Jo prepared carefully for her first baby's homebirth, but a combination of his being in an awkward position, and her having awkward midwives, meant that she transferred to hospital. Once there, her treatment is surely an example of ' woman's inhumanity to woman' ; she was treated apallingly by several members of staff and was not even helped to breastfeed.
I always knew I would want a homebirth if I got pregnant. If I'm honest this decision was less about doing the best for my baby and having a natural birth and more about my own cowardliness - I hated hospitals, needles, doctors etc. and just wanted to hide away from them all as best as I could. So when I found out I was pregnant with a much-wanted baby, I sprang into action; my plan was to do as much research as possible and put in place as many safeguards as possible that would prevent me from going to hospital during labour.
I used the homebirth.org.uk website extensively, trawling through the birth stories and the research and found out that as a first time Mum I was more likely to transfer to hospital for slow progress so I decided it was time to get busy; I attended pregnancy yoga classes from 12 weeks, I bought a birth ball and bounced around on it constantly (determined that my baby should be in the optimal position for birth), I attended a hypnobirthing course, I stocked up on homeopathic remedies, I had reflexology appointments, I joined the NCT, went to antenatal classes, I wrote and rewrote my birth plan, I lined up both my husband and my Mum as birth partners, bought a birth pool and hired a TENS. Oh, and I read about 50 books on the subject of birth from Ina May Gaskin to Sheila Kitzinger to Maye's Midwifery. Looking back now, I can see that I was a bit obsessed by it all but the more I read, the more convinced I became that I was doing the right thing for me and my baby; the possibility of a spiral of medical intervention just terrified me.
The pregnancy was relatively uneventful apart from the first 3 months when I suffered terribly from morning sickness. I was never officially diagnosed with hyperemesis gravidarum, but was put on cyclizine after losing over 2 stone in weight. I was sick about 10-20 times a day and could only keep down small spoonfuls of bland foods like mashed potato but my midwife and doctor were not overly concerned as I was quite overweight when I got pregnant and they were happy for me to continue with my plans for a homebirth.
My labour started 6 days past my due date. I had had a few niggles throughout the night and not slept very well and was wide awake at about 5am thinking that this could be it. I started to time my twinges and they were already about 5 mins apart but not lasting very long. I woke up my husband to tell him but he just grunted that I should get some more sleep and then promptly rolled over and started snoring again. I decided to get up and have a bath as I had read that if these weren't 'real' contractions then a bath might help them go away. It didn't. They were still coming every 5-6 mins, though still not very strong or long so I went back to bed and pretended to sleep. At about 8am I persuaded my husband not to go to work as I thought this was definitely 'it'; the contractions were still steadily every 5-6 mins and slowly becoming stronger. I called my Mum at about 9am and told her I thought today was the day and she should start making her way down to me. We were all pretty excited I think and thought that the baby would be born before the day was out.
Before long, I had my TENS on and my Mum had arrived and I was busy waddling round the house giving orders to my husband and Mum (DH on birth pool duty and Mum on cleaning duty). The contractions never let up - every 5 mins still and got stronger as the day progressed. It was a wonderful day really, all of us bubbling over with excitement and me marching round the house, clinging on to the furniture with each contraction. The TENS was a great distraction for those early contractions but not sure how much it really relieved the pain.
By 7pm that evening the contractions had become very painful and the pain was all in my back which I knew was not a good sign. I was reluctant to call the midwife as I knew this could still be the start of things but my husband and Mum were concerned for me and persuaded me to call them. They agreed to come round and see how I was doing and in the meantime I decided to get in the pool. In retrospect I probably should have held out a bit longer before I got in the pool as I'm not sure if this slowed things down but it was utter bliss in the warm water and I felt like I never wanted to get out ever again.
I took an instant dislike to the first midwife who arrived; I had not met her before, she was loud and shouty and promptly told me off for getting in the pool. She also made a big deal of telling me how tired she was and how long she'd been working that day which, to be frank, I didn't really want to hear. The first thing she wanted to do was an internal but I was reluctant for her to do this - I didn't really want to know how far I was dilated, to me it didn't make any difference, I just wanted to deal with it one contraction at a time. She made a loud phonecall to her colleague, complaining that I had refused an internal so she had no idea if I was in established labour. Then she went through my notes with me and asked me when I had found out I was pregnant. I told her that I had tested 4 days before my period was due with an early response test. She told me that it was impossible to get a positive test this early and said that she would write on my notes that I found out at 6 weeks. I said no, I found out earlier than this but she insisted I was wrong. I remember thinking how absurd this situation was - arguing with a midwife about something so trivial in between contractions that were becoming increasingly difficult to cope with. It also made my confidence in her abilities take a rapid nosedive - it was common knowledge that sensitive home pregnancy tests could detect pregnancy before your period was due, wasn't it? So if she didn't know this and was a midwife, then what else might she not know about? It wasn't a great start.
I eventually gave in to her constant badgering and agreed to have an internal. At this point, the second midwife had arrived to take over the shift so she performed the internal while I lay on the sofa. I had started on the gas and air by then and gulped it down as I received the internal which was incredibly uncomfortable. I was only 1cm dilated - I nearly wept. The next few hours passed in a bit of a blur; I was in the pool for most of it, still contracting every 5 minutes, still with all the pain in my back and sucking down the gas and air like my life depended on it. I remember telling the midwife that all the pain was in my back as I was hoping for some direction or instruction that might help turn the baby but she never really seemed interested and I was too out of it to put into practice everything I had learnt about positions to use in labour.
Around midnight the gas and air was running out (I'd been through 2 bottles by now) and I honestly thought that I might die if someone took that entonox away so the midwife called back the shouty woman to bring some more gas and air. I also agreed to have another internal and this time was told I was 5-6 cms dilated. This didn't lift my spirits at all and I felt like I wasn't coping at all and was screaming and crying that I couldn't do it. I was absolutely exhausted as I had slept badly the night before and been contracting every 5 minutes all day long. The pain now felt like 10 men were crushing the base of my spine with each contraction and I felt like I was going to snap in two. At this point I started asking for pethidine and the midwife agreed and put in a call to the shouty one to bring a shot of pethidine with her.
When the midwife arrived with the entonox supplies and the pethidine, I sat up on the sofa and felt a pop and a trickle of water and was informed by the midwife that my waters had broken. I gave one last ditch attempt at walking around which only succeeded in making me throw up violently in the sink and then collapsed back on the sofa crying for the pethidine. After it was administered I continued lying on my left side on the sofa and managed to doze between contractions.
Throughout all of this I felt incredibly unsupported by the midwives, they gave me no direction or advice and when they were both there, they just disappeared into my kitchen (I was in the lounge) and had a good old gossip and asked my Mum and husband to make them tea and sandwiches. At one point, when one of the midwives went into my bathroom to go to the toilet, she removed the pipe that was draining the birth pool from the bathroom sink and put it on the floor outside the bathroom and flooded the entire downstairs of my house! Apart from monitoring the baby's heartbeat they really did absolutely nothing for me and I feel incredibly let down by them.
Anyway, morning came and another internal showed I had not progressed so at about 7am the midwife duo started their double act trying to convince me to transfer to hospital. At this point I was so exhausted and in so much pain still that I could barely speak and just did not have the energy to argue the point so the ambulance was called and I was subjected to listening to the shouty midwife have another telephone conversation within earshot where she made a big deal of insisting they were transferring care as they had been "up ALL NIGHT with her" (i.e. me). The transfer to hospital was horrendous; I think I was in shock at this point and so scared that I just couldn't speak, if people asked me questions, I just nodded or shook my head. I felt embarrassed if I'm honest; embarrassed that I had been naive enough to think I could control this and get through it when obviously I was too weak. I remember thinking that I wanted someone to cover my face with something as I was wheeled into the hospital in case I saw anyone I knew! I had just given up really.
The welcoming midwife at the hospital was not exactly warm and friendly and demanded I give her a urine sample immediately. When I asked if I could take the entonox to the toilet with me to cope with contractions she snatched the mouthpiece out of my hand and told me not to be so ridiculous. I felt like a naughty schoolgirl. She examined me and said I was 3-4 cms dilated. We were all incredulous at this - when the last midwife examined me she said I was 5-6 - how was it possible I had gone backwards? The midwife said I hadn't gone backwards and that I'd never gone past 4cms. Fabulous. She also seemed to take immense pleasure in telling me my contractions weren't very strong and they needed to get much stronger and more painful to be effective - the concept of stronger and more painful contractions just sent me over the edge so when she said she was going to put a syntocinon drip up I caved and begged for an epidural.
The epidural was the start of another nightmare for me - I am pretty scared of needles but desperately wanted the pain to subside. The anaesthetist was yet another graduate from the NHS charm school and swept into the room barking loudly at the midwife and at my husband who had come to my side to hold my hand "move please, I don't want you fainting in my workspace" he then proceeded to tell me that a successful epidural was all down to the woman and her positioning, "so that means if it goes wrong it's all her fault then?" said my Mum, this made him backtrack a bit. He brought a student with him and I don't remember being asked if she could work on me but she went right ahead; the needle was inserted and removed 3 times before the consultant finally took over and successfully placed it. I remember crying and saying "please, what are you doing?" only to be told "please be quiet" by the consultant. I have never felt less human in my life; I was just someone's 'workspace'.
Things did improve; the epidural worked a treat and I was able to doze and then a shift change saw a wonderful new midwife take over who was kind and attentive and didn't shout at me once! I had a catheter inserted which I hated and the oxytocin was put in but this had no real effect and the day passed with me still not dilating further. My birth plan was now well and truly a thing of the past and I had gone from writing 'I do not want to have any internal examinations' to having had about 15 internals over the course of my labour. The nice widwife then asked if my waters had broken and I said yes but she said she just wanted to check and sure enough, they were still intact so she broke them and within an hour I went to being fully dilated.
It was about 6pm when I started to push - it was a strange experience as I was utterly exhausted and couldn't really feel much because of the epidural so felt like I had no idea what I was doing. During this time the baby's heartbeat started to drop quite a lot and there were lots of hushed conversations between the midwives as they examined the heartbeat trace. At about 7pm the obstetrician was called and he informed me that they had to get the baby out soon as he was struggling so he wanted to use a ventouse and, failing that, get me to theatre for a c-section. My heart sank further, everything just seemed totally out of control. The ventouse was attached and after 3 pulls, with 7 people in the room watching the action (I had only been introduced to 2 of them) my son was born at 7:10pm on the 18th September 2007. The cord was round his neck 3 times but he was a good colour and cried heartily so needed no further attention.
I was a mess mentally. I wasn't really interested in the baby now I knew he was ok - I just wanted all the lines and needles and things out of me and for everyone to leave me alone. I was told I needed to prove I could walk before they would disconnect me from all the paraphernalia so I jumped up and despite nearly collapsing managed to lumber to the bathroom where the catheter was taken out. Back in the room the epidural line was taken out and I was disconnected from the IV, though they refused to take the canula out of my hand. Then everyone disappeared and my husband and I were left with Fred, both of us paralyzed by tiredness and shock. It didn't even cross my mind to put him to the breast; as I said, I wasn't thinking very straight at that time. A couple of hours later, a different midwife came in and tutted when she saw we hadn't dressed Sam in a babygro (he was still wrapped in a blanket) so she dressed him and then tutted again when I said I hadn't fed him and proceeded to force him onto my breast whilst pinching my nipples. After an unsuccessful attempt she shrugged and said "well he needs to eat" and left the room before returning with a bottle of formula. I had very much wanted to breastfeed but just had no more fight left in me so dutifully gave him the bottle.
My husband was soon ordered home and I was left alone with Sam on the postnatal ward where no further breastfeeding help was offered and I was given formula to feed my son. I had no idea how to breastfeed and didn't feel confident enough to try it alone so by the time I had left hospital the next day, Sam was established on the bottle and always refused my breast from then on. I am an assertive and reasonably confident person normally but I felt more like a mouse than a mother when I was in hospital and was terrified of asking for anything in case I was shouted at or tutted at or subject to more 'rolling of eyes', even when I discovered I hadn't packed any baby wipes in my hospital bag I was too scared to press the buzzer to ask for help and so dealt with those first meconium-filled nappies with a pack of my own make-up removal wipes.
It was a horrible time; so far from the experience I wanted and I felt the care I received was at times very poor. I was very distressed following the birth, perhaps a form of post traumatic stress as I had trouble sleeping as all I could see when I closed my eyes was that delivery room and all I could think about was that epidural line being put in again and again. I felt like a total failure and the breastfeeding problems only cemented this for me, it also prevented me bonding with my son and I was very depressed for a long time and am only now beginning to feel my normal self again.
I'm not sure what could have been done differently and maybe I would never have birthed Sam on my own when the cord was round his neck so many times but I like to think it might have been possible. I think if I had had better care by the home midwives they might have picked up on Sam's back-to-back position and helped me labour in positions that might have turned him and if this had happened then I may have advanced more quickly and been able to cope with the pain better. I also think that if the home midwives had realised that in fact, my waters had not broken, then these could have been artificially ruptured much earlier as in the end, this was what advanced me quickly to 10 cms so this could have prevented the long-haul labour I had. I also wish I knew how tiring it all is so I could have stocked up on sleep before hand and also wish they told you that sometimes the contractions don't start 15-20 mins apart and get closer - sometimes they are 5 mins apart from the very beginning but you can still be hours and hours away from delivering.
Sam is now 15 months old and just started walking and DH and I are thinking about having another so this seemed like the ideal time to write this birth story and put it to bed. If I do have another, I will try for a home birth again and maybe if we can afford it, employ a private midwife this time so I know what sort of care I am going to get from the outset. I hope this story doesn't put anyone off - I think I am firmly in the minority as most reports of community midwives at homebirths are incredibly positive, I guess I was just unlucky. If anything I hope this story encourages more women to consider homebirth and take an active role in choosing the people responsible for their care.
Pain relief - what are your options at home?
First Babies and homebirth
Independent Midwives - what they do, and where to find one.
Doulas - professional labour supporters.
Transferring to hospital - why it might be advised.
Get Your Baby Lined Up - what it means when your baby gets in an awkward position, and what you can do about it.
Home Birth Stories
Home Birth Reference Page