Katja's Birth Story - by Claire Constable

Clare's second daughter, Katja, was born at home on 7 March 2002

I considered having a home birth quite early on in my second pregnancy but didn't mention it until about 22 weeks, as I wanted to ask my own midwife. She immediately agreed as long as my placenta had moved up by then (it had been low on the 18 week scan). I agreed to this - we were both confident that it would move, as it had during my first pregnancy.

At the 32 week scan it was discovered that although the placenta had moved enough, my baby only had one kidney and that it was enlarged. After being assured that many people went through life with only one kidney, but they would want to do tests after she was born, my first question was"can I still have a home birth?". The consultant umm-ed and ahh-ed for a while then said she was happy for me to remain 'midwife-led' – but said I'd need to take the baby to hospital within 7 days to be scanned, whereas if I gave birth in hospital it would be carried out before I was 'let out'.

(More details of Katja's kidney issues below)

All was set for the home birth – I was due on 27 February 2002 but this date came and went. On the 5 March I had taken my 15-month daughter, Alicia, for a walk, and on picking her up felt my waters go. They carried on leaking but I didn't have any contractions. I decided to give it 24 hours then if nothing had happened I'd call Sue, my midwife.

The contractions finally started about 3.30PM the next day, just an hour short of the deadline I'd set myself. Kurt helped me put on the TENS machine and I carried on as normal, followed by Alicia pulling on the wires. By about 7.20 the pains were about 4 minutes apart and I had to stop to concentrate on them. Kurt put Alicia to bed while I called Sue, as she lives half an hour's drive away. She asked if I'd be okay for a while longer while she had something to eat, or did I want her to come straight away. She arrived not long after 9, and after chatting for a while she examined me and announced I was at 6 cm and my forewaters were still intact.

By 10.00 I was throwing up so she felt that it wouldn't be too much longer and rang Colette, the second midwife. Up till then I'd been kneeling on the floor with my head in the sofa cushions and Sue kept feeling the bottom of my back to check how I was going, but I was getting tired so lay on my side on the floor and started to use the gas and air. By midnight I was fully dilated and my forewaters had broken, running first clear then with a small amount of menocium in them, then clear again, but the baby's heart rate remained steady and I didn't want to push. This went on for about an hour with the midwives asking if I was sure I didn't want to push as they could see the head. It was suggested that I stopped using the gas and air - the TENS machine had been unstrapped a while earlier - to see if that gave me the urge. I gave a small push with the next contraction, and then nature took over

I alternated between sitting on the floor leaning on Kurt, and standing up. Katja was finally born at 2.09AM on 7 March. After her head was out she shrugged her shoulders and did the rest herself. She was immediately given to me and we had a cuddle, then I was given an injection to deliver the placenta.

Kurt cut the cord and we cuddled for about half an hour, then Colette cleaned Katja up, getting pooed on in the process, and Kurt held her while I was examined. I had quite a long tear, probably due to a previous epiosomy, but the muscle beneath was intact and we agreed to leave it to heal without stitches.

Katja wasn't weighed until lunchtime the next day; Sue had forgotten the scales the night before. Her official birthweight was 5lb 12oz - slightly bigger than her sister.

Claire Constable

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More on Katja's Kidneys:

Katja had unilateral renal agenesis (so one kidney missing) and hydronephresis (the remaining kidney was enlarged as urine back flowed to it). MW spoke to a renal paedtrician before the birth, asking if anything with regard may affect her - there wasn't any risk to her but they wanted her to go on prophylactic antibiotics, so after the birth, mw gave her birthweight to the paedtrician who wrote a prescription, hospital pharmacy filled it and mw brought it back out later that day.

They wanted to do an ultrasound to confirm diagnosis/check serverity, if I had been in hospital I was told this would be done before I was 'allowed' to leave, as I wanted a homebirth they asked me to bring her in within a week of her birth (they filled out a scan request and signed it - leaving the patients sex and date of birth blank, that went in my antenatal notes for the midwife to finish completing and send it in for appointment to be made).

I seem to remember the midwife saying beforehand she was staying until baby weed just to make sure it was functioning (baby peed all over her along with mec as she came out so she didn't have to wait)



Claire had another baby, Conan, at home in December 2003.

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