Katie was born at home in March 2007.
I had been having contractions on and off for weeks but nothing felt very urgent. However, at 4am on the Sunday morning I had a strong contraction. Although the ones that followed weren't coming very regularly, I knew they were the real thing.
At 6 – after labouring in the bedroom, breathing hard and aware that number one was asleep in the next room – I urged my husband (with a firm "Just phone them") to phone the bleeper-holder. The first midwife arrived about half an hour later and I introduced myself by asking for the gas and air. She told me her name and, after examining me, she said that I was about 3-4 cms dilated and pretty much effaced. Hiding my disappointment (was that all?) I got on with it and the midwife phoned for the second midwife and the entonox. At this point I was coping really very well I thought, and still able to have brief bits of conversation, mainly going over my birth plan and history etc, but very quickly the contractions got closer and a little more intense.
The second midwife and student arrived and I was offered the gas and air (that stuff's good). By this point I had very little idea of the amount of time that was passing and it felt like the time went very quickly. Although I could hear and understand everything that was going on around me, I kind of went inside myself – just as I rather suspected I might, and didn't say anything.
My waters went spontaneously at 7.30 and they encouraged me to maneouvre myself onto the birthing nest that I had made. The birthing nest was an old single duvet covered by a waterproof sheet and then a nice old brushed cotton sheet and all sewed around the edge. The idea being that I could then be wherever I felt like being, without worrying about the mess or comfort. It worked very well even though I stayed on the bed the whole time. I have to say that the contractions didn't really get any more painful - they just blended into each other and were intense and required me to breathe heavily into the cushion (I was on all-fours for all but the very end). I used the gas and air for most of this and for me it made me concentrate on my breathing – it was certainly all I needed in the way of pain relief.
My mother and father had arrived by this point to pick up my daughter, who had woken about 8ish and gone downstairs to have breakfast with Daddy. To be honest I didn't really notice when my hubby was in the room or not! I started to feel some urges to push at about 8.15 (the timings start getting more specific from now on!) and then I very definitely know I went through the transition stage. I think I was making pushing type noises as the midwives wanted me to turn over so they could examine me to see if I was ready to push. I did turn over but knew that I was ready and the midwife just said oh yes everything was fine and I could push if I wanted. I couldn't have really stopped to tell the truth although, I did really try and keep everything slow as I didn't want to tear.
The midwife encouraged me to feel the head as it crowned and then I remember listening very carefully and doing (trying) everything she said (little push – breathe etc) I believe the cord was round the baby's neck but they untangled it, and then with a delicious slithery rush she was born. I cannot tell you how good that felt and the euphoria I was feeling at that point was unreal. She (yes, I had another she) was put on my tummy and then after I assented put onto the breast and she started to feed immediately.
I had chosen a physiological third stage, so after the cord had stopped pulsation my husband cut the cord and we waited for the placenta to come out. I had given birth at 8.40 and 12 minutes later with no pain or real push the placenta plopped out. At that point it started to go wrong. The rest of this story is not meant to discourage or scare anyone. If they would let me I would have another home birth tomorrow...
You do sometimes hear health professionals say things like "We won't let you have a homebirth if x, y or z" or "You have to see the consultant to check if you're allowed to have a home birth". However, this is misleading. It is not up to the midwife or doctor to "let" or "allow" you to do anything. Health professionals can give you advice, but regardless of the way they phrase it, the decision is yours. Someone in Chris's position may well be advised to plan a hospital birth because of the risk of a repeat PPH, but I think it is important to be aware that it's the mother's decision, even if the language used hides that fact. Midwife Mary Cronk suggests that parents memorise this phrase to use: "Thank you for your advice. I shall consider it, and let you know what I have decided."
Seconds after the placenta came out I started to haemorrhage and as the midwife knew that I had had a bleed after number one (we thought it was due to a prolonged labour and second stage) they had the injection ready. It didn't work. The words "she's gushing" were used and they put ergometrine into the vein. That slowed the bleeding down but I had already lost over 1000mls. I was still rather euphoric after the birth so I didn't really twig that it was anything serious. They told my husband to call 999 quickly and, as the ambulance was less than a mile away, it arrived within a couple of minutes.
It then became apparent that there was a problem. The stretcher wouldn't fit up the stairs. All the time whilst they were giving me oxygen and trying (and failing) to get a line in me to give me some fluids they were trying to work out how to get me downstairs and into the ambulance. Every time I tried to sit or stand up I just passed out – I had lost enough blood to make lying down a necessity. Although this only lasted about ¾ hour it was at this point that I began to feel that something serious was going on. In the end they dragged me downstairs on a plastic sheet affair with handles on the side, which was not comfortable, mind you nor was the ambulance ride.
After this the details are probably not of interest to anyone – suffice to say the procedure included a spinal and trip to theatre, several tubes in and one out, 4 pints of blood, bags and bags of the fluid and syntometrine and 2 nights in hospital. Katie was fine but very clingy those first few days. I think she felt the need for comfort as much as me.
The first time I realised how serious things were was after they brought in the consultant whilst I was in theatre to explain what was happening. I actually started to cry then and of course was tied to the table and couldn't even wipe the tears away. It took a while for everything to sink in partly because I was in shock and my iron levels were below 5 which is a bit on the low side. The consultant told me that there was nothing that they could see - I was one of those people who just bleed, although on reading my notes later I found out that they had removed a large clot by my cervix. My uterus was contracting well and all the right procedures had taken place – it wouldn't have been any different if I had already been at the hospital.
After I got home I was quite traumatised by the whole thing as well as anaemic and exhausted. The midwives were great and kept going over details for me as I was getting confused about what had happened when. I didn't tell anyone how much but I was also suffering from guilt that I had chosen to have a home birth when I was considered at higher risk and that all I could think about when all the drama was happening was that I had managed a home birth and how brilliant it was. That passed. In fact the senior midwife at the hospital came out to see me with my notes and went through everything with me to help me to clarify events and to answer any questions I had. It is a service she provides for anyone who feels the need after traumatic events. I feel through the whole thing that I was very well cared for and don't have a single complaint.
Don't let this scenario put you off – remember, if I could I would love to have another birth at home, but I don't think I would be encouraged. But do think about what could happen and make plans just in case. I live in a modern reasonable-sized home and never gave access a thought. I believe my midwives are now suggesting to people that they consider being downstairs as, in the case of an emergency, it would be easier to transfer.
Do you know what your estimated blood loss was in the end? Presumably if your blood loss had been critical then the paramedics would just have carried you out regardless of passing out? What treatment did you have in the end? Was it connected with retained placenta or uterine atony, or any form of trauma? Any details you can give may help other women and midwives to plan their own care if a similar situation arose.
I think my blood loss was critical and that in the end they did just drag me down stairs but it was not comfortable or easy on the midwives and my husband who had to help. The midwives seemed a bit critical of the paramedics who were all for waiting for help from a second ambulance.
I think my blood loss in total was a fair bit as they gave me 4 pints and considered another 2. I seriously don't like the sight of lots of blood especially going in to a person so I talked them out of it - I just wanted to be left alone by that point.
Kind regards, Chris
Post-partum haemorrhage - how likely is bleeding after a homebirth, and what can be done about it?
The Third Stage of Labour - what are your options, and the pros and cons of each?
You can't have a home birth, because... - some reasons why you may be advised against home birth, together with information and views to help you make your own decision.
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