For my 3rd birth I chose an independent midwife, or rather she chose me.
I am grateful to my NHS midwife for pointing out to me NHS protocol of how a VBAC (Vaginal Birth after Caesarean Section) should be handled and realised that I had been extremely lucky with the birth of our second child in carrying it off in a physiological, non-interventionist way. After a particularly stressful antenatal appointment in which I was told that I really should be receiving continual monitoring as soon as I was in established labour and would have a cannula inserted upon arrival (I was mentally la-la-la-ing with my fingers in my ears by this point), I decided it was time to have a conversation with someone who would explain the risks of VBAC to us and allow us to make up our own mind about the best way to bring our 3rd child into the world.
It was for this reason that I phoned Liz. I have know Liz Nightingale for some time. When I went very overdue with my first child, she took me under her wing (I’m allowed bird puns, I’m a Wren). This gave me an extra week of consideration before I ended up with an induction and the inevitable cascade of interventions that led to an emergency c-section. As someone who is horribly hospital phobic this was a very traumatic experience.
When we found out we were unexpectedly expecting our second child, Liz encouraged us to attend a Making Sense of Birth workshop run by Essence Midwifery Services. I remember one of the activities involved drawing out what came to mind when you thought of birth. The most striking thing about my picture (leaving aside the green vomit and the copious amount of blood) was the absence of a baby. Acknowledging that I had associated birth with pain and trauma, and not with new life, was the first step in a healing process that culminated in a very straightforward birth and a second beautiful daughter.
Anyway, back to the phone call…I think I was about 30 weeks pregnant. Liz agreed to come over to our house and talk through the risks of VBAC and the best ways to manage and minimise them. By the end of the evening Steve and I were certain that we would be better off having our baby at home. I could have gone back to my NHS midwife and insisted on a home birth, but I knew there would be resistance and I didn’t want to have a midwife in attendance who was not confident in HBAC (Home Birth after Caesarean Section) just because she had had so little experience of it. Within a few days we had employed Liz as our midwife and she took over all my antenatal care.
Well, Christmas came and went, as did my elder daughter’s 4th birthday. I was delighted that my antenatal care covered how I was feeling emotionally as well as physically as this meant that by the time I entered my 41st week of pregnancy, Liz was fully aware of how twitchy I was about going overdue.
On the morning of the 20th January, Steve declared that I would have the baby that day and decided not to go to work. I spent the morning making a gratifyingly complicated cake. Liz came over at lunch time and at my request gave me a stretch and sweep. She then sat and observed me for half an hour. (What she actually did was try to knit while my daughters climbed all over her). I just got on with my lunch. I decided that if I was going to have a baby that day, I had better get some rest, so I had a long snooze between about 3pm and 5pm. When I woke up, I moved from bed to sofa and proceeded to read Winnie-the-Pooh stories to my children. After 15 minutes of this, I realised that I was having to pause for breath due to contractions. Steve spotted this and suggested that he get dinner going while I phoned my friend who was going to look after the girls. After another 5 minutes I was having to stand up during contractions. Shortly after this I retreated to my bedroom, took a couple of paracetamol and phoned Liz. I believe I requested the TENS machine, but by this time I think I was kidding myself if I thought that TENS or paracetamol were going to be of any use. I remember thinking that I had mis-remembered how painful labour was, because when I had had my second child, it all seemed very manageable (I know I had been in the car parked outside Tesco’s on the way to the local hospital at least 6cm dilated and was still able to request the exact brand of crisps I required).
Steve convinced me that a hot bath would be a really good idea and filled the bath up to the top and helped me down the stairs to our bathroom. It was a bit after 6pm and I was vaguely aware that my friend was in the dining room helping my girls with their dinner and I was wandering about the house in my underwear – it took me well over a week to find my watch which I had taken off prior to getting in the bath. Steve brought me pizza and garlic bread and a piece of the cake I had made earlier in the day for me to eat whilst I soaked in the bath. Liz arrived at about 6.15pm and very calmly installed herself in the bathroom. I was relieved when she said that if I didn’t feel like getting out of the bath I didn’t have to. I had never seen what all the fuss was about water births before this point – I am now a convert! I could see her looking at me and looking at her watch and she was telling me how well I was doing and how the baby would be with us really soon. Steve was pressing down on my shoulders (on some acupressure point he had learnt) during each contraction. I had got to the point where I couldn’t face eating so I knew I must be fairly close to birthing our baby.
Liz needed to get a few more things from her car, so she left me briefly and call her colleague midwife Sarah Ifill to attend. I had been sat up in the bath but decided that I needed to lie down on my left and throw my right leg over the side of the bath. Sorry to get technical here, but on the next contraction the baby rolled from ROA to LOA the long way. Thankfully, Liz reappeared and I was able to request some gas and air, but I think that was the worst contraction and bad as it was, it was over in less than a minute. I was in very deep, hot water and leaning my head on the cold edge of the bath and had a cold flannel on the back of my neck and was drinking in gas and air (I love that stuff). I know I asked, ‘Do we have to?’ so I must have been zoning out. I announced that my waters had broken and Liz recorded the time as 7.36pm by calling the information to Sarah who was outside the bathroom writing notes. Within a few minutes I had birthed the head of my baby. That was the hardest bit and I felt that I had done enough and announced this. Liz told me that I had to get the rest of the baby out so I somewhat half-heartedly pushed with the next contraction and the baby slithered out at 7.47pm. Apparently it was a bit tricky for Liz as I was demanding she held my right leg up which didn’t leave her with free hands. Somehow she lifted the baby up into my arms and I felt down between his legs and as I’d suspected, but not known, he was a boy. Humphrey was very awake and we looked at each other in a surprised sort of way for a long time. Moments after he was born, my two big girls were brought in to see their baby brother.
Once his cord had stopped pulsing, Steve cut it and took Humphrey through to the sitting room. Liz helped me out of the bath and I staggered to the sofa where the girls were busy cuddling ‘their’ new baby. Humphrey then took his first feed and he latched on and sucked for ages. Eventually it was decided that I ought to get the placenta out and once that had been done (and my younger daughter had helped Liz examine it) I was tucked up in my bed with my baby. And that is where I stayed for the next week.
Liz’s postnatal care was superb and I have no doubt that it was her attention to detail and ability to include our whole family in her visits that made our transition from 2 to 3 children so easy.
Humphrey is now the most delightful three month old baby. We are very proud to call him a Purple Walnut Baby.