Positive birth story after a change of plans

A lovely, positive labour ward birth story, following a change of plans from a home birth to a hospital birth.

Background

✌️Second baby (first baby born in hospital on labour ward at 37 weeks; it was a fast labour (<4hrs) with an overall positive experience but wanted more control second time around & to be at home due to previous fast labour onset)

🩷 Known baby girl

🗓️ NHS EDD: 11th March

🗓️ Arrived: 39w+2

⭐ Planned: Home water birth

🌟 Actual: Water birth on delivery suite (due to home support and MWL services being suspended as a result of low staffing levels)

🔵 Pain relief: TENS machine, water, gas and air

🔴 Risks: GBS+ swap at 35 weeks following suspected PROM

💚 Other pregnancy details:

• low lying placental at 20w scan (declined consultant meeting at this stage and opted to wait until later scan), which was the right decision as it was 7cm clear of cervix at 32w

• Declined growth scan triggered when a new midwife (usual one was off sick) measured bump at 37w

Pre Labour

At 35 + 4 I attended hospital as I thought my waters might have gone and I was having regular tightenings shortly after this. Given the speed and gestation of my first baby, and the fact I wasn’t yet 37 weeks, I attended to have this checked. Anyway, all was well, it wasn’t my waters and tightenings stopped with some paracetamol and sleep. Whilst in hospital they did swabs (I hadn’t realised what for and would have declined with hindsight) and I found out a week later that I had a GBS+ result… annoying as this immediately came with a call from the MLU advising that I need antibiotics when I go in to labour (they hadn’t even read my notes which clearly indicated I wanted a home birth having discussed this with my community midwife just the week before!). Anyway, I advised I wanted a home birth which this midwife strongly advised against and tried to persuade me that I should be on MLU where they now give antibiotics for GBS (saying I don’t need to be on the delivery suite).

I politely said I wanted to talk to my husband about it and that I would then email with my wishes. She advised I speak to the consultant midwife if I wanted to remain at home as this would be out of guidelines and I said I would. The call with the consultant midwife was actually really positive, she went through all the options (including what antibiotics I could have as I’m allergic to penicillin) and when doing this it turned out the original midwife was wrong and I would need to be consultant led (which I was strongly against) to receive the antibiotics I could take as they were not the “usual” type. BUT the consultant midwife did say to me that they probably wouldn’t get them in in time to have the necessary effect due to how fast I labour as they need a minimum of 4 hours to take effect (something I’d already learnt from the home birth support UK Facebook group), and it was nice to have that confirmed by her in a constructive and pro choice discussion! She then confirmed she understood my reasons for declining antibiotics and that she would “sign off” my original home birth plan, as it made little difference where I birthed and that undisturbed at home would probably be best for baby as I would be left in peace to deliver (hopefully within 4 hours of waters going). Great! Or so I thought… 🤣

Labour

Fast forward to 39 +2, no sign of baby yet but getting more and more uncomfortable as I was struggling with pelvic girdle pain, something I also had with my first! I was surprised given previous gestation and signs at 35 weeks that baby wasn’t here so decided to do the miles circuit to ensure baby was in optimal position. IT WORKED. That evening at 10:30pm, after curb walking earlier in the day, whilst watching TV with my hubby with our toddler in bed upstairs, my waters popped. As labour had started in the exact same way as with my first (waters going first), I decided to do the exact same things to get everything going. I went for a warm shower whilst my husband got our living room set up for our home birth. When I got out of the shower I sat in the room on my ball and after about 30 minutes the contractions started coming. And as with my first, when they came they were regular and immediately 4 minutes apart. At this point we phoned the MLU to advise I was in labour and ask for midwives to be sent out as we were expecting another quick labour. When we finally got through I realised I’d be redirected to labour ward.. the midwife on the end of the phone coordinating care told me the MLU and home birth support was suspended as they were too busy/ not staffed to support either. I explained I wanted to home birth and she advised she had no community midwives to send at this time due to them supporting patients in or on their way to theatre. I told her I’d phone back in an hour to see if anything had changed and call an ambulance if I needed one in the meantime.

At about midnight I phoned again, this point I knew I had to make a decision and a fast one as everything was getting more intense. My TENS machine was on max and I was hoping for gas an air when I got in to the pool so knew I’d need a midwife or ambulance to bring this. When I phoned again, the coordinating midwife said nothing had changed, she had one community midwife out of theatre but no additional midwife available to send with her which is required for their policy. 'FML' I thought. I reiterated my wishes for a home water birth and she said it would be likely that it would need to be supported by paramedics as she couldn’t guarantee a midwife would be with me in time. At this point though she advised me that the ONE pool on delivery suite was available and that if I came in she could guarantee me this room, as well as a community midwife to support me, so I could still have the water birth I wanted and with the support of someone who would usually support home births (albeit not in my home). This almost felt like a mini negotiation as it would obviously mean she wouldn’t have to reallocate / move midwives around to facilitate my home birth. After a quick discussion with hubby I could tell this was the option we were both most comfortable with (vs going alone and/or calling paramedics, which I was not thrilled about the prospect of - didn’t scream relaxing home birth in my eyes)!

At 12:30am we rang my parents, they jumped in the car and came to our house to be there for my toddler in the morning & do the nursery run etc. (it was world book day too so they had a very important job of ensuring Elmer🐘 made it in)😆!

12:50 we were on our way to the hospital

1:15 after a slightly longer than planned journey due to a resurfacing road closure!! we arrived at hospital and I walked (when not having contractions) up to delivery suite and met the coordinator there. As promised she showed us to the pool room and showed us how to change the room lights and left us alone to set up the room as we liked. My husband set the lights pink (we knew we were having a girl so seemed appropriate) and put the frankincense oil in the diffuser we’d brought with us. After 10 mins my husband went to find her as we hadn’t yet been allocated our midwife and I wanted some gas and air, so she came back, set up the gas and air for me, and suggested we start filling the pool as I may want to get in soon.

At about 1:30 we met our wonderful midwife for the first time, she came in check in with babies heart rate and then read my home birth plan which we had left out, and advised she would go with all my wishes as they were still possible even though we were not longer at home. I felt more relaxed knowing I was in good hands and that she would be hands off. She asked if we would have a student midwife present which I agreed to as I had a lovely student midwife with my first and I thought what a great thing for her to see (hopefully a very hands off hospital birth)! The student midwife was invited in and sat in a chair in the corner of the room and just observed, whilst our primary midwife was in and out of the room (I didn’t notice this, my husband just advised me afterwards)

2am - after quick check in with baby on the doppler, I took of my TENS machine and finally got in the pool, it was such a calming experience and I felt in control and ready to have my baby.

2:25 - my body started bearing down so i advised the student midwife who went to get our primary midwife so that she could support.

2:30 - I was saying I can’t do it (same as my first), obvious transition looking back 🤣. Hubby and midwife reassured me that I could and was doing it and that I needed to breathe. At this point I sacked off the gas and air as it was no longer helping and my breathing had instinctively turned to panting with each contraction. The next 10 mins were a bit of a blur but I think 2 contractions later her head was out and then at 2:41 she was here!

Here cord was wrapped twice around her neck which I hadn’t realised until after taking her up and out of the water! Baby girl was crying immediately and our wonderful midwife stayed so calm and guided me to bring her closer to me in the water so that we could unwrap it together, despite one of the hospital midwives coming in all panicked saying “let’s clamp and cut” which I declined as per my birth plan. Once the cord was unwrapped I sat back down in the pool and had skin to skin with my baby girl in the water for about 20 minutes. After 20 minutes I decided to get out in the hope that getting up would help the placenta to come away naturally (something I didn’t wait for with my first). I sat on the bed with baby girl wrapped up for another 15 minutes or so before my husband cut the cord and we attached cord tie with support of midwife. 5 minutes after that with our midwife supporting my tummy I passed the placenta (without need for injection). We were then left alone for an hour, as per my birth plan, for undisturbed family time, skin to skin and baby girls first feed.

4:30am - our midwife returned to do baby’s checks, weigh etc. and discuss our wishes for discharge. We asked for a 6hr discharge which would mean we could go down to the MLU when it opened first thing and be discharged from there rather than going to labour ward and the midwife facilitate this.

7:30am - just before shift change our midwife took us down to the MLU and got us settled with tea/toast/biscuits and left us to it. The day shift midwives came on and came to do obs, baby girl’s resps were a little slow and as we’d had GBS+ swab we were advised to get her checked over by the paediatrician. I was not concerned as she was very mucusy (like my son was, likely as a result of fast delivery) but agreed as we were in hospital anyway it seemed silly to refuse. Obviously this delayed our discharge slightly but we went home exactly 12 hours (in line with policy for GBS obs) after she was born. Home to settle ourselves before my hubby went to collect our toddler, who arrived home super excited to meet little sister and it just topped off the most wonderful day!

Despite not being at home as planned, and not even getting the Plan B (MLU) we had a wonderful experience with our community midwife in a hospital setting. Hopefully this is helpful to those who want to navigate the system to ensure a positive hospital birth experience. My biggest learn (from homebirth Facebook page, and speaking to Vicky at one of the play cafes when I was pregnant) is that no birth is without risk, yet the risks are often presented in ways that scare parents-to-be in to making decisions convenient to those caring for them. Do your research, use trusted sources and don’t be afraid to push back / present these to those you are speaking to - I did this when declining appointments with the consultant for low lying placenta and also when declining antibiotics due to previous fast labour).