Kirsty's Birth Story

By Sarah Sadler

Sarah's first baby, Kirsty, was born on 14th May 2000, after a forceps delivery in hospital.

I'm one of those transferred home birth mothers who still like to think it was as near a home birth as I could make it.

I had an ectopic pregnancy in September 1998 and had one of my tubes removed as it had ruptured. This frightened me off hospitals probably more than I care to admit. Plus the hospital was connected with the death of that baby rather than the life of this new one.

I didn't cite this as my reason for wanting a home birth as it made me cry, but it was that, plus the fact that I had been born at home and my mother raved about how lovely it was versus the hospital birth she had with my sister.

Anyway, from less than 8 weeks pregnant, I was adamant. I'd had a couple of appointments with a consultant before my booking-in appointment to make sure that the baby was "in the right place" this time. Once we'd made sure she was, the consultant said that this pregnancy and birth would be as low-risk as anyone else's.

This was a very different opinion to my midwife's at my booking-in appointment. She was absolutely dead against it. Said that my scar might tear open during childbirth and I wouldn't be able to get to hospital in time (which is funny because I lived 2 minutes from the place). She said that she would make appointments for me to see Doctors who would "put me straight". I got upset and told her that I had the right to choose. She told me to discuss it again at 21 weeks. I said I'd mention it every time I saw them.

Sarah's midwife may have been thinking of the additional risk a woman faces if she has had a prior caesarean section. After a caesarean there is a very small risk that the scar on the womb could tear open, either in late pregnancy or during labour. Because the baby's blood supply depends on the blood supply to the womb, if the mother is losing blood from a tear in the womb, the baby is at risk. However, the only scar Sarah had to worry about was that from surgery to remove a fallopian tube. This would not leave a scar on the womb itself (just at the end of the tube), so should not cause a problem.

Came home absolutely furious and thanks to your web site knew I should contact AIMS (Association for Improvements in the Maternity Services). They were fantastic and told me exactly what to do. Wrote to the Head of Midwifery Services at Frimley Park Hospital and copied the letter to AIMS to show I meant business. Thought it would take months of argument, but I couldn't have been more wrong.

I received a phone call two days later from Sue, one of the other midwives from my team. I was all for changing teams so was a bit cautious, but she came to see us and said "Oooh, I love a good home birth". It turned out that the booking-in midwife wasn't anything like the rest of the team, in fact they didn't get on at all and if I'd seen one of the others first then there wouldn't have been a problem. Sue made my husband feel even more comfortable with the idea and also completely dismissed the scar ripping open idea because it wasn't through my womb.

Rest of pregnancy went beautifully with low blood pressure and no worries at all. There was the odd silly home birth comment like the one from a solicitor on our NCT course who said that my midwives shouldn't do it because they could be sued - I couldn't sue someone who worked in a hospital? I think you have to be prepared for people thinking you're a little odd.

When it got close, I went to my GP for some pethidine for the midwife to use, just in case. Doctor asked why I wanted it. I explained, and he asked me in an incredulous tone why I wanted a homebirth. I was fat and hadn't slept so the last thing I wanted was an argument and said "because I think it will be lovely". He stared at me, gave me the prescription and said "well at least you live near the hosptial I suppose". He was strange anyway - had pictures of people in the throes of death on his surgery wall.

When I was 7 days overdue, I had an appointment at the hospital. As I've said the hosptial is only 2 minutes away and the parking is hugely expensive and difficult to find so we always walked. Don't do this. They were running on time so there was little time for a rest between getting there and having my blood pressure taken. My bp was up and this concerned them even though I told them I had walked. I was desperate to avoid induction - you couldn't get further away from a homebirth! They decided to strip my membranes. This hurt, but was well worth it.

I went into labour less than two days later.

My labour is a long story, but in distilled form:

Started getting pains in the middle of the afternoon. Mostly backache so didn't take too much notice. These got progressively worse so went for a walk - kill or cure. Had a show so decided to get the house ready and line the bed with plastic etc. Put my TENS machine on.

Phoned the midwife at 11pm to tell her that it was under way. She said to take a couple of paracetamol and try to get some sleep. I was in far too much pain for sleep. Tried having a bath and told Kevin to sleep. By 4am the pain was horrendous and the bath really wasn't helping.

Phoned the midwife and she came to see me. I was 4cm dilated. Thank god I hadn't called her out for a false alarm! Dreaded doing that.

She went home again and we carried on until 7am when she came to see us again and I started to use the gas and air. She kept coming and going throughout the day which was lovely as you got the reassurance of seing her but it was essentially a private thing for the three of us (me, my husband and the baby).

Unfortunately things slowed down and I wasn't even dilating a cm every two hours. Things went slowly and very painfully until I had my first dose of pethidine. This helped and I got to 7 cm dilated. I was having extremely bad back labour and the baby had her back to my back (posterior presentation) so there was a lot of turning to be done.

Things slowed up then and it took around 6 hours to do the last 3 cm.

I started pushing at around 7pm. Couldn't get comfortable and didn't want to lie down. In the end they made me sit on the toilet. It was a tiny toilet so there really was only room for me and Kevin. He was yelling PUSH at me at the top of his voice and I was worried the neighbours would hear!

This carried on for a long time, but the baby just wasn't coming all the way down. She was stuck mid-way. The midwives finally made the decision that I would have to go in for forceps - we both felt I wasn't getting anywhere! I kept wondering whether I hadn't been pushing hard enough, but they were able to reassure me on that. They had tried all sorts of different 'pushing' positions with me and allowed me to give it my best shot.

During my pregnancy, I was lucky enough to form a good relationship with the midwives I had, and became completely confident in their wishes to give me the birth I wanted - they also had good home birthing credentials - recently having carried out a successful home birth VBAC (vaginal birth after caesarean). My agreement with Kevin was that I would transfer if my midwives thought it was the best thing for the baby and myself. I wouldn't have made that agreement had I not been sure that they would only transfer me for a serious reason.

Note from Angela:

Although Sarah's midwives may have made the decision to recommend that she transfer to hospital, and Sarah trusted their judgement, it is important to remember that only the mother has the authority to actually make the decision to go, or to stay at home. It may seem like a small difference, but language matters. It is your choice - but it is not always presented that way.

If you are ready to go to hospital, fine - after a couple of hours trying to push out a posterior baby, many women would be. But if you are not ready to accept hospital treatment, you are entirely within your rights to say that you will remain at home, regardless of what the health authority's policies on recommending transfer are.

In situations like this the mother may not want to enter into detailed discussions - it is then that your birth partner can really help you out by explaining that you would not want this, and that you had discussed situations where transfer might be recommended beforehand. However, the midwives do need to be informed by the mother that she does not want to transfer - they will not take anyone else's word for it. Something like "I'm not ready for hospital yet - I'm going to try here for a bit longer" should do. Your birth partner can then step in to stop you being pressed further. As long as the baby is not in distress, there is no urgency after all - what matters is how you feel.

That's the theory - in practice, many women feel they are not in a position to argue, or they may agree with the recommendation to transfer. But always remember that you do have a choice.

Back to Sarah:

We went in - I wouldn't have an ambulance, so we went in our car. The contractions stopped because of moving me so once I was on the delivery suite they made me pretend or else we were concerned they were going to caesarian me. Without seeing me, the Doctor said that the baby was too big for my hips (can't remember the technical word). They argued for me and told him that the head was well down.

I was desperate not to have an episiotomy so tried to negotiate with the doctor for a small cut if I pushed very hard. Don't think this worked. In the end she came out with one pull and apparently I did most of the work.

The photos show she had a forcep mark round one of her eye - her head was just not in the right position and this made her difficult to move.

She was battered and brusied but she was out and she was beautiful, weighing in a 8lb 1oz - Kirsty Anne.

I had to stay in hospital overnight as she wasn't born until 10.12pm. Horrible night and I just hated being parted from Kevin so quickly after the birth. Went home as soon as possible and was much better looked after by my midwives and by Kevin than I was in hospital.

Sarah Sadler
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