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AIMS Journal, 2013, Vol 25 No4

Vicki Williams shares the story of her sixth child, a home birth after two sections

I like best to call the birth of my sixth child 'free', because that is the closest word the English language has to describe it.

In medical/legal speak it was unassisted, I had no medical assistance, yet there are a number of people who assisted me, directly and indirectly, by giving help with practical tasks such as preparing my birth space, preparing meals for my children, teaching me, writing about their own births and about the process of mammalian birth. In medical/legal speak it was also unattended, as I was not attended by a medical professional, yet I was attended by the most loving companions I could hope for, Patrick, my life partner, who is both husband to me and father of our baby, and my daughter, who was 12 at the time. In early labour I was also attended by my own mother, who nurtured and nourished us all as best she could, who soothed my other children and helped me to clean my nest before gracefully granting us peace to rest and then get on with the task of bringing a new life Earthside. My birth was free, it cost us nothing, there was no financial or emotional price, yet it was worth everything I had and ever will have. The word perfect simply does not even come close.

Journeys start long before you set out. This story starts a long time before I got pregnant. My story begins with two well-supported midwife-led births, empowering and enlightening and joyous, then with a move to a new place and a cascade of intervention which led to an unwanted and totally preventable caesarean. The experience of losing my part in the process of making decisions about my body left me feeling traumatised and violated, and with a huge loss of trust in those who were supposed to have our welfare at heart. I have no doubt that they thought they were doing the right thing, and that they were scared when I tried to decline to follow policy, but that is little excuse for the bullying to make me comply with care plans which paid scant regard to best evidence.

After that followed a planned born before arrival VBAC (vaginal birth after caesarean), and baby number four arrived peacefully at home, on his due date, totally against medical advice. The story was published in AIMS Journal Vol:17 No:3.

After that things got more complicated. I had a late miscarriage, which was induced with misoprostol (cytotecin the US), which may be a significant factor in what was to happen next, one of the most dangerous complications of previous caesarean surgery, a pregnancy with placenta accreta.

When I found that I was pregnant again we were delighted, but from the outset it was difficult. I had regular and heavy bleeding throughout, no cause was found, but the placenta was low-lying and on the front wall of my uterus. Right over the most likely location for a previous caesarean scar. Our baby held out until 33 weeks and a day, when I had a massive bleed and called 999. It didn’t really stop and it was clear that the only safe option was an emergency caesarean, where it was discovered that my scar had separated and the placenta was in my abdominal cavity and also wrapped round and embedded into my scar. It was a mess and I lost more than 3 litres of blood. We were lucky to survive, many mums and babies are not as fortunate, placenta accreta kills and has a very high hysterectomy rate!

Baby Bob was fine, I recovered, and I was lucky that the surgeons had the time and the skill to repair my uterus. The surgery was scary, but less traumatic than the first time as I felt that I was well informed and in the best hands possible in the situation. The after-care and the NICU experience were less positive, and again we were faced with professionals who had only a limited grasp of evidence-based care. I desperately grieved for both my birth and for the pregnancy, I felt that all the chance to prepare for my baby and to enjoy that special growing time was snatched away from me.

In my follow-up visit the consultant (not the one who did the surgery, sadly) was very clear, she started with ‘No more babies.’ I asked why and she said that I could have another, but I would have to have another section or I would die. I didn’t bother to pursue that line of conversation any further. At that point I was happy with five children and not planning another in any case.

However, nature did not seem to view the situation with the same prophecy of doom, and I fell pregnant before I even knew my cycle had returned. Right from that very first moment, I knew that this pregnancy was going to be fine. There was none of the regular bleeding, cramping, spotting and dragging exhaustion that I had felt before, I was tired but felt well. I knew that all would be OK. I also knew that no amount of searching would provide me with medical evidence of that, and I would struggle to find any medical professional who believed in my body, and in the health of my baby, the way I could feel it from within.

There was no way I wanted to come out of birth feeling like I’d been part of a train wreck again.

We had booked a summer holiday, a road-trip across Europe, with five children and a caravan just before Irealised I was pregnant. We survived the holiday, and I figured that if I could manage travelling thousands of miles with young children, unpredictable food, strange water and morning sickness I could survive most things.

I had no accurate measure of how pregnant I was, but made an educated guess based on the date of a positive test, and the day I could feel my uterus above my pubic bone I counted as week 12.

By about 20 weeks I had begun to feel regular movements and there was no sign of any bleeding. I began to feel more confident that my pregnancy was going to be uneventful and that my baby and I were in a good place. I began to plan for the birth I wanted.

As a doula I am a frequent visitor to my local maternity units and to antenatal appointments with the women I support. I knew the drill. No, you can't VBAC after two sections; No, we can't support HBAC; No, you can't use water if you come in… If I'd asked for a midwife who would support all of that, would I have got one who was confident and happy looking after me? If I did, how hard would the supervisor have been breathing down her neck?

I couldn’t help but feel that no support is far and away better than fearful support, and I believed in my bodyway more than anyone else I spoke to. I was ready to take full ownership of the health and safety of my child. I’d also been in the position of having a birthing emergency and needing to call 999, where no amount of planning for the time of birth would have made the slightest bit of difference, and I knew that if I needed to take that route again I could do it.

I knew that I could only birth with those I trusted and loved around me, and that the only way I would feel, and be, safe was to take full responsibility for our health and the birth myself. I had to trust my deep instincts, because there is no way of gaining that knowledge from the outside. I knew that it was vital that I had privacy and space to labour and birth as was right for my body and my unborn child, and that any fear or disturbance brought into my birthspace would bring more danger to us both than it would relieve. I explored the option of Independent Midwifery, but that did not make me feel any safer, it still felt like inviting a stranger and an intruder into my innermost soul. It simply did not feel right for me. I talked to Patrick, who agreed that I should dance our dance alone, and only call on others if and when I needed their advice. The sense of relief and release that decision brought me was immense. Like a weight was lifted. I felt no need for antenatal testing, as no matter what was found, it would not alter our plans to love our baby whomever we were sent. I was happy to listen to my body and my baby, and only seek help if something felt wrong. The birth we wanted was one where only peace and love had a place. Nothing to draw my attention from the job I had to do, and nothing to prevent me hearing my body and my baby.

My pregnancy passed uneventfully, and with a serenity that comes from a deep sense that all is and will be well. There was no external fear, no undermining of that inner wisdom, no pressure to make decisions that were notmine.

And so the dance began.

I planned my blessingway for the Saturday after Patrick finished pantomime, his commitment was finished and mine was to begin. I knew I would not birth before I had his support, and I hoped that I would have several weeks of his help to get my nest in order. The day was wonderful, a much needed reclaiming of my sacred feminine space, both outside and within. I was wonderfully nurtured by a group of very special women, all of whom I knew I could trust to support my plans to birth my baby alone without fear or question. This was not a time to be explaining my plans or my motives, or to be trying to allay any fears that were not my own. I was blessed and blissed, the female energy and the love I felt was amazing, and I can't say strongly enough what a difference it made.

Eventually everyone headed home, and being the wonderful and in-tune women they are, they left withoutleaving a trace, well, to be fair, they left the place cleaner than it started and they left my body coursing with a massive, loved-up oxytocin glow. I was tired and happy, and I went to bed early. During the night I woke with a slight, but unmistakable, pop and a trickle of fluid. That had been some oxytocin rush!

As is normal for me, I had no contractions, and I decided it was probably a 'wet show' and went back to bed. I slept late. During the morning it became obvious that this was more than a trickle of cervical fluid, it was water, and it leaked every time my baby moved more than a little kick. A hindwater leak then. I could feel my baby very low in my pelvis and I was not worried about infection as I had no intention of having any internal examinations.

I decided to get my pool ready, just in case, and my eldest son was in his element pumping air, arranging hosepipes and moving furniture. The room was ready, the pool was up, the liner was in, I'd already admired the view from within and decided I was happy with it, and so, well, why not put in a little water, just to see how quickly it filled... Quite quickly. Well, since it was full of deliciously warm water, and the room was ready, why not get in and have a float... It was bliss. Absolute bliss. I stayed in the pool for most of the evening, and when I got out to go to bed I pulled over the cover and hoped that I would be using it for labour very soon.

Monday dawned. The children went to school, my baby was very low in my pelvis, the trickling was all but stopped, and I went about my day. By evening I was tired and so we topped up the pool and I floated until I was relaxed enough to sleep. I slept all night.

Tuesday I did not want to leave the house, I was feeling very insular and nesty, I wanted to only see those I love deeply and I wanted to clean every last inch of my home. I did venture out briefly to the local jacuzzi dealer to buy some water cleaner as I wanted to leave the pool ready and waiting. My parents and my brother and his lovely wife-to-be came to dinner, I was very spaced out and not really able to follow a conversation, but not contracting either. Again I spent the evening in the pool, and again I slept all night.

Wednesday brought no change, but during the night I started to feel contractions that died away as the sun began to rise.

On Thursday I had a visit from my lovely AIMS colleagues bearing lunch, and we had a planning meeting round my kitchen table. I felt far happier doing that than I would have felt travelling any further than the end of my driveway. I still wanted to stay in my nest and avoid strangers. My baby was dropping ever lower and that evening Patrick and I made a belly cast. I look at it now and I can see just how very, very low my bump was by that point. Again I had irregular contractions all night, and again they left with the dawn.

By Friday I was weepy. I was beginning to question myself. My early labour was a dark and desperate fight with my internal demons. A long talk to a doula sister was what I needed, and then another float in my pool. After a night of more meaningful contractions I was beginning to get tired and I was more than a little low-spirited when they once again stopped at the first rays of daylight.

Saturday was hormonal melt-down day. I was irritable and short-tempered. I was craving space and sleep, the children were craving attention. I ended up with a strop and a cry, and then I did manage to get chance to sleep during the afternoon, which helped enormously, but it brought me no more contractions until the middle of the night. Again, by dawn they stopped.

On Sunday I needed to rest, I was very tired. Patrick amused the children and I slept. Then I meditated, I asked my baby what was needed, but I didn't feel that I had a clear answer. All I could hear was time, I didn't understand, but I did know that everything was OK, and so I waited. It was now eight days since I started leaking waters, and I have to admit that I was more than a little tired of the 'wet nappy' sensation. My mum cooked dinner, I tried to help but I was next to useless in the kitchen, I could not concentrate on anything much. My baby was so low in my pelvis that I could not sit properly on a chair, and so I ate half perched on the edge, half leaning and kneeling. I was not feeling contractions but I knew there were now waves of energy flowing through my body at regular intervals. I was hopeful but resigned to another night of the same.

Mum helped put the children to bed, Bob, our just two year- old would not settle, so he sat on Daddy's lap, the others went slowly to bed, my mum left and I felt a deep need to be back in the water. I put some music on my phone and stretched out in the water. It felt so good. The waves of energy were still there, but there was no pain or pressure, just a dull ache in my lower back. I decided that I would get out of the pool, change my earrings (I have no idea why that was important, but it was) and watch a little of the Oscars before bed. I sat down to watch and Bob crawled onto my lap to feed himself to sleep. That was when I was belted by the only contraction I can describe as painful, and boy did it hurt. Enough, I shot up like a scalded cat and literally ran and dived back into the pool.

Back to bliss, the music was still playing and I was back to feeling calm, relaxed and not really in labour, although the waves now had much more energy and were coming about every song and a half. Gradually the energy built, I was talking to my baby, 'Are you ready little one? Let's do this thing.' I was aware that the energy was rather like a pressure cooker, I was making noises at the height of each wave because that was an effective way of releasing the 'spare' energy, but I honestly cannot describe it as pain.

I felt my baby plummet, and deep within my pelvis everything changed. I knew that this time things wouldnot be stopping and I was close to meeting our baby. I called for Patrick. Bob had just gone to sleep, the timing could not have been more perfect, or perhaps my body's response to what was happening could not have been more finely tuned. Patrick called Libby, she wanted to be with us, and she came straight down. I was aware and at the same time in another world, I was between worlds, my baby and I, straddling the gap between now and eternity, dancing our own special dance, watched only with love and awe.

We danced a while, I have no idea how long, and then the urge to push came, my whole being pushed, with no pain but a great sense of opening my body and my mind. I could feel a head, now barely contained within my body. Then came a change of song, and The Waterboys, The Stolen Child, started to play and then crowning began. I wanted to say so much, about what I could feel, what was happening within my body, that I wanted my husband and daughter to witness this amazing event, to tell them all the wonders I was experiencing, but all I could manage to actually say was, 'This is the bit that hurts the most.' With that my baby's beautiful, moulded head slid out, rapidly followed by the rest of his body. My baby, a boy, a son, a brother, a grandson, a nephew. I scooped him from the water and sat on the pool seat with him in my arms.

He took a deep breath, let out what sounded like a contented sigh and opened his eyes. The wisdom of ages was in those eyes, and they were only for me. He sought my face, and then my nipple. His little blue body turned pink as he searched and then latched, he didn't cry, it was warm, dark, peaceful and there was simply no need.

I looked, for the first time in days, at the clock. 11.55, a Sunday baby, just. My other boys came down, I am not sure if they woke or were woken. Grandparents were called with the news, the champagne was opened, the cake cut and the new baby admired by his family.

Some time afterwards the placenta was born, with little effort or mess, and I admired it in all its glory. We continued to enjoy the warmth of the water and the space yet privacy of the pool, but eventually it started tocool, and I decided that I wanted a bath and to go to bed. I had planned a lotus birth, but I had a very strong sense that I didn't want to go to the effort of preserving my placenta when I had a baby to gaze at instead, and I really and truly felt that its job was done. The surface of the cord was starting to dry, and it had been white and floppy for a long time. I was ready, and so we cut the placenta free, it is now buried in our garden, returned to the earth.

Bath and bed, more milk and a lot of love, what more does a baby need to start this life as a free man?

I felt so utterly amazing, like I could climb Everest. We called him Edmund, it seemed to fit.

Vicki Williams