Part 1: A VBAC mum negotiates one-to-one continuity of care with a DOMINO midwife for her hospital birth

A succession of events in my previous pregnancies and births, led me to realise the importance of continuity of care. I entered into my 6th pregnancy (4th birth) with much hindsight and was extremely determined to give this birth the best I could offer. My belief is birth is a special event. Our bodies and babies have a profound instinctual ability to orchestrate a cycle of events that gives rise to new life in the world. To enhance and protect this wonderful cycle of events, it was essential I create a support team (ie husband, midwife, doctor) and establish a positive natural birthing environment.  I had total trust in my body and baby (much credit to Ina May Gaskin’s books), it was my support network and environment that required planning.

The support immediately came in the form of an extremely professional home birth midwife, that I’d known from a previous pregnancy. My husband and I knew we could have complete trust in her to assist us in achieving a natural birth. A major issue was this birth was my 2nd VBAC (vaginal birth after Caesarean). Under HSE guidelines, I was not eligible for a home birth or have the care of any midwife in and out of a hospital setting. After much stress and many sleepless nights the home birth co-ordinators, our obstetrician,  HSE and CIS (Clinical Indemnity Scheme) came together and offered us a domino style birth with our midwife of choice. The one clause, was the birth must take place on the hospital grounds.

After much stress and many sleepless nights the home birth co-ordinators, our obstetrician,  HSE and CIS (Clinical Indemnity Scheme) came together and offered us a domino style birth with our midwife of choice. The one clause, was the birth must take place on the hospital grounds.

I accepted the offer, on the basis that our chosen home birth midwife was my primary carer for antenatal and postnatal care. She also had the authority over my care during the birth of our baby in the hospital. No hospital staff were permitted into the delivery room, unless requested by us.

In the few days prior to labour, our daughter was in a posterior position. It was wonderful to hear from the midwife, that posterior was just a deviation from the norm and just one of the many ways babies enter the world. I tried some different postures to help her turn but felt under no pressure had she not.

The night of 4th June (39 weeks), my husband and I went to bed about 10pm. As I lay in bed, baby was extremely active. Uterine Olympics were under way.  We both lay there unable to sleep and had a sense labour was approaching. We got up for a few hours and eventually went back to bed about 1am.

My waters broke that morning at 5.30am. No contractions followed. I woke my husband and told him D day had arrived. With much excitement we looked forward to this birth.  We made contact with the midwife at 8am. She suggested we go about our day and I should take a rest mid-morning. She would visit us at home about lunch time, unless we needed her before then.

For the next few hours life went on a normal. The kids had breakfast and I called my mother to let her know we’d need her to do some babysitting today. I went for a lie down at 10am for an hour. Immediately contractions started, although very mild but regular (every 10 minutes). Once I got out of bed they stopped for the next 5.5 hours.

Our midwife arrived at 2pm, with a lovely smile and a twinkle in her eye. We were happy to see her.  She brings with her a beautiful sense of calm. With lots of chat, she does her observation on baby and I. We’re both happy and healthy. It was a glorious sunny day, so we sat in the garden having a good gossip. Me bouncing on my birthing ball. Suncream lathered on, a cup of tea in hand, what a lovely way to await a baby.

By 4pm, contractions returned and again were very slight and irregular. My last birth, the 1st phase was long, but the 2nd phase progressed quickly. As I didn’t want to make the car journey to the hospital difficult, after a quick bite to eat we left for the hospital at 4.30pm. We arrived at 5pm and went straight to the delivery room. While the midwife liaised with the hospital staff, my husband and I set about creating our birth space. We pushed the bed to one side and put a mattress on the floor. I covered the mattress with a soft fleece blanket. We strung up fairy lights and the scent of lavender drifted around the room.

As the evening progressed, I snacked on nuts and rice cakes. I went to the toilet every 2 hours, to ensure my bladder would be empty and not slow the baby from progressing downwards. My contractions remained transitional for the next few hours. The mood was calm and I felt special having two people tending me. My husband was a fantastic support and I could sense he was savoring his participation in his daughter’s birth. We swayed together during contractions as I let my body lean on his. He would rub my neck and shoulders and take that last deep breath with me at the end of a contraction. A kind reminder, of one less contraction to meeting our baby.

During each contraction I would will my baby down through me. As a contraction started I bent my knees, relaxed my shoulders, neck and pelvic floor muscles and swayed taking deep breaths. My thoughts were ‘ relax, let go’. Contractions evoke a sense of stress, pain and fear. But to gain the most from them I knew not to fight them, but to let them consume me. As Ina May Gaskin says in ‘Guide to Childbirth’ book ‘let your monkey do it’.

Blowing raspberries and having my hands or feet firmly squeezed by my husband was all the pain relief I needed. The midwife was covering my back with a cold face cloth and it felt divine. I was now working hard and was been treated like a queen.

By 9pm I could feel labour had started to move to the next level. The midwife commented that she liked how I was dealing with the contractions, which had become regular. I was in active labour. I could see my husband was getting weary (hospitals have that effect on him) and I told him to have a cat nap on the bed. It was important I have him alert when I’d need him most. I had a rice cake and juice and said that would be my last bit of food for a few hours.

During the next hour contractions became more intense and I could feel myself drifting from the present and slipping into my own inner birth space (my monkey was doing it). Conversation was now just one word orders, ‘feet’, ‘neck’ (me ordering a massage), ‘drink’. I ripped the clothes off myself, I was so hot. Rests between contractions were much appreciated. Labour was truly under way.

I opted to lay on my side, on the floor as I need to rest. I tried to sit on the birthing ball, but felt I was sitting on my baby. It was uncomfortable. The midwife asked to do an internal (the first and only of the birth) about 10pm. I was ‘loose’. I got a sense, she expected it would not be long.

My temperature started to rise a little and she asked could she use the monitor to see how baby was doing. She assured me she would just hold it to my abdomen (not strap it on me) in what ever position I was in (hands and knees at the time). It was all done intrusively, baby and I were perfect.

The next 1.5hrs were intense. I could feel my pubic bones stretching. My deep breaths started to turn into deep moans and without thought I started blowing raspberries sounds or ‘horse lips’ some might call it. It was really amazing how something so simple helped me cope with such strong contractions. I knew I was in transition. Blowing raspberries and having my hands or feet firmly squeezed by my husband was all the pain relief I needed. The midwife was covering my back with a cold face cloth and it felt divine. I was now working hard and was been treated like a queen.

Midnight drew close and a 2nd midwife was called upon for the delivery of the baby. The midwife asked me to think about what position I wanted to birth in. I could feel the baby starting to move down, but the pushing sensations were short and sometimes weak. Exhaustion was creeping in and I opted to stay on my side on the floor.  After a few pushes, baby started to emerge very slowly. The backs of both her hands were at her face. I was ordered to move to the hands and knees position and push with all my might. I was leaning on my husband and pushing all I could. The midwife could rotate the baby but she was not moving down. She released her lower arm, then her upper arm and she finally delivered at 00:19am. All 7lbs 10oz of pure beauty was placed on my thigh. Her cord stopped pulsating within a few minutes and then we cut it. The placenta delivered naturally and the midwife showed it to us. Blood loss was minimal.

We snuggled our baby girl and marvelled at how simple and beautiful her birth had been. I got the best hug and smile from our midwife, who said to me ‘you deserved it’. I felt very proud.

She was weighed, check and dressed for her trip home. Ask any mother about the tea and toast after giving birth. It’s like a royal feast. After the required toilet stop. I dressed for home. By 3am, we were home cosy in the family bed.

The next morning saw the delight on our children’s faces as they met their little sister for the first time. A memorable moment, all of us in bed together, sharing in the joy.

The care we received was exceptional. The familiarity and friendship, with one on one care, meant our midwife shared our pregnancy journey with us. She listened to our needs and respected our choices. She strived to help us achieve the best birth we could. I looked upon her as, mine and my babies protector.

We are very grateful to the home birth co-ordinators and our obstetrician. They listened and supported us in our request for a natural VBAC, free of hospital polices/procedures. We simply wanted to give our baby the opportunity to enter the world in the healthiest and safest way. As Nature intended.

I wish every mother could feel like I do now. Proud, for demanding what I believe was right for me and my baby.

All birth stories and images featured in 42 weeks have been generously shared by members of the public in Ireland. If you would like to take part and share your story, we would love to hear from you. Get in touch through the website http://www.42weeks.ie, through Facebook at http://www.facebook.com/42weeks or follow us on Twitter at @42_weeks.

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One thought on “Part 1: A VBAC mum negotiates one-to-one continuity of care with a DOMINO midwife for her hospital birth

  1. Pingback: Part 2: Our Birthing Journey Life & Death…finally Joy – Fighting for respect; My right to choose how and where I birth my baby. | 42 weeks

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