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.

Patient and Public Engagement

Let’s talk about PPE. No, not *that* PPE, I’m talking about Patient and Public Engagement, also known as PPI – Patient and Public Involvement!

I’m pleased to announce that lately, organisations have been approaching BigBirthas to get involved in projects at the planning stage. This is great news!!

It is no longer acceptable (why was it ever?) for organisations; bosses, politicians, researchers, and healthcare professionals to make decisions about us, without us. People in positions of power, if you’re not asking about our lived experience, if you’re not listening to our stories, in whose name are you working? Are you really the experts here?

These sorts of scenes are just not acceptable:

Engaging with your audience (or representatives of it) at the outset has some very tangible benefits.

  • There’s a good chance that if you’ve overlooked something, service users will spot it. It’s our lives you’re talking about after all, and we’re literally the experts!
  • You can get the language right. You’re much less likely to draft something patronising, presumptuous, implausible, or antagonistic if it’s co-written/proofread by members of the intended audience.
  • You’ll understand what’s important to us; what floats our boat and what gets our goat. If your clients connect with what you’re saying, they’re more likely to listen. Honestly, if you want us to listen to you, it’s only reasonable that you hear us too!
  • Getting the language and tone right in documents encourages staff to do the same in their interactions.
  • Engaging with your audience at the earliest stages means you’re asking the right questions at the outset.

I’ve read so many hospital policies and research where it’s clear no representation was present at planning, drafting, or proofreading stage! It’s very easy for phrasing to become ‘us and them’, paternalistic, and ‘we know best’ in style when you’re external to the group in question. There are very few people for whom that approach yields the best engagement! Even worse, that language feeds into the psyche of those acting on your words.

How to find your audience

Therefore, if you want to do best by your clients, you need to get your audience involved, preferably as early as possible in the project. But how do you recruit your service users? If you’ve tried putting up posters and putting a link on your website and that’s not getting you anywhere, what next?

Reach out.

Former service users may have even more insight than current ones, but are less likely to see your invitation. If it’s too costly to contact previous service users directly, could you advertise in baby and toddler groups, with health visitors as well as maternity clinics? What about maternity voices partnerships?

Are the service users you do engage sufficiently representative of the diversity of your clients? Do you need to try thinking more out of the box to reach more of the people you should be speaking and listening to?

Have you considered why people aren’t engaging? Are you offering expenses or any incentive for people to give you their time and effort? Is it something super simple like the time you’re trying to connect? Avoid daytimes and particularly the school run, provide creche facilities, or reimbursement for childcare. For in person meetings, make sure parking is good and preferably free, and there are good public transport links.

Are you clear about what you’re asking/offering, and who the work will benefit?

If You Represent An Organisation

Big Birtha is always happy to give an opinion, and is on several advisory and oversight committees already. If you want more than one person’s input (you really should!) we have a BigBirthas Facebook Group of 300+ members, from which you could recruit participants. Or if you just want to ask a few general questions, and sound out some ideas we could facilitate a Q&A style open meeting and see what happens. We’re passionate about this stuff, and changing maternity services for the better, so you’re likely to get some great engagement!

Just get in touch via the Contact Big Birtha link. Explain what you’re up to and we can discuss how Big Birthas can get involved to help you make your next project as engaging as it can be, which is in all of our best interests.

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!

Your experiences and opinions are needed!

Hi lovely people! It seems I’m inviting you to take part in research once again! This time, your experiences and opinions are needed by Queen’s University Belfast. The researchers want to know people’s views on excess weight in today’s society.

They’re particularly interested in hearing from people who’ve been pregnant.

If you’re experiencing research survey fatigue, I apologise! It’s a really positive sign how far we’ve come that researchers aren’t just looking into issues around high BMI, but we’re regularly asked questions about our views on the subject too.

I advocate getting involved in as much research as possible that looks at our experiences, and gives us a platform. This is why I regularly publicise research on here.

As I see it, the only way to effect change is to make our voices heard. Your experiences and opinions are needed so the people making decisions know what’s really happening, and what we think about it! Change is slow in coming, but it is coming, and you can help make it happen!

Queen's University Belfast logo - Your experiences and opinions are needed!

Here’s the blurb:

Your experiences of having excess weight in today’s society

Have you ever had excess weight? Would you like to share your experiences and opinions?

Researchers at Queen’s University Belfast invite you to complete a questionnaire about your experiences of excess weight and your opinions on different terms used to describe weight/size.

We are looking for men and women who are over 18 years old to complete the questionnaire. We are also particularly interested to hear about the experiences of women who are or have been pregnant.

Please click on the link below to find out more about it and to complete the questionnaire: https://qubpublichealth.fra1.qualtrics.com/jfe/form/SV_2nUDx0DJGg8kFKZ.

They say the survey should take about 15 minutes.

Image courtesy of the World Obesity Federation
Image courtesy of the World Obesity Forum

Are You A Researcher?

Are you looking to publicise your study, or trying to find participants?

BigBirthas.co.uk is always happy to publicise relevant research on the topics of BMI and pregnancy.

Are you struggling with working out what terminology to use? Do you want to check you’re not missing something with the people your research actually concerns? Want to just check your thoughts and assumptions with some people with lived experience of the thing you’re studying?

If you’d like to run a focus group, we can help with that via the BigBirthas Facebook group.

It’s a friendly, welcoming space for people to discuss the issues surrounding higher BMI pregnancy. There’s healthcare professionals and doulas on board, as well as people who are, have been, or would like to be pregnant. We’re also happy to facilitate Q&A sessions. It’s generally better if these happen in the evening once children are (theoretically at least) in bed!

If you’re looking for members of an oversight committee or similar, we can probably help with that too. Lots of our members have experience with conducting research!

You can get in touch via the Contact BigBirtha page.