Tannice’s Covid-19 Birth Story

‘May you live in Interesting Times’, so the ancient curse goes. This year has been full of twists and turns, and if you’re pregnant, it comes with added anxiety about what that will be like. Will you be able to give birth where you want, with whom you want to support you? Usually I try to give advice that’s applicable on a national scale – but at the moment, with seemingly each NHS Trust making up their own rules as they go along, and those rules changing frequently, it’s impossible to know what the situation is on an individual level. So what I have done is focus on publishing individual experiences as a clue to what may be possible right now, and how other people have approached and experienced birthing in a time of Covid. This is an excerpt of Tannice’s Covid-19 Birth Story, published with permission. You can read the full version here.

Tannice's first child with her third on the day of his birth - a Covid-19 Birth Story
My first child with my third on the day of his birth

Tannice’s Covid-19 Birth Story

“Giving birth at home was something I’d wanted since after my first was born in 2016. Admittedly, when I was pregnant with my first, the idea of giving birth at home never even crossed my mind. As I was a “high risk” pregnancy, due to my high BMI, it was never even presented as an option.

My first labour was augmented with syntocinon – synthetic oxytocin – presumably because stress caused my contractions to slow down. After the shift change of midwives, I started to lose energy and momentum. I was also stressed by being prevented from eating (I had gestational diabetes and had thrown up my dinner from the night before after being a little too liberal with wonderful entonox).

I did all I was told during that labour – from having an epidural as a matter of course (in case my fat body couldn’t give birth naturally and I’d need a caesarean, they said) to readily agreeing to induction because of the gestational diabetes, I simply toed the line entirely.

Unfortunately “doing as you’re told” isn’t always the protective act you’d hope when it comes to labour and birth. It was not as beautiful an experience as I’d hoped. Whilst I narrowly avoided an emergency caesarean, I did beg for an episiotomy as I was so exhausted. I simply wanted it all to be over. Which wasn’t the way I’d imagined I’d feel about my daughter’s birth at all.

By the time I was pregnant with my second, however, the trauma of the first birth lent itself to my husband and I loving the idea of home birth.

Sadly, my second child was breech and I was taken to hospital gravely ill from a pulmonary embolism that kept me in the high dependency unit for about 10 days at 35 weeks’ pregnant. Now I’ve had my third child in a pool, at home, I realise that it would have been far tougher were I struggling to breathe, too. So I don’t regret the caesarean that I had with my middle child.

How safe is a home birth during a pandemic?

The environment for the birth of "baby A"
The environment for the birth of “baby A”

Many home birth services were suspended at the height of the first wave of the Coronavirus pandemic: the main reason being that paramedics were unable to provide category 1 (the highest emergency level) support for those giving birth at home. There were also concerns about sending midwives into a home setting with respect to distancing from other members of the household and the extended amount of time that the requisite two midwives would have to spend potentially exposed to Coronavirus in any asymptomatic but infected household. The viral load on those midwives was a consideration all hospital trusts had to factor in. 

However, there is no question that, when you purely look at the safety of a birthing dyad – mother and baby – it is quite clear that a home birth is safest for them. At a home birth you have just two midwives, the birthing person, the birth partner and any other members of the extended family, who can be asked to distance. This limits potential transmission to any of the family within the home. With Covid-19 restrictions on visiting, antenatal appointments, scans and attendance at birth (usually you must be in established labour – 6cm – before your chosen birth partner can join you) people having babies are struggling for support. 

Midwives do have policies designed to protect themselves and can of course wear as high a level of PPE as they think is prudent, but given they are in someone else’s home, they may feel uncomfortable insisting that, for example, the birth partner wears a mask or that other occupants of the home may not be present. This all serves to make the environment more tense and thereby will affect the birthing family’s experience. It’s essential, then, that the midwives attending feel comfortable doing so. Their hospital trust have a duty of care to them, too, at least under the Health and Safety Act 1974, if not just morally and ethically.

Tannice in her pool - So different from the hospital environment
So different from the hospital environment

What’s it like to have a home birth?

All in all, my home birth was a magical experience. I started having contractions as early as 22nd August but my son was not born until 11 September. We called out the midwives that first night and were close to calling several times again on various evenings until, on 10 September at around 8:30pm, the day after a stretch and sweep, my waters broke.

I was disheartened when the midwives decided that things were not progressing and that they would leave. I got back in my pool and was in a great deal of pain as the contractions continued. They came closer together and were even stronger than before so we called the midwives back a few hours later, after calling my parents to come and take care of our two older children. They were convinced there was a monster in the house after hearing my contraction-induced moaning!

Doubts

I was suddenly worried what would happen if I needed to transfer in for a repeat caesarean. Having previously been convinced it wouldn’t be necessary, I was suddenly struggling with the pain. After so long of having what’s called prodromal labour, I was exhausted from constant contractions and the anxiety around the increase in Covid cases across the country was making me suspect home birth could again be suspended.

That day I’d done an interview with local TV station, KMTV, talking about my fears about this very such problem.

The midwives returned with entonox and boy… was I glad to have it. So glad in fact that I blew through the remaining 1.5 tanks (I’d used half the first time they attended) and we were on. From waters breaking to Ares’ birth at 7:30am, the whole labour was 11 hours. The most primal and intensive experience of my life, his birth put me firmly in control of my environment and my body.

When I’d finally done all the work and he emerged, in my home, all I could shriek was “I did it!” and “I made him and I did it!”

I was truly elated and felt so very healed from the varied trauma of my first two births. I loved my body again and felt so connected to my own being that I felt the anxiety and historical grief melt away.

‘Advocating’ for the birth you want? It shouldn’t even be in our vocabulary

I had to advocate hard to get the birth I wanted. I had done so much research into home birth in preparation to birth my second child that I know everything I needed to about my rights and the NHS’ responsibilities to me under the law.

Of course, we hadn’t factored in the suspension of home births across the UK due to an unprecedented pandemic – but I did know the (small) risks involved when wanting a home birth after caesarean (HBAC). It wasn’t long after my first son was extracted from me that I began reading about HBAC. I carefully scoured the literature for all the factors involved in successful vaginal birth after caesarean (VBAC) to inform my decision to birth my last child at home. 

To sum up this weighty defence and advocation of birthing at home, the evidence is persuasive and significant. Historically, women have birthed in their own environment for far longer than they have within hospitals. Whilst I’m not against intervention, it’s hard to really know which interventions were truly necessary.

Birth Trauma Awareness Week

The medical profession will always, of course, err on the side of caution. But survival of mother and baby alone is not the only marker of a good birth. Ares was born during Birth Trauma Awareness week (7-13 September 2020). So many laid bare their traumatic experiences on social media that I felt almost guilty, despite my own history, that I’d had such a wonderful final birth.

We can have better births. We should never underestimate the importance of informed consent, personal choice, bodily autonomy and sovereignty. One shouldn’t need to know the system inside out to be able to get a good birth.

Once I had come down from the elation of my greatest birth of three, I realised something quite sad. I was celebrating not having been traumatised from the final birth I’ll ever have. Not to have been devastated by iatrogenic harm, discompassionate medical staff and a lack of postnatal care. I’d had a good birth. Sad really. It’s not much to ask for.”

Tannice and Baby Ares in the few hours after birth - a Covid-19 Birth Story
Tannice and baby Ares

Thanks Tannice for Sharing Your Covid-19 Birth Story!

And welcome to the world, baby Ares! Don’t forget, this is only an excerpt. You can read the full version of Tannice’s story, including links to articles for reference here.

Are you looking for a supportive community of like-minded people to discuss all things high BMI pregnancy? Pop along to our Facebook Group!

If you’d like to read more Birth Stories, you can find them here.

Nitisha’s Birth Story – Home Birth After Caesarean

I love a birthing story! I’m always excited to read about other mamas experiences in the Big Birthas Facebook group, and so I asked for permission to share this one with you. This is Nitisha’s home birth after caesarean. It actually took place in November 2019, but proving that baby brain is a lifetime condition, I completely forgot to add it until now. Sorry about that, and welcome baby Maya!

Nitisha's home birth after caesarean - welcome baby Maya!
Welcome baby Maya!

I got my homebirth after caesarean! 💪🏾

  • Waters broke at 36+7 naturally and so did contractions
  • 1 sweep at 37+3
  • Natural birth (no pain relief, too quick to get into my birth pool) delayed active management
  • Risks: high bmi, age, previous caesarean
  • Prep: yoga, aquanatal, positive birth company digital pack hynobirthing, saw a chiropractor, spinning babies exercises, positive birth after caesarean audio course.
  • Birth partner: Doula + hubby
  • Main sources of information: chilled mama and positive birth after caesarean.
  • Hyperemesis gravidarum (4-26wks) and pelvic girdle pain
  • I denied consultant led care after first appointment as we both agreed I was informed about the risks for a vbac and I felt there was nothing he could tell me that I didn’t already know /mythbust
  • Previous birth: induction led to fetal distress and emergency caesarean
  • Breastfed toddler throughout pregnancy
  • Toddler upstairs asleep through whole thing (rare occasion of sleeping through the night in his own bed)

After not feeling very informed in my last birth (waters broke, spontaneous start to contractions, induced before 24hrs post waters breaking) I was determined to be informed regardless of location and delivery.

This pregnancy and birth was so healing for me.

I really felt in control of my body, conversations which took place, and all options around delivery. I’d planned for hbac, hospital vbac, and caesarean, wanting to take control over any situation. I hadn’t planned for my labour starting the same way but was determined for it not to end emotionally the same way.

The VBAC consultant midwife was supportive and has changed hospital policy for midwives to use sense and monitoring birthing mums to individualise care and reduce need for vaginal exams! I had requested a meeting with her before the 36wk birth choices meeting as I didn’t want to be blindsided by policy and what they “wanted”. I had this at 32wks and planned my birth plan before of what I would accept and wanted. By the end of both meetings I was happy with my birth plan.

Home Birth After Caesarean

My waters broke 36+7. At 37 weeks I went to the Antenatal Day Assessment Unit and they confirmed my waters had broken. They checked mine and bubs stats; we were all fine so I respectfully declined any intervention for 72 hrs and said I would monitor bubs and fluid release.

Irregular contractions started within 24hrs of waters breaking. At 37+1 I went back to hospital for fetal monitoring and to check my stats and everything was fine. 37+2 – no checks, irregular contractions which increased during the night. 37+3 72hrs were up. I went back for monitoring and talk with a consultant and our stats were checked. The consultant said she thought I should be induced or have a caesarean because of my bmi being so high, I was told I only had 20% chance of giving birth vaginally.

I had a vaginal exam to assess options: cervix was 1cm thick, soft and 2cm dilated. Considered BRAIN and opted for a sweep. No contractions following sweep. Toddler wanted more feeds that night and we danced together. 37+4 still no contractions: walk with hubs, went for breakfast, chilled, massages, naps, laughs and lovin’, once toddler returned from nursery, more feeding. Rang doula to discuss plan.

I had settled that I would have an appointment at 37+5 to arrange what would happen if baby hadn’t come by 38wks. I would be induced with as little dose as possible of syntocinon. Once contractions began, turn the syntocinon off to allow body to do what it could and turn on if any stalls. The plan was also to discuss intervals of drip dosing and levels & what point I would have a caesarean section.

The contractions came back!

At 11pm, in bed, contractions came back. I was so chuffed as I felt the sweep was really invasive, made me feel uncomfortable and thought I shouldn’t have done it. I didn’t monitor, just let it happen. They became regular, so started to monitor. 1am I woke hubs and he rang doula and mother-in-law.

Just before doula arrived I went to my birthing room to relax and take in what was happening. At this point didn’t know whether we would stay at home or go hospital. Initially I was dancing to my 90s RnB club hits, but I was getting sleepy so laid down with a leg elevated to keep my sacrum free. The contractions were starting to increase and I needed my doula to push on my hips. I needed to change position, I went on my knees with my ankles out further than knees (one strong mama tip) and leaned on the sofa with my hips being pressed down during contractions.

Midwives arrived

Things progressed quickly, midwives called at 04:xx arrived 06:xx. During this time I carried on as I was, but the pain getting more intense. It felt like my whole pelvis was expanding. This is normal, I just didn’t know. I did keep checking my puppy pad for blood or meconium. At one point my hubby said I turned and growled at him.

When midwives arrived I wanted to go to hospital because I didn’t know that the pelvis pain was normal, instead I had 1 vaginal exam with consent, I was 10cm and midwife could feel baby’s head. I wanted to get in the pool but couldn’t wait, one breath and baby was out! I didn’t get a chance to catch her but I did cut the cord.

During birth I didn’t think I was Hynobirthing breathing well & didn’t really work for me, I was a bit too cave-woman rather than peaceful 😂 but my doula said I was doing it at the start and to relax but the elevator breath and the final breathing the baby out was great.

Congratulations Nitisha and welcome baby Maya!

Hopefully your husband has completely forgiven you for growling at him!

You can read more birth stories here:

Sarah’s Homebirth Story

Birth in a time of Covid-19

Twin Home Birth at 42+2

Or look under ‘Birth Stories’ in the Labour and Birth menu.

Sarah’s Homebirth Story

Many people who wouldn’t normally choose home birth are considering their options right now, due to covid-19 restrictions on birthing options. I’m a huge fan of birthing at home, having had my second baby in my lounge, but I appreciate it’s not for everyone! Hearing about other people’s experiences can be helpful to give you a feel of what it could be like. Of course, everyone’s experience is as unique as they are, but it’s so lovely when we hear positive stories in the Big Birthas Facebook group, and so I asked for permission to share this one with you. This is Sarah’s homebirth story.

Homebirth story - welcome Gabriel Leonard (pictured in a rainbow babygro)
Gabriel Leonard

Welcome to the world, Gabriel Leonard!

Just wanted to announce the arrival of our gorgeous 4th baby, Gabriel Leonard, born in a pool at home on Wednesday 15th July at 07.48am, surrounded by peace, quiet and love.

I am very much a larger lady with my bmi probably in the very high 40s (I refused to be weighed), I had gestational diabetes (GDM) for which I was on 2 500mg modified release metformin tablets. I also have a medical history of gall stones, diverticulitis, and polycystic ovary syndrome (PCOS). None of those things affect me and have just been found on scans over time rather than because of emergencies. I am otherwise fit and well and still perfectly mobile (something they like to presume is fat = immobile 🙄).

This birth was slightly different from my other 3. He was my latest to arrive (38+2, 39+1, 37+6) at 39 weeks and 2 days. To be perfectly honest I was losing faith in having a natural birth. When you have GDM the word induction gets thrown around a lot regardless of how well mum and baby are getting along 🙄.

The other things that made this birth different were the fact that in my other 3 births my waters had gone first, and then my contractions started a few hours later. With this baby I started off having some slightly uncomfortable cramp. That cramp then started coming and going and increasing in intensity. I called my homebirth team and they said someone would be with me within an hour.

Early stages

Husband set about getting the pool up and my mum (who lives with us) did a great job of herding the other wild animals (ie my other 3 😂). By the time the midwife arrived I was so uncomfortable but managing to own it by breathing through (seriously ladies, get hypnobirthing!). The midwife just sat there quietly letting me do my thing, not interfering or asking me to do anything at all.

I did start to have a little wobble, being unused to my labour starting before waters breaking, I thought I was probably only 3cm and thinking “Jesus, how do I make it through the rest!?” I asked for a vaginal examination as I needed to know in my own mind what I was dealing with. The midwife was fantastic and waited until in between contractions to assess me. I was 6cm!! Knowing this really helped give me the push to continue.

Time for gas and air…

The second midwife arrived with the good stuff (gas and air) and the pool was ready at last (which meant the husband got to live on for another day!). That amazing feeling when you get into that water is indescribable. Things felt like they really ramped up. Within a few moments of being in the pool my waters went which was such a strange sensation! Probably 5-10 mins later I could feel baby start to come.

I reached down and could feel his head (something I’d never done before). In the next 2 contractions his head was out and then in the next his full body. I lifted him out of the water and onto my chest. I don’t think I have ever felt more proud of myself in that moment.

The midwife asked for the pool to be topped up with hot water and occasionally wet the towel covering baby to keep him warm. The midwives said what an amazing and calm birth it was, I didn’t make a sound other than the grunty breath noise whilst my baby came out. (My husband said our toddler makes more noise whilst having a poo 😂😂). Placenta came away nice and easily.

Baby fed like an absolute pro. My husband eventually cut the cord and the midwife helped us tie our cord tie.

Reflections

It was the blissful birth I’ve needed. Baby was absolutely perfect and weighed in at 8lb 7oz.

I just wanted to say the homebirth team were sensational and never once did I hear “no”, “but”, “maybe”. From first visit they believed in me and my baby.

I also had a private midwife to do my antenatal and postnatal observations. She came a few hours after Gabriel arrived. She was so full of joy and happiness for us that we got the birth we needed. After doing the first set of bloods on baby (in GDM, blood sugars are done on newborns to ensure there isn’t hypoglycemia), she did a few other checks on us both, had some celebratory chocolate (it had been soooooo long without chocolate!) and left us to it.

My mum set about emptying the pool whilst the hubby child herded. I just sat there in my own living room in utter bliss eating toast and feeding my baby.

I did his second set of bloods which were also absolutely fine so no further bloods needed.

Still on a massive euphoric high.

So ladies listen to YOUR BODY, YOUR BABY. Do not accept no for an answer. There are still people in the profession that see beyond your weight and believe in you as a woman and as a mother. It’s taken me 4 babies to find that very special team of women.

Sarah pictured with newborn and toddler - homebirth story
Huge congratulations to Sarah!

Would you like to share your homebirth story? Or hospital birth story? Or wherever it happened to take place story?

We love hearing about births. Even if it didn’t go exactly as you hoped, or if all your plans went completely out the window! Huge congratulations to Sarah, and thanks so much for sharing your very special homebirth story. It just goes to show that GDM and other health conditions need not be a bar to homebirthing, if it’s what you would like.

Welcome to the world, Gabriel!

Birth in a time of Covid-19

I think most people are a bit anxious right now. There’s a lot going on and a lot to get your head around. But if you’re pregnant, it must be especially worrying. Particularly if it’s your first and you already don’t know what to expect. Pregnancy and birth keeps you on your toes at the best of times, but birth in a time of Covid-19 comes with further considerations.

You can read the Royal College of Obstetricians & Gynaecologists advice on coronavirus infection and pregnancy here.

We’ve had a couple of recent births in the BigBirthas Facebook Group. With permission, here’s a birth story from someone who just did it four days ago! Hopefully this will give a bit of information and reassurance on what to expect if you’re nearing your due date:

Kay’s birth story

I gave birth to my little legend on Friday 27th March.

newborn wearing a hat and clutching a finger -
birth in a time of Covid-19

I was induced at 37+5 due to obstetric cholestasis. (OC is a liver condition which affects 1 in 140 pregnancies in the UK. It is characterised by excessive itchiness, often on the palms of your hands and/or soles of your feet. A bit of itchiness in pregnancy is normal, particularly on a stretching tummy, but always worth getting checked out. – Big Birtha)

He came at 38+1. They kept me in hospital due being high risk with OC and high BMI and the midwives were absolutely amazing. They really put my mind at rest. The consultant and the anaesthetist were pushing for a c-section because of my size, but I rejected and carried on. I knew that I could do it.

In the end I managed all but the last hour without any pain relief at all and the last hour I allowed myself some gas and air. He was born at 2.10am on the 27th weighing 7lbs 14oz and is perfect.

My advice to everyone is to not let them put time pressure on you. If you choose a c-section, that of course is your choice and I am fully supportive, but I am so glad I didn’t let them hound me into one. The ward they put me on (postnatal) I was the only one that had a natural birth. It was so hard watching everyone else struggle even picking up their newborns, whereas I was up and walking about straight away.

Birth in a time of Covid-19 – Kay’s experience

They are taking the upmost care due to current situations, and I am generally a bit of a worrier. If you’re like me don’t let it get you down, I cannot express how safe they made me feel!

The midwifes were only allowed in that section of the hospital. Birthing partners were limited to one and had to take their own food etc. Once they were on the ward they couldn’t leave and come back again. It’s reduced the risk and made everyone feel more comfortable. We all washed so much too, mums, dads, and staff.

All in all it was a very positive experience, even in the circumstances.

Good luck everyone, from one very happy mumma. 💜

*****

Thanks for taking the time out to share that Kay, and congratulations!

Birth in a time of Covid-19 – highlights from the RCOG guidance

The Royal College of Obstetricians & Gynaecologists is carefully monitoring all evidence as it’s released. So for up to date information, it is definitely best to read the advice on their page. The below is current as of 31st March 2020:

Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus.

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population.

What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information, or NHS 24 if in Scotland.

Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service / NHS 24 for further information and advice.

The most important thing to do is to follow government guidance [to reduce the risk of catching coronavirus].

It is really important that you continue to attend your scheduled routine care when you are well.

If you have any concerns, you will still be able to contact your maternity team but please note they may take longer to get back to you

There is a long FAQ section in the Royal College of Obstetricians & Gynaecologists advice so it’s likely most questions you have may be covered there.

Stay safe, and look after yourselves.

x

Big Birtha