It's hard to believe that my little girl is already more than a month old (how fast babies grow!) She's certainly more alert - staring at windows and lights- using her unpractised little eyes more and more. She's beside me in bed as I type, mewling noisily....
I'd never have believed child birth could be so simple, calm and joyful if I hadn't just experienced it myself. Judging from some of the reactions I've had, though, you'd think I'd jumped from a plane without a parachute! It's made me realize how 'Hollywood' our expections of birth are (hospital wards, doctors, screaming patients, someone constantly telling you how many centimeters dilated you are and yelling at you to PUSH... a certified medical professional 'catching' the baby!)
In harried preparation for my own home birth, I did read Ina May's Guide to Childbirth by Ina May Gaskin. The first half is composed of stories of women who've given birth at The Farm, Gaskin's mid-wifery commune. It was a bit sappy and creepy, if I'm being honest. I wanted information. I was worried about safety, pain and mess (I love the idea of a homebirth... I just didn't want to look at evidence of it on my sofa or floor forever afterwards!). I think Gaskin's book is too much about her and The Farm to be of much practical use if you're preparing for a home birth. And I find the bit about orgasmic birth just too fantastical, though I'm sure it happens!
More spot on is Sheila Kitzinger's book Homebirth: The Essential Guide to Giving Birth Outside of the Hospital. A highly experienced British midwife, Kitzinger explains natural labour and birth in the right depth, with lots of practical advice. I highly recommend it. Looking back, everything in it chimed with my own experience.
Here are my top tips:
I've had both now: an induced hospital birth due to pre-eclampsia and a home birth, so I can appreciate the choice and the safety involved in both options.
Many would argue that for a normal pregnancy with no complications, a hospital birth is more dangerous! Certainly the statistics seem to bear out that hospital births involve larger numbers of unnecessary interventions, including nasty things like episiotomies!
Still, for this homebirth, I'd imagined all kinds of 'Hollywood' emergency scenarios, complete with anxious paramedics, blaring sirens and racing ambulances. But emergencies don't tend to come out of the blue. I'm no expert, but there are lots of ways a midwife monitors you and the baby during labour. For example, my baby's heart-beat was constantly assessed, and early on, I was told that if her heart rate didn't slow to a more normal pace, we would have to go to hospital. Luckily it did come down.
Here in the UK, a midwife can call a back-up ambulance in the very rare case there are signs of an emergency. You should, of course, discuss your concerns with a doctor or midwife long before the birth! But if you do have a normal pregnancy and home birth is an option - I say, go for it! (That said, Homerton Hospital, my local, has a new birth centre which is pretty impressive - pools, birthing chairs, etc - but they wouldn't consider me for it because I'd previously had pre-eclampsia. So beware that hospitals can be very pricey about letting you choose even if your current pregnancy is completely normal.)
Whatever your worries, Kitzinger's book delves into many of the possible emergency scenarios in a home-birth and explains the probability of each one.. so again, a book well worth having in preparation!
The right midwife
For those of you unfortunate enough to live in a country where child birth is dominated by male obstetricians, I'm so sorry! Midwives are not some hocus-pocus, touchy-feely pseudo-profession. They are health professionals in their own right. In Britain, many midwives train first as nurses. They're taught not to view birth only in terms of risk and illness, but as a normal process -- and what an amazing, intricate process it is! Any doctor who claims to be able to control birth or a woman's response to it is clearly arrogant and delusional!
Having said that, Kitzinger recommends that you find a mid-wife who's worked outside of a hospital and is trained in natural home births. (What's the point of having a mid-wife who's come from the hospital, only to try to control your birth at home?)
My midwife, Deborah Jordan, was fantastic. Utterly calm, soft-spoken and reassuring, you wouldn't know that she's a veteran mid-wife who's handled more home births than she can remember - including the rare emergency. Ironically, she was so calm and non-intrusive that I actually complained!
'Shouldn't you be doing something,' I kept saying when the pain in that second stage of labour really hit. Those Hollywood images! Here's what I learned from my natural birth:
A really experienced, confident midwife doesn't need to constantly poke and prod you to know what's going on. Deborah allowed my body to get on with it, providing just the right amount of monitoring and the right encouragement. Her hands-off approach may have appeared lacking to the un-trained eye. But in fact, it shows just how experienced and knowledgable she is.
Kitzinger explains:
"When a midwife attends in quiet confidence, she is able to tolerate inaction and can watch and wait on this child's coming to life.... She does not take charge or take over. She does not 'manage' labour: in many ways her task is a more difficult one than this. It demands great strength of personality. She needs to observe minutely and with sensitive awareness everything that is happening in the labour and to be aware of what is happening in the mind of the woman she is attending.... A good midwife understands when she should stand back and let things unfold, and knows when she needs to intervene. And the interventions are rare. Far more often, she gives quiet, tender support to the woman in her care, simply allowing the energy of birth to sweep through the mother's body, and helping her to find the strength within herself. When you stand watching a river in full flood, you know that you cannot fight its power. But you can use it so that its flow sweeps you onward."
(Again, Kitzinger's book has a very clear-eyed, informative chapter on modern mid-wives, their qualifications and what qualities to look for.)
Birth Pool
It's vital. Don't feel guilty about spending the money... Don't debate it. I can't imagine having given birth at home without it. They're designed to be big enough and deep enough to move around and to hold onto the side - invaluable when the pain hits. The Good Birth Company offers pools as well as excellent practical advice on when to fill, how much, what temperature, etc. You'll need a liner and you really won't regret buying a pump to empty the pool (imagine Dad having to empty buckets of water when all you both want to do is cuddle up with your newborn). It's also good to have a rubber sheet for under the pool. Ebay is also a good bet for mums to be who bought pools but didn't use them for whatever reason.
Of course, I didn't make sure I'd sorted a pool, so on the day I went into labor, I was frantically trying to buy second-hand ones locally! I can't imagine what the sellers thought of my increasingly desperate emails written in all capital letters. Luckily, a sympathetic, excellent friend down the road despatched her lovely husband into their loft to disgorge the pool both her children (and two others) were born in... and thanks to them, my daughter entered the world in a warm, cozy bath next to the Christmas tree in our front room!
Speak up
It's YOUR birth... you're not being irrational or precious by asking for help. Here's what happens if you don't:
Whilst in the first stages of labour, with my husband running around trying to buy plastic sheeting to use as a liner for the pool (see above)... I - and my gigantic laboring belly - were moving the sofa out of the front room to make room for the pool. Picture if you can, a small, hugely pregnant woman lifting and then pushing a double sofa around a narrow doorway, having to get down on all fours to un-screw two of the legs with a fiddly allen key because the sofa got stuck by the staircase! I didn't want to insist we move the sofa because I didn't think my husband would understand. Perhaps he wouldn't have, we often don't see eye to eye on these things... but being the one squeezing the baby out gives you the right to dictate terms! (And to give him his due, I'm sure he would have listened!)
Is it messy?
Honestly... no! Deborah brought large waterproof pads which we used when she broke my water. Other than that, I was in the pool for the entire birth. It's worth getting a rubber sheet for under the pool, and if it makes you feel more relaxed, cover up your sofa, etc with waterproof sheets from Mothercare. Yes, you'll be anxious about how you look.. and what might or might not happen during labour (poo)... but seriously, with all the pain and joy of a new baby being born... no one even notices these things, least of all you!
The other hot tip is to buy pull-up disposable underpants for after the birth so you don't feel worried about spotting or bladder problems - very comfy, no mess and they even come in pretty designs. That's it!
Pain...
Ok I won't lie: the second stage of labor, when the cervix is dilating to its widest circumference, is so god-damn painful, you'll cry, scream... beg for it to stop. BUT --- having experienced both a chemically induced labor and natural labor (both without painkillers of any kind)... I can honestly say you'll get through natural labor with flying colors. It's ten times LESS painful than induced labor. And the pain ebbs in between, so you get breathing space, which you don't with induction. Induction gave me nightmares for several years! Natural labour was painful, but only for short bursts. And once the birth was over, my body bounced back so fast, I was astonished. My midwife did let me use gas and air and it helped initially, but as she kept telling me during the worst bit, there's nothing short of an epidural to help the pain... and an epidural has its own strong consquences. Kitzinger and Gaskin both discuss many ways to deal with the pain that signifies your baby is finally coming to meet you! (Again, Kitzinger's book is more illuminating and informative on this score).
Is a homebirth as special?
Oddly, both my husband and I - as much as we wanted a home birth - felt it might not be momentous enough. In hospital, there are people around... you get visitors... you get to Bring Baby Home (every memory book has a dedicated page, for god's sake!)
So how was a home birth going to feel emotionally?
Well, here's what happened: once I felt baby coming out, I pushed when I felt like it. Again, Deborah didn't tell me what to do like in the movies... she said my body would know.. and it did! Sheila Kitzinger explains that the baby's head, when it touches the nerves of the perineum, stimulates a reflex that tells your body to push, and for how long!
I'll never forget what happened next.
Deborah said, 'Ok, Anu... just reach down and pull baby out of the pool...'
My jaw dropped. It was the middle of the night and the lights in the room were low... I couldn't see, so I felt in the water and a moment later, I was holding my baby girl in my own arms! My husband and I were completely gob-smacked! It was amazing and so unexpected. 'Ta-da' as her brother might have said had he been there!
I was the first person to touch her... She lay on my chest for nearly 10 minutes before my husband cut the cord and held her wrapped up in a towel. Once the placenta was out, I was able to stroll upstairs to my own bathroom, have a lovely, hot shower... wrap myself in my own bathrobe and join Deborah and my husband downstairs for champagne!
No hospital gowns, needles, bad food, disinfectant-smelling bathrooms or restrictions on who could visit and when! And best of all, I was mentally present for the birth (unlike the first time when I was delirious with the induced pain).
Two hours after she was born, the three of us were snuggled up in our own bed, fast asleep! How's that for momentous?!
Splendid! I can hardly fight a smile at how your angel arrived. :)
Posted by: Geetika | 30 January 2012 at 12:08 PM