Rosie's story - Amelie Daisy May's birth

 

 

Due date: Friday 11th May 2007

Birth date: Sunday 3rd June 2007


This was my third pregnancy as my daughter Katie was (still)born by elective section at 28 weeks +3 days on 12th December 2000.

She had Perlman Syndrome and Wilms Tumour, which is a childhood leukaemia kidney cancer. I had since met and married Richard in 2005. Genetically the chances of the same problem occurring with a different partner were between 1 in 500,000 and 1 in a million.

I then had a miscarriage in July 2006 at 10 weeks +3 days while we were on holiday in Amsterdam. We were both devastated.


The start of this, my third pregnancy was heavily monitored and we were very glad for regular reassurance scans. We were tentative about celebrating too early in case our hearts got broken again. The first half of the pregnancy however turned out to be textbook, with every scan showing normal growth and activity. With every scan we got closer to having our dream coming true. At 23 weeks we were told we were having a little girl. I couldn’t believe things were actually happening right. It wasn’t until I got past 28 weeks (the gestation of pregnancy which I had Katie) I breathed a sigh of relief and saw every new day of being pregnant as a step closer to meeting our new daughter.

At 28 weeks

We had a 4D scan.We came home with a 20 minute DVD of our daughter sucking her fingers and pulling faces from inside the womb. I was finally starting to believe I might actually have a healthy baby in my arms at the end of this pregnancy.

At 31 weeks

We hired a doula, Sallyann. We found her details on the Doula UK website. This was to be one of the best decisions I had ever made. I was anxious about the birth for so many reasons. Mainly though because of the loss of autonomy I had experienced during previous stays in hospital. However I knew that this should be a positive reason to be in hospital when a baby was born, so finding Sallyann was a positive step towards planning for the birth we wanted.

At 34 weeks

We attended an NCT Homebirth Support Group in Moseley, Birmingham. We met ladies who had great birth experiences and it got us thinking about what we wanted. We approached our midwife about it who was unsupportive. I wrote to her supervisor and had a meeting with her at Walsgrave Hospital in Coventry at 36 weeks, where we had been having all our scans. We basically addressed the midwife’s concerns and anxieties one by one.

Having not laboured before, and having had a previous section, I did not fit into the normal ‘criteria’ fora home birth. It was a very difficult time and a stressful build up to the meeting. Sallyann our doula accompanied us. I was saddened that I felt had to ‘fight’ for the home birth booking, but once we had shown we were making an informed decision based on our needs as a family, the booking was confirmed.

At the end of the meeting our new midwife Doreen was very pro-homebirth, upbeat, and supportive. I did not know at the time that I did not need a homebirth ‘booking’ as such. I didn’t know that a woman can change her mind at any time about where she wants to birth, including during labour.  I had every right to labour and birth at home, and if called, they had a duty to send a midwife.

We were booked in for a home water vaginal birth after caesarean. We were hoping I would give birth in our birth-pool that we had bought after attending the NCT Homebirth Support Group. This was going to be my first labour. Although we got the home birth booking, it was not easy. The Supervisor of Midwives focussed in very heavily on the risks of having a homebirth. However we had researched these risks well enough to make an informed decision based on what we felt would be the best birth for us as a family. I knew that in a hospital environment I would not feel able to birth, because for birth you need relaxation and for relaxation you need privacy and control.

From 41weeks

The local policy is to ‘offer’ induction at 40 weeks plus 10 days. We decided to decline induction and accept twice weekly scans and EFM monitoring for reassurance in accordance with N.I.C.E. guidelines. We were constantly repeating and having to re-justify our decision to ‘wait it out’ at home – this was unacceptable. Another meeting with the SoM took the form of us having the list of risks associated with ‘post-dates’ babies given to us, as if we were being told off.

Then a tour round the labour ward at Walsgrave. We stood our ground. I knew the due date was not 100% accurate, all monitoring showed baby and I were healthy and happy; baby was in the right position, with plenty of fluid and placenta still effective. Lots of support from our doula & the homebirth and VBAC e-mail support groups really helped us stick it out despite unhelpful comments from people all around us.

Everyone around us became impatient. My in-laws had booked a holiday for the time that I was going to be 41/42 weeks pregnant. They expected I would have the baby, they could come meet her, then go on holiday as planned. They ended to having to postpone their trip, and rang most days to enquire if I had given birth yet.  I decided to go into hiding. My husband was responsible for all calls and texts. I continued to swim every morning and listened to my Natal Hypnotherapy birth Preparation CD.

23rd May – 41 weeks +5

I had a stretch & sweep at home with one of the community midwives. The cervix was slightly round to the back and she managed to get one finger in to do the sweep. I produced a mucus plug 24 hours later which was very exciting. Looking back, it now feels ridiculous that I felt I had to have a sweep. Why should I not just wait at home and relax for my baby to arrive? I think I was probably pacifying them by agreeing to this. 

27th May – 42 weeks +2

I had a second sweep at with a community midwife. As I was ‘overdue’, the midwife preferred to monitor me for half an hour before she would consider doing another sweep. I was surprised to hear that she had never come across a woman so ‘overdue’ (this is ludicrous now to me – because I know that normal pregnancies can be anywhere between 38 and 42 weeks long).

With this in mind, I didn’t consider myself to be more than 2 days overdue. My cervix was slightly more round to the front and bit stretchier. This small amount of progress encouraged me. Every day was like an emotional roller coaster though. I am still so angry that I was made to feel like a freak for still being pregnant. Whatever happened to mothers following their instinct and listening to their bodies? 

29th May – 42 weeks+4

As a result of the pressure being put on me, we visited an alternative hospital labour ward (Warwick) and met a Supervisor. This helped me stay positive as they didn’t normally suggest induction until 42 weeks and even then, they had a more relaxed approach. It seemed they would not pressure me into induction. It was a smaller unit and much more homely. We decided that if we needed to transfer into hospital during our homebirth, this would be where we would go.

I was not surprised to hear that I was one of several ladies who had transferred their care from Walsgrave to Warwick, one of whom was in labour when she made that decision! At this point I was considering attempting use of prostaglandin gel/pessary and then going home. However as I was attempting a VBAC (vaginal birth after caesarean), they would only offer one administration before recommending further intervention such as ARM (artificial rupture of membranes) and oxytocin drip.

This was my worst nightmare as I would be less likely to be able to use a birth pool, and more likely to be pressured into being strapped to the EFM machine on a bed. I would also then be subject to their timescales when in fact, my body had its own already.

30th May – 42 weeks+5

Feeling desperate and isolated, I had some acupuncture called ‘natural induction of labour’. I came home with some lower back pains. The regular Braxton Hicks I had been having since 38 weeks were becoming stronger. The positive attitude of the acupuncturist really helped me through this day. I continued to ignore all calls and texts which all asked the same thing; ‘is baby here yet?’ For future reference, if anyone you know ever has a baby, do NOT continue to ask them if their baby has arrived yet. It's well intentioned, but all it does is add more stress to the “you shouldn’t still be pregnant” attitude coming from the health professionals.

1st June – 43 weeks

Had a third sweep at home (with lovely Doreen, my designated midwife). My cervix was stretchier .Doreen was surprised to find me disheartened, upset and feeling emotionally drained. She encouraged me to keep my resolve up and helped me feel that I was not necessarily a ‘freak of nature’, being 43 weeks pregnant. After seeing her I felt much more upbeat about our decision to wait it out at home. At this stage of pregnancy, what people say to you has so much effect…it can really turn things around. I learned that surrounding yourself with positive people was very important. 

2nd June – 43 weeks +1

Tried taking castor oil as it was recommended by many different people, but I knew it might give you the runs and make you feel ill. It did. But then I had mild contractions from 11am, every 10-20 minutes. I then managed to sleep from midnight until 2am. 

3rd June – 43 weeks+2

At 2am I woke up with stronger contractions. I started to time them, they were 1-2 mins apart. Richard called the midwife and Sallyann our doula. Up until now the bath had provided me with relief, however I found that having a contraction in the bath was not as relaxing as I thought it would be, so I got out again and waddled round the house, rotating my hips and repeating my mantra – ‘I trust my body, I trust my baby’.

The midwife arrived at about 3.20am - it was the same lady who had done sweep no. 1 and 2 . An examination I asked for revealed I was 2cm dilated with ‘waters bulging’. At 3.40am, my doula knocked on the door. I was sat on the sofa and shouted ‘it’s open, come in!’ and at exactly the moment when she walked through the door my waters broke with a huge gush all over the floor and sofa!

I let out an exited ‘Oooooh!’ and waddled off to the loo leaving a trail of clear fluid behind me. I was very relieved to see it was clear fluid - as one of the reasons we had been given for recommended induction for post dates pregnancy was meconium (baby’s first poo) in the liquor (fluid) and meconium aspiration (baby swallowing the poo in the water). 

Things were really starting to happen and I was so glad, because I had got to a point where I almost believed my body didn’t know how to labour or give birth. I was smiling and I felt great.

The next few hours were spent upright, stopping for contractions and blowing the pain away. Richard or Sallyann would meet contractions with massage at the bottom of my back which really helped and soothed me. We stayed downstairs for about an hour, then went up to our bedroom for a while. I had a selection of my birth music playing and this helped a lot.

I had spent weeks listening to it and relaxing in the bath. Now I could recreate that relaxation but whilst in labour. I slowly became more vocal, and eventually did not need to tell anyone that I had a contraction coming. It took a while to get used to the fact that a contraction made me feel like I needed the loo due to the pressure.

I therefore spent most of my time not too far from the bathroom. Richard filled up the pool and I started asking for gas and air. Sallyann urged me to save it for towards the end of labour which kept me going for a while, but after another visit downstairs to the loo, I found the contractions to be more intense and felt that I really wanted to try something to take the edge off.

I found out later that Sallyann did not realise just how strong the contractions had become. Some time later, I tried the gas and air whilst leaning against my bed, it made me feel a little drunk and hazy, but did seem to take the edge off the contractions. 

I felt I wanted to get in the pool at about 8am, and it was enough relief for me to get through the more intense contractions. I was being guided by my instincts, and what I felt was the right thing to do next. On examination just before I got in, I was told I was 4 cm dilated. This was fantastic encouragement for me. I now know that the four hourly NHS examinations during labour are optional and rarely an indicator of much, but I was looking for encouragement. 

The pool was in the corner of our little living room. The birth music was playing in the background. I asked everyone to leave the room apart from Richard. I stripped off apart from my bra and jumped in.

The pool was heaven. It made me feel I had more privacy to birth. I imagined that you could not see through the water, and felt that I could let go once my bottom half was submerged. I felt lighter and more flexible than I had been on dry land. I spent a while getting used to the pool before I found my comfort zone with my back to everyone. I was facing the corner of the room. That way I couldn’t see what was going on in the room around me. Sallyann and Richard squeezed into the space between the birth pool and the wall and held one hand each; I held the mouthpiece with my teeth. I found it helpful to bite down on it. Things were relaxed. It was like having friends over for coffee except one of us was in the corner giving birth. 

I closed my eyes during contractions, when I opened them it was like waking up. Sometimes Sallyann had her head down leaning on our hands clasped together. I really liked this as it made me feel less observed but still supported. I remember thinking about Sallyann ‘crikey you are one hell of a lady having birthed 4 babies, 3 of them at home in water with no gas and air!’ Sometimes I crouched, and other times it felt good to spread my legs back straight behind me floating in the water. I felt more supple in the water. I think this really helped Amelie move down the birth canal.

I used gas and air to get through every contraction. I was more focused and determined than I had ever been in my life. I said to Sallyann once I was in the water ‘I think I could really do this in the pool you know’ to which she replied ‘you could do this anywhere’.

I have learnt that if you have someone who totally believes in your ability to birth, you too soon learn to trust your own body to do this. It is no wonder that having a doula with you reduces the need for pain relief and also reduces the chance of a c-section by a whopping 50%.

Sallyann has since said that I was like two different people in labour. One was during contractions, I would allow the release of energy from my body by taking big deep sighing breaths, these soon changed into moo-ing type noises. It felt so good to make those noises!

I had my eyes closed through each one. She likened me to some type of goddess porn star because I was wearing nothing but a black push-up bra, and was sighing and moaning whilst experiencing these rushes of energy. Then she said the other person, was when I had finished experiencing a contraction, I would open my eyes, smile and look up, and in a soft calm quiet voice, ask my husband Richard if he was ok. 

Labour progressed well, although I didn’t know that. I was just concentrating on getting through each sensation, each one leading me closer to finally meeting our precious baby girl. The order of what I remember is a little jumbled up now. But here are a few things which have stayed with me; in between deep breaths of gas & air I breathed out noise almost like a long, loud sigh. I think they got higher with the intensity of the sensations. Eventually they turned to almost growl like noises. I said ‘do you think we should knock on the neighbours’ door in case of the noise?’ To which I got the reply ‘what noise?’. 

One of the songs on the birth music collection was Flowers in the Window by Travis. At the time of its release I had not long lost Katie. In the music video, the band Travis are seen walking round a new town, every inhabitant of which was a heavily pregnant woman. I always thought of it as one of ‘her’ songs and had vowed it would one day become a positive song for me. I somehow in between contractions managed to tell this little story to Sallyann and Richard. From that point on I felt like I could really let go. I think if you let go of whatever feelings are you holding onto, birth without pain becomes a possibility.

I also have two pencil sketches of Katie framed on the wall I was facing. I stared at them hard during one contraction and apologised in my mind to her for not having laboured, but opting for a section when I had her. It made me feel stronger inside. Another song on my birth cd was an Annie Lennox song called Stay By Me, the lyrics to which are ‘come on now baby’ which I had sang to my huge bump in the bath many times before, so listening to it in labour felt so right. I was on a complete mission to do this for my baby. 

Other mantras I said in my head which were helpful were:

‘Pressure, warmth and power’ (from the natal hypnotherapy cd) 

and

'Blow it away' 

I also concentrated on the images of other birthing mothers from the positive birth videos I had watched through my pregnancy. The main one was from the NCT DVD ‘Happy Birth Day’ of a lady who had a home water birth using gas and air, and made her own video diary leading up to, and through the labour. The other was an unassisted homebirth of twins (one breech) which I had seen online. Both had inspired me to stay focussed.

Once the second midwife arrived things changed slightly. She was older and more vocal than the first midwife. She seemed to want to take over a bit. Whereas the first was very hands off and just quietly monitored me intermittently, the second approached me in the pool during a contraction saying ‘what do you want to do about the 3rd stage Rosie?’ I remember thinking have you even read the birth plan!?! (It was up on the door of the living room).

But I ended up replying with something along the lines of ‘let’s wait until we get there’. Half way through a contraction the conversation between the midwives got too loud. They were rustling a paper bag or something. I shouted ‘too loud!’ to Richard and Sallyann. They asked the noise be kept to a minimum and then things seemed to get back to how they were before the second midwife arrived – hands off. I remembered what Sallyann had told me about ‘finding my voice’ in labour and felt good I had been able to do this. 

At one point Richard commented I hadn’t sworn once. I was struggling to express and vent the sensations and so gave it a try, shouting a loud ‘F**K!’ at the height of one of the contractions. It didn’t seem to help so I didn’t swear again. Richard later said it sounded unnatural, as though I “felt” I should swear; I went back to my growling. It was great to growl. It made me feel quite powerful. Looking back, this was the result of me respecting my body to do what it was designed to do.

I asked for the meptid at 9am, which we had in the fridge. I had been in the pool for 1 hour. It felt like there were hardly any gaps between contractions. I later found out that this was because I was in transition. Richard said things which really encouraged me like ‘just go with your body’. It was not long after this that my body decided it was going to push whether I liked it or not! I was so shocked that I was pushing with seemingly no effort on my part. I later learned this is the spontaneous ejection reflex; when the body does the work for you. 

I tried to relax through it and asked for meptid again. Sallyann reminded me that it would make my baby drowsy. The midwife suggested I have another examination. I was told that there was no cervix at all, I was fully dilated and that I could push when I wanted as my baby was ready to be born. There would be no point in meptid now as it would take 20 mins to kick in and I was so close. I was so shocked as it felt like I hadn’t been in labour that long, and as it was my first labour I was expecting a long drawn out affair. Second stage lasted about 30-40 minutes. Someone said ‘do you want to just reach down and feel the head….’ To which I replied ‘NO THANKYOU!’. I needed to focus on the sensations, and I knew my body would do the rest. In the background I could hear someone saying ‘she’s looking at me, I can see her eyes’. I didn’t realise the head was even out!!!

With the next contraction I decided to push when my body pushed. I was scared of tearing which might have been why I was holding back from pushing. It felt like someone was pushing a brick out of a brick wall, like grinding hard surfaces together. With the next push she was out. She shot out behind me, and I had to lean right back in order for her to be lifted through my legs and onto my chest. I was asked if I wanted to lift her out myself but I still felt like I was coming down off that last contraction and was a little shaky so asked the midwife to do it. She came out of the water all dark pink and big blue eyes. I was saying ‘I did it, I did it’ in disbelief.

She didn’t cry, her eyes were wide open. She just looked around at everything. She didn’t take a breath but I was reassured that she was still getting oxygen from the placenta so I could blow on her face to see if it stimulated her. After a minute or so of doing this I began to panic a little. I asked for some help. Richard cut the cord, and they took her to the corner of the room. The high sides of the pool prevented me from seeing what they were doing and I tried to relax through a few mild contractions. They had put the oxygen mask over her face and as soon as they did, I heard a cry and I burst into tears saying ‘she’s alive, she’s alive!’.

Looking back my only regret (apart from not having filmed the birth) was that I became impatient so quickly for her to breathe. I now know when I asked for help they could have helped by bringing the mask over to her whilst the cord was still intact. Next time I will aim to keep the cord intact until it has stopped pulsating because Amelie deserved to have access to all that good blood in the placenta – it is packed full of nutrients and transfers over to the baby following the birth. I could not have anticipated how I was going to feel seeing my baby so fresh and new and relaxed. The last time I had held a baby of my own was Katie, I never saw her breathing, she was so still. At that moment I needed this baby to breathe more than I had ever needed anything ever before. 

I tried to breastfeed her for the first time in the pool, but she was so long and slippery, like a big wet pink fish! The louder midwife tried to push my boob and her head together which looking back was unnecessary and made Amelie cry. She was calm once she was back in the water with me though. Whilst waiting for the placenta Richard had 15 minutes of lovely calm time swishing her around gently in the water. 

She was born at 9:45am so I had what I called established contractions for only just under 8 hours. However, all the books say established labour is anything from 4cm onwards, so I was in established labour for 3 hours 45 minutes. She weighed in at 9lbs 3.5oz and I was so shocked at how big she felt in my arms. I couldn’t believe I had been carrying her for so long. After a few minutes holding her in the water I decided to have the injection for third stage because I wanted to get out of the pool and get into bed with her and Richard. Six or seven minutes after the injection nothing had happened so with a little help I stood up, and just as I did the placenta fell out and was promptly caught by the midwife in a bedpan. I was ecstatic at this point. 

I would not do this next time round though. This is because with the injection there is a risk of the uterus clamping down before the placenta has been delivered. This is called retained placenta. For a homebirth, this can be sorted by massaging the uterus until the drug wears off and placenta is delivered. However, faced with retained placenta many NHS midwives would simply recommend transfer which would have taken away the wonderful experience which followed the birth. I am a little disappointed that I was not encouraged to deliver my placenta naturally because it was on my birth plan. Next time, things like dressing and weighing the baby can wait – they are not important at this early bonding stage.

I climbed out of the pool and was helped into bed. Richard had dressed Amelie during the 3rd stage, and we snuggled up. I had another go at breastfeeding which was pretty successful but took a few attempts to get it going. She is almost on the boob constantly now at time of writing this (9 days old) so we must have done something right. (Note from author: breastfeeding continued until Amelie was 4.5 years).

I have been on a complete high since her birth with no signs of baby blues (only tiredness). Everyone who meets her comments how calm and contented she is. I have no doubt that this, my effective contractions and short labour were all down to the fact that she was born in water and at home.

After I lost Katie I had tremendous support from a few charities that support parents through loss. I spent a lot of time singing their praises and spreading the word about their good work. Now I feel like I have to spread the word about home birth and its benefits – and not just for those who ‘tick all the boxes’. If I had needed to be transferred into hospital for any reason I would have been receptive to any recommended course of treatment either I or my baby might have needed. Her APGAR scores were 6 at 1 minute and 9 at 5 minutes.

I feel we helped make the labour short by being in control and staying calm. The preparation we put into the birth helped me to convince myself I was capable. I now help out with the local NCT VBAC Birth choices Support Group, and I hope I am an example of how you can have a VBAC, post-dates home birth in water.