Shelley planned a home birth for her first baby when she went into labour at 15 days postdates, but she found early labour very difficult, and did not have adequate pain relief at home. Although her labour progressed well and her baby's heartbeat showed no signs of distress, there was meconium in the waters during the second stage. Following the local hospital's policy, Shelley transferred to hospital and had a natural birth there.
By the time Erin was born it felt as though I had been fending off the prospect of induction for weeks. She eventually came in her own sweet time, 15 days overdue, and I'd been offered my first membrane sweep by an over-zealous midwife when I was only 38 weeks. For them to 'let' me go so overdue, I'd had to assure the midwives' supervisor that I was aware of the risks and was making an informed decision. I arranged with an obstetrician who was sympathetic to women like me to go in for daily monitoring from +14 days. After the birth, both he and one of the midwives congratulated me, "Good for you, you didn't let them frighten you into induction."
All those days spent wishing the baby would come, then when labour got going I thought "Someone make it stop!" I had planned a home birth, because I had the idea that the pain would be more manageable if I was in my own surroundings, and I wanted to manage without an epidural. Although I hate to say it, this was pretty naïve. By the time I was in established labour, I could have been on the central reservation of the motorway for all I knew or cared. My carefully compiled CDs remained unlistened to. As for not wanting an epidural, if someone had offered to knock me out with a mallet, I would have agreed. The only reason I 'managed without' an epidural was because it wasn't available at home.
Note from Angela:
Every woman's experience of labour pain is different, and while women almost invariably say they find the pain easier to manage at home than in hospital, there are times when an epidural is a godsend. Nobody should ever feel guilty or that they are 'wimping out' if they choose to use strong pain relief at home, such as Pethidine, or decide to transfer to hospital for an epidural. The point of planning a homebirth is that you stay at home for as long as it suits you and your baby. If, at any point, you or your baby need help, then that's what hospital is there for. It's such a shame that Shelley didn't get the midwifery support that she so clearly wanted at this stage in her labour.
For more discussion of pain relief options, please see Pain relief at home births
Back to Shelley:
I was woken up by labour pains at 3am, and Erin Rose was born 15 hours later, at 6.10pm. The midwife came at 8am and I was 1 cm dilated. At 12 noon she came back and found I was 3 cm and asking for gas and air, but I was told that I wasn't in established labour and she'd come back at 4pm if I hadn't called someone else out in the meantime. Looking back, I feel quite angry with her for leaving me at this point, because it was the following 2 hours which I experienced as the most painful. It was her midwifery team's Christmas lunch, draw your own conclusions.
I'd read of women napping, or even doing the ironing, between contractions. Hmm. Mine came with 2 or 3 minutes at most between them right from the start, so napping was out of the question. The contractions were becoming more and more painful, so I had a bath at midday to slow things down. It allowed me to catch my breath between contractions, although I missed my TENS machine. The hour after the bath was the worst of all. I would guess I was around 6 or 7 cm dilated by this point, with no pain relief other than TENS. I felt frightened and overwhelmed, not only because the pain was so severe but also because we had no midwife with us. Furthermore, I expected things to keep getting harder, whereas in actual fact things got easier. I'd always expected the pushing to be the most painful thing, but that's not what it was like for me, and if I'd known that at the time it might have calmed me.
Finally, a midwife arrived (at 2ish.) Angela was from another team and we'd never met, but she was wonderful. The gas and air was absolutely wonderful as well. I'd always imagined it to be pretty tame, ranking low as it does on a continuum of pain relief, but I loved it. Unfortunately, within 10 mins it ran out, and we had to wait for more. Even so, the worst was over for me. Soon afterwards I remember that my confidence came back to me and I thought "I can do this." I had my gas and air, I had the support of 2 midwives, and the end was coming into sight.
At 4pm they examined me and I was 10cm, time to start pushing, although the urge to push wasn't as overpowering as I'd imagined. I was standing up and my waters finally broke in a big brown splash all over the plastic sheeting. They were full of meconium, and I knew what that meant. (Baby poo in the waters is very common in overdue babies, but can mean the foetus is distressed.) The midwives confirmed that I'd have to go into hospital in case the baby breathed it in. When I argued that I didn't want to, everyone thought I was attached to the idea of a home birth and began to reason with me. I couldn't have cared less about that, I just didn't see how it was physically possible for me to move! But move I did, after a quick doomed attempt to push her out before the ambulance arrived.
If anything it's the next part of my birth story that gains me the incredulous looks, but in actual fact I wasn't that fazed by it. Between contractions I walked downstairs and out into the ambulance, in nightie and slippers, and we were blue lighted into the POW hospital. I was on an adrenaline rush by then, and I felt sure the baby was fine, her heartbeat was steady. Russell was a bit spooked, but I was starting to engage with labour instead of being overwhelmed by it. Sure, I screamed blue murder when I was pushing her out, but these were contractions I could do something with. One last Hammer-House-of-Horror scream, and out she plopped, looking as though she were made of rubber.
The first thing Russell said was thank you, a very touching and welcome understatement. All I felt at first was relief, feelings of pride and of joy came later. I remember being wheeled along the corridor with her in my arms. I was gazing at her, with tears in my eyes, so proud. We did get a couple of admiring glances, but the halls might as well have been lined with crowds throwing laurel wreaths as far as I was concerned. We had our girl.
Would I have a home birth again? Probably not. If I'd been under their noses in a hospital, the midwives would surely have given me pain relief earlier. Then again, given it earlier, perhaps I would have become habituated to gas and air, had an epidural, and entered the dreaded 'spiral of intervention.' Who can say what kind of birth I'd have had then? Although it took me a while to see it this way, I know that I'm very fortunate that my birth was a natural one, with no complications, and perhaps if I'd planned a hospital birth that wouldn't have been the case. It used to annoy me when people responded "A home birth? On your first?" but on reflection I think they were right. I'm afraid I wouldn't recommend a home birth to a first time mum.
Shelley
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