Home Birth After Caesarean - Ireland

I found out I was expecting Zoe Jane close to my son’s 4th birthday, and it was met with disbelief. We had welcomed our son Adam in 2016, and just 16 months later his little sister Jess. They had become our little Irish twins bringing with them a whirlwind of nappies, joy and sleepless nights. We had just about caught our breath by the end of 2019 when we had an impromptu discussion as to the pros and cons of another child. It was neck and neck on paper, yet just 1 month later, fate had decided that we were indeed to have another. I was overjoyed.

At just 6 weeks pregnant my thoughts were catapulted to the birth. I was on somewhat of a journey through the system – with Adam I had experienced an emergency c-section, and with Jess an assisted vaginal birth with forceps, and had felt unfulfilled with the experiences. My pregnancies had both been uncomplicated, and labours had both began spontaneously, but each had taken a turn in progress when the epidural that I felt I desperately needed took effect – both babies began to show signs of distress and intervention was required. I tried to find answers as to why this occurred and realised there could be a much easier way this time for baby and me.

One or two acquaintances had drawn my attention towards home births, and I was so intrigued when reading their stories amongst many others. I messaged my local community midwife to check for eligibility, and she recommended contacting Private Midwives since my previous c-section would eliminate me from HSE care. I had received some very prompt and reassuring messages from Liz, who then put me in touch with an available midwife in my area - Angela. This was just at the beginning of the pandemic also, where hospitals seemed even more daunting, and so was immediately put at ease after our Zoom introduction. I did have niggling doubts however – were home births more successful with a certain personality type; calm, flexible, zen like ladies and not anxious, pain adverse, over thinking accountants like me with a history of medical intervention? Angela reviewed my notes, listened to my woes, and told me there was no reason not to go for it, that she had assisted all types of women with home births. I held out for a bit due to the cost involved as I did not have health insurance, but the more I delved into findings on natural labours and water births, the more I felt compelled to trust my body to manage this process itself.

I signed up at 28 weeks pregnant and took the VBAC care package which starts at 30 weeks. Angela came to my house every 2nd week for the first 6 weeks and each week thereafter. It was lovely to have these appointments at home, chatting over tea and scones, each of them unhurried and free for any of the family to join in. My daughter Jess loved listening to the baby’s heartbeat, Adam loved telling her stories about his superheroes, and they both enjoyed reading the Hello Baby books that Angela recommended (Disclaimer: There are two different versions – only the home birth one is necessary!)

As my due date drew closer, I did become more and more anxious due to the resurfacing memories of pain, and the fear that the birth would not go as so desperately hoped. Angela would calmly reassure me each time and got me in contact with the perinatal mental health clinic who helped with letting go of too much expectation, and just setting simple intentions for the birth. Liz went out of her way as well in the week leading up the birth to meet up with me which further helped my confidence.

I really tried to prepare in a different way with this birth than the others. The first time I was heavily reliant on the hospital system and the absolute need in my mind for pain relief. The second time I had begun to research VBACs, and so enlisted the support of a doula to minimise interventions. I managed for longer with increased support, but still had had a mental block with an unmedicated final stage of labour. I felt immediately in the aftermath that this had limited my body’s abilities, numbed the experience and swayed the outcome. This final time I knew I needed to try and release this block and embrace labour in its natural form.

I found the book ‘Birthing from Within’ an excellent tool in realistically preparing for the labour. It was inspiring to discover how to be curious about the pain, learn from its feedback and how to give yourself the strength to encourage it at times in order to aid progress. This really helped shift my mindset; that I wouldn’t always be seeking comfort – that the pain could be necessary and beneficial, but that my mental suffering could be minimised and managed with careful preparation. Plumbing the depth of my own resources was one affirmation that I was committed to. Orgasmic birth was another book that I hoped that would take this mental journey a step further – working alongside the pain in order to convert it to pleasure. To release any emotional pain and allow yourself to feel the euphoria that comes with birth. I set about really trying to retrain my subconscious to that effect knowing this would take centre stage during the latter stages. I tried to quieten my mind through daily meditations, and turn my attention on really just sitting with myself and my body. This was a challenge as my thoughts have generally overruled. I began to settle my intention on that of a conscious water birth and visualised this each day in that precious waiting time in between late pregnancy and labour.

My due date of Oct 25th came and went without much ado. We did what we had begun to do every night – put the kids to bed, tidy up, and check that we had everything we needed if the baby decided to come that night. The insomnia really kicked in from here each night; each niggle wondering and waiting, and somewhat both relieved and disappointed by morning that it was business as usual. I wondered if baby would arrive with fireworks on Halloween night, but instead on November 1st we enjoyed a gorgeous leafy family walk in the forest. I relaxed that night on the couch with Jess cradling my bump as if she knew that it would be the last time she would do it.

November 2nd, I woke up early at about 6am with light cramps and went downstairs. I had been cramping on and off for the week and had been losing my plug for days so this was not unusual, but I must have been acting differently in the night as my husband came down to the kitchen and asked, ‘Are we having a baby today’? I l shrugged and laughed nervously. I got the kids off to school and was determined to do the opposite of my previous labours if this was in fact early labour, and vowed to keep well fed, well rested and well stretched. I ate porridge, listened to my hypnobirthing, had a shower and went for a wet walk in the park. The cramps started to intensify while I was there, but I took this as a good sign this time and tried to keep going to let gravity help me along, and hope my cervix was already dilating. When I came back, the nausea started to kick in, I began to feel lightheaded and could feel the faintest of contractions ripple through me.

My husband Enda was working from home and on his way to get the kids from preschool I said to him tearfully that I did think today was now the day. I made my way instinctively to the lovingly prepared nursery, looking out the window at the rainbow that had just formed outside, thinking I just had to make it to the other end of this arch now. I was beginning to feel overwhelmed at this point. My husband touched my hand and told me it would be ok and just to try and relax. I sat on the rocking chair with the Hello Baby book on my lap leafing through the pictures, wondering if today I would finally experience something like it.

I welcomed the kids home for lunch and Enda set about making me a big omelette to try and settle my stomach. I contacted my mother who called to help with the kiddies and take them to hers for a sleepover. It was about 2pm when I called Angela to tell her I thought today was the day, but that contractions were light with no distinct pattern yet. She told me to rest and that she’d be with me in a few hours. I hugged my mam and the kiddie’s goodbye, wishing that they could stay, but not feeling confident enough to be able to help them with their emotions as well my own during that time.

I went upstairs to play another hypnobirthing track while Enda began heating the water and preparing the pool. During this hour the contractions really ramped up and I got up suddenly and kneeled beside the bed. Whoa, here we are, I remember this. I quickly timed them, and they were every 3 mins and about 30 -40 seconds apart so I contacted Angela again and she said she’d be with me by 5ish, that it was good things were happening, but I could still talk though contractions, so we had time and not to worry.

I went downstairs to Enda, and he helped me with the tens machine and some hypnobirthing scripts. I walked around too looking at the affirmation posters I had made for motivation, and to remind me of all the tools that I had to manage this period. I went outside to the garden for a bit as well as I found breathing the fresh air grounding and calming.

At about 4.30pm I decided to take a shower as I remembered the jets had felt great during labour with Jess, and I knew I would get immediate relief from it. Angela arrived then while I was in there which felt just the antithesis of having to rush into the car and wait in traffic at that intervening time. She helped me to my bedroom to do the first VE. Unfortunately, she lost a very nice medical bag in the process when I projectile vomited on it! Each labour I vomit around that time and true to form, I did it again. Sincere apologies to Angela once more…..

I had told her not to tell me how dilated I was in case I fixated on timeframes as is my nature to do so, so when she asked Enda ‘Is the pool ready yet?’ both he and I were taken by surprise and were feeling hopeful that I was progressing well.

I was helped downstairs to the welcoming heat and hum of steam rising from the numerous Barka boilers we had around the kitchen. Angela then offered me gas and air while I leaned on the kitchen island and Enda helped me with counterpressure to the hips. The contractions had intensified once again. I vividly remember how different this also felt – to be in established labour surrounded by comfort and support as opposed to panicking in the car, stressed out in waiting rooms and incapably negotiating with hospital staff. I could now focus on what was needed there and then which was just to find a rhythm with my body and my baby.

I stepped in to the ready and waiting pool at about 6pm and felt immediate relief with the heat and buoyancy. The next few hours were as relaxing as it could possibly be in active labour – I was in my sitting room with fairy lights dotted around the fireplace, my Spotify playlist playing, breathing gas and air with each contraction, sucking on Lucozade ice cubes, and receiving support from those around me – Enda, Angela and then Liz when she arrived shortly after I entered the water. There was laughter as I got lost in the music between waves; True Colours from the Trolls soundtrack was introduced to me by my first two children, and taken to another level with my last baby!

I began to get shaken out of my trance when I started bearing down at the peak of each contraction and felt each muscle shudder and tense up each time. I felt confused as it seemed to happen for quite a while without being at the pushing stage and my mind started to ask questions. Again, as is my form with the other two, the baby appeared to be in an OP position contributing to the premature bearing down feeling. It was around 8pm that I felt like I needed to do something to progress labour as I just couldn’t focus anymore. I was about to embark on a journey now that I had never had the courage to take on before.

The midwives helped me to the bathroom to help baby move down – walking, emptying the bladder and straddling it backwards all were to aid rotation. This was agonizing but I had prepared myself for this stage and just tried to focus on the fact that this was all in an effort to meet my little baby sooner. After a short time I was helped back to the couch then where I kneeled forward against it and began to feel like I couldn’t take the pressure much longer – my whole body felt like it was contracting each time and when they would pass, I would catch my breath for what seemed like a few seconds before it would start again. Angela asked did I want another examination to check for progress as I was faltering, and I agreed. She told me I was 8cm so very close and that if I got into the running start position, I would help rotate baby further. This I did whilst pulling all the waterproof sheets off the couch as the sensation was so strong. I started to waiver again, but when Angela used the Doppler to check the baby’s heart rate and said ‘Your baby is still very happy there though’ it reminded me as to the primary reason I had wished for this natural birth – to avoid fetal distress.

With a tiny bit more resolve and a remembered partnership with my baby, I asked Enda to put on the hypnobirthing and I caught sight of Angela gesture to him to try and calm me down. This further centred me to steady myself and I asked to get back into the pool while holding onto Enda and stayed that way, kneeling into him over the edge of the pool. It was about 9pm at this stage and I believed I still had a way to go. When with just another few contractions I could feel the head come right into the birth canal, I was astonished.

I experienced a renewed vigour then knowing I was so close and tried to focus on my pushing breaths – grunting, panting and just easing her crown out which was far easier than anticipated. Her head had fully emerged then in the pool and this such a immense feeling when the midwives could see her, and were telling me all about her tiny features while we waited for her shoulders to emerge. I tried with all my might to push her body out with the next contraction, but she needed a little nudge, so the midwives and Enda helped me out of the pool, and it was there I birthed my baby; half standing, half kneeling holding onto Enda by the fireside. The visualisation of embodying the mother from the Hello Baby book had been manifested.

Afterwards I was helped onto the couch and given my healthy little girl where she latched on without much effort and settled in for her first feed. I was bathed in endorphins at this point and feeling such elation – the impending cramps of the placenta brought me back to reality. I decided to opt for a manged birth here and with a little jab and a tug the placenta came out. I felt a little raw as I was birthing it but when Angela examined me, I could not believe that I had only grazed and not torn. Such a relief after struggling with the recovery of an episiotomy after the birth of Jess.

The next hour or two were just so relaxed – Enda changing bed sheets, Angela doing the newborn check by the radiator, Liz deflating the pool and helping me to the toilet and shower. She even waited by the door and wrapped me in a towel when I was finished and tucked me into bed! By midnight I was eating a toasted cheese and drinking tea whilst snuggled up with my little bundle. The house had been cleaned up, the magical midwives had left, and the 3 of us got into bed for that first special night. It was made even sweeter the following day when my other two babies arrived home from their Nannas to meet their new baby sister with sheer wonder and delight. My heart was full.

Postnatally, the recovery from the physical labour was rapid. There were no side effects from drugs, no medical scars to heal, no emotional trauma arising from a sea of regret. Nonetheless it was an undoubtedly arduous task to recover from pregnancy, meet the demands of breastfeeding, manage the fluctuating hormones and sleep deprivation. The preparations made for the labour were so integral for this period too – realising the need to meditate and walk daily, to prioritise food and rest, and to practice acceptance for things that needed time to pass.

Having completed my journey from medicalised hospital births to a natural home birth, and 1 year postnatally, I find myself still very much on a journey. The natural home birth however has kick started a transformation in approach and a new benchmark for handling motherhood’s challenges – from managing her vast and ever changing demands, to allowing her moments of sheer joy.