Discovering I was pregnant in Blenheim, New Zealand, after the only two homebirth midwives around had left the province, was deeply concerning. If the only reason I was to give birth in hospital was because there was no one to attend me in a better environment, I needed to do something. I did, I went to the media and complained. It hit the front page of our major local newspaper, as DH and I decided to sell our house and shift to another province to access better maternity care.
At 20 weeks into the pregnancy we had made the huge shift from Marlborough to Otago, from the top to the bottom of the South Island on N.Z.. DH took up his new position driving for a local transport company in Lawrence and I finished my last exams to qualify as a vet nurse. I also muddled along homeschooling 3 of my 4 children, while my eldest attended a special needs boarding school.
On arriving in Otago I aquired a list of homebirth midwives and started phoning about. My eldest had been born in hospital in 1988 in what was a bungled shambles of a labour. Thirty three hours of torture, way too many drugs, way too many shifts of midwives, significant lack of informed consent and I ended up like a slab of meat spread eagled on a delivery table, the tail dropped away, my legs in stirrups and an unnecessary forceps delivery occurred complete with un-needed episiotomy. All this with a shocking overwhelming migraine like I never knew could be experienced. The migraine turned out to be an epidural headache. The Epidural was botched and I leaked spinal fluid. You know the stuff, your brain floats in it. Mine didn't float for the end of labour. My brain sort of slumped down and to one side thanks to the anaesthetist's incompetence.
But I digress. Following this nightmare I had 3 children in the subsequent years at home. And I wanted this, my last baby to be a homebirth too.
I interviewed a couple of midwives and at last asked Sheridan if she would attend me. Sheridan agreed, but later told me it was the most gruelling intial meeting she had been through as I grilled her for an hour about about her stats, practice and philosophy. I was looking for a true blue midwife. Not a medicalised Medwife. If I wanted one of them they are a dime a dozen and I need not have sold my house and shifted to find one.
So at 20 weeks I had my first antenatal visit and baby was fine, just as I knew she would be. I refused what I considered unecessary tests. But consented to get my initial bloods done.
I was aware that this my 6th pregnancy and 5th child carried to term was a big baby. I could just feel elbows and knees and the bulk of baby and guessed over 9 pounds. My previous baby had been biggish at 9 pounds 2 ounces. She had tested the attending midwives in that she presented with shoulder dytocia that took a few minutes to manage and was born needing a little oxygen to get started.
It was in my heart that this baby would also present as a shoulder dystocia. And call it mother's intuition but I knew it would be a tough one. Aware that my large baby would likely become jamned in my pelvis it made me even more determined to avoid obstetric and medical care as I knew that their only solution was to either slice my perinium and pull baby out with gadgets or more likely pre-empt a shoulder dystocia and cut open my belly as is the popular norm of doctors who think caesarean is the answer to any question. I have such low regard for the incompetence of obsteric care and their knife-happy tunnel vision that I realised I would have to be bolshy to protect my baby and my body. Thank goodness we still have some freedoms in NZ aye!
I discussed my concerns with my midwife and told her she needed to be prepared to manage a difficult dystocia. She was not fazed although repeatedly informed me, as was her obligation considering my history of dystocia, that I should consult an Obstetrician for a second opinion. I declined firmly and made sure it was noted in my care plan so that she was covered in the event of a witch-hunt. I was not about to see my midwife crucified for my choices.
My pregnancy continued well. I was spilling some sugar and was iron-deficient, but nothing to concern me. I invited 2 student midwives to the birth. 1 a second year student and the other a first year student. I also had a back up midwife to Sheridan, who in the end didn't make it to the birth. But also I had a girlfriend of 12 years and home birth midwife Belinda as a support person. I also had another friend to care for the other children – and of course hubby. Quite a troupe in the end.
I think I was 2 or 3 weeks over- I can't recall - when labour started. I don't believe in the modern obsession and fixation with due dates. Regular Braxton Hicks just became tougher and tougher to cope with. And late one evening they slipped from being annoying Braxton Hicks into contractions with more of a pattern to their regularity.
I had, in preparation, got a hold of the Pink Kit (a childbirth preparation kit) and laughed my way through the video, half heartedly mapped my pelvis as described and announced that it was claptrap to my midwife. I did however concede that my previous loooooong labours may not have been helped with asking for, and getting, enormous amounts of counter pressure into my lower back. That and labouring mostly on my knees and leaning up and over a sofa, with slack abdominal muscles, and baby dropping forward I may well have prolonged labours previously. So the idea this time was to be more upright more often, to use a swiss ball to sit on and help spread my pelvis and I decided to try to consciously relax inner muscles at the height of contractions.
Labour is the worst pain. In the moment I would describe it as truly unbearable and excruciating. Labour contractions are so extreme as to be all-encompassing. Words are weak and useless to really convey how bad they are for me. Super-human effort is required just to hold on to sanity and reality as the crescendo of the mind-blowing agony envelops my whole being. I bellow through each one. The only downside to the relief of a contraction subsiding away is the certain knowledge that in the moments to come another is about to begin. And then I am dragged slowly and surely into the desperate nightmare that is the next contraction. I swear to God if labour pain could be used as a torture technique at Abu Ghraib prison it would have extremist terrorists confessing to their evil plotting in less time than it would take for someone to offer an epidural.
I experience contractions mostly in my back. As I dilate the pain stays in my back and also progresses increasingly down my thighs. Towards the end I need pressure and heat (as hot as it can be arranged) via water soaked towels pressed firmly into my back and outside of my thighs as I bellow my way through each contraction. I would say scream, but screaming sounds high pitched. This low bellowing comes from deep within. It is not contrived or forced. As the contraction gets tougher, involuntarily I open my throat and airways fully and the bellow begins as a low moan and swiftly builds. At its height at full volume no one else can be heard above it, and can it last and last and last and last and last beyond what would be imagined as physically possible. To the uneducated, it may sound as though murder is being committed.
I am also not good at the dentists.
The swiss exercize ball initially was annoying. But I kept coming back to sitting on i,t deliberately working on keeping upright and 'open'. I consciously worked on changing p ositions every so many contractions so as not to get 'stuck' in one place. I struggle as a controlled sort of a person to just go with the flow and let go to the natural forces w ithin. But I allowed this labour to unfold more than I ever have before. I recall thinking as each contraction started to build to try and relax into it as much as possible and to not clench muscles and fight the pain. Which was easier said than done. I discovered that it really was impossible to relax into the contraction as they peaked. Just impossible. But I know for sure that I relaxed and let them go as soon as their intensity had passed. I had never done this conciously before, actually focussed on those inner muscles and let them relax as soon as the peak of a contraction was over. So I know that I allowed my cervix to open and dilate here. I still managed to be robotic about changing positions whether I wanted to move or not.
I spent most of my time in the living room, the largest room with the fire. But I traipsed down the hall to the loo on a couple of occasions and into the bath. I felt 'caught-out' by a contraction or two in the hall on my way back from a loo trip. These freaked me out, I felt cold in the hall and not on top of the contractions at all.
My labours typically had lasted 20 hours plus. I knew I could not focus on when the end was as it could be so much further away than hoped. If you start thinking about it all being over when you still have 10 hours to go you just make it worse for yourself. So instead I did a daft thing and kept it in my head (no matter where I was in this process) that I likely still had 10 hours to go so I wouldn't be disappointed. Seven hours in I asked Sheridan to do a V.E. and I was found to be at about 5 cm. This cheered me a lot. Which is silly as this has no bearing on anything. At 9 hours I was changing positions on every contraction. I recall clutching on to the legs of my large coffee table and writhing through a contraction, then rolling over and doing the same on my left side. I said that I knew I should get up for the next one but that I didn't want to. When Belinda told me I was fine where I was if I didn't want to get up I was almost relieved. My schedule of constantly moving to keep things ticking along wasn't as important as I thought.
At about nine hours I recall saying confidently that there was a long way to go. I said it with conviction and everyone around me seemed to take this as words from a wise woman in tune with her body or something. A few minutes later Sue offered to take the older children for a drive to buy ice creams (the 4 square is a 15 minute round trip) and I panicked and flatly refused to let her go and take them. I didn't say anything out loud in case I was proved wrong but I knew that if the children left, that they would miss the birth.
And then the urge to push came over me. After about 10 minutes baby had decended into the birth canal but it was very hard to push her head out. Several contractions and slow going had her head born. My waters broke at the same time. So now with baby's head born I needed to get the rest of her out. I could feel that, despite my massive efforts with contractions, I was getting nowhere. I also knew that with cord compression we had a very small finite time to get her body born. Yet each pushing contraction seemed in vain. And now my body took long periods to rest between contractions. Just as I had always expected, we had a severe shoulder dystocia.
I had been kneeling, leaning over the arm of a sofa. I lifted up one leg (in a sort of marriage proposal stance) and tried to bear down. Nothing! I lifted both legs up and got into a deep squat and pushed with all my might. Nothing! Next I went up and over onto my back, with assistance as, of course, baby's head was born. Two midwives rolled me to one side. At noon midday with one midwife holding one of my legs up to keep my pelvis as open as possible, the other midwife slipped both hands up beyond her wrists beside baby and h ooked her fingers under my baby's armpits and gently pulled her free. Sheridan said later that there was little resistance, she just popped free with barely a tug. I suspect in hindsight that going back and over probably freed her wee shoulder from being tucked under my pubic bone. Shoulder dystocia is never a problem of skin not stretching to accomadate a baby's birth, it is a bone issue with little shoulders likely needing to shift slightly. Being very active and rolling over had done this.
She looked dead when born, I am told. I was exhausted and lay with my back to her on the floor. Her cord still attached internally to the yet-to-be-delivered placenta. It ran between my legs and up to her belly behind me. Belinda and Sheridan worked on baby and told me that her heartbeat had never dropped below 100 through delivery. But she was not breathing on her own and was blanched white across her torso and unresponsive. The midwives bagged her (hand pumped a bag with oxygen into her little lungs) and vigourously rubbed her with towels. She had been sitting for 6 minutes on the perineum, which is a very long time. Then at almost 5 minutes post birth she still wasn't breathing on her own, although her heart beat was ticking along fine.
Belinda called to me.
"Peta, talk to your baby, she needs you."
She said this twice and I rolled over onto my side to face my baby. She was big, very big and she was white and a little blue. Blue doesn't bother me, blue is fairly normal. But white as a sheet it not a good shade to be when you are just born. I called her name several times and touched her face. I wasn't concerned at all, but knew she needed to pick up on her own. I kissed her head and kept talking to her in a low voice right by her ear. Her little eyes flickered and opened as I spoke and within a few moments was breathing on her own. She was very fluidy in her gurgley breathing but this cleared. She pinked up well in a short space of time and I gathered myself up off the floor and was helped over to the sofa draped in folded towels. I sat recovering and pulled on a tee shirt. We cut the cord as it had ceased pulsing some time before. We waited for the placenta and about 40 minutes or so after she was born the placenta was delivered, intact, complete and looking healthy. Not surprising when my bonny daughter was nearly ten pounds - it had served her well.
She was not bright and alert like my other home birth babies had been. She had been born quite shocked and 'flat' from sitting so long on the perineum. For a time as her head had been slowly born, her brow had sat in a vice squeeze for so long. I tried to nurse her and she didn't really get going well at all. The first mouthful of colostrum made her eyes startle open wide but other than that she was fairly lethargic. I wasn't overly happy with how she was going. Also her breathing wasn't great. It lacked the nice steady rhythm of in-out-in-out that you would expect. She breathed more in short gasps of in-in-out-in-out-out-hold-in-out-hold-in-in. I was exausted though, and crawled off to bed but could not sleep.
Sleep following labour for me usually is a deep restorative, wonderful, grateful not to be in labour-type sleep. But after half an hour of not sleeping I got up and watched Mel's breathing. She was lying on her father's chest and he too wasn't relaxed about her condition. She was still pink, wriggling, and fidgeting but I was unsettled. Her breathing, which we had expected to settle into a better rhythm, had not. A discussion ensued and I agreed with Sheridan that we needed to check her into NICU (Neonatal Intensive Care Unit - in the UK this is known as SCBU, or Special Care Baby Unit). Phone calls were made. An ambulance was dispatched to collect us. I wish in hindsight that I had asked for oxygen support as we left on the hour journey to hospital. And I think now of how she travelled in a carseat for an hour to Dunedin in an ambulance that would have had oxygen and I didn't think to ask for it. But perhaps I also should not have had to have asked. I believe that on this night we may have cheated death for the second time.
I travelled with DH in our car as we followed the ambulance which had our baby daughter heading for Dunedin. I was quietly sad that after how far we had come that we now needed to head for the hospital. But I was far more concerned that baby wasn't breathing right. I had now been awake for 36 hours. The day before labour, the whole labour and all the m ental and physical exertion that this had required and now we were into the next evening. We entered the NICU unit and baby was put into an incubator and looked gimoungous alongside teeney weeney prem babes. I was overwhelmed. I had never been in a NICU unit and at night it was lit up like a christmas tree with flashing lights and beeping machines next to incubators. A few silently working nurses were in the background and a couple of shadowy figures turned out to be new mums in dressing gowns leaning against or into incubators. I felt like I was in a movie. Everything was surreal. I must have been functioninig on adrenaline alone as the paediatrician just took over and performed blood tests, examined her and set up medications and at no point actually involved us in any of the decisions.
After she was settled into the incubator, the doctor ran through what sounded like a worn record track of information and disclaimers. He said it was likely she had breathed, or had been bagged a little amount of, amniotic fluid into her lungs at birth which had set up an infection. Then we were shown to a bedroom adjacent to the NICU nursery. It was about midnight and I lay on the mattress set up on the floor and didn't sleep much. Whenever I did drift off I was woken by a nurse to come feed my baby.
Mel could not leave the immediate area of the incubator connected to monitors and oxygen. By the next morning I was lightheaded and very 'spaced out' but thought I was fine. By mid afternoon I decided I needed fresh air as NICU is stiffling and stuffy. I went down the 5 floors to the street below. DH had gone home to children and was due back later. The fresh air wasn't helping and while sitting outside I could feel my heart start to race and the world started to spin as traffic and people passed me. I realised I had no identification on me and was about to collapse. I struggled and staggered up to the elevator. 'If I could just get back onto the ward'. The lift ride had me nearly pass out. I got up to the floor and clutching the wall I shuffled towards the main doors concentrating on keeping the world steady and controlling my breathing. Little lights were whirling in my periferal vision. As I got through the doors everything went fuzzy and then faded out of view altogether.
May I recommend if you ever pass out, do so on a hospital ward in front of 4 doctors having a chit chat by the water cooler.
I had gone too many hours/days with no sleep, little food, given birth and was over stressed. Mel's oxygen saturation levels in her blood should have been in the 90% area. When she came out of the ambulance she had oxygen levels in the 60% area. I was angry at myself for not making the ambulance keep her on oxygen and wondered if this had left me with a brain- damaged baby. My eldest is autistic and I know what it means to have a special needs child in the family. I had come so far and done so well, right up to the point where I included bloody medics into the scene. I had taken my eye off the ball for a moment and someone dropped it. It was going to take a while to recover from all of this. Passing out from mental and physical exaustion marked the end of this whole process and the beginning of that recovery.
Mel stayed a week in hospital with me as she was supported with oxygen and antibiotics till she was well enough to go home. Later x-rays and lab results showed she had not had an infection. The mega doses of antibiotics delivered via her umbilicus had been unecessary. All she had needed was time and oxygen waiting for her to recover from a tough birth.
My baby's name was to be Mel Eire. When we went to register her full name we wrote 'Mel Eire Grace' . Somehow it seemed appropriate, as is was through God's Grace that she survived a tough birth. She is a bright, precocious red head and at 2 years can count and knows all her colours. I am glad we had our home birth. It was a hard haul and difficult end. But in hindsight I know that hospital would not have been better for the labour and delivery. I had had a text book labour, it had progressed at 1 cm an hour, which in itself is not big deal but fits the hospital's criteria of what is acceptable. Her heart rate throughout had been reactive and healthy.
The only difference in care would have been at the end. Suddenly I would have been manhandled into stirrups. Then a God-like and overly dramatic Obstetrician would have sheared through my perenium with large pair of scissors 'saving the day'. My baby would not have been born any quicker. Mel would still have been born flat and still needed still oxygen and assistance to get going.
Worse I would have been unable to help encourage my baby to pick up and breathe on her own with her on a resus table on the other side of the room. With me being stuck on my back in stirrups like a stranded beetle. (When I say stranded beetle, beetles don't have to suffer the indignity of a God-like creature stitching its genitals back together while it lies prostrate). And I saw how my closeness to my baby, how my voice and caress had reached her and got her to respond and grasp onto life at critical moments after birth.
If I could have changed anything in how we handled was what presented to us, I would have headed for NICU a earlier and insisted on oxygen in the ambulance.
I was annoyed to hear people in the days to come, refer to what ocurred as a 'failed' home birth. It was written on her records in NICU. I had worked hard and delivered my child the way my ancestors all the way back to Eve have. Her birth was a triumphant success, overcoming shoulder dystocia. I was an informed mother in tune with my body and knowing what to expect. And I was attended by confident and calm midwives who had [have] the knowledge and experience of how to manage a difficult birth without using tools that belong in a garden shed or abatoir. That is not a failure, it's a bloody success.
Home Birth Stories
Overdue - what are the risks? What are your options?
Independent Midwives - what they do, and where to find one.
Big babies and homebirth
Shoulder Dystocia - what it means, and what can be done about it at home.
Transferring to hospital - why it may be advised, and experiences from women who've done it.
What if...your baby needs resuscitation at a homebirth?
Grand Multiparas - are you higher-risk after you've had five babies?
Home Birth Reference Page Site Contents