Home Birth Reference Site

William's Home Birth after a Caesarean, by Tina V

My first birth was not what I had wanted it to be. I had planned a homebirth throughout, but when I was told that my baby was measuring big, the pressure started to have a hospital birth. Despite my research that birthing a 'big' baby at home was not a problem, my confidence had been knocked and I eventually agreed to a hospital birth, with the compromise that the midwives would come out and support me at home for as long as possible and that I would transfer to hospital 'late'.

My labour started at 4.30 a.m. with contractions 2 minutes apart lasting 45 seconds to a minute each, and the pain was overwhelming. My baby was back-to-back . After 5 hours (three without midwives) we decided to transfer in for an epidural. By 9 p.m. I was stuck at around 4 and a half to 5 cm and the CTG was showing late decelerations. I was told that my baby was in serious distress and I needed to have a caesarean straightaway. My 10lb 6 oz baby was born at 10.32 p.m. with apgars of 10 and 10.

As time went on I became more and more upset and angry about my caesarean and before I got pregnant with my second I knew that I wanted a natural delivery, preferably at home. When I got hold of my notes from my first labour and discovered that those contractions where I had been lying on my back in hospital and apparently stuck without dilating had actually been turning my baby into a good position for birth and even worse, that I had apparently had my section for failure to progress and not foetal distress (which wasn't mentioned at all), I became very angry and disillusioned. I knew that had I been given the proper support throughout that labour I could have birthed my son vaginally.

So when I was pregnant with my second child, I fought hard for the kind of birth that I wanted. I researched the risks surrounding vaginal birth after caesarean, researched hospital VBAC (Vaginal Birth After Caesarean) policy, researched HBAC (Home Birth After Caesarean), hired a doula, used natal hypnotherapy CD's, and bought a birth pool and lots of lavender essential oils for burning and massage. I concentrated on convincing myself that I could and would give birth vaginally and that my body knew what to do if I just let it. So when the labour finally started I felt like I was ready for it!

I had been niggling for a couple of weeks with regular contractions which would last for about an hour and a half or so and then they would stop. It was really frustrating! But then on Easter Saturday night (term +11), my parents had been over for dinner as they were staying locally for a family 'do'. About 5 minutes after they left I went to the loo and about a minute later felt a trickle of something. It might have been due to a lack of bladder control, but I really didn't think so. About 5 minutes later I had a quite noticeable contraction. The contractions continued but they were fairly irregular 8 minutes, 7 minutes, 10 minutes, 15 minutes, 8 minutes etc etc. I was also getting a lot of discharge.

Eventually I went to bed. Throughout all of my niggling, whenever I lay down they would stop, so I thought that would be the best way to tell if this was the real thing or not. They didn't exactly stop, but they did seriously tail off, so I resigned myself to more waiting! That night I couldn't sleep properly and couldn't get comfortable. DH put my TENS machine on but I still couldn't sleep so I eventually got up at 5 a.m. for some raspberry leaf tea and a bounce on my birth ball and timed some contractions (I used Contractionmaster.com for some of them as that way I didn't have to look at a clock. I could just hit the space bar at the appropriate time and then after a few look to see what was happening). The contractions were about 8 or so minutes apart, fairly regular and noticeable but easy to deal with.

When we got to a sensible time of day we called my parents and asked them to look after DS1. They arrived at about 10 a.m. and off DS went. We got ourselves busy blowing up the birth pool and filling it to two thirds full. I knew it was too early to use it, but we hadn't done a trial run and therefore didn't know how long it would take to fill, so we had decided to do it early and then top it up when the time came. The major downside at this point was that my cold, which I had thought I had got rid of, was back with a vengeance and my left sinus was excruciating!

We let our doula know what was happening and got ourselves ready to meet our new baby. Unfortunately the contractions became really irregular again, and although I had some quite strong ones, they never got established. Our doula popped over a couple of times during the day to see how I was, but as nothing major was happening whilst she was there we agreed she should go home again.. Before her second visit I had been having some quite strong contractions whilst lying on the sofa that I had been having to breathe through, but whilst she was there they tailed off and then after she had left I had the strongest of the day! Typical!

Anyway, we decided to have some dinner and then go to bed and see whether I could get some sleep. I went to be at about 10 p.m. At about 11.30 p.m. I was woken by a strong contraction and jumped out of bed I instinctively had to lean over the bed and rock my hips and really work on controlling my breathing to get through it. I found that making a low-toned moaning sound on the out breath really helped. The contractions carried on like that throughout the night, sometimes 40 minutes apart, sometimes 30 and never closer than 20 minutes, but for each of them I had to get out of bed to deal with them. They were a little bit difficult to deal with mainly because I was waking up in pain, rather than building up to each one whilst awake. The really good thing was that I was able to sleep in between them so by morning I actually felt really refreshed!

At 7 a..m. I woke DH up and he made me a coffee which we had in bed without the disruption of a toddler for the first time in years bliss! I was still getting contractions but they were easier to deal with now I was fully awake for them. After that I got up and had a shower again I had a few more contractions whilst I was in there, but they were easy to deal with, especially when I had my DH holding the shower over my lower back during them. I checked my cervix in the shower and could hardly find it the contractions through the night had definitely been doing something and I estimate it was about 95% effaced by the morning. I also had a big show whilst I was in the shower.

Once I got out of the shower things really started happening and there was no doubt this was it. The contractions got to about 5 or 6 minutes apart and I had to really concentrate to get through them, but was able to cope really well with just slow, deep breathing and my TENS machine. I had been using Natal Hypnotherapy VBAC preparation CD's and found that by saying "3, 2, 1 relax, Tina" slowly during each in breath and then making the low-pitched moaning sound on my out breath I was able to control my breathing and breathe really slowly and deeply which meant that I could deal with each contraction fairly easily. Our doula came over at about 10.40 a.m. and I got in the pool pretty much straight away when she arrived. Oh my god the pool was amazing! The contractions were now coming at about every 5 or 6 minutes and I don't know whether the pool necessarily reduced the pain (which was still very manageable) but it made it so much easier to properly relax in between, which in turn made it easier to deal with the contractions when they came. I was also able to get into much more comfortable positions than would have been possible on dry land.

The contractions started to get a bit more intense and my doula and my DH swung into action. I was kneeling in the pool leaning over the side during each one, whilst holding my DH's hands. My doula was using tea towels soaked in really hot water to rub over my back during each contraction (yes my DH really did need to boil kettles and get lots of towels, lol!).. I cannot tell you how much that helped! In between contractions, Dh was sorting out the rest of the room getting a mattress out and lighting my lavender oil burners and candle (not that I could smell them because of my cold!). At one point he moved a side table and saw some dead leaves underneath it and decided to get the hoover out! He got told in no uncertain terms that if he turned it on I would find a way to cause him lots of pain! It wouldn't have been so bad, but it's not like he does a lot of hoovering when I'm not in labour, lol!

The contractions did slow down a bit and I had a couple that were about 8 minutes or so apart, so my doula mentioned that if they slowed down much more I would need to think about getting out of the pool, which I really didn't want to do! We had agreed to call the midwives when they were 3 minutes apart and a short while later they were! We called the midwives at 12.25 p.m. and the first one arrived about 45 minutes later. A second midwife arrived shortly afterwards. The midwives did their checks: my blood pressure, my temperature etc. Then the first midwife asked me to get out of the pool so she could palpate my tummy to see where baby was. I agreed, but only on condition it would be quick the thought of having a contraction out of the pool whilst lying on my back was not appealing! We did that and he was still ROA or thereabouts. I jumped back into the pool just in time for the next contraction.

I went to loo at one point and they asked me to wee on a stick and then told me that I had to get my energy levels up and eat and drink something quickly, so my doula and DH kept making me drink lucozade sport in between each contraction as I couldn't eat a thing (I had three dried apricots all day until after the birth!)

She then asked me about a VE. This was one of the things I had been worried about as I knew that the stopwatch could start ticking, especially as a VBAC'er. Eventually at about 2 p.m. I agreed as, in my heart of hearts, I knew that the contractions had been effective and I felt the need to know how much! She was able to do this whilst I was in the pool and I was 5 cm. Everyone else was really positive about this but I actually felt quite deflated and didn't know how I was going to get through the next 5 cm as the contractions were starting to get really serious now!

I started shaking and remember looking at my doula in panic saying I couldn't do it anymore and I didn't know how I was going to cope with the rest of labour. Of course, these are all classic signs of transition and in the conscious part of my brain I knew this, but there was no way I could believe I had progressed so far so quickly. My doula and my DH were great they kept me focussed on dealing with each contraction one at a time and it really helped. Unfortunately my doula had to stop with the hot towels as apparently my back was getting a bit raw from it not that I had noticed, lol! So she started in with the lavender massage oil instead which also worked really well.

The midwives suggested that I try gas and air, and although I had been a bit reluctant beforehand, I thought I still had hours to go, so I agreed as I didn't think I would make it all the way without it. The gas and air was interesting! It was a completely different way of breathing from the slow deep breathing and moaning I had been doing and I wasn't sure whether I liked it, but it definitely acted as a distraction. I got through one tank in what felt like about 4 contractions (no idea how many it actually was, lol!) and started on the second. They called for more to be brought along, but we never got that far, as I had started feeling a bit pushy by now and didn't need the gas and air anymore.

It started to dawn on me that I was there or thereabouts when the midwives started getting concerned about the temperature of the pool and I realised this was because of the baby and not because of me! This was around 3 p.m. although I only know this because the first midwife's shift finished at 3 p.m. and I remember my doula saying that she wanted to stay because she was convinced the baby would be here in half an hour. She was a little bit out with her estimate!

With hindsight we think the pushy feeling I was getting was probably a premature pushing urge as when I really did start pushing, it felt completely different. The first midwife did say at one point that once I started pushing they had time constraints. I knew that unless the baby was showing signs of distress I was going to ignore any arbitrary time constraints so I told them to ignore the time too they said "We are!". Good for them.. I remember joking with them at this point that really I was only pretending to push. My doula suggested that I check myself to see what I could feel. I told her that I could feel a hard ridge inside and she said to me "That's your baby!". Wow!

The replacement midwife arrived at about this time. It turns out this third midwife is a Supervisor of Midwives and she was definitely a bit more twitchy than the first two had been, but everything was still okay. I agreed to a second exam at about 4.15 p.m. and they confirmed that I was fully dilated (not that I really needed anyone to tell me that as I was most definitely feeling an uncontrollable and overwhelming urge to push!!) so they took the start of the second stage from then.

I was still kneeling and leaning on the side of the pool during each contraction and pushing away whilst growling at full volume like a lion (it felt like roaring to me, but I am reliably informed it wasn't, lol!)! It was extremely liberating and felt completely natural! After a while (no idea how long, though) the midwives suggested that I might want to put my chin down during each contraction and moan rather than roar. I asked why and they said no reason other than that my throat would be so sore I wouldn't be able to speak the next day otherwise. Actually they were right and by putting my chin down I was able to focus my energies downwards a lot more easily. The midwives were checking the baby's heartbeat after each contraction and it was absolutely fine.

There was a point in the second stage, fairly early on I think, when I was getting some pain over my scar in between contractions. Deep down I knew it wasn't a problem, but I also knew that I had to mention it, because if I didn't and something went wrong I would never be able to forgive myself. The third midwife was obviously very concerned when I mentioned it and questioned me closely, but apparently what I was describing wasn't the sort of pain which worried them. It felt like an intense tingling sensation right over my external scar and was really uncomfortable, but a few contractions later it seemed to calm down again and looking back it was really as if during the contraction this area was tightening up and then at the end of each contraction it just took a little bit longer for this bit to relax. Over the next few contractions though it was able to relax more and more quickly until there wasn't really any noticeable sensation any more in between contractions thank god!

The second stage was progressing fairly slowly I think, although I wasn't aware of time, so they suggested that I might like to stand up and hang off DH's neck and push in that position. They said that the main thing I had to decide was whether to stand and deliver above water or whether to kneel and deliver under water. I tried both! The midwives and my doula were great cheering me on and telling me I was pushing really well, but it also felt like a really intimate thing between me and DH. We definitely gave birth to our boy together! DH's back hasn't been the same since, though...

After a while they were trying to see whether the head was there and I couldn't believe they couldn't see it it felt like it was almost out. My doula suggested that I reach down to feel for the head. It was amazing the head was still inside, but I could feel it and it was covered in hair. No-one knows when my waters went, except that it was sometime between 5 cm and 10 cm, but I suspect that it was quite soon after the VE at 2 p.m. and that was why the last 5 cm was so quick. There was a point at which the water in the pool went a bit cloudy and we think that must have been from my waters, but no-one paid any attention to when that actually was!

I was pushing away and started to feel the head descending more with each push. I was trying to hold the head down in between each contraction and I think I may have had a bit of success, but it did slip back a bit each time. Then a few pushes later and I could feel the head crowning. The third midwife started going on about the length of time it was taking, but I just ignored her and blocked it out and concentrated on getting my baby out. It did sting when his head was crowning but I just told myself over and over that I didn't care about that I wanted to make sure that I wasn't sub-consciously holding back. The only problem now was that I was starting each contraction standing but ending up in the water, so the midwives told me that I had to choose I had to be either under water or out of it, so I decided that I would get out of the pool. DH let out some of the air from the pool as I stepped out to make it easier to get out the head was halfway out at this point and not going back in at all. I instinctively went onto my hands and knees just in time for the next contraction and his head was born with that push. Absolutely amazing!

The midwife did fiddle around a bit and at the time I thought she was helping the head out, but it turned out that the cord was around his neck and she was removing it. The next contraction came and out came his shoulders with no problem, although they did need to wiggle his hips a bit to get them out. William Jacob was here! It was 6.03 p.m. after an established labour of 8 hours. The second stage was recorded as 1 hour 45 minutes. William was officially 13 days late.

The midwives gave William a quick rub with a towel to get him going and then he was handed to me through my legs all within a minute or two of his head being born. It was such a different experience than after my CS where I didn't get to hold my DS until a few hours later when he was already dressed..

I leant back against my sofa and had some lovely skin-to-skin cuddles. I remember touching his head and recognising the part I had touched when he was still inside. That was magical. 17 minutes later at 6.20 p.m. he had his first breastfeed. I had a couple more mild but quite uncomfortable contractions and someone suggested I gave a gentle push. Out came the placenta just 27 minutes after the birth. It was in good condition (although they did find a knot in the cord, which may have been there throughout or may have happened when they took the cord from round his neck) and we have kept it and planted an apple tree in the garden with it.

Shortly after delivering the placenta DH had a cuddle with William whilst the midwives checked me. I had a small second degree tear (no stitches) and some grazing. I also had a prolapsed cervix, which the midwife pushed back in (painlessly!) and told me to make sure I do my pelvic floor exercises. They weighed William and he was a healthy 9 lb 9.5 oz with a head circumference of 36 cm and Apgars of 9 and 10.

An hour later and the midwives had tidied up and left and I was enjoying a (small!!) glass of champagne and St Agur sandwiches yummy! We had our first visitors at about 9 p.m. and that's when it hit us that if we had been in hospital my DH would have already been sent home by then and I wouldn't have seen anyone until 10 a.m. the next morning.

It was an amazing birth which in many respects was made all the more special by the fight I had had during pregnancy to have a homebirth after caesarean. People had told me I was risking the health and possibly the life of my child, but we knew that for us by giving birth at home we were actually giving our son the best chance of a good and happy start to his life. I am completely overawed by the strength of the labour. I was (apparently, lol!) calm and in control throughout the labour but it was instinctive and I had no choice in what I was doing: I just had to do whatever my body made me do and in my heart of hearts I know that it worked because I didn't question what my body was doing, I just went with it something that is a little bit unnatural for me! I also know that there is no way my DH would have participated so much in the birth if we had been in hospital and his complete involvement is one of the things that has made the experience so special for me. The pushing stage was really quite amazing - really hard work, but the contractions were completely different from the first stage contractions, and didn't hurt as such - they were exhausting and it was difficult to deal with at times but there was no choice but to go with them!

I couldn't have done it without my doula and my DH and I really feel like it was a team effort. 2 weeks later and I am still on such a high. The grazing caused me some discomfort for the first week, but the tear has been no problem at all. I most certainly wouldn't change a thing about the birth.

Tina V

Related pages:

Pain relief - what are your options at home?

Waterbirth at home

Big babies and homebirth

Doulas - professional birth partners.

Get Your Baby Lined Up - what it means when your baby gets in an awkward position, and what you can do about it.

Hypnotherapy for childbirth

Overdue - but still want a homebirth? When is 'postdates' risky?

The Third Stage of Labour - what are your options, and the pros and cons of each?

Fathers and home birth - fathers' feelings about the birth, and how they can help.

Homebirth UK email group

Home Birth After Caesarean

UK VBAC/HBAC (Home Birth After Caesarean/ Vaginal Birth after Caesarean}) group: http://groups.yahoo.com/group/ukvbachbac

Home Birth Stories

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