I am currently pregnant for the sixth time, and this will be my fourth baby. In January 2004 I gave birth to Lukas, followed by Esther in June 2005 , a miscarriage in May 2006, Leah in April 2007, a miscarriage in September 2007, and the new one is due in October! (nearly a baby every year – how scary is that??)
My first birth was a planned homebirth, although I transferred to hospital and ended up traumatised by the whole experience, so much so that until now I have not been able to write up what happened. We hired an independent midwife for both the girls birth's, which enabled me to have a waterbirth at home both times – they were lovely and I did write those stories down very quickly so as not to forget how wonderful it was. This time around I am hoping for another homebirth, and I am trying to do this on the NHS.
Having had uterine surgery to remove some benign tumours in 2001, we were told that having children might prove to be difficult for us – something we can luckily have a very good laugh about now!! It was a complete shock to find out I was pregnant for the first time, but we quickly got used to the idea and our holiday budget was quickly used to make our house vaguely child-friendly – we were in a renovation project and walking on the rafters rather than floorboards at the time! The pregnancy progressed well, despite the chance that the uterine scars could cause abruption. I can’t remember at what stage we decided on a home birth, or what the reasons were – I think it was just an instinct that childbirth was something normal and not a medical emergency, and therefore I was happier staying at home than going into hospital. The Community Midwife was happy about our homebirth plans.
I had recurrent urinary tract infections, and upon analysing one of my samples, the GP commented that they had found an unusual bacterium – Strep B, but that this was nothing to worry about. No vaginal swabs were offered and I don’t even think the midwife was informed. Blissfully unaware, we did the hospital tour when I was 36 weeks pregnant (just in case) and I walked past a poster saying ‘Strep B Support Group’ – this stopped me dead in my tracks – I had no idea I needed any kind of support for this! I rang them up and having got all their info through the post, I booked an appointment with the midwife who simply said that Strep B would change my options. I was strongly advised to have IV antibiotics, which meant I had to go into hospital. I was o.k. about the IV, but not about the prospect of a hospital birth – I just could not see why a midwife could not lay a drip at home when they routinely do this in hospital. It took a lot of fighting to get the community midwife team to agree to lay the drip at home, and all the drip stuff was delivered a few days before my due date. I even managed to get some magic EMLA cream prescribed so I would not feel the needle going into my hand!
Two community midwives had expressed that they would not support me if they happened to be on duty when it all kicked off. Their names went down on the front of my blue notes, a reminder for my husband to tell them not to send these two out if they happened be on duty. I asked to have a copy of the duty rota so I would have some idea who would come out, which put me at ease a bit more.
While the baby went overdue by 9 days before anything happened, I was so tired of constant varying opinions – every midwife had their own opinion, there was no consensus or a local Strep B policy – I photocopied the info I had been sent from the GBSS charity for the community midwives so they had something to go on. I felt I was the most awkward mother-to-be, but I was also so confident that everything would be fine – unfortunately, with all this Strep B stuff going on, we did not even explore what would happen if ... I needed to be in hospital, we had not even a scrap of a birth plan other than having the baby at home! I hung around waiting for it all to start happening – I did not even have any Braxton Hicks to keep me amused. I made loads of neutral-coloured announcement cards, and a template on the computer for the insert with all the vital details.
On the 19th January, I woke at 2 am with definite contractions, and David immediately called the hospital as we had been instructed to do so they could send someone out to lay the drip. We were so excited you could have scraped us off the ceiling! My first course of action was to amend the hitherto blank birth announcement inserts on the computer – silly, I know, but I thought it best to be organised and type in the date at least . Little did I know that I would ‘still be in one piece’ 24 hours later! The midwife came and set the drip up, gave me my first lot of antibiotics, and said that a midwife would check on me every 4 hours to give me more antibiotics.
I coped well with the TENS machine, we went for very brief walks – always conscious that soon it was time for the midwives to come back. I would have loved to go out for longer, and I am sure that would have sped up labour a bit too. By the time it was evening, I had met most of the local midwifery team and several students, and every midwife brought with her their own opinions on Strep B. I was still arguing my case even in labour, getting very stroppy after every midwife visit. I was so tired, mentally and physically.
By 7 pm, I was still coping well and I agreed to be examined – I was only 1 cm dilated and promptly burst into tears I was so disappointed. The night shift had started and I was made aware that they had severe staffing problems and they may have to draft in midwives from other areas. The midwife on night duty was not keen to ‘pop out every 4 hours for my drip if nothing was happening’, so she asked me to go into hospital to be monitored briefly and have the consultant prescribe oral antibiotics to last me through the night if all was well.
This is the point that I regretted ever since – I should have refused to go - there was no evidence of any foetal (or maternal) distress, and absolutely no reason for me to transfer into hospital – I was not even in established labour at this point!! All I wanted was to be left alone for a while, and I thought going along with the midwife’s suggestion would get me a peaceful night at home, if this was going to be a long-haul birth. I agreed to go in, fully expecting to walk out of there again to resume our home birth. I knew full well that oral antibiotics were not an effective means of preventing Strep B infection in the baby, and naively assumed then consultant would know this and tell the midwives to keep on supporting me with the drip at home! We did not take the hospital bag, or a camera, or anything else.
Once in hospital, the midwife strapped me onto the belt to monitor the baby’s heartbeat. I was strapped on there for an hour; apparently there were minor irregularities which were unusual for such an early stage of labour. (it turned out that every time I had a contraction, baby’s heart rate went up, but immediately recovered – apparently this is perfectly normal). Whilst on the bed, a young midwife said she needed to examine me – at least we found out I was 3 cm dilated – hooray! I smiled wryly as she said I was now officially in labour.. it was about 9pm.
The consultant came over and he was very nice but made us feel as if we were being very irresponsible for even wishing to go home again – the second time within hours, I burst into tears, and I just became very frightened. There was not enough time to think, and I knew that the decisions we were having to make now would not be informed at all. All I could hear was the beeping from the heart monitor.
A very nice midwife (she was my saving grace, she went with me to the delivery suite and only left when he was born) encouraged me to have a long bath while David rushed home to get the hospital bag. Wisely, she said that once I was in the delivery suite, they would not let me have a bath any more as I would need to be on the bed with the foetal heart monitor around my belt. A waterbirth was not offered and presumably out of the question, even if I had asked for it. I lay in the bath crying, feeling scared and in pain, desperate for David to come back. The contractions were now getting so much stronger, and I was beginning to go into my own little world. The ‘show’ popped out while I was in the bath – at least a bit of company while I waited for David to return!
I got out and we were told to go to the delivery suite. I found it really difficult to walk at this stage and it took me ages to get there. At midnight, I had gone to 6cm dilated. In a last attempt to get some control back of my birth, I insisted that I wanted to use the birth ball, but the midwives insisted that I still had to be on the monitoring belt and preferred me to be on the bed. By now his heart rate was absolutely fine again, so I just got off the bed and bounced on the ball, leaving them to deal with all the cables. I was so cross by this stage, and beyond caring. I remember getting told off for losing the baby’s heartbeat all the time! David massaged my lower back, so much so that he had cramps in his thumbs – a small price to pay for a baby!
Eventually I gave up and went on the bed, but not before another midwife just came in, did not introduce herself, spread out my hand on the bed and rammed another IV drip in – the other side had tissued and was really sore by now. I remember shouting at her for not even introducing herself and hurting me, and she just said that my I should have other things to worry about!
I was finding the contractions very difficult now, and was offered Gas&Air which worked well for me, although for some reason I was advised to restrict my use of this so they gave it to me when they thought I needed it. At least I could still have a little bit of a breathing space between contractions. This ended abruptly when I was examined again (I think it was around 3 am) and I was still at 6 cms. The midwife said that it would be better if my waters were broken, in went the crochet hook, out came a huge gush of water and absolute hell started. Unbearable pain came from nowhere, and I could not breathe.
I don’t remember the rest of the birth very well. I was so frightened, and remember feeling as though I was looking down on my labouring body and thinking ‘this is not me’. There were loads of people in the room – I was the only woman in labour and I think all of the maternity staff came in for a bit of entertainment... I kept saying to David that I was going to die, and all he could do was hold my hand – he was a bit sidelined by all the professionals in the room. I was screaming the place down with every contraction, was told when to push and when not (nobody thought about helping me breathe!).
For some reason, the obstetrician decided that things were not moving fast enough, so they added hormones to the drip I already had (my notes record that this was started 15 minutes before the baby was born). I was flat on the bed, with the midwife and the obstetrician holding my legs apart, and I have a very clear memory of my perineum tearing which made me be sick.
At 5.56 am the baby flung out to the edge of the bed, through his cord which had been around the neck, I was told it was a boy to which I replied ‘good, he will never ever have to do what I have just done!’, before I flopped back on the bed and shut my eyes. The placenta slithered out painlessly after I was given the injection (no-one thought to ask me – mind you, they may not have got a very polite reply anyway...). Finally, the bloody heart monitor was switched off, but in my head its sound continued for a few days longer. I did not want to hold my son or even look at him. David cuddled Lukas (who weighed 8lb 2 oz) while I drifted into sleep, and my second-degree tears were stitched.
All the professionals left us alone for an hour - so much so for this ‘high risk’ birth they made me out to be, because of the Strep B – no-one checked Lukas for signs of infection until 7 hours later. I was left feeling numbed by the experience. Coupled with great breastfeeding difficulties – Lukas was severely tongue-tied but this is another story- it took me a few weeks to bond with my new baby son.
In hindsight, I don’t think we were well enough prepared for all the ‘advice’ that would be given to us even in labour. The baby was never in distress, and I remained well throughout, so there was absolutely no reason for me to transfer to hospital. Had I found out the Strep B implications earlier in pregnancy, I would have made an informed choice against IV antibiotics – this certainly complicated the homebirth we planned and was probably the only reason why I had the hormones added in the end, a ‘while we have the drip in anyway’ kind of approach. Strep B was never found in the birth canal, so my risk factors were very low anyway. I think I was unlucky to have had my baby when many of the community midwives were off sick and that my labour kicked off properly over night with a reluctant midwife on night-duty. I am sure that my 28-hour labour could have been much faster had I been allowed to move around more.
We were wrongly advised to call the midwives out very early for the drip, whereas the current advice is to wait until you are in established labour –this would have meant we could have spent the day in peace and I could have rested before it all started properly. Worst of all, though, was my feeling of being completely out of control of my birth and being absolutely terrified – this must have amplified the pain of the contractions and made it so unbearable. I literally thought I was going to die because of not being able to breathe. However, I am grateful to have had a healthy baby by what the hospital would call a normal unassisted birth – although little about it felt normal to me!
I did write a long letter of complaint about my maternity care and this led to a Strep B policy being implemented, and it helped me vent some of the disappointment and anger about my birth experience. The senior midwife came to my home and talked me through my birth notes, and she acknowledged that I had been receiving antibiotics far too early, and that I should have remained at home as there were never any concerns about the baby’s or my wellbeing.
Group B Strep - your options for homebirth, and choices regarding antibiotics.
First Babies and homebirth
Transferring to hospital - why it might be advised.
The Third Stage of Labour - what are your options, and the pros and cons of each?
Home Birth Stories
Home Birth Reference Page