The Story of Tabitha's Birth

By Laura

Laura's first baby, Tabitha, was born in December, weighing 8lb 13oz

My daughter, Tabby, was born in hospital after a planned home birth. I had my first contraction about lunchtime on Monday 6th December, and Tabby arrived by emergency caesarean at 12.55pm.

Tabby was posterior all the way through labour, which resulted in slow progress (a very long pre-labour) and my utter exhaustion. After 36 hours at home I asked to transfer to hospital so I could have an epidural. My intention was to rest and conserve what little energy I had left for the delivery. I was 7cm dilated when I arrived at hospital, took another 10 hours to dilate fully (with the help of syntocinon and ARM [artificial rupture of membranes]), but after two hours of pushing her head had not descended at all and I had to have a caesarean.

Deciding on a home birth

When I became (unexpectedly!) pregnant, I automatically knew that I wanted to try to have the baby at home, and my partner agreed wholeheartedly. My mum had had my older sister at home and I knew from talking to her that it was her favourite birth experience. I was extremely lucky in that everyone important to me completely supported my decision.

My wanting a homebirth was not because I wanted to have a natural, drug free birth (although I hated the idea of pethidine), it was because I wanted to be in control of my labour and my birth, to be surrounded by people I care about, and to be in familiar surroundings.

Booking the birth

Although decided on my plan, I didn't know how to go about it. My mother-in-law, who works for a local Community Health Council, did some research for me and found that one of my local hospitals has a dedicated home birth team. I rang them myself, when I was about seven weeks pregnant, and prepared myself for defending my right as a first time mother to plan a home birth. Margaret, who I spoke to, didn't flinch at all (I was surprised).

My GP was less supportive. I had only recently registered with her, and by the time I saw her I had already booked with the midwives. She was very negative, telling me that she had covered home births in the past, but did no longer. She used every trick in the book to scare me but I managed to stand my ground - although I burst into tears as soon as I got to the car park!

Pregnancy

I had a mostly trouble-free pregnancy, no sickness but niggling heartburn in the last trimester. I enjoyed all my antenatal appointments; they were so relaxed and I felt so lucky to be able to build up a relationship with one person. I felt relieved not to have endured long waits at crowded, depressing antenatal clinics. It just seemed so right to have Margaret come and see me and Aaron at home, in our living room. My mum was present for two of my checks (I wanted her to be at the birth), and my three-year-old niece visited once and was overjoyed to hear the baby's heartbeat.

We rented a birthing pool from the Active Birth centre. I was not convinced by the idea of a water birth, but was willing to try anything that would help with the pain.

The beginning!

My due date came and went, much to my impatience. Margaret had been telling me for months to think in terms of 41 weeks rather than 40, but I still found it hard to wait.

Finally, on Monday 6th Dec, six days after my official due date, I woke up feeling a bit odd and sick. A bit of natural induction (otherwise known as sex!) left me feeling quite uncomfortable and twingy. Aaron and I thought something might be happening but we tried to remain calm. I rang my homeopath who advised me take one of the remedies in my labour pack (caulophyllum) to help strengthen the contractions. We ate lunch and went for a walk in the park.

About 7pm I had a show and became quite excited. My contractions became more regular and uncomfortable, I felt as though the real thing had begun. I asked my mum to come over (told her to wait until after EastEnders!), and I rang Margaret to warn her. She was amazingly blasé and just said it could still be days. Margaret visited me for the first time late that evening. She did the vaginal examination (VE) that I asked for and told me I hadn't yet begun dilating and was still in pre-labour, and to call when things progressed.

Nobody got much sleep that night. I found it hard to rest as standing upright and walking made the contractions more bearable. I used a TENS machine but I wasn't convinced it helped much. I didn't want to be massaged but I did crave human contact through my contractions. Margaret came back in the morning. I still hadn't dilated, but I was still coping okay with Aaron and my mum for support. She performed another VE on my request early Tuesday afternoon, which (thank god!) showed me to be 2-3 cm dilated. I was relieved but still disappointed. The contractions had got more painful and I was beginning to get tired. I was incredibly clingy and couldn't bear Aaron to leave my sight.

Although Margaret had previously suggested waiting as long as possible before using the pool (at least 5cm), she now suggested we tried, especially in the light of my tiredness. I got in the pool for the first time about 4pm - it was wonderful and relaxing, and I got out frequently to pee and walk around. I didn't want to eat or drink at all, even though I tried to make myself as I knew it would help my strength.

As it turned into evening again I was really flagging. My last VE at home took place at about 11pm; Margaret said I was 5cm. I was fairly distraught and cried. I had been trying so hard and felt miserable and exhausted. I told everyone that I was tired and wanted to go to hospital for an epidural. Everyone tried to persuade me against it and we reached a compromise that I would get back in the pool and see how it went. An hour later, I looked into Aaron's eyes and said 'take me to hospital'. He knew I meant it.

Margaret wrote up my notes and rung the labour ward to warn them. I didn't want an ambulance (there was no emergency and I was not ill!) and we decided that Aaron would drive me and my mum. Margaret would go home and the plan was that she would come to the hospital when I had had some rest (courtesy of an epidural), and she would still be able to deliver the baby. We took quite a bit of time getting ready to leave and had a fairly relaxed drive to the hospital.

Once in hospital I was examined (1.30am), now 7cm dilated (must have been the movement), and fitted with a belt fetal heart monitor. I asked the midwife if I could just have it on for a bit, but in the end in stayed on throughout. I had an epidural which helped me to rest a bit. But everyone knows that interventions are a vicious circle…My membranes were ruptured about 4.15am on Wed morning in attempt to strengthen my contractions. At 5.15am, tired and desperate for it to be over, I was put on Syntocinon.

Finally at about 9.30am I was declared fully dilated and it was planned that I should begin pushing around 10am for an hour or so. I found the pushing fairly impossible as I had had (at my request) several epidural top-ups and couldn't feel a thing. The midwives now on duty weren't very helpful and kept forgetting to tell me when I had a contraction, so Aaron and my mum watched the monitor and told me when to push. But my baby wasn't coming out!

The midwives told me I was pushing correctly, and after an hour and half the obstetrician came in, and suddenly there were quite a lot of people in the room. He did a VE (the worst of them all by far, partly during a contraction) and said the baby's head was not descending and it was still too high to use ventouse and they wouldn't use forceps that high. My choice was either to transfer to theatre and carry on pushing and see if they could do ventouse (if not, c-section), or just to opt for a c-section straight away.

The baby was fine and amazingly had shown no signs of distress, but I was still tired and quite overwhelmed. I didn't know what to do, and needed to discuss it with Aaron and my mum. At this point aaron got quite cross and asked everyone to leave us alone so we could talk.

I decided to go straight for a c-section as I didn't want to be in the position of transferring to theatre and having a highly medicalised instrumental delivery, which probably wouldn't be successful anyway. For some reason I felt that a c-section straightaway was preferable; I felt that the other option was just setting me up to fail.

I was examined again just before the operation and there really hadn't been any change. Everyone was lovely during the operation. It was stranger than I expected, the pressure and being pulled in all directions was very odd. But importantly, all 8lb 13oz of Tabitha Grace was perfect and she howled in absolute crossness as soon as she was lifted out. I breastfed her as soon as I was wheeled to the recovery room, and after an initial debate about whether I needed a blood transfusion (I lost a lot of blood), I was up on the postnatal ward.

Up on the ward, all the nurses and midwives were lovely, but I was still sad that I had to be in hospital. In fact my main concern about the c-section was how long I'd have to stay in ( I was told at least 5 days). I was desperate to get home and felt totally miserable away from Aaron. I just used my time in hospital proving to everyone that I was recovering well and should be allowed home as soon as possible. I managed to talk myself into being discharged on Friday (two days later).

My physical recovery was good (I think), helped by vast quantities of arnica. I was relieved to pull out my own stitches under the watchful eye of Margaret (I was discharged back to the homebirth team which at least provided some continuity). I managed a slow walk to the shops three days after the operation. My emotional recovery took longer.

Reflections

I am disappointed I did not get the home birth I wanted; I can't pretend otherwise. It is important to me that I felt in control most of the time. It was completely my decision to go to hospital - my midwife would rather I had stayed at home! But I think I knew that things weren't going quite right.

I will never know whether, if I stayed at home, everything would have been fine, but I was too tired to consider it at the time. I expect I shall always wonder 'what if'. I wished I hadn't had to have the c-section, but being that I did, I consider it to be a good experience of a c-section.

I am extremely glad that the majority of my labour was spent at home; this is how I think it should be for almost everyone. I have many happy memories (now that I have forgotten the pain) of labouring at home. For example, my midwife was terrified of cats and much of our time was spent shutting the cats in the cellar (they kept managing to open the door!).

I don't know why I have found it problematic coming to terms with the birth. I had considered the possibility of transferring to hospital, my labour bag was packed so it would be easy to take out of the house, and Aaron and I were interested in doing a hospital tour (but never got round to it, too lazy!). However, I had only thought about the possibility of a vaginal delivery in hospital, not a caesarean. I couldn't see why I would possibly need one. My mum had had three straightforward births and I felt better prepared than most.

I got hold of a copy of my notes about two months after the birth, and I felt it very cathartic to go through them and try to understand exactly what happened. I have also talked it over many times with Aaron and my mum, and continue to do so a year later. I still feel jealous when women talk of their wonderful home birth experiences, and I wonder if I hadn't just held out a bit longer... But I don't think that the birth has affected either Tabby or my relationship with her. I was fully supported in breastfeeding her (still feeding at 12.5 months), the ward staff encouraged me to keep her in bed with me, and she really is the calmest, loveliest baby ever. Aaron and I just joke that she couldn't be bothered to find the right way out and was just trying to be different. My scar is referred to as 'Tabby's trap door'!

Having said all this, I would really like a vaginal delivery next time and I definitely feel a determination (right or wrong) to 'do it right' next time around.

Laura

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