Monday 10 December 2012

Hannah





                                                                               




Both of Hannah's babies were overdue, by NHS standards, very overdue….even so, she trusted  her first baby to give the cue and had a positive and simple birth at 42 plus 3, with labour starting spontaneously. With her second, she chose to be induced - and went on again, to have a second positive birth experience. Here she tells why - and how.....


When I was 42 weeks and 2 days, I had an assessment scan and found my baby to be perfectly healthy, with an optimally-functioning placenta. Afterwards, I had a meeting with a consultant midwife at the hospital, to talk things through. She agreed to support my plan for expectant management - I was to go in to be monitored daily, to ensure my baby's wellbeing. She also supported my wish to give birth at home should I have gone into spontaneous labour.

A plan was also made in the event that I should choose induction. I was to be supported to give birth on the midwife-led unit, in water if I should desire, with intermittent monitoring.

As it happens, I chose induction as I personally found the wait caused me anxiety (I have suffered from anxiety issues/panic attacks in the past).

This whole process was incredibly important to me. I simply was NOT happy to be induced according to anyone's timetable but my own.

I had to request this individualised care - it was not offered. It was simply assumed that I would have 1, 2, 3 sweeps, then hey-presto: be induced at 41+5 according to hospital policy. Well my policy was different. 

I was always clear that as long as baby was healthy and I was ok, I would wait.

When I did decide to go ahead and have an induction, it was my choice, not theirs.

In the event, labour took only 3.5 hours from the first contraction after they broke my waters, until he was born. It was totally manageable and much easier than my first birth, physically.

There were some concerns about my baby's heart rate during transition and it did look at one point as if a c-section would be needed for a quick delivery. I was rushed into theatre, which was not nice. However, again my wish to avoid intervention was listened to and honoured: The obstetrician halted her theatre team (who were prepping me for a spinal), and made them hold back whilst I pushed my son out into the world.

She LISTENED to me. She WATCHED me. She OBSERVED me and what my body was doing.

I believe that it was down to my determination during that scary time, and the obstetrician's sensitivity that I avoided a c-section, and subsequently will go on to birth my future children without a scar in my uterus.

My experience was positive and that is very much down to the respect I was given by my community midwives and the consultant midwife. They didn't try to bully me, or scare me into towing the line. I was supported to make an informed choice. They listened to me, and my husband, and they accepted that the decision was ours.



There is an incredible amount to be learnt from Hannah's birth stories. There is of course always a risk with going over 42 weeks, but when midwives and doctors explain this to women in this situation, they rarely if ever quantify that risk in useful percentage terms. 

More often, women are read the riot act, or bulldozed with loaded statements like, your risk 'doubles' after 42 weeks...  which of course mathematically it does. But if women knew that the doubling was from a 1% risk of placental failure, to a 2% risk, they might not feel as scared - or as irresponsible as they are so often made to feel.

I think it would be true to say, that all round the country, pregnant women who are overdue, feel pressurised into sweeps and inductions - and genuinely believe they have no choice in the matter. Certainly it doesn't feel like choice when a medical expert implies the situation is dangerous, or that you are irresponsible - and fails to balance that information with the risks an induction will also bring.

The last woman I was doula for, declined induction at 42 weeks and while being monitored, was told by a midwife, 'you do realise your placenta is likely to pack up in labour don't you?'. She was so frightened, she couldn't stop crying. 

Of course, the maternity system needs to inform women that there are certain risks in these situations. But the key word is inform.  Given our maternity service's watchword is 'choice', shouldn't it be the case that a woman advised to have an induction, is IN THE SAME CONVERSATION told the risk of a syntocinon drip - informed of the cascade of interventions a drip is likely to trigger?

Perhaps if the risks were presented in a proper and balanced way like this - in a way that treats women like adults  - more of us would, like Hannah, feel able and empowered to make an informed choice. 

For some that would be to wait - as Hannah did with her first, and for others, that risk would still be intolerable and they would agree to induction - but as Hannah did for her second birth, on their terms. 

Such an approach is absolutely KEY to getting a good birth experience. Even if an induction ends in an emergency c-section, when a woman enters into it with this mindset - with a sense of control - she almost always comes out the other side with a sense of acceptance and satisfaction. 

The difference I see as a doula when a woman draws her own boundary, as opposed to being frogmarched or even frightened into it, is immense. The three inductions I have attended in the last two years, where the woman has done the deciding, remains the agent in her birth process, and feels respected and trusted by her caregivers,  resulted in utterly normal, spontaneous deliveries. 

As well as being informed, it is absolutely crucial that women ask for meetings, as Hannah did.  Talking to a midwife or consultant, where a woman can be heard and helped to get an appropriate plan, helps her to get OFF the obstretric conveyor belt and  create a relationship with her caregivers. It is, after all, in relationships that we get the chance to communicate, where both parties' viewpoints are seen and heard. When there is a real opportunity to air feelings/fears/wishes, and trust is built. It really is just a case of picking up the phone and asking. Hannah's meetings were the key plank to her entering her induction with confidence.  So follow suit. Turn unknown territory into something more known - and you are much more likely to have a good birth experience. 





Friday 30 November 2012

Ella

                                                                           
                                                                               

                                                                               


Cloudea, Ella's second daughter was born quickly and easily, at home in her bedroom. Here Ella tells us her good birth story....


My contractions started on Monday morning, coming on quite intensely just as they did with my first daughter.  However,  I knew it wasn't established labour, as once my toddler woke up things slowed down and  I had the latent phase everyone talks about.

I spent the day doing all the things that you’re supposed to do to pass the  time... I had a bath, went for walks, I even baked a cake!  And then I went to bed.

Between midnight and 1am I had some strong contractions and then suddenly, a very big one that made me scramble on to all fours. 

I went to the bathroom and soon I was standing over the bath, gripping on to the edge with a relentless cycle of intense contractions.  

My partner was trying to time them, but since it was hard to tell when they were starting or finishing, she called the hospital.  A midwife said she'd be with us in half an hour.

I really wanted to get to our bedroom, where we’d set up a nest.  Like last time, the contractions came on quite violently and suddenly, and I was struggling to find something to hold on to – in both the physical and psychological sense.  But once I managed to get to the bedroom,  I was able to shut everything else out and focus on my breathing.  Now I was anchored. 

The midwife arrived at 2.15am and wanted to examine me and listen to the baby’s heart beat.  I was kneeling on the floor with my elbows on the bed, and she asked me to lean back on the floor.  Every time I tried to move the contractions became more violent, but I eventually managed to sit on the bed, and when the midwife found I was already 8cm, she went to the gas and air, which I'd asked for.

I was able to get back into my kneeling position and the midwife could check the baby’s heartbeat without disturbing me.  In my birth plan, I had said that I would prefer to stay in my zone, and asked that any communication be done through my partner.  I carried on riding out my contractions using my breathing and the gas and air when they were really strong, and then my partner whispered in my ear .

“The midwife is worried that the baby is getting tired, so you need to push on the next contraction”.  I sat up and said “What?!”  I couldn’t believe it was time. 

I remember reaching down and feeling the top of her head and feeling incredibly excited – so spurred on to push her out. The midwives guided her down but left her between my knees, for me to pick up.  It was so amazing and exciting reaching down for my beautiful baby.  I held her to my chest and she grabbed on to me with both hands and I thought I’M IN LOVE!

It only  took a couple of pushes and she was here, born at 3.30am!  A two hour labour! 

The midwives helped me to get comfortable, went and made me a cup of tea and then left me, my partner and our baby.  It was amazing – the middle of the night, all was still and peaceful and we were able to enjoy the first magical moments with our new daughter, in the comfort and privacy of our own bedroom. 

I thought my first daughter's birth, also at home, was amazing and I really hoped to be able to give me second daughter as good an arrival. Her birth was even better... it's not often that you hear words like 'peaceful' and 'exciting' in birth stories, but that is exactly how we describe this birth. I almost wanted to push her our again!


How I love Ella's nest. She couldn't have highlighted the most basic need of labouring women better. A private place, with utter peace and quiet to retreat to. And as soon as she got it,  now that she felt 'anchored' as she put it, her body could do it's thing. There was nothing for labour to snag on, no disturbance to derail it's flow....right on cue, with her body's needs met....the labour powered off and her baby came.  Honour the physiology, help the hormones flow, and birth can be simple. 

Thursday 8 November 2012

Melissa

     


                                                                       

Melissa's son Oliver was born at home, on September 19th.  She chose to give birth alone, with her husband and a doula to support her. 


During my second pregnancy, I opted for minimum contact with maternity services and began to consider freebirth. What appealed about the idea was the freedom and control it gave back to women and birth. I could imagine nothing more peaceful than allowing birth to take over with no interference. The more I thought about having midwives present, the more I felt it would be detrimental to my birthing experience.

I don't have a personal issue with midwives or hospitals. I think they do an amazing job under great pressure. But I don't believe that all women automatically need care in such a systematic way.  Our bodies are designed to give birth, it is a normal physical function and if the woman is healthy and the pregnancy low-risk, it's my belief that birth does not belong in a medical setting or need over-seeing by medical experts. I believe in a woman's ability to birth successfully provided she is surrounded by the right, supportive environment that she was able to make an informed decision about.  

As my pregnancy progressed and I gained more knowledge I knew I wanted to give birth alone. I did not have a specific due date as I had no ultrasound. I knew I was due sometime late September. 

On the morning of the 18th I woke up having mild contractions but by lunchtime they stopped. At 5pm I had a show and contractions started picking up again. They were very intense coming every 20 minutes or so. At 8.00pm my partner, David and I settled our daughter, Sofia,  into bed. During this time the contractions became closer together but remained erratic. I ran a bath but began to feel extremely dizzy and sick. I was feeling afraid of the pain and so decided to contact our doula, Tina. 

I followed my bodies cues and feeling the need to be on all fours I knelt on on the floor, resting against the bed, face down in the duvet. I used David's hand and leg to help me through contractions, pushing and squeezing while he held our daughter asleep on his other side. 

Time seemed to passed slowly and I didn't realise just how fast things were progressing.  I was gradually feeling as though I was losing the ability to speak and all  I could think about was water. It was now approximately 11.30 and David suggested I try the bath again.  As I tried to get up, I leaned back from all fours and the pain was intense. With David's help and a lot of concentration, I eventually made it into the bath. As soon as the water touched my skin, I felt instant relief. As I lowered myself down the water transformed the sensations. The contractions just came and went and I was completely still, silent and intently focused. 

When Tina arrived, David went to help her with the pool leaving me alone in the bath. I thought about the idea of getting up, walking down the stairs and getting into the pool and it seemed like an impossible task. Then quite suddenly I heard a loud pop and a small gush of red came from between my legs followed by a stinging sensation. I laid back as I felt my body in complete control. A familiar sensation overtook me as I instinctively seemed to seize up and bear down. I let out a loud noise that I couldn't hold back. Tina came straight up to the bathroom and sat by my side holding my hand. We both knew my baby would be here soon. I still felt afraid and holding her hand helped me feel strong. 

As I began to push my baby out I reached down to touch him. I felt the unmistakable feeling of his soft scalp and hair. With every push I could feel his whole body.  It felt as though my body was moulding  itself around his, easing him into the outside world. I felt excitement as his head appeared. I could feel our baby moving under water, half way between my body and the outside world. I began pushing again, his shoulders moved out and again a short pause before the rest of his body finally emerged in the water. I immediately lifted him up and put him to my chest. The rush of emotions and pure relief was incredible. 

I remained in the bath for around an hour and a half, chatting with Tina and eating toast.  I delivered the placenta in the toilet, then cut Oliver's cord. I rinsed and checked the placenta, keeping it to one side as I planned to encapsulate it myself.

I am now beginning to process this experience and place it's meaning  within the context of  my life. It feels like a true achievement,  I have experienced something really special, a moment of absolute clarity, control and freedom in a world that frequently limits our choices and confines us within very narrow margins. It has been a journey that has opened my eyes to new perspectives about life and birth.


Thursday 25 October 2012

The Arrival of Tommy


                                                                                                            

                                                                                   

The Arrival of Tommy Hunt..... 

At 5am or thereabouts, on a cold morning last December, I woke up with a slight discomfort. My waters broke. I was amazed/terrified/exhilarated and bewildered. I called out to my husband from the toilet ‘Andy, it’s started!’. 

I was aware it could still be a very, very long time before we met our baby so reassured Andy we should just get back into bed and sleep.  

Within 30 minutes or so mild contractions had started, but I still wanted to stay in bed and was almost in denial about what was happening. I wanted our doula to know that things might be unfolding, so sent her a text and then carried on pretending it was a usual Monday morning. 

We decided to watch a film in bed. I then remembered that keeping things normal,meant I should still eat. So we went downstairs and had porridge and tea. All the while the contractions were getting a bit more distracting but I was determined to carry on ignoring them. Frozen Planet was the next show on TV, I’ll never be able to look at polar bears in the same way! Whilst they were padding about on the ice, I was on all fours in our living room feeling like one of them...

I’m not sure what happens to time when you’re on your journey to having a baby, but I certainly have no concept of it looking back now. I remember retreating to the bedroom and kneeling by the bed with my head under the duvet. I suddenly felt the need to be alone, focus and have a word with myself. The contractions were becoming stronger and I got quite emotional, I needed a big hug and reassurance from Andy, and then I needed to be alone.

My doula arrived. I was so pleased to see her. She and lovely big inhales of lavender oil got me through another couple of intensive hours. I remember wondering when it might be good to go to hospital, and then feeling that actually I wanted to be at the hospital, so around 2pm, we left. The journey was bizarre. Initially my contractions slowed, but then once under a big blanket in the back of the car, I concentrated on keeping going, I really didn’t want to lose the momentum that was building. I felt that as long as I let it, my body would know what to do. My long, slow breathing, helped me stay on top of the waves of pressure I was feeling. 

Arriving at the hospital scared me, the contractions were getting stronger and faster, which was good but I didn’t want to be distracted. I felt that as long as I focused I could handle it. We arrived and I was on the floor, on all fours. My eyes were closed, and I was concentrating deeply so I didn’t feel remotely self-conscious. Being right inside myself, felt a safe place to be and I just wanted to be able to carry on and let it happen. 

A midwife approached and started asking questions.  I gestured that my doula and Andy should speak for me - I couldn't afford the distraction. They both knew that I wanted a natural water birth and I did not want to know how far dilated I was, just whether I was truly ‘in labour’. The midwife was astounded, but I was adamant. I had planned this as I knew that if I was given a number of centimetres dilation, I would focus on this. Too much and I may have panicked that the baby was coming too soon - too few would mean disappointment. 

Fortunately, the midwife confirmed I was staying, but there was no birthpool available. My heart sank. I had only really prepared myself for a water birth. However things were ramping up and I had no time to feel too sorry for myself. My doula assured me we could use water for pain relief and went to run a shower. I began to feel I was losing a bit of control here, I’d managed to stay calm so far, counting my breaths and knowing exactly how many breaths each contraction lasted and knowing a break was coming.

We went into the bathroom only to discover no hot water. With  cold water on my back…I lost it. I'd been holding on to the idea of hot water and now I felt helpless. I remember asking my doula for pain relief of any kind and quickly. She calmly and reassuringly suggested I try gas and air before anything else. The midwife set this up and it gave me amazing relief and the confidence boost I had needed. 

However I was still nervous of where exactly I was going to give birth. I wanted to be in a pool, I’d only ever imagined being in a pool. The room we were in felt stark, I didn’t want to be on a bed and I couldn’t get comfortable. I don’t know how long we were in this room. I was so focused on breathing, counting, the ramping up and the calming down of each contraction time just went.

I think Andy had a stern word about the lack of hot water, a new midwife started and by some small miracle she found us a birthing pool. I was so delighted. I remember asking her how we would get there, she had a wheelchair for me and when we got to the room, I couldn't believe it - the room was perfect, just what I needed. Dimly-lit, lots of space and the sound of running water as the pool filled. 

The relief of the warm water was immense. I could move more freely and got back into the rhythm of the contractions. Things ramped up, I felt scared, but it was because things were changing and I felt the need to push. My doula was amazing, just her presence reassured me that things were going ok. I felt like pushing lasted an eternity and it was harder than I could ever have been prepared for, but at the same time I knew that my body could do this, I just had to keep going. 

The moment Tommy was born will stay with me forever, there he was ‘swimming’ in the water, I picked him up and couldn’t believe my eyes. He was perfect, beautiful and our precious son.  


What's to learn?

The most important thing to learn from Gemma's great birth, is how she had a grounded and realistic expectation of what real labour was. Even though at home, her contractions were coming every three minutes (while she was on hands and knees, watching polar bears in the rests inbetween), she knew it was unlikely to be labour, from the simple fact that she could tolerate the telly.  A woman in real established labour just wouldn't want or be able to engage in that way - the stimulation would be too much.

She knew, because she'd informed herself, that true labour was more of a state, and that though the contractions demanded some attention, they didn't demand all of her.

And then that changed...quite suddenly, after a trip to the loo. Now her bedroom felt a better place to be.  Peace and quiet, darkness, privacy.  These were the things that now helped her to cope and drop deeper. 

Now something more established was taking over - technically, (though as she rightly said it's far better not to get hooked up in rational numbers and measurements) she would have been 4cm or so, which meant her body had started the work of opening up. 

This can feel intense, an acceleration, as Gemma puts it....'a ramping up.'  Certainly it's tempting to rush into hospital at this point, and even feel a little afraid. But the best thing to do is as Gemma did, 'have a word with yourself.'  Remind yourself that change almost always signifies a GOOD thing, progress....and to trust that. What is happening is right, not wrong, and to find your feet with that. 

Take one contraction at a time, go with the flow, and labour proper gets a chance to take a hold. When this happens, a physiological momentum builds and it is far less likely that labour will slow and stall.

When women stay at home for an hour or two once contractions are very strong and regular, (see the tellmeagoodbirthstory page on helping labour to happen for more 'proof' of labour) they usually arrive in hospital full of sturdy confidence - they can feel for themselves that it is working. There's no panic, no need for rescue........she trusts her body to take her to the next stage.  

And a final word about the car journey...in case you are thinking you'd rather 'get in early' fearing the journey in will be uncomfortable, note this. The advantages of the quick and efficient labour that is likely to result from waiting at home that bit longer, FAR outweigh the discomfort of the car...especially if you are on hands and knees in the backseat, leaning into a sturdy pile of pillows (never use a baby's carseat as a reason not to do this....it's a priority and sitting in the front with a seat-belt on will wreck the best of coping rhythms) 

Sunday 14 October 2012

Rachel's baby girl





Rachel's baby girl Evie , her second child, was born a few weeks ago, at home. Here's how it happened.... 

I had very erratic contractions all through Sunday - some 5 mins apart, some 10 and this went on all through the night.  In the early hours, they were becoming more regular and more intense, but did not seem to progress much (particularly when compared to my first daughter’s birth). 

On Monday morning I was in no doubt that the baby was on it's way and we agreed that my husband Jules should take Anna (our 2 year old) to nursery and when he got home he would fill the pool. Once I was on my own, I started having more regular contractions - about 4/5 mins apart that were more intense, but manageable with breathing and bouncing on the birthing ball.  

I rang the midwife around 7.45 am,  she listened in to me having a contraction on the phone and said someone would be with us within the hour to see how things were going. 

By the time Jules got home at 8.40am the contractions were coming thick and fast and were very intense and painful. I was just about coping – leaning over the kitchen work top, a wet flannel pressed to my face, trying to control my breathing and by this stage making quite a few moaning sounds. I was now in no doubt that I was fully in labour!

We were just about to ring the midwife again, when she called. She spoke to Jules, heard me in the background and said a colleague would come right away. By now  I was getting urges to push - Jules was just about to ring 999, when a midwife arrived.  She rushed to get some gloves from her car - and just ten minutes later, Evie was born.

Although it was quick, I did not feel the slightest bit scared (even when the midwife hadn’t turned up) and I'm sure that's because I felt safe and secure. The midwife said how amazing the hormone oxytocin was for getting going, once a woman feels safe and that those precious to her are safe too. And that just felt so true, as the moment I knew my little girl was at nursery, the contractions really went up a gear.

It wasn't what I had planned. I never even got the birthpool filled. But it was nevertheless amazing - I was in my environment, I was in control, I delivered without any pain relief, upright leaning over the dining room table, with Jules telling me how wonderful I was. 

And then of course, there was after...the bliss of being at home - having a shower in my shower, pottering around my house, having a lovely cup of tea and a laugh with the midwives, whilst Evie fed.

I can safely say that the whole experience has really empowered me - I did it by myself and my body knew what to do. I also felt totally relaxed afterwards, as I have ever since - very different to how I felt after staying in hospital last time. 

After the birth of my first daughter, I stayed overnight in hospital, even though the birth was simple. I found this really difficult, being alone, trying to master breastfeeding...Jules had to leave at 10pm and I remember feeling very anxious all through the night - a feeling that  continued for some time when we got home. This time, I have felt totally different .

The icing on the cake to the whole experience was Anna coming home and showering Evie with kisses and showing her all her toys! It was lovely that they met in our home – that evening was very special – the four of us together – as it should be. 


A clever person once said, if you want to know how to do something, copy someone who has done it already. With that in mind, the good birth stories on the tellmeagoodbirthstory blog are for drawing lessons from.  

Positive birth outcomes have just a handful of key factors.... yes all births look different from a distance, but examine them closely and a pattern emerges. There are always, ALWAYS the same things in place. It is true that a small minority of births will always be slow or complicated, no matter what is provided, but that still leaves an immense 80 per cent chance of labour unfolding without difficulty, if we pay attention to what our bodies need. 

In this respect, Rachel's story has lots to teach....she had privacy, she had safety, she had familiarity.....the blessed trinity as far as birth goes. Her plan was to let things start and stay at home if everything was progressing....so she was following her body, not some fixed-in-stone homebirth plan. 

As it was, she did feel things accelerate and in turn trusted that....and then her home setting really yielded benefits. There were no variables, no disruptions, nothing for her labour to snag on. 

The only concern was her daughter, and once she was safe....she could completely let go, her body kicked brilliantly into gear....

And of course finally, the icing on the cake as she calls it, was the joy and reassurance of having her family around her afterwards. 

It's strange that so much focus these days is having our partners with us through the birth, and yet when the baby comes, it's considered normal for him to leave. If you had your baby during the day, and are staying overnight, your partner will almost always be asked to go, and this can be stressful. It's such a very special night, that first night, and yet so often women find themselves feeling alone and at sea. Another good reason for having a baby at home!

Monday 1 October 2012

Starting off



Off we go....

Since tellmeagoodbirthstory.com started out in the Spring, we have been collecting positive birth stories from all around the country....from Ipswich to Illminster, Manchester to Maidstone.....hundreds of them....

The stories of course vary, but in one way they are all the same. They contain the kind of honest, straightforward joy to make our breath catch...stories full of self-amazement, immense awe, hope... the stuff that lifts us all out of the dailiness of our lives to somewhere higher and very wonderful. That most extraordinary of ordinary events. A baby being born. 

These stories, the energy behind them - together they're like the most precious of metal - a resource - and we need to mine it and make it useful.  They need hearing....if we stand any chance of reversing the epidemic of birth anxiety, they need spreading...

Tellmeagoodbirthstory is already connecting pregnant women feeling anxious or even scared about birth with women who can share with them their positive experience - so we are well underway on the one-to-one front. 

But here in this blog, I intend to spread the good some more...here is where in some detail, women will tell their stories first hand....along with a little side analysis from me as doula detective.

My aim is, as always, to prove that a good birth doesn't come down to good luck.  I will keep saying it, keep showing it, keep shouting it, until maybe, finally, something will start to shift, and women en masse will once again realise that a simple birth comes down to a few simple things.

So look in next week....and hear how Rachel had her little girl...............

Natalie xx