Diana's
story
I
have, since I was a teenager, always expected that any baby I
had would be born at home. So when I came down with pre-eclampsia
with my daughter, I was shocked and horrified that they wanted
me in hospital and wanted to induce me. I fought for seven days,
but eventually agreed to the induction - which failed - and eventually
agreed to a caesarean. I had at that stage all of the stuffing
knocked out of me. I didn't have the confidence to try for another
home birth.
When
I became pregnant this time I was aware that I didn't agree with
the NHS' "rules" for VBAC births. I wrote to Pembury
Hospital asking specific questions about things such as using
the birthing pool and the use of a hand-held monitor. The reply
made it clear that I was on a collision course with them. At the
same time I started to read VBAC websites and other info and realised
that I really HAD NO CHOICE but to go for a home birth. I knew
from Pembury's "guidelines" that if I put my foot down
they would send out a midwife to me at home. But I decided I didn't
want this birth to be a fight and I employed
Virginia Howes [who I know has two other clients who read this
list - although I don't know who they are] to be my independent
midwife.
The
main difference in the care I received from Virginia to that of
my NHS midwife last time [who always came to my home as well]
was that her overwhelming expectations were that it would happen
the way I wanted. My NHS midwife, who I liked as a person, always
talked about ifs and buts and conned me to sign forms about going
into
hospital if XYZ happened.
The
birth:
It
was all new to me as I had never experienced labour, let alone
even had a contraction. On Monday I had what I thought might be
a show. Then around Tuesday morning I awoke around 2am and realised
that I was having very mild contractions. These continued throughout
Tuesday until about 11pm Tuesday evening when they became painful.
Each time I had one I had to get out of bed and walk around with
the Tens machine. They were coming every 5 minutes through the
night [although I think I slept through the occasional one]. At
7am I called Virginia and she arrived by 8am.
Cliff
didn't start filling the pool until 8.30am, so it wasn't full
enough until about 10.30am. I had started yelling with contractions
around 9am - but still found walking around during contractions
the best. I was hesitant about getting in the pool because I felt
that I
would need to stand up with every contraction. But I was more
comfortable in the pool. Later on around lunchtime I asked for
gas and air. It didn't seem to take the edge off the contractions,
but it really helped me to breathe in and out deeply and stopped
the
screaming - which was making my throat raw.
I
stayed in the pool until Virginia said she thought it was a good
idea to do an internal. In theory I thought I wouldn't mind internals
[they were one of my greatest bug bears about the experience of
having Maia in hospital], but I really didn't want one when it
came down to it. But I knew she was right and inside me wanted
to know how well dilated I was. Eventually I got out of the pool
and had the internal. Apparently I had fallen asleep very
briefly in the pool. Virginia said I was 7-8cm's dilated. But
at this point I was started to get a bit negative and replied:
"so you mean 7". In reality it must have been 8.
I
asked her if I could have pethidine, but she said if I had it
I would have to come out of the pool in case the baby was born
floppy. So I decided against it - knowing in my heart of hearts
that it was the wrong thing to do at that point. She encouraged
me to walk to
the end of the hall and back, which took a good 10 minutes. Once
I got back to the lounge I had one contraction in which I started
pushing involuntarily.
I
went back into the pool then. I remember feeling very negative
and asking if I could go to Pembury [knowing full well this was
ridiculous as I couldn't have faced the drive] and have an epidural
:). Several times I said I couldn't go on. But I knew in my heart
of hearts that I could and I had to. I really didn't believe that
Virginia and Cliff could see the head. But I began to feel it
crowning after about an hour and a bit of pushing. Once it did
crown, I could see the end was in sight. I knew in my head I should
be breathing the baby out, etc etc, but I just wanted to get it
out, tear or no tear! After three or four contractions the head
popped out. What a relief that was. It was then one more big contraction
and the body followed. I have never felt so relieved in my entire
life. He came to the surface and started breathing immediately
- so I didn't have to get out of the pool. After a few
minutes Virginia put a stool in the water for me to sit on. Within
10 minute there was another contraction and the placenta shot
out. I didn't realise they could come so quickly without drugs.
I
had torn, but not bady. In the immediate aftermath I was quite
shocked at just how intense giving birth is. It's
now five days after the event and I am very glad I did give
birth at home. I'm sure going to hospital would have been the
first step in a very quick slippery path to intervention. After
my caesarean I was too ashamed to tell anyone that didn't need
to know that I had had one. In the last five days I have told
everyone I
know that number 1 was by caesarean and this one was at home.
I was hoping that it might be inspirational to other women in
my situation. I've certainly spoken to two women I know who had
caesareans first time around and who had serious doubts they would
be able to give birth naturally in future.
When
the doctor came around for the home visit he commented that the
practice recommended women go to hospital as "all the evidence
shows it is safer". What a load of baloney. Virginia is writing
to him to point out that this is just plain wrong.
Although
I've not been involved in this eGroup so much in this pregnancy,
I did get a lot of helpful support and information last time around.
It's such a wonderful resource for anyone who wants a homebirth.
Why
I chose an independent midwife
I’m
someone who thinks twice before spending 50 pence. So it may seem
odd that I’d pay £2,000 for a service I could get for
free from the NHS. But could I?
My
first birth experience went from bad to utter disaster. I’d
planned a home birth. In the end I had a caesarean. It was an
outcome that I could not have contemplated and certainly didn’t
come to terms with until very recently.
When
I fell pregnant second time around I thought initially I would
choose to go to hospital. I lacked confidence in my ability to
labour and give birth naturally. And I was scared that I would
be the one in 200 women whose scar tears open under pressure from
contractions. This I knew had a high chance of resulting in my
or the baby’s death.
But
then I started reading anything and everything I could find about
vaginal birth after caesareans [VBACs].
In
her website www.homebirth.org.uk <http://www.homebirth.org.uk>,
Angela Horn writes: “Around 75% of VBAC candidates do give
birth vaginally, but the remaining 25% who have repeat caesareans
will do so for many reasons - rarely for uterine rupture.”
But
it was when I read that home VBACs had a much higher success rate
than planned hospital VBACs that I really started thinking.
Soon
after I wrote to the head of obstetrics and gynaecology at Pembury
Hospital explaining that should I give birth there I would expect
to use the birthing pool and did not accept that continuous fetal
monitoring was appropriate for me. The latter, I had read time
and time again, was used as a poor replacement for one-to-one
midwifery care.
The
reply, which included a copy of Pembury’s “guidelines”
[rules] for VBAC births, convinced me that should I walk through
the swinging doors into the labour ward I would have my heckles
up - not a good situation for a labouring woman. Among other things
I would be given a vaginal examination on arrival, followed by
two-hourly vaginal examinations. If this wasn’t enough to
put me off giving birth at Pembury, I was told that hand-held
monitoring was out of the question. That meant labouring on my
back with a continuous monitor on.
If
also found it insulting that I would, in the hospital’s language,
be coming in for a “trial of labour”. Hogwash. I would
be going in to “give birth”. Even at Pembury, more than
65 per cent of VBAC women give birth naturally.
As
far as I could see, the hospital saw me as a walking uterus threatening
rupture.
For
much of the next couple of days I struggled with the idea, but
eventually realised that I had little choice but to plan a homebirth.
Pembury’s
guidelines did, interestingly, say they would send a midwife to
home if a woman “insists on home birth”. But I feared
that on the day I would be sent a midwife who didn’t have
confidence in me or experience with VBACs and I would be transferred
to hospital forthwith. Had I ended up with another caesarean,
I would have never known if it was in my best interests or due
to a lack of experience by the midwife, insufficient care, or
obstetric anxiety.
Choosing
an independent midwife was not difficult. A friend of mine had
employed Virginia Howes for a hospital birth and I was very impressed
with Virginia’s skills as an advocate.
Pembury
and Maidstone hospitals do not allow independent midwives to practice
- although many other hospitals do. But they can attend as doulas
[birth partners]. This was sufficient for me. If I needed to transfer
from home to hospital, I had an experience professional with me
who had my best interests at heart and was able to fight on my
behalf.
As
it transpired, I went into labour naturally, and the birth was
trouble-free, if long. Virginia monitored me regularly and checked
for signs of the uterus rupturing, but nothing went wrong. The
first stage was 18 hours and the second, an hour and a half.
I
often wonder what would have happened if I’d gone to hospital.
My labour was only minutely bearable when I was in the pool. I
couldn’t bear to be on dry land - let alone on my back with
a continuous monitor. Pembury’s rules also said that a registrar
must be called if the active second stage continued for more than
30 minutes. Mine took three times that. Would I have been pressured
to have a caesarean at that stage?
Ultimately,
all I know is that Virginia had the experience and the confidence
in me to let a perfectly normal birth progress to a natural conclusion.
Coughing
up the £2,000 for Virginia’s services hurt. But I would
still employ her if I had my time over again. If I’d had
another caesarean, my partner Cliff would have had to take weeks
of unpaid leave off work as we don’t have close family support.
It would have cost us just as much.
End
