Posted by Clarissa Primavesi on
Please introduce yourself and family
Hello! I’m Julia, London mum of 3: Scarlett (6 years), Ella (4 years) and Reuben (13 months). Every birth is unique, so it shouldn’t come as any surprise that I’ve got 3 quite different birth tales to tell. From sky high blood pressure, epidural, episiotomy and ventouse delivery on the labour ward…to a speedy en caul water birth in the midwife-led unit…and finishing with our last (well, probably last!) baby being born at home, in our kitchen. Reuben’s birth was, in many ways, the hardest of the 3 but it was also the most empowering as it took place completely on my terms, based on my choices and decisions. It’s his home birth that I’ll focus on for the purposes of this blog post, although it’s difficult to talk about that birth without referencing the ones that preceded it as they have shaped and informed my knowledge and expectations around labour and birth.
Did you write or discuss a birth preference in preparation?
I made a list of my hopes and preferences, which I attached to my hospital notes, for each of my 3 births. First time round, the only thing I knew I wanted was to try for a water birth and, even when I heard that both pools at my local hospital were closed for refurbishment, I didn’t really consider an alternative scenario. I’m sure that contributed, at least in part, to the panic and high BP I experienced on the day! I realised for my subsequent births that I needed to be a bit more flexible – or at least to focus on the elements that were within my control. This is one of the primary reasons I opted for a home birth with Reuben – I knew I desperately wanted use of a birthing pool during labour and the only way to guarantee that (assuming we could get it set up and filled in time!) was to birth at home. It also meant that I could partially alleviate one of the biggest worries I had in the lead up to Ella’s birth: what to do with my other children. We have no local support network, so being at home meant that we could be completely self-sufficient as our other children could remain with us throughout. We talked to them lots about the birth and what they could expect in the lead up to my due date and encouraged them to be as involved as they would like to be. As it turns out, they weren’t particularly interested in being around during the labour but my eldest daughter cut Reuben’s umbilical cord once he had been born!
What type of birth did you have?
Reuben was born at home, in a blow-up birth pool borrowed from a friend. After a couple of weeks of period pains and lots of Braxton Hicks, I was feeling pretty fed up and huge as my ‘due date’ came and went, even though I didn’t agree with the date set by the sonographer at the 12 week scan. At 41 weeks’ pregnant (39+5 by my dates) I awoke to mild surges around 1am on a Sunday morning. Initially, I wasn’t certain that things were definitely on the move, but decided to head downstairs and start preparing the birthing space just in case: fairy lights on; essential oils diffusing; soft music playing… After half an hour I woke my husband, Matt, to help me inflate and begin to fill the pool. Although we’d tried the tap connector in advance, it was only once the hose was in place and tap on that we found water sprayed out of the sides so could only use minimal water pressure and it took around 1.5 hours to fill.
I spent that time on my knees either bent over a birthing ball (borrowed from another friend) or leaning against the side of our bed, so that I could be near the toilet, with a hot water bottle resting on the small of my back. The surges increased in frequency and intensity quite quickly, so we called the hospital at 3am and within minutes had a callback from Gloria, one of the midwives from the homebirth team who I had seen for some of my antenatal appointments. We are lucky to have an amazing homebirth case loading team of 4 for our area, so I knew I would know at least one of the midwives attending Reuben’s birth and, on that day, it was Gloria who was on call. Gloria is one of the most upbeat people you will ever meet – everyone is ‘angel’ or ‘darling’, and her laugh is nothing short of infectious! I can’t tell you how good it felt to hear her voice on the end of the phone and the comfort it brought. Already knowing my history and how quickly I birthed Ella, Gloria didn’t question when my husband told her I was in established labour. She headed straight over and also called the second midwife immediately. They both arrived around 4am and by 5am I was ready to feel the relief of the warm pool water, so I stripped off and jumped in! (Obviously I wasn’t as energetic as that phrase suggests – perhaps more accurately: I crawled over and somehow heaved myself over the side and flopped, ungracefully, into the pool).
I asked for gas and air after about half an hour in the pool and found sucking on it gave me something to focus on and helped me to regulate my breathing. By this time, Matt had left to look after our girls who never normally wake in the night, but of course did – twice – while I was in labour. It was as though they knew something was going on! Luckily Gloria was happy to stand in and provide her arm for me to squeeze. I think I entered the transition stage shortly after requesting the gas and air, as I got quite emotional with Gloria. By this time labour had reached a pretty intense stage and the noises I was making as I began to bear down were very primal! My body took over but, unlike with Ella where I could feel her moving downwards with every surge, I felt like I really had to work hard during this labour and that I was making little progress. Gloria suggested an internal examination to check how things were going – I’d stated in my birth preferences that I didn’t want any vaginal examinations, but by this stage I was anxious to know if there was any reason why the birth wasn’t progressing as anticipated and I trusted Gloria’s instinct. She would have seen that Reuben was presenting posterior, but she didn’t tell me; she just kept on being positive and encouraging. When I put my hand down between my legs I could feel the amniotic sac bulging and, although I would have loved to have a second en caul birth, I began to believe that it was Reuben’s waters holding him back. I asked Gloria if she could break them for me, which she did – again while I was still in the pool. This wasn’t quite the quick fix I had been hoping for, but 42 minutes and a lot of hard work later, out ‘popped’ Reuben, still in the occiput posterior position and weighing in at almost 9lb 8oz. No wonder that was hard work! It was 8:06am that same Sunday morning on 27 October 2019 when we welcomed our baby boy into the world. The girls had popped their heads in an hour earlier and were happily watching telly in the lounge next door – apparently I was being too noisy ‘mooing like a cow’ (they did a hilarious impression of me) for them to sleep any longer.
It was so lovely to wrap up in my huge, fluffy dressing gown and sit on my sofa for skin-to-skin snuggles, knowing we didn’t need to go anywhere, while the next midwife to come on duty checked me over – no stitches needed; just some rather angry piles to treat!
Although I wasn’t 100% set on it, I had hoped for a physiological third stage of birth this time round. But after a few minutes of skin-to-skin in the pool, the water suddenly went a deep red and Gloria was keen to get me out and administer an injection of syntocinon to speed along delivery of the placenta. When Ella was born this had taken some time and a bit of tugging(!) despite the injection, hence I was quite surprised when I briefly lifted my pelvis from the seat of the chair I’d been sitting on next to the pool and the entire placenta the size of a dinner plate just slopped out onto my kitchen floor! Gloria and I couldn’t stop laughing…
Best thing you packed in your hospital bag (or used if you were at home)?
I didn’t pack a hospital bag for our home birth, but I’m a bit of a ‘planner’ and like to be organised, so for me gathering together the things I thought I might need or want to hand during labour and the immediate aftermath was quite a cathartic process and part of the mental preparation for the big day. I was really thirsty in the pool and would highly recommend pink lemonade Lucozade and coconut water to keep you hydrated and give you a boost of energy. I found I couldn’t eat at all during any of my labours but did manage to drink a litre of both of these! I also requested the midwives use a cord tie, rather than the standard plastic clamp, when cutting the umbilical cord. These are much softer for the baby and easier to manage during nappy changes, plus the cord tends to dry out much quicker. For Reuben we chose a crocheted tie with an elephant on one end and a heart in rainbow colours on the other, as a little nod to the pregnancy we had lost the year before he was born. Whatever you pack, let your birth partner know what you’ve packed and where they can find everything as there were things that I’d intended to use but forgot all about when the time came!
Anything else you want to share?
Before birthing my first daughter I believed that labour and birth were something you ‘just needed to get through’ and I was completely unprepared, mentally. Whilst there are always potential unknowns and things don’t always go to plan, I think that a large part of labour and birth comes down to preparation. Knowledge is power, after all! The more you can understand about the physiology of birth, the better. If you get a chance to attend a hypnobirthing course or to read a book on the subject, it is well worth your time. The breathing exercises and visualisations are so helpful and generally hypnobirthing gives you the tools to be able to make informed choices and to have the confidence to enact those choices. Regardless of how you birth your baby, and whether things go ‘to plan’ or not, remember that there is no such thing as one perfect way to give birth; no right or wrong choices. It is simply important that you make the decisions that feel right to you, in your own unique circumstances.