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.

Homebirth Midwife

Look what Deborah Neiger has just brought onto the market! It’s your very own homebirth midwife doll and accessories!!

Ha ha, not really. This IS homebirth midwife Deborah Neiger, plus all her kit laid out in all its glory. So, if you’ve ever wondered what’s in a homebirth midwife’s magic toolkit – here it is. We’ve come on a bit since the days of Call The Midwife!

Or maybe not! In reality, Deborah says that at most births all she uses is the Doppler (14), the incontinence pads (3), the scissors (31), the gauze (6), the scales (20) & baby weighing sling (12) – plus the wonderful midwife (1), obviously!

Homebirth Midwife and kit -Deborah Neiger

Second thing to note is that Deborah says the list isn’t exhaustive, and it’s not listed in order of importance.

The Kit

  1. A kind and sensitive *known to you* midwife
  2. Rebozo for comfort measures or to help fetal positioning
  3. Lots of incontinence pads to soak up birth goo
  4. Catheter if passing urine is difficult or a full bladder is causing excessive bleeding
  5. Cord tie
  6. Gauze Swabs, mostly used to check the perineum for damage after birth if desired, or for microbiome seeding
  7. Placenta bag if parents want it disposing of
  8. Fetoscope
  9. Penguin suction, NEVER used as routine, only as part of resuscitation should it become necessary
  10. Gloves
  11. Pinard
  12. Baby weighing sling
  13. Stainless steel mirror for pool use
  14. Doppler
  15. Transducer gel for doppler
  16. Birth pack, only carry it for the unlikely possibility we ever need the Spencer Wells clamps and super sharp episiotomy scissors in it, though it actually has never happened
  17. Some needles and syringes to administer emergency drugs or vitamin K to the baby, if needed/wanted
  18. Cord Clamp
  19. Lube in case of vaginal examination, also not routine ever
  20. Hanging scales
  21. Sphygmomanometer to take blood pressures
  22. Giving set and tubing for Entonox
  23. Vomit/emesis bags (or as Deborah likes to call them – puke tubes!)
  24. Stethoscope
  25. Entonox tank
  26. Urinalysis sticks
  27. Infrared thermometer
  28. Emergency drugs to control excessive bloodloss (Syntometrine, Syntocinon, Ergometrine) and vitamin K if desired by parents
  29. Tongue depressor, for use during insertion of Guedel airway during baby resuscitation if necessary
  30. Bag and Mask for baby resuscitation
  31. Sterile scissors to cord eventually once fully white or placenta birthed, unless Lotusing
  32. Sharps bin

Addendum, not in photo!

  1. Phone! This is useful when you need to look up things, if ever in doubt, and to summon help.
  2. Torch. To huddle and write notes when in a dark room, check heads emerging in darkness if there are concerns, check perineums.

Thanks for sharing, Deborah! I had no idea my lovely homebirth midwife most likely had all this stuff nearby when I gave birth to my second!

If you’re interested to find out more about Deborah and her work, you can follow the link to her original Facebook post here.

You can also find support at the Big Birthas Facebook Group here.

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

Why hospitals need to grant pool access to bigger women

Anyone who has followed this blog for a while will know that I strongly believe hospitals need to grant pool access to women with higher BMIs.

My being denied access with my first-born is one of the reasons this blog even exists! I’d discussed it at every appointment, was promised a pool birth in the hospital (so long as the pool in the delivery suite wasn’t occupied when I needed it), taken on a tour of the pool room, but then repeatedly denied access to the pool while I was in labour until someone finally told me at 8cm dilated that I would not be allowed to use it after all. It’s also the reason I chose to have my second baby at home!

Hospitals need to grant pool access to bigger women - Big Birtha's Home Water Birth

My second labour and birth, where I did have access to a pool, confirmed everything I had suspected. The warm water was incredible at helping me manage the pain of contractions! Coupled with that, the buoyancy provided by the water meant that I could move around with ease. I was so much more comfortable and relaxed – even during contractions!

The frustrating thing is there’s no evidence to support restricting access!!

To be honest, there’s not a lot of good-quality evidence about the use of birth pools full stop. But because so few women get access to water birth there’s no data to show it’s safe for larger mums. But because there’s no data to show it’s safe, we’re denied access! Anyone see a problem here?

I’m not alone in thinking this!

It turns out that Health Care Professionals are beginning to notice this. So I’m delighted to report that the Association for Improvements in the Maternity Services asked me to write an article for their journal, complete with oodles of references for you to wave in the faces of healthcare naysayers you may meet. Enjoy!

AIMS Journal Article featuring Big Birtha

https://www.aims.org.uk/journal/item/waterbirth-high-bmi