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Eleanor Rose's birth, by Jillian

It was Saturday 21st June 2003, eight days after my due date by scan, and two weeks after my due date by LMP. Around 5.30pm I started getting period pains about five minutes apart, after an afternoon of gardening (I knew it would bring on labour eventually!). They got steadily more painful, until eventually I told Mike that maybe he should cook tea, as I thought I was in labour - you should've seen how fast he tidied the lawnmower away! I think he thought I was going to pop any minute.

A midwife came out to the house to check me out at 8pm and said I was 3cm dilated and fully effaced, and probably in labour, had a long chat with my husband about schools (he teaches at her old school), then she went away again telling us to call for another midwife when we felt we needed one. Hannah, who had just turned 2, went to bed and I paced around and tidied up, or sat on a pillow on a bucket, which seemed to strengthen the contractions. Mike spent the evening on the internet researching boys' names - we'd suddenly both decided we weren't sure about the one we'd chosen. Around midnight he hung up the connection, dialled 1571 and found two messages from the hospital checking that I was okay, the second saying that they had decided to send a midwife out to me.

Half an hour later two midwives, both called Ann, came out to the house, and told me off for not leaving any lights on or making it easy for them to find. They checked me over. I was 5-6cm dilated so officially in labour, hurray! Mike made them coffee and we all sat round the sitting room waiting for me to get on with it. The midwives sat at one end of the living room on a little couch and talked quietly. It was one midwife's first homebirth, so the other explained what was going on much of the time, or they just drank their coffee peacefully. Every so often they listened in to the baby's heartbeat. The contractions were still manageable - I spent most of them leaning forwards holding onto either the mantelpiece or the door handle, breathing deeply. It was lovely to be at home, not confused about where I was, and to be asked permission for any checks or other procedures before they were done rather than being told it was 'policy'.

Every so often I felt like I needed a poo, and went upstairs to give it a go - one of the midwives sat outside just in case the baby arrived very suddenly. But nothing appeared to be forthcoming.

Everything slowed down around 3am - the contractions were only coming every 15 minutes, and I was really tired but carried on pacing to keep things going. I just wanted the baby born so I could get some sleep. I think I started on the gas and air sometime around then. This was quite different to my first birth, where by this stage I'd had two shots of pethidine, and was lying on my side sucking desperately on gas and air during contractions, then sleeping in between - I felt much more in control.

At 4am-ish we decided to break my waters to speed things up. Before doing this, one of the midwives did an examination and found that I had a cervical lip, so she pushed it out the way during a contraction while I sucked on the gas and air - this wasn't as painful as I'd expected - in fact nothing about this birth was as painful as I'd expected, after my first birth.

We set everything up ready for second stage, which included putting the futon mattress on the floor and covering it with plastic sheeting, and the midwives spreading their kit nearby. Then one of the midwives broke my waters, which, unlike my last birth, were the perfect colour with no meconium anywhere. I expected everything to really hot up after that, but the contractions were still pretty manageable.

I knelt on the futon mattress on the floor while leaning on the couch, and started pushing. After a while the contractions really started helping, although the cervical lip hurt a bit. Mike sat on the couch so I could lean on him, and I remember clenching my jaw as I pushed and groaned quietly. I think this stage went on for about 45 minutes

I could really feel the head coming down - much better than my last pushing experience - the kneeling upright position was helping. The head came out quite gradually, with one of the midwives supporting it, then there was a pause when the head was out (big relief for me, knowing that the worst was over) and she checked round the neck for the cord. Then with the next contraction the baby was out in a gush, and lying on the futon looking up at us. A girl! (Mike says at this point he couldn't work out where his son's penis had gone - he was convinced he was having a boy.) It was about 5.30am, and I suppose I'd been in active labour for about 6 or 7 hours.

All well - Apgar of 9, then 9 ("But only because I never give 10," said one of the Anns). Mike cut the cord, then I turned around and gave her a cuddle, but she didn't want to feed. I started shaking and feeling weak, but the midwives said this was normal. I felt terrible - sick and faint. Ellie weighed in at 7lb 6oz - a bit smaller than Hannah, especially considering she was overdue. I had only a tiny graze, much better than the second-degree tear and stitches I'd had first time round.

I'd decided to have the synetromine injection partly because my platelet count was on the low side, making me a bit worried about bleeding too much, and partly because I'd had it before with no problems. The placenta wasn't showing any sign of arriving, so after half an hour one of the midwives pulled it out quite firmly - I felt a tearing sensation inside me as it came away, but didn't think much of it. The midwives seemed to think the placenta looked all right, although Mike thought it looked a little ragged. I was thinking more about how I felt at that stage - I'd wrapped a towel around myself and wasn't feeling quite so sick and weak any more, although I didn't have that 'on top of the world' feeling that I'd had after birthing Hannah, which surprised me as this had been a much easier birth.

Everyone cleaned up and ran me a bath, then I trudged up there and sat in it. It seemed to be filling up with blood fast but I didn't worry about it - I was more worried about how tired I felt and the fact that Hannah would be waking up in about an hour, and that my mum was away for the weekend so one of us would have to look after her having had no sleep.

We both got into bed, and I breastfed Ellie on both sides for about half an hour - she was clearly a natural breastfeeder. Then I lay down to try to sleep, but was getting too many afterpains, and also seemed to be gushing blood all over the inco pad on the bed.

After half an hour or so I sat up and looked at the pad, which was soaked, as were the sheets. My pants were dripping blood everywhere despite the maternity towel. I woke up Mike and told him to call a midwife, then got myself into the empty bath and sat there bleeding and feeling more and more ill. Mike got Hannah up, and desperately called our friend Aoife to come over and take her, while Ellie slept on our bed surrounded by bloody sheets. We also decided at that stage to call an ambulance, despite the maternity unit having told us to wait till the midwife came and let her make the decision.

A midwife arrived, got me showered and into pants with maternity pad in (I found this quite funny considering I was soaking each pad with a single gush of blood), then she lay me on the bed, tried to get a drip in and took all my vitals. I remember her shaking, and seeming quite shocked. The paramedics arrived, sorted out the drip for her, put an oxygen mask on me, wrapped me up in a blanket, put me on the chair, carried me downstairs and wheeled me out to the ambulance. It was about 8.30am and the neighbours were out in force, apparently.

One paramedic said to the other, "So, nice gentle ride to the hospital then?" and the other replied, "Yep, but let's not stop at any red lights eh?" The one looking after me asked me to rate the pain on a scale of 1 to labour. As another agonising afterpain hit me I said '4…5…6…7… ow ow!' He gave me some Nubain.

I started to feel out of it, I suppose because of the Nubain. Was wheeled straight through A&E to a room in the delivery suite, where I was catheterised and a midwife handed me the gas and air mask and suggested I go for it. A doctor removed more clots and placenta from my uterus using sponge-forceps (?) The only pain relief I had was gas and air - okay when I was totally out of it, but I kept coming back to an agonising reality. After the most painful five minutes of my life it was over.

I lay there bleeding, with drips and midwives everywhere. Mike had appeared at some stage, holding Ellie and looking worried. He told me to get some sleep and I drifted in and out of consciousness, glad that I could bleed on someone else's sheets and not worry about them. They changed them about every half hour because they were getting so soaked.

After an hour or two of this a consultant came for a chat and suggested I go into theatre. I agreed after checking I would get proper pain relief. Because of my low platelet count (just above 100) the consultant didn't know if the anaesthetist would be happy to give me a spinal, and thought I might need a general anaesthetic. At this point I was keen on a general - I just wanted to go to sleep and wake up better.

I asked what would happen if they couldn't remove the remaining placenta pieces or whatever was causing the problem, and he told me they'd give me hormones to restart my labour. I remember at this stage feeling absolutely exhausted and terrified at the prospect - it didn't occur to me that I'd be given pain relief that actually worked. There seemed to be no guarantees that anything was going to stop the bleeding. Meanwhile the blood for my transfusion hadn't yet arrived, and the amount ordered just seemed to keep going up and up - initially one unit was ordered, eventually the order went up to seven units.

I was wheeled off to theatre around 12ish, given a spinal, and my blood transfusion was started. The anaesthetist was juggling and reorganising so many drips I felt like Clapham Junction. In theatre they put me in stirrups, and shone lights on my bits. Lovely.

The same doctor as before cleaned my insides out thoroughly. I couldn't feel anything on the inside but she pressed pretty hard on my stomach on the outside, which was incredibly uncomfortable. The doctor was saying that the placenta pieces were firmly adhered to the wall of the uterus, and that she was basically peeling them off. I moaned and groaned a lot, and was told how well I was doing. Various midwives were massaging my tummy and saying in increasingly panicky voices (or was that just me?) that my uterus STILL hadn't contracted. I lay there wondering if I was going to bleed to death, or have to have a hysterectomy - I remember thinking that at least I had two beautiful daughters. I wished I'd had a general anaesthetic, and had no idea how I was going to get through this awful experience. Then I started feeling sick, but the anaesthetist noticed and must've given me something because that passed fairly quickly.

Eventually, it felt like hours later, I came out of theatre feeling like death, and was wheeled back to my room with oxygen mask on and drips in both arms. On the way I passed my mum, holding Ellie - she'd obviously driven at high speed from Wiltshire where she'd been that morning. In my room I started to feel better gradually, as the blood started going in and staying there. I was told I'd need five units of blood at least, possibly seven.

Mike took my stepdad (who really doesn't like hospitals and was looking almost as bad as me!) for some food, and mum came in and talked to me while cuddling Ellie. I started to realise that the worst was over, and cheered up immensely simply because I felt almost human again, and I wasn't going to die. I was still a bit worried that the bleeding hadn't really stopped, but every time the midwives checked (and believe me, it looked like carnage down there) I was told that the bleeding was down to almost nothing.

Mike came back, talked to mum about going and cleaning the house for us (I dread to think how it looked when she arrived), and their plans for later. I realised I was going to be in for the night, while Mike went home. At this stage I had an oxygen mask on, catheter in, a drip in each arm (and wasn't supposed to bend either of them) and had no idea how I'd sit up, let alone stand up, walk or look after Ellie.

Mike and I spent some time with just Ellie in the room. This was the first chance I got to really bond with her - till then I'd just been focused on how I was feeling. I fed her on both sides while lying down - someone just lay her next to me and she latched herself on. I finally got to really look at her properly, and even had a bit of a cuddle by lying her next to me. Mike took some photos of me for posterity - not a pretty sight. Both of us were knackered, so we dozed off a bit, with midwives coming in every so often to check my bleeding, change blood bags over and take my BP and temperature.

Around 7pm-ish Mike left to pick up Hannah and take her to mum's house. At 7.30pm Aoife turned up, which was really nice - she'd had Hannah all day and was off to Ireland next day, so it was good to introduce Ellie to her before she went. She said the worst moment for her had been when she arrived at the house, saw Hannah running around the sitting room and Mike crying so much he couldn't tell her what had happened, and she had assumed the worst but couldn't even ask.

Around 8pm Aoife left, and my blood transfusion was finished, so the midwife decided I might be ready to try getting up. My catheter was removed, then I was helped to the bath, which was actually the birthing pool (I felt guilty that I'd taken up the single birthing pool room all day). I wallowed in there, washed my hair, then attacked my bits - liver everywhere, or that's what it felt like. Disgusting. By the time I'd finished the bath was full of horrible bits of placenta and clots, and I was definitely ready to get out.

I was wheeled off to a room on the postnatal ward - gosh, a single room to myself! How nice! And they didn't even charge me.

I was told not to try standing up on my own, but needed a pee very suddenly so rushed off to the loo feeling apprehensive about how painful it was going to be. Not too bad, amazingly. Thank goodness I hadn't had any stitches after the birth.

Then Ellie and I spent the night in the hospital, with midwives coming in every so often to give me IV antibiotics, take blood for testing, check my BP etc. I came over all shivery cold at one stage and got a bit scared that I had an infection, but it went away. Ellie screamed all night, kept everyone awake, and breastfed a LOT. We eventually fell asleep around 6am, woke up about 8am, had breakfast, and waited endlessly for paediatricians, doctors, midwives, prescriptions, blood test results, etc before I was demanded to leave at around 1pm - we were still waiting for various bits and pieces but Mike said he'd just come back for them later, we were so sick of waiting.

Home! At last. And at 6pm Hannah finally got to meet her little sister, who was by this stage a day and a half old.

I made an amazing recovery, due no doubt to the high quality of the blood I was given. Within three days my platelet count and iron levels were both towards the top end of the scale, I didn't need to take any iron tablets, and I felt physically recovered within a few days. I asked to go through my notes a few days after the birth, which one of the midwives did with me - I felt quite confused about what had happened when, and I wanted to know how close I'd been to dying, or to having a hysterectomy. All the midwife would say was that it had been 'quite a nasty bleed' and that they saw bleeds like mine only every month or two. I suppose I'm still asking that question, although feeling a bit better about it all mentally.

I'm now five months pregnant, and have been considering my options for this birth. I've talked to my consultant about what happened, and we suspect that I had a multi-lobed placenta, and that part of it remained behind when the placenta was forcibly removed. (I had a multi-lobed placenta with Hannah, but it caused no problems.) On that basis he thinks I have a slightly higher chance of more retained placenta pieces and that I should consider giving birth in hospital, but he agrees that I'm not going to bleed to death at home, and that it is my choice. Mike is really positive about another homebirth, because it was a much more pleasant birth experience than in hospital.

I'm going to have a late scan which will hopefully check the placenta very thoroughly, and if it shows any signs of being multi-lobed then I think I will give birth in hospital, but otherwise the plan is to have this baby at home. I am nervous about having another PPH and retained placenta, but I feel that if it does it'll happen wherever I give birth. At least if I do end up in hospital I know exactly how I want the birth to go, what I will be asking for, and what I will be declining. I continue to be much more scared of needing a C-section or assisted birth than anything else, so staying at home seems to be the best option for me.

I'm saddened by the fact that people who don't know the full story of this birth seem to assume that I had a PPH because I gave birth at home, and that I nearly bled to death at home (actually I nearly bled to death in hospital, if anywhere, but they don't seem to be able to hear that - I lost an estimated 750ml of blood at home before the ambulance arrived, then I lost an estimated 1500-2000ml of blood in hospital before they decided to give me a spinal and take me into theatre). I feel like a bad advert for homebirths, no matter how lovely I tell people it was. But those people who are interested in homebirths are generally much more willing to listen to the full story, and not to discount homebirth as a dangerous option.

Jillian

Update:
Read the story of Jillian's next birth - baby Mark

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