I had an upsetting birth experience in hospital with my first baby, Lewis. However it didn’t put me off having more children – if anything I became even more convinced that home was the only place I wanted to give birth (unless there was a medical reason not to).
When Lewis was 6 months old my husband and I decided that we wanted another baby; being far more relaxed about trying to conceive now that we had one baby to enjoy, we decided not to not try as opposed to anything more active. We were surprised but thrilled when I discovered I was pregnant a month later; and as soon as I was 8 weeks pregnant and we’d had a good early scan to be confident the pregnancy was progressing, I started planning my second birth.
In the meantime, I had decided that I wanted to engage a doula to provide extra support and advocacy during my home birth. I interviewed two women, both of who shared my views about natural birth, and I noticed a pattern emerging. The doulas (one of whom was a retired midwife herself) felt that the medicalised approach to birth in the NHS could undermine the process of natural birth. When I asked them directly, both admitted that to have the best chance of achieving a totally undisturbed birth I might want to consider hiring an independent midwife.
So I contacted Carrie McIntosh, Independent Midwife, on the recommendation of the first doula I’d spoken to. Carrie came to my house for an “interview” but I was already fairly convinced that engaging her was the right thing to do. Sure enough, we spoke and I instantly realised that she not only shared my opinions on how much more smoothly birth is likely to go when undisturbed, but also that she was going to be in a position to practice what she preached, being unhindered by NHS policies.
I decided that Carrie was to be my midwife, and engaged her formally – signing the disclaimer required at the time by independent midwives to say that I understood she would not be practising with insurance, and setting up my standing order to pay her fee in monthly instalments.
My pregnancy progressed smoothly, baby was perfectly happy at every antenatal check (Carrie would come round to the house in the evenings, which made things a lot easier for us) and my health was excellent – blood pressure perfect at each check and never any traces of anything worrying in my urine.
At 31 weeks pregnant, I noticed something funny about the sensation in my hands. Everything I touched felt freezing cold, even if I knew it was only slightly cool. Chalking it up to some random pregnancy-related strangeness I ignored it and carried on as I had been. However the following week something else strange happened when my tongue suddenly felt as if it had been burned and I lost my sense of taste. My hands were no better, and I was starting to have difficulty holding a pen properly to write with. By the end of that week, I felt achy and weak, and assuming I was coming down with the flu, I left work early on the Friday afternoon; I was shocked to find how difficult I found walking home from the bus stop due to the weakness in my legs.
I spoke to NHS24 over the weekend, who arranged a neurological check-up for me with a doctor at the Western General Hospital. The situation deteriorated during the course of my 33rd week of pregnancy; I felt too weak to go to work, and by the middle of the week, my skin was numb across about 75% of my body and I was having serious trouble walking. Finally admitted to hospital at the end of the week, I was diagnosed with Guillain-Barre Syndrome (GBS), an autoimmune condition where the body attacks its own peripheral nerve system, causing ascending paralysis accompanied by swallowing and breathing problems.
I spent 13 nights in hospital, first waiting to see if the condition would “plateau” by itself and start to improve, then as time went on and I continued to deteriorate, for a 5 day course of treatment which thankfully set me on the road to recovery.
By the time I was discharged from hospital, I was exactly 36 weeks pregnant and still having real trouble with sensation and mobility. I knew I was on a timetable to recover my strength in time to give birth, and started to worry about what was going to happen when the time came. Not for the first time I was incredibly glad that I’d engaged Carrie as my midwife; her unswerving positivity and pragmatic attitude to my condition were a huge comfort to me during what was a really frightening time.
Carrie’s thoughts were that as the GBS was not at all pregnancy-related and was unlikely to affect my baby, I should still be able to give birth naturally, and she would still be comfortable attending me at a home birth unless there was any clinical evidence to make transferring to hospital advisable.
Between us, Carrie and I agreed that my main problems in labour were going to be strength and stamina – I simply didn’t know if I was going to be able to cope with the demands of childbirth, given that I couldn’t stand up for longer than a few minutes, and even sitting up for any length of time was tiring. I knew in my heart that the only chance I had of achieving an active birth, where I could move and change position according to my instincts in labour, would be by using a birth pool. In water, I knew I would be as mobile and comfortable as I possibly could be – and therefore able to make the most of my very limited strength.
At 37 weeks, Carrie and I met with the consultant obstetrician that I had been referred to after the GBS diagnosis, and a consultant anaesthetist he asked to come along. My aim for the meeting was to come up with a Birth Plan B in case when I went into labour I wanted to be in hospital. Apparently the consultants’ aim was to scare me into giving up the idea of home birth. I was told of horrible things that might happen to my blood pressure and pulse with the onset of active labour, advised that the placing of an epidural would be complicated and risky due to the existing nerve damage from the GBS, told that emergency caesarean under general anaesthetic would be ultra-complicated and risky, that I could require ventilation, that I could die, that my baby could die…
The consultant anaesthetist in particular continually talked in absolutes; “when” you get your epidural, “when” you need your caesarean section – calling the various interventions “yours” as if they belonged to me and I’d already begged her for them.
I was terrified that I was being bloody-minded to the point of endangering myself and my baby, but I could still sense Carrie believing in my ability to give birth, so from somewhere found the strength to tell the consultants that although I would have a very low threshold for transfer to hospital on clinical indications of any problem with the labour or the baby, I would not be deciding where to give birth until I knew how I was going to feel when labour started.
My understanding of the risks I faced was very different from the medical view. They feared that my blood pressure and pulse rate would cause me to crash; I feared their continuous monitoring of those, which would confine me to bed where I wouldn’t be able to cope with the pain. They feared that an epidural would cause permanent damage to my already raw nerve casings; I feared being forced to labour on my back which would make the dangerous epidural necessary. They were concerned with constantly looking for what might go wrong; I needed to know I’d given myself every opportunity for things to go right.
Things kicked off more or less the same as they had with Lewis – albeit nearly 2 weeks earlier. After more or less constant Braxton Hicks contractions which began while I was still bed-bound and paralysed in hospital (with hindsight, my clever body trying to shift poor persistently posterior Adam into a more sensible position ready for birth – foiled by my forced immobility), my waters broke overnight between 37&6 and 38 weeks.
Then, the same wait for “proper” contractions. I knew the statistics – 86% of women would go into labour within 24 hours of membrane rupture; so I was determined to wait it out this time and avoid the syntocinon drip. It took another 3 days for my labour to start (by which time I was getting very anxious) and at 38&3 my first ever natural “real” contractions started.
This time, instead lying in bed in a sterile and frightening hospital room, I was propped up on pillows on my own couch. Lack of sleep in the last few days of my pregnancy had drained me of so much strength that my residual GBS symptoms had been getting worse; by the time my waters had been broken for 3 days I was having trouble walking again. Nonetheless, once my husband had helped me to overcome a last-minute crisis of confidence, the thought of hospital was banished from my head and didn’t occur to me again.
Contractions became steadily more intense throughout the morning. I was in a strange state of denial; having never gone into labour at all with Lewis, and following the prolonged “false start” of broken waters and incessant Braxton Hicks contractions, I had started to feel like I would never give birth. So every stage I reached and passed was accompanied by a feverish thought in my head – “Oh God, I really hope I’m in labour now!”
Carrie had popped out to run a quick errand, and on her return I was clearly working hard. I had moved through to the dining room, where I could balance my huge pile of prop-me-up pillows on the side of the birth pool so that I could lean forward on to them while sitting on the edge of a bed we had set up – it had become impossible for me to sit upright on the couch any longer, I simply didn’t have the strength.
A quick examination, and my first shot of the gas & air (I have a horror of internals that makes me tense up and panic, so wanted to be comfortably stoned) revealed that I was 4cm dilated, and in active labour. This meant only one thing to me – that I could get into the birthing pool! I have never felt such a profound sense of relief as I did when I slipped into the water – instantly my mobility issues vanished, I could move about with ease, my weight was no longer dragging me to the ground and making me ache – I could float, I could turn, I could lean forward; and it was easy.
As far as I can remember, things sped up from that point. I was using the gas & air to get me through the contractions which seemed far too far apart and too short for me to be in active labour. I heard Carrie telling me that I was doing brilliantly, that the contractions were right on top of each other, and I was confused. Then I realised that I had been counting the feeling of pain as a contraction, and in fact there was a period of painless pressure on either side of the short (but intense) pain which meant that my contractions were coming thick and fast, and only hurting me at their peak now that I was relaxed and surrendering to the process.
The whole birth became a sort of strange “out of body experience” as rational, informed Elaine watched primal, animal Elaine in the pool going through the stages of labour. I remember words coming out of my mouth; “I can’t do it. It’s too hard. I can’t do it!” (Gosh, you sound just like you’re going through transition!)
Suddenly my body was pushing; (Oh! You just pushed!) nobody had told me to – it just happened. My despair of the moment before had been reassured by Carrie’s confident “you are doing it Elaine, you’re doing great” and was suddenly replaced by an elated certainty that came out of my mouth with the words “Ahaaa – nowwe’re getting somewhere!”
Pushing lasted 30 minutes, and not once was I told what to do. My body pushed for me, as my husband held my hands and bathed my face and neck with cool lavender water; the second most blissful thing I have ever felt – after the initial plunge into the birth pool.
As I felt Adam’s head pop out, (Surely I must be in labour now!) another great wave of relief washed over me, and with the next contraction I felt his body slide out. Carrie said “Well Elaine, do you want to pick your baby up?”
I looked down between my legs to see Adam apparently swimming, and I felt incredible, strong, powerful, elated, amazing as I reached into the water for him. Then I remembered that my stupid hands were still numb when I fumbled with the slippery little bundle and dropped him again. Luckily, Carrie caught him, and helped me manoeuvre myself to the edge of the pool where I sat with my new baby on my chest and wept tears of joy, relief and general emotional overload.
The rest of the process was straightforward, if a little tedious. I was shattered, and getting out of the pool reminded me of just how weak I was physically. The placenta was being a bit stubborn, so Carrie and Jenny, my second midwife, helped me onto a birthing stool where I briefly felt resentful (I’ve just had a frickin’ baby – can’t I have a break now?) then amused when I remembered reading the words of midwifery guru Ina May Gaskin who told one similarly tired-of-it mum “oh honey, this is the easy bit – there aren’t any bones”. I had a few contractions and pushed it out without any bother.
Then it was back to my couch for cups of sweet tea and bacon sandwiches. Adam had a little feed on my right breast, and then me, my husband and our two beautiful boys had a huge cuddle on the couch before Adam and I were transferred, grateful, happy, spent and (most importantly) safe, to our own bed.
I don’t want to write too much more, because that seems like such a perfect ending to me. All I want to add is that I am glad every single day that I chose to give birth at home; I’m glad that I chose Carrie as my midwife, and I’m glad that I have a wonderful husband who trusts me to give birth to our babies without needing a doctor. In the same PROM / OP baby scenario as first time round, with some extra complications added by the GBS, I had a healthy, safe and natural birth – simply because I was cared for and supported in labour by people I trusted, and I was allowed the peace and privacy I needed to let my body do its wonderful job of giving birth.