Simon's Story - Another Home VBAC

by Tikki Potter

Tikki's first baby was born by a forceps delivery, and her second was a caesarean for breech presentation. Her third baby, Sophie, was born at home, as was Simon...

It's amusing looking back through Sophie's story which reads something like "..as this was to be our last baby"!

Simon's conception came as a pleasant surprise, so when I started to bleed early on in the pregnancy I was devastated. Fortunately it all settled down and from then on I had a wonderful pregnancy, as they have all been, feeling so well and full of vitality.

Having employed an independent midwife, Elaine, for Sophie, there was no question of us not using her again. I taught extra NCT courses (Tikki is an antenatal teacher) to get together the money, even though Elaine had reassured us that we were not to worry and could pay slowly. She also reduced her fee.

I had two due dates: the one based on my last period was 1st May and the scan (from when I bled) was 7th May. I have gone at least 2 weeks over with the others and joked that this baby would be born on 20th May, my eldest son Ben's 9th birthday…little did I know!

1st due date came and went with no sign of this baby. He was in a good position and engaged. 2nd due date came and went, still no indications of a baby wanting to put in an appearance. By about the 14th May I had started to put into play some of the complementary methods of induction: ankle massage, aromatherapy, pineapple, sex etc. I was keen to encourage this baby out before Ben's birthday, so 3 days before we made a concerted effort, homeopathic remedies whilst romping round a field, followed by ankle massage, clary sage bath, nipple stimulation and sex. But still nothing, not even any significant tightenings. We then decided to put everything on hold until after the birthday weekend. Well we did, but the baby didn't!

Around 10pm on the night of 19th my waters went as I went to get out of bed. Just a trickle but definitely gone. I was mortified and had a little cry, feeling sure this would mean the baby would arrive on Ben's birthday. I rang Elaine in a bit of an adrenaline flap, shaking as I spoke. She suggested I rang her back after about ¼ hour to say whether any contractions had started. I was getting some twinges so she decide to come over to see if we could get the labour going so I didn't niggle all night.

We sent Hugh to bed, knowing that he'd have to man the ship tomorrow fairly single handedly, and set off for a post-midnight walk around the village, with, surprise surprise, a bit of ankle massage and homeopathy thrown in! No contractions later I decided to take some castor oil I had in my cupboard and went to bed. Elaine slept downstairs on the sofa.

I woke around 3am with contractions and an urgent loo visit. I couldn't lie down during them so mooched around the house, not wanting to wake Hugh upstairs and not really wanting to go downstairs in case I woke Elaine. At 5-ish I felt I really wanted some support and company, so woke Hugh up. He spent the next hour or so rubbing my back during each tightening. At around 6am I went in the bath, rolling onto my side for each contraction.

"Happy Birthday Ben, the baby's coming today" was Ben's birthday greeting as he stumbled through for his early morning wee. We did the present and card thing upstairs in between contractions, which were now quite painful. Ben and Rosie did a bit of back massage and Hugh started to re-arrange the day. Family and friends had to be redirected to my sisters where the "alternative" party was to be held after lunch, Granddad had to be primed to take 2 excited 9yr olds swimming (Ben's treat) and Sophie went off to friends down the road. Ben and Rosie had both wanted to be there for the birth and I them, so we'd tried to stay flexible about this. But Hugh didn't feel he could be there for me (and himself), and look after Sophie, aged two and a half.

I didn't feel inhibited at this point by the children's presence, but as the labour dragged on, and we reached 10 am, it was obvious they were getting bored. So off they went to my sister's, with cake.

Almost as soon as they went my contractions stopped, and from this point on my recollections and timings are extremely hazy. The baby was still lying in a good position. We did some walking around the house, dancing and up and down the stairs with no joy. We tried some nipple stimulation which produced a run of a few good contractions a few minutes later. But they soon petered out. I was getting the odd contraction here and there, but there was no rhythm, or build up with them.

Elaine felt we should have some time to ourselves and popped over the Motorway Services (what a treat) for lunch and a snooze, telling us to page her should things pick up.

I decided a sleep would be a good idea, and settled down on one side and dropped off very quickly.

I awoke after 1 & 1/2 hours to the most awful right-sided back pain. It was fairly well constant, but with dreadful waves of sickening muscular cramp type pain up around kidney level that went all around, front and back. I just didn't know what to do with myself and was convinced I'd hurt my back and was experiencing referred pain of some description. I sank into the bath and we paged Elaine. It was so hard to tell if the pain was a contraction as it was nothing like I'd ever experienced, and I really couldn't say whether my uterus was tightening or not.

Elaine suggested some paracetamol and we went downstairs. I would get the odd contraction that really felt like one, pulling above my cervix, and then the rest of the time nothing apart from the bloody horrible back ache. If somebody had offered me an epidural at that point, I really think I would have had one. Instead Elaine suggested some "hip throwing" in case it was the baby causing the pain. After about 30 mins, the pain seemed to go.

It was now early afternoon and my labour was still not really established. The sporadic contractions continued only if I kept very mobile. Aromatherapy and homeopathy seemed to make little or no difference. We talked about how I felt about this labour, and the baby arriving on Ben's birthday. I didn't feel it was of consequence now, and just wanted to get on with things. Elaine asked her partner Melanie to come for some support I think, and also because she lives some way away from me and only arrived after the 3rd stage last time.

Elaine offered me an internal with a view to a stretch and sweep, and we were all very surprised to find that I was 6cm dilated. She was able to stretch my cervix easily to 8cm (I think). But despite a rigorous stretch and sweep, I still didn't have any more contractions.

Their next plan was to get me to walk about, up and down stairs, around the house and squat whenever I had a contraction. The idea being that this might encourage the baby further down, and trigger some better contractions. I felt uncomfortable in the garden doing this as we are quite over-looked, but felt even more "over-looked" indoors with Hugh, Elaine and Melanie all there. I felt the most overwhelming pressure to perform. When I mentioned this Elaine said she'd noticed that whenever I was by myself, my contractions completely stopped, it was only around others that they seemed to keep niggling on.

I was getting very fed up and tired, but they were like slave drivers! Meant in the nicest possible way. I flopped on to the armchair and slept sitting up for about 20 mins. Elaine spent time with us exploring options and explaining what might be suggested if we transferred to hospital. She was unsure what was going on and was wondering if there was some reason why this labour was not progressing. She wanted to be clear that we understood fully.

Another couple of hours passed I think with odd runs of contractions, some strong, some weak, and then none for some time. They were very hard to deal with as I didn't know what sort of contraction it was going to be, or how strong it would be. With Sophie's I was carried through with a one way ticket and felt able to cope with the increasing pain - this labour left me feeling lost, disorientated and endorphin-less!.

Another internal found me miraculously 9cm with an anterior lip. The baby was still in the right position and well flexed and had descended. Elaine could easily push the cervix back around the baby's head and we tried to engineer some contractions with her fingers in place to do just that, but none were forthcoming. She asked me to push and the lip went up around the baby's head, but went back down when I stopped.

Next plan, get really mobile (great), make contractions and then push during them to get rid of the anterior lip. I had really, really had enough. It was late evening and I just wanted to sleep. No contractions were happening. Hugh just kept saying how like Ben's birth this was. Elaine seemed unsure what to do next and the conversation moved on to the possibility of transferring in to hospital. As she pointed out, the hospital would be keen to get the baby out and would probably suggest syntocinon, despite the fact that I'd had a C/S previously. She also pointed out though that as the baby was literally just there waiting, synto would probably mean the baby would be born very soon. I really did not want to do this, especially when Elaine said she'd recommend I went in an ambulance!

I felt I just needed a really good sleep and would have renewed energy to get on with it. "Couldn't this just be a very, very long 'rest and be thankful' stage?" I can remember asking. In the end we negotiated a sleep for as long as I wanted, and when I woke up we would have 1 hour at trying to get the baby out. If this wasn't successful, then I'd go in. So at around 1am I went up and crashed in bed, whilst Hugh, Elaine and Melanie apparently sat discussing the events and how they were sure that I would wake in cracking labour.

Unfortunately, I awoke at half 2'ish with the awful back pain again. I lay in bed rocking from side to side unsure what to do again. After 10 mins I had to wake up Hugh as I couldn't cope. I then remembered I had a TENS under my bed that was for antenatal class demo purposes. Hugh got it out and put it on. Once we'd got it operating (instructions of "watch the video" aren't greatly helpful) it did seem to make a slight difference.

Just before 3 we woke Elaine as I felt I couldn't go on any more. The back pain was sickening and again I really didn't know if I was contracting or not. Elaine performed another internal and I was fully dilated (baby still in good position). It was suggested I should get up and move again to encourage the contraction, but the pain in my back was so intense that I just couldn't. Again I took some paracetamol.

Still no notable contractions to work with or urge to push, faced with the choice of transfer to hospital or pushing without any urge to do so, I chose the latter. Elaine kept her fingers in place to try to give me some indication of where to push, and Melanie told me when I had a contraction. It felt very wrong to breath hold and push like hell, for as long as I could. I knew, and Elaine acknowledged, that it wasn't ideal. We tried with me kneeling upright on the bed onto the headboard, me lying on my side. Elaine and Melanie wanted to try one contraction with me in McRoberts just in case that was the problem, but of course, I didn't have any contractions in that position.

Hugh started to potter round and pack a bag for the transfer into hospital. Much as I didn't really want to go, it was now looking rather appealing. I felt I had had enough.

My back pain had eased off again, possibly due to the paracetamol or TENS. So I was "bullied" into getting up. Elaine suggested a half kneeling position, but it didn't feel good to push in that position. It seemed to send the direction of push off to the side. All I managed to push out was a huge wee all over the absorbent pad!!

The hour was up, but Elaine suggested just ¼ hour more of going up and down the stairs, as there was no way this baby was going to be born unless I had some decent contractions. So at just gone 4am I started off down those bloody stairs but half way down just felt I'd had enough. I asked Melanie if I could give up. She laughed in a gentle way and pointed out that it wasn't giving up, all I could do was my best. I reached the bottom and said I wanted to transfer in. As we turned around to head back up to get sorted, I felt a contraction coming. I did not want this one, I had made up my mind to go in! Two steps up "Is that a contraction Tikki" asked Melanie, "Just a little one" I replied, doing my best to get up those stairs and ignore it. Four steps up, little contraction turned into BIG contraction with a real guttural moan at the end. "That doesn't sound like a little contraction" was Melanie's comment. Followed by "Do you think you could be a few steps up by the next contraction?" Ever compliant I crawled up a couple only to be hit by another very purposeful contraction, the end of which felt rather pushy. This revelation by me, was passed on upstairs rather like it followed some military reporting protocol, and repeated excitedly by Elaine and Hugh who both rushed to the top of the stairs.

The next couple of contractions left me in no doubt now that this baby was on its way. I could feel the head coming down and round, pushing on my sacrum.
Elaine swapped places with Melanie and had a look and could see the head. She asked if I was going to have the baby on the stairs, and as it was so comfy, and the only bit of carpet with underlay, it seemed like a great place. Hugh lay on the landing with his head beside mine, and Elaine struggled to keep the cat out of the delivery pack.

For the last couple of contractions I didn't feel the need to push at all, I could feel my body doing it for me. It all felt very calm, if a bit painful!

At 4:30 on 21st May, out came Simon Patrick "Harry" Potter. He had waited until his brother's birthday had passed. He sat on the stairs briefly as I turned round, I felt too shaky to take him through my legs on the stairs. I scooped him into my arms, and Hugh and I discovered we had another son.

As I'd already agreed, due to a long labour that didn't seem exactly overflowing with oxytocin, and the history of a bit of a bleed with Sophie needing syntometrine, I had the injection as soon as he was born. Again the cord felt a bit worrying and Elaine asked me to squat and push out the placenta with the next contraction. My uterus remained a bit boggy and I had a few gushes, which was worrying for me. An injection of ergometrine later and my uterus had the consistency of a brick and the bleeding stopped.

At that point the family arrived back. I hadn't realised that the children were being delivered back at 5am by my parents who had to go on elsewhere. So although they missed the birth, they and my parents saw Simon while he was still very new. Everyone had cuddles, Simon had a feed, balloons were put out to let the village know, and Elaine and Melanie cuddled and thanked for their patience, perseverance and faith in me.

Simon weighed in at 9lb 8 ¾ oz. His apgars were fine, his head remarkably unmoulded and round. He seemed not all put out by his bizarre journey into this world.

Elaine continued to visit me for 2 weeks and gave me plenty of time to talk through the experience. Thinking about it, it was indeed very similar to Ben's labour. But with Ben I'd been in hospital and things had been moved along more swiftly. If I'd been in hospital this time I'm sure that would have happened again. If I'd survived without a ruptured uterus (!) I may have been very thankful that my labour hadn't been so protracted. But with the benefit of hindsight, I am so very, very happy that Simon was born at home. That triumph, that amazing feeling of power, that you did it by yourself, cannot be beaten.

I was, yet again, fortunate to be looked after by a very competent and experienced midwife. She enabled us to push the boundaries of "acceptable" further than most NHS midwives would have felt confident or able to do. During her antenatal and postnatal visits she became like a member of the family.

Both Hugh and I will be eternally grateful to her and Melanie, and they will always remain a part of our lives, either in person, or in our memories.

Tikki Potter

Thames Valley Midwives - Tikki's midwives, Elaine and Melanie.

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