From: Anna-Luise Dewar To: angela@homebirth.org.uk Date: Thu, 29 Jan 2009 16:48:22 -0800 (PST) Subject: Birth story for the website - wonderful homebirth with some complications afterwards Hi Angela, I've been a big fan of your website (and you!) for years and found reading the birth stories particularly useful. The ones where everything goes to plan are of course the ones that made me consider a homebirth in the first place and then the ones where things didn't go to plan were so useful in cementing that decision and answering a lot of the "what if" questions. Because of that I thought it might be useful to post my birth story too, as it's another example where things didn't go entirely smoothly but this was no cause for panic and the outcome would not have been better in hospital. The part after the birth is quite long, as I didn't want to just stop after the birth and leave a potential reader worried about what happened to Sophie and wondering if she's OK now. I definitely wanted to end on a positive note as I don't want people to feel sorry for me in any way, I wanted to try and convey how easy it can be to cope with the unexpected if you have a positive attitude. Regards Anna-Luise Dewar

My daughter Sophie was born at home on 5th December 2006 at 3.10am weighing 6lb 3oz.  There were some complications after she was born, which is why the following story is extremely long.  My apologies in advance.

I had declined the triple test, as I definitely didn't want to terminate the pregnancy if there was a problem and preferred to be relaxed and happy throughout.  This worked very well: I felt fantastic all the way through and concentrated my efforts on preparing for a beautiful pain-free birth.

A couple of days before my due date I started feeling my cervix doing things whenever I was sitting down or otherwise relaxed.  In retrospect I was obviously having contractions, but I just didn't think of it that way at the time!  They were not at all painful, I could just feel my cervix dilating in little waves.  I started to get quite excited and telling people it would definitely not be long now.  Everybody laughed at me!  I was warned constantly not to get too excited, as I should expect to be late and as soon as I felt that I was ready it would probably be another two weeks on top of that.

The day after my due date (4th December 2006) my mum and I took the dog and met a couple of friends for a nice long walk.  About half way through the walk I started to feel a little bit wet down there.  I asked very red-faced whether they could see a wet patch and was told that it all looked presentable.  A few minutes later the drip-drip-drip I was feeling turned into a trickle and the wet patch developed quite quickly.  

As soon as my mum and I got home I gave my lovely IM a ring, who came over straight away to have a look at the fluid.  She said there was a little bit of meconium, but it looked quite old and I shouldn't worry as everything else seemed fine.  I said I would call her back when the contractions became more regular or if I needed her.

The contractions soon became quite regular, albeit 10 minutes apart or so, and I started getting very excited.  I started using my hypnobirthing techniques during each contraction and looked forward to each one.  This may sound bizarre to some, but the self-hypnosis that I'd been doing for the past few months involved telling myself that I knew that the contractions wouldn't be painful, that they might feel quite intense, but that feeling wouldn't be pain.  Instead of dreading the pain, I looked forward to the feeling that was telling me that my baby was being born.  

We gave my mother-in-law a ring to invite her over for dinner and we all had a lovely meal together; my DH, my mother, his mother and I.  Occasionally I stopped eating and focussed inwards, but I'm not sure that anybody else really noticed.  

After my MIL left, my mum and DH set up and started filling the pool.   Things progressed nicely, with contractions getting more intense but definitely still manageable.  I mostly leaned forward against DH and breathed during contractions and we chatted in between.  I had absolutely no idea how far along I was and in fact was convinced that this must still be pre-labour because it was so easy.  We occasionally timed the contractions and I gave Carrie (my IM) a ring when they were 5 mins apart to update her.  I said I didn't need her yet though and that I would phone back later.  

When I was planning everything I thought that music would be really important to me and I had a pile of CDs set aside, but in the end I stuck the hypnobirthing CD on repeat and forgot about it.  

When the contractions were about 2 mins apart I really felt that I wanted to get in the pool, so I gave Carrie a ring and she said she'd come straight over.  I'm not certain what time that was, I think around 11.30pm or so.  When she arrived she offered to examine me and I said yes.  Initially I had planned on no exams at all, but I just wanted to know so badly how far along I was!  She had a check and said I was fully dilated and that if I wanted a waterbirth I'd better hurry and get in the pool.  I was ecstatic because I fully expected her to say I was 3 or 4 cm and I think I would have been a bit discouraged at that point!  

The contractions were really intense by this point, not painful but I felt like I was losing control of my body a bit which I found scary.  Getting in the water was absolute bliss.  My muscles, which I think may have been tensing up a bit from fear, relaxed beautifully and I had a few minutes' break before the urge to push began.  OMG that took me by surprise.  When I'd read about the second stage there was a lot about "breathing the baby out gently".  Well that just wasn't going to happen!  My body totally and utterly took over and just pushed.  I tried breathing out in any way that I could manage and what emerged was something that sounded suspiciously like a very big cow bellowing.  We had a bit of a giggle about that.  We giggled about a few things in fact, which was great.  The pushing lasted quite a while, I think just under 2 hours in total.  When the head was getting close to crowning Carrie told me that when it was crowning she would remind me to pant and asked DH to remind me as well.  With the next contraction (not crowning yet though) DH dutifully said 'Remember to pant'.  I told him: 'Not yet, silly!', which we all thought was very funny at the time.  When it happened there was absolutely no mistaking it, this was the first time it got a bit ouchy during the whole labour.  Nobody needed to remind me to pant, as I was a bit petrified of tearing.  

Finally the head was out with apparently loads and loads of dark hair.  I heard Carrie say 'Look, the hands are up by the face.'  I thought it would get easy now, but the next bit was a bit more difficult.  First of all I didn't have another contraction for a few minutes and when I did it didn't come out straight away.  Carrie I think was starting to get a little bit worried, so she asked me to stand up.  Now the body flopped out and I was finally holding my baby.  It turned out that it hadn't been the hands that came out with the head but the feet.  

My first words were 'Hallo baby!' and 'You look a bit funny!'  She was a bit blue and her legs were tight up against her body, with the knees hyper-extended so they looked a bit like bananas curving towards her body.  On her lower back was a massive blue-purple lump almost the size of her head.  No wonder the body had a bit of trouble coming out!  She wasn't breathing, so Carrie first of all tried to revive her in my arms but then quickly clamped and cut the cord to take her over to the table to resuscitate her.

I just stood there, totally spaced out from all the endorphins, not even thinking of moving.  Why oh why didn't I get out of the pool and join my baby at the table??  In retrospect I'm very angry with myself for that, but I guess I was so high from that beautiful labour that I just couldn't think at all.

It took quite a long time to revive her; in the end Carrie had to give her mouth-to-mouth, which I believe was quite difficult because she couldn't put her on her back.  I found out I'd had a girl because Carrie said "Come on little girl, breathe!"  Natasha (the second midwife, who arrived some time during the second stage) phoned for an ambulance, saying that we had a baby girl born at home, not breathing and with some kind of birth defect.  This was the first time that it actually sank in that there was a problem.  Finally we heard a cry and then the ambulance was there already.  Natasha got me out of the pool so I could go and see Sophie before she went off to hospital with Carrie and my mother.  DH and I stayed behind with Natasha to deliver the placenta.  Natasha asked if I wanted the injection under the circumstances, to which I said yes.  I didn't want to waste any time in getting to the hospital too.  Before Natasha had the chance to give me the injection I decided to just try pushing even though there was no contraction, and the placenta just flopped out.  Natasha phoned for a second ambulance, I went for a quick shower, got dressed and then we were off to hospital.  It was a little while before we were allowed into the neonatal unit to see Sophie, who was in an incubator.  She was absolutely beautiful.  I didn't really have a chance to look at her properly before, so it was lovely to see how much she looked like her father.  She was crying though, which was very distressing.  We weren't allowed to pick her up and hold her, only stick our hand in to try and soothe her.

A doctor came in (probably around 4.30 or 5.00 am) and told us that she obviously had some kind of spina bifida and that she would need to be transferred to the Royal Hospital for Sick Children for an operation to remove the myelomeningocele on her back.  We decided that Sophie should have a vitamin K injection (having originally not planned this), as she was due to have major spinal surgery and it seemed she would need all the help she could get to recover as quickly as possible.  The next few hours were very strange.  Time expanded and contracted very bizarrely.  They found us a room so we could get a couple of hours rest.  I was feeling quite shaky and weak, so we had a little sleep.  Around 9.00am a different doctor asked if I wanted to try breastfeeding.  I leapt at the chance, but by now she had a drip in, so wasn't hungry.  I did enjoy holding her though.  I don't know why we were now suddenly allowed to hold her and not before when she was actually hungry and would have benefited from a feed and a cuddle.  I wish now that I had been assertive at the time and insisted on trying to feed her when we came in to hospital.  I just trusted the 'experts' in the face of an unknown situation.

Around lunch-time we were all transferred into Sick Kids where we moved into Ward 7 (neurological ward).  We talked to the consultant neurologist and the neurosurgeon who explained to us exactly what spina bifida is and what this might mean for the future.  Sophie's operation was scheduled for 9.00pm that night and we spent the meantime getting organised and finding out more information.  All in all this was the longest day of my life.  We went through every conceivable emotion and had to come to terms with a lot, but by late afternoon we were on our way back up and were feeling a lot more positive.

The operation was quite long as a lot of things needed to be done.  The spinal nerves that had grown out of the gap in the spinal column had to be cut off (they served no function as they didn't lead anywhere) and the myelomeningocele had to be removed, then a plastic surgeon had to close up the area, which was extremely large.  I think they were finished around midnight.  They had intubated her so that the machine could breathe for her because she was very deeply anaesthetised and they wanted to keep her under until the morning.  When we got to ICU the next morning though, we were told that she had woken up around 2.00am and had extubated herself.  We knew then that she would be a tough little cookie!  We were so proud of her!

When she was two weeks old she developed symptoms of hydrocephalus, so she had to have an operation to install a shunt to drain off excess fluid.  The thought of brain surgery so soon after spinal surgery was really worrying, but there was really no choice.  I couldn't believe how quickly she recovered.  The wounds on her head were healed long before the wound on her back was.

After a month everything had healed up and we were finally allowed home on New Year's Day.  What a brilliant start to the new year!

Sophie continues to be a delight and a joy.  She's a very smiley happy child and she doesn't seem to have been damaged by hydrocephalus at all.  She has some mobility and continence issues, but we're working on these to great effect.  She can now crawl around at a rate of knots and stand up while holding on to something.  Her physiotherapist has great hopes of her walking with no aids other than splints to strengthen the ankles, which is much better than anyone expected in the beginning.  We catheterise her regularly and she has managed to develop some control over her bowels, so she is now out of nappies before any of her friends are.  A minor triumph, but it feels fantastic!  It has been the most amazing rollercoaster ride (with lots more to come, I'm sure!) and I really feel that my life has been enriched by the experiences that Sophie has enabled me to have, warts and all.

I'm so glad that I didn't know that she had spina bifida before the birth.  I would not have had a home birth, in fact I probably would have had a C-section given the size of the myelomeningocele.  The fact that we were able to cope so well and adjust so quickly (within a matter of hours) can I believe be attributed to us being well rested and calm beforehand and having had such an easy birth.  If we had been 'prepared' we would have been total wrecks!  There is absolutely no way that you can possibly prepare yourself for something like this.  Sophie had the help she needed as soon as she needed it, so there would have been no benefit to knowing about it before.

I'm now pregnant with my second child and am very much looking forward to an equally wonderful birth with perhaps a little bit less trauma afterwards!