Sunday 16 January 2011

Anon's story, UK - overdue home waterbirth

"I'd had to fight to keep my homebirth because I was past term + 14 by scan dates, although that was a week ahead of where I was by LMP & ovulation (so according to the scans I was already a week pregnant when I started my last period!) and I have a strong family history of "late" babies. Had to see the consultant at T+15 (Monday) and the one I saw basically bullied me into a hospital birth, which left me me very upset (mainly because I dreaded the thought of being strapped up to monitors the whole time, which he told me I'd have to be because I was now "high risk"), but then I went home and researched my position and the risks involved. Basically the NHS claim that the stillbirth rate trebles after 42 weeks is based on very dodgy - not to mention old - data, and more recent research shows that the risk only really begins to rise significantly after 43 completed weeks. (In fact at 42 weeks the risk is only about the same as at 38 weeks!) So I wrote a letter to the Supervisor of Midwives (based on the one on www.homebirth.org.uk but with some personal justification added) saying that I was continuing with my plans for a homebirth. Handed it in at the antenatal clinic when I went for monitoring on Tuesday, and also showed a copy to the nice mw who was doing my monitoring, and she took it upon herself to make a phone call and put a copy of the letter in my file to make sure that the message got through. I'd been booked in for induction on the 11th if he hadn't appeared by then; considered backtracking on that too, but decided to stick with it in the end.


On Tues night / Wed morning I got up for my customary 3am loo visit and things felt a bit wet, so I put in a pad and went back to bed. Contractions started at 4.10am, about 10 mins apart and lasting 45-60 seconds. I was feeling them in my back to begin with, and had had no back pain at all up to then, so that was how I knew they were the real thing starting. Around 5.40 I called the hospital (having been told to call early in labour since it was a homebirth) and at 6.30 the on-call mw came round. She established that I was 2-3cm and "nicely effaced" (I'd had 4 sweeps, the last one at T+13, and each time was 1-2 or 2cm but with cervix still long & posterior, so it was a relief to hear that I was actually progressing, especially as the trickling seemed to have petered out by then) and stayed for about an hour. I was coping fine by breathing through the contractions - using HypnoBirthing techniques - so after that she left me to wait for the community mws to come on duty. The lead mw arrived around 9.40 and was very impressed that I was on the Internet in between contractions right up until I got into the pool at 4cm! She told me that because I was beyond T+14 my case was outside their normal protocol and so they had to have a third, supervisory, midwife present for the birth, and they also needed to listen in to the baby's heartbeat with the Doppler every 15 minutes. That kind of monitoring was no problem at all! The second mw was my usual community mw, so it was nice to have someone there whom I already knew, and the supervisor (consultant midwife) was delighted to be asked to attend a home waterbirth because it's something she hardly ever gets to do in her current role.

At 11.40 I was starting to groan through the contractions (though I was still getting a decent break in between - I think the interval was about 7 minutes, and I don't think they were lasting more than a minute or so) so I was examined and told I was 3-4cm and could get into the pool when I wanted to. I pottered around online for a little bit longer then decided it was time to get into the water. Almost as soon as I got in, contractions started to pick up and I had two without a break in between - though apart from that they never really got to the stage of coming too thick & fast to give me a breather. Started using gas & air at 12.30 and was soon bellowing my way through the contractions (DH said I sounded like a moose!). The hardest thing was not being able to make a single out-breath last the whole contraction, and having to stop and inhale. I'm not sure how much the gas & air actually helped but I wasn't about to stop using it to find out! The mws were great, very encouraging but respecting my request to be left to get on with it as far as possible. I started to feel the urge to push at 12.48 (according to my notes) but it still took a while after that: my waters went with a big "pop" at 1.32, the mw had a quick feel at 2.12 and said the birth was imminent, and Xander was born at 2.19. I fished him out of the water myself and within a few minutes he latched on and started to feed. We noted that he still had loads of vernix on him - not post-mature by any means! 

One mw estimated his weight at about 7 1/2 pounds but in fact he turned out to be a whopping 9lb 7oz when weighed! Not only that, but I realised later, when I looked at his charts in the red book, that he had an enormous head - just short of the 99.8th centile line for boys and would have been off the scale for girls - in other words, if you were to line up 300 newborns in order of head circumference then he'd probably be the biggest!

We were left skin-to-skin for nearly an hour and I could feel the uterus contracting, but after nearly an hour the placenta hadn't yet come out (I didn't realise I had to push it out!) so I was asked to get out of the pool so that it could be given a gentle helping hand (I had asked that the cord not be pulled). I managed to stand up but couldn't lift my leg over the side of the pool, but gravity, a bit of bearing down and some very gentle coaxing by the mw got the placenta out intact within a minute or two. Left the pool water rather red though!

Blood loss estimated at 350-400ml, and I had a 2nd-degree tear - with hindsight, it was no wonder given the size of his head! - but it was left unstitched as suturing would have required a trip to hospital. (It healed up OK.) The after-pains were a lot worse than they were with DD, but I gather that's normal for 2nd & subsequent babies - and they did seem do their job very effectively, according to the mw when she visited the next morning. Was told by the lead mw that I shouldn't take ibuprofen if breastfeeding, which was news to me (and to my normal mw!) but the paracetamol wasn't helping so I looked it up online and the NHS site said that small amounts get into breastmilk but it's unlikely to harm the baby, so I went ahead and took it anyway.

Incidentally, it turned out that both of my children were born at T+10 by my dates - if that's not consistent then I don't know what is!"


Click here for a link to comprehensive home birthing information

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