Philippa planned a home birth for her first baby, Oscar, but transferred to hospital as he was in a difficult position. She managed to give birth to him without the assistance of forceps or ventouse - quite an achievement in the circumstances - but sustained a third-degree tear. her second baby, Delilah, was born at home in April 2003.
With my first child (Oscar) I knew as soon as I was pregnant that I wanted to try and have a home birth. It just seemed the obvious place to plan to have my baby. I see hospital as a place to go if you are ill and wanted to have the privacy and flexibility of being at home if possible.
He was due on 30th of December 2000. That day came and went, I wasn´t too surprised or disappointed as had been told many times that first babies tend to be late. However I didn't have to wait too long as I was woken at 2.30 am on New Years Eve by my waters breaking with what felt like a pop and a trickle. As soon as I stood up they gushed out and seemed to go on for ever!
The contractions came almost straight away but were fairly mild and infrequent so we took the advice of the midwife and went back to bed and managed to nap a bit which slowed them down even more. We woke up properly at about 7 or 8 in the morning and they came back a bit stronger. Things obviously weren't progressing quickly so we decided to go to Tescos to speed things up a bit, while stocking up on supplies.
During the day things gradually got more intense but I was coping quite well until about 4pm with breathing and finding comfortable positions but it was getting harder. The contractions were still not regular and we were in contact with the midwife but she kept going and coming back. She did my first internal at around about 4 pm and I was only about 2cm dilated which was OK. However she told us that the baby had his head up rather than tucked in with his chin on his chest and explained that this probably accounted for the relatively slow progress. I felt a bit disheartened but decided to struggle on at home and see how things went.
After the internal the contractions were immediately much more unpleasant and I was feeling the pain very intensely in my back and my bottom (due to constipation). I wasn't very happy but decided that I'd get in the bath, as the midwife thought it was a bit early to use the birthing pool. She went away and left us for a bit longer. The bath didn't help much as we didn't have enough hot water to get it really warm as my husband, Moray, had accidentally left a tap running earlier.
After the bath I was beginning to get very unhappy with the pain and finding it hard to cope. We got the midwife back - it all gets a bit hazy now - I'm not sure if she examined me but basically she still felt things weren't progressing well as the contractions were still not regular enough to be really established. At about 7.30 pm she became concerned about the baby as his heart rate was fast. Also I was and had a temperature. Because of this she wanted us to go into hospital as this could indicate an infection.
By this stage was starting to think about how nice an epidural might be as my contractions were really hideous - all in my lower back and bottom. So I was fairly happy about the need to transfer as I'd lost confidence in my ability to cope with the pain at home. In retrospect I wish I'd been able to try the birthing pool for the pain before transferring, but it was not to be.
I was really panicky about going in the car in so much pain (sitting down was awful because of where the pain was) but mercifully the contractions slowed down a lot with all the distraction. A short journey later we arrived at the delivery suite of Southmead hospital (Bristol). I was immediately strapped to a monitor; the baby's heart was still too fast. I was given paracetamol to get my temperature down. On examination I had dilated a bit more, but not much, and the baby's head was still tipped back.
I started using gas and air, which did help a little, but not enough, so I requested an epidural. At first the midwife tried to persuade me to keep going without as I had wanted to avoid one. However after another internal she decided that it would be a good idea as they wanted to use a drip to get things moving as progress was so slow. Unfortunately the anaesthetist was busy with an emergency C section so I had to wait about 4 hours which was a complete nightmare. The entonox just kept me going, but this was by far the worst bit of the whole labour. We saw the new year in with me sucking on the mouthpiece for all I was worth while fireworks went off outside somewhere! Moray was being absolutely fantastic (as he was throughout) and kept me going until finally they got the epidural in at about 12.30am.
During all that time Oscar's heart kept all the doctors busy worrying, as it got faster and faster and at one point was going right off the scale as he was moving around so much. I was too high on the gas and air to be scared about this. Luckily the consultants were very reassuring and kept quite calm about it but I was starting to think it might end with a C section at this point.
The epidural worked brilliantly. I felt like a new woman by 1pm and was chatting and laughing and feeling really positive again. Once the epidural was in they put me on a drip to try and get things moving faster; slow but steady progress was made from then on. Oscar was still causing trouble though as his heart rate was still very erratic, either too fast or alternatively dipping between contractions.
On transfer to hospital my midwife came with me, but she was called away to attend another woman having a home birth at some time during the night so I was left in the care of the hospital midwives. The night passed slowly and relatively calmly. I even napped for short periods and we kept the epidural well topped up as I couldn't bear the thought of the pain returning once it had gone. Finally on examination was told that I was 9cm and could try pushing at about 9.30 am. This completely pepped me up and we felt really excited that we had got that far after everything that had happened.
I couldn't feel any pain at all but could feel the pressure of the contractions so managed to time the pushes quite well. I started to push and then Oscar's heart started dipping again so lots of doctors rushed in and were about to get the ventouse out, when one of them looked and said that she could see his head so there was no need for any assistance. After only about 5 or 6 more contractions he was born just after 10am. He was delivered straight onto my tummy, all pink and yelling his head off. This was the most wonderful experience and I felt so incredible and really pleased that I had managed to take an active part in the pushing.
Then I realised that there was a lot of activity going on down below after the placenta came out and was told I had torn badly when his head came out and would need lots of stitches. Thanks to the epidural I couldn't feel it at all but was very disheartened to learn I had a 3rd degree tear.
After the stitches they tried to sit me up and I immediately felt really dizzy and sick. I nearly blacked out and threw up - more doctors came rushing in and started pressing red buttons - I was dimly aware of poor Moray in the corner holding Oscar and looking terrified! It turned out I had lost a litre of blood and my blood pressure consequently plummeted - hence the symptoms. Because of this I had to lie flat all day and had 2 units of blood given to me. Unfortunately due to the after effects of the epidural and blood loss I wasn't in a fit state to go home that day. Oscar kept me entertained and Moray kept me company and I was sent up to the ward by 8.30pm as I was stable by then. This was horrible as Moray had to go home and I was in floods of tears at the prospect of a night in hospital instead of being together as a family which was what I had wanted.
All in all it was hardly what I had written in my birth plan, but was worth it all in the end. Being in hospital wasn't a totally negative experience as I have nothing but praise for the midwives and doctors who I came into contact with in the delivery suite. I just wish that I hadn't needed to be there in the first place.
Here is the story of Delilah's birth. With Oscar (my two year old) I had a fairly long and difficult hospital birth having hoped for a home birth; so this time I didn't quite believe that I was going to be so lucky.
Having had a previous 3rd degree tear and heavy blood loss I was expecting to meet some opposition in my home birth plans. However I am lucky that my local midwives (the Bishopston team in North Bristol) are very supportive of home birth. They were not at all concerned about the tear I had had previously but did want to find out the cause of the blood loss as they were worried about the risk of PPH (postpartum haemorrhage). Luckily it was clear from the hospital notes that the bleeding was from the tear, not from the uterus, so I didn't face any opposition at that point.
At 32 weeks I had to have a scan to check the position of the placenta as it had been low at 20 weeks. At that scan some concern was raised about the size of the baby and the doctors at the hospital wanted to me to return for a growth scan at 37 weeks, saying that if the baby was large then that a homebirth wouldn't be advisable. I declined to return for another scan as I had heard and read so many stories about the inaccuracy of these scans in predicting babies' weights. My midwives were very supportive of this decision as they felt that I didn't palpate unusually large for dates. I was very glad not to have to go back to the hospital again.
On the 14th of April I went to my antenatal yoga class. I was feeling impatient but had resigned myself to a couple more weeks of being pregnant, as I was only 38+1. I enjoyed the class as always but recall being rather more restless than usual. I decided to do full squats for the first time in weeks and when we did some work on instinctive positions for labour, I found that I wanted to do lots of circling type movements with my hips as we experimented with positions for the first stage. Little did I know how soon I would be using them for real!
When I got home, I ate, watched the new Harry Potter film on video and went to bed. I had a reasonable nights sleep and was woken by contractions on Tuesday 15th of April at the civilised hour of 7.45 am (Moray, my husband, having already got up with Oscar at 7am). They felt just like some of the stronger BH contractions that I'd had on and off for weeks, a mild period pain but it was nothing new to me in this pregnancy so I thought nothing of it expecting them to tail off later on. They were coming about every 5 minutes and lasting about 20 seconds.
I got up and made some breakfast. At 8am I was standing in the kitchen eating my toast and drinking tea when I suddenly felt slight gush of warm fluid down my leg. When my waters went with Oscar it was more like a flood, so, typical pregnant woman in denial, I considered the possibility that I had suddenly developed stress incontinence. Deciding on balance that this seemed unlikely I called through to Moray something along the lines of I can't quite believe it but I THINK that my waters might just have gone, and I am having some mild contractions this morning It gradually sunk in that in all likelihood I was in labour and that we would be meeting our baby rather sooner than anticipated.
I was excited and restless, pacing around the house and thinking about what we needed to organise if things got moving quickly. I didn't want to hope too much that they would, as with Oscar it took 32 hours from my waters breaking to him putting in an appearance. I considered not bothering phoning the midwife until labour seemed more established, but on balance decided that I should. Mainly because so many babies were due in Bishopston that month I wanted to make sure they knew I might need them later in the day! We also decided to phone our friends Sara and Dave who would be looking after Oscar and alert them so that they would be available to collect him when needed.
I made the phone calls, which was a nice distraction. As I was doing so I was pacing around the house with the phone and noticing that the contractions were already gaining strength although were still 5 minutes apart. I was filled with a kind of amazing energy and excitement. I couldn't sit still, just kept pacing around the house and getting on with things between the contractions, gradually aware that I was starting to use a bit of breathing to deal with them as they got more intense. I didn't feel anxious at all, just really excited and exhilarated.
The midwife arrived to check me over at 9.30 am. My BP, pulse etc were all fine. She didn't do an internal but felt my bump and pronounced the baby to be in a great position LOA and well down in the pelvis which I was really encouraged by (having had a back to back labour with Oscar). She felt my tummy during a contraction and said it was quite a strong one. By then I definitely needed to breathe through the contractions, and had to stop talking to her while having them. I was standing and swaying and swinging my hips around, massaging my bump. She left us at 10am having said that she thought we might meet our baby by 4pm (I had asked her to predict a time!). I couldn't quite believe that I might only have 6 hours of labour in front of me and felt really pleased at that! She told us to page her if we needed her; otherwise she'd be in touch in a couple of hours. We had been considering a dash to Tesco to stock up but she advised against this saying that I might actually have the baby in the supermarket if we risked it!
We then had a few more practicalities to deal with. We decided to ask Sara to come and collect Oscar as things were obviously progressing well and he was somewhat of a distraction. I was very organised and phoned to cancel an appointment I had that afternoon with a nappy customer, and a reflexology appointment for later in the week. The contractions were still about 4-5 minutes apart but were gaining strength and were also longer now, about 45 seconds. Meanwhile Moray started filling the birthing pool as we now realised that I might need it sooner rather than later. On our test run it had taken 3 hours to fill and get up to the right temperature. We packed a bag for Oscar and Sara collected him at 10.30. I said goodbye to them after a contraction that had me hanging off the banisters! He went off happily and I was totally fine with it, knowing that he was in excellent hands, and hoping that he would be back in time for bed in the evening.
Once he was gone it was as if my body knew it could get on and have that baby. The contractions almost immediately got more painful. We paged the midwife to return with the message come now and bring gas and air!'
Moray was frantically rushing around boiling kettles and pans to help speed up the pool filling process so I just got on with it on my own which was fine. So different to last time where I wanted him by my side. This time I was so into my body and flow of the labour I didn't need him in that way. I was still standing and pacing between contractions, leaning against wall swaying and circling my hips during them. It was a glorious warm sunny day outside and by this time I was feeling really hot and sweaty. I managed to get it together to time the contractions and realised they were closer and longer again (3-4 minutes apart and 50 seconds long).
At this point I decided that I'd better get the TENS on, realising it was already a bit late but thought it was worth a try. I was now finding the contractions very strong but was coping well with the pain which felt very productive, low down and all at the front. Moray took a break from kettle boiling to get the TENS out and put it on me. I was very impatient, shouting instructions at him like a sergeant major and demanding to be told which buttons to press etc. Once I got it on I quickly realised that starting with a low power was pointless so I quickly cranked up labour mode 1 to full power. This seemed to help a bit for a while but I fairly quickly put it into mode 2, which seemed more helpful again on full power! At about this time I also started making sounds on the exhale during contractions, a sort of ahhhhhhh' noise trying to keep my voice at a low pitch so I wouldn't get a sore throat. I think that the TENS machine did help as after putting it on the contractions gradually got less painful again although were still frequent.
The midwife finally arrived back at 11.30 after being paged twice (her pager had apparently fallen off!). By then I had changed from my standing position which no longer felt right. I tried all fours but that didn't work and eventually found the most comfortable place to be was sitting on the birthing ball rolling gently back and forth and round in circles during the contractions still with the TENS and my aahhhh' noises.
The midwife checked the baby and me again and all seemed fine. She was pleased that labour was progressing well and decided that her 4pm estimate was rather late! I had lost all track of time by this stage anyway so it didn't mean a lot to me. We had some discussion about the merits of gas and air, which I was asking for. She encouraged me to wait for the pool, which was getting close to being full enough to use by now (Moray still dashing back and forth with boiling pans). She pointed out that unless I got in that soon, I might not have time to use it all! We also discussed whether to do an internal examination but decided there was no need as it was obvious that labour was progressing fast and furiously. I didn't care how dilated I was or wasn't as I was happy that my body was doing its job.
By 11.50am the pool was full enough to use (although not quite as full as I would have chosen). I wanted to make sure that I didn't have a contraction between taking off the TENS and getting in the water so Moray pulled off the pads as fast as he could. Unfortunately for him he forgot to ask me to switch it off first so ended up leaping around the room yelping with all four pads stuck fast to his fingers! I jumped into the pool and quickly found a reasonably comfortable position, which was kneeling hanging onto the edge of the pool. It was lovely feeling the water take part of the weight of my body. The first contraction in the pool was overwhelmingly strong and painful (this is one reason I'm sure the TENS had been having an effect). Immediately the noises I'd been making took on a new volume and urgency (thank goodness the neighbours on both sides are elderly and rather deaf!).
I demanded gas and air again but the midwife wanted to hear the baby's heart first so I had to wait for a few more contractions while she fiddled around with that. I began to feel pressure in my bottom with these contractions and was aware that my baby was moving down ready for birth. I was really excited, realising that this was transition and that I would be meeting my baby soon. The midwife confirmed this and reminded me that I wouldn't have to put up with too many more of these incredibly powerful contractions. She paged the second midwife and then finally got the gas and air sorted. She also encouraged me to turn around in the pool so she could get to the relevant bits of me (it was in the corner of the room so she couldn't get round).
This was another thing that I liked about being in the pool. It felt like I was in a little bubble of space that was all mine. No-one could get too close to me and touch or examine me without me actively moving and co-operating with them. It felt like a very safe and grounded place to be. The gas and air helped as I had been sure that it would. It took the edge off the pain but luckily didn't make me too light-headed so I could still focus on the job in hand. By this time Moray was finally able to come and see how I was getting on as he had finished filling the pool. I had hardly spoken to him in the last couple of hours. I remember gasping between contractions something to the effect of it's really happening at home, I can't believe it's been so easy this time! (Except perhaps with the odd swear word in for emphasis which I won't repeat here!)
The contractions gradually changed from painful abdominal ones to ones with the overwhelming urge to push. I'd not experienced this before having had an epidural with my first labour. I found these contractions much easier to cope with and less painful. The noises I was making changed again although I couldn't really tell you what they sounded like at that point! It felt like someone else was making them. The midwives encouraged me to take it slowly to avoid a tear (I had a bad tear the first time so was anxious to protect my perineum as much as possible). I felt the head crowning with my hand along with the burning sensation described in antenatal classes and then after a couple more contractions felt it come out. The shoulders followed with the next contraction and Delilah Marguerite Sloan made her entrance into the world at 12.30 pm. I somehow managed to turn around by lifting my leg over the cord in a rather bizarre manoeuvre and they put her in my arms for the first time. I was totally elated and amazed at my achievement and what my body had done! The midwives commented that she was a good size (which she was at 8lb 11.5 oz) but she looked tiny to me, being used to her brother.
I got out of the pool quickly to await the delivery of the placenta. They got me comfortable on some cushions on the other side of the dining room. Thank goodness we had our trusty B&Q tarpaulin down to protect our carpet! I had ideally wanted a physiological 3rd stage, but as my blood loss was a little heavier than they would have liked, I agreed to have syntometrine to speed up the process. The placenta came quickly and easily after the jab and I was too distracted by my lovely baby girl to notice much. They then examined my perineum and found I had a small tear, which needed a couple of stitches. This wasn't too unpleasant and I was thrilled to only need a couple after last time!
By 1.30 pm I was upstairs in my own bed breastfeeding my new baby with my husband next to us. The midwives left shortly afterwards. Oscar came home to meet his new sister later that afternoon and life just carried on! This was exactly why I had so wanted a home birth. It was everything I had hoped for and more. I feel so blessed to have been lucky enough to have such an amazingly positive birth experience this time around.
Philippa de la Haye
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