Nicky planned a home birth, but tragically, despite a good birth, her daughter Kim never took a breath, and died shortly after birth. No reason has ever been found for Kim's death - she was an undiagnosed breech, but this did not explain it. Despite living through every parent's nightmare, Nicky cherishes the memory of her daughter's birth, and feels that something very positive has come out of it - Angela.
Nicky has since had another daughter, Jodie, who was born safely at home on 23 March 2004.
I contacted an Independent Midwife before my second pregnancy because my fear of hospitals had resulted in a very traumatic birth in hospital; I needed to be able to guarantee one-to-one care and develop a relationship of trust with my midwife during the pregnancy, and know that she would be with me throughout the labour and birth when the day came. I planned a home birth again, but wanted to maximise my chances of actually staying at home this time.
After we had met Sarah and talked at length I felt relaxed enough to go ahead and try to conceive. We fell pregnant promptly and I spent nine blissfully relaxed months having all my antenatal visits, bloods taken etc., at home, and having two private scans at consulting rooms in a nearby city - I didn't set foot in a hospital the whole time and it was fantastic. I felt increasingly confident in my body's ability to have a good birth at home with the support of a midwife I trust and the husband I love.
We discussed scenarios for transfer in detail in the weeks leading up to my due date. I knew that if she looked me in the eye and said 'we have to move you now' it would be serious, and I'd go. She would accompany me into hospital if it was necessary, and be my principal carer there, so I'd have someone I knew, and who also knew me and my situation well, stay with me throughout, whatever happened.
In the event, my second labour went exactly as I had hoped and needed it to go, right down to labouring overnight while my son slept soundly upstairs. I had a very convincing false start for most of a Monday and Tuesday, and we even filled the pool, but the contractions faded away, leaving me 4cms dilated and even more uncomfortable than before as the baby had obviously moved further down. We didn't know how long we would have to wait for labour to start up again, so I took it easy and rested. We didn't have to wait long.
After tea on the Thursday I had a hot shower and some paracetamol and went to bed for a doze as my back ached and I was very tired. Oliver had his bath and came to say goodnight in his pyjamas at about 7.45pm. As I leaned towards him to touch his face and say goodnight, I felt a hot seep and wondered if that was what I thought it was! I lay still until Oliver was settled, then got up to go to the loo. My waters had broken and were now trickling steadily, nice and clear. I ended up kneeling in the bath as the loo was too uncomfortable and I didn't know when they were going to stop. Mark called Sarah who said to call back when I had a regular pattern of contractions. I started contracting at 8.55pm and after 4 at 6 minute intervals Mark called Sarah back and she said she was on her way. We made our way downstairs and Mark began to fill the pool.
I was excited and nervous but not at all afraid. I moved about freely and soon the contractions were only 4 minutes apart and becoming more intense. I trotted upstairs to the loo regularly and each time I seemed to have a really good contraction while on the loo - it must have been a good position for me - so Mark suggested bringing the 'new' loo downstairs. (It hadn't yet been plumbed in and was on the landing!) Mark put it by the pool so I could lean with my hands on the pool rim, and I put a 'caremat' on it to protect the seat and make it a bit softer.
We had lit a fire earlier and it was very comforting to kneel with my back to the fire's warmth with some of the contractions, and Sarah gave me a backrub with massage oil. I couldn't believe how much I was enjoying the labour, it was amazing to be able to feel so good about it. I had been concerned that I might be troubled by flashbacks in this labour and had discussed strategies for coping if it happened, but I need not have worried, I was completely focused on this labour, birthing this baby, and felt confident in my mind that my body could do it.
By half past midnight I asked Sarah to put on the TENS for me and by half past one I needed Mark to rub my back and shoulders to help keep me from tensing up as I breathed through each contraction. Things seemed to be moving more quickly now and by 1.45am I wanted to get into the pool and had to be unwired from the TENS to do so. By the time I entered the water I was 8cms and I remember saying something like 'Wow, 8cms already - brilliant!' because I was so pleased that I was so far on and coping really well, so relaxed and calm. I had been embracing the increasing intensity of the contractions, welcoming them as we got closer and closer to meeting our baby. Sarah also radiated a great sense of calm which was a great help.
Once in the pool I knelt facing Mark and holding onto his forearms as he knelt outside of the pool. We looked into each other's eyes as each contraction came and I breathed through it. The warmth of the water was even more comforting than the fire's warmth had been as it was all-encompassing, supporting me, allowing me to instinctively move as I needed to. After about an hour in the water I started to feel I wanted to push, it was becoming more and more difficult to breath through each contraction, but still the pain was not overwhelming.
By 3.15 the urge to push couldn't be ignored, Sarah checked that I was fully dilated and confirmed her suspicion that the presenting part was a bottom - the baby was breech; the appearance of meconium in the pool had been a clue a little earlier. I had no fear or panic I just thought 'This'll be a challenge!' and got on with it! Sarah is experienced in home, water and breech birth. There was no reason to move me as I was progressing very well and the baby showed no signs of distress, having a good heartbeat throughout.
I rested my hands on the integral seat of the pool (like the seat part of a corner bath) to push with each contraction. The water was brilliant for being able to move to push more effectively, and by this time my left leg had gone numb due to pressure on the sciatic nerve, so being in the water meant that this was no handicap at all. I have had sciatica for years on and off, and had started to get pins and needles earlier in the labour. Had I been on 'dry land' this numbness would have been a major hindrance in moving and changing position.
After nearly half an hour the baby's bottom started to emerge, I could feel it slip back a little after each push at first, but soon it was out, and not long after, the feet were born - I felt that bit! - the baby was pink and had a good heart beat. Sarah suggested Mark move round the pool to see what sex the baby was and he needed a little help to recognise that she was a girl!! He was so excited, and I was amazed as I'd convinced myself that the baby would be a boy all through the pregnancy, not daring to hope that we'd made the little girl I so desperately wanted.
Gradually I managed to push and push until only the head remained. There was a natural pause in the contractions here which gave me a chance to get my breath back and muster a bit of extra energy, then they started up again and the head was soon born with a great sense of release. I'd done it, I'd birthed an extended breech baby into water, second stage was only 50 minutes in total, half of that moving her down, the other half pushing her out. It was 4.10am, and as I turned around in the water Sarah guided Kim up and I held my beautiful little girl in my arms. I remember seeing a 'Mona Lisa' smile on Sarah's face in my peripheral vision; it must be a wonderful thing to see mothers look upon their precious baby for the first time.
In a matter of seconds Sarah realised that all was not well - Kim had not taken a breath. Sarah acted swiftly to clamp and cut the cord and start to try and help Kim breathe. I had held her to me for seconds, then watched as Sarah did what she needed to do, and Mark called 999. My beautiful little girl never breathed; she was stillborn. The paramedics took over from Sarah and I was helped out of the pool. Sarah gave me the injection for a managed third stage as Kim would not be feeding from me to stimulate the hormones for a natural third stage. I felt wobbly and faint and my left leg was still dead, but I was very calm.
Kim had had a good heartbeat throughout the labour and birth and was coming out pink; she showed no signs of distress at any time. Mark went to the hospital in the ambulance but Kim's heart had stopped beating before she left home and she was certified dead on arrival at the hospital.
I suggested organ donation, but a newborn's organs are not suitable. I also suggested a postmortem as my brother and his wife had lost a child at the age of 20 months after an illness he had been born with, and my other brother and his wife were now expecting their first baby, so we needed to know if Kim's death was connected. No abnormalities were found, she simply didn't breathe.
Less than three hours after Kim's birth I held Mark's hand and told him "I can do that again - let's make another baby." In the days and weeks that followed we talked at length about the birth. Mark said he thought I seemed to be in just as much pain with Kim as with Oliver's birth, but I explained that the difference was that I was coping well this time, able to focus on the contractions one at a time, relaxed at home instead of in a state of fear and panic in hospital. I'd had pethidine and entonox before but didn't need anything more than the water this time, and because I was relaxed it progressed really well and it took only a third of the time. Compared to last time, it was a breeze, even though she was breech!
I will always be grateful for the healing gift of Kim's birth. I have so much of my life back now, being able to make love to my husband without images of stirrups and stitches, actually wanting to make love and no longer feeling haunted, all because of the way the birth went for me. No one else on this earth could have done what Kim did for me; she gave her Daddy his wife back.
I am glad we didn't know that Kim was breech any earlier; I'm so pleased that I gave birth to her at home - there was no reason to move me, I wasn't in trouble and neither was Kim. It is unlikely that the outcome for Kim would have been any different for being born in hospital, but the outcome for me would have been very different - I would have been very afraid, I might have had an instrumental delivery and more stitches, or a section, and I would now be in a terrible state, emotionally and physically, still 'away' from my husband. I might never have been able to contemplate another pregnancy and birth, unable to complete the family as we want, and I'd probably be blaming being in hospital for Kim's death, whereas I have no doubt whatsoever that we had the best possible birth that we could have for both of us, relaxed, drug and intervention free, in water, at home.
I have enjoyed writing this story and reliving the labour and birth, the calmness and anticipation, the elation and the achievement. I am so proud of myself for doing such a great job that day, and I can't think of Kim and only feel sad because of the good that she did in her brief life. The fact that she died does nothing to take away the joy and wonder of her birth, and it is that which is significant in helping me to come to terms with her death. The tangible result of the miraculous healing of Kim's birth will be the next beautiful baby. And I hope to give birth to him or her at home, in water, with the support of Mark, my wonderful husband and Sarah, my amazing midwife. I do hope that the next baby is a girl, in which case her middle names will be Sarah Kim, but whatever the next baby is, all the love we would have given Kim we will give to Oliver and his new baby brother or sister.
not2early @ homebirth. ntlworld. com
(remove the spaces and homebirth. to get the real email address)
"The body is well, the mind is managing, and the love of Mark, Oliver and Kim's healing gift are keeping the heart from breaking."
Although Kim was in the breech position, this does not explain her death at all. There were none of the complications which are sometimes associated with breech birth, such as a trapped head or bleeding into the brain from a rapid delivery of the head. There were no signs of problems such a compressed cord - and there is no reason why a baby should die simply because it was born breech. Kim simply did not breathe - she had no reflexive urge to breathe, no gasp reflex - and could not be persuaded to breathe by any resuscitation method tried. It is possible that Kim had some undiagnosed brain abnormality which meant that she did not breathe, and which also explained her being breech - but we will never know, as the autopsy found no reason for her death.
Many people will wonder if Kim might have lived, if she had been born in a hospital. Nicky feels strongly that she would not have. With very aggressive ventilation, there have been cases of other babies who had no reflexive breathing urge living - sometimes with severe brain injuries, because of oxygen deprivation occurring before breathing was established. However, there are also plenty of cases where all the technology in the world could not persuade a baby to breathe - and at some stage, they have to breathe on their own, without the aid of ventilators.
Many thanks to Nicky for telling Kim's story; it cannot have been easy.
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