Pat had a traumatic hospital birth for her first baby, Jane; just six months later, she found herself pregnant again. On this page she tells the story of three very different home births.
When I was 4 months pregnant we moved to France. We'd bought a run down farmhouse and planned to set up a campsite on the land. All our plans came to nought in the end for various reasons - but to set the scene, we were now living in a damp mobile home in a muddy field while trying to render the house habitable (basic plumbing being the immediate priority).
In the light of my traumatic first birth experience (which I still didn't feel completely recovered from) I was worried about the approaching second one. I felt that having had an epidural, I still didn't know the pain of childbirth and was no better prepared second time around than first. I took comfort from the fact that Michel Odent was French and that therefore the French maternity service would be much less interventionist and more woman-centred reflecting his views. After all, he was a famous obstetrician, wasn't he?
I couldn't have been more wrong, and later found out that Michel Odent had been more or less forced out of France and was working in the UK where his practices were better tolerated. Just my luck!
I attended just two ante-natal classes before realising that the French were even more interventionist than the British. We were literally sat down and told what was going to happen to us...
"First you'll be shaved." "Why?" I asked. "Well the doctor prefers to be able to see what's going on" was the reply.
"Then you'll be put on a drip"
"Why?" I asked again - suddenly conscious that no one else in the group seemed to share any of my concerns, and were all staring at me...
"So that we can speed you up if it's going too slowly and slow you down if it's going too fast" came the reply.
"Don't tell me, you're going to handcuff me too !" I joked flippantly - at which point one of the group kindly pointed out that if it was so much better in England maybe I should go back home...
I thought it was worth one last go, and tried to explain to the midwife after the class finished that I'd had a bad first time, and didn't want to find myself in the lithotomy position again with my feet in stirrups to which she replied "Well, Madame O'Brien, you must understand that to have a baby it is nonetheless necessary to open ones legs."
OK, I thought. Time to accept defeat.
Where do I go from here?...
Well, then the most amazing thing happened, and fate dealt me a wonderfully kind blow. Purely by word of mouth I heard about an independent midwife called Mme Olive who lived in Lucon 1/2 an hour's drive from our house. She apparently specialised in home births, and was the only midwife in the whole department to do so (home births being generally considered with abhorrence).
Until now I hadn't really been an active exponent of home births and I was wary of the advocates of natural childbirth, as the media always led you to believe they were slightly wacky !!? I was also still confused over why everything had gone wrong for me first time around and my back-to-front logic was telling me that nature had let me down.
I'd needed intervention hadn't I? What would have happened if there hadn't been any? I still thought that my failure to progress was somehow my fault, and that the doctors had saved both my life and the baby's. What I didn't forgive them was the assault on my dignity - but medically I still believed I'd needed them to intervene.
So it was as a measure of desperation - faced with the unsympathetic approach of the hospital - that I picked up the phone and called Mme Olive.
We arranged to meet - I was now 8 months pregnant and increasingly frightened of what lie ahead - but it took just an hour of talking with Mme Olive, to restore me with a ray of hope.
I remember walking out of her office and smiling (for the first time in a long while).
She'd listened to me, she'd heard what I'd said, she'd assured me on all fronts that I could have a home birth - she could see no problems. Above all she was a highly competent professional midwife totally dedicated to her work - and I was more than happy to put myself in her hands. For the first time I started to feel positive about what lay ahead.
We met frequently after that and she really educated me about the different stages of labour. She showed me home videos of births she'd attended, and whilst I found several of them hard to watch as they were uncomfortably intimate, I drew strength from the images of women giving birth, remaining strong, in control, coping with pain awesomely. I also understood more what was going to happen physically, and later on when in labour would really appreciate the visual images that I'd seen and which I could assimilate so much more quickly than verbal explanation.
One of my main fears was of the baby getting stuck again and the risk of cerebral palsy if it was deprived of oxygen . Mme Olive showed me research papers and statistics showing that the hospitalisation of the birthing process had not decreased the incidence of CP at all, and that therefore the risk was no greater at home than in the hospital.
She was very 'up-front' and honest with me. I asked if any babies she'd delivered had died and she answered yes, two, out of 1500 (if my memory serves me); both would have died regardless of where they were born.
I remember realising that there were no guarantees to be had, that yes, there were risks to be run, childbirth cannot be risk free - but feeling that I was taking a route which empowered me to face those risks and to understand those risks rather than run from the all-pervading and irrational fear of childbirth engendered by the medical profession.
I felt I was entering into a partnership with Mme Olive, that I was participating in this, making an informed decision myself about how I was going to try to have this baby and taking responsibility for it rather than simply obeying doctor's orders and keeping my fingers crossed.
So my mind was made up, I would have the baby at home.Neil had no problems with this and was totally supportive. The only trouble was that "home" was still a mobile home and the lack of decent sanitation - no flush toilet - no shower or bath -was still preventing us from moving into the house. Still there was time, hopefully.
I went along to my GP just to let her know what I was doing and to my surprise she was totally aghast! "What - have the baby at home! - Not on my recommendation you don't! Better safe than sorry - you never know what could happen!" Once again I tried to explain - but to no avail.
"Have an epidural" she said "I had epidurals when my children were born and it was so easy... in fact I was playing cards when Camille was born! "
Great...! Luckily, not having the GP's consent didn't affect the funding in any way and I was fully entitled to the services of an independent midwife, whether or not the GP agreed.
So now, with Mme Olive's support I was anticipating a home birth, - we were still behind with the house - but at least we now had a flush toilet and a couple of rooms were just about liveable in.
My "French" due-date was the 10th of January. There was a 10 day discrepancy with my British due date of the 1st as each country works it out slightly differently - but it was on the early evening of the 9th that I started to feel those early labour pains.
I phoned the midwife straight away just to let her know I would be needing her later - but to my consternation she was out! Her husband wasn't sure where she was and suggested I try phoning the labour ward at the hospital. This I did - but they didn't know where she was either. Now I was starting to panic as I knew she had no back-up. It was Mme Olive, or nobody. If she broke her arm, or if her car broke down or if she was simply ill, there was no one to fill in...
Fearing the worse I telephoned the hospital to explain that I might have to go in after all, - if I did, I wanted an epidural as I knew I couldn't fight the system and thought it best to just give in to it.
"But Madame, you can't have an epidural because you haven't seen the consultant" said the midwife on duty. This confirmed my worst fears - I was going to end up falling between two stools - trying to have a baby naturally in totally unnatural surroundings and ending up with it all going wrong like the first time. I put the phone down and started to panic...
Then Mme Olive phoned --- what a relief! I think I must have dilated about 3cm just on hearing her voice. She was on her way, - she hadn't broken her arm or broken down - she'd be uncontactable because at the birth she had been attending the phone had been unplugged!
I was happy again... The contractions got stronger. We planned to have the baby in the living room of the house and had put a mattress on the floor. I'd also put a pile of 4 fairly firm sofa cushions at one end of the mattress and adopted a forward leaning position over these cushions (in kneeling). I found this a really comfortable position. I just wanted to stay completely still and concentrate on relaxing through the waves of pain.
By the time Mme Olive arrived, I was 7cm dilated. This was such a boost to my moral after the agonising slowness of my first labour. Mme Olive examined me just that once, (again a welcome change from the constant internal examinations in the hospital) and from then on sat on the sofa eating yoghurt and drinking tea, reassuring me all the time that nature was taking its course and I was to do whatever I felt like. Above all she encouraged me to concentrate on "opening up" my body, to spread out my arms and my legs, to go with the pain and open up to it rather than clench my muscles and fight it, to breathe through the contractions rather than hold my breath. To let the baby birth itself. Her voice was calm, her manner totally reassuring, I felt safe in her hands and would gladly have attempted a handstand if she'd suggested it!
Suddenly in the middle of a contraction I felt a huge downwards thrust within me. I felt violently sick too. I'd never felt anything like this before - this baby was on the move. My waters broke. "Should I push?" I shouted out between contractions. "Yes if you feel you want to" came the reply.
The urge to bear down was so overwhelming. This was nothing like the "pushing" I'd been ordered to do first time around.
I was still leaning over the sofa cushions at this point, but Mme Olive wanted me to roll over onto my back in a half-lying position. She wanted to be able to protect my perineum, which I learnt had not one, but two scars from the previous episiotomy. She felt she would be unable to see to do this effectively in the position I was in. She joked that "next time" I could stay in my preferred position for the birth - but this time it would be better for her to be able to watch the perineum closely and to stretch it gently as the head crowned.
Reluctantly I turned over, and leant back on my husband.
I needed to push for a while longer yet, and started to have flashbacks of trying to push out Jane, my first baby. I had brief moments of panic that this second baby too was going to get stuck - but then, ever so slowly, Sandy started to move again and Mme Olive was suddenly telling me not to push but to pant.
In the next contraction the head was out, two or so more pushes after that Sandy was born! (a healthy 9 lbs) Again, what a relief! But this time there was more than just relief. I felt on top of the world - I'd done it! - not a single stitch was needed. I started to tremble all over and Mme Olive started to rub my legs and told Neil to do the same. I tried to talk to them - but all that came out was a totally gibberish mix of Franglais - incomprehensible to either one. I was so emotional I couldn't think straight. Mme Olive told me to ask Neil to get a "serviette" and I sent him off in search of a sanitary towel. What she'd wanted was in fact a bath towel wrap the baby in!
She didn't want to move me at all, and suggested I stay on the mattress with baby Sandy for the remainder of the night. This I did. Sandy latched on easily, and after a few minutes sucking went off to sleep. We stayed there cuddled up together blissfully sleeping until 6:00 the next morning, when Jane ran in to see her new baby sister.
I could not believe how fit and well I felt the next day. I was so grateful to be able to walk without any pain!
After my first baby, the pain from the stitches had been so unbearable I could only walk with my knees clamped together for the first week. But now, I could not only walk totally normally I could sit down on hard wooden chairs without wincing or needing 3 cushions and a rubber ring! I'd hardly lost one night's sleep, and being in such good shape made looking after Sandy so much easier than when I had returned from the hospital with Jane, so beaten-up and exhausted.
I think this was when I started to feel angry all over again about what had happened to me first time around. Now I felt I knew what having a baby could and should be like - I had something to compare with. I analysed all over again what had gone wrong first time around, and now I started to see that the hospital setting itself and the mis-management of my labour had led to all the interventions and complications that followed.
Mme Olive had said to me that a good second birth was often therapy after a bad first, and in some ways I found this was true as I re-lived my rage.
She also said that the third time I'd be able to relax more and get it "just right". I joked that I didn't want to hear talk of a third time just yet!
Neil was now returning to work in England for long periods of time and we hardly spent any time together. However, he came home for just four days the following Christmas, and it wasn't long before before I realised that baby number three was on the way.
By this time we had realised that we were fighting a losing battle trying to establish ourselves in France. The odds stacked against us were just too high and life was too hard. We were living apart most of time - Neil working in England while I stayed in the house in France with the babies - increasingly lonely and isolated. Hardly an ideal set-up. We finally agreed that neither of us wanted to carry on living this way. It was time to throw in the towel and go home.
We returned to the UK, first staying at my mother's house, and then renting a small house nearby in Hillingdon (West London). This was where I would plan to have baby no 3. After such a positive home birth experience with Sandy, there was no way I was going to return to Hillingdon hospital. Just the thought of that place sent shivers down my spine.
I signed on with a female GP, thinking that women might be more inclined to favour home births than men - but she referred me to another surgery run by a male doctor for my maternity care, as her surgery didn't cater for home births! I wasn't particularly bothered which doctor I had; it was the midwives who were the crucial components of a home birth.
I had hoped to try and re-create my French experience - but I realised that exceptional midwives like Mme Olive were few and far between, and I'd be extremely lucky to find a perfect English equivalent. However, I had thought that it might at least be possible to have a one-to-one relationship with a midwife who could guarantee being at the birth. After all what was the point of establishing any kind of rapport with someone, only to find they were off-duty when you go into labour leaving you with a stand-by midwife who you've never met?
As it stood, the system in place didn't allow for any 'rapport' to be established anyway. I would be seen by a team of 6 midwives. Each one would see me just once before the birth (so that they weren't strangers to me) - but there was not time for building up any kind of rapport - In some ways it then didn't matter which one attended the birth as they were all equally unknown to me.
They were all pleasant and friendly enough - but they didn't win my trust as Mme Olive had done so completely, and I knew I wouldn't put myself in their hands so unquestioningly as I had done with her. I took strength from the fact this was my 2nd home birth and felt that I was going to do this myself, with a midwife in the wings. The first time around I'd needed that bond of absolute trust in Mme Olive. That was now missing, but I had more confidence in myself and persuaded myself that I didn't need the midwife as much as I had done before.
Editor's Note: Under the UK's National Health Service, it is very unusual for a woman to receive all her antenatal care from one midwife, and to know that midwife will attend her baby's birth. Home births are often attended by a midwife working in a team of 6-8, as Pat describes.
This is understandable, as in order for a midwife to guarantee to personally attend your birth, she effectively has to put herself on call, 24 hours a day, for several weeks either side of your due date; NHS midwives work long hours, and are not highly paid, so few feel able to provide such a service. Some NHS midwives will do this - if they have built up a close relationship with the mother, or if they love attending home births. However, normally if you want a one-to-one relationship with a midwife, and want to know that she will be there when you give birth, you will need to hire an independent midwife.
Back to Pat's story....
Baby No 3 was due on 13th September - almost 3 years to the day from the birth of my 1st daughter Jane. As both my first two babies had been late, I was surprised to find myself going into labour on the evening of the 11th, 2 days early.
We got Jane and Sandy in to bed, and waited until I thought the contractions were really strong, before phoning the midwife. Sue was on duty that night and soon arrived on the scene. I expected to be at least 5 cm dilated judging by the pain - but I obviously totally mis-judged this because Sue announced that I was only 1 cm dilated. What a shock!
I think that with my memories of Sandy's birth being so euphoric, I had managed to totally erase any recollection of the pain. I expected this birth to be easy, and I was taken aback by the severity of the contractions.
I wanted Mme Olive... I didn't want to do this on my own after all...
We planned to have this baby in the bedroom. Everything was rather cramped; it was only a small house and our double bed left little space for manoeuvre around the rest of the room. I tried to pile up sofa cushions on the bed and get into the same forward-leaning position I'd been in for Sandy - but the bed was too wobbly, it didn't feel right. I just could not get comfortable. Sue suggested I walk around and keep mobile - but there was precious little room to do this. Gradually the contractions started to ease off... and then they more or less stopped.
I slumped onto the bed in side-lying, closed my eyes and fell blissfully asleep - for about 2 minutes - and then I was violently awoken by a massive contraction which frightened the life out of me! There was no gradual build up here, no preparation, no time to concentrate on over coming the pain or go into that trance-like state letting the waves of pain roll over me.
I was violently sick just as I had been at transition stage with Sandy. I just panicked. I needed Sue to talk to me, I needed reassurance - but Sue was quiet and when she did speak her voice betrayed a slight nervousness. I felt her anxiety compound mine, another huge contraction hit me. I didn't know what to do - I couldn't move - I had my legs clamped shut together but didn't dare move them apart.
Sue asked Neil to phone the doctor quickly, as the birth was imminent and he was meant to be there...?
Editor's Note: doctors do not normally attend home births in the UK; midwives are the experts in normal pregnancy and birth care, and most family doctors have little experience in obstetrics. In the past, when home births were very common, family doctors would be called to attend difficult births, and might conduct forceps deliveries at home. Nowadays, such interventions are not undertaken at home in the UK; we transfer to hospital instead. However, in a perfectly normal birth such as Pat's third, there would be absolutely no need to have a doctor present. Exceptions sometimes occur when a mother has a good relationship with her GP and the GP would like to attend, for the experience.
Sue persuaded me to roll onto my back and open my legs - the head was crowning. With each contraction I was now pushing as hard as I knew how. At one point, I had my feet on Sue's thighs (as she squatted between my legs) and I remember resisting a great urge to push her off the bed! I thought she had her hands around the baby's head, and that if I pushed her off the bed the baby would come out with her.
She saw this coming and shouted "Don't push me off the bed!" and after a few more contractions, Rachael was finally born.
Sue seemed as relieved as I was. I liked Sue, but I sensed she perhaps wasn't overly experienced and I couldn't trust her like I could Mme Olive. This made a big difference. I was constantly asking her what she was doing, I was perpetually suspicious of her actions. I even thought she was tugging at the umbilical to try and pull the placenta out rather than wait for it to happen naturally. In retrospect she needed to talk to me more - when you can't see for yourself what's going on, you need to be told and although she was perfectly competent I felt her nervousness through her silence.
Rachael was put straight to the breast and had only one problem with latching on... the umbilical cord was too short and kept pulling her away! I had to bend almost double to let her suck! - and it made me laugh - which didn't help matters!
So I'd now had two home births, each very different labours, in very different settings. When I learnt of the arrival of our 4th child I planned to have another home birth - but this time with more realistic expectations.
This fourth pregnancy was hard work. I seemed constantly tired and irritable with the other 3 children and I was longing for it all to be over - however Charlie (as we'd decided to call her) had other ideas and once again, at 14 days overdue I was in the consultant's office, standing my ground and refusing to be induced. I was attending the hospital daily for monitoring and everything was perfectly fine, so I felt completely justified in my decision.
This time around I'd been very lucky to have a midwife specialising in home births attached to my GP's surgery. She was completely on my side and very supportive - but couldn't guarantee being at the birth. Once again I met a team of midwives - but like the last time did not really have any close rapport with any of them.
In the event, when I started going into labour (the very afternoon after seeing the consultant) I had Karen, a very young midwife who I'd never met before as it was her first day on the 'team'.
As for Sandy's birth, we'd planned to have this baby in the living room, and had brought down a mattress. Karen seemed very relaxed and confident and I felt ready to face what lay ahead. I resisted the temptation to get too comfortable too soon, and kept on my feet until the pain was severe enought for me to want to assume my preferred position - kneeling and leaning forward onto the sofa.
This was the most straightforward labour of them all - there was a steady progression in the contractions from first to second stage and then the tell-tale sickness preluding that overwhelming urge to bear down. Karen remained very reassuring throughout, and I was pleasantly surprised by her calm and confident manner as she'd looked too young to me to be very experienced.
Karen suggested, as the head was about to crown, that I turn over so that I was leaning backwards onto the sofa supported by my husband. I wasn't sure about the wisdom of this, but I'd been bearing down for a while with little or no movement as recompense so I agreed to try her idea. She thought this change in position might just give the baby the impetus to turn its head slightly and ease its way out. And she was right. Suddenly I was being told to pant rather than push, and in the next contraction Charlie was born in one long movement. A healthy 9lb 7oz.
Of all the births, this one was the most straightforward and the quickest, lasting under 2 hours. I felt very grateful to Karen, whose competence belied her age.
I think that obligatory post-partum cup of tea after Charlie's birth was the sweetest, most appreciated cup of tea I shall ever have in my whole life ..And how I savoured it!
I knew I would have no more children. I knew this was the last time I would feel that euphoric after-birth mix of emotion as I kept brushing my lips across Charlie's downy head, exalting in this new life in my arms, trying to breathe in her new-born smell and keep hold of this magical moment, wanting to anchor it somehow in my memory, to never let it go.....
I feel very lucky to have had three such blissfull ,magical moments, but still feel angry and resentful that I can only recall my first daughter's birth with pain and distress........
N.B.In the account of Rachael's birth I thought it best to change the name of the midwife as she might object to being named. The other names are all original.
Back to the birth story of Pat's first baby, Jane.
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