Birth Story:
A February Home Birth in Dublin

My mother-in-law is a professor of midwifery, and long before I ever got pregnant, I was exposed to lots of conversational details about the medicalization of childbirth, the inflated rate of caesarean sections, the cascade of interventions and midwife-led care.

I had long known that the safest place for a low-risk woman to have her second baby was at home.  My sister had had a successful home-birth a year earlier, so when I became pregnant for the second time, a home birth was, naturally, a consideration.

Having good maternity cover on my health insurance, I knew I had the option of going with Private Midwives but felt that maybe I should consider the Holles Street Hospital homebirth scheme considering that I was lucky enough to be in the catchment area and lucky enough to have an uneventful and low-risk pregnancy.  My sister’s experience with the scheme had been positive, and I briefly considered it as a simple, straightforward option.

However, I quickly learned that Private Midwives was more flexible should any complications arise in later pregnancy and labour.  My first baby had been twelve days overdue, and the scheduled induction at 41 weeks had felt like a curse on an otherwise blissfully healthy and uneventful pregnancy.  My body, which had done everything it was supposed to do to nurture this baby, was suddenly, in the eyes of the hospital, not doing things right.  I realised then that despite the ideal of a woman consenting to medical interventions in her maternity care - advocating for this right was really very difficult.  While I would not exactly consider my first hospital birth as being traumatic, it was long and exhausting and resulted in the typical sort of cascade of interventions of which I had heard - epidural, fetal distress, episiotomy, forceps delivery, and some gaping of the episiotomy wound several days afterwards.  I attempted to build a relationship with my hospital midwives, but my labour and delivery spanned three shifts.  Although the young, earnest midwife who cared for me throughout most of it was familiar with my birth preferences, once doctors were on the scene her lack of power and authority was palpable, and despite my own condition, I remember feeling a deep sense of pity for her that she was not being allowed to do the job which we both wanted her to do.

And so, if I could have the same issue of going overdue, I booked with Private Midwives early in my pregnancy.  I assumed that if I needed flexibility in my maternity care - it would be for going post term.  I knew that Private Midwives would allow a woman to go to 43 weeks, with close fetal monitoring, before medical intervention, and as such - assumed that this would be likely with me.

Private Midwives arranged an initial visit with my midwife Angela.  Angela came to the house one afternoon last summer, and I was initially a little surprised at her calm, laid-back attitude.  I think I had been expecting a salesperson, who would inundate me with success stories and statistics and promises.  But no, she sauntered in and we had tea and a chat.  She met my daughter and played with her and her dolls’ house.  I liked her, but somehow, she was so far from what I had expected that I was a little confused.  I think the notion of a medical professional as someone who talks at you, (however nicely), rather than with you is deeply instilled in our culture of healthcare.

My pregnancy continued uneventfully, and I didn’t see Angela again until 36 weeks of pregnancy, when my antenatal care transferred from the Coombe to Private Midwives.  I loved the relaxed nature of these home visits, where there was never any time pressure, and in which my 3-year old was often happily included as Angela’s little helper.

Towards the end of my pregnancy, I was feeling quite anxious.  I had some Pelvic Girdle Pain, which depressed me a bit as I couldn’t be as active this time around - my first pregnancy had been so comfortable right to the end.  This was also causing me difficulty in sleeping.  In my first pregnancy, I had done a hypnobirthing course, which encouraged me to think positively about labour.  This time around, however, I felt that thinking positively hadn’t worked, and was regularly remembering the worst and most painful parts of my lengthy first labour.  I avoided telling people that I was planning a homebirth, as I felt convinced that I would end up with a hospital transfer.  I read a lot of birth stories in Ina May Gaskin’s ‘Spiritual Midwifery’ book, and while I found them fascinating, after a while I became concerned that I wasn’t ‘hippy enough’ to really manage a natural birth.  So, I stopped reading them.  I hadn’t given up on hypnobirthing entirely as I know that the research is there to support its effectiveness, so I had downloaded the Gentle Birth app to my phone.  However, I didn’t commit to it much this time around as I found it boring.  The birthing affirmations seemed corny, and I found the hypnosis difficult.  I always felt like I was doing it wrong, couldn’t switch my mind off, and then felt guilty that I wasn’t listening to the tracks enough.  I eventually decided that this guilt was counter-productive and stopped trying so hard - I resorted to just turning it on at night as I went to sleep and forgetting about it the rest of the time.

When my due date came around, I did not take it seriously, taking my first labour into account.    The ‘birthing suite’ - our spare converted-garage bedroom, was not fully prepared.  While I was anticipating that I would spend early labour wherever I felt comfortable in the house, I was convinced that the ‘noisy bit’ should happen out of earshot of the neighbours, and so this room seemed perfect.  A perfectionist streak in me wanted it to be a Pinterest-worthy oasis of calm, however my tendency to procrastinate, together with the anxiety around childbirth and my pelvic girdle pain were obstacles to achieving this by my due date.  Fairy lights seemed a priority somehow, but against all advice, we hadn’t gotten around to a trial-run of the birthing pool.  I was starting to feel somewhat stressed at my lack of preparedness, but somehow not stressed enough to fully finish the preparations.  Having spent weeks trying to declutter, I was reluctant to bring more stuff into the house, and so the list of items needed for a homebirth went largely unaddressed.

And so, when my waters broke at 40+2 in the early morning, my response was one of panic.  We were not ready.  I had not slept well and I was determined, after my experiences last time, to be well-rested for labour.  I messaged Angela, informing her that I was going back to sleep, put on my eye-mask and ear-plugs and forced myself, as best I could, to try and get more rest.  A few hours later, as my husband was getting up, I instructed him on what to do with the birthing pool.  I again tried to force sleep whilst catastrophizing in my head - images of the birthing pool leaking water all over the floor or having punctures.  However, he reported that it seemed fine, and came to ask if I was getting up.  I still felt that I hadn’t slept enough and was having no contractions.  I worried that getting up might bring on contractions, but there is only so much sleep you can force on yourself.  When I finally got up after noon, I was relieved that nothing happened.  I made arrangements for my mother to take my daughter out, and then slowly went about making the final preparations in the ‘birthing suite’.  I finally worked methodically through the list of supplies recommended and made sure they were in place in the spare room.  I sent my husband out to do the weekly shop, did a load of laundry and some other household tasks.  I finally accepted that I had done all that I would manage to do and sat down to dinner.  Angela had arranged that she would visit that evening after dinner.

When she visited that night, I learned that under Private Midwives policy, I had up to 72 hours to wait for contractions to begin before they would recommend a hospital induction.  This is a significant difference to the HSE scheme, which only allows 16 hours.  I was feeling very thankful to be with Private Midwives.  Angela explained how to monitor temperature, respiration and pulse every four hours, and then left for the night, reiterating that I could call or text any time before she returned in the morning.

Although I was happy that I felt significantly ‘readier’ than the day before, I still assumed that my baby would have inherited my procrastinating nature, and that I would need all the 72 hours I had.  We went to bed, but as was the pattern in this pregnancy, baby started her ferocious kicks as soon as I lay down, and sleep did not come.  Having worried about her being in a posterior position, I turned on the light and spent some time on all fours on the floor, reading a book.  I tried again to sleep, this time putting on some Gentle Birth tracks to help.  At some point I drifted off, but maybe around 3am I had some awareness of slight pains in my abdomen.  I kept Gentle Birth on and tried to ignore them.  I drifted in and out of sleep for some time, but at about 5am, I found that they were really quite severe, but after my lengthy experience in my first labour, I was not convinced that this was real labour yet.  I decided to get up and walk around to see if they would go away and went to the kitchen to have something to eat, reveling in the fact that I was in my own home - with access to my own food at any time I wanted.  While getting a bowl of cereal however, the contractions suddenly felt very severe, and I struggled somewhat with getting the milk from the fridge.  I admitted to myself then that this was no false labour, and that these definitely must be real contractions.  I downloaded a contraction timer app and woke my husband to ask for help with my TENS machine.

The contractions were severe and very different from my last pregnancy.  Their duration and the intervals between them varied significantly.  I was confused and didn’t know what this meant and decided to ring Angela.  It was 5.45 am I was aware that Monday morning traffic would start building in another hour or two and reluctant as I was to wake her prematurely, everything felt so unpredictable that I didn’t want her stuck in traffic when something was happening.  When I rang, she asked me how regular the contractions were, and I felt stupid for not having a proper record.  She asked if I was having more than one every ten minutes and I couldn’t tell her - I offered to wait another ten minutes and time them better with my husband’s help, but she said no, it was fine, and that she would come straight away.  I felt uneasy that I may have called her too soon, but we settled down to watch tv in the sitting room anyway.  I asked my husband to take over the timing of contractions, and at this point the slight sense of panic I had been experiencing lifted, knowing that Angela was on her way.

Angela arrived at 6.15 am and began setting up equipment and updating my notes.  While she was here, the contractions slowed right down, and I felt silly for having called her out so soon.  After our programme ended, she suggested we go to bed and get some more rest.  My husband went upstairs, and I said I’d follow, after I went to the bathroom.  Once I got to the privacy of the bathroom, the contractions returned with alarming ferocity.  15 minutes later, Angela and my husband were knocking on the door and I was groaning on hands and knees on the floor.  They brought me back to the sitting room, and at this point, Angela did the only vaginal examination of my entire pregnancy and labour.  When she reported that I was 6cm dilated, I felt no sense of defeat - unlike my first labour where every vaginal examination depressed me at my lack of ‘progress’.  Neither however, did I feel a sense of accomplishment - I knew already from the contractions that something was happening, and I knew from my reading of different birth stories during pregnancy that the number of centimeters can change very quickly.

Everything felt a bit frantic at this point.  Angela made the call to the second midwife and began covering the floor and couch in the living room.  She sent my husband to fill the pool in the ‘birthing suite’, and I continued to labour leaning on the exercise ball.  I felt happy in the knowledge that things were happening, and extremely thankful that Angela was there and that I had rung her when I did.  Fifteen minutes later, I was using Entonox, and another 20 minutes or so after that I began pushing with contractions.  Liz, the second midwife, arrived at 9.30.  At some point, I was asked if I wished to move to the pool, but I knew that moving that short distance would be too distressing at this point - all fears about the neighbours hearing the birth had vanished and I simply didn’t care.  The labour was going at what I felt was a comfortable pace at this point - although the contractions were painful, I was experiencing a reassuring and calm break between them - it was entirely different from the sense of debilitating panic I had felt even between contractions on my first labour - dreading the next contraction almost before the current one had ended.  I feel that this was definitely helped by the sense of safety I felt from being at home with gentle caregivers who helped me to trust in my body’s capabilities.  After the initial rush, I did feel at one point that the pushing phase was taking a long time, but Angela reassured me that everything was fine, the baby’s heart-rate was fine after every contraction, and that it was simply a lovely gentle birth.  I was offered the chance to feel my baby’s head (which felt nothing like a head) and to see it in the mirror.  Although it was painful and hard work, I felt safe in the knowledge that it was not going to take hours, and that I was safe and my midwife was there.  Liz worked away completely unobtrusively in the background and set up a resuscitation station in case it was needed for the baby.  The sunlight was streaming through the curtains.  Ireland AM was on the television.  At some point, I asked my husband to turn the sound down.  He muted it, and I corrected him - for some reason I wanted it on, just not loud.  I have no recollection of anything that was shown on Ireland AM that morning, but I knew that I wanted it to stay on.

At 10.47, after pushing through a very strong contraction, I asked if I had torn.  There was a slight silence, and my husband said…. there’s a baby.  They told me to turn around and look at my baby, and I kneeled up from the exercise ball and twisted around to see it was a baby girl.  They told me to pick my baby up, and as I tried to figure out how to do that, Angela helped me from my knees, over the cord, to sit back against the couch and pick her up.  We had immediate skin to skin contact.  She was perfect.  Somebody covered us with a towel, and my amazing baby girl had her first breastfeed within ten minutes with only the gentlest encouragement.  Shortly afterwards, I felt another contraction coming.  I was aided back into position against the birthing ball and delivered the placenta with only the mildest of traction on the cord.  The cord was left to pulsate until white, and my husband was instructed in how to cut it.

My baby was perfect.  Nobody took her away to weigh her or measure her, and she stayed in my arms or my husband’s arms for her first few gentle, peaceful hours.  We decided to delay weighing and dressing her until my older daughter came home after Montessori.  Both grannies were present to see her awe at meeting her little sister, with no hospital visiting policies to worry about.  Angela enlisted her help in weighing the baby, counting her fingers and toes, and dressing her.

Because of the premature rupturing of the membranes, my baby was at an increased risk of infection.  Because of this, Angela stayed all day to monitor her every few hours.  In between, she cleaned up, wrote up my notes, made tea, and helped me process the amazing thing that had just happened.  She assisted us up to bed before leaving.

Over the next week, Angela visited almost every day, and I realised the full extent of her job.  She wrote referral letters for hearing screening, the GP and Public Health Nurse, filled forms for registering the birth, ensured that I got the Anti-D injection needed (as I was rhesus negative), took the heel-prick test and delivered it herself to the hospital, and arranged for clinical waste collection.  Although the home-birth system is not well-established in Ireland, she ensured that my baby and I would get every check-up that a hospital-born baby would - despite some less-than-accommodating hospital policies.

My physical recovery was extremely swift, and aside from needing time to process the wonderment and awe, I had needed no stitches, and felt perfectly able to resume normal life very quickly. The neighbours claim they heard nothing.

After the birth, I recognised that reading positive birth stories of normal, unmedicated childbirth had really helped me recognise the sensations of birth, (despite my unfounded fears of inferior hippiness).  Having had an epidural with my first birth due to exhaustion, I worried that I had not really experienced the pushing phase first time round, and this was causing me some anxiety beforehand.  I have documented this birth in detail, both for my own records, and in the hope that reading it will be helpful to others in allaying any fears about home-birth.  Having had such a positive experience, I now strongly feel that all women should be encouraged to consider whether home-birth could be an option for them and should be facilitated in accessing this care if they choose to do so.

I am thoroughly satisfied with my experience with Private Midwives.  I don’t think I have ever paid so much money for something yet felt so thoroughly happy that it was worth every cent.  Even if it were not refundable under my health insurance, I would have no regrets in having chosen them for my care.  I have such profound respect for the midwifery profession after my two birthing experiences and feel very saddened that midwives are often not afforded the autonomy and working environment that they deserve in the hospital system in this country.