Or the birth I thought of and the birth that I had

Nikki tells of birth of her fifth child, a homebirth after four caesareans, the birth she thought she may never have.

After a miscarriage at 11 weeks with a fifth baby, we sat down to decide whether or not to try again. We weighed up age, risk of abnormality, cost of starting all over again, monetary as well as emotional and decided that we would go ahead and let nature take its course - if it was meant to be, then it would happen and be all right, if it wasn't, then it wouldn't.

One month later - I was pregnant. CVS testing showed a healthy (as far as could be ascertained) girl, balancing up the odds in our family.

Now that I knew that the pregnancy appeared to be healthy and fine, I could think about what I wanted from my care and birth. Having had four previous caesareans, I didn't rate my chances too highly within the NHS. Regardless of the way I gave birth I knew that I didn't want to spend the whole pregnancy fighting a system that was not geared up to respecting women's choices and decisions for the pregnancies and births.

So, we made the decision to employ independent midwives and I approached Anna, whom I had spoken to when pregnant before. She was happy to take me on and suggested her mother, Mavis, as second midwife. The two worked under the umbrella of Yorkshire Storks, so Chris Warren became a third midwife.

At the booking in visit, we went over everything that had happened with my previous births, but at that time, no explanation could be given as to why the last two babies had decided to go from being very well engaged to oblique during labour. We decided to explore all possibilities and Chris suggested going to see an osteopath in Leeds, to whom she referred all her clients with malpositioned babies. Over subsequent appointments we found that my pelvis and coccyx was fixed on the right hand side - probably due to a skating accident in my teens. Once this was freed up, the sacro-iliac pain I had been putting up with disappeared.

Throughout the pregnancy I felt that I carried this baby much better and easier than with previous ones - maybe due to a more mobile pelvis and the abdominal exercises I had been doing as well. My only concern was that I seemed quite small, even though the baby appeared to be doing well.

So it was full steam ahead and planning for the homebirth that I would love to have and hoped to achieve. As I hire out birth pools, I thought it would be rather nice to use one - particularly as it was so close at hand! We put together three birth plans - one for home, one for VBAC in hospital and one for a caesarean birth in hospital. We worked out where to put the birth pool and asked good friends if they would be prepared to step and look after the children at short notice - I wasn't sure whether or not I would want them there, or even in the house.

My instinctive feeling about when this baby would arrive was based on Lewis taking his GCSE exams. The last one was on 20/6, so I felt that any time after that would be fine. The last 3 babies had all arrived around 38 weeks, so it seemed reasonable to assume that this one would be no different, although anything is possible.

The last week, as I turned 38 weeks, I started to put things together - a carrier bag of items just in case I needed to put an overnight bag together quickly, doubling up on nappies, breast pads, knickers etc. The baby clothes were brought out and hung up and drawers filled with vests and socks I never thought I would see again. Music was put together and essential oils and carrier oil bought, ready to use. We were going away at the weekend, so the plan was that on our return, the pool would be assembled, the conservatory cleared and everything in place ready for my labour and (hopefully) birth. I was looking forward to the slow build up of labour, to being able to use the pool, to the smell of the oils and the calm, peaceful atmosphere I hoped my baby would be born into. I had been listening to a hypnobirthing CD and wanted to use the music during labour to help give me the encouragement and motivation I needed to believe that this time I could actually give birth.

On the Thursday, I felt rather strange and different and wondered if something was starting. I didn't say anything to Mavis at the ante-natal appointment, because I wasn't sure and in any case, if this was early labour, it could stop and start and go on for days. As the pregnancy had been different and this baby was sitting in a different position (on my right hand side, instead of on the left where the others all gravitated to), we had no idea as to how this labour would go. We were guessing that first stage might be quicker - I have laboured with all the previous births - but that second stage might take some time, particularly as I'd never done that bit before.

We were planning to go down to Chris' (my husband) parents, in Warwickshire, for the weekend and meet up with close friends for dinner. If I was still waiting for things to get going in a week's time, I knew I would regret going, so off we went on the Saturday.

The two of us spent a rather nice Saturday afternoon mooching about Leamington, buying last minute items and treating ourselves to a new digital camera, as our old one was slowly giving up the ghost. I was getting what I thought was strong Braxton Hicks throughout the day and Chris did ask me if I thought these were the real thing. My reply - "If I can walk and talk though them then how can it be labour". I was used to labour starting with period like contractions, so convinced myself that this was latent labour and could still go on for days and I might as well enjoy myself while I could. Anyway, this just felt niggly and different.

Saturday evening, we made our way to Rugby to see our friends Kevin and Claire, whom we met during ante-natal classes for the last baby (now 5). I was definitely feeling uncomfortable by now, but passed it off as late pregnancy niggles - I was determined to enjoy what looked to be a last weekend before the birth. Whilst we sat and chatted, I felt the need to go to the loo and looked as though I was having a show - a lot more mucus than usual, but still I ignored what was going on.

Halfway through dinner I nipped to the loo again as I felt a bit damp - it looked very much as though my waters had started leaking - a very strange situation to be in - it had never happened before. I could no longer ignore what was going on. Claire asked if everything was OK and I asked for a pad, as it looked as though things were happening. I then went to the dining room and asked Chris if he minded missing pudding as I thought we needed to make a move. He later told me that he though Claire and I had had a falling out! Once he realised that it looked as though this baby was on the way, everything moved quite quickly. We left Kevin and Claire's house with their good luck wishes and made our way back to his parents' house. So we set off and on route I rang Anna to let her know what was happening and that we were making our way from Warwickshire to Yorkshire as quickly as possible. I still felt that this could be latent labour and could go on for hours.

We got back to Chris' parents' house at about 11.15pm. They were very surprised to see us. It was a hot and sticky night, so they had only just got all the children to stay in bed and go to sleep. When we said we were going home because the baby was on the way, they were equally surprised and concerned and wanted us to leave the children behind. The only problem was that Lewis had another exam on the Monday and it would have been difficult to leave them there and for Chris to try and get back in time to fetch them.

So, we got them all out of bed, put them in the car and left by midnight. All the time, I was feeling more uncomfortable, but still sure that this could go on for hours and I would make it back home with no problems.

At this point, the contractions (which is what they really were) were coming about every 3 - 5 minutes and lasting about 30 seconds. My only thought was whether I could manage sitting in a car for the next 1 to 2 hours whilst we made our way home.

As we made our way up the M1, the contractions started to become stronger and at 12.30 am I rang Anna to let her know that I was having to really concentrate on what was happening with my body. I was also wishing I was at home and not in the front of the car. She reminded me that we could stop off at Mavis' house on the way home if we wanted, to get checked and see what was happening.

I can remember looking at the clock in the car and timing the gap between contractions - about 2-3 minutes. I was desperate for sleep and found myself dozing in-between them. Each contraction needed effort of concentration to focus on them and I found myself not only breathing and trying to relax, but also singing my way up and down a scale as each one increased in intensity. Fortunately it was a clear road and we didn't have any hold-ups, apart from when we thought we were behind a police van, which turned out to be an ambulance.

All the way up, Chris kept asking if I wouldn't just like to go to the nearest hospital - no just take me home. I think it would have been grounds for divorce or murder if he had tried to!

At 12.55 am, I rang Anna to let her know this was it and we were heading straight for home, we weren't going to Mavis - we'd already passed the junction and were going up the M18. Anna said she would phone Mavis and Chris and then be on her way.

We arrived home at about 1.15am. We had done a 2 hour journey in a 1 hour and 15 minutes! By this point I was having massive contractions where my body was doing things I appeared to have no control over - I felt as though I was almost ready to push. All the way through this I kept panicking that the baby had moved and she was in danger and that if she came out vaginally she would be dead. I couldn't believe that this was a straight-forward labour and everything was going to plan(!)

I managed to make it into the front room, having had a massive contraction by the car. I was sure I must have woken the neighbours up (mind you they might have thought it was someone from the pub round the corner!). I settled in a comfortable position on my knees draped over the sofa, relieved to have made it home, whilst Chris got the children out of the car. The older two had stayed awake the whole journey - excited, but more so by the speed we were travelling at - apparently 100 mph at one point. Edward woke up when we got off the motorway and after being reassured that the noise I was making was because the baby was on her way, became as excited as his brothers. Eloise, on the other hand, was a bit frightened by it and needed some comforting.

Throughout this, I remained convinced that this baby was not in the right position and that I dared not push too soon until I was sure. Chris kept reassuring me that so long as I could feel this hard knobbly bottom, then she hadn't moved.

Anna arrived and got to work. She checked round and said she needed to listen into the baby's heartbeat. She found it - just where she was hoping. After feeling round, she told me that the baby was head down and in the right position - moving down well. We managed to get my trousers off. I never realised how difficult it is to move in this late stage of labour. It took a lot of effort to get in a position to take them off and just as I did I remember saying that I thought I had wet myself - no this was the rest of the waters going. Once they were off and I had managed to get back on my knees, Anna asked to do a VE (the only one I had) and told me that I was fully dilated - she couldn't find any cervix at all. I suspect that I had been like this for some time as I had been having rather pushy contractions that I was fighting - frightened that the baby was not in the right position. I said so - I told her I was frightened and scared and that I couldn't do this. Anna told me to put my hand down and feel my baby's head. She put a mirror on the floor so I could see this little dark haired head appearing and disappearing. She encouraged me - told me that I was going to do this - I was going to have this baby, just as I hoped. I felt then that I could let go and work with these contractions, rather than holding back as I had been doing.

As soon as I did this, I could feel her moving down inside - it was a very strange feeling. I felt determined and focused - in a place I hoped to be. All the thoughts of the birth I hoped to have went out of my mind. I didn't care whether there was music, oils and warm fluffy towels. I just wanted to help this baby out. There was a sense of excitement in the room, with Chris rubbing my back and me trying to push with each contraction. I kept trying to keep the towels underneath me and moving them round in a nest of some sorts - it wasn't deliberate, just something I had to do, each time I moved with a contraction. It seemed like a long time, but I had one huge contraction and thought that's it, this baby is coming out NOW!!! I pushed as hard as I could and she shot out. I remember thinking as I was pushing that any minute now Anna is going to tell me to pant as the head comes through, instead of which she was telling me that my baby was born and I could pick her up.

I picked her up in the towels on the floor and gazed at her, completely unbelieving that I had actually just given birth. Anna and Chris were telling me that I had done it, but it just didn't sink in. Chris tried to shoo the children up to bed, but I shouted him to let them come in and see their new baby sister. It's a fantastic memory - all those faces looking in awe - they didn't see the blood or the mess, they just saw a newborn baby.

So much for the planning - the pool never made it into the house, let alone assembled. The aromatherapy oils were still in our bedroom in their boxes. The nice warm fluffy towels I was going to buy, well they're still in the shop and the music I was going to put together - the CD's were still by the computer waiting for me to do it and we had to make do with me singing through the contractions! So nothing went the way we hoped and planned, but I still got the home-birth and I still gave birth vaginally. Regrets? I should never have gone to Warwickshire!! Then I could have practised what I preach and used different positions and all the stuff I hoped to instead of trying to find a comfortable position in the front seat of the car - not to be recommended in strong labour!

But would I change it? Not a thing. Maybe my labour wouldn't have progressed as fast if I hadn't been away from home. Maybe I wouldn't have coped as well, although I often felt that I wasn't coping at all. Maybe labour would have stalled and I would have needed that transfer to hospital.

But I still cant get used to the fact that I managed to labour and give birth, at home, after 4 caesareans - something I was told I would never do.

© Nikki 2005

See Nikki's Caesarean birth of her fourth child.

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