Andrea has twelve children, seven of whom were born at home. Her tenth baby, Seth, was a planned, unassisted birth, and she planned the same for her eleventh, Lydia. Unfortunately Lydia got stuck and eventually arrived by caesarean:
This was my 11th baby (10th pregnancy) and I was planning an unassisted homebirth. I already had birthed 6 babies at home and my last child, Seth, was also a planned unassisted birth. I felt, and still do feel, homebirth is the safest birthing option when things are normal, and an unassisted homebirth where a womyn tunes into her body and baby to guide her is safer yet.
Early on in my pregnancy I had a strong suspicion my placenta was anterior, as I didn't feel the baby move until quite late. This was later confirmed by ultrasound about mid way through my pregnancy. I wasn't really concerned as I'd had anterior placentas before, and even though they tended to encourage my babies to the posterior position (babies like to face their placenta) they always turned during labour and birthed without a problem. I'd been familiar with fellow New Zealander, Jean Sutton's, Optimal foetal positioning theories for some time. I'd used her ideas on turning babies with my 4th child (now 10) during a 36-hour start/stop labour due to a posterior position and they worked well.
During my pregnancy I had active and painful Rheumatoid Arthritis flares in my feet that prevented me from doing a lot of walking and standing. So as I was sitting a lot I always made sure I had a pillow under my tailbone to tilt my pelvis and encourage my baby forward. I made sure my knees were below my hips, and when I was lying down I'd try and massage the baby around and into a more anterior position. Despite all this and more she stayed persistently LOP/LOL (L= Lateral, or back against my left side). Still I wasn't too worried, I'd been here with quite a few of my babies and they had all turned once in active labour. No need to panic I thought, she'll turn when she's ready, and if not, plenty of babies are born face to pubes (posterior), I'd even birthed one of my twins, an 8lb 8oz face to pubes baby myself 3 ½ years earlier.
The day before I turned 41 weeks I had a pressing need to go shopping and fill my pantry, buy those last minute birth/baby things and have a nice long lunch on my own in a café. So I spent Sunday doing just that, I bought some more cloth nappies, some new fluffy towels to catch the baby in, another wool Singlet (it was mid winter) and thoroughly enjoyed a relaxed lunch and savoured a frothy hot chocolate while reading some trashy womyns gossip magazine..alone :o)
About midnight we decided to go to bed, and while rubbing away a Braxton Hicks that felt a little more forceful I told Peter "I think I'm probably going to be having a baby tomorrow." I stayed up for another hour just tidying up, doing my nesting thing, and feeling an urgent need to put those freshly washed new fluffy towels in the drier. I had another grippy BH and knew that was an early labour contraction. I decided I'd better go to bed now and get some sleep as I'd probably be in labour tomorrow.
I'd slept about an hour when a contraction woke me. I got up and went to the toilet and discovered a show. I was wide awake now and contractions were too strong really to sleep through so Peter went and chopped some more firewood (at 2:30am) and stoked the fire up more to get the house nice and warm as I'd let it die out before I went to bed. I put my Nora Jones CD on and put some Neroli oil in my burner, took some homeopathic birth aid, and got my birth supplies ready. I spent the next few hours peacefully contracting, moving between the snugly fire lit lounge and my safe bedroom/birthspace.
Things were moving along quite well and quickly, and by 6:30am I felt that familiar transition adrenaline rush and pushy feeling. I took some Rescue Remedy and checked myself, sure enough there was that hard round head, no cervix, fully open and ready to go. My membranes hadn't gone yet and the baby had a small balloon of waters over its head. The membranes felt very latexy and thick, I couldn't feel any sutures or fontanelles through them, but it didn't concern me as I thought it was just the membranes and waters obscuring things.
I moved onto my birth mat, kneeled over my beanbag and waited for the next pushing contraction...and waited...and waited...and waited. Second stage lull I thought, very common, happened before, don't sweat it, go with your body. Half an hour later (about 7:00am) they started up again, but they weren't lasting very long at all. They seemed strong enough, but just as I'd get one small push into them the contraction would be over. After an hour of this I was starting to get the feeling all was not quite right. This was my 11th baby, it should just fall out. Well, not literally, but it shouldn't take 1 ½ hrs in second stage, it's never taken me this long, not even with my first and he was born weighing 10lbs. My babies come in one or two contractions, not long after that first pushy/adrenaline feeling. This just wasn't what my body did in labour.
I also was not feeling her move. With Seth he was just so active in labour, it was very reassuring that he was ok. I wasn't getting any movement at all from this baby, no physical feedback. It just didn't feel 'ok' at all. I checked myself again and that head was still there. While I was checking a contraction started and my waters went; finally I got to touch my baby skin to skin. I stroked that little hard head, felt the crumply little caput/wrinkle that was forming on the right side and was spurred on to get this baby born and meet it.
Another hour went by with me trying every position known to womyn kind to get this baby down, standing, squatting, kneeling, all fours, swaying, I even spent time on the toilet as I heard that helps some babies descend. I was strongly feeling that this baby was stuck, in fact I knew she was stuck, this just wasn't right. I kept saying during my contractions "come on baby, you can do it, come on baby" but I was clearly hearing this baby saying it couldn't help me, I had to do it, she couldn't help herself be born. Even though I felt she was alive I verbalised to Peter that I thought the baby had died, that's why she wasn't helping herself be born, that's why she is stuck, that's why there is no movement, the baby has died. He said "I don't think so dear" and rubbed my back, I knew she hadn't either, but I needed to tell him she couldn't help me, and I didn't think I could get her out on my own.
Another ½ hour and with me pushing between contractions now as well to try and get her out, I decided I needed to talk to someone. It had been 3 hours now and I knew she was stuck, I knew she needed help getting out but I needed someone to confirm what I felt. I rang my midwife friend who I had a casual agreement with through my pregnancy. She knew I was planning an Unassisted birth and was very supportive; she visited me a few times in my pregnancy and made herself available by phone whenever I needed her. I told her my concerns and that I was 'thinking' of transferring into the hospital if she wasn't born soon. She asked if I wanted her to come up but I didn't think there was anything she could do for me at home that I couldn't do myself, she agreed and said to keep in touch and phone if I changed my mind.
Another 3-4 contractions with no progress and increasing pain in my back, I'd changed my mind. I rang her back and said "she's stuck but I don't want to go to that hospital". I knew I had to though, I knew she needed help and this new increasing pain in my lower uterine area, and her lack of movement told me things had moved away from normal, I needed to transfer.. but for the life of me I couldn't bring myself to do it. I phoned her back and we discussed again transferring. I explained my concern that I would give birth on the way there knowing my luck. How many stories do you hear of womyn transferring at the 11th hour and giving birth in the back of the car or Ambulance, that was not something I thought was safe or wanted for my baby. She offered to ring the hospital for me to let them know I may come in. I made sure she told them I may not either, should the baby come soon.
A few more contractions with still no baby and the phone rang, it was the hospital. The midwife there wanted to send an ambulance as my midwife had said 'if' I was coming in we were driving ourselves, we know our road so much better and in my experience of getting Ambulances here it takes forever and they struggle with our narrow windy, country road. I got the 'Having your 11th baby at home alone is so dangerous and you and your baby could die" speech from her and again the ambulance was strongly advised. After a long silence and mumbling f*ck f*ck f*ck under my breath I agreed. I hung up the phone and cried. God f*cking Damn it, why me, why now, why this baby, how can this happen to ME. Super homebirther of 9,10 and 11lb babies, transferring to hospital with a stuck baby, the humiliation.
As expected the ambulance took forever, with each contraction I had before it got there, I willed that baby out of me with all my worth. Please, please, please come out now before it gets here. Too late I heard the sirens coming, my heart sank. I still hadn't even got anything together to take into the hospital. All I could think to take was my big bean bag to hug. The sirens came...and went. They had drive right past our house. I sat in the lounge riding another massive contraction ripping my back apart, and watched as the ambulance drove back...and past the house again. Oh good lord, good job no one was dying or anything. In the end I walked up my driveway to the roadside, swearing to kill the ambulance driver with my own two hands if I had this baby outside in the rain on my driveway, and waited until he drove back.
Finally he arrived, but then he wanted to ask me a million questions, 'when did labour start' 'what number baby is this' 'How old are you'. I put my best demonic voice on and said 'just get to the hospital already'. His last question was 'Why did you leave it so long', I just stared perplexedly at him and said "because I thought the baby would come"...duh. I don't think he realised this was a planned homebirth.
I later read in my notes when the midwife had called dispatch she had told them to 'tactfully' try and site an IV cannula too, good job for him he didn't or he would have needed an ambulance, I think he sensed this and with sirens and lights blazing he left for the hospital with my Peter following in our car. The drive was torture. Each corner, and we live on a very windy country road, would bring on a contraction that would rip my back apart. I wish we'd driven ourselves, Peter is a much better, faster and safer driver, knows the road like the back of his hand, and the car doesn't throw me around as much as that trampoline on wheels did.
As we entered town he pulled over on the side of the road, and a second sirens-a-blazing ambulance pulls up behind us. "What are you doing" I asked, "keep going to the hospital". I thought they had decided to stop and try and catch my baby on the side of the road. It turns out he was picking up ambulance #2's driver up so he could sit in the back with me. He was concerned at the strength of my 2-3 minute apart contractions and thought he might be doing some baby catching, plus he said the other guy was a better driver. The rest of the drive was even worse, better driver my arse. It was raining and this moron was speeding at over 165km an hour down the motorway with my husband trying to keep up. I told him more than once to slow down, to which he replied we're only allowed to go a little above the speed limit (100km), we're not going that fast. My husband had to do 165km to keep up with them, and still couldn't. He lost them at a set of lights that they ran when red. They so endangered my life.
Finally we arrived at the hospital at about 11:00am and was greeted with a wheelchair, now I was to become a patient. No longer a womyn having a baby, but a sick person requiring a hospital and wheelchair. I buried my head in my hands and hid my face as they wheeled me to the delivery suite. This was not the plan, what had gone wrong. Why was my body failing me. The first words I heard when I arrived were "She's not booked", like it was the crime of the century. After more questions the midwife asked if she could assess the baby and do a tracing. I could not lay down for an abdominal palp because of the severe pain it caused my back, but I tried, being the good girl that I am. I got the distinct impression though that the midwife thought I was being difficult.
The on call OB came in and asked more questions. I told him I'd been fully dilated since 6:30am and he asked how I knew. "I examined myself" I said, a blank look came over his face. "Are you a doctor?" he asked. "No" said I." A Nurse?" No. "A Midwife?" No. "Then how do you know this" he asked? "Well it's not rocket science" I replied. Peter was getting pretty shitty at his arrogance now too and said "Look Mate by the time you get to #11 you become pretty good at knowing these things". The OB didn't reply and asked to do a VE. I was in so much pain I said no. He got all huffy and I told him the midwife had just done all this ask her for the info she got. The midwife then flapped that she couldn't feel anything in my pelvis and wasn't sure what position the baby was in. So I tried to lay back and let him do a horrid VE, the pain was unbearable, I told him to stop.... He didn't "Get out now" I yelled "Get out, Get out". It felt like he was digging for potatoes, it was agony, clawing away inside me, digging around my baby's head like that to feel how she was positioned, it was awful. He said he couldn't get a good feel of the baby and really needed me to lay back and let him try again.
The thought of going through that again was too much. I asked for an epidural. If he wanted to dig for gold inside my pelvis I needed some pain relief. I needed some pain relief anyway. It was now 11:30 and I'd been pushing for 5 hours, my back was ready to split open, and the pain was beyond anything I'd ever experienced in my lower uterus too, I was tired and I knew I was going to need some assistance, probably ventouse so I wanted an epidural. He said no...the bastard. He didn't think that was the best thing and wanted me to have some Gas to relax and lay back again for him to examine me. I told him I'd had a light epi with my twins birth and it was great, it took the pain out of my uterine area for an internal version yet I could still walk and push with full feeling. The perfect solution I thought. I also thought I might be able to push better and deeper if I could remove that pain from my back and get her out on my own. He again advised against it. I told them I was officially requesting an epidural. They said I could request all I liked but it wasn't that simple. I needed to be fully assessed for presentation and position first, and a drip had to be put in.
Between contractions I let him try again to do a VE while I sucked on the Entonox. He wrote his dx in my notes as: Fundus=38, Cephalic, 2/5, VE=Cx fully dilated, OP, 1cm (arrow down) spines, no caput moulding, CTG=Reactive. I had my IV inserted and around 12:00 midday the anaesthetist came to insert an epidural...20 minutes later my contractions were still every 3 or so minutes and very strong, it hadn't worked. The anaesthetist was called back to give me a top up, again it didn't work.. This was turning into a disaster, I was in so much pain and my baby was not budging, she was also starting to now have early decelerations because of my prolonged and very strong second stage contractions.
A new OB was called, I liked this one much better, he was a little more respectful and seemed rather more competent than the other one. I climbed back on that horrid bed and endured another VE. Verdict from this OB was: Station -1, OP to OT, Fully dilated, clear Liquor. We made a plan to move to theatre and have a spinal as the epidurals were not working, thoroughly assess the baby's position and see what would be the best way to help her out. He wanted to help her out vaginally but we discussed the high possibility if they fail I would need a c/section.
And so it began. I was prepped for theatre, and moved to the receiving bay, contracting all the way. I had the spinal sited at 1:30pm and when it had taken full effect I was able to have a deep VE to find out what was holding this baby back. She was indeed stuck, she had entered the pelvis sideways and was stuck in deep transverse arrest.
The surgeon said it was not wise to use forceps or ventouse, not because his skills were shoddy but because of her position, they would have been too dangerous to use. She needed to be born via caesarean section. I agreed and she was finally born at 1:41pm, 7 hours after I first started pushing. The OB held her up to me and said here she is. She? She? I thought I was having a boy, I was so sure I was having a boy. How can this be a she, check again. Yup it was a she, a beautiful, chubby, perfect she baby.
After a kiss and a cudle Peter got to hold her while I was stitched back up. Unfortunately for me there was a complication during the surgery. The lower segment of my uterus had become very thin from the prolonged strong second stage contractions, and as the baby was born it tore extensively along the left side and I lost more blood than I should have due to this. The repair seemed to go on forever, I could feel all this pressure and tugging in my chest. I started to heave, a side effect of the morphine, I was told. Oh joy. I was given the first of my transfusions in recovery when my post-operative hb was found to be only 60.
The next 4 days in hospital were an emotional and physical roller coaster. I battled with all the questions of why it had gone the way it did, why did she get stuck, why her, why me, what went wrong. I don't think I'll ever have an answer, sometimes what is just is and you have to accept it. I am sure I made the right decision though. I listened to my body and my baby and I made the decisions I felt were right for us, they weren't decisions I liked or wanted, but they were the right ones based on my intuition.
I can't be 100% sure what would have happened if I'd chosen not to transfer and kept on contracting with an obstructed labour, but knowing how thin my uterus had become due to an obstructed labour I am pretty sure it would have ruptured before I birthed Lydia, if I ever managed to all. I'm sad for the birth I lost, but I'm not regretful for the birth I had. I have learnt and grown so much from my experience. At first I was angry with my body for failing me, but I realise now it didn't fail me, it saved me. I listened to its signals, its change in pain, its response and I acted on it. My body isn't a failure, it's an amazing success :o)
Update: Andrea's twelfth baby, Oscar, was born at home in April 2005!
Seth's birth story
Oscar's birth story, and afterbirth story.
The hospital birth of Andrea's twins, Rose and Amelia, is on the Association of Radical Midwives' site (www.radmid.demon.co.uk)
Grand Multiparas and home birth Home birth after caesarean
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