A Home Birth after Caesarean Birth Story

Based on everything I learned, I believed that a “trial” of labour on a busy maternity ward would decrease my likelihood of having a smooth physiological birth. I’m a really private person, so the idea of trying to birth on a bed on a busy noisy hospital maternity ward, with bright lights, continuous monitoring, limited mobility and unknown medical professionals wandering in and out was really daunting. I could see that I would struggle to relax and feel safe, which would not help promote oxytocin or reduce adrenaline. It was easy to see how interventions could become necessary in those circumstances. So instead of my birth plan being driven by the fear of a uterine rupture (which is actually a very small risk for VBAC mothers), I decided to focus on increasing the chances that things would go well by planning a home birth where I’d have dedicated midwifery support in a comfortable and familiar environment.

At around 12 weeks’ gestation I started looking for an independent midwife who could offer continuity of care and a way to avoid the coercion I’d experienced in my previous pregnancy. It quickly felt as though everyone I spoke to was recommending the same person – Rene Bozier. From my first conversation with Rene, I got the impression that she would be a good fit because we were on the same page about so many things- she didn’t seem fazed that I wanted a VBAC (she’d supported so many of them), and she was willing to wait and see what happened in this pregnancy in relation to gestational diabetes rather than assuming the worst-case scenario from the outset. She seemed to completely understand the benefits I saw in a home birth and had a holistic non-interventionist approach which I really appreciated.

After negative comments with my registered obstetrician, I was grateful to be having a much better experience with my private midwife, Rene. While my NHS appointments were never more than about 5-10 minutes long and I generally saw different midwives each time, appointments with Rene lasted over an hour and a half. She spent a lot of time getting to know me and my husband, discussing our experiences, preferences and developments in the pregnancy. I realise now how much trust she built up over those sessions. I knew, for example, when she asked to perform a vaginal exam during labour that it wasn’t requested lightly- she knew I didn’t want them as a matter of course and I knew she would only ask if she thought it was clinically important in the circumstances. Similarly, because she’d talked to me at length about warning signs of a uterine rupture, she knew that I would tell her if I felt any of them during labour without her needing to ask. It was an amazing partnership to build over such a short period.

Labour started when I was 39 weeks’ pregnant with some period-type pains and back ache first thing in the morning. I ignored the signs and took a bath, having convinced myself that since I hadn’t laboured before I would go past my due date. At lunchtime I went to the bathroom and realised that I was bleeding- a fair amount of bright red blood, with no sign of any mucus. Dr Google suggested this could be indicative of lots of scary things, so I texted Rene who reassured me that - together with the other symptoms - it sounded like it was my ‘bloody show’ and the start of labour. The cramping came back and became more frequent early afternoon, each time lasting around a minute but not in any regular pattern. Everything slowed down mid-afternoon when my toddler woke up from his nap and my sister and brother-in-law came to visit. I kept quiet about my early labour signs, not wanting any questions or fuss. I still couldn’t quite believe it was happening and didn’t want to excite anyone or feel overly observed. I wanted to let my body progress quietly in its own time.

At around 5pm the cramps picked up again and started to get more frequent but still irregular. It continued like that throughout the night and most of the next day- I got a fair amount of rest but found it impossible to sleep. By the next afternoon, the novelty had worn off and I started to feel a little grumpy about the fact that early labour was continuing unchanged, and I hadn’t been able to sleep. Rene suggested that I go for a walk which made the surges increase in frequency and intensity. I had to lean on my husband and breathe through the surges, and they started to become more regular (around 2 in 10 minutes).

Back at home, my husband closed the curtains, lit candles and turned on the scent diffuser in our living room. He had set up the birth pool to test it 2 days prior, and thankfully it was still inflated. Rene came to check me over at about 7pm. She took my blood pressure, heart rate, temperature, and listened in to baby. She stayed for around an hour, mostly observing. My surges initially slowed when she arrived but towards the end of her visit were picking up as I relaxed again. Rene said that she would go home for a while, but that she expected she would be back later that evening and we should just call when we wanted her.

After Rene left, I continued to labour at home. Sleep proved impossible again, so we watched a romantic comedy and I bounced on my birthing ball, standing up and leaning over the sofa during surges. I was experiencing a lot of back labour so I took a shower and afterwards started using a TENS machine to ease the discomfort. I started using the Freya app to time my surges which by 10.30pm were coming 3 times in 10 minutes. Everything was starting to feel a lot more intense, so my husband called Rene and asked her to come over and he then started to fill the birth pool.

Rene arrived at about 11pm, by which time the surges were 2-3 in 10 minutes, lasting 60 seconds each. By then I was listening to hypnobirthing tracks between surges and had my eyes closed a lot of the time. I was feeling relaxed and focused, so I loved that Rene didn’t disturb my concentration when she came in - she was calm and quiet and didn’t make a fuss or ask lots of questions. She just let me carry on and observed quietly while starting her paperwork.

Over the next couple of hours, I couldn’t face the prospect of food, I could only sip on water and Lucozade, the TENS machine became more irritating than helpful, and I needed my husband or Rene to apply counter pressure to my lower back when a surge hit. My only sense of time passing were the hourly checks that Rene performed, and the blood glucose finger prick tests that my husband was helping with.

Around 1am Rene encouraged me to go to the loo, and I realised that I couldn’t. After peppermint oil drops didn’t help, I agreed to an in-out catheter, which left me feeling much more comfortable.

By 2am I still hadn’t got in the birth pool and felt guilty about ignoring it any longer, as my husband spent so long filling it up and getting the temperature right. I remember him trooping backwards and forwards to the kitchen with pans of hot water after it had cooled down, and Rene jumping protectively in front of me as if he might tip it over my head! Although I wanted to get in, I was nervous as I felt very hot. I stood at the open front door for a couple of minutes to cool down before taking the plunge.

Despite my reservations, the pool turned out to be blissful. As soon as I got in, the water washed over my skin bringing a wave of relief. I dropped to my hands and knees for surges now, and my husband stood behind me, applying much-needed pressure to my lower back. Between surges I sometimes chatted but often just relaxed, feeling tired but happy and calm – if a little nauseous. My husband switched on some music and I remember Motown tunes and Taylor Swift playing quietly while the candles and fairy lights flickered around me. This felt so much easier than early labour - I was surprised and couldn’t understand how this experience could be enough to bring about the birth of my baby although I could feel him moving down. My birth notes say that I told my husband, Rene and a second midwife that had joined us (Tess) that it felt “so different from what I expected” and that I felt “out of my body”. Since getting into the pool, my surges had slowed and become a lot more intense (sometimes making me whimper). I was hot, sweaty and not at all glamorous, but I wasn’t finding it difficult to cope.

Throughout active labour my husband had been helping me to test my blood glucose scores once an hour, in line with my birth plan to manage my gestational diabetes. I needed to keep my blood sugars below 7mmol/l. I had agreed with Rene that if they went over this level twice in a row then I would transfer into hospital. If they went over this level by a significant amount on any one test, then I would transfer in immediately. Until this point the tests had shown that my blood sugars were great. At 5am, the reading came back as 7.2mmol/l. I tried to stay calm, knowing that adrenaline can make blood sugars soar, but I had a churning feeling in the pit of my stomach. I’d come so far and I desperately did not want to have to transfer in. My husband suggested that I drink a couple of tablespoons of apple cider vinegar mixed in with some water and eat a piece of cheese. I had been doing that at bedtime throughout pregnancy to help manage my fasting blood sugars but it had not occurred to me to write it into my birth plan. I was so grateful to have something to do, if for no other reason than to stifle my anxiety. I drank the vinegar, ate the cheese and upped my water intake over the next hour, dreading the next test at 6am.

During the hour that followed, my surges were very strong, releasing some of my waters, though they remained relatively slow at just 2 in 10 minutes. My back hurt during each surge and just before 6am I started to feel some pressure. I was still feeling hot and sweaty as my body was working so hard. It wasn’t a great time to have to do another blood glucose test.

I administered the test myself, keen to make sure that I’d carried it out as carefully as possible so that I knew it was accurate and I should act upon it, even if it was high and meant transferring to hospital. Thankfully the result was 6.3mmol/l - almost a whole point down from the hour before and miles below the threshold I was worried about. I felt oddly victorious as well as relieved. It gave me a big boost of confidence to think that I could labour and manage the GD at home, using the same strategies I’d adopted during pregnancy.

At 6.30am, half an hour after I first reported “pressure” during a surge, I was continuing to labour as before with surges every 6 minutes, lasting about 45 seconds. Rene suggested that going to the loo might encourage surges to pick up some more. It did – I had strong intense surges in the hallway and in the bathroom, but I still wasn’t feeling any urge to push. Rene gave me homeopathic remedies Gelsemium and Caulophyllum to try to encourage the labour as well as offering some frankincense to smell. My birth notes report that I did some active pushing around this time, though it was not feeling natural.

At 7.10am Rene asked if there was a reason I was still ‘up’ breathing and in my tired, confused state I didn’t really have an answer – it was what I had been doing throughout and I had no instinct to change that now. She encouraged me to breathe down through my body during contractions to support my body pushing. I found this difficult, even though I’d tried to practice antenatally. Again, it didn’t feel natural, and I didn’t think I was doing it properly. Looking back, I think it was confusing when I spoke about feeling pressure. I think I was probably feeling the baby move down some more. I wasn’t really feeling an urge to push, and I wasn’t ready to start ‘down breathing’ though I gave both a try.

20 minutes later, Rene suggested that I get out of the pool and try sitting on the loo again. Like before I had surges in the bathroom and on the stairs but nothing about those felt any different than before.

When I came back into the living room, Rene said that she would like to do a VE to see if it could help her to understand what was happening. I consented with a heavy heart – we both knew that I didn’t want any routine VEs and that she wouldn’t have asked if she didn’t think it was important. I lay on some towels on the floor and found that position to be excruciating as soon as a surge hit. I have no idea how people labour on their backs. It was agonising and I was desperate to get up again. I also felt tense and stressed by the need to have a VE and found the whole experience to be very uncomfortable. As soon as it was over, I got up, feeling like a defendant waiting for a verdict in court.

Rene told me that I was 8-9cm dilated and that while my hind waters had leaked, my forewaters were bulging and had not broken. She suggested that I lay on my side on the sofa and that we see how things progressed, reassessing in an hour. My heart sank – I took that to mean that there was a concern that I might be ‘failing to progress’ and that I might be asked to transfer into hospital if things didn’t pick up. At the same time, I was absolutely determined that it wouldn’t happen – it was now 7-50am, I was exhausted and couldn’t imagine the discomfort of a transfer at that point, let alone hours of additional labour. I was ready for my baby to be born and felt a sort of quiet resolve that I couldn’t explain.

I lay down on my side on the sofa and asked for a rolled-up towel to be placed between my knees. With my next surge I felt a strange sensation as if I’d birthed a warm balloon full of water. My waters had finally broken properly, and it felt like a relief. A release. Things felt different immediately - now I really did feel pressure. Rene seemed to understand that without me having to explain it. She suggested that I could get back into the pool if I wanted to. There was a bit of discussion between the midwives about the colour of the liquor – it was slightly stained, suggestive of a small amount of meconium, but Rene wasn’t at all concerned for which I was grateful.

I got back into the warm water, suddenly feeling as though I knew exactly what I had to do. I wasn’t on all-fours now. I instinctively wanted to lean upright and forwards with my arms over the edge of the pool and I clutched onto my husband’s hand as my body took over and started to push for real.

Less than 30 minutes after the VE, at 8.18am, Rene reported that she could see the baby’s head. I felt the ring of fire urgently, understanding what it was but still bewildered as to how baby’s head was possibly going to be able to come out when it clearly didn’t fit. But with a couple of surges out it came at 8.25am. I heard Rene call out to the second midwife that the head had been born. With the next surge, less than a minute later, out came baby’s body.

I pulled baby Quentin up out of the water and held him to my chest, as Rene slipped the cord from around his neck. I was in total awe looking at him and I felt overwhelmed by the realisation at what I’d done. He screamed continuously as soon as he was brought out of the water, and I tried to reassure him as I kissed his face and held him close.

After a couple of minutes Rene asked if I could get out of the pool as there was some blood loss and she wanted to understand how much and why. I lay on the sofa with Quentin, and Rene asked for consent to give me an injection of syntocin to encourage the delivery of the placenta because of the bleeding. It wasn’t my preference, but I wasn’t too upset about it because the birth itself had gone so beautifully.

At 8.38, nearly a quarter of an hour after being born, Rene supported me to encourage Quentin’s first breastfeed but he was too busy crying.

At 8.48 the cord was clamped and then cut by my husband, Quentin still yelling non-stop.

At 8.51 Rene encouraged delivery of the placenta by gently tugging on the cord. I didn’t like that sensation at all and initially asked her to stop. But I was uncomfortable lying on my back on the sofa so a few minutes later Rene used ‘controlled cord traction’ to help deliver the placenta which came with some additional membranes.

Tess and Rene checked over the placenta. Tess talked me through what I was looking at and also showed me that I’d got a really long cord with an unusual ‘true knot’ which we hadn’t known about antenatally.

At 9.18, Quentin finally stopped yelling and began suckling. My husband and I then enjoyed some alone time with our new baby as Quentin had his first breastfeed and the midwives enjoyed a well-earned cup of tea.

At 10am I passed Quentin to my husband who weighed and measured him with Tess (3570g/ 7lb 14oz) and put on his first nappy while Rene checked me over. She reported that I’d got a first-degree tear and a couple of grazes – she explained that those were the source of the bleeding which was relatively minor in the end (about 350ml). Rene suggested that it wasn’t worth suturing, and I agreed.

At about 10.20am, I left Quentin in my husband’s very loving, awe-struck arms and went upstairs for a shower. Rene found some pyjamas for me and tucked me up in bed, my husband came upstairs and passed Quentin to me for some more skin-to-skin time, bringing croissants with apricot jam, a glass of orange juice and a coffee – it tasted heavenly after months of managing gestational diabetes. Both midwives left soon after and my husband tidied up downstairs before he came and joined us in bed for some sleep.

It all felt so magical. I felt and still feel so full of love and gratitude for the people around me who had offered me incredible support and, probably for the first time in my life, gratitude and pride in my body which had done exactly what I wanted it to do for Quentin and me. I felt a huge sense of achievement, and that positivity and confidence helped me in the more difficult and sleep deprived moments to come. It wasn’t perfect in the sense that I’d needed the in-out catheter and I’d had a VE. But that didn’t stop it being absolutely amazing and the fulfilment of a rite of passage I’d missed out on the first time. I wouldn’t change a thing.