Lex's Home Birth, by Jo B

I was very interested in the whole subject of pregnancy and birth so when I was pregnant with Lex I did a lot of reading and became convinced of the benefits of active birth. It wasn't until I met my community midwife at my GP's surgery, however, that the idea of having a home birth began to seem like a real possibility.

I liked the idea of home birth and knew a fair amount about its advantages but I had almost dismissed it from my mind. My reasons were that this was my first baby and home birth just isn't the image of childbirth which springs first into the mind of the uninitiated. It's difficult to get rid of the pervasive image of the mother giving birth in a hospital. The idea was obviously floating around in my subconscious though because all it took was for the midwife to casually ask if I had considered home birth for it to suddenly seem like a really good idea. We talked about it a little bit and I said I would go home and think about it but I knew by how excited I suddenly felt that I was already convinced.

After that it was all pretty much plain sailing. I did have to go in to the see the obstetrician for a 'telling off' for wanting a home birth with my first baby but I was well armed by then, having read Janet Balaskas' ' New Active Birth' and spent a lot of time on Homebirth.org.uk! I knew enough to know my rights and also to know that in a normal healthy pregnancy there is nothing to suggest that hospital is any safer than home. Be it your first or your fifth child!

Anyway, all was set for my home birth to go ahead when I went into labour five days after my due date on Tuesday 2nd July 2002. I'd had a show about two weeks earlier and had been having a lot of quite strong Braxton Hicks in the meantime. I was niggling all day Tuesday and had more 'show' around lunchtime. Although I still couldn't swear to it, I had enough of a feeling that this might be it to suggest to my husband, Ian, that if there was any chance he could slope off early from work then I'd like to have him around.

He managed to get home a little bit early and I phoned my antenatal yoga teacher to let her know I thought I might be going into labour and wouldn't be at the class that evening. A friend of ours called round on his way home from work - that must have been around 6pm- and it was then that I began to feel that things might definitely be happening because it began to be uncomfortable having someone there who I wasn't completely at ease having contractions in front of. They were coming about every ten minutes at this stage and as soon as they started to come a little more frequently we suggested to our friend that it might be time for him to be off.

When he left, Ian and I put my 'nest' together. It consisted of a single duvet on the floor, a plastic dust sheet over that and an old double duvet cover over that. Also, an old beanbag up against the sofa, a pillow and a cushion or two. I already had a wooden chair to hand and a low stool for squatting. I'd been using the chair regularly in the weeks leading up to the birth. I'd sit astride it, leaning forward on the backrest, to promote good foetal positioning. Anyway, the chair didn't get used after I'd finished watching TV that evening and the stool didn't get used at all - unless either of the midwives sat on it!

So, having put the nest together, I sat astride my wooden chair to watch Eastenders, which finished at 8pm, and then phoned my Mam. She was to be my second birth companion. She also happens to be a qualified midwife but wouldn't be present in any official capacity as she would be too emotionally involved to be objective. She was to be there solely to help and support me. My Mam suggested it might be useful to time some contractions so we watched Holby City and timed. They were coming between six to eight minutes apart and lasting 45 to 50 seconds. Towards the end of Holby City I was finding it harder to concentrate on the telly and the last couple of contractions we timed were four minutes apart, at which point I decided I really needed a warm bath.

The warm water was very soothing but I did have the very silly idea of washing my hair. The vision in my head was that I would get out and dry it and be all clean and fresh for the rest of the birth! (As I say, I hadn't done this before!) What ended up happening was that by the time I got out of the bath the contractions had intensified and I managed to get myself dry and dressed and made it as far as my nest and into an all fours position where I remained with long wet hair hanging in my face until my mam arrived and thought I might be happier with it tied back out of the way! (I was).

Things begin to get increasingly vague in my mind from this point. I do remember that the contractions were pretty painful by now and that I was beginning to get quite impatient for my mam to arrive by the time she actually did. The position I found myself most often adopting was on hands and knees over the beanbag. I found that I didn't like having my back touched at all during a contraction - especially not with any pressure (massage as a way of coping was therefore straight out of the window) but I was happy to have my hands held or my arms or legs rubbed.

Ian phoned the midwives to let them know what was happening but they weren't too interested until I was contracting every three minutes for a minute. That is unless I wanted pain relief or further reassurance. I was happy enough at that point just to wait for my mam.

When she arrived she was putting a light hand on my tummy during contractions which I found tolerable then but not later. The thing she did which was most helpful was to talk me through each contraction, telling me when it would be peaking and that it would be passing soon. Before you've ever been in labour you think to yourself that a contraction lasting a minute every four minutes wouldn't be so bad as that would give you three minutes each time to recover but in reality it doesn't feel quite so easy. It takes you at least another minute to even 'get your breath back' and during most of those minutes of 'recovery' you're still feeling pretty uncomfortable.

Note from Angela:
Women report quite a range of experiences of the time in between contractions. Sometimes the 'rest' period really can be peaceful and restful, even if contractions are only a minute apart. Jo's experience shows that you can't rely on this, though - so if there is any sign that you might be going into labour soon, get your rest in beforehand!

My mam reckons she arrived at about 11.30pm and that they called the midwives out fairly shortly afterwards. One funny thing I remember is that when the midwife arrived one of the first things she wanted was a urine sample. A sample! At a time like that! Getting from the lounge to the toilet seemed, at that point, like the most impossible task in the world. Still, ever obliging, I was helped up after a contraction and shuffled slowly into the bathroom, leaning on Ian. I was having trouble bending so Mam had to take my trousers and pants off for me. All need for dignity had luckily left me long before then!

Having managed that and sat through a few more contractions, I was helped back to my nest. I've no idea how much longer I was there for but I remember I was mostly still kneeling over the beanbag. I was pushing upwards with my arms a lot during contractions and there was some concern that my wrists would get tired in that position so I was encouraged to kneel with my head in Ian's lap as he sat on the sofa and my arms crossed over in front of me. I think I still felt I wanted to push myself more upright during the contractions though.

Before I moved into that position I had been feeling a bit too hot and Mam was wiping my face with a wet flannel which was very soothing. The flannel somehow ended up in my mouth where I could bite and suck on it. I do remember vaguely having a moment of clarity where it suddenly occurred to me to wonder what sort of a picture I presented on my hands and knees on my living room floor with a wet flannel hanging out of my mouth!

Things started to get very intense and a couple of contractions were so bad that I was saying I couldn't do it - I couldn't have many more like that. Mam suggested I get in the bath as I had found the warm water soothing before and I agreed to once more attempt the impossible task of moving the short distance to the bathroom. I shuffled in there, step by painful step, leaning heavily on Ian. I had at least one contraction standing up in the bathroom and that was utterly horrible.

I got in the bath at 2am and apparently I was in there for two hours! I was very surprised to hear that afterwards as it didn't seem like very long. I was mostly lying on my side with Ian's arm under my head (poor darling, that can't have been very comfortable for two hours!) and Mam was pouring warm water into the bath when it started getting too cold for me. I was sometimes having contractions which would make me shivery and I was also losing mucous plug with many of them.

It was while I was in the bath that the second midwife was called as they thought I must be nearly ready to push. I was still convinced that I 'couldn't do this' and that he'd never come out.

Eventually I'd had enough of the bath and I was helped out. Mam dried me off while I leaned over the bath watching the water and bloody mucous drain away (a very weird memory!) then I was put back into my t-shirt, fresh pants and a pad and helped back to my nest. I'm not sure how long the next bit went on for but I remember having blankets piled up on me because I was shivering uncontrollably. This shivering would then turn into a really vicious contraction. It was pretty horrible.

Anyway, I was getting quite tired but I wasn't getting any pushing urges so the midwife suggested that I have an internal to see what the state of play was. I agreed as I was fairly curious myself by this stage but wanted, in that case, to start on the gas & air. I wasn't at all convinced that it would help - that anything would help- but I needed to try something.

So the bottle was brought and I started breathing it in. It was wonderful!! Such a relief to have a distraction from the pain. Once you reach a high on the entonox you feel kind of dizzy and light headed and it gives you a slight disconnection from yourself and what's happening to you. It still bl**dy hurts, of course, but it gave me some relief and enabled me to smile for the first time in ages. I also remember having my first thought which was unconnected to exactly what was happening minute by minute to ME as it flitted through my head to wonder what had happened on Big Brother that evening!

The Entonox also made it possible for me to turn around for the examination. The internal showed that I was only 7cm dilated and the baby's head was still pretty high. This was disappointing but not nearly as devastating a discovery as it would have been before the introduction of the entonox. It did mean that they wanted me to try some different positions to use gravity to bring the head down. I spent quite a few contractions standing up, leaning on Ian, until I got tired and had to get back down to a lower level.

When the midwife next examined me, an hour and a half later, I wasn't much further along but Lex's head was a lot further down. She suggested that she could try to break my waters. Although it was in my birth plan that I didn't want the waters broken she felt that it might speed things up and that I'd been going for quite a long time now. At this stage I didn't care too much about the birth plan, I just wanted the pain to stop. I was quite scared sometimes and still convinced that he would just never be born - that it just wouldn't happen. So she ruptured my membranes and I went straight from 8cm to an anterior lip.

Shortly after that disaster struck - the third bottle of gas & air turned out to be a dud! They had just opened it for me and it was empty! So they had to call someone to bring some more while I lay on my side with my crutch taken away. I was still clutching onto the mouthpiece though, like a drowning woman! Ian remembers telling me to be calm as the hospital was only five minutes away, not believing me to be sufficiently 'with it' to know what time it was but I knew it was rush hour and came straight back with 'what about the bl**dy traffic!' Amazingly, I was so freaked out that I managed to slow the contractions right down. They had been mostly coming thick and fast but apparently I only had three or four in the half hour or so that it took for more gas & air to arrive. It was a horrible time for me though. One of the midwives coached me on breathing through the contractions and I just had to hang in there and mentally cross my legs. Mercifully the drugs eventually turned up through the morning rush hour traffic and I was able to 'relax' and get back down to it again.

Some time later I started getting pushing urges. These started off as long contractions and then suddenly turned into unavoidable pushing. Unfortunately I was bleeding when I pushed and Pauline, my main midwife, suspected the anterior lip was still there. She did an examination which confirmed this. So now I had to hold on and breath through the pushing urges. Again they wanted me to try different positions to get rid of the lip. This was very much according to my birth plan but I must admit that by now I was exhausted and all I really wanted to do was to lie down on my side and do gas & air!

At some point later they decided that the anterior lip was gone and it was time for me to try pushing but by this time the pushing urges had gone and they never actually came back again. Having to breath through the earlier ones had somehow stopped them from happening any more. They wanted me to concentrate on pushing so I wasn't supposed to use the gas & air any more. That was hard news to take! I was standing up at the time, supported by Ian, and Saleme (the 2nd midwife) was trying to take the mouthpiece off me. I refused to let go and growled at her that I wouldn't use it but I just needed to keep hold of it for now.

Anyway, all the attempts at pushing were getting me nowhere so I lay down for another internal. The anterior lip was still there and this time Pauline held it back while I pushed. That was painful! She was telling me to push past the pain and I screamed and pushed for all I was worth. That got rid of it so now I was free to go for it. Unfortunately I still wasn't getting any pushing urge so, with no instinct helping me, it was very difficult to get it right and very little was happening. At this point Lex's heart rate was dipping and everyone was telling me I had to push him out now. I was trying very hard but everyone wanted me to try harder. I was pushing twice through contractions and I was being encouraged to push three times. It was very painful and I was exhausted - I think I screamed quite a lot.

I was beginning to feel very scared for my baby and not a little scared for myself. I hadn't picked up at the time on the fact that his heart rate was dipping but I knew what everyone was getting at when they said I had to get him out now and I was terrified that I was going to lose him. I had miscarried my first pregnancy and had five weeks of early bleeding with Lex and I felt that to lose him now after all of that would be dreadful. To be honest I was in so much pain that I was kind of scared that I might die as well. In retrospect this type of fear is very common in transition and is thought to be very helpful in supplying enough adrenaline to exhausted mums to find the strength to push their babies out.

The ambulance had already been called and was on its way. Pauline suggested an episiotomy might help us get him out and I was now perfectly happy to go along with anything which might help. So there I was lying on my back (in the worst possible position for giving birth according to all the information I'd read during pregnancy) and Pauline was just siting the injection to numb me for the episiotomy when along came another contraction and I just pushed with all my might. Suddenly there he was! Pauline let out a surprised 'oh' and stopped what she was doing. Mam said later that she didn't know where I got the strength from to push like that after 15 hours of labour but it was sheer terror for his life that did it.

Anyway, his head was crowning and at this point I have my highlight memory from the whole labour because Pauline suggested I put my hand down and feel his head. And there he was, all warm and soft. It was lovely and whenever I cupped his head in my hand for months after that I would remember that moment. At the time though I was still rather concerned to know if he was alive. I think I asked at the time and several times later but they couldn't answer me at this stage. When his head was out they had to stop me and suction him as there was evidence of meconium having been passed. The waters had been clear when they were broken but he had been stuck on the anterior rim for a long time and had obviously become distressed at some point either then or on the way down.

After that I got to push again and the rest of him slithered out. That was such a relief but I was still asking "Is he alive? Is he ok?". Mam and Ian were apparently crying but I still had my eyes closed for a little while. Mam didn't know how to answer my questions because apparently when he came out he was so blue he was almost black but he pinked up straight away after a bit of oxygen and I was told that 'yes, he was alive'.

Note from Angela:
Babies which have had a difficult birth are often 'blue' when they are born. This is not normally a problem - often the baby turns a healthy colour after a few seconds, perhaps with the added stimulation of being rubbed with a towel, or given some air by 'bag and mask', or some oxygen. The real danger sign that midwives look out for is when a baby looks grey or white at birth. For more on this topic, see What if your baby needs resuscitation? (www.homebirth.org.uk/whatif.htm)
Back to Jo:

I opened my eyes and sat up slightly and he was handed to me wrapped up in a towel. I cried. He had his little eyes firmly closed but he was here and alive and I was so happy about that and about finally getting to meet him. There was also some crying from relief and shock. His head was really pointy from being squished so badly as he came down and he had little red spots like a rash across his forehead and temples which is apparently caused by the pressure. He also had a small swelling near the top of his head and just off to one side which led Mam to believe he might have had his head slightly to the side rather than properly flexed as he was coming down.

At this point the ambulance arrived. The midwives weren't entirely happy with Lex's breathing and because of the meconium they wanted him to go to hospital for observation. So, as the cord had already been cut to give him resusitation, I agreed to have the injection to speed up the delivery of the placenta. Mam had a little hold of Lex and then asked if I wanted her to give him to his Daddy. I did. Ian had gone to let the ambulance crew in and was chatting to them in the kitchen so Mam took Lex to him and said "here you go, Daddy."

Meanwhile Pauline tried pulling on my cord to get the placenta out and it snapped off in her hand. Oops! So I had to try and push it out. I was knackered though and I really couldn't face pushing anything out ever again. All that was happening was that my bladder was opening. Pauline said this was good as I hadn't been in a while and it might help get the placenta out if I empty my bladder so to just go ahead. So here I am in my lounge, squatting in a puddle of blood, with my house full of virtual strangers, my mother to one side, my husband and newborn son to the other, p*ssing on the living room floor! Very, very strange.

The placenta, however, would not come away. So now I had to go into hospital as well as Lex to have a retained placenta dealt with. After all that - 15 hours of labour, no drugs until 7cm and then only gas & air, finally pushing him out all by myself on my living room floor - I ended up being carried down my stairs by the ambulance crew, strapped to a chair with a blanket over me. Mam came with me in the ambulance with a midwife holding Lex. Ian followed in the car. Apparently that was the most trippy time of all for him. After not having had any sleep and witnessing all of that to have to then go out to his car and drive to the hospital. Apparently it took him a minute to remember where it even was! The thing I remember most about being carried to the ambulance is that it was raining outside and it was lovely and fresh. That and a vague worry about what the neighbours might think if they saw me being carried out to an ambulance.

In the ambulance I was feeling pretty uncomfortable and I had a bit of a cry. Probably shock. When we got to the hospital I was taken to one of the labour rooms and hooked up to a drip which was hopefully going to make my placenta drop out. Of course it was making my womb contract in order to do that and although it felt nothing like a full blown contraction I was fed up of being in pain at this stage and just wanted it to be all over with. Also I was too uncomfortable to hold my little boy or to nurse him and I was upset about that. We had tried putting him to the breast at home in an attempt to get the placenta out but he hadn't been interested then. I got Mam to wheel his cot over so I could at least see him. He was breathing fine by the time we got to hospital but they still wanted to observe him for 24 hours.

I was supposed to be on the drip for an hour but at the end of that time my placenta still hadn't come away and it took a further three hours for the theatre to become free. During all that time I was still hooked up to the drip and I was pretty unhappy about it. I cried some more - frustration this time. I also had terrible indigestion and even threw up at one point - all over myself. Apparently I threw up over Ian's hand in labour as well. Oops. Don't remember that one.

Eventually I went into theatre and had a spinal block so they could remove the placenta. Imagine that. After going through all that to have my home birth with only gas & air I ended up in hospital afterwards, effectively having an epidural to get the bl**dy placenta out! Still, I wanted the homebirth and lack of drugs for Lex's sake and by that stage the numbing spinal block was a blessed relief. Although I do remember thinking it would have felt very weird to have one in labour. They said my placenta was well and truly stuck and there was no way it would have come out on its own. Morbidly adhered is the technical term. Afterwards they stitched me up while I was still numb. Although I avoided the episiotomy I did tear from finally pushing him out so fast.

So, finally I was wheeled back to where Ian, Mam and Lex were waiting for me. Mam and a midwife propped me up so I could hold and nurse my little boy. He nursed for a little while and although I was worried that he wasn't getting anything it was lovely to do that and to finally have a proper cuddle. I was surprised to see that he had my eyes. Nobody in my immediate family has eyes quite like mine and now I have a son who has them. He has his Daddy's nose and mouth though, we think, and is altogether cute and lovely.

Mam and Ian were starting to look pretty exhausted so, soon after they got me down to the ward, I insisted that they go home and get some rest and come back with my Dad at the later visiting time.

I spent 24 hours in the hospital and, although everyone was nice, I did find it difficult to be there and I was very ready to come home by the time they were happy to let me go.

All in all I was very glad I had chosen to have a home birth with Lex. It was great to be in my own environment and I found that I could easily let go of my inhibitions and go with what was happening to me. I wouldn't have liked having to choose a time to go into hospital if I had been having a hospital birth and I would have hated leaving the house and going anywhere while I was having contractions. I remember that when the ambulance crew arrived I was really relieved that they had arrived after I managed to push Lex out and not before. I just couldn't imagine how they would have got me down the stairs and into the ambulance in the condition I was in then.

I also retain a tremendous sense of achievement from the whole thing. To think that I did that all by myself (well, more or less!). Also, I think that if I had been in hospital and somebody had offered me an epidural at around 5cms I probably would have taken it. Now, approaching the birth of my second child, I am armed with the knowledge that I am perfectly capable of managing to get through a birth with only gas & air. Perhaps this time I might even manage without that!

I am also very grateful to the midwives for being so respectful of my wishes with regard to the birth. Although things did not exactly go according to plan and as a result there were quite a few deviations from my birth plan, every deviation was discussed with me beforehand and my permission obtained for whatever change they thought best to make. I have a friend who had a very badly managed hospital birth and she can hardly speak about it to this day without feeling tearful and traumatised. I have no such trauma associated with my memories of Lex's birth. It was a shocking experience at the time but it was shocking in a natural way and it wasn't many days before I began to look upon it all as very positive and interesting. In fact, even my uncomfortable time in the hospital, waiting to go into theatre, was lightened by a thorough discussion with my mam and Ian about the whole thing and even some laughter about the weirdest and funniest aspects of the birth. All in all I would not have had it any other way than at home and I recommend to anyone having a normal healthy pregnancy to seriously consider birth in the comfort of your own home.

Jo B

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