Denied a home birth

ISSN 0256-5004 (Print)

By Sara Shah

AIMS Journal, 2009, Vol 21 No 1

Sara Shah tells her story of staff shortages and lack of choice

I am finally writing my story of being denied a home birth due to staff shortages. It is a long story. It starts when I was pregnant with my first, as it was the reason I decided on a home birth.

The unit I booked into was fantastic and very supportive. I wasn't thinking about a home birth at all and I definitely didn't think there was anywhere else to give birth but in hospital. The midwives were fantastic I had one midwife for the whole of my care with them; I had her mobile number and could call her whenever I needed her.

By 34 weeks we had moved to East London where all my problems started. I booked into a new hospital and right from the beginning I knew I didn't want to be there. I used to live locally so knew about the hospital from friends giving birth there and hating the experience. I also read many negative stories in the news and and on the internet about local experiences and how unclean the hospital was.

I was booked and given my new notes. No named midwife, I was told you will just see whoever is there at the time of your appointment. I went over my due date so was booked in to see the consultant. He booked an induction date for 40 +12 in line with hospital policy, to which I just nodded as I knew no different and just thought he knew more than me.

The day came, I went in at 7.30am, my appointment time, with my husband. We sat at the ward reception for about an hour while they were doing hand-over. I was given a bed at 9am next to other women with babies. I sat there with my husband wondering when I was going to get induced. I was told labour ward was full so I had to wait until labour ward confirmed I could be induced. While waiting to be induced my husband had an argument with the male cleaner who just opened my curtains without letting us know. I had a heartbeat monitor on and so wasn't covered. Being Muslims my husband was very upset and to be honest any man would be. The cleaner didn't apologise and just carried on and my husband had to tell him to get out and the guy started moaning that my husband shouldn't be there because it wasn't visiting hours yet!

That over, I was given the gel at 4.30pm. The midwife was quite nice. I had already been having some strong Braxton Hicks for days before anyway and, to be honest, I wished I hadn't been induced as I would have gone into labour naturally eventually. I started having strong contractions pretty much straight away. By 8pm my contractions were pretty strong and I wasn't coping very well so the midwife told us to go for a walk, which we did. It was very, very painful but I was still breathing through them, not hysterical yet. We got back and they told us visiting time was over now so my husband had to go home. They said that I wasn't in proper labour yet and that they would call him when I was in labour. I didn't want him to leave and he didn't want to leave to so we decided to go back out together and sit on a bench outside the hospital, with me in a hospital gown. It was so horrible being in labour outside the hospital just because we wanted to stay together. Then we went back inside and went to a reception place with chairs where people wait for appointments as I wanted to lie down. It was very uncomfor table so I decided that my husband should go home and I should go back to the ward.

He took me back to the ward and went on his way home. As soon as I got back in I started to feel like pushing and I was telling the midwives that I am feeling like pushing but I was told not to be silly and that I should go and get in the bath. I did that and came back out as it wasn't comfortable. Still feeling like pushing I told the midwives again and a midwife said to me, ‘Oh you just push, we are all midwives here we will just deliver you.’ I was feeling really upset and sad as I didn't want to deliver there and I must have been scaring all the other women, some waiting for inductions and some who had already had babies.

I went and laid down on my bed and shut the curtains. Five minutes later (at about 9pm) I heard a pop and my waters broke. At this point I couldn't hold it anymore and started shouting for the midwives who were nowhere to be seen. A very nice lady came to help me, she was holding my hands and telling to be calm. She could barely speak English but she was so nice. I could see she was in labour as well but she was still there holding my hands and telling me to call my husband, and that I shouldn't push and to wait for my husband. I must have been squashing the life out of her hands but she was still there with encouragement.

A midwife eventually came, it must have been about 10 minutes later, and told this woman to go away and that I was fine. As she was Ieaving without even asking if I was OK I shouted that my waters just broke. Then she came back and said Oh... Then started to tell me to get off the bed so she could change it and for me to go and change my clothes. I couldn't get up and was wishing my DH was there to help me. She was very impatient and very impolite, literally shouting at me to get up but I couldn't as the contractions were on top of each other. I told her I wanted some pain relief and she said she would change the bed first. She grabbed my hands and pulled me up and told me to go and change. I staggered to the toilet and got changed while she changed the bed. On my return she pulled my top up and gave me an injection and I swear I never knew what she was doing. Later I realised she had given pethidine, well I guess anyway. To be honest I was only asking for gas and air.

She checked me and said I was 5cm. I didn't give permission for that either.

By 10pm my husband was back and a midwife came from the MW led unit and they took me to the labour ward. I had my feet up in stirrups and was on that gas and air like it was my best friend. I don't remember anything more until the gas and air was taken away from me and I was told it’s time to push. I couldn't believe it and thought, ‘Oh No, she's so cruel.’ I started pushing and the head was visible, my husband says she pushed the head back in and gave me a cut because she thought I would tear otherwise. My baby was born at 11pm, weighing 7lb.

After having my baby he was taken away from me and put under the light, and while I was being stitched I remember crying I want my baby and the midwife telling me I’d have to wait. I had only seen him when he was put on me after being born, I didn't even touch him. I felt like he was hers.

I was taken back down to ward and of course they sent my husband home hours after his first son was born.

On the postnatal ward a midwife came to me and said, ‘Here’s a bottle.’ I said I wanted to breastfeed and she said, ‘Well that's your problem if you want to be up all night feeding.’ I just nodded my head and gave a smile. Another lady called a midwife for help with breastfeeding, the woman was about four beds away from me, and I heard the midwife shout, ‘This is your second baby, you should know this by now.’ I decided I was never again giving birth at the hospital as I knew we wanted more kids. As soon as I got home I started looking on the internet for home birth. My baby must have been a month old and I knew my next baby would be born at home. I was seeing things about home birth refusals and read lots about it but didn't think it would happen to me.

When I got pregnant again I went in for my booking appointment. No mention of where I wanted to give birth so I said to the midwife I wanted a home birth. She said the service had been suspended and carried on asking me questions about my medical history. I couldn't believe what I was hearing. I went silent for a moment and thought about all those things I had read on the
internet and it was happening to me. She looked up at me and I knew there was no way I was giving birth there again and I wanted a home birth. I told the midwife that I had already written an email to Head of Midwifery, who had told me to discus this with my community midwife, with no mention of staff shortages. The midwife called a more senior midwife who came and stated I couldn’t have a home birth as there were not enough staff blah blah blah.

I was very insistent that I was to be booked in for a home birth and my one year old was getting tired as we had been there for two hours already. Then the senior midwife said, ‘We will put home as a choice for place of birth but it’s not guaranteed and you will have to come in when in labour if we don't have midwives to send to you.’ I thought, ‘fair enough for now,’ as I wanted to go home.

As soon as I got home I wrote another email to the Head of Midwifery explaining what had happened. I received a reply saying they were recruiting and by the time I was due in October it should be all sorted.

I continued having appointments with a midwife at my GP’s surgery who was absolutely fantastic and very encouraging. She told me to continue fighting as she and some other midwives love doing home births but obviously can’t go over the heads of management.

When I was about seven months the lovely midwife told me that there were still no home births and no new midwives. At this point I thought, ‘That's it, I am not sitting here and waiting anymore.’ I wanted a guaranteed home birth. I contacted AIMS, wrote letters to everyone possible, even my local MP, and a very strong one to the Trust Chief Executive and the Head of Midwifery. At this point I was so emotionally drained, I cried lots whenever I thought about not having a home birth and having my baby at the hospital. I spent hours everyday looking for help anywhere possible, called all the local hospitals but was told we do home births but you aren't in area. I felt I was getting nowhere, I was emotionally exhausted. I had a meeting with a senior midwife from the hospital and she was so horrible and mean and didn't care about what I wanted. She came to tell me to come to hospital to have the baby in the unit and that they wouldn’t send anyone, and that if I called to tell them I was in labour they will send me an ambulance. I was crying and telling her what happened to me the first time but she was so cold. She told me things have now changed as she was in charge of the wards and they don't mix women anymore and the hospital is now clean...

I think I had given up at this point, even though I knew I wasn't going to give birth there, I didn't know what I was going to do. I went to see a birth centre an hour away from my house, I was that desperate, and decided to give birth there. One day I was out with my husband shopping when I got a phone call from Mal, an Independent Midwife, who said the Trust had employed her to do my home birth. I couldn't believe it. I was so excited and jumping around. I was 34 weeks.

It took them three weeks to sort out a contract for an Independent Midwife. I finally met her when I was 37wks. Mal was fantastic, we liked her straight away. She told us about herself and how she had been a midwife for 24 years. I couldn't believe that I was going to have a home birth and actually have a midwife who was so experienced and so lovely. It felt like dream...

From now on I had antenatal appointments a couple or more times a week just so I could get to know her and the other midwife who would be at the birth. They were so lovely and spent hours at each appointment answering all our questions and preparing us for our birth. They also did reflexology on me from 39 wks. We had a session on breastfeeding and another on birth.

Finally my home birth...

I was 40 + 4 and I had an antenatal check and a reflexology session at 12pm, to get labour to start. I was offered a sweep but I declined as I had been having some strong Braxton Hicks for two nights before. I thought I was actually in labour but then it stopped. After Mal left I continued to have on and off contractions. About 4pm I went to see my husband who was asleep as he had worked the night before and was going to work nights again.

I was excited and told him, ‘I think this is it and I don't think you should go to work.’ We were a bit doubtful as to whether I was in labour so decided to let him go to work. I was doing ironing and at one point I had to stop to breathe through the contraction. Then I knew I was in labour but still not sure so called Mal who said she couldn’t be sure and that I should have a bath, then it might either speed up or stop. I went and had a bath with my first son, it was 7pm by now, and put him to sleep. I sat down to watch TV and ate a baked potato. I had to wait for the contraction to stop then I ran to the kitchen to get some food. I was still not sure if I was in labour.

By 8pm I had put on the TENS. It was really helpful and I kept going to sit on the toilet as it felt quite nice. I still didn't think I was in labour. About 9pm Mal called me to see how I was. She immediately knew I was in labour and told me to call my husband home, she was on her way. I called my husband and asked him to leave now, he suggested he wait half an hour more, I said, ‘No, you need to leave now!’ and hung up ... he thought I wasn't in labour either and didn't want to come home and then have to go to work the next day as I wasn't in labour.

Anyway he left and got stuck in traffic. He finally got home at 9.45 and started putting the pool up and filling it with water. Mal arrived at 10pm. She was so calm and her presence was so relaxing. I felt like an angel had walked in. I was having problems with the TENS and by now it was on full. Mal helped me to breathe and not to tense up through the contraction. I then lay down to be checked, with consent of course, and couldn't believe it when Mal said I was 8cm!!!

I got in the pool and it was so lovely. My husband sat in a chair in front of me rubbing my back. It was so nice I am actually smiling thinking about it all. The second midwife came some time later and I was just listening to the Quran in the background and reciting that, I was almost not feeling any pain. The lights were dimmed and Mal and Amelia just stood in the background and left us to get on with things in our own way. I just let my body do the work and was just so relaxed. My baby was born at 12.50am. Although I had to get out the water straight away as he was having difficulty breathing, the cord wasn't cut and Mal was so calm and kept saying he is breathing. I wasn't worried at all because I knew he was fine. He was given some oxygen and started crying straight away.

He was 10lb, we couldn't believe it, and I didn't have a cut or tear, unlike with my 7lb baby where I was cut.

My husband cut the cord and read a prayer in his ears. I then breastfed him and worked on getting the placenta out. Mal put a bin bag in the toilet and I sat on the toilet and the placenta came. We buried it in the garden the next day. My elder son was asleep so we decided not to wake him up. Mal and Amelia left at 3am and we went to our bed with our new baby, and my husband didn't have to leave! Mal showed me different positions to feed our baby as I had problems with my first. He’s three months now and been breastfeeding exclusively. He’s already too big for his 3-6 month clothes!

It was one of the most wonderful experiences of my life and we have already started saving for the next baby in a few years time. We will definitely be paying Mal to look after me right from the beginning.

I hope that my experience helps someone to fight for what they want. I am so glad I kept fighting as now other women won't have to go through what I did, hopefully.

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