Nilsson, now age 8...
After my 20 week scan I decided I'd better start thinking about how I'd like to plan my birth. It hadn't really crossed my mind until then. I knew that I'd rather not have the baby in hospital, since in my childhood and even in adulthood I had had some pretty difficult and disempowering hospital experiences and had developed something of a distrust of the medical world in general. I felt sure that I didn't want to have lots of people busying around me and mostly I just didn't want to feel that my birthing experience was out of my control.
My instinct was just to be at home, but I wasn't sure if that was possible for me. Fortunately I lived in an area of London that had a home birth team of midwives attached to the local hospital, and I was supported by the midwives I saw during pregnancy. The system is somewhat different in England, in that midwives provide most of the care during pregnancy and much of it during labor too, even within the hospital setting. What else is different is that it was all free!!!
I started researching my options and all of a sudden I knew I wanted to try and have a water birth. It just felt good to me, I always feel calm and relaxed in water and somehow I just knew this is what I wanted to do. We signed up for childbirth education classes at the active birth centre in London, a great place run by Janet Balaskas, a well-known and respected woman at the forefront of the active birth movement. We were lucky enough to be taught by Janet herself. What an inspiring and encouraging experience that was, and a home water birth was what I wanted. I made a birth plan which the midwives went through with me a few weeks before my due date. They explained to me what I would need to have in my home for the birth and what they would bring. I had already learned about my pain relief options if I decided to be at home and in water. I was determined (but not attached to) the idea of not having any medical pain relief. We had studied homeopathy for labor and bought a special homeopathic remedy kit for labor. We had aromatherapy oils, flower remedies and nice music and lighting planned. We hired the birthing pool from the active birth centre and had it all set up in the living room. I went to active birth yoga classes.
Baby was due on Christmas day 1999. The midwives told me that the only day they would not be able to come out to my home would be millennium NYE – remember people thought the world may come to an end, or at least all systems would crumble and there would be chaos and looting in the streets? So when baby didn't arrive by NYE I was a little worried... no need though, because he decided to wait until my 'you're late' appointment at the hospital with the consultant on 6th January. I was very worried that 'they' would 'make me' have the baby, if they decided I needed to be induced then I would have to be in hospital. Luckily my consultant was not too rigid. He gave me the weekend to have the baby before I might need to come into the hospital and be induced. Actually he swept my membranes, which he didn't tell me and I could be upset about but actually I am grateful, he knew how much I wanted my home birth. (The midwives told me that is what he'd done after the birth when we were wondering why labor was so very fast!)
Strong contractions started that afternoon. I went to bed after acupressure point massage, a long walk, curry, wine and sex (we were following all the advice about how to get labor going!). At 4am I woke up with a particularly strong contraction and I instinctively rolled to the edge of the bed and stood up. There was a popping sound and my waters had broken. I was so excited!
Contractions were immediately pretty strong and after half an hour or so of wondering around the house with a towel between my legs and stopping wherever I could get comfortable for the contractions, I decided it was time to call the midwives. A midwife came to see me half an hour later, I was 5 cm dilated so was allowed to get into the birthing pool (we'd already filled it up because I so wanted to get in). She left again and said another midwife would arrive shortly to stay with me throughout. It was so much less intense in the pool. The water was relaxing and the contractions seemed more manageable. By the time the midwife arrived I felt pretty much in control and was in my own rhythm of breathing through contractions and resting between them. Labor progressed quickly. At one point the midwife asked me to get out of the pool to be examined. I had a few contractions out of the water and the difference was amazing – the pain felt unbearable. It was as if the water dulled or softened the intensity of pain. When it looked like second stage was imminent the midwife called for the second midwife to arrive. The only one who was nearby enough to arrive in time was on her rounds with a student midwife. She offered to leave the student midwife in the car but by that time I was in my zone and would have been happy having a stadium audience, so in they came. Something about the birthing pool suited me so well. It was as though I had my very own womb, it was my own space and I was so calm and focused on what was going on for me that nothing else mattered. The midwives and my husband were wonderful, respectful of my calm place and quietly supportive. Once when contractions slowed down during the second stage, I took a homeopathic remedy which brought them right back again. The second stage ('pushing') was nearly 2 hours long. Usually that would be about the time the midwife might consider a transfer to hospital. In most hospitals that long a second stage would be considered problematic and some intervention would likely happen. Anyway, baby arrived 7 hours after my waters broke, 9lb 9oz, long and with an impressive head circumference! Later the student midwife told her colleagues she couldn't believe I pushed that big baby out! I stayed in the pool the whole time, and baby was born underwater.
We got out of the pool, I hovered over a bucket and delivered the placenta, and then we lay on a futon on the floor, baby and I, while I was examined and all that stuff. The midwives left when all was taken care of, and there we were, at home. Went to bed!
What I realized in conversation with the midwives after the birth (I saw most of the team in the weeks after the birth, including those who did not come to the birth) was that they were all so passionate about what they do. They loved home births, loved that they were able to be what they are supposed to be and what they are professionals at. In hospitals they are second to doctors and specialists. At home they are the specialists and can practice their wonderful art just the way they should. I felt so proud because I was the talk of the department – what a wonderful birth they all heard it was and how they wished they could have been there.
Rosa, now age 5.....
By now I lived in an more rural area of England, but was fortunate that the local hospital also had a home birth team. It wasn't on such a grand scale though, so there was a small chance that if the midwife on call when I needed one wasn't experienced in water birth I wouldn't be able to deliver in the water. And if they were really busy at the hospital they might not be able to come at all. I did have a problem with my MD office when I told them that I was pregnant and asked to be referred to the midwife team for pregnancy care (that's how it works) - when I told them I was planning a home birth they refused to have anything to do with me or even refer me for services. I received a phone call a few days later, a female doctor really laying it on thick about how irresponsible I was being, how I could die and my baby could die if I didn't go to hospital to deliver. I did manage to find a local doctors office that was willing to take me onto their books.
The night I went into labor, I called the midwife team almost immediately because I knew that labor would often progress even quicker in second and subsequent pregnancies and I was half expecting a 2 hour labor. The midwife on call didn't have experience in water birth, but such was their dedication that she called the hospital and 2 midwives that were actually officially on hospital duty but had previous home birth and water birth experience left the hospital and came out to me. Apparently it was a quiet night on the labor ward and they could spare the staff, luckily for me!
When the first midwife arrived it turned out I could probably have waited a few hours to call, but it all worked out nicely because it meant that we had a few hours to sit and chat and get to know each other a little. She was very calm and gentle, and had a great deal of experience and confidence in childbirth and home birth. I realized that the midwife I had had first time around was a little nervous about certain things, so that there were a few small details I had conceded because they didn't seem too important (for example I would have preferred not to get out of the water to be examined, would have preferred to stay in the pool with baby for a few minutes and nursed rather than get out immediately, and I would have liked not to have to hand over baby while I got out of the water). This time I knew the midwife and I were on exactly the same page, and with me being that more experienced this time too, it was wonderful. The second midwife arrived and we waited.
After a few hours of drinking tea and visiting between contractions, things got more exciting and I was able to get into the pool. I was probably only in there for an hour or so, when quite the opposite to last time, the second stage consisted of 2 contractions. In fact, the midwives and my husband were making tea and toast in the kitchen when I shouted to them 'er, I think the baby's coming!' they came in just in time – baby Rosa shot out with such force that I exclaimed 'WOW!' and the midwife caught her with milliseconds to spare. This time we stayed in the warm water and nursed a while. I needed a lot of help to get out of the pool whilst still holding the baby, but managed it and again we settled down onto a futon mattress. Rosa was 7lb and 13oz, but looked so tiny. This time the placenta took a little longer, but when it came, the midwife showed me how it worked, what all the parts were and what they did, I didn't see it first time. It felt so much better for it not just to be 'clinical waste', to be disposed of immediately. We sat there for quite a while quietly, the midwife stayed until we were ready to go to bed. I know she must have examined me before she left, but she was so very non-invasive and in the moment with us that I don't even remember it.
I feel so lucky that I was able to have the birth experiences that I had, and grateful beyond words to all the midwives who were so present with me. It's a strange system because they were part of the overworked, underpaid NHS (national health system) so not only did I not meet them before the labor, but I didn't see them again afterwards. (I did make sure to write nice words in cards and give champagne though..)
