My First Labour and the Birth of April / Ali Chapman, Norwich / 5th - 6th December 2003.
I can remember feeling incredibly vulnerable and as though I was about to get swept along by a tidal wave when the midwife first explained to me the current procedures associated with breech presentation. My foetus, April, had never tried any other position except head up in my ribs and the thought of anybody trying to turn her round ignited my first fiercely protective motherly vibes.
The last ten weeks of my pregnancy were guided by my strong gut feeling that April was to be born the way that she chose to present herself. I spent about an hour each day lying upside down on a slanting ironing board, visualising her head choosing DOWN, I tried handstands in the swimming pool, ‘moxa bustion’ on my little toe acupressure point, homoeopathy, talking to her and explaining the difficulties…. but no. She was happy with bum first and as we approached due day her little bottom got further down into my pelvis (by this stage encouraged by me doing some fantastic hip circling dances around the bedroom) so that as breechies go, she was in the best possible starting place.
I will mention briefly that there were very few health professionals who supported my gut feeling. I was supported by my own midwife, but as the obstetricians have favoured caesareans over the last few decades, there is not much midwifery training in breech vaginal deliveries (especially not unassisted ones which in my understanding is the safest route). Whilst being very aware that surgery would be safer if problems arose during labour, I was certainly not going to be on the list of elective operations. I wanted April to tell me when she was ready to be born.
So on that morning when I passed on cleaning the fridge for the 5th time that month, I felt very positive, very ready and very prepared. Having had a number of nights where I had thought labour was starting (only to drift off into slumber again and be surprised when morning came and there was still no baby!), it was with a quiet, knowing relief that I glanced at the clock at 11am. I couldn’t at that point put into words why I was looking at the clock but it was perhaps a twinge, a tightening inside unlike any other feeling period pain or otherwise.
So I sat on my kneeling chair in my deep pink bedroom reading a book, every so often glancing at the clock. Not really wanting to speak to anyone, just in case my excitement would make the contractions stop, putting me back in the ‘still just heavily pregnant’ box! I ate a fantastic lunch and returned to my chair.
I let my 2 female birth supporters know that today was the day at about 2pm. My wonderful friend Ros would be on her way later after work, and my fantastic doula Rachel would be ready for my next call when I was ready for her to come. I decided to wait a while before telling my husband – I was still very content with my still, calm day.
I phoned Jonathan at about 4.00 explaining that he needed to come and fill the birth pool. His excitement and disbelief was (as I predicted!) quite a turning point as he was the first person I shared my labour time with. The pains accelerated now that I had my own audience – and J quickly realised that this was not another false alarm. He began his job of filling the pool and this kept him comfortably occupied for approximately 4 hours!!! Just in time for us to confirm that April was still breech and that we would not be using the pool at all!! but instead would be taking our box of goodies to the hospital to continue labour there. The birth pool filling provided us with quite a lot of humour. It was worth the hire price just to keep Jonathan busy and useful.
In those four hours of Jonathan’s quest for the perfect depth and perfect temperature, the contractions understandably increased as labour progressed. When Ros arrived I was having to lean on the banister for support. I had clary sage burning in the oil burner, my CD of music on, dimmed lighting, some beautiful pieces of cloth I had bought from a haberdashery and some crystals around and about. I sometimes leant on the beanbag, sometimes on the straight-backed chair and then as it all got stronger again, I was hanging on the open bedroom door when Rachel arrived. Throughout labour, acupressure on my lower back during contraction was priceless.
I had found out about a lot of these possible positions at the Norwich Birth Group, run by two fantastic doulas, Rachel and Shawn, where I also received information about how labour progresses (physically, mentally, emotionally and spiritually) as well as the specifics of breech delivery. All this was invaluable for my preparation and so for April’s safe arrival and my safe, empowering experience.
The lucidity between contractions I found really funny, that I could be working through a long pain one moment and chatting and laughing the next. I felt able to really allow the excitement that I would soon meet April. Being at home for this part was perfect – I was in charge of what I needed, I was safe and comforted by my territory and, importantly, Jonathan was comfortable and able to protect me.
We asked the midwife to come to us at about 10pm and, as agreed before, she checked my cervix to see how far I had progressed and also to confirm what part of April was waiting to come out first. I remember being surprised that the cervix was not as open as I had imagined and I also found that the contractions became more painful following the examination. I think that the act itself caused me some distress so that I felt less in control than the comfort zone we had created.
So we now knew that April had not done her final flip and was definitely breech. I talked calmly with Rachel and the others and gradually came to the decision that I would like to decamp to the hospital while I was still lucid so that we could settle in and recreate the home environment there. I spoke to the head midwife on the delivery floor and she said she would be happy to assist me in my planned midwife-led vaginal delivery and that the ‘pool-room’ with dimmed lights was available.
The car journey was not so great but the best position I found was on all fours on the back seat with my arms around Jonathan as he sat beside me. It was a 5 mile trip to our hospital and when we arrived at about midnight I took GREAT pleasure in breathing the still night air and seeing the beautiful moon.
I had a big contraction just inside the doors and someone offered me a wheelchair, which I found hilarious! There is no way I am sitting down, my friend.
We got in the lift and were welcomed by Sarah and led to the room. Rachel and Ros put some of my bits and pieces around – I had brought the pieces of material, a walkman with speakers (we knew that we couldn’t plug anything into the hospital mains without getting it checked so everything we took had batteries), some oils for massage… that’s all I remember at this stage. We achieved a good balance of light and the main positions I remember adopting here was standing up and leaning on the bed, walking around and on all fours on some cushions on the floor. Managing the waves I think was all about listening to my body and responding to its needs… all the movements help the baby to move its way down the birth canal through the relatively small space in the pelvis.
I got on the bed once for a doctor who had asked if she could ultrasound to get April’s definite position. I found any kind of restriction of movement very difficult to deal with and they are the only points that I look back at with memories of discomfort. Somehow the intensity and astonishing depth of the contractions is easier to remember if I was able to move and flow with the wave. Gas and air was offered to me at this point and I blurringly held the nozzle only to throw it away when the contraction actually came bcs I couldn’t be bothered to work out how to use it!
I stamped my feet a lot. Jumped up and down. Sang my way through the contractions – long, loud, tones to echo the feelings I was experiencing. None of this was rehearsed and looking back I don’t really remember, but I know that they were my steady root – the singing helped me to bring any higher, more scream-like sound down to a healthy channelled tone.
At one point around this stage, my legs were shaking and Ros prescribed the homoeopathic remedy Pulsatilla. It was all pretty intense around now but I wasn’t aware really, I was safely in my own world. By planning and preparing my wishes beforehand with Jonathan and with Rachel, I was able to switch off my rational brain and this helped labour to progress at its natural speed with me feeling naturally focused.
I’ll attach my birth plan to the bottom of this story… basically I found it helpful to introduce myself and the gist of how I see life and labour before getting down to the specific requirements. Writing the plan helped me to focus on what I wanted and visualise the birth a little. I tried hard not to get too attached to any one idea of birth as I couldn’t be sure exactly what would happen (having never done it before!)
At one point the doctor alluded to the fact that I would be in labour “for hours” and this scared me a lot. I was very upset and fortunately Rachel was very quick to talk in my ear reminding me to take each contraction as it comes, that all would progress perfectly and that I am not ‘in time’ as others were seeing it. The endorphins gave me everything I needed to cope with the pain – all I needed as a labouring woman was those around me to let me feel it, to not be scared or perturbed by my calls and to rejoice in the power of this incredible journey.
So that’s all the detail I can remember of the first stage. My transition phase was a strong feeling of needing the loo but when I sat on the toilet there was no poo to be found… instead I was shouting at the midwife asking her what to do as I didn’t know etc.etc. (I think this was the most impolite I got!) and I found myself back to the bed.
So, here I am standing against a hospital bed, Jonathan on my left side, Ros on my right and Rachel sitting on the chair behind me – and she quietly (I was told later) informed the midwife that April was presenting. I remember a call going out and a few other people coming in the room.
Her little feet came out after the bum and Sarah was talking me through it and I felt like someone was touching April, which scared me bcs I knew it was safer not to touch a breech… but it was her ‘bicycling’ her legs pushing herself against me. Then there was a pause between contractions and finally April’s head came too. I was leaning on my two supporters taking the weight off my legs in a supported squat. This worked perfectly although both of their backs were painfully put out on the final push (they both suffered for days) so I would advise anyone else to get their support team to check their stance before any pushing happens!!
Possibly due to the pulsatilla I had taken, the third stage was immediate as April came out wearing the placenta as a hat.. this was quite a shock and quite messy and meant that the midwife acted swiftly to cut the cord and give April to the paediatricians for ‘checking’. I would have preferred her to have been given to me and the cord left to stop pulsing but I understand that the second and third stages were much quicker than expected, so trust that people acted as they did.
Jonathan went and stood by April while they checked her breathing and things. She was really well. I was in shock, totally excited and overwhelmed at having completed the task. The pain stops immediately (there were no afterpains with this first birth) so the elation and rush of endorphins is Incredible. I couldn’t really get much of a grip on the situation just repeating – I did it, Bloody Hell, I’ve had a baby!!!
And then of course I met April for the first time. The midwife kept telling her colleagues to give the baby back to me and that she was fine etc.etc. Jonathan found that part hard feeling an enormous sense of protection towards our new baby and I was relieved to get her in my arms and to my breast. It was about 3.15am by this point. Here began April’s life on Earth!
The Birth of Ruby / Trudii Isherwood, Norwich / 5th of June, 2008
For the most of my life I had little to do with children - absolutely sure I didn't want any, not at all gooey over babies. Whilst training as a nurse in the early 90's I did a 3 month midwifery placement, which to my amazement, I enjoyed, but still no ticking clock.
Fast forward a decade and overnight I decided wanted to become a mum (which at 37 scared the life out of me). Luckily husband had the same epiphany at the same time. After a few weeks of heavy discussion, including the 'am I too old' issue, we decided that we'd try for a year. If fate meant it to happen it would, if not, we wouldn't pursue it. Came off the pill, 2 weeks later I was pregnant.
I think it was meant to be.
Right from the start I was very sure about what I did and didn't want. Perhaps years of being a nurse in the NHS had taught me some lessons. I recalled my midwifery placement and though had amazing memories of the births I had the privilege to witness, had horrible memories about the services that women had to endure.
I entered the 'system' with a visit to the GP and saw my midwife a few weeks later. When I said I wanted a home water birth, she looked terrified. At the time, there was no independent midwife in the county and the one outside the county was booked up, so I was stuck with the NHS. I was discouraged to do what I knew was right for me and my baby ("well you are an older mother") and encouraged to be reliant, disempowered and compliant.
The birth group was my strength. I knew what my baby and my body needed. The support I got from Rachel and the many mums and dads I met allowed me to assert my wishes with a firm knowledge from all the research and teaching,
My midwife realised I wasn’t going to toe the NHS line and my birth plan was in place.
Then………we found out that Ruby was breech. I was to be 'allowed' a vaginal birth but not at home. Due to a flawed report a decade ago, NHS midwives are not trained / allowed to deliver breech births so I would have to deliver Ruby in hospital with an obstetrician present. I cannot tell you how much this terrified me. I was not going to allow another person to control my birth, thus I took what may seem the rather odd step of choosing an elective caesarean. How can I equate this with not losing control you may ask! Well, by choosing to have an elective caesarean, I decided exactly what was going to happen. Had I gone with the vaginal hospital delivery, there was a very good chance that an anxious medic oozing adrenaline would have put a stop to my contractions and sent me down the forceps / ventouse route. I couldn’t face being whisked away for an emergency caesarean, having to reargue to syntocinin issues and all that could have come. I also had such a strong instinct that it was the right thing to do – as it was, Ruby was born with the cord wrapped twice round her neck. Being breech, a vaginal birth could’ve been quite hazardous......instinct is an amazing thing.
When we found out she was breech, I was pressured into having her delivered at 36 weeks, but armed with a huge sense of this being my baby / my body, I held out until 3 days before my due date – I was determined to give her every chance to turn.
I tried everything to turn her, both by spending the last days of my pregnancy with my bum in the air and even by trying for a manual turning by an amazing consultant, but... she wanted to stay perched in the lotus position until she entered the world, so caesarean it was.
I had an amazing birth, and though Ruby came into the world in a way I began completely against, I am absolutely sure that I delivered her in the way that suited us both. Ruby was born with the cord wrapped twice around her neck. Vaginal delivery may have been disasterous - instinct is a powerful thing!
I thought all my antenatal yoga would be going to waste but as it was, I used golden thread breathing while the epidural was put in – didn’t feel a thing. Considering I was in an operating theatre, I felt almost ‘high’ and so unbelievably relaxed. Ruby was born onto my chest (albeit with a little hike over the curtain!). Once all the necessary was done, I undid my gown and lay her as low as I could onto my tummy. She did a mini breast crawl, rooted for my nipple and latched on. The team said they had never seen a caesarean delivered baby feed so quickly and naturally. In the weeks that followed I got almost quite fed up of hearing about what a chilled baby I had, and I was back on my feet quicker than friends who had delivered vaginally.
I put all of this down to knowledge and an unshakable sense of following what I knew was right for my and my baby. And I couldn’t have done it without the support of the group.
I’ve just read this back and it sounds like I am a major critic of the NHS! I’m not – I’ve worked within this organisation for over 2 decades and love it and will defend it with a passion. But.....it is a monster, it is a machine and these days it is a business. It has policy and protocol, and as much as it promotes patient choice, to an extent wants to keep us safe by telling us what research says is best for us. This may be great for an ingrowing toenail, a heart bypass – hey I know nothing, so not gonna argue with a cardiac surgeon, but for the delivery of babies, something the females of this earth, whether human or not, have done by instinct for millennia, it may not be the best option.
Trudii is happy to speak with other women about their experiences of pregnancy and birth. She can be contacted by e-mail.
Arthur’s Birth Story / Ruth Mace-Tessler, Norwich / 1st-3rd October 2009
We knew early that Arthur was a breech baby early and despite being strongly advised to take the c-section route I felt that for me it went against everything I wanted for his and my birth experience. We had originally been undecided about where to birth but as the weeks went on I knew that I wanted to be as home for as long as possible.
As the weeks rolled by it was clear that I needed to inform myself much more about the possibility that he might stay that way round and what, if anything, we wanted to do about it. We were offered an ECV but declined as I was worried about the potential stress that it could cause him, and also felt that if he wanted to turn then he would. We also tried acupuncture, osteopathy, moxabustion, lying in the knee chest position (my bottom in the air which when you have heartburn is rather unpleasant for any length of time!) playing music to the baby, waving flashlights about, and trying to encourage movements with frozen peas, as well as meditation and conversation with him about why it would be good to turn around but all to no avail.
So, I read the AIMS book on breech options and scoured the internet, and we decided that we would try for as natural a birth as possible, at least have a trial of labour. I also called a supporter from the birth group and it was such a valuable conversation to have with someone who had experienced exactly what we were going through and had come out the other end with a positive experience.
We were part of the birth group and had Rachel as our doula and without all of the support that we received I am not sure how well we would have fared. We came under a great deal of pressure from most of the midwifes we saw (I saw 9 through my pregnancy, which made it hard to get any sense of continuity or trust), and the consultant who gave us a scan at 37 weeks to see where the baby was, basically laughed at us when Isaac suggested that we just waited to see what happened rather than opting for an ECV or an elective caesarean at that point.
Once we were past our due date the midwives were more supportive (at weeks 41 and 42) but on day 13 we started to receive unsolicited phone calls to the house from the delivery suite trying to clarify our plans about having a breech baby at home. Even though I had informed myself of the risks of staying at home with a breech it was very unpleasant to have this repeated to you while in early labour over the phone. We declined to go to hospital for a scan to determine where the baby was, as our community midwife had confirmed his breech position the day before. By the end of the call I was quite emotionally drained and tearful but tried not to let it interfere too much. Later that day I had a ‘show’ and again tried not to get too excited but called Rachel to update her. By the small hours of the morning early contractions seemed to be getting more regular and we decided to call Rachel who made her way over to us, and stayed with me that night as I dozed on and off.
By the morning there was still no baby, something I found very disappointing. Isaac called the hospital to cancel our ‘discussion about induction’ appointment which we were scheduled to have at 9.00am as there didn’t seem much point in going as things had begun. Isaac had to have another discussion about all the dangers of proceeding by ourselves at home (now 14 days ‘overdue’ and with a breech!) and when the hospital called back a second time we said that we would be happy to see how things progressed over the weekend and we would see someone on Monday if necessary.
Rachel then left for us to get some rest and we were just snuggling down together when another phone call came in from our midwifery team leader saying that she was outside and could she come and have a chat?
Needless to say this bullying was not helpful and even though there had been a breakdown in communication (the hospital said they had no record of us out in the community wanting a breech home birth) I explained that I was beginning to feel thoroughly harassed by all of their interruptions. She was very understanding but at that point it felt like too little too late, as our privacy had been invaded. Every time we had an interruption from outside my contractions slowed again, or at points seemed to stop entirely. To experience this was an amazing confirmation of how clever your body really is and when feeling threatened my body had decided to wait a while. We again had to discuss going to the hospital for monitoring but again declined to go on Friday and agreed to go in on Saturday afternoon if nothing had happened.
Finally we were alone and things could begin again! Isaac made food at my request (which I then didn’t want) and I began to be sick – which I knew was a good sign. I decided to get into the shower – I had liked the idea of water and it was at that point that the contractions really started to take off.
I sang to the baby and talked to him about how we wanted to meet him finally and made more noise than I thought I would have, and Isaac brought me drinks and decided to call Rachel. She arrived at about 8pm and I stayed in the water for a while, whilst they prepared the living room. Rachel helped me move to the birth space and it was exactly right – low light, soft music, candles etc and I laboured very happily under a towel mainly on all fours as this is supposed to be the best position for a breech labour. It was such a relief to be in a safe, dark space with people I trusted.
Isaac called the hospital at 1 to ask if someone could come out and see how we were doing and that was when we found that there was no-one available for homebirths that night. The midwife on the phone told him that they were on divert but that because of our circumstances if we were to transfer in then there would be somewhere for us to go. We discussed what this meant with Rachel (as I did not want to get there to be put in the waiting room or in a corridor somewhere) and we decided we needed clarification. Isaac called back and when he was told that we could have a room we decided that it was the time to go. We gathered our bag, and other things to remind me of home and set off.
The hospital seemed silent when we arrived, and we were greeted by the most wonderful midwife, who treated our wishes with the utmost respect, as if having a breech baby was perfectly normal. I had an initial scan to see where the baby was, and then monitoring as both me and him were what she described as ‘a little excited’! I thought this would be intrusive but in fact I don’t think I really noticed it after a little while and it didn’t inhibit my movement. I laboured well for a number of hours, being sick some more and spending long stretches on the toilet or leaning against the bed.
My waters broke at 5am and were meconium stained but again this was not an excuse for panic stations, and I began to push. A second midwife joined us but Sara stayed with us through the shift change – something I was very grateful for. My contractions came and went but slowed and decreased in intensity at time and we changed positions to try and optimise their effectiveness, as at this point I felt very tired and Rachel began feeding me sugar which helped a lot. I laboured a while longer and he started to descend. At some point we were obviously progressing well as Sara began to prepare the delivery pack but progress was slow and after much effort (about 3 hours of pushing) not much more was happening.
Sara advised that although we had made good progress it was unlikely that I would have my vaginal birth I had fought so hard for. She left us to discuss the idea of a c-section with Rachel, and we discussed whether there was anything further we could do. Sara even agreed to try and rotate him (as we all thought his back was to my back which could have made things more difficult) at our request. At this point I didn’t really want to do this as I felt so tired but I knew that if I didn’t I would always wonder if it would have helped. We tried the manoeuvre over 2 contractions which was the most painful part of the labour but Sara didn’t want to force it and we agreed to go ahead with the caesarean.
Everything happened very quickly and I had forms to fill out and consent forms to sign but everyone was very lovely and I felt very well looked after. Isaac and Rachel were able to come with me into theatre and it wasn’t nearly as scary as I thought it would be, the spinal being a big relief after labouring for so long. Sara waited until I was out of theatre (several hours after she was supposed to have gone off shift) to see if we were alright and I still feel blessed that we had such a wonderful midwife. Both Arthur and I were totally fine all through labour and he was born hale and hearty. If we were to have another breech baby, maybe I would push harder to have it at home, but we would do it all again, and there is nothing I would change about the decisions that we made.
Ruth is happy to be contacted on 01603 446455.