Experiencing Caseloading

ISSN 0256-5004 (Print)

AIMS Journal 2014, Vol 26, No 3

Vicky Cottrill shares her birth story

Following the birth of my first baby, I was incredibly anxious about being pregnant again. My experience wasn’t particularly awful compared to stories I have heard, but it was incredibly painful, quite scary and not something I wished to repeat. I was rushed from the natural birthing centre to the labour ward, as my baby’s heart rate had fallen dangerously low, which after the event, I understood was down to me dilating very quickly. The transition to the labour ward, from the birthing room, was a significant change and the room was full of people, all of whom seemed to be talking to me and I wasn’t sure what was going on. I ended up having an episiotomy so they could help to deliver the baby as soon as possible and following this, I had complications with the stitches and it took me far longer to recover than friends who had caesarean sections.

When attending my booking-in appointment for my second pregnancy, I was asked if I would consider a homebirth and I said absolutely not as I was adamant I wanted an epidural this time. I was lucky enough to be referred onto the caseload team offered by West Middlesex which meant I had continuity of care from the same midwife throughout my pregnancy. Natalie (my assigned midwife) was incredibly supportive and enabled me to discuss what happened at the birth of my son and go through my anxieties.

As my pregnancy progressed, I became less inclined to opt for an epidural, for all the same reasons I didn’t want one for my first child – I’m a control freak and don’t like the idea of not being in control of my legs and I knew from last time, I’d want to be fully mobile and active during labour as that helped me to cope with the pain better. I also felt that birth is a natural process and I didn’t really want too much medical intervention.

I decided that my preference would be to try for a water birth at the natural birthing centre again, as I felt comfortable there last time and knew that if I needed more pain relief, it would be available on the labour ward.

A week after my due date I hadn’t felt any movement from my baby all day, so I called Natalie, who wasn’t on call at the time, but her colleague Po Ying answered and suggested I came into triage to be checked as I’d tried all the usual tricks to get baby to move. Thankfully everything appeared to be fine with the baby and we went home later that evening.

That night as I went to bed about 10.30, I thought I could feel dull period pain, which is how my labour began last time. I tossed and turned until about 1am with the knowledge that things were definitely happening. By 2am, the feelings were getting stronger and I started timing them. By 3am they were less than 10 minutes apart, so I woke my husband and we called my mother to come over so we could go to the hospital. About 20 minutes later I asked him to call Natalie as the contractions were coming faster. Po Ying answered as Natalie wasn’t on call, and she said to see how I go and call back when they’re stronger. I spent time over my birthing ball in a darkened room and focused on my deep breathing and everything I’d practised from pregnancy yoga. 15 minutes later I told my husband to call her again, and she said she’d come over. I then got into the bath as I found this really helped with the pain last time. Po Ying arrived at 4am and I was still in the bath, managing the contractions through breathing and the feeling of the water - at each contraction I was asking my husband to run the taps full pelt as the sound and feeling was really helping!

I asked Po Ying to find out if there was a pool room free at the birthing centre, which there was, but at that point I made the decision to stay put! I knew I wasn’t going to ask for any pain relief, the contractions were so close together I knew things were really progressing and I was in the zone, and the thought of dressing, getting into the car and going to hospital was totally against my natural instincts at the time. I had my husband and a very experienced midwife at my side and I was in the security of my own space where I felt comfortable.

I recognised the transition phase from last time, as I suddenly felt scared and couldn’t face the prospect of continuing the birthing process! My midwife spoke calmly to me and reassured me that I was getting ready to birth my baby. I then felt the urge to push and she guided me through the pushing phase in a very calm manner. I focused hard on using each contraction to its full advantage and listened to the midwife.

Not long after, my baby girl was born, in the bath, at 5am! I had done it, and at home! I sat in the bath and cuddled her! Shortly afterwards, my son woke up so my husband took her in to meet him, whilst I stayed with the midwife to deliver the placenta.

caseloading 1

I then got into bed for a while and cuddled my little bundle. Po Ying then helped me to shower and dress and I got back into bed where I was joined by my husband and son. My mum made me some tea and toast.

As I hadn’t planned for a home birth, I hadn’t got anything prepared at home, but as it turned out, we didn’t really need anything and my midwife cleaned everything up from the birth, and all the towels just went into the wash!

I was fortunate enough to just have a first degree tear this time, which we decided didn’t require stitches and a week later I was scrambling around after my son at a soft play centre!

Natalie, my assigned midwife came to visit me that afternoon and ever y few days for the first 10 days, which was wonderful and the aftercare support and advice she gave us was absolutely fantastic and really made such a difference to the early days. It was also wonderful having the continuity of support once again.

I can’t thank Natalie and Po Ying enough for the fantastic support they gave us and the experience of such a wonderful birth. On reflection, a homebirth was always my preference, but I never thought I’d be brave enough to do it! Having spoken to people locally, I discovered that three other women in my street have had home births, so it’s more common than I realised.

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