The spinal anaesthesia was done in what felt like a second and before I knew it the drape was raised so I couldn’t see in front of me and the surgeons were starting.  I could feel touch and a surreal feeling of them rummaging around inside me, but it wasn’t painful.  I tried to imagine exactly what they were doing as had seen so many caesareans before and knew the sequence of steps.  My husband didn’t have to use his imagination at all as was standing watching the entire thing!

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The drape was lowered to reveal the first little head and set of shoulders squeezing out of me.  She had a look of shock and disgust on her face as she was brought out into the cold.  I felt such relief at her cry, as she was the smaller one we had worried most about.  Our second had a similar reaction to being taken out of her warm home and I don’t blame either of them!  They were passed to me all bundled up but the first was very soon taken to the special care baby unit due to her small size – just 1.6kg.  It felt so wrong when she was taken away.

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I was wheeled into the recovery area where I lay skin-to-skin with our second daughter.  She started to breastfeed (another relief that she was able to do this) and then she did the most gigantic black tarry poo all over me. 

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My husband had gone to the special care baby unit immediately after the op and didn’t come back for hours as he had felt bad leaving our first.  It would be in the evening that I had enough feeling in my legs to be able to get into a wheelchair to make it up to see her and hold them both again.

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My recovery was luckily very straightforward, perhaps partly due to the small incision (the obstetrician knew they would be tiny after all!).  Perhaps walking by myself the following day pushing the other twin’s cot was a bit much as I came close to fainting alone in the lift, but I slowly made it!  The greatest challenge in those early days and weeks was producing enough milk for the two, but that did happen with time and perseverance.

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Joanna’s 2nd Birth - Our Home Birth

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Our initial birth plan went out the window after I took the KG Hypnobirthing teacher training course.  Although I had had a caesarean before and there was a 1 in 200 chance of the scar rupturing during labour, we made the informed decision to birth our son at home rather than on the labour ward.  We accepted the small but potentially catastrophic risk, feeling there were also risks associated with the routine procedures for VBAC women on a labour ward and the potential cascade of interventions.  Instead, I trusted that my body could labour well if I was relaxed and well-supported in my own home.

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At work, the more junior doctors were shocked I would “take such a risk”, but surprisingly the consultants were more supportive.  We found a very experienced team of home birth midwives to look after us and felt very supported by them. 

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We ordered a birthing pool and I spent quite a lot of time lying down with my eyes closed and listening to a couple of hypnobirthing CDs.  I almost always fell asleep half-way through and was not 100% confident that my mind was taking in the information!  Nonetheless I was confident I would be relaxed in my labour and was feeling very positive and looking forward to the big day.

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As my due date passed, I became more apprehensive about the prospects of a postdates induction, what felt like an increasingly large baby, plus I was becoming fed up with friends, family and complete strangers asking when I was due and whether I was having any signs of labour.  I opted for a membrane sweep at 41 weeks – I considered it better to give my body a kickstart and reduce the chance of an induction, although I know I could have declined it.

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The sweep followed by manically running up and down the stairs, bouncing on the birthing ball and hoovering may have helped move things along.  A few mild period pains came and went that afternoon.  Then the following afternoon whilst out in a faraway country park alone apart from my little two-year-old girls and with no phone reception I felt twinges and realised I had started having surges, albeit irregular and lasting only 10-15 seconds. I thought I had better drive home!  I told my mum and she said she would take the girls to stay with her for the night.  It felt a little unnecessary as I was convinced my labour was some way off and would probably take a long time – my body had never laboured before after all.

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However, by the time my mum arrived at around 8pm, my surges were getting stronger and longer.  My husband and mum seemed to be taking forever to get the girls ready to leave and I became pretty irritable, asking when they would go.  My mum had thought I was in a bad mood and being rude but hurried them out of the door anyway!

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I left my husband watching the World Cup and went into our bedroom with the birthing ball, closed the curtains and put one of the hypnobirthing CDs on.  I just wanted to be on my own.  I had done some pregnancy yoga classes and tried out every birthing ball position I could remember but when any surge came I felt really uncomfortable with all of them.  I knelt on the floor leaning over the bed for a while and finally curled up on my left side in the bed. 

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I replayed the same track on the CD again and again.  During the surges I could only concentrate on slowly breathing through them, but when they subsided I was able to listen to the words for a short while before falling asleep, only to be woken by the next surge.  I had no idea how much time was passing but it can only have been an hour before there was a sudden gush of warmth between my legs as my waters went.

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I shouted for my husband and asked him to check my waters were clear (no meconium) and to time my contractions so he could call the midwife and let him know what was happening – I did not want to be distracted by timing them myself.  They were coming every 5 minutes.  My husband was also running the bath for me as the pool was taking forever for him to inflate (it turned out he was using the deflating pump rather than the inflating one!).  The midwife said all sounded positive, to get in the bath and to call him again in another 45 minutes.  My husband returned to fight with the pool.

 

My surges quickly became more intense and one after the other.  I found it difficult to get off the bed but managed with a lot of willpower.  Once in the bathroom I felt nauseous and leant over the toilet for a while although was not sick.  I then sat on the toilet and felt I needed to open my bowels (not much came!).  I knew the feeling of needing to poo is similar to the baby’s head coming down, but I thought surely not, I cannot be so close to having the baby yet.  I had what felt like seconds between each contraction and each surge seemed to last a long time – perhaps 90 seconds or more.  The thought crossed my mind that what if this was too much for my scarred uterus to take, but there was no pain in between contractions so I pushed the thought to one side.

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I got into the bath and crouched down just where I had stepped in, loving the sensation of warm water around my belly.  My husband called the midwife again (just 15 minutes after the last call) to tell him the surges were becoming much stronger.  The midwife said he was coming.  My breaths were long and loud, but I did not care whether the neighbours could hear me through the open window. 

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The surges were becoming so unbelievably intense and I had a little panic that I would not be able to continue if they remained this way for hours and hours.  I checked myself (I am a midwife after all!) and my cervix was paper thin, around 7 cm dilated and the head was so low.  My husband rubbed my head and hand – any other touch irritated me.  With the next contraction the head was coming down and I could not quite believe that it could be happening already.  I grabbed my husband’s hand so that he too could feel the head coming.  He called the midwife again who said he was putting his foot down, advising my husband to call for an ambulance.

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During the next surge I felt the head push through in one quick movement and the feel of the head between my legs.  There had been no burning or sharp pain as I had expected to feel.  And with that the contractions stopped.  My husband who had been on the phone to the paramedics and trying to remember my age (he was a little tense!) checked they were on their way and put the phone on the floor.  We could not quite believe his head was already out!  I then sat back in the bath in what felt like the natural position to move into.

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The midwife shouted through the open front door around five minutes later and came bounding up the stairs.  I was so relieved to see him.  He sat at the foot of the bath, said hello and just smiled the most reassuring, happy smile.  I had been panicking that I had had no surges since the head had come out but he said not to worry.  Almost immediately I could feel the baby’s body turn inside me which was the most surreal feeling! 

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The midwife suggested I stand up and he gently released the baby’s shoulder by pulling the head slightly towards by rear and out slid Alexander.  I sat back in the bath and there he was screaming up at me for just a second before he relaxed into the outside world, completely alert and beautiful. It was 11.22pm, around three hours since my daughters had gone and two hours since my surges had ramped up.

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The paramedics appeared although in that moment it didn’t click who they were.  I wondered whether they were journalists for some strange reason and I remember giving them a confused look.  One of them turned on the bathroom light which so felt harsh and glaring.  My husband quickly asked him to turn it off and I loved him for that.  The paramedics stayed on the landing, waiting to see if they would be needed and soon left.

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I opted for a physiological third stage and the three of us sat chatting for some time.  The cord pulsated until the last bit of blood had transferred into Alexander.  Once it was white the midwife clamped and cut it.  I then felt a strong period pain-like surge and I think the placenta separated at this point.  I did not have any urge to push and so stood in the bath to see if it would come that way, still holding Alexander but with two sets of strong arms close by in case I felt unstable.  The placenta came out. 

 

The water was getting cold and there was no hot water left in our water tank, so they helped me out of the bath with Alexander still in my arms, we got onto the bed and were covered with dry towels. 

The midwife checked whether I needed stitches which I did, but he was able to then and there on my bed. My husband made himself very scarce at this point and went to make the tea!  I used the gas and air throughout and was as high as a kite.  I can really understand how beneficial using gas and air could have been during the labour, but it was not to be for me as it had all just happened so quickly.

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We then drank tea and ate biscuits whilst Alexander had his first breastfeed.  The atmosphere was so happy and relaxed.  The midwives then went downstairs to write their notes and left my husband, me and Alexander to be together.  It was magical to think that in just a few hours our son had made his way into the world.

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I do wonder whether Alexander’s birth experience helped him to be such a calm and contented baby, although I am sure his sisters helped too by being a constant source of entertainment for him!

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