Thursday, 24 June 2010

Birth story

It's only taken 10 months to write all this down, but here it is...

After a lovely homebirth first time round, there was no question about opting for a homebirth with this pregnancy. The first weeks were a bit difficult – we had had 3 early miscarriages within 6 months and were naturally worried about another loss – but after an early scan and the booking in appointment things went pretty normally.

Whilst DS was persistently OP during pregnancy and labour, this time my bump was rounder and the baby lay OA! And of course, after being surprised by a baby arriving at 39 weeks first time round, it was predictable that this time it would be different….

At 40 weeks there were no signs of labour, and I was getting to that stage when you think that the baby will never be born. I woke a few nights later with contractions and couldn’t stay in bed, so got up, put my TENS machine on and starting wandering around the house getting a teensy weensy bit excited. A couple of hours later things seemed to be progressing so I got my husband out of bed and made him put the birth pool up – which was at that point rolled up in a box out of the way. After another hour or two, I was feeling pretty tired and lay down on the sofa to get some rest. The TENS was on and I found the regular buzzing on my back quite relaxing. The sun was rising and the morning would soon be here. And then everything stopped….

We arranged for our son to spend the next night at his grandparents, anticipating that labour might get going again that night. Contractions were still coming now and then, but neither strong nor regular, and I had a feeling that the baby’s head wasn’t quite in the right place. So we took ourselves up Blackford Hill in the afternoon in the hope that this would get our baby nicely lined up – much as we had done when I was labouring with DS. That evening we relaxed with a take-away and went to bed early. I got up in the early hours with ctx, got the TENS machine on again, looked longingly at the pool and resumed the routine of standing and swaying as the tightenings flowed through my body. After about an hour things tailed off again. And I went back to bed and back to sleep.

When I woke in the morning, things had stalled completely. No ctx, no more show, nothing. Our son was at nursery, my husband was working at home, and I was fed up. I remember thinking that this could go on for days. I went out with my husband while he did some work, and we had lunch together at the local IKEA. There were several women with tiny babies there, and I joked with my husband about going and sniffing one of them to get my hormones going.

Later on in the afternoon, I went for another adventure on the hill, but this time walked up and down the large flights of steps at the bottom. I went sideways, doing my best to open my pelvis, shift my weight from side to side and encourage my baby into a really good position. When I got back, DS came home from nursery, we had supper and he went to bed.

At about 9pm I had to admit that I was beginning to contract again – I’d been ignoring it thinking it might go away – and I got the TENS machine on and DH started to time the ctx. A couple of hours later, DH rang triage to let them know that I was in labour. Ann – the CMW team leader rang back and got ready to come over. She arrived about midnight, went through my notes and birth plan and examined me. I was 3 cm; the head was well applied and the membranes taught. The baby was still anterior and everything looked pretty good. She and DH got on with the usual things – cups of tea, notes & observations, checking the birth pool – and I wandered about just dealing with the ctx, stopping and concentrating when I needed to and trying to relax in between.

About 1am or so I decided I would like to get into the pool – so I stripped off and got in, and soon Ann called for the second MW – a student who had never been to a homebirth before. She arrived and took over with the obs. Baby was very happy and I was doing my best to cope with some quite intense ctx whilst floating about in the warm water. DH was occupied keeping the water at a reasonable temperature and making tea and conversation with the two MWs.

A bit later on I felt like pushing, so started working with the ctx to push the baby down (I remember this happening when labouring with DS. It was followed shortly after by transition and delivery!) I thought I was well on the way. The MWs got the baby things ready with a hot water bottle. After a while I said ‘I don’t think I’m getting anywhere’ and Ann said she’d like to examine me again to see what was happening. My ctx had slowed down and she was a bit worried that things might stall again. I then endured a rather uncomfortable VE while I was still in the pool (I just had to try and hold myself steady and keep my bottom up off the floor of the pool). 8cm she said, membranes still intact and taught – but the head on one side. It was time to get up out of the water and get things moving a bit faster again. [I agreed to this VE- it seemed sensible to find out where I was in terms of dilation and why things were slowing down and I was really, really pleased not to have to get out of the water….]

For a little while I stayed out of the pool and tried various places and positions to get comfortable – always upright, sometimes standing, sometimes kneeling. I got back into the pool and stood between ctx leaning against the wall and DH and rocking from side to side, sinking down into the water only as each tightening came. At some point during this phase, I was sick a couple of times, and I started to complain about not being able to do it, and it hurting and all that transition-y stuff. It seemed to go on for ever, and the MWs encouraged me to try the gas and air – but it seemed like too much effort to concentrate on that at the same time as concentrating on the sensations in my body. I gave the mouthpiece back.

The MWs said something about my membranes, and I thought they must have seen them release into the water. They’ve just gone I said; I felt them pop. Oh good, they replied, nice and clear – they hadn’t been able to tell at all. It was just after 6am and it was getting light. Ann had told me earlier that as soon as my waters went the baby would come. She was right, a contraction or two later the head was crowning and I reached down to touch a small hairy head. The body came soon after and I caught my baby and brought it to the surface. ‘A boy!’ said my husband, but I checked out the netherparts and said ‘no, it’s a girl!’ The cord was short, so it was hard to cuddle her and she seemed happiest being swooshed gently in the warm water looking up into my face. After a few minutes DH cut the cord and we got out of the pool to get warm/dry and to deliver the placenta. She weighed 8lb 4.5oz and had a fine head of red hair just like her daddy. APGARS were 9 and 9. Labour was recorded as 9.5 hours with a 1 min second stage. 3rd stage took 18 mins. Blood loss was minimal at the time of delivery (none in the pool), but there were a few gushes later.

Just after I delivered the placenta our son woke up and came through to meet his little sister. He was a little bit confused to find two MWs in the house, but very excited about the baby!

Perineal damage was minimal, with a 1st degree tear that the MW described as ‘a nick’.

Although the baby was OA this time round, in many ways this labour was harder that my first (OP) labour which progressed rapidly from 4-5cm dilated to delivery. My first labour began with SROM, and this time that was almost the last thing that happened before the baby was born. I think this accounts for the hesistancy of my labour and the tendency for the baby’s head to move into an asynclitic position. Still, thanks to supportive MWs – and DH! – we managed really well at home using gravity and hip hitching to get the baby (back) into a good position and using TENS and water for pain relief. Transition this time was also more difficult – it seemed to go on for ever, and I apologised to the MWs later for being sooooo grumpy – I was even complaining as the baby’s head crowned! Nevertheless, we had another drug free labour and home water birth – and another lovely, lovely baby.

We were very pleased to share the birth with a student midwife. She was on her last placement before graduation and really keen to come to a homebirth. Ann (the team leader) had phoned me a week or so earlier to ask if I was happy for a student MW to attend and I said yes without hesitation. I work in a university and always try to support student learning and experience where I can – so, thankyou Tina. We wish you well in your career.

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