Jane’s Birth Story
told by Kay

Jane certainly had an interesting previous birth history including 2 caesarean sections and 2 induced labours. It was the on-going kidney disease that was the most concerning however and how pregnancy and birth might adversely affect her. Jane could most certainly be considered ‘high risk’ which is why she was unsupported by the NHS in her wishes for a home birth.

From the offset Jane had had to deal with increasing negativity starting from why she had got pregnant in the first place to the facing up to acute kidney failure. Jane’s plan had always been to have a six children and this baby would make the family complete. She told me about other kidney patients she had met whilst seeing her specialist – those that followed their instincts and did what felt right always seemed to do better than those that followed all the rules. Planning birth in the relaxed atmosphere of home felt right too - and this was going to be the last time she would have the chance! Of course the role of the midwife as well as supporting women’s choices, is to provide safe care for mother and baby. Jane was fully informed about the potential risks surrounding the birth process and the additional risks surrounding her kidney disease. I accompanied Jane and her husband David to an antenatal appointment with the consultant obstetrician to ascertain exactly what additional care could be offered in a hospital setting that couldn’t be at home. The obstetrician wanted to do an elective caesarean section but Jane was adamant she wasn’t having that. We put together a comprehensive plan of care for labour and the immediate post natal period which included taking blood tests, careful monitoring of blood pressure and fluids in and out. Our threshold for transfer to hospital would be low and I checked with ambulance control in the area as David had expressed concern about how long a journey by ambulance might take. I sent a letter to the head of Midwifery in the area detailing the plan of care. She telephoned me the next day to say she’d received it and that she would pass it on to the relevant staff who might become involved.

Jane went into labour 4 days after her due date. As soon as she rang me to say her waters had gone, I was on my way green light on! Although Jane’s other labour had been longish I always felt this one wouldn’t be! I rang Virginia and she set off too. When I arrived at the house, Jane was obviously in established labour but still managing to walk around to organise Max – Dave was on this way and the other children were at school. Jane was finding the pains tough – I put the TENS on for her and brought in the entonox. Virginia arrived soon afterwards. Bloods tests were taken as planned but a community midwife wasn’t forthcoming so we had to ring round for a taxi to take them to the hospital.

We informed the labour ward at the hospital that Jane was in labour and that the blood test were on their way. Labour progressed quickly and normally. Virginia then had to deal with a telephone call from a labour ward manager who was very agitated as she had not received the plan of care that had been sent previously – she was being instructed directly by the obstetrician at the time. A lovely baby girl was born soon afterwards – much to the delight of us all, and a huge relief to Jane!

Another telephone call came from the hospital to say that one of the blood test had clotted so it must be taken again. This was unreasonable as Jane had just given birth and the plan was to repeat all the blood test again in 6 hours anyway. I telephoned and spoke with a supervisor of midwives who agreed and said that Jane ‘was not a pin cushion’. In the hours that passed we carefully checked Jane’s blood and made sure she was passing urine. Baby Jasmine was greeted by her brothers and sisters, had a good breast feed and cuddle. I helped Dave and Jane’s eldest daughter Charlotte prepare dinner and we all sat down to chicken pie.

Then a community midwife knocked on the door with a letter from the hospital obstetrician detailing what care Jane should receive! This had obviously been written following the phone conversation Virginia had had earlier. Virginia and I were angry about this and felt we were being bullied and speechless that Jane had had to pay £30 for a taxi to take her blood tests to the hospital as a midwife couldn’t come to collect, yet it was ok to send a midwife now with an instruction letter after the event! Our plan was to stay with Jane for six hours after her birth to check she remained well. More blood test were taken, we said our goodbyes and left for the hospital to hand over care as the community midwives would be doing post natal visits.

What a fantastic day and well done Jane for trusting in your abilities to give birth the way you wanted to. Virginia and I were walking on cloud nine too as we felt we had truly been ‘with woman’ that day.