Sebastian's home birth, by Fiona Keithley

Our son, Sebastian Andrew, was born at home on September the 4th (2004) at 10:25 am. He weighed in at 7lbs 9oz or 3420g in modern money.

Our first hurdle arose many months before Sebastian was due. The "criteria" for a homebirth in our location appears to be somewhat restrictive. Although we never actually found out what these criteria were, we were presented with a series of obstacles. First off was, its your first baby, is this a good idea? Second, you're too old for a homebirth, you don't want to take the risk do you? Simple insistence on our part eventually made the health professionals crumble. Nevertheless, we got the feeling that they weren't keen on a homebirth...

 

 The biggest hurdle, however, was administrative. Our nearest hospital's obstetrics unit closed recently and the health authority's alternative is an hour's drive away. Obviously a home birth requires backup, should anything go wrong. In our case, the designated backup was just too far aware for our comfort. However, there is a nearer hospital just on our authority's boundary, a mere twenty minutes drive away. Therein lies the problem, the homebirth would need to be covered by one authority and the backup care by another. This led us into a minefield of NHS procedures, processes, protocols and some reticence by one of the hospital trust's involved. It wasn't until almost the last month that persistent pressure on our part and a good deal of support form at least one hospital that we eventually gained all the agreements required.

 

  Sebastian was due on the 25th of August, and at 38 weeks we knew we had succeeded when the 'home confinement' equipment arrived. And what a lot of bit 'n' bobs turned up! Thinking we were home free, we had one last problem to overcome, the health professions were concerned that a test taken eighteen months prior, for thrush, had shown up a very light growth of Strep B. We had almost forgotten about this, and so had our GP. Finally, a compromise was reached, we could have the homebirth, but only after signing a disclaimer stating we were aware of the possible consequences of a Strep B infection in a newborn baby. Ironically, an allergy to penicillin would have meant the hospital protocol of a antibiotic drip given during labour to prevent possible cross infection to Sebastian would have been a non-starter. We would have gained nothing by being in hospital yet we were still presented with this last hurdle.

 

 Finally, the due day arrived, but no Sebastian. Undaunted, we still had ten days home confinement cover left and undertook a regime of hot curries and long walks with our two dogs. Our induction examination appointment was scheduled for three days before the cover was due to end. The day came and the two of us went off to the backup unit for examination. We were both worried that we were going to miss the window for the home birth. The good news was that the examination showed two cm dilation, but the cervix had not started to efface. The very helpful midwife offered to sweep the membranes as this can "get the process going".

That evening, after yet another hot curry and another long walk, we had a light show and few mild contractions. Ever hopeful of the real thing, we kept mobile until well after midnight, resting just seemed to slow the process down. At 2:00am we gave up exhausted and disappointed the pre-labour was slowing; off to bed we toddled. At 7:00 am the next morning a contraction woke us both and we got up and attempted to keep mobile. Another hot curry and long walk and 12 hours later the contractions started to pick up. We called the midwives were told to relax we were definitely underway but it was still early days. Three hours later, and much back rubbing, we called again, this was the real thing they said, but were told to "stick with it until you get 3 strong contractions in 10 minutes".

 

 At 2:30 we were both exhausted and exhilarated, we were definitely underway; another call and the two midwives were dispatched. At 4:00am, Lynne and Morag arrived, one having travelled from the furthest boundary of our rural health authority. In typical fashion, the contractions slowed as soon as the midwives arrived and we relaxed. The four of us sat in the lounge and had discussion about the possibility of an examination to see how we were progressing, it was rather surreal taking tea and biscuits and making small talk whilst we discussed a intimate medical procedure. The examination was given upstairs on our bed, the good news was that although full dilation was still some way off, we were now fully effaced. In between what Lynne described as mild to strong contractions, if these were mild then heaven knows what was to come, we toddled back down stairs and made more small talk.

 

 This was almost the lowest point, thinking we still had more time to go and that the midwives would leave us to progress further on our own and send the next shift in at 8:30 am. We were exhausted from being up from 7:00 am that morning and having had contractions all day hadn't helped. Thankfully, with the dawn came progress and the waters broke. The lack of dignity and the mess really upset us, this was to pale into insignificance as we found out what was to come! However, what we would have felt by comparison in a hospital would have been much less dignifying.

The contractions had reached another level and it was almost impossible to focus on anything else. Morag suggested a bath and about 6:45am we went back upstairs. The bath had a major impact, the leaking waters were no longer a point of discomfort and the labour pains were eased. After about an hour in the bath the medical equipment started to be unpacked with gusto. We didn't realize it but Sebastian's arrival was imminent. Another 30 to 45 minutes passed and there was some concern expressed that the warmth of the bath might become too much. A move to the bed was made. Unfortunately, it was too late for the mattress protector; we were on the bed and comfortable and that was all that mattered. Now out of the bath, the contraction reached yet another level and the gas and air was administered. This allowed the two of us to focus on the breathing, whether it brought any pain relief we cannot really say, but the end result was that things were better.

  

  At this point the midwives told us that normal procedure would be to perform another internal examination, however, we were aware that an examination after the waters had broken would increase the chances of Sebastian getting cross infected with Strep B. We all agreed this wasn't wise!

 

 After about 30 minutes of severe contraction Sebastian decided to give us a scare. We were not yet in the second phase but, during a very strong contraction, he had decided to make a bid for daylight. It was much too early and the midwives were concerned about his pulse rate. The hand-held monitor showed his pulse had dropped well below the baseline taken when the midwives first arrived. Another contraction and another pulse rate test, then another. The maternal oxygen was prepared, then just as we thought it would be needed, Sebastian's heart rate, much to everyone's relief, recovered. Another twenty minutes of gas and air and contractions and then relative calm descended; we had reached second stage.

 

 An attempt was made to get everyone more comfortable and ready for the delivery. Everyone was showing signs of tiredness and the two midwives were now on overtime, the deadline had passed for the shift changeover but we were too far along for a new team to be sent out. Thankfully, the local clinic's midwife had been alerted and having cancelled her appointments, Kathleen, arrived to help out. Everyone was ready for the last big push!

 

At 10.25, about 25 minutes into the second stage, with five of us in our small bedroom, Sebastian arrived to make it six. A healthy baby boy.

Thinking it was all over, we breathed a sigh of relief; little did we know that two more hurdles were in front of us. The third stage proved somewhat more of a challenge that we had anticipated. Sebastian was given to us and had a small feed while we waited for the placenta to arrive. We had decided to have a natural third stage, no Syntometrine. After twenty minutes of agony we still hadn't completed the third stage. Out came the gas and air again; it was hoped that this would help to restart the pushing to help get the placenta out, only now there wasn't much gas left, the bottle was nearly empty. So far the birth experience had been much as we expected but after an hour later we still had no afterbirth. We were getting worried. However, the gas and air was helping. One final push and a tug on the cord by Kathleen and it was out, ragged, but out.

 

The plan had been to change the bed and have tea and biscuits with the midwives while we got acquainted with our son. However, we were to be dealt one final twist of fate, it wasn't to be! Sebastian's delivery had caused some damage and stitches were needed, more than the midwives were happy to do at home. The midwives were all deeply disappointed, Morag was almost in tears as she broke the news. Oddly enough, this news didn't upset as much as we thought! After all, we now had a beautiful baby and he was, as planned, born at home! So our two hour old son, his Mum and Kathleen got a free ambulance ride to the nearest hospital. The new Dad was left on his own to struggle with an unfamiliar car seat and then follow on once the house was locked up.

 

We can't wait until he gets older to tell him about his ambulance ride, with sirens and flashing blue lights. The hospital staff were extremely helpful and we were soon on our way home. It had turned into a beautiful sunny afternoon we were exhausted, but elated and proud, and decided to call in at some friends to show off Sebastian. After all, it was such a beautiful day! Twenty minutes later we were sat in their garden sipping a celebratory beer in the sunshine. We had done it, we had achieved what we had set to do all those months ago, our son had been born at home, just like his Mum had been, a little over 40 years before!

 

Fiona, Andrew and Sebastian....

fiona_keithley123 @ yahoo . co . uk
(remove '123' to get the real email address)

Update: Fiona's next baby, Gabriel, was born at home in 2006.

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