|Saskia Rose's Birth|
For my first daughter, Lily, I planned a homebirth. I don't like hospitals and I certainly didn't feel ill. I didn't even really like the routine monitoring and scanning offered in pregnancy. It always felt to me as if people were looking for things to go wrong.
I did my research, was encouraged by women I'd met at the local homebirth support group and the information and stories I found on websites and an online discussion group. With my homebirth 'booked', I was excited and waited for 'the day'.
As with many first labours, 'the day' was actually several days of things getting started. It was a very hot early autumn, sleeping was difficult and I spent three nights pacing the flat into the small hours, wondering if 'this was it'. By the time things did eventually get going, I was pretty tired.
My local community midwifery team were very busy that night and a midwife from the neighbouring area arrived, who I'd never met. This wasn't necessarily a problem in itself, but for me, on the night, it was. She was not the right attendant for me. I remember feeling anxious that she was perhaps not comfortable and even tried to make jokes or put her at ease. Perhaps she was tired too. She didn't seem very interested in being there or even in being a midwife. She watched the clock, examined me regularly and gradually eroded the confidence I had that I was doing okay. She called her supervisor and with every check and exam, discouraged me further. My pleading for more time began here.
Eventually, she suggested we go to hospital for pain relief in order for me to rest. We were left alone to discuss this. Reluctantly, I agreed, on the proviso that I would have a 6 hour discharge following the birth. A surreal ambulance ride later, where I refused to sit or lie down, we arrived in the labour ward. 'My' midwife handed over my notes and practically ran away. I've never seen her since, nor do I think I'd even recognise her face. I only remember her name because it's in my notes.
Strangely, even though I was where I absolutely did not want to be, I felt a momentary sense of relief that new faces might help me more than she had. I say momentarily because my fate was more or less decided the moment I set foot in the hospital. I had the strange experience of witnessing things happen to me in a textbook fashion to illustrate the 'cascade of intervention' I had read and heard about. It was strange to be aware, for example, of begging for the midwife watching the monitor to help me kneel up on the bed to help my baby get in a better position or see me pleading for more time to get my baby out naturally, and avoid a caesarean. It was plain humiliating to have three obstetricians ram their hands up inside me to decide how they thought the baby was lying. They never agreed, except that it was high. Good baby, I thought, who'd want to be near their probing fists?
I had arrived at 7am at the hospital about 8cm dilated. By about 4pm, I'd had an epidural, had my labour augmented with synthetic hormones, and, with numb legs and yet another internal exam, was informed I had reached the magic 10cms. As if to rub my nose in my silly homebirth fantasy, the consultant stood at the foot of the bed (were her arms crossed or is that my memory giving me poetic license?) and suggested I try to push. Inevitably, I couldn't feel a thing and, crushed, agreed to their sordid caesarean operation for 'failure to progress'.
I remain convinced that I could have birthed my baby. I was devastated that this had happened. It forced me to question so many things, not only about the birth but about myself, my partner, our relationship. How could the exact opposite of what I had hoped and planned for, have happened to me, chapter by chapter? What had I done wrong? Why didn't my partner protect me? What kind of a weak person and, now, mother, am I? God, it even has a label: 'failure to progress'.
It is not too dramatic to stay that, on one level, this event destroyed me. BUT, it set me on a journey of recovery, empowerment and understanding which enabled me to make the choices I made for my second daughter's birth.
Thank God for the internet! Slowly, as I came to terms with my feelings about this, in my view, unnecessary caesarean (I will always refer to the reason for the surgery as 'failure to wait'), I realised that I was not alone. I discovered that my feelings of wanting to grieve, sense of failure, guilt and shame to name a few, were not only common but perfectly normal responses to a traumatic event on this scale. I was not mad for wanting to punch the next person who told me I should be grateful or that 'as long as the baby's healthy, that's the main thing…'
Slowly I regained a sense of self and as I read of similar experiences and saw our local hospital c-section rate creep up to 21% (that's 1 in 5!), I decided to set up a savings account for an independent midwife, should we ever have more children. Each month, for about a year, I put away odds and sods and a regular modest sum. I even started my search for the right midwife before becoming pregnant. I knew that, armed even with all the knowledge, background statistics and supportive partners under the sun I could never take the chance that the wrong midwife would turn up when the time came round again.
I wanted to have this baby at home and I wanted someone to support me and help me do that. Consequently, I spent a long time planning this birth!
I interviewed 3 midwives who covered our area of town and felt an immediate rapport with Sandesh and hired her. I was thrilled to discover that she worked in partnership with Jacqui who was the first IM I'd seen, before being pregnant. The combination of these two highly skilled midwives was a sort of personal dream team…
A huge sense of relief enveloped me and I was truly able to enjoy my pregnancy. I looked forward to each visit, unrushed at home, where Sandesh and Jacqui got to know me and my little idiosyncracies/worries as well as my eldest daughter and my partner. Contrast this with dashing across town on public transport to wait at the local health centre for anything up to an hour where an overworked (sometimes disorganised) midwife would shuffle my notes around, take my blood pressure and forget that I was planning a homebirth.
This particular element of independent midwifery - continuity of care with a known midwife - was such a crucial difference to the NHS care I'd received before and, in my view, is the most important. For me, it meant that when the birth time came, I was so at ease in their company I could truly just 'get on with it'.
As for the labour and birth, a couple of days before my estimated due date I woke at about 5am with niggling crampy tightenings that were hard to ignore. I wandered around the flat for a while, then tried to sleep, but realised that something was happening. As my first labour had worn me out in the early stages I was very conscious that I wanted to conserve energy.
I woke Louis to let him know and felt both exhilarated and scared. We had a long weepy cuddle and he got on with looking after Lily while I got into the rhythm of dealing with the contractions.
Louis asked my friend to come and collect Lily at about midday. I heard their voices at the door but was absolutely glued to the bath with the shower running down my shoulders and back. I spent a long time there - an hour?
Louis called Sandesh around 5.30pm to let her know that things had started. She asked to talk to me and, at first, I didn't want to - denial, perhaps? When I did speak to her I felt extremely emotional and could only give her clipped responses. She was used to me becoming quite overwhelmed by feelings about birth; I'd regularly well up when talking to her about Lily's birth or planning this one. I think that she was on her way to have supper with another midwife and asked if she needed to come straight away. I think that deep down I felt that I wanted her with me there and then but I knew she would be around, a short drive away.
Anyway, she was able to judge that I'd be okay without her for a while!
Alone without our 2.5 yr-old to distract us, Louis and I spent a lot of time getting used to the contractions and using the hypnobirthing techniques we'd been practising. Louis was such a support in this phase of labour. Just the 2 of us, at home, me leaning on a wall, or his shoulder as a contraction was building up, Louis calmly prompting me to count or breathe or visualise. We had been pretty good in preparing ourselves with hypnosis techniques. It certainly meant that I could deal with each contraction and each little psychological boost must have helped maintain physical energy. I remember something that really helped was a photocopy of one of my father's paintings that I'd stuck to the wall. It was the place I'd go in my head if things became a bit tough. I also had a picture on the wall of a baby in the perfect position inside the mother - these 2 images received a lot of my attention as I leant on the bedroom wall!
I tried the pool but it didn't feel at all right.
Sandesh arrived at 8.30pm. I spoke to her on the phone - Louis had been keeping an eye on the timings - and said that I'd prefer it if she were in the neighbourhood. Little did I know that she was phoning from downstairs!
At that point I was pretty much cocooned in the bedroom, pacing around a tiny area and leaning into the wall with each contraction. I'd rock my hips quite a lot and had started to get a bit more vocal - lots of humming I think! Even some moaning.
Sandesh calmly made herself a little area in our living room and conferred with Louis about how I'd been doing. She came to check on me - just talking and reassuring that I was doing fine. I think she took initial bp reading and perhaps checked baby's heartbeat.
I'd been using the TENS machine from early on. It became a bit of a pain as the pads weren't very adhesive so I think Louis had fixed it with masking tape. At around 10pm Sandesh suggested I get in the pool. This time it was fabulous. Sort of. First of all, things picked up immediately and I threw up - this was not the only bodily ejection Sandesh would catch for me that night. I didn't so much feel relief from the contractions (though the weightlessness made things far easier), but I did feel a real sense of being in a safe, warm, place and that was relieving in itself. I turned away from the room and knelt on all fours, leaning over the side of the pool. And this is pretty much how I remained until baby arrived.
Not long after being in the pool (around 10.50pm) I felt a big whoosh as my waters broke into the water. I was a little panicked by this as I didn't expect it to feel such a force in the water. Sandesh calmed me down with some reassuring words.
Things needed my full concentration and when Jacqui, the second midwife arrived at around 11.30pm, I didn't acknowledge her. It was lovely to know that both these women were with me now and that meant it wouldn't be long before I'd finally meet this baby.
With some rather strong contractions, I felt the baby moving down and REALLY needed water poured over my lower back NOW! Around this time I have a vague recollection of Louis and Jacqui sharing a little joke about me biting his finger. I remember feeling like I needed to poo. Too late, Sandesh had already been quite expert with a sieve, fishing out my latest emission. Ah, to be a midwife…
At about this time I kept thinking that things were taking for ever. I was convinced the baby was stuck. I remember expressing a worry that I didn't "know how to be" between contractions. I meant that I couldn't see how to relax in between. I realise that I was trying to push the baby along and this tension was counter-productive. So hard to let your body just get on with it.
Eventually I had a completely overwhelming expulsive contraction - like my whole body was retching downwards. And then I felt the baby's face turn inside my vagina - the weirdest sensation. I could feel its little scrunched up features. I was nearly there but couldn't believe it and was sure that the baby was stuck. I kept talking to the baby: "come on, baby, come on baby" and Sandesh suggested I feel the head but I didn't want to.
At 1.01am with a few more pushes, or non-pushes, with Jacqui and Sandesh reminding me to pant to prevent myself from pushing, the little baby slithered into the water. As I turned over to lean back against the pool, Sandesh gently made sure I could scoop the baby up to greet her. Yes, A girl! And we'd convinced ourselves that it was a boy. We'd chosen a boy's name and dear Saskia Rose went without a name for over a week.
She was, of course, beautiful. She was dark-haired, pinky purple with quite a lot of vernix on her shoulders. She blinked up at me and I think I just said "Hello". She gave a littIe cry. I held her to my breast and held her hand as Louis looked on and Sandesh and Jacqui were so discreet to gently stand aside at this so longed-for moment.
I stayed in the pool until the cord had stopped pulsating and Louis cut her cord (about 20 minutes later). Louis held her as Sandesh and Jacqui helped me out. I was a little cold and a bit dazed. No sign of the placenta so, wrapped in a couple of towels and a fresh t-shirt, I waddled off to the loo where not much happened for a while. I'd wanted a physiological 3rd stage and finally, I got my chance to push! Sandesh held the cord and I gave a big push to land the placenta with a thud in a bin bag in the loo. They're nothing if not ingenious, independent midwives… Better out than in, I thought.
With Sandesh's help, as Jacqui wrote up notes, I made my way to bed. I'd got a small tear inside (baby's fingernail probably) which looked like it would heal well without any attention. With my big mesh knickers on, I was tucked up in bed and tried to get the baby to feed. She had a little feed but wasn't very interested - seemed happy with a cuddle. Much like her mother, although I was very keen on the tea and toast which arrived shortly after.
Sandesh and Jacqui showed us the placenta - we leant over from the bed to see it. It was really quite beautiful and seemed to be in good shape. They did describe each area in great detail but I wasn't at my most attentive, I confess…
I think we made a few calls with Sandesh and Jacqui there as they cleared up. Louis emptied the pool and was very grateful that we'd bought a pump. At around 3.30am our fantastic midwives kissed us all goodnight and scheduled a visit for later that day. Louis climbed into bed beside our new daughter and me.
It doesn't get better than that.