The Tale of Olivia’s Birth - Homebirth After Cesarean
Published in Midwifery Matters Autumn 2016 Issue 150 The Gift of Life They say that most parents these days will reflect back on their birth experience and think, “well thank goodness we’re all alive”, and hopefully you can add, “and healthy”. “What’s wrong with that?” you ask? For us, we had that whole phrase on repeat after our first daughter’s birth. We were thanking our lucky stars that after a very long three day labour which ended in an emergency C-section, that everyone was alive and healthy at the end of the ordeal. We were grateful to the medical team that delivered our baby, even if they were the most traumatic experience of the whole birth experience for us. This phrase gets used by most new parents after their birth experience especially hospital births, because birth has become somewhat of a survival test where you are grateful to get out alive, rather being grateful for experiencing the miracle of life. A New Chapter, Another Birth Now we were expecting again. It was time to face the trauma that had been lying there, a trauma that had been smoothed over with, “thank goodness we’re all alive and healthy”. Four years ago we hadn’t intended on being at the hospital and since I have heard many stories from people I knew about their traumatic first birth. Stories of how they had gone on to have magical second births, by making choices based on what they had learnt from the first time… perhaps that could happen for us too. VBAC The current trend in the medical scene is that after a Caesarean Section, you are encouraged to have any further births vaginally (referred to as Virginal Birth After Caesarean or VBAC), but wait there is a catch… you are also expected to have them in hospital. I jumped through every hoop they put in the way so that I could have a homebirth. The meetings with the obstetrician were nothing short of horrific, with talk of death and using statistics that were as solid as a puff of smoke. I discovered there is a lack of research in this area in the UK, with most statistics coming from the USA. The difference in birth practices in the two countries are phenomenal. The USA seems to have a carefree attitude towards induction drugs, with rapid and violent effects on the body and so increasing the chance of scar rupture. Furthermore, the USA has different suturing techniques, rendering the Caesarean Section scar weaker. With the chances of medical intervention and possibly another caesarean being far greater in the hospital environment, I wanted to labour naturally so my body could stretch open and birth safely at its own unique pace. “The most commonly quoted rate of caesarean scar rupture in the UK is around 0.5% or 1 in 200. Unfortunately many women understand this to mean that they have around a 1 in 200 chance of losing their baby, their uterus or their life. This is simply not the case.” Jenny Lesley, Birth After Caesarean, www.aims.org.uk If the women you care for are planning a VBAC or better still a HBAC then Jenny Lesley’s book is an absolute MUST READ. A Rebel Right From the Start I had booked in with a small group of NHS home birth midwives who serviced our local area. They were renowned for their services and their success rate. Also you would get a ‘named midwife’ the chance to meet all the others in the team in case your midwife wouldn’t be able to get to your birth – this was what I wanted! But because I had a Caesarean Section scar, I was referred to the obstetrician. If I still wanted a home birth against the recommendation the home birth midwives would take me. This was my first ‘hoop’. However, I was a rebel without a cause because, one thing that we did learn last time was that you have to surrender and let go to whichever way the birth takes you. It’s all very well to want a certain type of birth, but you have to be prepared to give over to safety first if it comes to an emergency situation. Nick and I agreed that we would travel the path of the natural home birth, but we would also be happy to use the medical facilities if we needed to. This time however, we would be prepared for every eventuality. We were not keen to have a repeat traumatic experience in the hands of hospital staff again. January 4th – When You Are Ready Baby It was my actual EDD, an oxymoron when you finally arrive on that day itself. With all the pressure that happened after the EDD with Scarlett’s late arrival, I discovered that statistically the chances of giving birth on or before their EDD were extremely low. This time I wasn’t prepared to go through that pressure on an estimated date. I feel strongly that when a baby is ready to come, that is the correct date. So right at the very beginning of this pregnancy, I added five days on – everyone was working to an estimated due date of January 9th. Having extra time up my sleeve made me feel very relaxed during every talk about what would happen if we went over the 9th of January. Health professionals discussing induction plans did not make me feel very safe or trusting of my own body. Both of these feelings are important in the lead up to birth. I have to say, I felt slightly bad for telling a lie, but if women are being told a date that has a 7% chance of being true, then who exactly are the ones being lied to here? January 5th – Safety First It was Sunday morning, and I realised that there was no way I would get myself (all large and with baby’s head engaged) plus Scarlett down to the card shop and post office to do Christmas thank you cards. I sat down at the computer and began my ‘Christmas thank you emails’ instead. “…I guess we will be in touch soon with news.” I finished the email and hit SEND. At that moment my waters broke. “Hmmmm we’ll be in touch sooner than you know” I thought to myself! By the early afternoon the contractions were getting stronger and coming about every 10 minutes. By dinnertime I wasn’t feeling like eating, Scarlett and Nick date their roast chicken while I rode each contraction alone. I was waiting for them to finish; Scarlett was keen to get out the door to her friend’s for her first over night stay too. Plates cleared she was off and so was I, now giving myself permission to let go and begin my journey of birth. The midwife was called, the doula was on her way. It was dark and the rain was coming down hard on the skylight in the hallway. I rocked and spiralled, bent over the banister at the top of the stairs. I was now ready to call this place ‘my cave’. The Safety of My Cave The first time around I had known about creating a safe place to birth; a place that is ideally familiar, free from intruders, dark, warm and quiet. A place that harks back to the cave, where for thousands of years our ancestor’s would have found safety from the world outside. While some women might actually find a hospital atmosphere their safe place, I didn’t. Opting for a home birth (both times) was my obvious choice – home is was my safe place, my cave. “Get smart: If you go to McDonald’s you get a hamburger: go to Pizza Hutt, you get a pizza. If you want a natural birth, stay at home. If you want an obstetric birth, go to hospital.” Julie B, Melbourne, Australia. From the book ‘Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience’ by Debra Pascali-Bonaro and ElizabethDavis Emotional Safety In her book Ina May’s Guide to Childbirth, Gaskin talks about the vagina being like a sphincter, with the same characteristics; how vaginas, like sphincters, are affected by the emotions. How emotions and intrusions during the birth can actually contract the vagina during childbirth. This was a huge discovery for me. Mainly because it explained why I was ‘only 3cm dilated’ when the midwife arrived after 3 days of labouring with Scarlett. On arrival, before she could even shake my hand to introduce herself, she was giving me my first (and only) vaginal examination where I lay at great pain on my back while she inserted her hand up my vagina. It is hard to believe I consented to that, but I was scared and believed I was putting myself in her ‘safe’ hands. I am now absolutely positive that I would have been more than 3cm before the stranger with the rubber glove at the ready turned up on our doorstep in the middle of the night. This had been my first clue – my body wasn’t a lemon, it was responding to the intruder. Mental Nesting Out with the old: because if a vagina is like a sphincter, mine wasn’t going to feel comfortable opening up if I didn’t get over the emotional baggage from the last time. I had cleared a lot of fear and trauma from my first birth; trauma that had begun at home and continued all the way to the operating theatre. There we had to insist – loudly – that the radio blaring Heart FM was turned off while they delivered our baby, and no one except the anaesthetist talked to us. Our midwife disappeared leaving us to fend for ourselves. This was about as far from ‘safe place’ as you could muster. In with the new: As well as clearing the old stuff I was also busy nesting mentally. Almost all of the books I was reading had birth stories in them; it seemed that getting positive birth stories into our heads paves the way forward to reaching them ourselves. But I found it really hard to read all these and my time as a parent already was precious – I wanted the cold hard facts, not someone else’s personal story. The Full Meaning of Safety So what I eventually discovered was that to get the right conditions for your safe place you didn’t just need to have familiar and safe surroundings, but also needed familiar people. The last piece of the puzzle for me was when I read that I would need to go into theta while awake. The environment needed to be such a place that you would be able to go to meditate or go to sleep in. All of a sudden it all made sense, I knew what I was looking to create. This fitted in with what I knew about the cave, but it really made clear that of course I wouldn’t want music, clocks, computers on, bright lights, or people I had not met before if I was going to go into theta. “When not altered by Pitocin or other interventions, the brain waves of laboring women are in theta frequency. This is the deepest level we can experience in a waking state. (We move into delta with sleep.) Theta is associated with extrasensory perceptions, creative inspiration, and spontaneous problem solving. In theta, time becomes relative and elastic. Anyone who has given birth (or attended a birth) can attest to points in the process when minutes seemed like hours and vice versa.” Debra Pascali-Bonaro and Elizabeth Davis The Importance of a Doula The books I was reading all mentioned the same thing; the importance of having a doula. It was November and I was looking for a doula at the last minute and through a great crisscrossing of connections we met Jennie. I had a list of everything that I would want in a doula and we were sure she was right for us. Jennie lived close by and knowing she wasn’t too far was important to me. She had had five births herself and four of those had been at home. She was quiet but confident, and her stories told of being sensitive to the needs of a birthing woman. We really felt that she was intuitive, aware and mindful. “In the time surrounding birth, women need to feel secure, they need the sort of protection that is provided by the presence of a mother. But for many reasons special to our time, many women cannot rely on their own mother and the father of the baby cannot also be a mother figure. That is why they need a doula.” Dr Michel Odent I was rocking and moving my hips in a spiral movement when Jennie arrived at our dark, warm and quiet home. I cried as she came up the stairs, a release of energy now that she was here to take over the thinking part of me that I could now turn off; she would think and arrange and know what to do next. Alex the midwife arrived and sat in the room. I knew her. All bases were covered by the people around me. The possibility of scar rupture was in the safe hands of Alex who was monitoring my pulse and the baby’s heartbeat every quarter of an hour or so, when it fitted in with my labouring. I didn’t have any pain relief, maintaining full awareness of my body. I continued with the contractions, one after the other. Eye’s closed, head down, trying different sounds and movements to pave the way through them. Then all of a sudden I was bolt upright awake, my eyes were wide and I looked around. The contractions moved, I breathed silently through them looking around. I refreshed my energy levels with some Miso soup, which has all the 9 essential amino acids, high in Vitamin K (which can be obtained through food and passed to the baby via colostrum, negating the ‘need’ for synthetic vitamin K injections) and minerals. January 6th By midnight I was well and truly in transition. Nick ran the bath and lit the bathroom with candles. It wasn’t long before I was in the bath and involuntarily pushing. The urge to push and the contractions had all moved to my back. The inevitable poo happened and as I needed fresh bath water Alex suggested I get onto the toilet seat so that I could open up my pelvis. Kate our second midwife arrived, she sat in the hallway just enough away from the action, I knew her. Something came over me when I felt the crowning head. “I need two towels, one on top of the other, down on the floor here in front of me please, now.” I dropped onto the towels on all fours, the contractions were everything now, all engrossing. Alex was there with the mirror and a fleeting thought occurred as I saw the top of this baby’s head, I needed to slow down or I could tear. I pushed the thought out of the way with the next contraction, pushing was involuntary in a very wanting to be voluntary way. There was no time for thoughts right now, I was my body not my mind. Jennie offered me a hot flannel to place on that crowning head, what a welcome sensation that was. The midwife notes report that I was on the toilet floor for 11 minutes while they were running a fresh bath for me to get back into. 11 minutes of contractions, mirror and torch, hot flannel and immense contractions, and with just one of those contractions out came a head and body – slipping right into my hands, I placed the baby gently on the towels in front of me. Nick and I got to know our girl, touching her, holding her and holding onto each other. Here she was, at the end of the journey, out into the world for the first time. She had arrived alive and healthy. We called her Olivia. The bath was ready and all of a sudden I was overcome with coldness. I shivered with shock and so climbing into the warm bath with this baby was the most delicious sensation. Nick sat beside us, and we marvelled at the miracle. Olivia went straight onto the breast, a towel was wrapped around us in the water and we sat there for some time before the big move into the family bed. One hour later the placenta birthed naturally and cut the cord. This TED talk with Dr Greene is a great resource to show women the benefits of delayed cord clamping: www.youtube.com/watch?v=Cw53X98EvLQ Tea was made, biscuits handed out, measurements, weighing and excited conversation, everyone was tired but high on the magic of the miracle. By about 3.30am everyone had gone, leaving Nick, baby Olivia and me in the quiet, warm, safe cave. We slept together in our huge family bed, Olivia in between us, I thought of the Japanese saying; that we were a river, and here we were a river of new life. “The mother is one bank, the father another, and the child sleeping between them is the water.” Cosleeping Around The World by James J. McKenna, Ph.D. www.naturalchild.org/james_mckenna/cosleeping_world It was just after lunchtime when Scarlett arrived back in the house. Excited yet calm, she gracefully climbed up onto the bed and with the biggest smile greeted her sister for the first time. The New Leaf The next week was spent in bed, with lots of rest and then some more rest. It was a time where we got to know our new family; where we hung out, talked, read books, ate all together in the bedroom and gradually got back to normal. I could finally put away all the birth books. I had done it, we had had a natural birth. I had made that journey from wondering if I even could do it, to having had an HBAC. With both of my births I would not change a thing, each one I learnt from the experience, each birth delivered a miracle into our family. Each birth will always be drowned in the memory of overflowing love for the baby girls that came to us. There is also going to be the tale of the different births; one where our power was taken away from us in the most undignified way while the other tells of empowerment bringing someone into this world ourselves as the miracle of nature intended. As with every piece of history, I hope that our girls will learn from the past and this story. And perhaps this here tale can help any other woman wondering if she can do it too. “Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.” Ina May Gaskin Disclaimer: The details in this story are what worked for me… I don’t recommend that you fiddle your EDD, decline Vitamin K or leave the vernix on; I don’t recommend anything except doing your own research. This is my story and throughout I made many ‘educated decisions’ after looking at a lot of information. |
Photo: Nick Caro
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