Ella's birth story, by Ruth

We had found out that we were expecting our first child relatively late in life, and therefore we were keeping an open mind about how things would go. I was surprised and pleased to find that I felt very well during the pregnancy and had no complications. We booked in to the West Middlesex Hospital as I had heard very positive accounts of the care offered there.

About half way through the pregnancy we started to think about the actual birth and I felt strongly that I wanted to labour at home for as long as possible. The more I thought about it, the more I felt that I would be more comfortable and able to cope with the labour in the familiar surroundings of my own home. I also felt that childbirth is not an illness requiring medical treatment (unless there are complications which obviously do need medical intervention), but rather a natural life event.

My Grandmother had told me about the birth of her two children at home, and, after a lot of discussion and thought, I broached the idea of a home birth with the West Mid community midwives, who were supportive and encouraging. They went through the reasons where a transfer to hospital would be necessary and also told me that 50% of first births end up transferring to hospital for pain relief. I decided to aim for a home birth but tried to keep an open mind about transferring in to hospital. We attended both NCT and the West Mid antenatal classes over the summer. We attended the NCT home birth group too and learned about independent midwives. We decided against an independent midwife as we felt we had got to know most of the West Mid community team and felt happy that we would get the support we needed.

I was nearly two weeks overdue, and desperate to avoid an induction as this would mean being in hospital from the start. I did all the usual things to try to bring on labour, including acupuncture and reflexology. At 12.30am on the Monday before I was due to be induced on the Tuesday night I woke with strong period-type cramps every 15 mins. This continued all night and all day Monday, easing off slightly during the day. I phoned the midwives on the Monday morning and they said to keep them informed of any changes. The pains intensified on the Monday night but were still only coming every 10-15mins. We asked for a community midwife to visit late on Monday evening. Someone I didn't know, from another team, visited and examined me, and said I wasn't in labour, to go to bed with some paracetamol and get some sleep! I recall thinking she must be mad! A bit of encouragement at that stage would have been helpful.

I used the water pool we had at home ready for the labour and then eventually I did manage a couple of hours sleep. Things continued pretty much the same during Tuesday, with the pains easing off a bit during the day. Another midwife visited Tuesday lunchtime. She didn't examine me but checked baby's heart rate, which was fine. She talked about whether we might want to go in to hospital to have things speeded up, and as I'd had little sleep for two nights and was beginning to feel tired, this seemed tempting, but we agreed to continue on at home until evening when I'd ring in to the hospital and decide what to do. I spent the rest of the day in the water pool! By 8pm the contractions were coming every 8 mins and were getting very painful. My husband phoned the West Mid to be told that they were very busy and no-one could come out until after 9pm, when the on-call community midwife, again someone from another team who we had not met, could visit. I was thinking seriously about an epidural by this time and we talked through the options, finally deciding to go in to hospital at about 10pm. The car journey was interesting, with me in the back seat on all fours, shouting very loudly with each contraction, which were coming every couple of mins by now!

We arrived at the West Mid at 11pm to be greeted by Sandra, one of the midwives. We went into one of the antenatal rooms and she examined me. I was thrilled to find that I was 7cms dilated. I insisted on staying upright and refused to get on to the bed. The belt monitors were put on me while I remained upright. I couldn't decide whether to have pain relief or not - as things had progressed so far I didn't want to slow it down by having an epidural - but the pain was becoming difficult to tolerate. After a lot of indecision, I finally said I wanted an epidural and Sandra called the anaesthetist. He got no further than the door when my waters broke with an almighty gush - Sandra had realised that this was going to happen and had stood back to avoid getting soaked! She did a quick examination and said I was ready to push! Everything then seemed to happen so fast and I was trying to find a position that was comfortable for pushing - Sandra suggested I got on the bed. I eventually found a good position, sitting up supported by pillows and pushing against Sandra with one foot and my husband with the other.

After what must have been about half an hour of pushing (and shouting) with the contractions, with Ian mopping my brow in the traditional way, and resting in between the contractions, our lovely baby daughter slithered into the world. As she was delivered, the cord seemed to be in the way and so it was cut and Sandra did an episiotomy to prevent me from tearing badly. The exhilaration was incredible. I could not believe that I had managed to do it all with no pain relief at all in the end! And our daughter was absolutely gorgeous.

Ella Rose was born at 2.10am, just three hours after our arrival at the West Mid. She weighed in at 6lbs 14oz and was very pink and alert. A young female paediatrician checked her over as there had been meconium in the amniotic fluid but everything was fine. Another midwife gave Ella her first bath and then Ian held her while Sandra stitched me up - I did try out the gas and air for this (very nice too!). Eventually I held Ella and the three of us were left alone for a few precious moments before being taken up to the postnatal ward.

Having had time to reflect, I feel very positive about Ella's birth. I was thrilled to have given birth naturally and to have stayed at home for most of the labour. We were very happy with the midwife who delivered Ella and we were impressed by the standard of care at the hospital, and I did enjoy being looked after in hospital afterwards. But we do feel that the NHS system has quite a long way to go before it can truly offer a home birth option. I now understand why some of the women I met through the NCT were recommending the independent system. While the community midwives said that they are fully supportive of home births, at the crucial time when we needed a certain level of support, it was not there. Especially with a first birth, I feel that you need quite a bit of support during the early stages and then as the labour hotted up we needed someone here at home with us, not a voice at the end of the phone telling us how busy the unit was and that they couldn't come out. We were very much left to our own devices until we got to hospital.

I very much hope that the NHS system can develop, reinvesting resources where necessary, into a midwife-led service that can truly offer home births for women who wish to have their babies at home. If there is a next time, I would feel that an independent midwife would be a must if I wanted to be assured of a home birth, and I think that is a pity.


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