cup of tea, and Andrea then ran through the standard battery of tests – blood pressure, temperature, heart rate etc. The baby was obligingly still lying in the perfect position, which was a relief after the posterior labour I had had with Catherine.

We then sat around and chatted for a while until John suggested lunch for him and Andrea – I didn’t fancy any, but I went into the kitchen to keep him company while he put some tortellini on to cook. When it was ready I decided to stay pacing up and down the kitchen while they ate, but by the time they had finished it felt like the contractions were getting really close together and Andrea suggested that I might like to get in the pool. The water was about the right temperature, although still a bit shallow, but I got in anyway – the water was high enough to cover my bump, but not my lower back, as I knelt leaning forwards on my hands, so John kept filling for the time being. 

From this point labour proceeded pretty much as I remember from last time, although I felt much more in control because of knowing what to expect – when it started to feel like it hurt all the time and I really just wanted it to stop, at least I could remember that I felt like that last time as well, and actually it did stop fairly soon after. Also, I found that if I felt in need of a rest, I could lean right forward and things would slow down a bit; if I started to worry that I hadn’t had a contraction for a while, I could sit upright, and it would bring on a contraction almost at once.

About half an hour after I got into the pool, Andrea called Anja, the supporting midwife, who arrived about half an hour after that. Shortly after this I went into transition – contractions slowed right down, and I became completely uncommunicative, and it basically felt like it hurt all the time. It was very difficult to find a time when I was happy for Andrea to listen in to the baby, but Andrea was very patient and kept asking “is it OK now? How about now?” so I only had to nod when it was not too bad. Shortly after this I was sick – I had been drinking Ribena all throughout my labour, which is bizarre as usually I’m not that keen on Ribena, and I remember thinking when I was sick that it both looked and tasted just like warm Ribena...

Shortly after this I felt the beginnings of an urge to push, and I managed to overcome my labour catatonia enough to communicate this to the midwives. I heard the clock striking 3 o’clock, and told myself that by the time it chimed the half hour the baby would be with us. I told the midwives “it’s nearly over now!” The next contraction the urge to push was irresistible so I gave into it, but only a “breathing” push at the height of the contraction, not a held-breath-straining kind of push. Anja asked if I had pushed that time and I confirmed that I had. No-one was telling me what to do, which worried me at first (since Catherine’s birth had been more “coached”) but then I realised that if I needed to be doing anything different someone would surely tell me, so from then on I just did what I felt like, which was as little as possible: a little bit of a breathing push when I couldn’t resist it. So the birth was very gentle and quiet, and quite slow: Andrea and Anja told me afterwards that they wouldn’t have known I was pushing at all were it not for the fact that I was pushing a little bit of poo out. I didn’t feel the need to make any noise at all, apart from heavy breathing.

A few contractions later and I could suddenly feel the baby’s head, which was the strangest feeling, as if it had suddenly appeared there. I let the midwives know. The next contraction and I felt my perineum begin to stretch, however the baby’s head slipped back and released the stretching feeling immediately afterwards. Andrea said that this was good as it meant my perineum was being stretched very gently. The contraction after this and the baby’s head crowned, and Andrea told me to stop pushing and start panting. I actually then panted the rest of the baby out! 

The next contraction Andrea told me that the baby’s forehead had been born – the widest part – and that my membranes hadn’t broken, so it was still in its “cowl”. She asked if I wanted to put a hand down to feel, but I said I just wanted to get the baby out! The one after that the whole head was born, and the next one brought the shoulders, and with the one after that the baby was finally born. Andrea pushed it between my legs and I guided it up to the surface, however this pulled the cord tight around its neck – it was wrapped around twice – so I instinctively lowered the baby back down again to disentangle it. John told me afterwards that he had never seen two middle aged women move so fast, as they thought I was going to put it back under the water! It was 3.24pm.

The baby still had its membrane over its face, and looked to me to be very blue and floppy. It also didn’t appear to have breathed yet. I just kept on saying “Is he alright? Is he alright?” We were convinced that the baby was going to be a boy, because apparently the majority of babies with irregular heart rhythms are boys, and the heart rate had also been at the “boy” end of the spectrum. Andrea blew in the baby’s face and gave it a bit of a rub with a towel, and it soon started crying. She suggested that I have a look to see what it was, but I wasn’t ready to move just yet. When I did have a look a little while later I was amazed and delighted to find that we had another little girl.

I sat and cuddled her in the pool, both of us wrapped in towels where we were out of the water, until the cord stopped pulsing and Andrea cut and clamped it. I then handed the baby to John and got on with the serious business of delivering the placenta. I hadn’t managed a natural third stage last time and was determined to give it my best shot this time. Although I wasn’t feeling any contractions at all, I pushed anyway – when nothing happened I tried standing up, and then finally got out of the pool and squatted on the bedpan. Anja suggested I hold my tummy with my hands to give me something to push against, and eventually I felt the placenta slipping out, and felt absurdly proud of myself!

John had by this point rung my Mum to tell her to bring Catherine home, and left a message as she hadn’t answered her phone. However shortly afterwards they arrived home. I showed Catherine her new baby sister which by this time I was feeding her, still sitting on the floor leaning on the pool, both of us wrapped up in towels. Catherine’s first response was “Can I show her my new shoes?” Someone made a round of tea (most welcome), and then Anja took Catherine off to the kitchen to examine the placenta, where Catherine came out with the wonderful comment “It’s great fun having babies, isn’t it?” and Mum got her first cuddle with the baby while Andrea examined my perineum (“as intact as intact can be”). 

I sat on the sofa with my girls while John and the midwives got on with the job of clearing up, then finally they disappeared off home leaving me to share a can of tomato soup with Catherine (to crown a day of bizarre food choices) before Catherine was put to bed and John and Mum had a slightly more substantial meal before we all turned in for an early night.