Ceri - a home birth after caesarean

by Helen Bates

Ceri - born 25 September 2000 - 6lb 4 oz

I will briefly outline my first birth experience so that you know the background. In March '98 I was induced (Queen Charlottes and Chelsea Hospital) 4 days postdates due to a high blood pressure reading and some signs of pre-eclampsia. The induction failed and I ended up having a ceasarean section. I was left with the feeling that the whole process had been a screw-up and my c/section was necessary only as a result of the mismanagement of my labour.

When I found I was pregnant again I eventually decided that my best chance of having a vaginal delivery or VBAC (vaginal birth after ceasarean) was by having a home birth with an independent midwife. I had discussed having a hospital delivery but found the restrictions that would have been placed on me as "trial of scar" labour would have been too restrictive and seemed designed to ensure that I would end up with another c/section.

I am a scientist and I had looked at the research relevent to VBAC and the risks and issues surrounding it. I was sure that it was safe for me to have a home birth with the right expertise around me. I am a great supporter of the NHS and am saddened that I had to look outside of the NHS to find the care that I needed.

After booking with my independent midwife Andrya I felt like a huge weight had been lifted and I actually began to enjoy my pregnancy without worrying about what battles I'd have to fight at the end of it.

I had a very healthy pregnancy with no oedema, stable blood pressure (mostly) and felt very well throughout. I attended an Active Birth Workshop as well as an NCT Refresher Course and read loads of literature (provided by Andrya) on homebirth and VBACs to keep myself positive and confident that I could achieve my aim. Whilst doing all this I was also aware that there was a possibility that things wouldn't work out and that I might have to transfer in. But I was in no doubt that if that did happen it would only be for good reasons and that I would really have done all I could for a successful VBAC.

One of the things I picked up from these books was that good birth partners were an enormous help and if things took a long time it was good to have more than one birth partner to share the work of supporting the mum. I decided to ask my friend Christine if she'd consider being a birth partner along with my husband. Christine has had a home birth herself and I knew she would be very positive, supportive and knowledgable. I was delighted that she agreed to take part.

Then at an antenatal appointment just two days before my due date it turned out that the baby had turned breech!!!! I was shocked and upset but Andrya remained calm and said that this still didn't necessarily mean I couldn't have a home birth. She spent ages with me going through the options if it stayed breech and what I could try to do to turn the baby again (it had ony turned a couple of days before). So I spent the next two days with my bum in the air, went to have acupuncture and took a homoeopathic remedy - I was going to try everything to turn this baby! Something must have worked as on the Friday night I felt loads of movement. I wasn't sure if it was enough and kept lying down trying to feel where the baby was but of course I couldn't figure it out and thought even if I could it was just wishful thinking. I called Andrya and she came over to see me on the Saturday evening (my due date) - to our huge relief she confirmed that the baby was no longer breech. Hooray!! We were all set again for a normal delivery.

We had decided my Mum should come down from North Staffordshire on the Monday as it was quite likely I'd have the baby sometime in the next week. It turned out to be good timing as I woke up at 5am on Monday (2 days postdates) feeling uncomfortable. I had period like cramps and had to go to the loo about 3 times in the next hour. By 7am I couldn't doze any more and got up to make some tea. The contractions were coming every 5 minutes but mild - I was just walking around rubbing my bump and that helped a lot. I took up a cup of tea for Martyn and woke him to tell him he wouldn't be going in to work today (I had also had a slight show so was now convinced this was IT). I decided not to tell my Mum as I knew she'd just worry all the way down on the train and she wasn't due to arrive till about 2pm anyway. I phoned Andrya at about 8am just to let her know things had started. She suggested I had a bath and tried to get some more sleep and to let her know when I could no longer talk through contractions or sooner if I felt I needed her there.

Almost as soon as I'd put the phone down the contractions started coming a lot more strongly. Going back to sleep was out of the question so I tried the bath. I found this made the contractions seem ten times worse because I was leaning back so I got out again very quickly. By 9am I was kneeling over the sofa during contractions concentrating hard while Martyn got Emma (age 2y6m) ready to go to a friends house. Just before they left Emma came over and rubbed my back during a contraction. When it finished and I stood up again she said "Are you better now Mummy?" We told her that the baby was coming and when she came home she'd have a baby brother or sister and she happily went off to play with her friends. I was having another contraction when the phone went. Christine came on the answer machine saying she was off to Ikea but had her mobile if anything happened. I managed to get to the phone before she hung up and told her things had started so she decided to abandon her trip to Ikea, sort out someone to look after her Emma and then she came over.

From the time Christine arrived at about 10am I was having strong contractions every 3-5 minutes. Martyn and Christine made a great team supporting me; I was holding onto Martyn and using my TENS and Chris was massaging my back during contractions. We eventually decided to call Andrya in and she arrived at 1am. From the time Andrya arrived I have the most wonderfully detailed notes even including what was playing on the stereo!! Andrya felt my tummy, took my pulse, bp and listened to the baby. She said the baby had a good strong steady heart rate and my contractions were "strong" which was good as they were probably very effective. I was now having 4-5 contractions every 10 minutes and they were lasting 40 seconds so not much of a break between them and they continued at this rate for the rest of the labour.

By 2.30pm I wanted to know how far things had progressed and although I dreaded finding out I was only 2-3cm I also needed the encouragement if I'd got further so I requested a vaginal examination. I was relieved when Andrya said I was 4-5cm and "very stretchy" (last time I didn't get beyond 3cm). Andrya then suggested trying to walk up and down the stairs to encourage baby's descent and pressure on cervix. This was really hard to do and I had to stop midway to cope with the contractions.

At 3.30pm I was feeling really tired and wanted to try some more pain relief so asked to try the Entonox ('gas and air', aka nitrous oxide and oxygen). Unfortunately the Entonox just made me throw up and my heart sank as I realised that this was it and I'd now have to cope with no other form of pain relief. From then on things are a blur as I just concentrated on coping with each contraction as they hit. Andrya was frequently checking my pulse and the baby's heart rate and one of the things that kept me going was Andrya saying that the baby was really happy with a strong steady heart rate. It occurred to me that I could ask to transfer in but the thought of trying to move anywhere was far worse than the thought of coping with just the next contraction so I dismissed the thought from my head and told myself to get on with it.

By 5.30pm I was really finding it difficult. I was so exhausted and was wondering if it was ever going to end! Andrya said she thought I was in transition and to hang on in there as I was doing so well. She was right, as soon after that I began getting bearing down urges at the end of the contraction. Second stage is recorded as being from 6.15pm. The back-up midwife arrived at 6.20pm and after trying several positions we found that I could push most effectively lying in a left lateral position with my right leg supported. With masses of encouragement from everyone I eventually gave birth to Ceri at 8.15pm weighing in at a petite 6lb 4oz. She was delivered into my arms and I just sank back into the cushions beaming with joy and relief.

When the cord stopped pulsating Christine cut it and then I had the tedious part of waiting for the placenta to come out. Eventually I delivered the placenta at 9.35pm - a 1hour 20 minute third stage. I had no stitches and after having a lovely bath was tucked up in my own bed with my georgeous new baby daughter.

Emma stayed overnight at our friends house and came home the next morning to greet her new baby sister. She has been in love with her ever since and keeps asking if she can stroke her "very very gently" and hold her.

I know I couldn't have done it without the wonderful support I had from Martyn and Christine and the calm expertise of my fabulous midwife Andrya. The whole experience was mentally and physically exhausting and painful but it was so much better than the last time. I never felt scared or out of control and the only time that I started wondering if I could do it I had everyone encouraging me and telling me that I was doing really well. This was so different to last time where as soon as I showed I was in pain I was told I wasn't coping and should have an epidural! I am sure that had I tried labouring in hospital I would not have been so relaxed and confident and would have ended up with another c-section due to "failure to progress".

My recovery is also much quicker and I was feeling (more or less) back to my normal self after just one week. Last time the c-section and stress of hospital delayed my milk coming in until day 5 by which time Emma had lost a lot of weight and I had felt forced into giving her formula which really upset me. I remember bursting into tears and thinking "I can't give birth properly and now I can't even breastfeed either". I have had no such problems this time round with my milk coming in on day 3 and Ceri feeding well.

Ceri is totally gorgeous (of course!) and so far has been a very easy and contented baby. I remember Emma crying for hours every night but so far Ceri has showed no inclination to follow in her sister's footsteps. It is tempting to think that this may be because of her gentle and calm entrance into this world - but who knows?

My two birth experiences are so different as to be incomparable but I certainly know which one I prefered! So if I ever have another baby I will most definitely be having it at home again!

Helen Bates
helenb@tio.ndirect.co.uk

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