My first daughter should have been born at home. Instead, I was abandoned by my community midwife and a most unnecessary, traumatic and unwanted violation of my body took place purely for a breech presentation. I suffered post trauma syndrome and depression for over a year, and flash backs that left me weepy and terrified still occurred during my last pregnancy. In addition, the depression put a great strain on both relation and friendships. To this day, I still cannot cope with the attitude "you've got a healthy baby, be grateful....." The strength of these emotions left me feeling frightened and isolated. I sought help by contacting my local NCT group, VBAC Information and Support Group and AIMS. Michelle, Linda and Beverley took me seriously and were angry about my treatment. Finally feeling less alienated I read everything I could lay my hands on: "Who's having your baby, Silent Knife, Spiritual Midwifery" etc etc.
I had started to write to our four local hospitals to find out their policies on VBAC when I became pregnant. My partner Marco came with me to visit the two that invited us to discuss the contents of my letter. We got the usual responses; depends on the consultant, but basically continuous EFM, drip set up, starvation and to come to hospital as soon as I started labour. There might be room for some negotiation, but not much. One hospital forwarded my letter to another hospital because I had asked about homebirth policy. I later spoke to a woman who had a VBAC there, and she told me her waters were broken at 3 cm dilation as policy, in order to ensure her labour did not stop! My local hospital (the one that had forced the caesarean) said that I could try for a normal delivery, but it would have to be in hospital because of the risk of the scar rupturing. When I asked if this was the 0.05 to 0.5% risk, as opposed to the 2.7% chance of non previous section related risks, there was a silence, followed by a quiet, "you are well informed." These responses reaffirmed my distrust of hospitals.
I took the advise of various friends, including a midwife, not to enter into any dialogue with hospital consultants. I could not change their attitudes, and it was not worth the risk of me being undermined and upset. I booked myself under the care of the Homebirth Team. When I expressed my worries to my named midwife that she may panic if I did not have a text book labour and delivery, she said that I must meet all the members of the team, chat to each one and decide who I wanted. Her main concern was to ensure that I had the best possible experience this time round. Sandra set up appointments with the other 3 members, and I grilled each one on their feelings about VBAC. They all knew what I had been through. I chose Alex. All my care took place in my own home. I did not miss not having a scan. I requested that the fetal heartbeat be listened to by Pinard and Stethoscope only. When the sonicaid was used twice, on both occasions, my baby jumped and moved in a frantic way for several hours after. Freya (our daughter) became a dab hand at finding the fetal heartbeat with the pinard and stethoscope.
This pregnancy was very different to the first. I had a lot of pain around the scar area during the first 16 weeks. Three friends had sections which sent me into deep concern about the possibility of genuinely requiring one this time round and I swung from cheerful optimism about this homebirth to worries about having to go into hospital and the occasional doubt (for the first time ever) about my body's ability to give birth, something I had yet to do. Close friends maintained quiet certainty that this time I would give birth. Jan promised to be with me and to not let any one treat me like I had been treated before. I needed this kind of labour support. Again, I took friends advice and kept my distance from anyone with negative attitudes towards my plans for a home birth. My baby turned to a posterior position and I became worried, as the few people I knew who had had posterior babies had ended up with sections. This time I told people about my fears, and was surprised and relieved to hear how many had had, and had given birth to, babies who were posterior. This also helped prepare me a little bit for an anticipated "back ache" labour.
We hired and collected the birthing Pool, just at the time of the press controversy over their safety. I was totally unperturbed. I reached 37 weeks and the midwife supervisor wanted to know if there were any signs of labour, as I had gone into labour at this stage with Freya. She also wanted to come and visit me. I knew about her visits to VBAC mums. In line with hospital policy she has to warn us about the dangers of a homebirth after a c/section. I wish they would balance the story and warn women about the dangers of hospital births. I refused her request.
Ten days after my due date I ate a remarkably small evening meal and went straight to bed. I woke at 9pm and did something very strange (for me). I sat down in our kitchen and started some hand sewing. Deep inside I knew that my labour had started. Earlier that day I had accepted that if this baby wanted to be born under Scorpio, so be it. I would no longer try and hold on for a Sagittarian.
I returned to bed to get some sleep. Ha Ha. By midnight I had spent half an hour on the loo straining(!!) with diahorea and a very niggly back. This was a very different start to my first labour. From the site of the epidural needle hole (from the c\section) down and across my pelvis, it niggled.
I sought out Jan, who was staying with us. She rubbed my back and hugged me, suggesting that I try and get some sleep, as I would need my energy later. We were both excited. I wondered about, and returned to the loo. More diahorea and pushing. The toilet seat began to annoy me, no longer relieving the backache, so I ran a bath.
An hour later I went back to bed. It was 2am. It hurt to lie down. Marco got the bean bag and rubbed my back. I eventually gave up and returned to the loo. I tried reading Spiritual Midwifery to help me relax and find ways of dealing with the back ache. I was not comfortable on the toilet, it seemed to make the backache come in stabbing like waves, and increased the pressure on my pelvis. I squatted on Freya's potty. I could not feel a single contraction. My abdomen was firm, I kept my hand on it, but I didn't feel any contractions like I had been getting from about 36 weeks. The backache began to feel like my vertebrae were being slowly wrenched apart.
At 4am I asked Marco to get up and get the front room ready, returned to the bathroom and ran another bath. This did not help, I could not get comfortable and there was not enough space to move around in and I felt even more irritated. I got out, squatted as the backpain intensified and realised that I was pushing, yet no more diahorea even though I could feel a solid lump. I did a self internal. The head, and only about 2 inches from the opening of my vagina!! I screamed at Marco to get the midwife. He asked if I was sure, as we had decided not to call her until the last moment (this was my insurance against any potential pressure or interference that could lead to another unnecessary c\section). I was feeling so much pain that if I was only 4 or 5 cms dilated, I wanted support to cope with it and maybe the midwife would know different positions to help me cope. I joked about wanting my epidural now!
Marco could not get Alex or find any alternative numbers. By this stage, I absolutely could not engage in any polite dialogue and I snapped hospital details. Marco could not find the number. In my mind, I knew exactly what to do, but my mouth did not engage. My body had more important matters on which to concentrate. I walked into our front room to find the pool half filled. At this stage, I just wanted to curl up and go to sleep. I tried, ha ha!! Getting down was almost as painful as lying down after the section (only this time I succeeded!) This did not work as my back felt sharp stabs, so I slipped into the pool. Bliss!
I heard and felt a "pop" as relief spread through my body. White lumps of vernix bobbed and danced on the water. I felt a very strong urge to push as though I had diahorea again and returned to the loo. Nothing happened, except the backache got worse. The telephone rang, and I heard Marco say: "Well I don't want to sound blase, the contractions are only 5 minutes apart, but Caroline says she is in a lot of pain." It was a good thing I was beyond talking because mentally I called him all the names under the sun. The backaches and pushing down were coming in surging waves, and I squatted into each peak.
By this stage, I had given up trying to keep quiet, and moaned and screamed when I needed to. This helped! I looked at my belly and saw the four kicks I could feel arrive in a straight line along my Linea Nigra from the top downwards. I felt my baby saying "I'm O.K. Mamma, I'm on my way." I did another internal. Instead of a hard head, I felt a large, soft spot and wondered if the baby might have turned breech(deep inside me I knew that she had not). Julia arrived and came straight to me. She asked where it hurt and did I want a massage? She touched my back and I snapped "Don't touch me. Hurts!" And she didn't. As she quietly left me I felt comfortable with her being in our home.
I finally decided to return to the pool and asked Julia to do an internal. She patiently waited whilst I found a comfortable position, ensuring that our floor was kept covered. I did not feel a thing. The complete opposite from my hospital experience. With a deep smile and tranquil voice she said "I can't feel the cervix.......It's all down to you now." I knew there was a reason for all that pushing. She asked if she could listen to the baby's heart beat and out came the Pinnard. I got back into the pool. The water didn't take the pain away, rather it softened the sharpness.
Marco had asked me to try not to make too much noise in case it frightened Freya. When she did finally wake up, she playfully roared back at me as my attempt to sing ahhhhhhhh rose to an arrrrggggggggggggghhhhhhh!! I had a sore throat for several days after. I barked at Marco to join me. I called out for Jan, who came down with her 16 month daughter Saskia. The girls played with, and around the pool. I heard them playing with the bolts at one stage, but was almost oblivious to what was going on beyond me. Julia occasionally asked to listen to the baby's heart with the pinnard. When I could not cope with Marco raising me, she left me alone. No forcing the issue or spouting hospital policy like it was the law of the land.
Sandra, the 'back up' midwife arrived. I felt so happy that she was attending me after all. I remember feeling the head with my hand. There really was no going back. I was feeling impatient, but it hurt so much I cried; "I can't do this, I've had enough. I want to go home." I understood and enjoyed the glorious absurdity of this, with the two midwives gently telling me how well I was doing. I stood up and leaned on the side of the pool. Julia said that if I wanted to give birth standing up it would be better to get out, or I would have to be standing up completely so that they could catch the baby. I immediately slid down into the safety of the water. No one was holding my baby this time before me.
The door bell rang, it was the postman with a parcel for our new baby. I said that I was hungry, Julia gave me a dextrose tablet, someone talked about getting a banana, and I drank more water. I was quite thirsty at this stage. No enforced starvation. Within half an hour (not that I knew the time then) my perineum felt like a ring of fire. I knew the head was "crowning" and I was wanting to really push and at the same time hold back. I knelt upright on one knee, with a vague awareness of Julia saying "pant, it will slow the descent of the head." No way could I finally hold back, I had to come through this ring of fire, and quickly.
I looked down and saw a dark head. My arms instinctively reached down and lifted my daughter from between my thighs up to my breast. She was perfect. A huge swelling on her head from the long second stage did not worry or surprise me in the slightest. No one took my baby from me, no one unexpectedly sedated me. Zsofia's eyes were wide open and serenely looking around. No terrified screams from my baby. Beautiful tranquillity. I had instantly forgotten the "pain". It was not there. Still in the pool I asked for the phone and rang my Mother. "I've done it mum, I've just given birth to our second daughter, less than five minutes ago, I've got to go, I'm still in the water, can't talk any more".
I was not stranded in a strange bed, alone, unable to move or contact people. I felt so calm, so elated, so whole.
Freya joined us. Apparently she had almost toppled in as I was giving birth. Tandem nursing soon began. Jan came in with champagne and Sandra gave me a piece of hot buttery toast, smiling as she said, "I remembered your birth plan". No pleading for breakfast! And no pain in my body from the weight of the food.
The midwives had regularly checked the temperature of the water, topping it up a couple of times with pans of boiling water. I asked what time Zsofia had been born. "2 minutes to 20 to" came the reply. " What, 7 or 8?" "No, 10." 9.38am. I was surprised at how late it was! It was snowing as she was born.
I had planned on cutting the cord after the placenta came out. However, 40 minutes later it was getting cold, and for the first time, Julia touched Zsofia as she checked that the cord had stopped pulsating. Cotton cord had been boiled, which Marco used to tie the umbilical cord, before cutting it. 7 minutes later I pushed the placenta out and put it into a bowl. I laughed as I chased this amazing organ around the pool! Sandra and Julia then helped me to the bathroom where a bath was run using some wonderful aromatherapy oil Jan had bought me. I ran the bath too hot and got very dizzy.
Sandra dried me off and got me into our bed. No being made to walk, unsupported, to a cold hospital washroom with toilet bag in hand, attached to a drip, catheter and drain bag. Julia checked me over. I had a slight tear that did not require stitches. I still could not get over the wonderful care and kindness of my midwives. Sandra asked if I would like the baby weighed. Sat at the bottom of our bed, her face was a picture as she lifted Zsofia up and asked us what we thought. Marco said 7lbs, I said about 8lbs. 9lbs 1oz to be exact. My pelvis, that had been declared as unproven to risk a 7lb 3oz baby, had accommodated 9lbs and 1oz of beautiful baby. My scar was finally mentioned as Julia looked at it and asked how it felt. Fine. I am the first, first time VBAC they had attended at home. I am so, so happy that I and Zsofia birthed and delivered by ourselves.
The midwives have various records to complete, and as mine had not been called out until the last moment I was asked when the pains had really begun to hurt as they tried to record the lengths of stages. At the time this made my first stage seven hours and second stage just one and a half hours. A few days later, as I read through my records I decided to write in the times that I knew. I wanted there to be an accurate record of my first VBAC labour. First stage had definitely started by 9.00 pm, so that made it eight and a half hours. My second stage began around 5.30am, making my second stage 4 hours in length. Would I have ended up with forceps, or worse still, another c/section had I been in hospital? I believe so.
It takes time to recover from a baby's birth, no matter how they arrive into this world. I was surprised at how tired I was. But this time I have enjoyed my recovery. No drugs, nothing to prove and a continuity of care in my own home that made me feel special and cherished. No nightmares, no depression. For the first time since Freya's birth I am beginning to feel normal.
I knew the night we made love that I had conceived, and that baby was a she. I also knew that my due date had very little to do with when she would arrive, so along with a strong dislike of people's reaction when a baby decides not to come on that man made designated day I played vague. I was not overly impressed with my experience of the maternity services in West Sussex and had strong feelings about who I did not want as my midwife.
By 22 weeks I decided to heed the nagging of friends and sort out maternity care. As all properly informed women know, you do not have to see a GP to confirm a pregnancy or to book maternity care. Midwives are practitioners in their own rights and you can book yourself for care directly with them. When the hospital phoned me to verbally answer my written questionnaire about their birth statistics (minor things like ceasarean section, forceps, episiotomy rates labour management policies etc) I was prompted to ask for a midwife. I said I did not want the local one, please arrange another (as is all women's rights). This midwife was quite taken about, so I cheerfully quoted Changing Childbirth and added that if the hospital did not want to meet my request maybe I could book an independent midwife and they would pay her bill. I was reassured that this would not be necessary and that she would make arrangements. I also received a frosty silence when we discussed my obstetric history. A previous caeasaerean and I wanted homebirth, the midwife relaxed when I said that I had already had a homebirth since the caesarean. I had been enjoying my uncomplicated pregnancy up until that point.
One month later and this baby was bubbling about in me, popping like a champagne cork under my right rib cage whenever I drove. I still had not heard from the hospital as to who my midwife would be. I went to London to take part in a conference on the rising caeasrean section rate. Still without a midwife I later got talking to Mary Cronk and asked her if she would take me on. She smiled and said she would be delighted. I was relieve
In the comfort and convenience of my home I had to tell Mary that I was in the process of suing a health authority for assault and an unnecessary c/section, was she worried about this, or would it compromise her? She was not in the least concerned and was totally supportive of my case. I was able to relax again back into my pregnancy. It was so reassuring to know that I had maternity care that would not be wrapped up with hospital policies and politics.
By the end of my booking visit, Mary had sussed out the kind of labour support I wanted without me having to say, "hands off, I don't like being interfered with". She respected my feelings. I also enjoyed the totally one to one care that I was now guaranteed. I could not have asked for better care than Mary went on to give me. She respected my views and wishes, including my choice not to have any blood tests or scans. I was able to question without being made to feel that I was threatening her, and she shared some very interesting information. She also respected my knowledge of Vaginal Birth After Caesarean, so we worked as equals.
On Saturday 18th January I had an urge to go to London and get things sorted out for this baby's arrival. I met up with a friend who wanted to come and video the birth and we finalised our plans. She was all set for early February, having ensured that her nanny had not booked any leave. On the Sunday I emptied out the linen cupboards and labeled up a bag marked "labour linen". I also dug out the terry nappies and Marco and I had fun practicing cotton nappy origami!! At least I had another three weeks to improve!
Twice during the early hours of Monday morning I got up to go to the loo with a clarity of vision that said "this is an indicator of labour" but my logic said, "another three weeks to go." I snapped at Marco over breakfast, bad temperedly got the girls to school and nursery and collected Toby. He fell asleep so I went shopping. I had this urge to buy things for the house!! Finally home and I noticed little pushing down sensations in my lower back.
I made a drink and some toast, then decided to phone Mary. I was so airy fairy and munched my way through what with hindsight I now realize were contractions. I could not tell Mary what was going on, so she asked me if I felt any different to yesterday. I had to think about that before deciding "Yes". She asked me if I would like her to come and see me, I was not sure. I should have warned her that I'm anti-social and totally unassertive or able to ask for what I want in early labour. We agreed that she would come out at about three, after I'd been to do a postnatal support visit. I did phone Marco's office to ask them not to send him to the Isle of Wight that day, I might be in labour, but when Christine asked me if I wanted her to warn him, I said "No, it was probably braxton hicks and I did not want to worry him, plus my labours tend to take a nice time."
It was time to collect Zsofia and return Toby. I told Carol about the pushing down sensations and she thought it might be the head engaging, something I had never experienced. A few people flapped at the playgroup when I let on that "I may be in labour, but it's early yet." I had to finish my totally unnecessary shopping and dragged a hungry daughter around Bognor. We got home and I just could not be bothered to make her any lunch. I told Zsofia to help herself to my Nutella and make some sandwiches, I had to go and visit a lady. I remembered the books on breastfeeding and lent on the car for support as a massive wave surged around my middle. I squatted and wandered if I should be going out. My conscience reminded me that she had already been messed about enough by the "authorities", I did not want to let her down.
On route I toyed with the idea of dropping Zsofia off at Carol's, but again, I knew she was taking Matthew to a party and did not want to spoil this for him, I would need Carol later as my birth supporter. I arrived at Linda's and apologised for being late, I thought I might be in labour, and promptly spent the next 20 minutes crawling around her sitting room floor! She was adamant that her husband drive us home, but I refused (in the back of my mind I was trying to work out the practicalities of retrieving my car) and said that the vibrations from my old jalopy were good for my backache.
Fortunately Barry followed us home. In that seven minute journey I had four incredible contractions and cried out for Marco (why aren't we telepathic??). Barry came to the door and asked if he could do anything to help. I told him to feed Zsofia, could he do beans on toast? I needed to go up stairs and make some funny noises. I phoned for Marco to come home. It was about 2.30pm. Several contractions later I tried to walk downstairs, strange, I needed to walk as though I just got off a motorbike after 2 hours in the freezing rain. Barry had made me a cup of tea and in his panic, had picked up the first carton Zsofia had pointed to as milk and poured in orange juice!
I wanted a bath and had gone to boost the hot water and heating, and then sank the strongest, sweetest cup of tea of my life. I returned to the bathroom and carried on with my labour. The phone rang and I waddled to answer. A cheerful voice asked if she was coming straight to me or..." and I groaned long and loud. "I'm coming straight to you" was the response. My midwife was on the way. In what seemed next to no time Zsofia called "Mamma, Mary's here". A wonderful voice asked "what's this about long labours, do you want your back rubbing?" Mary's hands went straight to the right place and the warmth and relief they generated was fantastic. I heard Andrea bring Freya home from school and knew my children were in supportive hands. I felt safe.
Mary asked me where I was having the baby. Ha ha! My original plan had been to use the sitting room, but that was not prepared, and I could barely walk. Mary gently half carried me to the bedroom and I crawled the rest of the way. I remember her lobbing pillows at the wall and suggesting that I lean up over them. She asked if she could do an internal to check the baby's position. With my history of last minute breech and Occiput Posterior I was happy for her to do this. "OHH, About three more pushes and this baby will be here" she cheerfully said. She later said that I shot her a look of such "withering disbelief". I did believe her, precisely the reason we had taken her on, I trusted Mary, but how could I have got this far into labour and not even realised how things were progressing, and Marco was not home. At that point I felt a great sense of despair. I wanted Marco with me, he was going to miss the birth of his daughter.
I turned round and my waters exploded across the bed and wall, dripping onto my VBAC photo album! Zsofia came in and I asked her to take the album out, as Barry bought up a bowl of hot water. Freya then came in and Mary started to protectively shoo her out, but I said it was O.K. So Freya climbed on to the bed and I explained that the baby was being born and not to worry as Mamma was making a few funny noises. She stayed for one 2nd stage contraction and with great dignity got off the bed and announced "I don't like Mamma's funny noises, I'm leaving." I am beautifully noisy in second stage. I was in a low kneeling squat and two pushes later, "Bubbles" was born. It was 3.17pm.
After a while Mary asked me if I would like to greet my baby. My initial reaction was, no, not yet. Then I moved to pick her up, she was lying quietly on the bed, her eyes looking around, taking in her new surroundings and Mary passed her straight to me. How Mary worked in the tiny narrow space between my bed and the wall is of constant amazement to me! And now, here I was, holding our 3rd daughter. She truly was pretty and had a mass of auburn hair and brown eyes. I remembered the tiny son I had miscarried a year before and placed Bubbles to my breast. I was in love with my baby.
Excited faces appeared at the doorway and Mary checked with me that this was O.K. It was lovely to share the joy of "Bubble's "arrival with friends. Mary put them to good use, finding extra blankets for us! Freya and Zsofia ran in to see their new sister then disappeared. I heard voices shout, "Papa, Papa we got a sister," Marco's footsteps urgently bounded up the stairs straight to us and then it was just 3 of us as he greeted his new daughter. He'd been stuck in Crawley and mobile phone and radio signals had failed to reach him. His company had had to contact the council and get someone to go and tell him to come home. He'd missed the birth by 5 minutes. I then watched her eyelashes, one by one, dry out and uncurl, like an emerging butterfly's wings.
Soon after I began to feel like pushing again and Mary noticed something unusual, there was a true knot in the umbilical cord. I was even more grateful to have booked Mary. Had my waters been artificially ruptured I could have had a severely compromised baby. The first photo's were taken, of the knot. It occurs in about 1 in 7000 births. After the placenta was born, Marco cut the cord and we tied it with string. I do not like plastic clamps.
I was helped into a much needed bath, and Bubbles came too, she was very calm in the water. Mary organised Andrea and Marco into getting things ready for when I came out, and clothes for baby too. I so appreciate the warmth and intimacy of my own home when giving birth, and the sheer comfort of my own, freshly made, clean bed afterwards, bliss! Not to mention the fresh, hot coffee and new baby snuggled in my arms. Freya and Zsofia were able to join us and get to know their new sister in a relaxed and sharing family way.
Andrea cooked a meal before she left, and this was greatly appreciated.
My aftercare from Mary was second to none. She gave me all the time I needed. She taught me how to hand express my milk, tie a cotton nappy without using pins and totally boosted my confidence as a mother. She has an incredible knack of noticing something positive and stating it. I did not want the PKU test done because of the distress taking blood had caused Freya. Mary explained why it hurt and reassured me that if Erica's foot was kept warm she would be fine. Erica did not even stop breastfeeding when Mary took a blood sample.
I felt absolutely wonderful after Erica's birth.
Marco and I want to express our heartfelt thanks to Andrea, Carol, Phyl And Mary.
Nov 1997
Our 4th daughter, Iona was born on January 10th 1999, after an uninterrupted, short labour and 34 minute 2nd stage, we think she was occiput posterior (OP - her spine lay against my spine).
The labour was enjoyable, and as I moved into the 2nd stage, I felt her head move down, and I knew what was happening, and in knowing what was happening I felt in control, and in feeling in control, I was able go with my body, an amazing and empowering sensation. Marco supported me and Carol held the camcorder, making encouraging noises and reminding me to lower the noise to lower in my abdomen, rather than high in my throat. This really helped me to relax, I was amazed (thanks to Shiela Kitzinger for suggesting this after I had told her about my sore throats from previous labours!!).
In the few seconds between Iona's head being born, and her body, I rapidly debated the merits of gently pushing her out, or just going for it... My perineum is so sensitive to touch during labour I just went for it and she zoomed out! Her cord was thick and I felt Marco's face brush against mine as he leant forward to see his baby. She was gently crying, I picked her up and gathered her to my breast, she was so white with vernix. With Freya (our eldest daughter) so quietly sat next to me, I felt a completeness with my family.
A few minutes later, I wondered whether to push, to see if the placenta would come out, I couldn't be bothered, and suddenly, it was there! Then I asked for a towel to wrap Iona in, as she seemed a little cold, and discovered that the towel just soaked up the vernix. There was a knock at the door and in came my lovely midwife, Andrea, followed by my 2nd labour assistants. I cheerfully greeted her with the words, "you're too late!!" And the birthday party began.
Andrea had understood my need for a hands off, spiritual midwife right from our first meeting, about 4 weeks before Iona's birth. She found a back up midwife who also shares my philosophy on birth, and I was so happy to have found a midwife who was also prepared to BE a midwife, my advocate.
I wish so many of the women I support could find midwives like Andrea and Kelly. In the situation concerning VBAC, women not only have to find faith and confidence in their bodies they also benefit greatly from having a midwife who is not scared of natural birth, and who is prepared to be as her honourable title means, "With Woman".
See also Caroline's birth reports of her traumatic caesarean - Caroline's caesarean