A brief history of Sarah's children's births:
I will start the story at 43 weeks as in my mind there was never any doubt I would get to 43 weeks. I had seen a consultant at 20 weeks to confirm that I would not be interested in IOL (induction of labour) for postdates but would wish to access monitoring post 42 weeks. This had been positively received and agreed. However, on seeing a different consultant at 42 weeks (due to what I felt were nervous midwives despite perfectly normal scans and CTGs) I was informed that he was less likely to 'tolerate' my position on IOL post 43 weeks. At 43 weeks I was due back but was anxious I would meet a battle so a friend advised I contact the SOM (supervisor of midwives) to discuss my position as my named midwife was off. The SOM then offered to discuss my case with my original consultant. (The second was away anyway.) This was done and I was pleased that I had been given the support of the SOM, the Cons and there had been no mention of withdrawing support for the planned HB. I left feeling well and pleased.
However, less than 24 hours later at 43+1 I had a bad night, the scare stories had built up and I was filled with self doubt again despite promises to myself not to let this happen. This was my last pregnancy and as far as I was concerned it could last as long as it needed to, just like the others had. But others still felt the need to question my judgement and instinct and I found my self again justifying to all and sundry what I was doing or indeed not doing. I spent that Tuesday night waiting for the baby to move and like a watched kettle that never boils, it was a quiet night. Baby hiccups being the only relief in the dark. I was overtired and emotional when I got up and decided I wanted a sweep but the CM said they were 'too busy' to come out and asked me to go in to day case for monitoring. DH was at work so I asked him to come home and take me and I went for a walk in the rain on my own while my mother took care of Sally. When I got back I had bad backache and what seemed like long and sustained but ineffective conx (contractions).
On arrival at day case, I said I had come for a sweep and was told that 'I couldn't keep just doing that'; I was 43 weeks and had had two attempted sweeps neither of which had been possible due to a closed cervix no surprise to me as with my third I had gone from 1 to delivered in an hour. I hardly felt like I was becoming a serial sweep addict. I was monitored with CTG and the MW asked me to see the Reg. She ordered a second scan first (I had already had one at 42 weeks)and it was again all normal. I saw the Reg who asked to examine me and she said I was still 1 cm but all other signs were good including some stronger and more regular contractions which kept coming despite my anxiety at being in hospital. I was asked to return on Thursday for CTG and to see the Reg again on Friday if things hadnt progressed. I met the community midwives on call before we left - and they were lovely, saying to call as soon as I wanted them and they could always come out and check if I was feeling unsure. DH (husband) and I went home.
Things began to progress much better at home. Time flew and the contractions became more regular, more frequent and finally stronger. DH filled the pool up with hot water. I was very excited and positive, full of energy despite the lost night's sleep and I marched round determined to keep the momentum. Mum entertained Sally. At 3.00 pm I told DH I thought the MWs needed calling. I was very fast delivering before and they had asked for an early heads-up. By 3.30 they were at the house and the conx had got strong enough for me to want to get into the pool. I had opted to have no VEs unless there was a clinical reason for doing so. The CMWs were happy to stand back and wait. I felt really good. I knew from the scan that the baby was well down and in a great position for birth. The contractions were good and strong and I was managing them really well. Sally (aged 2) wandered round the pool asking me if I was 'awright?' and bringing me drinks. After a conx she would often look at me very concerned and say 'sore?' but she was really calm and chilled. I had warned mum that I thought she might not be as laid back as the older two had been at her birth but I was wrong. It was all par for the course for her. Like the most natural thing in the world having your mother mooing in an oversized paddling pool in the conservatory. She didn't even get too cross when she wasn't allowed to get in. David held my hands as the conx got harder and mum pressed down on my back to help ease the discomfort.
After two hours of significant contractions the MWs began discussing what was going on with each other. They referred to my notes and asked me about the surgery I had had on my cervix following a bad smear test. I confirmed that this had been after Sally was born but told them that I had asked and been told that the only thing that might have been a problem was premature labour! I had been very clear in consenting to the surgery that I planned to have further children and would not wish to take any steps which might hinder this. I had planned to get pregnant within six months of the smear results and would have waited (for the surgery) if our chances at conception and a safe pregnancy and delivery would have been compromised for what in effect was a preventative measure, not treatment. I had also previously discussed this with my CMW (community midwife), who knew me very well, and we had decided to go back to hospital at 36 weeks to make sure that my op would have had no effect on my labour. Without even assessing me or the consultant even seeing me (despite a 1 ½ hr wait) I was told it would have no effect.
The CMW asked me if I would think about getting out of the pool to see if gravity would help, use the toilet and allow for a VE (vaginal examination). I agreed and was still very positive. I went to the toilet and walked up the stairs to the bed. I wasn't rushed and when I was ready the VE was carried out. The CMW reported that the cervix was only 1 cm and as described in earlier documentation. I was gutted. She advised me that she felt it was scar tissue which she had tried to stretch but couldn't and would need to phone the delivery suite for some guidance. She did this and they advised that they were happy for me to continue for a further two hours. With the news that I was 1 cm and being out of the water, I felt the need for gas and air. One leaky bottle, the other only half full and me now consuming it at great pace, my father was dispatched to collect two more from the hospital. My eldest two children came home from a friend's house where they had had tea and everyone carrying on the business of birthing.
I worked so hard for those two hours. I talked to my body, telling it to open. I talked to the baby asking it to work with me. I was tired but I was determined. For every contraction I stood up and gave my body every chance to use all I had. In between I rested on my knees or over the bed but the gaps between the contractions soon became so small I just rocked from one leg to the other. All the while the baby was monitored intermittently and was found to be coping well.
At 7.00 pm, the delivery suite deadline, the CMW asked again if she could examine me. The result was still 1 cm. No change. The contractions were getting harder but I said I could manage them. They were the hardest I have ever had. The phone call to the delivery suite resulted in a request that I transfer in to be examined by the Reg. I agreed reluctantly and cried bitterly as did DH. Before I knew what was happening, still trying to remain ahead of the next contraction, three ambulance crew marched up the stairs. I was horrified. My son was distraught. Every time we move over for an ambulance and the kids ask why we tell them its because some is in trouble and really needs the help fast.
All I can remember is saying, 'I told them I wanted another baby, I told them'. They wanted me to lie down but I refused. DH had to follow in the car. They turned the sirens on and all I could see in my minds eye was my little boy terrified that we were in real trouble. At the hospital the CMWs had followed and DH was there as I arrived. Ironically, knowing the short cuts got him there first without the blues and twos. We went in and I was asked to get onto the bed from the ambulance trolley. I just got off the trolley and began to regain control of myself and the labour. The CMW handed over to the HMW (head midwife) who was also a CMW normally. She was kind and asked if I would mind being monitored. I declined the continuous belt monitoring and she was agreeable. The Reg was called and he asked to examine me.
He again reported 1 cm and that it was indeed scar tissue that was causing the problem. All I recall him saying was that it would either give or it wouldn't. If it wouldn't I would need a CS. I dreaded to think what 'give' actually meant but I imagined it tearing. I asked him if there was anything I could do and he said there is nothing and that I couldn't be working any harder. He said a drip could not make my contractions any harder and there was nothing else to be done. He gave me till 11 pm which the MW thought was 'cruel' but I was prepared to make the most of.
After he left the CMWs left, which left me feeling abandoned and vulnerable. The first hospital MW reported that she was about to go off shift and that someone else would be taking over. She apologised as she asked if it was okay to go and check the other lady she was looking after but said she would be back. After about half an hour she left and the new MW came in. I don't remember her saying her name. I was offered some toast, I asked for more water as the Gas and Air dried my throat. The toast came, the water didn't. David chased it. After the disruption of the transfer in and the exam, my body again frapped up the conxs. They were harder than ever and my whole body worked against the brick wall that was the scar. After an hour I said to David that I didn't feel any different, that nothing was changing and that I didn't think I could work any harder. I didn't want to be so tired that if I had a caesarean then once the pain had gone with the epidural, I would fall asleep, something which had happened to a friend. At 9.15 DH and I agreed that we would like to be examined again at 10 pm as the conx were getting so much harder and faster. There was no gap between them and I was exhausted. The MW came in and went out and said nothing that I recall. She occasionally monitored the baby. David told her what we had discussed and at 9.45 she left to call the Reg back.
It was them that I felt something, ever so slight, shift. I told DH 'something happened, get her back' he pressed the button. An assistant came in and I remember David saying, 'get her back we need the MW' or something to that effect. With the next conx which was almost immediately, my water broke and I felt the baby fall within me. It was like an explosion from within and had I been at home it would almost certainly have been a new carpet and probable redecorate. There was quite a lot of blood and tissue.
I thought I was saying to David, 'get the bed down' but he recalls it as my dramatically miming with my hand pointing downwards. He came round to help me and I shouted 'bed' he must have got the message because the bed began to go down so that I could climb on. I was terrified that it would just fall out. I climbed on and as the MW walked back in, he did. He must have fallen about a foot as I was kneeling up. I was in shock and asked David to take off his shirt and pick him up because I couldn't move my legs and he was just crying. David took off his shirt and I remember hearing her say, I am just going to cut the cord. I shouted NO. I want it to stop pulsating. I think she said 'Oh'. I again said to David, pick him up. She then said oh its stopped, now I will cut it' . He picked him up and told me he was a boy. David says he is sure that she had already clamped the babies end when I told her to stop which would explain why it took no time to stop pulsating. I still couldn't move and the MW asked me about an injection. Again I recall saying no.
There was blood and fluid all over the bed. I couldn't move but DH was holding the now-named Ben (DS2 - Dear Son 2) My legs began to shake and I wanted to sit down so that I could hold him. I tried to turn around and sit down. It felt like the MW just stood there and watched me struggle in my weakness. No effort was made to clear the bed or make it more comfortable. I tried to feed Ben to stimulate the uterus but he wasn't interested and I was so uncomfy. She began to gently tug on the cord which felt horrid. She suggested I change position and get on all fours. Again having no offer of help to move my knackered body and having to crawl through the mess. In the end it took nearly 45 mins to deliver the placenta. She left the room.
I asked when we could leave. She said she didn't think we were allowed to go before 6 hours but I said I wanted to be back in time for my children waking up. She said she would speak to the Paediatrician. I had a bath but as I hadn't packed a bag I had no clean clothes, no towels, no knickers, no pads etc. We had to ask for everything. I was given one hand towel to get dry with, David rummaged to find another as it was soon a mess. I got dressed and DH said he thought Ben was hungry. He was and he fed for an hour. We waited an hour and a half for the Paed to come and tell us that she couldn't examine Ben because he wasn't 6 hours old and asked us to sign a self discharge /waiver form all about death, respiratory distress and sepsis. At just before 1 am we left and were home in bed by 1.30 am.
Ben had a tongue tie just like his big sister Sally which has now been snipped. Otherwise he is well and after an unsettled couple of days is now very content. I took a long time to recover from this birth physically and am still trying to undo some of the damage done not only physically but emotionally too. I am glad I waited for Ben to come when he was ready. I dread to think how I would have faired with an induction given the scar and I suspect that having been assessed for induction planned cs would have been suggested anyway. A couple of midwives have commented since that this is most likely. If nothing else this birth has confirmed for me that home really is the best place to give birth and that the relationship you develop with your midwife is more significant than I already believed.
You have had surgery on your cervix - can you still have a homebirth? Other birth stories where this has been an issue.
The cervix, surgery and scar tissue - UK midwifery archives. (www.midwifery.org.uk)
Birth after cervical surgery on the US Midwife Archives, including suggestions for breaking up the scar tissue by what sounds like a stretch and sweep, and some case histories where this has been very successful.
Siblings at a home birth - what to do with your older children? Should they be present?
Transferring to hospital - why it might be advised.
Overdue - but still want a homebirth? When is 'postdates' risky?
The Third Stage of Labour - what are your options, and the pros and cons of each?
Homebirth UK email group
Home Birth Stories
Home Birth Reference Page