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Kira's birth story, by Suzanne Williams

Suzanne's first baby, Kira Louise Packer, was born at home on 2 May 2002. Suzanne was 37 years old, and she went into labour on her first day of maternity leave - at 37 weeks of pregnancy. Kira was asynclitic (head tilted slightly to one side) and had her hands up by her face, so it was quite an achievement for Suzanne to give birth to her without assistance. Despite this, Kira was born only five hours after Suzanne felt her first contraction.

Both my partner, Vinnie and I are nurses so once we found out I was pregnant in the autumn of 2001 it came as second nature to us to do our homework and find out what the research said about birth outcomes, interventions etc.... needless to say we both decided that we wanted as natural a birth as possible with as little intervention as possible.

At first I thought about a midwife-led unit, but when I found out that my nearest one was over half an hour's drive from where I lived, along country roads and 12 miles from the nearest hospital the idea of a homebirth took hold. I couldn't see the point of travelling all that way when I only lived 5 miles from the nearest hospital, which had far better emergency facilities than the one close to the midwife-led unit. I knew I would be much happier at home and envisaged being able to chat to my friends via the Internet during the first stage of labour, wander around the house and use my bath as and when I wanted. I am the type of person who likes to be in control and felt that home would be the place I was most likely to get this.

All my antenatal care was with the local community midwife team and my midwife, who was the one who had initially pointed out to me that I could have a homebirth, was completely supportive. I sailed through the pregnancy with no complications and no reason not to have a homebirth. I worked full time throughout my pregnancy and had a contract that finished very conveniently on the day I was 37 weeks (Tuesday 30th April, my 37th birthday!).

Although I had had a strange feeling I wouldn't go to term and my midwife said the same at my antenatal visit when I was 36 weeks 6 days, I was surprised when labour did start. It was my first day of maternity leave (Wednesday 1st May), I had just been to my antenatal yoga class and was walking along the street (about 1pm) when I felt a gushing sensation (luckily I was wearing a pad!). I first thought that I had lost all bladder control, but when it happened again I realised it could be my waters breaking. I was on my way to my reflexology appointment, and all I could think about was that I must get there and think about what to do next! (All thoughts of buying some lunch went out of the window!). Since I wasn't having any contractions and nothing more seemed to be happening I carried on with my hour of reflexology and then made my way home.

By the time I got home (3.30pm) I could feel more gushing and, after discussion with my Health Visitor, who was making a courtisory antenatal visit to introduce herself, I called my midwife, Lynn. She confirmed that my waters had broken, that I was 1-2cm dilated, and started talking about induction if I hadn't started labour by Friday morning (less than 48 hours after my waters had broken). I let her book the appointment for the Friday morning, but did say that I would see how I felt on the morning! I couldn't remember the exact NICE* guidelines so didn't want to start an argument at this stage before I had some evidence to back me up (first thing I did when she left was check the NICE guidelines to find they advocate allowing up to 96 hours after the waters breaking before induction is really necessary -guess who wouldn't have turned up at the hospital on the Friday morning!).

(*NICE: National Institute of Clinical Excellence, which published guidelines on induction of labour recently.)

Lynn left after informing me that the midwife on call that night was called Sally, was very experienced in homebirths, and that I might like to try a hot curry, sex and some reflexology to help things on the way!

By this time it was 5.30pm, my partner wasn't due home from work until 9pm, so I rang him just to let him know what had been going on. It was his first day in his new job and I could tell from his voice he was a little shocked, but he calmly said, "OK, ring me if anything else happens and I'll see you later". I was surprised when he arrived home an hour later. Apparently he had been so shocked that he hadn't known what to do until his boss asked if everything was OK and when he told her my waters had gone her reply was "So what are you doing here? Get yourself off home".

I rang my brother next as it was his birthday and told him that things had started happening, but that it was very unlikely that the baby would be born before midnight. When I phoned my mother she was almost in tears. Living over 200 miles away, there had never been any plans for her to be at the birth, but her instinctive reaction when I told her that things had started was that she wanted to be with me and got quite upset at the thought of not being near me.

Once these phone calls were out of the way, I went up to the computer and proceeded to catch up on my mail and inform those who would want to know about the day's events. This is where my partner found me when he arrived home. After being reassured that nothing more was happening but knowing things could start at any time, he proceeded to tidy up the house, making sure everything was ready for the birth, while I just sat there chatting!

By about 8.30pm I was starting to get restless and had some uncomfortable period-type pains, so I decided to have a bath with some Clary Sage and Jasmine oils to help the process. Whilst in the bath the pains seemed to get stronger and I think I had my first contraction. I was out of the bath and chatting quite happily to my friend Julie at 9pm but wasn't convinced that the pains I was feeling were contractions. I described them Julie who confirmed that they sounded very much like the contractions she had had with her daughter. It was then that I thought I really must time these contractions - they were 10 minutes apart.

While Vinnie got my birthing nest ready - a thin mattress from the sofa bed laid out on the floor of the lounge covered by a plastic sheet and old bedding, lighted the candles and got the soft music ready, I carried on chatting to Julie between the contractions - just getting up to walk around or sit on the toilet during the contractions.

At this point I realised that I should be using the Tens machine, but it was a bit of a nightmare because I was rather oily from my bath and the pads wouldn't stay in place for long. When they did, it did seem to help with the pain, but I had difficulty operating it as I hadn't tried it out before. It was one of the things I had meant to do during my first few days of maternity leave. At one point Vinnie tried to help by turning the machine up but all that did was make me vomit! It was like something out of a comedy farce - me moaning in pain and saying I 'm going to be sick and him racing around the bedroom trying to find something for me to be sick in - in the end he found a half empty "Celebrations" chocolates tin left over from Christmas under the bed, emptied out the remaining chocolates onto the floor and I spent the next few contractions with my head in the tin!

By 9.30pm the contractions were 5 minutes apart, and by 9.45pm they were 3 minutes apart. At this point the contractions were extremely painful and I could no longer chat to Julie between them, so Vinnie had to explain to her what was happening and that he was calling the midwife.

While we waited for the midwife, Vinnie managed to get me downstairs to the lounge and settled on the "nest" before hunting around to find the nightie I had chosen to wear for the birth - it was in the tumble drier, having only been washed that day as part of my preparations for the birth. The old towels I had intended to use were still in the washing machine soaking wet -we certainly were not prepared!

Sally arrived around 10.30pm. I initially was worried that I was going to have someone I had never met before at the birth, but as soon as Sally walked in the room I felt so reassured - she was lovely. She asked me if I wanted her to do an internal to see how things were going and I agreed readily. I was a bit concerned when she said I was 2cm dilated - I couldn't see how I could take this much pain for many more hours. I expected her to say that she would leave and come back later as I know they are only supposed to stay once the women is in established labour (4cm dilated), but she made no move to go and we settled down to the business of getting the baby out.

The next hour and a half is a bit of a blur to me. I can remember thinking that I wasn't getting any time between the contractions and they were so painful - Vinnie on the other hand reckons I kept falling asleep between them! I do remember asking if the Tens pads were in the right place and Vinnie and Sally laughing because I had two of the pads on my bottom and me screaming "Don't make me laugh, it hurts!" At one point Vinnie noticed that my eyes looked glazed over as if I was on drugs and Sally explained that it was the natural endorphins playing their part. I can also remember saying that I understood why people opt for C-sections and epidurals and that I wasn't going to have another baby! (guess who's already planning a home water birth for the next one!)

During this time we tried out many different positions with the guidance of Sally - she was so supportive - suggesting a change of position when she could see I needed to move and reassuring me all the time that I was doing brilliantly. We made frequent trips upstairs to the bathroom trying not to drip anything on the new carpet! (I'd had a large bloody show not long after Sally arrived and it continued to leak through out the labour, but there was not trace of any mess the next day once Vinnie had cleared up the old bedding and protective sheets we used).

Around midnight something changed. I became suddenly very alert and the contractions felt different. Sally noticed and asked me if I felt the urge to push. I said I wasn't sure, but she could see that my body was pushing involuntary and told me to go with it and start pushing. Sally asked me if I wanted to try the entonox (gas &air) which I did, but I didn't like the way it made my head swim and I couldn't concentrate on the pushing - it reminded me of being very drunk - yuk! So we went on without the Entonox. At some point Sally called the second midwife, Carol, who I remember apologising to as she walked into the room to find me on hands and knees with my bum in the air facing her - what a sight!

The second stage went on for ages; she just didn't seem to be moving down despite many position changes, so Sally asked me if I wanted her to do an internal to see what was happening - again I was more that happy to let her - I wanted to know too! She found I had a cervical lip and asked me if I wanted her to help the baby over it - oh yes I certainly did!! And with the next contraction I felt a movement downwards. From then on (about 1/2 hour) Kira moved down with each contraction.

Around 2am Sally asked me if I wanted to try a different position to actually give birth in - Vinnie sitting on the sofa supporting me in a squatting position in front of him. I was more than happy to try this as I seemed to have tried every other position and didn't feel I could get my legs open enough in any of them!! With a couple of pushes, out came Kira. I have never been so relieved in my life - the pain had gone!!. As she lay there on my stomach coughing and spluttering a bit, the nurse's instinct in me came out and I asked if she needed suction or oxygen. Vinnie later admitted that he was a little worried at this stage too, but she had a Apgar score of 8/10.

Once she stopped coughing and lay there gazing up at us, I lifted the cord out of the way and took a peek, but didn't say anything as I wanted Vinnie to find out for himself that he had the daughter he had been hoping for. We waited for the cord to stop pulsating before Vinnie cut it and he cuddled Kira to keep her warm while I changed position to deliver the placenta.

I delivered the placenta less than 15 minutes later (physiological 3rd stage) after giving one push and then talked to my parent and brother on the phone, laying there with Kira in my arms. I couldn't believe it when Sally told us the time of birth was 02.11am - I had gone from first contraction to birth in around 5 hours. Officially, established labour was probably around 3 hours! Sally jokingly said that my next one would be even quicker and easier!

Vinnie got out the bottle of champagne he had chilling ready in the fridge and Vinnie, Sally and I celebrated the natural homebirth of Kira. She only weighed 5lb 8oz, but part of the reason I had trouble pushing her out was that she had had her one hand up on her cheek and the other up to her chin and her head was slightly to one side (which probably caused the cervical lip). I had no cuts or tears, just a couple of grazes (I think I would call them gouges!) which didn't require stitches.

There were times during the labour that I doubted my ability to birth her without any intervention, but Vinnie and Sally were so supportive, encouraging, never doubting that I could do it that it is thanks to them that I felt such an overwhelming feeling of satisfaction with the whole labour and birth, despite the incredible pain.

After sipping some of the champagne and eating half a Mars Bar I relaxed in a lovely warm lavender bath prepared for me by Carol before she left and by 4am Vinnie and I were tucked up in bed with Kira, neither of us able to stop gazing at her!

Kira is now 7 days old and the apple of her Daddy's eye - she's definitely going to be a daddy's girl! We couldn't have asked for a better baby - she's so calm and could win a gold medal for sleeping! Sally commented the other day that she was a laid-back baby because her parents are laid-back, but I think it might have something to do with the whole experience of her birth -Mum calm and relaxed (well apart from all the moaning and groaning that went on during each contraction!) in her own environment, a midwife who guided and supported without interfering, and the gentle atmosphere of candlelight.

As I said before I have already decided I want to try a home water birth next time, and I will be booking Sally to attend the birth - all we have to do is decide on how big an age gap we want between #1 and #2!!!

Suzanne Williams

suzanne at packerwilliams dot plus dot com

Update: Kira had a big brother, Jamie, in July 2003.

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