Home Birth After Caesarean

Monica O'Connor

(Monica is co-ordinator of the Home Birth Association of Ireland)

I was nineteen years old and on my own when I birthed my first child in November 1986 in one of Dublin's three large maternity hospitals. It was a nightmare.

After three hours, during which I thought things were OK-I was breathing through contractions and chatting to the student midwife about her holiday in Greece-I was told I was "going nowhere fast" and given an infusion of oxytocin.

Though I'd sworn I wouldn't take drugs, two hours later I was begging for something. Forty-five minutes later I received pethidine; twenty minutes after that I told the disbelieving midwife that I wanted to push.

Although she told me not to be ridiculous she soon confirmed with her hand on my abdomen that I wasn't pretending, so I was wheeled from labour to delivery.

My son Dara emerged twenty minutes later. He was whisked away and a paediatrician was called. While I was being stitched I was asked "Are you delighted?" All I could answer was "Is he all right?"

Thirty minutes after his birth I finally heard a cry. I was allowed to hold him for only five minutes. When I asked what was wrong, the reply was "he's tired" ("drugged" would have been more honest). I wanted to breastfeed but Dara didn't respond-no one explained that pethidine had caused his lethargy. He was kept in the premature unit even though he was eight days "over" and weighed seven pounds three ounces.

Thirty-six hours later I finally got to breastfeed him properly. Meanwhile he'd been bottlefed without my permission. When I asked why he had no rooting reflex-"Did you give him a glucose drip?"-I was asked if I was a nurse. When I replied that I was not, I received no information. In frustration I took to reading his chart. I found out that in those long hours between his leaving me at 10 pm to the time when I got to hold him again at 2 pm the next day, he'd had his stomach pumped out and his chest X-rayed.

I don't think it's justifiable to say that all this happened twelve years ago and things have changed. They have changed a bit, but that was Dara's only birth and active management of labour-pioneered, to our shame, in Dublin's National Maternity Hospital-ruined it for us both. With the support of my mother and La Leche League, however, I breastfed Dara for three years, no thanks to the Maternity Hospital!

Pregnant seven years later and in a stable relationship, I decided things would be different. I'd met people who'd had homebirths-how sane that sounded! I joined the Home Birth Centre, went to support meetings, arranged for independent domiciliary midwife Ann Kelly to be our midwife, read lots.

But ten days before Oisin was due, I got a thumping headache. Ann diagnosed preeclampsia, took us to hospital and cared for Dara while I had a cesarean section.

Now I had two bad births to heal. Of course the doctors said I'd never be a candidate for a homebirth, but twenty months later, independent domiciliary midwife Dolores Staunton helped us deliver Emmet at our new home, and it was the most empowering thing I have ever done.

My independent domiciliary midwife had never done a VBAC, but through reading Nancy Wainer-Cohen and Lois J. Estner's "Silent Knife", etc., we were sure it would be OK.

I also got hold of a confidential report from one of Dublin's 3 large maternity hospitals into uterine rupture - in 68,000 births, there were 13 cases of uterine rupture - in 11 of these, oxytocin was involved. The other two were "high parity" ( 4 and 6, if memory serves!)

In hindsight, perhaps I should have protected myself more from naysayers - get all the positive feedback you can. Emmet went transverse at 37 weeks, but I did the exercises from Janet Balaskas' "Active Birth" and took some homoeopathic remedies and he turned after a couple of days.

Monica O'Connor PRO
Home Birth Association of Ireland
hba@iol.ie

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