Home Birth Reference Site

Eva's home waterbirth, by Sarah H

My midwife knew on booking me in that I wanted a homebirth. She was the same midwife I had had for my first pregnancy. I had planned a homebirth then, but complications with the placenta were seen on a scan so I was unsure about going ahead and had a hospital water birth instead. The 'complications' were never there when the placenta appeared.

Will ('DS' - Dear Son) was born in Nov 2003. He arrived at 40+11. I had been booked in for an induction at 40+12. Although "educated" - NCT classes and all that, I had very much "accepted" that I had no choice. However, I was terrified at the prospect and was relieved that he arrived under his own steam. Having said that, I tried every 'natural' means of induction known to man (except castor oil!!) and only when I gave up and succumbed to the thought of induction did he make his appearance. The only thing that could have made his birth better would have been for it to happen at home. He was SROM (spontaneous rupture of membranes) followed by contractions every 5 mins. I had a good seven-hour labour using TENS, gas and air and the birthing pool. I had no tears and recovered well.

With my second pregnancy I wanted a homebirth, but not at the cost of a waterbirth. I did loads of research on pools and settled for a deluxe BPIAB (Birth Pool In A Box) kit and a compromise on size, quality and cost. We plan to have more babes and therefore I can use it again and, should I have opted for a hospital birth at any point, I could have taken it with me in case the others in the unit were being used. It will always make a good paddling pool too.

Note: For birth pool suppliers, see the Waterbirth page.

My hospital's policy was to support homebirth between 37 and 42 weeks, so the target date I set in my mind was getting to 37 weeks. This was a mistake as I was full of expectation once we had reached that point and with a previous 40+ pregnancy I should have expected to at least make close to my due date.

40 wks also came and passed. I was having acupuncture for SPD (symphysis pubis dysfunction - pain in the pelvic joints) and my physio offered to try the induction points but to no avail. I had this twice. As with my first pregnancy I tried all 'natural' means of induction but on researching post date pregnancies found increasing evidence that it wasn't uncommon, or as risk loaded at the 'automatic' tendency to induce might imply.

At 40+10 I was asked by the midwife to consider seeing the consultant and she advised me that 'they' would be 'concerned' regarding going over 42 weeks. At this stage I had already made a decision to go to 43 wks but agreed to see the consultant at 40+15. This meant ignoring hospital policy to be induced at 40+12 to ensure delivery by 42 wks.

I choose to see the consultant to see if he could provide a counter to the research I had done. I wanted to be as broadly informed as possible. He advised me that induction involved the 'transfer of risk from child to mother'. He suggested that induction resulted in no risk to the baby but gave a 25% risk of cs and a high level of risk of intervention, which my research had suggested was a risk to the baby. He denied that there was a significant risk to me. However, what struck me at most bizarre was the information he provided regarding risks to post-date babies. He advised me that "they didn't know" what risks going post 42 wks were for babies, just that the incidence of death did increase but that they didn't know why. So these babies might have died anyway, even if they had been induced. He couldn't say whether the death rate of induced babies was higher or lower than those rates for post 42 wks.

Note from Angela: See 'Overdue, but desperate for a homebirth?' for discussion of risks of postdates pregnancy. The research suggests that the babies most at risk from prolonged pregnancy are those with intra-uterine growth restriction - babies which are very small for their gestational age.

I agreed to be monitored daily on CTG and have a scan for fluid levels the following week. At 40+15, my first CTG showed an active baby and an active womb. I returned to hospital with DH (Dear Husband) and DS the following day for CTG which again showed an active and content baby and contractions every five mins, although I could only just feel them as mild tightenings. I felt very well and positive.

It was during that appt that a couple of the midwives from the ward came to meet me. Because I was planning a home waterbirth, something I believe that had not happened locally before, I was to be supported by a third midwife from the hospital team who was experienced in waterbirth. One of the midwives who came to meet me was a trained aromatherapist and gave me advice regarding the use of clary sage. She also offered me a third sweep, which I accepted. She was exceptionally positive regarding the likelihood of labour starting within 24 hours. So much so she told me it probably wasn't worth booking in for CTG for the next day, but I didn't want to tempt fate.

We all went home and relaxed for the rest of the day with the tightenings becoming stronger. Because I had SROM with my first I didn't know what a contraction with intact waters felt like. At 9.00pm that evening I told dh to go to bed and get some sleep. I was too excited to sleep and didn't want to wake up again still pregnant.

By 11pm the contractions were getting uncomfortable and I wanted the TENS on so had to wake dh to help. As they were also frequent we called the midwife. She came out to assess me and we set up the pool to 'bath level'. That meant I could get in at any time without possibly slowing the labour. I had 'wallowed' while pregnant and it was great to have the extra space you don't get in a bath. At around 1.00 am the midwife left as I wasn't really in active labour, but she was sure it would be within 24 hrs and asked me to call her back when the contractions were too uncomfortable to talk through, and regular as well as frequent. I called my mum to let her know things were starting to stir. She decided to stay put unless we gave her 'the call' within the next few hours. Failing that she would just turn up first thing in the morning. Dh went back to bed and I snoozed on the sofa with the TENS on.

I woke up to a real toe-curler at 5.00 and timed them for half an hour. They were every five minutes and really deep so I got dh up and he called the midwife. He asked if I could get in the pool before she arrived and she said fine but I wanted to save the pleasure till I needed it. It was all quite bearable really. Dh must have sensed that baby wasn't far off because he began filling the pool more before starting to fill the pool up to delivery level.

My mum arrived at 6.15. She would have missed the whole thing if we had waited to get confirmation from the midwife that the baby was coming. But I never have asked her why she came quite so early in the morning. If nothing had been happening we have still been in bed. The midwife arrived at 6.20 and began setting up. She called the second midwife straight away and a few moments later called the third. This bit felt very chaotic somehow but I still felt in control. My only concern was that people didn't make too much noise and wake DS, who was asleep upstairs.

The water temp in the pool was too high for delivery (something we hadn't thought would be a problem) but I loved it I just wallowed in the hot water, flipping onto my front for contractions and floating on my back in between. Cold was poured in by the bucketful to one side. I tried not to stir it until the midwife said it was too hot - her temp reading was above the hot water inlet (hosepipe). The midwife wanted to examine me but couldn't do it in water as her gloves made it painful. I agreed and managed to get out. I was five cms. After getting back in I felt ready to push.

The midwife asked me to get out of the water to push as it wasn't deep enough. I refused - she had expected I would. She again asked me to get out because of the temp being too high, which is when I stirred it up! Finally, when she could see there was no stopping the baby, she asked me to get out because the second - never mind the third - midwife wasn't here. "I have to ask you to get out Sarah, you know I haven't done this before and I am unsupported" she said - "Don't worry" I replied "I have told you before, I have!"

Note from Angela:

What a brilliant response! And what a shame the midwife thought that Sarah needed her permission, or her assistance, to give birth in the pool.

It's surprising that the midwife thought the pool temperature was too high for delivery, but not for labour. Usual guidelines are that high water temperatures (including hot baths) can be dangerous in labour, but not for delivery itself. This is because the baby cannot easily get rid of excess heat from its body while it's in the uterus. For every degree that the mother's temperature rises, the baby's rises more than one. However, it is common for pool temperature to be raised for the delivery itself, both to keep the baby warm after birth, and to reduce the risk of the cold water stimulating the baby to breathe before it is brought to the surface. So Sarah's midwife was right to be worried about the pool being too hot, but the timing was completely wrong.

The midwife did make it clear that she was not confident in waterbirth, and apparently was not up to date in good practice for the use of water in labour. The Royal College of Midwives has stated that attending waterbirths should be considered part of normal midwifery care, so all midwives should be able to assist at one.

For more on pool temperature and other waterbirth issues, see the Waterbirth page.

Finally the second midwife arrived with the gas and air and my mum and dh were helping her unload the rest of her kit when my midwife shouted "Can everyone please come in here now!" Mother and dh arrived back to see the head being born. I had had two gasps of gas and air, which did nothing. Baby arrived with the next contractions I caught her with the help of the midwife and we had a lovely meeting. It took us a few moments to remember to check what gender she was. The community midwifes didn't rush me at all.

The cord was left to stop pulsing and the midwives were happy for me to try to leave the pool with everything still intact despite the short cord, which felt really weird tugging. After I left the pool, the third midwife arrived and I got comfy on the sofa to try and breastfeed Eva and see whether the placenta would come. With the cord being short I opted to have it cut then so that we could settle in properly.

As with my first birth, contractions completely stopped once the baby had arrived. I had chosen to have natural third stage and wanted to have time to cuddle my baby but the hospital midwife was very keen that I get on and finish the job. As there did seem to be a lot more blood in the pool after this birth than the last, I did eventually agree to stand and try pushing the placenta out which worked fine. I refused an internal on the grounds it hurt and bleeding was minimal. In all the whole thing lasted 1 hr 50 mins.

The rest is just a lovely haze….

Sarah Harrison

Update:

Sarah had another baby, Sally, in 2007.

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