Kiera Davies was born at 5.54am, Thursday 14th September 2000.
Aged 26 and pregnant for the first time, I began considering homebirth when I was about 4 months pregnant. At first it was just an idea to explore - and I became interested in the idea because I'm not a big fan of hospitals. I simply just don't like the 'conveyor belt' feeling and wanted the birth of my baby to be more on my own terms.
The more that I read about birth and homebirth, I found out that women seemed overall to have a much easier time when they had the support of a midwife that they trusted. These days it's unlikely that a woman will even know the midwife who helps deliver her baby at hospital, which was another reason for me to consider homebirth. I really felt that I would be able to do what I wanted - mainly manage without pain relief - if I gave birth at home.
I did a lot of reading and research into the subject, and began to find out how safe homebirth is. It's at least as safe for mother and baby, if not safer, than hospital birth. However, at the same time I also found out that many GPs are not keen on homebirth - especially for first babies.
I armed myself with all of the information, and found out about my legal rights as I prepared to tell my GP and midwife that I wanted a homebirth. I found out that it is every woman's right to have a homebirth - even under law - and also that a woman does not need the 'consent' of her GP to have a homebirth. I even researched a local independent midwife as I thought that if I did get a negative reaction to the idea, I could just opt out of the NHS altogether.
I was pleasantly surprised when I had no trouble initially from the doctor or my midwife about the idea. So I booked my homebirth and started making plans. I decided to hire a birthing pool for pain relief, and stocked up on massage oils. I continued my reading with Active Birth by Janet Balaskas, Home Birth by Sheila Kitzinger and Home Birth and Labour Pain by Nicky Wesson. I was all set. I asked a particular midwife that I liked especially, if she would attend my home birth even if she weren't on duty. She agreed. I knew then that I could have her there, thus getting the support that I wanted, and the Community Midwife would be called to attend in the final stages.
Towards the end of my pregnancy I had a slightly high blood pressure reading. The particular doctor who I saw that time was against homebirth and really tried to scare me out of it with warnings of pre-eclampsia. Fortunately I had anticipated this attitude, and knew what the real warning signs of pre-eclampsia were (let's just say that one high blood pressure reading is nothing to worry about) and so I stood my ground.
Monday of the week that I eventually had the baby, I had a very high protein reading in my urine. My midwife, who is very supportive of homebirth, said that she would like me to get checked out at hospital. As I knew that her recommendation was solely based on me having the best care, as opposed to any personal reasons that she might have had for stopping my homebirth, I went without arguing. The hospital immediately assumed that I would stay in overnight - my worst nightmare at that stage! As my blood pressure was totally normal, I eventually managed to agree with the Registrar that if my blood tests didn't reveal any protein in my blood (a true warning sign of pre-eclampsia) and my urine were also clear, that I could go home. As everything was fine, I was very glad that I had insisted on what I wanted to do, so I went home without any more fighting! This mini hospital experience once again convinced me that hospital was not really where I wanted to have my baby.
On Tuesday the 12th we spent some of the afternoon queuing at the petrol pumps, as did most of the country. The petrol crisis didn't concern me particularly as I thought that the emergency services would be fine.
I went into labour on Wednesday morning at about 8am. I rang my midwife and had a chat with her - I was sure I was in labour even though the pains were not very strong as they came regularly every 10 minutes all morning. My midwife Mel said she would attend, and as it was her day off, she would just let her boss know what she was doing - not anticipating any problem at all.
Her boss then rang me to say that she had called before, but hadn't left a message. She wanted to let me know that 'Sorry, we know you're in labour, but we have had to cancel the homebirth service due to the petrol crisis. You'll have to come into hospital'.
I was very surprised, but thought that we'd be able to find a way around it. As I wasn't dealing with a midwife 'on duty' I asked if Mel could attend anyway. The Head of Midwives told me that she couldn't, as she was uninsured to do so. She also said that Mel had to conserve her petrol for when she returned on duty the following week. I offered to collect Mel and so use our petrol, but she essentially said that as a decision had been made not to provide homebirths, there was nothing we could do about it.
I knew that legally, if I insisted that I was staying at home to give birth to my baby, that the Health Authority was responsible for ensuring that a midwife did attend. However, after discussing this with Mel, I decided not to do that, as it would only set a negative tone for the birth. I also felt that any midwife 'forced' to attend under those circumstances would likely be in a negative frame of mind, which would affect her care of me.
Editorial Note: This was extremely cheeky of the health authority, as in fact midwives and other health workers were the only people in the country who had reliable access to fuel that week - protests at high fuel taxes in the UK were blocking supplies for non-essential use.
As Nikki explained, in such a situation, you could state that you were refusing to go into hospital, and that if you gave birth without a midwife present, the health authority would be responsible. You would probably be told that they were very sorry, but that they really couldn't help... but it's almost certain that a midwife would in fact turn up.
I have not found any record of a case in the UK where a mother in labour insisted on staying at home, and a midwife did not arrive. However, most people do not want that sort of confrontation, or to play a game of nerves, when they are in labour. Nor do they want to take the risk of a midwife turning up just to try to pressurise them into going to hospital.
However, as Nikki points out, you migbt not be on the best terms with your midwife in such a situation. What happens next is a good example of a very well-organised woman having a back-up plan and being resourceful even while in labour!
I then told Mel that I knew of a local independent midwife called Elaine Bachelor, who I had found on the Internet early on in my pregnancy - and that I thought I should talk to her. To my surprise, Mel had studied midwifery with Elaine, and had worked with her in the past! With such fabulous recommendation I called her immediately. It was now about 12pm on Wednesday.
Elaine was terrific - and even the fact that I was already in labour (a very short notice job for her as she usually manages pregnancies from the beginning through to post-natal care) didn't faze her. She came to see me at 1pm. At this point I had been having period-pain intensity contractions every 10 minutes all morning. After talking through practicalities of payment etc (Elaine set aside all of my worries, was totally prepared to be flexible and bend to the unusual circumstances) Elaine examined me and pronounced me to be 4cm dilated!
I was amazed I'd had so much progress as labour really hadn't been difficult to cope with. Elaine left us to it and agreed to return later. At about 3pm, just as I went for a lie down, the baby suddenly moved somehow - I heard an audible click or pop (I thought my waters might have broken and rushed to the toilet) and my contractions went instantly from every 10 minutes to every 5 minutes and were more intense. I'm not sure exactly what the noise was - the baby moving somehow and putting more pressure on the cervix but the baby definitely turned things up a gear!
By 4pm, the contractions were every 2-3 minutes and were quite intense. I decide that I'd like to have Elaine with me now and so I call her. Mel, my NHS midwife also decided she wanted to come in a non-official capacity. At this point I started using a TENS machine - which I can recommend for that stage. I don't know if it really helped, or if it just gave me something to focus on with each contraction - but it definitely worked for a few hours. After that I got into the birth pool. I then stayed in there for hours. The midwives took it in turns to rub my back with oils, and I focused on my scan picture of the baby during contractions to remind me what all of this was for!
I managed my pain very well, putting into practice all of the techniques that I had been reading up on. All was going very smoothly - the midwife checked the baby's heartbeat every few contractions and she was absolutely fine - far less bothered by the birth process than I was!
By midnight I was beginning to feel a bit pushy so the midwives suggest I'm ready to begin pushing. We tried several positions but after about an hour and a half nothing is really happening. In hindsight, I think that I wasn't really ready to push - that stage was more transition, and I would have been better to let it happen for a while until the real pushing urge began. My waters still hadn't broken by this point, although they were bulging during contractions, so eventually I gave in about 2am and agreed to let the midwife break them for me.
We keep going, and keep pushing. I got her head all the way down so that I could feel it, but she was still not coming out. I tried every position known to man, but she still didn't want to arrive. I know we did everything we could. I pushed on the floor, on the bed, on the stool, on the toilet. On my side, on my back, hanging off my husband, squatting down - you name it - we did it! The midwives are more than prepared for me to keep going as I'm still doing okay after 12 hours of strong labour, and the baby's heartbeat is still absolutely fine.
At this point the midwives are not sure if the baby was posterior, or if one of her shoulders is a little stuck, or some other thing is holding her up. By 4am we were beginning to wonder if she was ever coming! After discussion we decided with the midwives at this point to go to hospital to get a little help.
I got dressed, made it down the stairs, the porch steps and the drive, and into the ambulance. I think that was the hardest part of the entire labour! My very pushy contractions were still coming every 2 minutes. I got into the ambulance around 4.30am. As we're driving along my waters break again. In hindsight I think that the bumpy ride might have somehow jolted the baby into a new position - as these waters are coming from behind the baby and hadn't been coming out before. We arrived at hospital and got into the delivery room for about 5am. I had great trouble getting onto the bed, and am put on a monitor - the baby was still fine.
I agreed to use the ventouse, but didn't want an episiotomy. After the doctor had read my birth plan (he took his time!) we began, and Kiera arrived very shortly afterwards at 5.54am weighing 6lbs 10oz. I was home again by lunchtime and Kiera is wonderful.
So all in all it worked out well. I laboured and did the majority at home. It is a bit of a shame that the baby wouldn't come out after so much effort - but it's not a big deal as all was resolved to great satisfaction! I would have liked to have actually given birth at home, but for some reason that we'll never know - Kiera just didn't want to! I did manage to do 15 hours of strong labour without pain relief, which was one of the main reasons for the homebirth anyway. To be honest, I still feel like I had a homebirth - and, most importantly, will be doing exactly the same again next time. However, next time I might try walking down the stairs or going for a drive to bring the baby on, before calling the ambulance.
Looking back, I'm very glad that I did so much reading and really knew both my rights and the facts about pregnancy and birth. If I hadn't been so well armed, I might not have been able to even book my homebirth. I am sure that a less-informed person might have ended up in hospital, despite wanting a homebirth, purely on what their GP said, or if there were another petrol crisis.
Given that you ended up transferring, it sounds like it's a very good job that you had Elaine (independent midwife). If you'd had NHS midwives then they would presumably have been under pressure to transfer you after 2 hours of pushing, and since it sounds like you have the stamina of a marathon runner, you might not have been ready to go in then?
That's right - without Elaine I would have had to go to hospital much sooner. My NHS midwife did attend too - on the quiet as a 'friend' as she would have been disciplined if she came 'on duty'. Bless her she was great too!
The supervisor of midwives, who came to apologise to me about an hour after I'd given birth, wasn't impressed when I made a crack about sending her my bill from the independent midwife, though!
I pushed for 4.5 hours by the time we transferred, but it ended up being 6 hours total pushing. My husband has taken to describing me as 'well hard' :-)
I highly recommend Elaine Bachelor who can be contacted via http://www.thamesvalleymidwives.fsnet.co.uk.
I would be happy to talk to any woman considering homebirth - firstname.lastname@example.org
Photos of Kiera are on Nikki's website. (www.nikkiandroger.org.uk/kiera/ )
Nikki's Web publishing business produces very slick, professional, businesslike websites - have a look at Impact Web Publishing Limited (www.impactwp.com).
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