Tag Archives: Physiological third stage

Third time lucky

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After supporting this family over multiple pregnancies it was an absolute pleasure for the team to be able to facilitate the birth they have always desired.

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Team Stats 2018

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We are delighted to be able to finally share our 2018 stats with you.

The Surrey Hills Homebirth team work within a continuity caseloading model which means that we continue to care for our clients throughout their childbearing journey, even if plans or place of birth change along the way.

In 2018 we were responsible for the care of 190 pregnant women and their families (6.3% of 2998 registrable births supported by Royal Surrey Maternity in 2018).

Of these families 27% birthed their first baby and 73 % had had at least one child before.

We welcomed 99 girls and 91 boys in to the world.

From our caseload of 190 clients, 135 (71%) families planned to give birth at home with the Surrey Hills team at the onset of established labour.

The remaining 55 families opted for an alternative place of birth. This change in planned place of birth occurred for a number of different reasons including consent to Induction of Labour, the development of situations/conditions which recommended a hospital based birth and moving out of area.

79% of our caseload (n=190) knew the midwife who was caring for them in labour.

Of the 135 families who planned to give birth at home at the onset of labour 97.1% had a vaginal birth.

24 of our clients experienced an in labour transfer (17.8%) to an alternative place of birth. 111 families birthed their babies at home as planned (82.3 %). 3 of our families were transferred in the immediate postnatal period (2.2%).

Altogether 27 families (20%) were transferred during birth or in the immediate postnatal period.

Of the 135 families that planned to give birth at home at the onset of labour 98% used hydrotherapy (birthing pool) with 71 births (63% of our home births) occurring in the water.

95% of the clients that birthed at home had a physiological (natural) birth of the placenta with optimal cord clamping.

A Positive Birth Experience

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When my community midwife suggested home birth to me at my booking in appointment with my second pregnancy I politely declined, thinking absolutely no way did I want to have a home birth. I was terrified of labour after a traumatic hospital induction with my son and didn’t really want to even think about having to go through labour at all.

As my pregnancy progressed I realised I had to face up to it sometime and booked onto the Royal Surrey maternity ward tour as I had given birth at a different hospital before. Being on the labour ward had me in floods of tears and did nothing to dispel my fear.

I started a hypnobirthing course and the hypnobirthing teacher suggested homebirth again to me and after the emotional experience of the labour ward tour, the idea started to make a bit more sense. It was actually my husband who cemented the idea as he knew I would be a lot more relaxed at home.

The more I thought about it the more it made sense and I was desperate for a different experience of labour this time. I went to a homebirth forum to meet the team and had a lot of my fears put to rest. At 28 weeks pregnant I made the decision to switch to the homebirth team.

Having all my antenatal appointments at home was the first huge benefit, I already felt more relaxed especially knowing that I would know the midwife who would be there at the birth.

My named midwife (Tanya) was so reassuring throughout the pregnancy, was great with entertaining my son during appointments and it felt like a friend visiting rather than an antenatal appointment.

As my due date got closer I started to feel excited at the prospect of having a home birth and really hoped everything would go to plan. I set the living room up with the birth pool and positive affirmations so it was all ready to go.

When I was 40+6 Jodie came to do my appointment and asked me what my thoughts were if I got to 42 weeks. I decided to have a sweep there and then as thought it could do no harm and I was desperate to avoid induction. I was 2cm dilated so Jodie reassured me it was unlikely I’d get to 42 weeks which was a relief, and joked that she’d see me later as she was on call. 

Later that afternoon at 4.30pm I started to feel period pains. I timed them for half an hour and realised they were coming every 2 minutes and I might be in labour. I contacted Jodie to let her know and she said to keep monitoring and let her know when they intensified.

I put my tens machine on and carried on focusing on my breathing. My husband started to fill the birth pool as we were worried it might take a while because of our boiler.

I practiced my hypnobirthing and focused on breathing through my contractions. I spoke to Jodie again at about 7.15pm and she said I sounded too happy still but she was ready to come when things intensified.

At 7.45pm I asked my husband to phone Jodie and ask her to come. She got to us just after 8pm and immediately suggested I get in the pool. Shortly after that I felt the urge to push.

Having not experienced the feeling of pushing/crowning the first time around due to an epidural, this made me panic a bit and I asked for gas and air for the last bit of pushing.

At 8.42pm my daughter was born in the water! I felt immense joy and was so proud of myself for doing it. 

The whole experience was incredibly empowering and I felt so relaxed throughout. My husband even has a video of me straight after birth asking why my baby isn’t crying, she was just so relaxed too!

I stayed in the pool for a while after and then Jodie wrapped me up on the sofa to cuddle and feed my baby in the comfort of my living room. It was so lovely to be in our own surroundings getting to know our new baby rather than the loud and busy postnatal ward.

To have had such a positive birth experience made all the difference to the first few weeks with our new addition. After my son’s birth I swore I’d never do it again but this time I’m sad I can’t repeat it as it was so amazing!

I cannot recommend the Surrey Hills home birth team enough. They are so encouraging, incredibly skilled and have the most amazing ability to give reassurance when needed but to step back and let you and your body get on with labour your own way.

It felt like it was just my husband and me throughout the labour but I knew Jodie was there if I needed her (the second midwife arrived after my daughter had been born but I never felt it was an issue with it just being Jodie and a student midwife).

Jodie actually took photos of my daughter being born and sent them to me straight after. I never would have thought I’d want photos but I am so pleased she just went ahead and took them.

The team supported me to believe in myself and trust my body and baby. My only regret is I wish I’d made the decision to have a home birth sooner so I could have experienced their incredible care throughout my pregnancy.  

Surrey Hills Client February 2019

…the best day of my life…

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A couple days before my due date I’d started to get anxious at the thought of going over due. The thought of wasted time at home waiting and then the idea of being induced filled me with dread. I was already on the dates, raspberry leaf tea and clary sage but I decided to ramp it up with a curry, a reflexology session, a pineapple and whole evening on my birthing ball.

This seemed to do the trick because at 4.30am at 40+1 I felt a little trickle and thought ‘hmm…that can’t be anything else’. Trying not to get excited I went to the loo to put a pad in and went back to bed. About 15 mins later the same amount leaked again and I got out of bed.

Not just wanting to lie there I went downstairs and had a cup of tea and a chocolate biscuit. I decided that if this was it I wanted my husband Sam to get some good sleep in because this could be a long day or so.

However at 6.30am the period pains were enough for me to wake him with a ‘I think it’s all starting’. He was wide awake and ready to go. We had it all planned that we’d make the living room cosy, watch something light hearted and put on the mp3s, all to keep the oxytocin high.

However as the period type pains quickly ramped up and we’re quite painful I wondered are these full on surges not just period pains? I’d expected strong tightening across my belly but it was all low down period pain and it felt like there wasn’t much of a break in between. So at 7.30am I called the homebirth team and was told to just chill and see what happened.

It then ticked over passed 8am and I really thought these are strong so I called back and the next midwife on shift for the homebirth team answered (Laura) and reiterated that I was a first time mum and I could have a good 8-12 hours ahead of me and I just needed to relax and maybe I should get in the bath.

The surges were starting to make me be sick, and I asked Sam to call my mum who used to be a midwife to tell her what was going on and check I wasn’t harming the baby by being sick. I found out after that she told Sam this was all a good sign and my body was really in the process of labour.

Sam ran me a bath and I was in, but the surges were progressing so at 8.15am I called again, really starting to feel like I was a nuisance but I just knew my adrenaline was rising at the thought of delivering our baby without a midwife.

Laura suggested herself and the student midwife get over to my house to see me and take it from there. They arrived, and Sam tells me now that immediately I calmed down and my mindset changed from one of slight panic to ok its time to go!

I continued to be sick whilst having a bath and for every surge Sam counted with me, in for four and out for eight. I realised, after one particularly intense surge, that my body would give me a break and the next wouldn’t be so bad so I took them one by one realising I could get through them.

Suddenly the bath didn’t appeal anymore and I went to my bedroom but lying down was really uncomfortable, so the student midwife suggested I kneel over the bed and she rubbed my back.

This next chunk of time was a blur but I was asking for the gas and air. Laura said she’d prefer I used the gas and air only once in the birth pool (due to the amount they carry!) but before I got in the pool she’d prefer to examine me. I had absolutely no problem with being examined and when she said 7cm although I was really pleased I said out loud ‘so I’ve missed the chance of an epidural!’.

In planning the birth, in the back of my mind I thought I’d be transferred to hospital for pain relief but now I knew I was doing this at home.

I got in the pool and it really was as good as they say for pain relief. It felt warm and I had lots of space to get comfortable.

After some time I started on the gas and air and that was amazing, I loved it! I really felt the benefits and it just took away any apprehension about the surges.

I remember hearing Laura in the hall describing where we lived to the second midwife who joined for delivery and Sam saying ‘that’s because you’re close now’.

I don’t remember any transition stage but I remember a feeling of needing to push at the very end of a surge. And Laura just encouraged me to go with my body. She didn’t do any checks and I didn’t feel like she interfered at all.

At this point there was the strong feeling of ‘I need a poo’ so I went to the toilet, here I did my best pushing and felt in 100% the right position. Laura said afterwards that she thinks this was a really productive part of my labour and the baby moved really well, so much so they had to persuade me to get back in the pool as they wouldn’t be delivering the baby on the loo!

I got back in the pool and back in the squatting position but this time the pain was in my legs, I felt like an athlete pulling my muscles during the surges. I was worried to change position to lying on my back as I didn’t want to slow anything down but my midwife reassured me it wouldn’t in the pool. So there I was with Sam holding one leg and the student midwife the other both massaging my hamstrings as I pushed!!

I could feel the progress now with each push and my baby was crowning. I held him still as just the forehead was out following the midwives instructions but on the next surge his head and body all came together and I said to Sam ‘it’s a boy it’s a boy!’ I couldn’t believe I’d done it!! It really is the most unbelievable feeling in the world!

Without even asking, my midwife team did delayed cord clamping and suggested a natural delivery of the placenta whilst Sam had skin to skin.

I’d only decided on a home birth at 38 weeks but it was the best decision I’ve ever made. If anyone is considering it I’d strongly suggest you ask all your questions and scenarios as I think there are a lot of misconceptions about the safety of homebirth.  

I think back on my baby’s birthday as the best day of my life and would relive it over and over if I could. 

I cant thank the Surrey Hill Home Birth team enough for their support and care, and for giving me the most positive experience possible. 

 

Thank you!

H and baby B February 2019

Homebirth After Caesarean

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My first labour with my son was a 3 day back to back, including 6 hours of the syntocinon drip due to slow progress and only dilating to 4cm, when he got into distress and it ended in a category 1 Emergency Caesarean.

Whilst I was delighted that he was fine and healthy, I found the recovery after the C section hard as I developed an infection, and 2nd time around I was keen to try something different. 

I kept going back and forth between wanting a planned C-section due to the ease of organising and at least not having to go through labour again, and then wanting to try for a VBAC (Vaginal Birth After Caesarean) because it was an experience I really wanted to have and because for me I felt it was the braver decision.

At about 6 months I decided to go for it – I saw a statistic that said 90% of people are eligible for a VBAC but only 10% try, and I wanted to be part of that 10%. As a coach, I support and challenge my clients to take smart risks, and giving it my best shot was in line with my values and who I want to be.

In the end my birth story was pretty straightforward. I had minor contractions from mid afternoon, and in the evening we settled down to watch a cheesy Christmas film. The contractions started to ramp up about 10pm when I found the need to lean over the sofa for some of them. I decided to sleep in the other room to let my husband get some rest and the contractions continued through the night whilst I breathed.

At about 1am we called the midwife and she said to continue doing what we are doing, as they weren’t yet long enough in length. Around 3am I noticed a shift in contractions getting much stronger and felt like I was entering a different phase. I think one of the books talks about first room and second room and I did really feel a change. 

My little boy woke up around 6.30am and was collected by his grandparents around an hour later. Suddenly then everything ramped up, I felt like I could really let go and I started being much more vocal with more primal noises.

Our doula, Zara (www.doulabud.co.uk) arrived and said to call the midwife, Heather, as it sounded like I was bearing down. She arrived after 8am and from there on in she just sat quietly and enabled me to get on with it myself, in hindsight by doing less, she actually did more.

Zara massaged me with aromatherapy oils and my husband came in and let me squeeze his shoulders for the tougher contractions. After about an hour or so I started pushing and also felt a need for more energy. Zara gave me a couple of spoonfuls of honey which was just the boost I needed.

I continued to push and Heather suggested I get up from the all fours position I had been in the whole time and stand up over the bed to help use gravity, and open my legs wider. This was the only intervention she suggested the whole time, and it was very much offered if it worked for me.  

Zara used a rebozo scarf wrapped around my tummy to help shake from side to side and help ease her out also.

EJD was born at 10.09am in the superman position – with her arm up by her head. She came out all in one go and literally flew into the world! 

After the birth I held her in my arms whilst we waited for the placenta to come, I was happy to have the injection but Heather advised as I hadn’t bled much to wait a little longer. Within 20 minutes of sitting of the loo it was out and we’d managed to have a birth without any medication at all – it hadn’t occurred to me to put the TENS on or ask for gas and air at any point as I didn’t feel I needed it.

During the birth there were times I doubted myself – I felt like the pushing stage was taking too long and I wondered if I would need intervention, and to be honest I had doubts all the way through pregnancy if I would be able to do it.

However, I felt amazing afterwards, like I could honestly do anything I put my mind to – quite like wonder woman! It made me realise again the power of listening to my body and intuition and I couldn’t quite believe I had done it – it felt so surreal.

Surrey Hills Client November 2018