Experiencing pregnancy in another country taught me a lot about different attitudes to childbirth. I was often surprised at the overwhelmingly dramatic and fearful stories surrounding birth on British TV and even among mothers-to-be. As soon as I got back to pen, paper, screen and keyboard after my maternity leave, I decided to do my bit to redress the balance. As 2016 draws to a close, I’d like to share the story that was the most important one of all for us this year. My wonderful midwives asked me to write it for their website and I am reposting it here.
When journalist Danielle Batist tells people her first child was born at home, she’s still surprised to get asked: “Oh wow, was that planned?” Intrigued by the UK attitudes to births compared to her native Holland (where home births are ten times more common), she set out on a journey to highlight positive birth stories of women empowered by knowledge, trust and choice. Here, she shares her own experience.
In hindsight, I was obviously in labour. From about lunch time on, I’d been having tummy cramps and back pains not unlike those announcing a heavy period. It was Good Friday, 9 days before my due date, and I’d been looking forward to a long weekend off. Being self-employed, I had worked almost right up until the end. My short maternity leave was spent ticking off the long baby-to-do list following our recent move to South London. Kev, my other half, had warned me every time I mentioned just how much we were going to relax during Easter: “Dani, you’re jinxing it! If you say that one more time you’ll definitely go into labour on Good Friday!” Let’s just say that sometimes, just sometimes, he’s right…
It was a lovely, sunny day and as the forecast for the rest of the weekend was bad, I convinced Kev to join me for a long walk. I didn’t mention the sensation of my belly muscles hardening until we sat down for coffee and a rest. “It’s probably just practice contractions, you know, those Braxton Hicks things they talked about in the antenatal class”, I reassured him. We stopped by home to pick up some baby name shortlists we’d been compiling, as we were still not 100 percent sure of our choice of girls name. Even though we hadn’t found out the gender during our 20-week scan, I somehow thought we’d have a boy. The fact that we had not decided on the girls name yet didn’t worry me. Just in case though, I suggested to Kev that we would settle in a quiet corner of our cosy local (red wine for him, juice for me) and go through the lists again. We narrowed it down to about four or five before we got home. We still had at least eight days to decide anyway, or so we thought.
As we walked the stone’s throw distance from the pub to our house, I started feeling the ‘practice contractions’ get a bit more intense. “Are they still there?”, Kev asked, before looking at me and concluding that he was pretty sure this wasn’t the practice bit anymore. At home, I quickly Googled ‘Braxton Hicks’ and read: “For up to a week before labour starts you may notice some of the following early signs of labour: frequent ‘practice’ contractions of the uterus, which feel like a hardening of the abdomen or backache.” Although that sounded like exactly what I was feeling, I still told myself this might actually last a week and that there was no need to panic or ‘declare’ I was officially in labour just yet.
That evening we were supposed to go out for dinner with a close friend. The restaurant was nearby and I had been looking forward to what I thought might be our last meal out for a while. I’d decided to take a nap for an hour before heading out. “Are you sure you want to go?”, Kev asked warily when I got up. “We can just order a take-away, you know.” I said something along the lines of ‘contractions here or there, what does it matter’ and we agreed that if I felt it getting worse at any stage, we’d go straight home. When the waiter came and asked if anyone wanted wine, Kev looked at me doubtfully but I nodded that yes sure, he should go ahead and have some. He wondered about driving, but as we’d planned a home birth I was confident we wouldn’t need to go anywhere, and even if we did, it would have worn off by then anyway. In the meantime a little glass would at least help settle his nerves!
I had to catch my breath a few times during dinner as I could feel contractions intensify, but with Kev and my friend talking away, I managed to pretend to myself as much as them that nothing was happening. After we settled the bill, Kev stopped me in my tracks when I announced we could still go for one at the local. He quickly told our friend that we’d be going home as I needed a rest. I guess he knows me better than I know myself sometimes. We strolled along the pavement and I had to stop several times to wait for a contraction to pass. I looked at him with an excited grin. “What do you think?”, I asked. He smiled back. “I’m pretty sure you’re in labour, Daan. This is it.”
Back at home at about 10.30pm we quickly packed the hospital bag; something we’d said we would do over the weekend. I was pretty relaxed about packing up and being ‘on standby’, but we put some necessities into a rucksack as the midwives had suggested, just in case of an unexpected transfer. Downstairs in a big black box was the birthing pool we hired, as well as a crate full of clean towels, snacks and some newborn clothes. When I asked my midwives what I needed to have ready, they gave me a surprisingly basic list. “Don’t worry, we’ve got everything we need in our car at all times. Just leave out some biscuits and tea”, they said at my last check-up a few days earlier. Credit to their exceptional antenatal care in the 7 weeks since I moved to the area, I fully trusted them and nature to take care of the rest.
Long before I knew about oxytocin, I knew that the smell and sight of hospitals made me queasy and on edge.
I went to bed but couldn’t sleep or even lie still for a moment. I tried to relax, listening to my breath and feeling the baby move and kick in between contractions. They started coming closer together, though I hadn’t measured time. After what felt like half a night (but was in fact less than an hour), I couldn’t lie down anymore: it seemed like without distraction, the pain intensified and I felt the urge to be up on my feet. I figured I best let Kev sleep as long as possible: I knew I would be going on adrenaline but he would probably benefit from a few hours of rest. After all, I still thought we could be in this for 24 hours yet.
Once downstairs, I closed the curtains, dimmed the lights and put the heating on. I’d never really pictured how I might have kids, but somehow always assumed it wouldn’t be in a hospital, unless there were medical emergencies. Being Dutch, where home births are fairly common in uncomplicated pregnancies, I didn’t consider it to be a rare choice. I was born at home, my brother was born at home, and I figured I would do the same when the time came. “You’re not ill, you’re just pregnant”, my mom, a nurse, often said. Long before I knew about oxytocin, I knew that the smell and sight of hospitals made me queasy and on edge. If feeling safe and at ease would benefit my labour, then for me there would be no better place to be than home. And here I was.
I looked at the clock: 1am. Somehow I wanted to keep moving. I started some swaying exercises from my pregnancy yoga class. Leaning on the kitchen worktop with my elbows, I moved from left to right and back again, eyes closed, until each contraction faded. I followed my breath and didn’t take notice of time. At around 2am I searched for a ‘contraction timer’ app on my phone as I started to get a little worried about how often they were coming. I downloaded the first one on the list and started timing them. Pressing the start/stop button was weirdly calming. They were about 3 minutes apart. I remembered something about calling the midwife if there’s three in ten minutes and went upstairs to wake Kev.
As soon as I showed him the last few recorded times, he rang the midwife buzzer system and was put through to Vicky, the on-duty midwife from the lovely NHS community home birth team that looked after me. She asked to speak to me and I remember thinking: ‘How on earth can I talk if I am in the middle of this?!’ It turned out that is exactly what she wanted to hear: Heavy breathing and me not being able to say a word: it meant she was immediately able to confirm that I actually was in real labour! She coached me through the contraction and asked if I was coping. I said I was and that my waters hadn’t broken yet. She asked Kev some questions about how long I’d been having these regular contractions for and was assured I was doing well. She said she’d be there in an hour and explained that turning up too early could disturb the flow and stall my labour. If we wanted her there earlier, we could ring right back as she was nearby.
Kev started blowing up the pool. By now, I was on my knees, hanging over the side of the big arm chair in our living room. Every two minutes I’d call him over to put counter-pressure on my lower back. As contractions started coming closer and lasting longer, poor Kev spent at least an hour running between me and the pool. Heroically, he managed to set it up and keep me sane at the same time. Suddenly my waters broke with a gush. I remember being surprised at the volume of water but it was all clear, which reassured me everything was fine.
By the time the midwife came around 4am I was upstairs, on the toilet, unable to get off. Every time I tried to stand up I was overtaken by another surge, stiffening my whole body. To this date, I can’t picture where in the bathroom Vicky was, but I can clearly hear her voice, just as I could then. “Just breathe through it, Dani, you’re doing really well. Just go with it. Get through this one.” In my state of overwhelm, she broke it down into bits that I could just about understand. “Just get through this one. Each one is one closer to the end.”
She asked if I wanted her to check how far dilated I was. I said yes. If there was still any part of me that believed this was going to last another day, I needed that thought to be shattered. This was getting too intense. I needed to reassure myself that I was going somewhere. I lay down on our bed but had to get up as soon as I felt the next contraction coming. It was so much more painful lying down. Vicky noticed and quickly measured me before helping me up again. Five centimetres. I was glad to know but at the same time frightened by the thought this intensity would last another five hours (I somehow seemed to remember reading an average of 1cm per hour is average for first time mothers though at this stage, I had lost all concept of time).
Kev and Vicky filled the pool with the extended hose pipe the birthing pool company had supplied. Often, midwives ask to wait filling the pool until they arrive. Getting in too early can slow down labour. I was ready to go in but had to wait a while for it to fill as no one expected my labour to progress so fast. All I wanted was to immerse myself in the water and it is hard to describe the feeling when I finally could. Instant relief. I tried to explain it to Kev later: it is not that the pain of contractions is any less, but it means that you can catch your breath in between. After hours of tenseness, I was able to relax each muscle and float in the warm water, recharging for the next wave.
They were coming thick and fast now. Time to rest became shorter with each one. I alternated being on all-fours during contractions with floating on my side in between. I remember being amazed at the fact I could stretch out into the pool and thought it was impressive they accommodated my Dutch tallness. The mad stuff that’s going through your mind! Soon after that though, it was as if my logical brain stopped and a massively powerful thing took over. In an instant, I understood the true meaning of the words ‘force of nature’. There was no more talking. No more thinking. Just this noise coming from deep inside of me. I didn’t hear the second midwife, Erika, come in. I didn’t think of the neighbours (as I worried I might). I closed my eyes and tried to remind myself that I was so close to meeting our baby now.
I knew I was transitioning and the intensity of the pain overwhelmed me. I tried to stop it. I tensed each and every muscle in my shaking body. I squeezed Kev’s hands so hard it must have hurt, but he kept telling me how well I was doing and that it was all going to be OK. I had hoped to have a birth without interventions or medication. The midwives do carry gas and air and you can have a TENS machine, but even in the midst of labour it didn’t cross my mind. I somehow felt nature was taking over. In the distance, all I heard were Vicky’s words. “Just go with it. Don’t fight it. Just go with it.”
Erika suggested I put one foot underneath my body, so I was half squatting and have gravity on my side. As soon as my foot touched the bottom of the pool, I felt stronger. I knew I needed to push and Vicky told me she could see the baby’s head. On the next push, a burning sensation and she told me to hold. I’d read about this, and the fact that, if you are able to, it might minimise tearing. But that was before I had the faintest clue what it would feel like. I’m pretty sure I screamed that I couldn’t do it anymore and, in that moment, silently promised myself I’d never put myself through another birth again. Another contraction and Vicky’s voice again: “Just go with it, Dani.” I pushed with all I had left in me, right through every pain barrier I had ever known. Head. Shoulders. Body. Legs. She was born at 6.29am.
I reached underwater to catch the baby and brought her towards me. Kev later said that all I kept asking was: “Is she OK?”, followed by: “Is it a boy or a girl?” Vicky smiled and said: “I don’t know, you have a look!” I lifted her out the water, exposing her to the air for the very first time. Still covered in vernix and with her eyes closed, she took her first breath. Her soft cries stopped when I brought her to my chest. I looked at Kev, right beside me, and cried.
The midwives stood back as a miracle of life unfolded in a plastic blow-up pool. They let us be us, reassuring us that everything was fine and everything could wait. We waited for the cord to stop pulsating before Kev cut it and we waited for the placenta to deliver itself naturally. Mostly, we waited for this immense new reality to dawn on us.
She’s perfect. She’s a girl. She’s Nova.
How I found my brilliant midwives
At 31 weeks pregnant with my first child, we moved to South London. When I told my new nearest hospital that I wanted a home birth, they transferred me to their ‘caseloading team’: a small group of NHS community midwives who support women wanting to give birth at home within the area. It was a postcode lottery and I just happened to be lucky that such a brilliant team was available to me.
My midwife Emily came to our house for all my check-ups and introduced me and Kev to her colleagues in person, so we knew whoever would be on call. It was her colleague Vicky who attended my labour, in the middle of the night during Easter weekend. She was calm, she was supportive and she let me ‘get on with it’, just as I had hoped for.
Kev was fully involved and helped with anything from supplying drinks to getting me through contractions, and filling the pool. He even found them a desk lamp to provide some extra pool light in our dimly lit living room. Together with Erika, the second midwife who is routinely called in for the final part of labour, they helped me deliver a healthy baby girl. After the midwives made sure we were comfortably settled, they stopped by to check on us every day for the next ten days.
Seeing familiar faces in these precious and intimate first days at home was wonderful. It made us feel confident about caring for our daughter, breastfeeding her and getting to know her. On several occasions, they encouraged us to talk through the whole birth experience in detail, from the comfort of our own sofa with a cup of tea and a biscuit. At the time I didn’t realise how much that helped me to give such a huge, life-changing event a place.
I feel very lucky to have received the excellent, continuous midwifery care I did. I am convinced it played a crucial role in my positive birth experience. Continuity of care is a major concern within the NHS; something they highlighted in their National Maternity Review earlier this year. A report released by Green Templeton College and King’s College London presented further evidence to show how women and babies benefit from maternity care provided by a single midwife, or a small group of midwives whom they get to know throughout pregnancy, labour and the early weeks of motherhood. I sincerely hope this will lead to an improved, positive birth experience for many more women in the future, regardless of where and how their births take place.
I remember Emily explaining the chemical workings of hormones to be during our birth preparation talk. Vicky later summarised it for me like this: “For a labour to progress, the love hormone oxytocin needs to be produced. This hormone is only released when women feel safe, calm, relaxed and loved. Fear, stress and anxiety stimulate adrenalin and cortisol which then blocks oxytocin and natural pain relieving endorphins. In turn a labour can slow down and become more painful. That is why it is so important to get your head in the game. Teach and prepare yourself to let go of fears and inhibitions, give in to your body and let nature take its course. This may not guarantee a straightforward birth, but it will guarantee a positive one.”
I could not agree more. Information is empowerment and feeling respected in your choices regardless of how things turn out is key. I will forever be thankful for the experience our wonderful midwifery team enabled our brand new family to have. And if we ever do have another child (yes, it turns out your brain does make you forget what you went through!), I know the positive energy of these brilliant women will stay with me, wherever in the world we will be.