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I have just had my second child at home in a birth pool with two superb NHS midwives in attendance. It was a dream delivery for me - less than 4 hours from start to finish, using gas and air for pain relief, and a complete feeling of comfort and safety. But because of a bacterial infection in my vagina in my previous pregnancy, it went completely against official policy.
The birth of my daughter in Australia had been about as medicalised as it gets, barring emergency caesarian. In the 18 hours I laboured in hospital (having been progressing very happily in the shower at home), I'd had the works - continuous monitoring via a clamp to her scalp and a belt on my belly, oxytocin drip, epidural, an assisted forceps delivery with episiotomy and finally, the crowning glory, manual removal of a retained placenta. I had then spent many miserable and painful weeks establishing breastfeeding as her jaw was so sore and her state so sleepy she couldn't latch on.
In late pregnancy, I had had a positive swab for Group B Streptococcus, a bacteria found in up to 40% of the female population. It can cause serious infection in newborns but this is very rare. The most common policy adopted in most western countries now is that GBS mothers should be given intravenous antibiotics from the onset of labour, to reduce the risk of the bug being picked up by the baby. The pregnancy is classed as a higher-risk one, and as a result a woman's options in labour are often drastically limited. To start with, home births are considered out of the question. The worst thing is, if you've tested positive for GBS once, you're considered a lifetime carrier, even if, as was my case, it no longer shows up in your system.
Note from Angela: This is indeed how many obstetricians treat women who have a previous positive GBS test result. However, the guidance from the Royal College of Obstetricians and Gynaecologists is that a previous positive test result should not affect this pregnancy, and that if a woman does test positive in this pregnancy, IV antibiotics should be discussed. It is not clear whether IV antibiotics actually benefit babies overall or not, so some mothers decline to have them, even if they have tested positive for GBS. Similarly, some mothers go ahead with homebirth plans despite GBS. See the page on Group B Strep and Homebirth for more discussion.
Back to Charlotte:
I am 40 years old, which was another factor in the strong attempt to dissuade me from the home birth plan.
I only realised how strongly I felt about my experience when preparing for the birth of my second baby. I was absolutely determined he should arrive in the living room and not the labour ward. My partner was very nervous about it, but kept it to himself in support of me. So - we had gathered all the old towels, buckets, torches and other fantastical items required by midwives attending a woman 'at home', and we were waiting for him to come. But as the days went by, in to the overdue zone, the window for a home birth was closing.
On Saturday 2nd September, at 5 days overdue, I went with heavy heart to the local antenatal clinic to book a hospital induction for a week later. The NHS in my area "allows" women to go 12 days over 'dates' before advising this route to kickstarting labour. I thought the deadline would provide a psychological spur, but I was determined to do everything possible to avoid that appointment - I dreaded the prospect in fact. Induction via oxytocin pessaries or gel statistically increases the likelihood of intervention at birth, as more electronic fetal monitoring is required - and women are not permitted to labour in water, which I passionately wanted to be able to do. I had booked for the following Monday morning a 3 hour, £120 reflexology session by an ex-midwife, and if that failed, the castor oil, sperm baths and vicious curries would follow.
Note from Angela: see 'Overdue - but desperate for a homebirth?' for more on this... some areas, like Charlottes, will offer you induction at 12 days past your due date, while others don't offer this until 14 days. In any event, induction is an offer, not an obligation! It may be the right choice for you, but be aware that it is always your decision, and that you can still plan a homebirth no matter how 'late' your baby is.
Back to Charlotte:
The midwife I saw at that appointment was so encouraging of my choice to birth at home, so relaxed and positive about my chance of going in to spontaneous labour. I left her room thinking "I want that woman at my child's birth". She had told me she was on call that night. If it is possible to mentally conjure a labour to start, I think I did so that day.
At 4.30 am the next morning, as I heaved myself over from one side to the other in bed, I heard a loud double click, followed by a warm trickle between my legs. We were off. I called to my man to grab a towel and help me to the bathroom, where I watched the lovely pale pink waters flow in to the loo. That was a good start - clear waters mean the baby has not passed meconium in the womb, which is a sign of distress.
I thought I might be able to go back to sleep and wait for contractions to start later on. But almost immediately, I felt a stirring at the cervix and knew I had to get up and get ready. I came downstairs and started tidying up the kitchen, clearing the way for the hosepipe to run from the kitchen sink through to the living room, where stood a fantastic inflatable birthing pool ready for action. I had thought to give my man a lie-in, but by 5am I felt the swell of contractions coming regularly just under 10 minutes apart and knew we had to start filling the pool. It was not a moment too soon. The hot water tank took ages to heat up again and we only just managed to get enough warm water in it before the action began.
I called the midwife at 5.30, in between issuing commands to my darling Rupe to get this or do that. She came very quickly, took my temperature and pulse and said she had to leave again to take another home birth mum to hospital who was already at 10 cms dilation. What a nightmare thought that was.. She said to keep her posted on the frequency of contractions and she would be back as soon as possible.
At this point, our 3 and a half year old daughter woke up and came downstairs "because of all the noise". She settled in to an armchair with cbeebies on very quietly and calmly watched us bustling about. I can't believe how clearly and calmly I went about getting all the things I knew I would want ready. It was as if a secret software programme had activated in my brain which directed exactly, and with total neutrality, the preparation. Lights in certain positions, wet flannels in the freezer for later, ice cubes ready, hot water bottle and heat pack standing by, essential oils in the burner, lucozade and nuts and sultanas close by. One of the last things I did before the contractions really took hold of my brain core was to put our two biggest pans on the stove to boil - like a good old fashioned birth. And all the while, I was timing and writing down each contraction.
At 7am I rang my mum to ask her to come get Ginger - I said she should aim for 7.30. We also rang the midwife back and told her things were speeding up - 1 contraction every 4 or so mins by now. She said she was just setting off back from the hospital but it be about 40 minutes. At 7.22 I had the first whopper pain which made me moan out loud. Ginger came over and stood at my side so sweetly. She asked me if I wanted some water - it was absolutely exactly what I wanted. I couldn't believe how intuitive she seemed to be being about it. I briefly regretted our plan to remove her up the road to my parents for the birth, thinking she might be fine with it all. But it was the right thing to do. When my parents hadn't arrived by 7.35, I barked at Rupe to ring them - by this point I knew things were moving much faster than I had ever dared hope. They rang the doorbell minutes lateer, but I was not in a state to talk, and off they went with our beautiful girl.
The midwife, a wonderful calm, low-key person who looked like she had seen a few births, arrived at around 7.50. At this point, our labour log book stops, with contractions being noted every 2 minutes. She took one look at me, braced against the wall with one leg cocked in contracted concentration, and told Rupert we would need the water ready as soon as possible. She never once did a vaginal exam. Her companion midwife arrrived a short while later. I finally climbed in to the water at around 8.20am, with pans and kettles of hot being poured in behind me to top it up as the tank once again was not hot enough.
It was bliss to sink in to the warm wet. I could tell that I was entering the strange animal world of full blown labour, where the primal back brain takes over and communication is reduced to the barest minimum. I remembered in my labour with Ginger talking and joking and commentating pretty much throughout until I was simply too exhausted for words - but that primitive state never came upon me. I knew this time around was what all those books were about. And while there was still fear there about the pain to come, the excitement, and sense of rapture at being so comfortable at home, never left me.
The last hour before Oscar's birth is a bit blurred in my mind. A kind of delirium takes hold I think in that final phase. All I recall is heaving breaths on the gas and air bottle, followed by breathing as if I were swimming front crawl. Head up for in-breath, down and to one side for the all important out breath. I remember holding on to Rupe's forearms as if my life depended on it. So much so that when our boy's head crowned and I felt my whole body were about to split apart, he actually wanted to go and have a look at the head emerge but was too polite to ask me. I felt every inch of movement of my baby's body through me, and the so-called "urge to push" I had read about in such depth wasn't an urge at all but an overwhelming, body-contorting, banshee cry-inducing imperative - it did not emerge from my control, it was exacted from me by a force entirely outside of my influence. I can only describe it as the most extraordinary, sublime, all-powerful sensation - physically more akin to an absoultely enormous and entirely positive vomit than a controlled push...
At 9.20am, after 15 minutes of this not-pushing, out he swam, silver sleek like an otter, guided wordlessly by my lovely midwife in to my quivering arms. He slowly opened one eye, then the other and stared up, calm, without crying. Rupe crouched behind me as I lifted up the cord to find out his sex - as with Ginger it seemed so secondary to the momentousness of his arrival. His rather alarming grey-purple shade slowly turned red - first the nostrils, then the lips, then all suffused with blood. I felt the long thick white umbilical cord still pulsing with our combined bloods so I knew he was getting oxygen. The midwife just took his heart rate twice as he lay against me to check all was well, but otherwise left well alone - for over 30 minutes. We sat motionless, me weeping with relief at his safety, joy at the manner of his arrival, and yes, a sense of personal achievement and absolute awe at the power of the birth experience when it goes the way nature intended.
Home Birth Stories
Siblings at a home birth - what to do with your older children? Should they be present?
Pain relief - what are your options at home?
Waterbirth at home
Older Mothers and homebirth
Group B Strep - your options for homebirth, and choices regarding antibiotics.
Overdue - but still want a homebirth? When is 'postdates' risky?
Homebirth UK email group - a homebirth support group by email.
Home Birth Reference Page