“It took courage to fight for what I knew was best for me and my baby.” Ellie’s homebirth after caesarean (HBAC)

After an emergency caesarean birth with her daughter following a failed induction due to suspected oligohydramnios (deficiency of amniotic fluid), Ellie knew she wanted her VBAC birth in November 2015 to be somewhere she felt comfortable and safe, at home. Here’s her story…

“I was determined not to be put under pressure again for unwanted intervention. The best way that I could see of achieving this and safely having a VBAC, was to birth at home. I researched extensively before making my decision and felt entirely comfortable that I would have the best chance of labouring effectively in a comfortable and safe environment, which for me is at home.

I explained my intention to birth at home at my booking appointment and then discussed it further at subsequent routine antenatal appointments with the community midwife. Whilst they openly said that they “wouldn’t recommend it”, not until 34 weeks did they mention that they “might not be able to send a midwife due to staffing issues”. I was crestfallen. I left the appointment in tears and spent the next few days not sleeping very well and in an anxious state. The community midwife had told me that I could hire an independent midwife or rely on a paramedic. I even talked about going it alone as I could not contemplate labouring in hospital, to which the community midwife asked me whether I had done any hypnobirthing, but that they of course would not recommend me doing this.

After seeking some great advice from some doula and midwife friends, I felt much stronger and able to stand my ground, knowing what was best for me and my unborn baby. I had an appointment with the Consultant Midwife to discuss place of birth the following week. I was expecting to talk more about the VBAC itself but a lot of the meeting focused on the staffing issues at the Rosie. I explained clearly my reasons for insisting on a home birth and as we went through the ‘what if’ scenarios, I agreed that I would transfer in if there was a clinical indication but with regards to their staffing/resource issues, that I was not prepared to transfer in and risk iatrogenic harm (from a cascade of intervention) or major abdominal surgery. After the meeting, my agreed home birth plan was issued and disseminated, and I looked forward to preparing for my home birth. I later received a letter which again cast doubt over whether a midwife would attend, however, I was so close to my due date that I chose to ignore it.

I was due on Bonfire Night – my contractions started on the afternoon before and there followed two-and-a-half days of slow labour. As I thought that things were moving along, I got up with my husband, Darren, very early on the Friday morning and put on my TENS. We phoned into the DU to let them know that we thought that things were progressing to give them as much notice as possible but that we were happy on our own. Nevertheless two midwives came out to see me and just before they left I was vomiting however the contractions were not intensifying so I went to bed to rest. On getting up I spent the day trying to keep things moving and wore myself out. I found it difficult to get any proper rest and was getting really frustrated.  In the early hours of the morning I took off my TENS, had a bath and then I spoke to a lovely midwife who was worried that I might have an infection but she understood how important it was for me to stay at home. She came out to see me and reassured us both that there was no infection but that I was pretty exhausted. She advised me to rest (and stop worrying about keeping things moving!) otherwise I might not have the strength to make it through. I can’t thank this midwife enough – I just needed some sound advice from someone who understood me and my plan, and she helped me perfectly.

I woke on the Saturday morning at 8am after a few hours sleep and felt so much better. My contractions had continued but amazingly I’d slept. When I got up they immediately started getting stronger and closer together. I knew things were moving rapidly so Darren called the DU and asked for the midwife to come. He then got me downstairs and out to the annexe where the birth pool was set up. I got in and immediately felt the benefit of the water and felt so relieved to finally be in the pool.  The contractions kept coming faster and stronger and I began to panic, especially as I kept having the urge to push. The intensity was hard to bear but fortunately I calmed myself down. I really felt that I needed some pain relief and had gas & air as soon as the first midwife arrived. As I got into a rhythm, I felt much more able to cope, but then the canister failed and I panicked again!

I swung from coping to needing reassurance. The midwife suggested that I could check progress myself but I didn’t really know what I was looking for, so I asked her to check with a VE. I was fully dilated. I used the support of the water to help me to move when I needed to and then ran out of gas & air. I felt a couple of times my baby move position and from there things would progress again, but the pushing stage was about 1h30. I did struggle with not knowing how long things were going to go on for and how I was progressing – I think I just needed some reassurance and this is where with hindsight, I could really have benefited from having a doula. But I managed eventually. My waters went (which felt strange) and I could feel my baby moving down, and then slipping back again! I asked the midwife to help me as I wasn’t sure whether I should be pushing or panting and at the very end I wondered how on earth I was going to push the baby out – I just didn’t know what else I could do. I moved position again and finally his little head was born. I rested for the next contraction and was so relieved when I made that final push and he was in my arms.We sat in the water together and I fell in love. Chester was born at 13:37 at 8lb 8oz.

ellies-hbac-nov-2015The midwife suggested that I birth the placenta out of the pool. I was not having any contractions, but soon after moving to the bathroom, the placenta came and I took a shower whilst Darren enjoyed some skin-to-skin. Unfortunately, I had a third degree tear and had to transfer in by ambulance to have it repaired in theatre. Everyone was apologising to me but I was just so elated to have managed my VBAC and managed my home birth. I couldn’t have been happier. Yes it would have been perfect to have been able to stay at home but I was grateful to be attended to so well and have things properly dealt with. I was delayed in theatre because of an emergency case and it just amplified how lucky we all were; so a night in hospital was no big deal.

If I could offer myself some advice, it would be: hire a doula! And listen more carefully to my body. I was looking for reassurance in the wrong place at times, which led to panic. When I listened to myself, I was ok. It was the hardest thing I think I’ve ever done but such an amazing experience. Sat in that birth pool with my baby in my arms, I couldn’t believe that I managed it. I still can’t. And I am so thankful that things progressed as well as they could and that I managed to have him safely at home. I feel blessed and I’m truly grateful to all the people who offered their support when I needed it the most, to give me the courage to fight for what I knew was best for me and my baby.”

Ellie’s homebirth coincided with the Rosie Hospital changing the way its homebirth service is staffed, we wrote about the change on our blog and how the changes affect women and their birthplace planning and confidence. If you have any feedback about the Cambridge homebirth service, please contact Healthwatch Cambridgeshire.

If you would like to connect with other local women planning birth after caesarean, join our private online support group, you can read more about it on support page.

There’s information about this hospital on The Rosie’s Hospital VBAC data page, including its VBAC guidelines and VBAC rates.

Here’s a blog we wrote about how women planning a VBAC can gain access to midwife-led units and birth centres, it’s called “Let me in!”

And for monthly face-to-face support, there’s the Cambridge Birth Choices free drop-in group, held on the second Friday of the month at Cambridge Women’s Resource Centre and the last Friday of the month at Satyam Yoga Centre.

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