Sarah Mitchell - Amber's Boat Birth

Sarah's first baby, Amber, was born at home, on a narrowboat. Sarah managed to push Amber out herself, despite Amber's head being asynclitic (tilted to one side) - quite an achievement for a first birth. Sarah's midwives were from the Albany team, which is famous for having a home birth rate of around 40% despite drawing its clients largely from an area of social deprivation.

I had fleetingly considered a home birth but thought it was only for wealthy women with independent midwives. However, when I first spoke to my midwife she suggested it. My partner Martin and I live on a narrowboat and cleared an area for birthing (approx 6ft x 6ft) which proves you don't need lots of room for a home birth.

About a week after my due date I felt desperate for labour to begin and felt like I was going to have a period. I had niggling cramps that never got going into proper labour and felt physically and emotionally sensitive. My midwife, Annie, did a sweep, although it was unsuccessful because she couldn't reach my cervix. However, she explained what she was doing to my partner who did the sweep successfully the following day (he has longer fingers). I also took blue and black cohosh, had sex, and went for walks to try to induce labour.

2 days later I awoke around 6am with a definite contraction. They came every 5 minutes and Martin and I stayed in bed and rested while we could. Mid-morning we got up and showered, which made the contractions slow right down, so we went for a walk to attempt to speed them up again (this got them back to every 5 mins). They continued like this throughout the day and I pottered about the boat, stopping between contractions and breathing through them, as they were uncomfortable but bearable. I was feeling very excited. Martin went out and did some errands while he still could. I paged Annie at lunchtime to say things had started but there was no need to come.

By 6pm things had started to intensify. I was spending a lot of time bouncing or rocking on my birth ball, or rocking on my hands and knees. I wanted to have a bath but decided to wait til after Eastenders (!) as I didn't want to use the bath too early and have nothing to rely on when the pain got more intense. 8pm I got into the tub and stayed there for an hour as the water eased the pain. When I got out I went back to my birth ball again and from then on I spent most of my time on all fours, leaning on it and resting back between contractions. Annie phoned and spoke to Martin around 9pm, but we were still OK on our own, so she said to call back when the contractions were 3 mins apart or if we felt we needed her.

I found breathing long, slow inhalations through my nose and exhalations through my mouth helped me cope and stay relaxed through the contractions. I would count the breaths, so I knew how long it took to get through contractions and I knew at which count they would peak. This really made me feel in control.

Martin paged Annie who arrived about 11pm. Every 20-30 mins she checked the baby's heart beat, which remained OK throughout the birth process. Annie offered to do a VE shortly after she arrived but I didn't want this, as I knew I would be soul-destroyed if I was only 3 or 4 cms dilated. We continued like this for the next few hours and I got back in the bath. Martin said I fell asleep between contractions, but had 2 huge ones which made me jump onto my hands and knees. I got out the tub and got back on my hands and knees, rocking, and the contractions by this point were incredibly strong. I was starting to feel really tired and asked Annie for a VE as I needed some positive encouragement. She said I was 7-8cms dilated which I was very pleased about. All my senses were intensified. I was encouraged to drink diluted fruit juice which tasted so horrible and I could really smell soap powder. Colours were also very intense and my sense of touch was enhanced.

Around 4am I was struggling with the exhaustion so the three of us had a discussion about Annie breaking my water bag to speed things up. There was meconium in the water but as it was old and thin Annie didn't think it was necessary for me to go to hospital, and I was 9.5cms with an anterior lip. Annie tried to push the lip back but it kept slipping again, so Annie told me to go and sit on the toilet, which was quite comfortable. Around 5.30am while I was on the toilet the contractions changed and I got the most incredible urge to push. Poor Martin thought the bathroom was going to collapse and I used the toilet and wall (wooden) to brace myself against for pushing! I remember opening my eyes between contractions and seeing that the sun had risen and the colours in the boat were really amazing. I was really happy about this as my baby would come into the world under sunshine.

I pushed and pushed and pushed. Around 7am the second midwife came and by this point I was on a birthing stool. She did a VE and confirmed that the baby wasn't really stuck, but the head was tilted instead of coming down crown first. I pushed standing, leaning on Martin, kneeling with alternate feet on the floor and back on the birth stool and still baby didn't come. At this point I lost faith in my ability to push my baby out and said I wanted forceps (?!). We discussed the possibility of going to hospital and the midwives gave me lots of encouragement to continue. Suddenly I got a second wind and stated "I will push my baby out!" and I pushed with a will and strength I never realised I had. Shortly after I saw the top of my baby's head in the mirror and Annie got me to kneel and explained she wanted baby born slowly to reduce the chance of me tearing. Baby's head slipped back though so I jumped back on the birth stool as I felt I could get her out when I sat on that and I wasn't going to get off for love nor money! Finally her head crowned and Annie told me not to push but to breathe - incredibly difficult to go against such a forceful urge to push. After a couple more little pushes Amber was born at 8.52am on a beautiful, hot, sunny July morning.

After her nose and mouth had been suctioned she was put in my arms and I saw I had a beautiful, perfect daughter. We stayed like that for a while and Annie tugged the cord, saying the placenta wasn't ready, when I had a huge contraction wave over me and the placenta came out with a big splosh of blood! We lay in the birthing area for ages gazing at each other until she fell asleep. Her cord was tied and cut and we all looked at the placenta - Amber's life source for the last nine months. Amber and I then got into the bath and then to bed while the others cleared up. A couple of hours later the midwives left, Martin joined us in bed and we all cuddled up as a brand new family - beautiful. My daughter's birth is the most empowering and spiritual experience I have ever had.

Sarah Mitchell
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Update: Sarah's second baby, Sky, was another boat birth baby...

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