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Mila's birth, by Becky

Becky wanted a home waterbirth for her first baby, and she prepared thoroughly, with hypnobirthing, active birth classes, and having homeopathic remedies and aromatherapy oils available. She transferred to hospital because there was meconium in her waters, but was still able to put all of her forward planning into use. Becky and her partner kept their heads and fought to keep their daughter's birth as gentle and intervention-free as possible, and Mila's birth story is an excellent example of negotiating the best birth you can, in difficult circumstances, while not compromising on safety. I particularly liked Becky's idea of taking her baby in the birth pool and letting go of her sadness at not getting the birth she'd hoped for, while celebrating her daughter's arrival.

My waters broke at around 7.30am on Saturday. I was in bed on my side, asking her when she's going to arrive, when suddenly I felt a trickle down my thigh. I sat up in bed and the trickle turned into a rush of liquid. I pushed at DP's (Dear Partner's) backside to check the liquid that had begun to pool around him, which woke him up. I told him my waters had broken and I think I have meconium. He shot up and I was kneeling in the bed at this stage, on top of a pillow trying to catch the massive flow. I couldn't quite believe how much liquid there was!!! I had tried catching some in a camisole that was in the bed, which wasn't very helpful! I eventually managed to walk to the bathroom, without dripping too much on the carpet and got into the bath for the some of the flow to come out.

It was really at this stage that I realized I would probably have to go to the hospital for this birth. I was devastated; it had been one of my fears to have to transfer into hospital for any reason as I just don't trust the hospital process and what they would try and make me do. We'd been planning a homebirth right from the very beginning and I was so looking forward to it. My partner is Dutch (the homebirth rate there is approx. 30 percent) and it seemed the most natural thing in the world to have this baby at home.

I sat on the toilet and had a good cry, then took some Rescue Remedy and tried to calm down and do some deep breathing to make sure my baby was getting good oxygen. My only reference to meconium was my sister's third birth, which she got through with no problems, delivering naturally - although had to be induced which I had thankfully forgotten about - so although I was concerned for Mila, I was quite calm about the situation with regards to her health.

I called the hospital about half an hour later and was told I had to come in, and would have to stay in. I did ask, naively, certainly with hope, if I would be able to come home after being monitored, but was told that isn't possible with meconium. I was offered an ambulance, but thank God we'd recently bought a car so we could drive in.

Note from Angela: It's always possible to come home after being monitored, if you choose to do so. Whether it is a good idea or not is another question. There is much controversy over how much difference meconium makes to your baby's risk level. It is standard hospital policy to advise hospital birth and close monitoring in the presence of any meconium at all, but in fact there is a great difference between the situation where there is thick meconium and thin meconium, whether the baby is postdates or not, and whether the baby's heart rate is showing any sign of distress or not. See "Meconium" for more discussion.

Back to Becky:

I then spent the next 45 minutes or so packing two bags with all the stuff I would need. We took bananas with us, and a flask full of honey and chamomile tea, which was so delicious and such a godsend. We took music, my ball, clary sage, homeopathy kit, clothes etc. I didn't know what was going to happen, and whether I might have to stay in, so I tried to take as much as possible.

By 9ish we reached the hospital and I began to time my contractions. They were very mild and I don't know how long they were lasting (impossible to time on a mobile!!) but they were coming roughly every two mins. Once we got up to the ward, we were kept in the waiting room for about half an hour or so while they prepared the room. Meconium stained waters kept draining out of me, soaking down my legs and into my socks, which was really uncomfortable. I went and got changed into my dressing gown and we attached the TENS machines.

At this point I was still feeling pretty calm, having a bit of a laugh with my partner and eating some sneaky bananas, in case they 'forbade' me from eating. I then went and spoke to the desk to find out when my room would be ready and ended up speaking to the doctor, who informed me that I would have to be induced! Well, I was not having any of that! I must admit this really upset me, and I was trying to hold back the tears when speaking to her. I was really shocked by this as I just hadn't considered it at all. It seemed ridiculous as I was actually in labour!

A little bit later we finally got into my room, and I was put on the monitor for ten minutes. The doctor came in again and I told her that I didn't want to be induced, and I was quite upset, and crying. I was on my own with her at this point. To be fair, she was reasonably nice, and eventually admitted that they can't do anything without my agreement, though of course I know that they can be very 'persuasive' when they want to be. She said that once a CMW (community midwife) had been found for me and I was examined, they would expect to augment my labour.

I had kept a close eye on Mila's heart rate during the ten minutes monitoring period and it was really steady and strong, and I felt bolstered by that. My feelings were then dashed a little later when one of the nursing midwives came in and also said they'd need to augment as they needed to wake the baby up as she hadn't been reacting a strongly as they would have liked during my contractions.

Thank goodness they had to find me a CMW (due to me being a homebirth transfer) and everything changed as soon as she arrived. She was more than happy with Mila's reactions on the monitor after the initial ten minutes, and said that she was probably just sleeping through the first part, which I found very encouraging. She didn't once mention augmentation and was very calm and just got on with the job in hand. She gave me an internal, and although I had stated on my birth plan that I didn't want any internals, everything was pretty much out the window due to the meconium. I was pleasantly surprised that the internal was not nearly as bad as I thought it would be, and I was 2 cms dilated with a very thin cervix. That was at 11.40am.

By this stage my contractions had slowed down to every five minutes but they were a lot stronger. Eventually the original doctor came in with another doctor, I guess the chief consultant or whatever you would call them. She said she was ok with my chart and the fact that I was already labouring was positive so they would be happy to give me a couple of hours before (trying to insist on) augmenting the labour. Honestly, it's such a crime that despite me being in obvious labour, they were still not immediately supporting the natural birth process!

I was very pleased that they were finally off my back and I could get on with the job in hand. I looked at my homeopathic birthing kit and took a dose of Caulophyllum, which is the chief remedy for strengthening contractions, and also began really sniffing on my clary sage bottle. I then went to the toilet and had another couple of contractions whilst in there. After that I went back to sitting on my ball, and the contractions were really beginning to need my full attention. I was on my own at this point but that was ok, as I used the opportunity to call my mum in NZ, who I had phoned when my waters broke. She'd left a message wanting to know if things were ok, and I wanted to reassure her that we were at the hospital and things were progressing nicely, which she could hear as I had to stop speaking to her during a contraction.

I was coping well with the contractions but felt really dirty and was rapidly going through pads to soak up the meconium and water. I would have loved to jump in the shower or bath at this point, but the TENS machine was already on and the monitor belts were hanging off me so unfortunately I couldn't. I did feel really encumbered by all these wires dripping off me. I was also still in my dressing gown and t- shirt and it was a far cry from the lovely naked water labour and birth I was planning!

My partner was out of the room as he had to go out and put some more money in the parking meter (what a stupid system, you can only pay for three hours at a time!!!!) and meanwhile they wanted to give me some antibiotics as I had a slight temp and they were hoping that some would also cross the placenta and help Mila.

The midwife tried twice to insert a massive great needle into my hand. By the time the second attempt failed, I burst into tears. It just seemed so unfair that they would insist on using such a large needle for a labouring woman! These attempts really hurt, I bled a lot and when she applied pressure to stop the bleeding that really hurt too. Eventually she had to get the doctor to come in and insert it, who kept trying to get me to lie on the bed so she could do it, can you imagine!!! I refused and insisted on staying on my ball, eventually she had to comply and I put my arm along the bed and promised to stay still while she did it (haha, I'm sure this doctor hated me by this stage and I'm positive I was labeled as the difficult one in room 9).

I asked why we couldn't use a smaller needle and they said that they wanted a larger IV just in case they needed to augment the labour. I was so close to telling her to use the smaller needle as I'm not going to allow any of that sh*t in my body anyway, but I just couldn't be bothered in the end and let them insert it. She did say that I was doing really well and it was looking pretty positive, then she and the midwife started whispering to each other. I chose to believe that they were discussing how well my labour was going and that I probably wouldn't need 'assistance' after all. God only knows what they were actually saying, but I didn't want to dwell on anything negative.

Shortly after this the midwife was called away to do something else (by the way, people kept knocking and asking her things and coming in, and I said it was like Piccadilly bloody circus and can't we lock the door! Unfortunately that's not allowed!). By this time the contractions were beginning to be very strong indeed and staying on the ball wasn't helping. I decided to get on the bed on my hands and knees and put a pillow under my stomach to curl around. I naturally assumed the bum-in-the-air position to slow down the contractions. It wasn't so much a conscious decision, more my body taking over. The contractions had become really strong very quickly, and I began to try different techniques to cope with them. I had my head hanging over the edge of the bed by this stage, gripping the sides of the bed.

I tried the HypnoBirthing breathing technique as I'd been working on these for weeks (hadn't had time to do the course though) and although I could really feel that it helped as that contraction was less painful than the others, it took too much concentration to maintain due to the speed and intensity of my labour. I then began bellowing as I had learned in the Active Birth course we did, which really helped a lot. My partner returned and heard me down the corridor. The situation had changed so rapidly, he actually thought I was just exaggerating! LOL!!

At this point I was beginning to feel sick at the peak of a contraction and I felt my toes curling up. The midwife then came back and took one look at me and asked if I was just having a contraction or was I actually pushing. I sat up and said I don't know what the f**k is going on actually! Then said that I was trying different pain control methods. She asked to examine me again. We had to wait for another couple of contractions as they were coming very quickly now. She examined me and said with slight shock that I was 9cms and she could feel the baby's head. I was over the moon! We guess it took about 45 mins to dilate from 2cm to full dilation.

By 1pm I was already into stage two. I really couldn't say what transition was like, it was all so intense and is such a blur, but it did feel like I'd taken some really strong drugs, although I hadn't had any drugs at all. I guess it was a mixture of the oxytocin, adrenaline and endorphins.

My partner was great throughout, he kept reminding me to breathe and was extremely encouraging and supportive. I couldn't bear being touched though, so no massage for me. There were definitely a couple of times that I lost my breathing and it was wonderful to have him there to hold on to and help regain my focus. Whenever a contraction started I pulled on his clothes and hand and pulled him bodily into me as far as I could. This really helped a lot, especially as I couldn't bear to be touched so there wasn't much he could do for me except help me to breathe and be a rock to centre myself on. I can equate the first stage of my labour to being on a galloping horse if you don't know how to ride. It's not frightening as such, but so fast and such a blur, that all you can do is close your eyes and hold on for dear life! LOL!

The second stage was actually blissful compared to the first stage. It was a completely different sensation which took me by surprise. I managed to get some rest before the expulsive reflex started. Unfortunately, the midwife wouldn't 'let' me use any active birth positions for this stage as she was very concerned about Mila breathing in meconium. She wanted me to lie on my back, which I refused to do and compromised by lying on my side. I'm a very petite woman and I didn't want to impede the birth in anyway by closing off my sacrum.

Because of this position I really felt that the expulsive reflex was not very strong and although I wanted to breathe my baby out, the meconium put a stop to that and I had to push her out instead. I found this not at all painful, but really hard work, like pushing at a huge set of very heavy wooden double doors that you really want to put your whole body into pushing open, but you're only allowed to use your arms. I found it really difficult to learn how to push and breathe at the same time and very hard to bear down when lying on my side. I really wanted to move into a better position, but I had to accept that the one I was in was the safest for my baby. I really didn't feel her descending at all, and although I reached down and felt her head, I was so out of it that it didn't really register too much with me.

Note from Angela: I'm not aware of any evidence at all to suggest that this position was safest for the baby. It is known that active and upright positions shorten the second stage of labour. If the midwife was concerned enough about getting Mila out to tell Becky that she "had" to do voluntary pushing rather than gently "breathing" out her baby, one would have thought that she would support Becky in using upright positions to help her in the second stage. It sounds to me like the midwife was probably concerned about how she was going to get access to suction the baby's mouth and nose when she was born, to clear any meconium out of them. It is standard practice to do this when a baby is born through meconium, despite little evidence that it improves outcomes. However, many midwives would do this with the mother in other positions - for instance, many women find all-fours a comfortable position to be in for second stage, and the midwife can get access to the baby's face this way.

Towards the end of this stage I was getting very tired, and drinking a lot of chamomile tea with honey to keep my strength up. My partner was wiping my face with a pad soaked in cold water which felt lovely and was also giving me water to drink. I remember thinking to myself that if forceps were safe for the baby and not horrific for me, I would most definitely have called for someone to bring them! I was really tired and kept asking for someone else to do this for me. I also kept saying that I just wanted her out. With each contraction I tried so hard to make this the one that would birth her. Eventually I felt her crowning, and although it stung a bit, it didn't really hurt at all. What did hurt was the head bursting through my labia minora, which stretched and grazed them and boy did that smart!!! I definitely swore at that point.

Unfortunately the cord was very tightly wrapped around her neck so the midwife cut it before I could birth the body. It was so tight that she struggled to get one finger underneath in order to clamp it. I was very disappointed that Mila couldn't get all her blood but there was nothing to be done about it. The next contraction birthed the body, and she was immediately taken to be checked by the Pediatrician, who was very discreetly waiting in the room to check her airways.

Note: The baby is born with the cord around its neck in around 1/3 of births in the UK, but the tightness of the cord can vary a lot. Where a midwife is committed to not cutting the cord unnecessarily, she can often use a technique called "somersaulting" the baby, where she supports the baby's head very close to the mother's perineum as the baby is born. Midwives who are experienced in attending births without cutting the cord prematurely, say that it is almost unheard of for one to genuinely be too tight for the baby to be born. However, the reality is that midwives have to think and act fast and may not be in a position to practise new techniques at the moment your baby is born.. For more on why it is beneficial to avoid cutting the cord early, see www.cordclamp.com

Whilst she was doing this, I had begun to shake violently and was extremely cold, it took quite a bit of asking to get some blimmin blankets to warm me up!! I was really out of it and I was bleeding reasonably heavily. The midwife was looking worried (I don't really remember any of this, my partner told me afterwards) and I was as white as the walls, so my partner gave permission for her to give me Syntometrine. On my request he also gave me an Arnica tablet and I began to calm down. I wasn't disappointed as we weren't able to wait for the cord to stop pulsating anyway. Next time, I'll go for the physiological third stage, as well as hopefully getting my homebirth!

Very quickly Mila was given back to me and we had skin on skin contact for about an hour. It took about half and hour for her to start feeding and all this time she was very alert, very calm and spent a lot of time looking around. She cried a bit after the birth but otherwise was very chilled out. Her Apgar scores were 9 at 1m and 10 at 5m. She spent a lot of time looking at my hair!

I was still in slight shock due to the speed of the birth and after about an hour I gave Mila to my partner and ran myself a deep hot bath. I was finding the situation quite surreal, and felt a bit detached from it all. As I had to stay in hospital overnight, I wanted my partner to spend as much time as possible with Mila, and so he mostly held and cuddled her until he had to leave at 8pm. I missed him terribly, but it was good to have that time with my precious daughter on my own, as I finally really bonded with her and we also got the breastfeeding licked (excuse the pun!). I hardly slept that night and held her constantly.

Yet another note from Angela: if you do end up giving birth in hospital, and you and your baby are fine, you can discharge yourself at any point after the birth. Some hospitals request that you stay in for 24 hours if the baby was born through meconium-stained fluid, but it is still up to you. When the baby is in good condition, some parents make the decision to go home sooner and carefully observe their baby at home. You do not have to wait for a paediatrician to check your baby before you go home, although you may be told that this is the case. Clearly if there has been any sign at all that the baby is unwell then it would be sensible to wait for a paediatrician to check, but in fact you can go home and return at another time for a newborn check. As with so many things in healthcare, it can make you feel more comfortable about having intervention, staying in hospital etc.. when you know that you do actually have a choice!

Back to Becky:

It's now 10 days later, her weight is up from 5lb 11oz to 6lb 6oz which is just fabulous. So far she's a very chilled out little baby, who feeds and sleeps beautifully. She loves sleeping on her daddy's chest and is absolutely gorgeous and we swing between feeling like it's absolutely normal that we have a baby, to looking at her with awe and finding it hard to believe that we have a baby!!! I'm sure this is very normal for new parents.

As for me, although I'm disappointed we didn't get our homebirth, I'm absolutely delighted that I achieved my aim of a natural birth with no pain relief. I feel like a different person, extremely empowered and want to brag to the world! I'm so glad I could give Mila a drug free birth, even though it wasn't quite the peaceful transition that I was hoping for. I'm really pleased I stood my ground against the doctors and am aware that it could have been a very different situation indeed. I was lucky that I had gone into labour already, as it would have been more difficult to refuse induction if I hadn't.

I can see how easy it is to be swept up into a very medicated birth if you haven't done your homework and preparation and don't know the implication of these interventions. It's imperative, to my mind, that women continue to educate themselves so they can say no to unnecessary intervention.

A week and a half after the birth we set up the birthing pool. I set up the room with candles and played the cd we used for the early stages of labour and after the birth. I breastfed Mila as we descended into the pool as this was also her first time in water, and she held on to that breast for dear life, suckling like crazy but trying to look around to see what's happening without having to leave the breast. I cried as I looked down at my beautiful daughter. It was a very moving moment to finally see her in my arms in the water. Using the pool in this way has really helped me overcome my sadness at not getting the home water birth I so longed for. My partner also came into the pool and we spent about an hour in there, playing with Mila and cuddling her.

Next time I will definitely have my homebirth!

Afterthoughts:

I would be absolutely delighted for you to include Mila's birth story on your website! I loved (and still do) reading through birth stories before the birth and in the weeks and days leading up to Mila's birth, I read through all the first timer homebirths on the site over and over again. I found them very encouraging and reassuring. Though it's ironic really, as I'd prepared for every consideration except meconium!

One of my greatest fears was having to transfer due to 'lack of progress', so even though I was very disappointed that I couldn't have my home birth, the fact that the transfer was out of my hands made it much easier to cope with.

I sincerely hope that other women will be encouraged by my experience, that despite having to transfer it is still possible to have an active, natural birth. In many ways, for me at least, wanting to have a homebirth in the first place was all part of my learning curve and education on how wonderful birthing can be when we take back control. I guess what I'm trying to say is that aiming for a homebirth in the first place helps women to be assertive and that makes it easier to continue to be assertive in the delivery room if a transfer is needed.

If my experience can help other women I would be over the moon!

Do you have any advice for other women who transfer to hospital?

One top tip depending on how much time a woman has, is to have a shower before going to the hospital! All that meconium was pretty gross and it kept dripping down my legs, soaking into my socks. I was in a bit of shock and it just didn't occur to me to shower before leaving the house. Once I was in hospital, it was a rollar coaster of monitoring for 10 mins, and then continously almost straight away, and I never got the chance to take off my t-shirt and dressing gown let alone have a shower. I felt pretty disgusting after a while.

The other top tip is to remember to close the curtains if it's daytime to achieve the low lighting for baby's entry into the world. I meant to do that but events took over and I regret the fact that I forgot.

A more practical tip, check with the car park attendant about parking meter payments. Some hospitals give you a pass so that you pay the next day, and it would have been beneficial if my partner hadn't had to keep leaving to feed the meter.

Note from Angela: Ask the midwife, too. Some hospitals will tell the security guards not to clamp you, if you arrive in an emergency and can't get out to change the ticket.

I loved having chamomile and honey to drink, that was extremely helpful, so pack a flask before leaving for the hospital.

Becky

Links

Meconium in the waters - what does it mean for your baby and your birth?

Transferring to hospital - why does it happen, what are your chances, and advice from mothers who've done it.

First babies and home birth

Back to Home Birth Stories

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