From the Daily Telegraph 17/05/2006

Why I still believe in home births

Midwife and mother of three Traci Relph lost a son in tragic circumstances after opting for a home delivery. So why does she continue to insist that it is a safe and attractive alternative?

Two-o'clock in the morning, and I was in the late stages of labour with a midwife struggling to save the life of my baby boy as an ambulance rushed us through the deserted streets of south London to Lewisham Hospital.

'Percy would not have been saved even if I had given birth in a hospital'

I was seven centimetres dilated and she had pushed her hand right up into my vagina, trying in vain to keep his head from crushing the umbilical cord carrying oxygen to his brain.

She kept her hand there for 56 minutes, even as I was being wheeled at high speed along the corridor into theatre, and right up until the moment my baby was lifted up and delivered by Caesarean.

Percy was a big baby - 9lb 10oz - and he had suffered a prolapsed cord, which meant it had been delivered before him rather than after as in a normal birth. As labour had progressed, his weight had been pressing down on the cord, restricting his oxygen supply.

Following the C-section. Percy was placed on a ventilator but it was clear he was very sick. My husband, Simon, had to break the news to me when I came round from the anaesthetic. We were both utterly traumatised. Percy suffered multi-organ failure and, three days later, after we'd said our goodbyes, the ventilator was switched off.

That was in June 2001 and I was 37 years old, a mother of three who was part-way through midwifery training. But nothing could have prepared me for the trauma of a home birth that went horribly wrong.

Earlier in the evening, as the first contractions had begun, I'd been laughing and joking with my in-laws and friends. Having had two home births already, I felt fairly laid back and comfortable in my own environment, and Simon, head of marketing in a graphic design division, was equally relaxed. We had no idea of the nightmare that would ensue in the early hours.

This week, the Government announced plans to encourage more women to give birth at home, while Health Secretary Patricia Hewitt has ordered a report to examine the evidence for and against home births with a view to making them more widely available on the NHS.

As a woman who has given birth to five children, three of them at home and two in hospital - and as a midwife - I can speak from personal and professional experience about this controversial issue. Some have criticised the policy as a money-saving, headline grabbing initiative that will put babies lives at risk, while others welcome it, condemning what they see as the over-medicalisation of birth.

Despite the terrible loss of my son, I'm in favour of anything that promotes home births. Let me explain why.

I'd been converted to the idea of giving birth at home after I had my first daughter, Fred, now aged 17, in hospital. I swore I'd never do it again. The hospital midwife had taken an instant dislike to me and, at one point, vindictively slapped me on the legs to get me to change position. I was given pethidine for pain but it made me so sleepy that I felt completely out of control.

The births of my next two - Millie, now 13, and Herbie born in 1997 - took place in my bedroom. They were easy, pleasurable even - and far less stressful than being in hospital, although Herbie was a big baby at 9lb 12oz. I felt in control and I had the same fabulous midwife for both births who gave me all my ante-natal care and whom I had come to know very well. It was this hugely positive experience that made me want to train as a midwife.

I can vividly remember every detail of my other children's births, but I have blanked out a lot of what happened with Percy. I've been over and over it, but I don't believe he would have lived if I had given birth in hospital. He might have been delivered sooner, but he would have been severely damaged by oxygen deprivation, resulting in physical and mental impairment.

I had been feeling calm about the labour but the backdrop to Percy's arrival was one of tremendous stress. Herbie had been diagnosed with leukemia just before his second birthday, and was undergoing chemo- and radiotherapy. I had begun my training as a midwife, but gave it up after six months to look after him.

We were told there was an 80 per cent survival rate for this type of leukaemia and Simon and I were optimistic Herbie would survive, so we decided to have another baby. I was pregnant with Percy when we were told Herbie had relapsed and wouldn't pull through. So in the run-up to Percy's birth, I was also managing the care of my terminally ill four-year-old.

And, with hindsight, I can see that the preliminary stages of Percy's labour were very different from the others. My labour kept stopping and starting and I remember thinking it was a bit ridiculous that after three children, I still couldn't tell whether or not I was in labour.

It was when I finally did go into labour that things started to unravel. Suddenly, there was lots of thick, black meconium, which is the contents of the baby's bowel and often a sign of distress. Shortly after, the midwife found that the umbilical cord had prolapsed, prompting the emergency call for an ambulance.

Herbie died later that same year, aged four-and-a-half. It's impossible to describe the awful sadness of losing two children; it was a time of terrible grief. But you have to find a way of dealing with the things that life throws at you, and I believe that, in both cases, it was fate. I think there are some babies who were never meant to be.

A year later, we had a daughter, Gertie, who is now four. She was born in hospital by elective Caesarean, because she was breech, which meant her bottom was positioned in the birth canal first, rather than her head, as is normal. If I were pregnant again now, though, I wouldn't hesitate to have another home birth. I'm still convinced that for low-risk women, they are very safe and I oversee many of them in the course of my job.

What happened with Percy was nobody's fault. It was a rare occurrence that no one could have predicted. After losing Percy I felt I couldn't go back to midwifery but, six week after his death, I had a meeting with my consultant and a bereavement counsellor. The consultant said she felt I had a lot to offer as a midwife, and her words stayed with me.

I completed my training and qualified last year. I am now working at St Thomas' Hospital in south-east London where I'm part of what is known as a case loading team, which means I provide ante-natal care for women in their homes and look after them right through until the birth, whether that's at home or in hospital.

I really enjoy getting to know them and there's a sense of great satisfaction in being there for them, right through the pregnancy and labour.

I wish Percy had lived, of course I do. But I don't feel negative about home births. For the vast majority of women they are safe and far less stressful than being on a labour ward, where intervention is much more likely.

They may not suit everyone, and some women will obviously prefer to be in hospital, but I think the Government is right to give more women the choice about where they have their babies.

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