Lizzy and baby Cormac - A change of birth place and an empowering birth experience
Lizzy and Adrian joined Hannah, Birth Wellbeing Midwife, for a Private Hypnobirthing course in May 2022. During the course they decided to have their baby at home, however when Lizzy went in to labour her plans changed dramatically. She ended up having fairly long labour and a hospital birth, in theatre. Despite the changes in planned place of birth circumstances Lizzy had a calm, positive and empowering birth, which she attributes to hypnobirthing.
Before getting pregnant I’d always avoided thinking much about labour and delivery, my knowledge and experience coming from the sensationalist media. Unconsciously I presumed the whole thing was going to be awful but I couldn’t specify why. At the beginning of Hannah’s course, she asked Adrian and I to write down our fears about birth, mine were: 1) labour not progressing, 2) needing a spinal injection, 3) needing to be unconscious for the baby’s birth. Adrian’s fear was that I’d have a traumatic experience and would struggle postnatally as a result. Both of our fears could have been realised if we hadn’t done Hannah’s course and had the tools to cope when things went off piste.
I had a straightforward pregnancy. At around 26 weeks we decided to plan for a home birth; up until this point we’d been aiming for the MLU. I still had my bags packed for the hospital, knowing that a transfer could be required. On Hannah’s suggestion we’d written down our preferences for multiple scenarios, including if I needed an emergency section. I felt so empowered and prepared for the birth. When I did have the inevitable “wobbles” Adrian was able to reassure me and help me stay in the right head space. I would say I was just the right mix of excited, apprehensive but feeling confident overall.
On the morning of my due date, I had a midwife appointment at home. She advised me to keep active as the head wasn’t yet engaged, and she showed me some pressure points I could now begin to use. I did both of these things, wanting to help my body move towards labour when it was ready. I walked into town that afternoon and took the dog out at about 6pm. At this point I was crampy but didn’t pay much attention to this. When I got home at 8pm I felt notably tired, I had some food, a bath with essential oils and got into bed with a hot water bottle for my cramps. At about 11pm I realised these weren’t cramps, they were coming and going, and were, in fact, early contractions which I couldn’t sleep through! I remember feeling a wave of excitement, and then reminding myself to stay calm, this initial stage could be a long one. Rest and relaxation were going to be key.
I went downstairs and told Adrian to get to sleep, one of us needed to! I lit some fairy lights and tea lights and put on Gavin & Stacey to get the oxytocin going. I lay on my side resting, with a peanut ball between my legs, the contractions coming and going and I was able to breathe through them. At about 1:30am I thought I should try to sleep, so went to bed but the contractions were stronger, and I could no longer lie down through them, needing to be on all fours. It really is true what they say, if you listen to your body, it will tell you the positions it needs to be in at each stage. At about 2:30am I wasn’t getting much of a break between contractions, so I got into the bath to see if that helped. It really did! I had a lovely bubble bath with candles and made sure I was drinking plenty of sugary fluids for the long event that I was in for. At 4:30am my phone battery was about to die, and I was using my phone to track my surges (the app was now telling me to contact the hospital), so I decided to get out of the bath and to wake Adrian up.
We had some breakfast and Adrian called the hospital to let them know things had started but we were managing well for now. I spoke to the midwife who advised water, paracetamol, and the TENS machine. My surges slowed down between about 5am (Hannah had told us this might happen, so we relaxed and watched a film, Adrian took the dog for a walk and picked up some supplies in preparation for hosting our home birth team).
At 8am the contractions then came back with vengeance. At this point we got the TENS machine on, and we put on some stand-up comedy on YouTube. I was still getting onto all fours for my contractions but was having to pause the TV as I found the noise irritating. I’d also deleted WhatsApp off my phone as I didn’t want the distraction. I see now this was me getting “in the zone”. At around 11am my waters broke, I wasn’t sure this was what it was at the time, but on reflection it was obvious. From then on, I found I was needing to stand for contractions, leaning on the kitchen worktop. I also found I wanted some support from Adrian during them. He would squeeze my hips and I would power up the TENS machine. At around 1pm I got in the bath again, and once again found great relief! Adrian inflated the pool during this time, but we didn’t fill with water. At around 3pm the contractions were so regular it was time to call the hospital again. I needed some support at this point. I was hoping that one of the community midwives would be able to come and assess me at home, but this wasn’t the case unfortunately, due to staffing. I cried when I was told I would have to go into the hospital (I can still cry now thinking about that moment). Up until this point, I was enjoying the whole process so much, even though it was extremely intense! I’d set up a brilliant nest to labour in, and when I look back now, I feel so grateful that I had had this experience for the first 16 or so hours. From this point on however, things veered away from our initial plan and required us to think on our feet whilst also remaining as calm as we could. This is the point at which I can safely say it would have gone a very different direction had we have not done Hannah’s course.
At The Hospital
So, into hospital we went. It felt horrible having to put clothes on having laboured at home in the comfort of my underwear! The July heat was intense, and I had begun to feel nauseous as the contractions had been intensifying. However, I saw this as a positive thing, my community midwife had said this often happens as things progress, and it meant that my body was getting closer to meeting my baby. I packed a small bag, not my birth bag, but I had water, headphones, some oils, etcetera, enough to keep me ticking over until I could get home. When we arrived at the hospital at about 4:30pm we were put into an assessment room. It wasn't ideal; small and extremely warm with a window opening out directly onto the pavement and car park. There was no pillow and no fan, but none of this mattered in that moment, because to my mind I was only there to confirm my waters had gone, and then I was going home for my home birth.
I provided a pad that confirmed it was in fact my waters that had gone. I was delighted! Surely now I could go home. My contractions were still coming thick and fast, and I was standing up over the bed to breathe through them. They were a little noisier by now. I had to ask the staff to stop talking to me during them so that I could focus and wait for them to pass. Having confirmed my waters had broken, the midwife advised us that we could soon go home, and that we were just going to be “popped on” a monitor to check the baby. We were advised this was standard procedure. On reflection now, I wish I had asked why this was clinically indicated, and what our alternatives were. My brain forgot about BRAIN! Adrian reminded them that we had planned a home birth and asked how long until we could go home. We were reassured that it was standard procedure and we’d be on our way in no time. I raised that I really wanted to maintain being upright and mobile and they said that they would fit me with one that would allow me to do this. The only reason I knew I could stay mobile and that this was something I could ask for was because of Hannah’s course and her detailed explanation of various interventions and possible alternatives. I have no doubt that being able to stay mobile kept things progressing for me, and simply by knowing what was available to me I was somewhat empowered in an otherwise potentially disempowering situation.
For the next two hours I contracted, alone in that room, looking at a graph that I had no idea what it meant. I could see the baby’s HR was changing with my contractions, but I had no idea whether this was normal, or whether it was of concern. For 2 hours the midwives came in and out of the room, looked at the printout and left again. Somehow none of this registered with me in that moment, I was in my own birthing zone and I’m so grateful that I was, and that I managed to stay in that zone. At one point we were told that the midwives were waiting to get a “steady baseline” before allowing us home, but that the HR response of the baby was fine. I asked if I could do anything to help them get the baseline they needed and was told that I couldn’t. My contractions were intensifying, and I just focused on letting my body do what it needed to do, ignoring the setting I was in. Adrian asked for water, a pillow, and a fan which we got, and we focused on making do with what we had until we could get home. Thankfully I was completely unaware of clock time.
After shift changeover a new midwife came in. She looked at the print out and began to explain they were not happy with the baby's heart rate. I had been attached to the machine for around 3 hours at this point and hadn't been informed of the concerns until now. The midwife explained that they were seeing decelerations which were not normal, when she learnt that we hadn’t been told this yet, she arranged for the consultant to come to see us. This was another point at which I really feel we could have lost control. Instead, while we waited for the consultant I focused on breathing and Adrian, conscious that I had now gone a few hours without fuel, went in search of a sugary drink for me. As it turned out, this was nowhere to be found, and he came back with 7up free which gave us both a bit of a laugh, but I now know he was really concerned and frustrated that he couldn’t get anything for me. We had sweets in my bag but I couldn’t stomach them now, feeling quite nauseous, I had been sick whilst Adrian was off in search of some fluids for me.
The consultant came at around 8:30pm. She explained that it would not be advisable to go home, and that the home birth team would not likely be happy to support my birth at home as they had seen decelerations. We understood this and explained that we were happy to stay if that was what was required. It just felt good to have some answers so that we could move forward with a reconfigured plan. At this point I just really wanted to be somewhere more conducive to labour than this tiny assessment room. I raised that I would prefer to be on the MLU and the consultant said she’d have to check whether we could do this, stating again that due to my now being “high risk” I might need to be consultant led. I explained that if this was the case I’d like to be in the water if possible. Once again at this point I am so grateful that we’d done the course with Hannah and had not only done our preferences for our home birth but had also done them for every other possible scenario. It meant that at each stage as our planned route changed direction, we had a plan of action that we’d discussed beforehand. At no point did I feel that spinning sense of loss of control. We knew what to do to keep my body progressing. We knew that some things were out of our control, but a lot of things were still in our control. There was a lot of power in that. I honestly think it is what allowed me to continue to feel this was a positive experience.
The consultant explained that they would have a water birth room in around 40 minutes, this would be around 9:30pm. In the meantime, I could have a vaginal examination (VE) to understand where I was up to in my labour, and we could build a plan based upon this. They explained that I couldn’t go home following the VE due to infection risk, but as we’d been advised against going home, this made little difference. I wanted to know how far along I was as I’d now been labouring for 22 hours. Again, I am so pleased I had no concept of clock time. For the four hours we had been in the hospital, my contractions hadn’t slowed (thankfully) and I felt confident knowing my body was still doing exactly what it needed to do despite the rapid change of plans. I’d been sick and my contractions had notably changed, this was all indicating I was moving along well. At 9pm I had the VE, they waited until I’d finished a contraction and then did the VE. I immediately had another contraction, flipping onto all fours on the bed. The midwife announced that I was 2cm. I clearly remember looking at Adrian and repeating “2 cm?!”. I was having back-to-back contractions. I was getting sick. My noises had changed. I didn’t understand how I could be experiencing all of this and “only” be 2cm dilated. This felt like another pivotal point where I could have lost control, given up in my body’s ability, but Adrian reminded me that I was doing what I needed to do, that we could do this and essentially to trust the process. I got back in the game, I had to keep this labour moving forward! We could not have done this if it wasn’t for our course.
The midwife asked me if I would like pain relief. I asked for gas and air but was told I couldn’t have this until I was 4cm. I asked when I was likely to be 4cm and was told that everyone is different, and that I would be assessed again in 4 hours. At this point, I decided I needed to throw all my hypnobirthing practice at the next four hours. I needed to help my body to get as far as it could, so that I could have some G&A! As it turns out, in four hours’ time my baby boy was in my arms but I didn't know that then. I was told that I could have paracetamol and codeine in the meantime, so I did. However, I got sick with the next contraction so that was them out of my system, and I couldn’t be given any more until four hours’ time. Again, this could have caused me to spin, but I literally got my head down and breathed. I sat on the birthing ball, a sheet around me to keep warm between contractions and a fan on me to keep me cool during them.
It was down to me then. The clock had started, it was 9pm and I had until 11am the next day before the induction process would begin. I had a way to go and wanted to do everything I could to get there. Adrian left to get the birthing bags from home (we live a very short drive away), and I continued as I had been doing. I remained upright and mobile, leaning on the bed for contractions and resting in between. During this period, while Adrian was away, and I was alone in that assessment room my contractions changed again. This was the second or third notable change and would be the last. I was now getting a very strong sensation of my abdomen pushing downwards. This was completely involuntary. I went with it. From this point on I went very “inwards” and details are a blur. I was so focused on each surge, breathing as it came and sort of mooing it away. Looking back now, it’s a similar sensation to when you’re getting sick, you can feel it coming and there’s nothing you can do to stop it. Adrian says that when returned about an hour later I had completely changed, and he knew things were getting serious.
At some point around now, the team advised that they were losing the baby's heart rate recording when I contracted and requested that I would need to remain still for them. From that point on I barely left the ball, resting on it with my head on the bed between contractions, and sitting upright on it trying to maintain good contact on the baby's heart rate for the medical team as I contracted. I was going to the bathroom regularly between contractions, and on reflection this was a method of coping for me. I was in my zone and trusting my body, which gave me a real sense of relief. I told a midwife my contractions had changed when she came to check the trace, and she said “oh ok, that’s good”. The next contractions came, and the pushing sensation was intense. I can still remember what it felt like, my pelvic floor pushing down against the birthing ball, something was happening.
The next time the midwife came in I said they were continuing to change and that I was now pushing, so the midwife told me I would be reassessed. It was now around 11pm, two hours since the initial VE. As the trace wasn’t satisfactory, they also explained they’d like to put a FSE on the baby, and I was happy with this suggestion as I had learnt about it on the course. This to me was a ticket to the water! I was offered to empty my bladder before the assessment. As I stood up Adrian said I was standing as though I had a bowling ball in my pelvis. I hobbled to the bathroom and when I sat down, I had a massive pushing contraction which I could not stop. There was quite a bit of blood, and I opened the door to the midwife who had heard the contraction, and didn't want me to deliver in the toilet. Neither did I. At this point, I was able to rely on my breathing, I felt so calm and “matter of fact”. I trusted completely that my body was doing what was needed.
I went back into the assessment room and lay down for the VE. The contractions were coming so regularly that I begged them to wait for the contraction to pass before they did the assessment and fit the electrode, but they couldn’t wait as they needed to monitor the baby. Breathing through that experience was key. I’m very, very pleased I had used the Epino in the lead up to labour. The midwife said I was now 6cm. For some reason the consultant then did another examination, and I will never forget the moment I heard “she is 10cm, get her gas and air”. The relief of the gas and air was short lived, as they immediately pressed the emergency button and explained that we needed to go to theatre for a general anaesthetic and c-section…. The hypnobirthing course had saved us as so many points along the way, but none as much as at this moment! When we did the course, this was what I wrote down as my top fears, being unconscious for the birth of my baby, or a needle in my spine. I was now looking down the barrel of both options and I felt completely calm in that moment. Everyone around me seemed to be working with urgency, but I was completely relaxed. As they pulled at my jewellery and shoved paperwork in my direction, I knew what our plan was. I reminded Adrian that he was to go with the baby to NICU if needed and that he wasn’t to stay with me, he was to do skin-to-skin when he could, and that our colostrum was in the midwives’ freezer. As they raced me down the corridor I continued to have a pushing reflex- I asked the midwife what I should do and she said to go with it! To push if I needed to push! So I did. All the way to theatre I breathed and I pushed.
When we got to theatre the consultant examined me again and announced that he wouldn’t do the c-section, the baby was too far descended, but they needed to get the baby out quickly, so I’d need a spinal and forceps. This is the first time I can remember feeling panicked- I was scared of this. I wobbled, but I recovered. I breathed and had gas and air as 2 amazing midwives held my hands and supported me as I got the spinal. These same midwives then held my hand and had a hand on my stomach to tell me when to push. I felt so supported by these women in this moment. Supported by the entire team, in fact. I pushed a couple of times and told them I couldn’t do it anymore; I was exhausted. They told me the head was there and with one more push, my beautiful son was put on my chest. Again, because of the course I knew I could ask for skin to skin immediately, I had asked for this just before I had received the spinal “if I don’t have to be unconscious, can I have skin to skin with the baby?”…”yes, if they don’t have to go away with the doctors”. So, the midwife moved my ECG electrodes, and put Cormac under my gown. I’ll never forget the moment his eyes locked onto mine and we had done it. He was here safely. The midwife asked if I hoped to breast feed and when I said I did she offered to help him latch, right there in the theatre. I was completely oblivious to what was going on around me as we began our feeding journey. I attribute much of our straightforward feeding experience to this midwife being proactive, probably helped by the fact that we then had four hours or more of skin to skin while I was in recovery, Cormac latching on and off as it suited him.
Following the birth I was on cloud nine. I couldn’t have been happier with how it all went and was amazed at what my body had done. I was so grateful that we had done Hannah’s course, and we had all of the tools in our toolbox to keep our heads through the whole experience, and to allow my body to do what it needed to do even though the environment wasn’t what we’d have planned or hoped for. Processing all of that has taken some work. Adrian and I did a lot of talking about it and have continued to do so. I’ve also talked to close friends about the whole experience. I downloaded the KGH postnatal tracks and used them to help me with sleeping and just to relax and recover. I can hand on heart say I cannot wait to have my second birthing experience, when I look back now, I can’t believe what my body did all on its own and I can’t imagine how completely different my experience and outlook could have been if we hadn’t done Hannah’s course. After Cormac had arrived a few of the midwives even commented on how calm I had been throughout!