Tuesday, August 5, 2008

My experience of an unplanned homebirth – Mother, Nanna, Midwife

The birth of Isabella Rose, my granddaughter 19/07/08

If you are following my blog you will be aware that my daughter Faye was due in July. Faye was now 5 days over her due date, she was drinking raspberry leaf tea three times a day, eating curry, walking and trying various other methods of trying to get into labour, which will not mention on my blog.
It was Friday evening I was going over to see how Faye was, it was a real winters evening, dreadful, cold and wet. I got to Faye’s to find her upset, very emotional, teary. Brendon (her husband) had been outside in the dark, wet night trying to fix the shed roof, as it had blown off in the storm. Little Dylan was pestering mummy to go outside and help daddy; it was all a bit much for Faye, she was much stressed and rightly so. Brendon came in and decided that the shed could wait, Faye went off for a long hot shower, I started dinner, Brendon finished it and Dylan was playing in the lounge, the house was back to normal.
We had a lovely dinner, settled in and watch some telly. I had a listen to the baby with my Doppler, her head was well down, and it would not be long now. I went home about 1030pm. I had a sixth sense Faye would go into labour, I stayed up on my computer till about 0130ish and gave up on the idea of a birth and went to bed.
The phone rang at 0300, it was Faye saying “mum my contractions have started, can you come over”. I jumped out of bed, woke the rest of the house up, my husband Ian and step daughter Kirsten (18yr) and we all went off in the car. It took us about 20mins at that time of the morning to get to Faye’s house.
When I got there Faye had just got into the bath, she had woken up with contractions at 0245hrs, and had two really strong contractions when she had called me, and up until then she had been asleep.
I added several drops of Clary sage to the bath water to assist with the contractions. Faye was contracting about 2:3:10, they were irregular in strength she was complaining her back was exceptionally painful. On palpation the baby was LOA, head well down, fetal heart was within the normal range, membranes were intact, and all was well, progressing normally. Dylan was asleep, Brendon was getting drinks for everyone and Ian was watching the golf. I had briefed Kirsten that she would be my record keeper.
As I was watching and talking to Faye I noticed her contractions although irregular were very intense and I got the sense that things were progressing quickly, it was now 0345 and she was contracting 4: 10, still in the bath, the water was very therapeutic for Faye it helped her back pain enormously. The fetal heart was 140bpm before, during and after the contractions. Then there was a spontaneous push, Brendon asked was it time to ring the birth centre? Faye got out the bath, and walked around, and with every third contraction Faye spontaneously pushed. Brendon rang the birth centre to advise them Faye was contracting, however I told him I didn’t think we would make the birth centre as I thought Faye was fully dilated. As Brendon was talking on the phone, Faye’s water broke at 0430, it was clear liquor, I then examined her to confirm she was fully dilated head was plus 3 spines. We were going to birth at home. Brendon told the birth centre and then called an ambulance so that I could have some back up if required for the baby. I also got Kirsten to call my friend Lorraine (who is also a midwife) who came to back me up, and Faye & Brendon know Lorraine so they were also happy. Kirsten stripped the bed, Brendon put towels on the heater, and we were just waiting for the baby to arrive. Faye was doing so well, fetal heart was good throughout. The ambulance crew arrived, and asked how long it would be? I said about half and hour at the most, they did not know about birthing and were very happy for me to continue, they put some blueys on the bed, bought in the delivery pack and then went to talk to my husband, whilst Brendon, Kirsten (who was doing the record keeping) Lorraine and I supported Faye. We were all in the en-suite of the bedroom, Faye was leaning over the sink, contracting, irregularly, every second contraction was strong, Faye pushed very well, the vertex (head) was advancing well, she crowned at 0450, head was then born, Brendon said “the baby is trying to breathe is that OK?” next push the body was out, Isabella cried as soon as she was born & did a poo (passed meconium), at 0455, I passed the baby to Brendon, he caught his daughter, we turned Faye around and she walked into the bedroom and climbed up on the bed, we were waiting for the third stage, the placenta, Faye was cuddling her baby, Isabella was crying she did not want to come out, she rooted to find the breast, it was beautiful to watch. The placenta was delivered, Faye had started bleeding, and her uterus was boggy, so I rubbed up a contraction until it was firm, we put the baby on the breast to encourage her uterus to contract, Faye’s uterus relaxed again, so I rubbed up another contraction. I asked the ambulance crew if they had oxytocics and they said they don’t carry them. We made the decision to transfer into the Birth Centre (FBC) as Faye needed the oxytocics to help contract her uterus. Faye had a small labial tear that was not bleeding and she had passed urine not long before the birth. So we put the baby, skin to skin with mum, and warming blankets on top, I kept rubbing up for contractions, and encouraged the baby to breast feed.

Once we arrived at the FBC Faye received the oxytocics and her uterus contracted well, and she went home again in 5 hours. All was well.
Birth is not an emergency: it is simply an emergence
Jeannine Parvati Baker

On refection, it was a 2 hour labour; Faye said once she had the first two contractions she thought this would go quickly & thought she would not have time to go to the FBC. Brendon was not phased as he and I were with Faye for Dylan’s birth and Brendon felt it was all under control, Kirsten felt traumatised as she had not experienced a birth before, (good contraception for her) however she did think it was great birth. Ian (pops) enjoyed watching the golf.
I was surprised the ambulance crew do not carry oxytocics. I am very proud to have helped Faye again birth her baby and at home, even though it was an unplanned home birth. I would like to have had an oxytocic at home to give to Faye, then she could of stayed at home, but then it would be a planned homebirth and I would have to be an independent midwife. This then raises the question of indemnity insurance or lack of it for independant midwives and I could not work with out insurance.
Thank you Faye & Brendon for sharing and allowing me to support you during this very intimate time, it has truly been a pleasure and a real honour. I am humbled by the experience. The highlight of my career is to assist my family through labour to achieve the birth they want.
If mothers have an instinct to give birth, midwives have the impulse to assist them” Jeannine Parvati Baker

Dylan with his baby sister Isabella 2hrs after the birth.


Laura Jane said...

Its lovely to hear this story of your new grandaughters birth. I can see how it would be a pinnacle of a career, to birth a grandchild, and at home too!

Great work team! Trust the emergence of birth, and understand the process well from a physiological perspective to manage without an oxytocic in an unexpected situation. That was really good midwifery care.

Anonymous said...

Love your quotes Pauline

Will forward this to the UG midwifery students. Enjoyed your comment re oxytocic at home and how that changes your role at the birth (grandmother who happens to be a midwife to IM).

Love the gloves Brendan

Anonymous said...

It was really great and reassuring to have you there helping us Mum. A Mum and a Midwife how lucky were we.

Thank you!

Anonymous said...

really interesting story

Anonymous said...

lots of room for professional discussion here

infomidwife said...

thankyou anonymous for you comment.Yes, I agree there is lots of room for professional discussion - how would you like to start? I am not sure which direction you would like to go in, so I will follow.

Lorraine said...

Hi Pauline
Thanks for calling me in as back up in your daughters unplanned home birth. It was great to be part of such a lovely birth even if it was only the 3rd stage! Your trust in me as a friend and a colleague is wonderful.

potty mouth mama said...

That was such an incredible and beautiful story. I loved reading it. Thank you for sharing such a beautiful birth.

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