Elderly Primigravida has three home births

AIMS Journal, 2022, Vol 34, No 3

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By Deborah Maw

I was labelled as an elderly primigravida (pregnant for the first time) at the age of just 31 and warned severely about the dangers of a home birth by the midwife who visited on my GP’s referral.

My experience of home births was fairly limited. However I had attended a home birth, had a close friend who’d had two home births, I’d read Spiritual Midwifery inside out and assisted a friend at a home birth - AND I was terrified of hospitals. I was unmovable in my determination.

I was living in a remote Scottish farm two hours from a hospital and with no phone (pre-mobile days) so I could understand the midwife’s fear on that account, but when I went to visit the consultant in Dumfries he was so disparaging of my somewhat unconventional birth plan, and effectively wouldn’t let me out of his room until I relented. I left in tears, phoned my lay midwife friend in Southern Ireland, bought a car, packed all my baby things and an accomplice and drove to a remote cottage in County Cork.

My daughter was born on a summer’s day 2 months later (3 weeks late - not usually permitted) with me in a squatting position pulling against a tree for support, after two days of labour and a three hour second stage (not usually permitted in hospital). When I went to register her birth in Skibbereen the registrant had forgotten how to fill out the paperwork - it had been 20 years since a baby had been born in the area - everyone went to the hospital in Cork. This was 1988. She is now blessed with an Irish passport.

Three years later I was living in Macclesfield - which has its own maternity unit - and I had a phone. My baby was due mid-winter, so nothing outdoors planned this time. I was blessed with a midwife who was not afraid of home births. I went into labour around my due date and had arranged for two close friends to assist - one a healer and trainee doula, the other Salli Ward - who had had two home births herself (and who asked me to write this).

The first stage was straightforward, about 10 hours, and the second stage was 3 hours again. My midwife was so calm throughout and yet she explained afterwards that pre-transition the baby was presenting face first. She decided to wait and see if it would change - it did - to a brow presentation. This is usually considered to be undeliverable and an automatic caesarean section in hospital. She shared that because she knew I’d done a 3 hour second stage before, she knew I had the strength to do it again. No tree for support this time and my two friends bravely supported me with my arms around their shoulders as I squatted again to deliver.

Seven years later - now 43 - I was pregnant again in Macclesfield. The same midwife attended me antenatally and we were excited to be working together again. But I went into labour while she was on holiday. The midwives who arrived were anxious. Fortunately my healer friend also came, and this time I had a partner. We had decided on a water birth.

The first stage was fast - I was in transition by the time I knew I was in labour. The endorphins never really kicked in. It was the early hours of the morning; the midwives took their time arriving - not believing me that I was in transition - and my partner was working a night shift. They all arrived when I was already urgently needing to push. This was my partner’s first child and he went into anxious busy mode setting up the birthing pool. I could tell the midwives were also anxious. On examining me they had discovered the baby was in a back to back presentation. Fortunately my friend was steady and calm as a rock, speaking on my behalf, insisting I be kept at home, and keeping me going up and down the stairs to free up my pelvis. After over two hours of second stage contractions the midwives were clearly agitated and talking about transferring me to hospital up the road.

I was upstairs squatting over the toilet with my friend when the midwives came in and basically said give birth now or we’re taking you in. They kept telling me to push as if I was having a poo - my partner who had spent all this time attending to the birthing pool - came in and whispered so calmly in my ear ‘imagine your pelvis opening and the baby sliding out’ - and out he slipped - I was effectively using the toilet as a birthing stool. Another three hour second stage. The power of love and trust.

As a family we spent many hours relaxing in the pool, first in the house, and then, it being mid-summer, in the garden. A few days after the birth, my baby developed a strange purple area on his upper back and thickening of his arm muscles. The doctor was perplexed and sent us to a paediatrician, who equally had never seen such a phenomenon but had heard about it. Subcutaneous fat necrosis - due to oxygen depletion in the adipose tissue. It had disappeared by two weeks. He’s now almost 22, and was described as being of ‘gifted’ intelligence at school - so no lasting damage. This harmless condition was relatively common pre-routine C-sections for any birth that does not comply with the standard textbook birthing ideal.

I appreciate that my stories seem a bit scary - my age, 3 weeks late, 3 hour second stages, brow and occipito-posterior presentations, subcutaneous fat necrosis. I share them because with a confident, experienced and reassuring midwife they are not necessarily excuses for caesareans. And yet I am convinced that had I been in hospital for my first, that would have been the outcome for all of them.

I highly encourage all pregnant women to read Ina May Gaskell’s Spiritual Midwifery. It’s old now, 1970’s, but childbirth is still childbirth. There are accounts from dozens of women that she delivered safely in extremely basic conditions, through patience, trust in the process, love and reassurance. The first half of the book gives detailed information, diagrams and descriptions of how to deliver all manner of different births. We may never need to deliver a baby ourselves; however it’s fabulous to be informed as to the variety of perfectly normal deliveries.

Would I have changed anything? Yes. After the ‘pushing’ experience of my third, I now know that forcibly pushing is not necessary - unless the mother is made to lie on her back. In a more upright position i.e. squatting, kneeling, birthing stool, the body’s own pushing impulse with the aid of gravity, is sufficient - the mother only needs to relax into the experience, allowing the pelvis to open and the expulsion of the baby to happen naturally.

Also, I was ill-prepared for breastfeeding - most women in 1988 bottle fed or fed 4 hourly. I was feeding on demand and had never heard of the need for a baby to latch on properly, never heard of hind milk and I didn’t produce an abundance. My nipples were in a mess for weeks; however I persevered and we enjoyed 4 years of happy feeding (the last 6 months, I was tandem feeding).

I believe so much of our attitude to childbirth is now ruled by fear. We’re so unprepared and ill-informed - we’re not surrounded naturally by birth and breastfeeding from an early age as in traditional cultures. The mother is afraid and expected to hand over control of her own body, the partner is clueless, the medics are exhausted and terrified of litigation, and hospital environments are not conducive to a relaxing, loving, reassuring and nurturing experience. We have the right to choose our own birthing experience. Get informed and take it.

Author Bio: Deborah believes that everyone is free to make their own decisions, to follow their inner guidance. She began her education in science; however, after gaining a PGCE and PhD in Biochemistry, she changed track, travelling for 4 years before starting a family and re-training as a complementary therapist and artist. Deborah now works with people who want more freedom in their lives, freedom to follow their dreams.