Unattended homebirth at 44+3

I had only met one person who had used a doula before I got pregnant. She was from Malaysia where it was the norm to have one and after she explained a doula’s role, I knew that whenever I was pregnant, I would do my best to have one too!

Fast forward a few years, I was pregnant, living in Folkestone and on the hunt for a doula. I had read that you should interview several people to ensure you connect well enough with the person you choose, but within 5 minutes of chatting with Lucy, I knew she was right for us. Lucy stayed for over 2 hours in that first meeting at my house (this was all before there was any commitment to hire her) in which time I got a wealth of information and she left me with a lot to think about.

I didn’t have a strong birth plan in mind when we first started talking, other than I really wanted a water birth as I’ve always been most relaxed when in warm water. After that first meeting, I quickly realised that there would be limited control over getting a water birth in hospital (limited pools available, complications resulting in a pool not being provided, etc) and so I started to consider a homebirth, something I had never been against but hadn’t considered as a real possibility for me. This also coincided with a couple of unrelated outpatient hospital visits where I suddenly became very aware of how I felt in the windowless, badly lit rooms and thought about how dreamy it would be to have my baby and then be in my own bed.

I started watching homebirth videos and researching the pros and cons – it didn’t take much to convince me that a homebirth was for me however, my partner Jamie was a little dubious on the basis that we would not have medical care to hand should it all go wrong. One antenatal session with Lucy later and he was totally on board! The information that Lucy offered us was so well-bolstered by extensive research (a lot of which we read through) and her wealth of experience in both home-birth and hospital births gave him the confidence to get on board with a homebirth journey. We also attended the Folkey Birth Club Birth Circle in which a local mum was sharing her free-birth following two hospital births story – hearing how redemptive her experience was really made us think how much we wanted to ensure that our first birth was not something we would have any regrets about (something that seems to be very common in the UK birth world!)

We attended a few more birth circles and had another antenatal session with Lucy – in this one we discussed the details of my birth plan which had a few out-of-guidance requests such as no monitoring of me or baby during labour (I didn’t feel the need as trusted that I would know if I didn’t feel right, and from my research, did not think that monitoring of baby was helpful in anyway). Lucy advised emailing some senior midwifery staff to ensure that my birth plan was adhered to but this was something I was very unsure about doing. I thought ‘surely if it’s on the birth plan, and we have that printed out for them to read, they will respect it??’. I also didn’t want to be that demanding pregnant person who was a bit of a diva (hello people pleaser persona!). Lucy shared with us that in her experience, showing that you are well-researched and fully understand the pros and cons of your request in advance tends to be better respected than if you wait until the big day to try to explain your out of guidance requests during labour. This made a lot of sense, as in my own line of work, I would absolutely respect someone’s request more if they were showed how well-researched they were. I also knew just how important relaxation was during labour and the thought of trying to justify my requests to someone when I could potentially avoid it was enough to send that email. After checking we had hit all the relevant points with Lucy, we sent it off and very quickly got a response from the Head of Midwifery to assure us that they would support us. I thought nothing more of it, having no idea how important that email would be in a few months time.

My pregnancy was thankfully low-risk and rather uneventful. Other than feeling a little more tired than in the second trimester, I didn’t feel any different as I edged towards the end of the third trimester. I attended all of my midwife appointments until 37 weeks (this included a homebirth assessment) at which point I decided I would not go to any more. I knew that under no circumstances would I be induced as everything I had learned through the birth circle, discussions with Lucy and my own research had firmly cemented my belief that birth happens when it happens and the baby will come when they are ready, and I knew the post-37 week midwife check ups would largely be to discuss induction.

My due date (8th March) came and went but I wasn’t concerned about this in the slightest as I had always had in my head that baby would come “late” – to the point my partner asked me if he had the due date wrong in his head as I kept saying it was late-March! I had told family and friends my due date (won’t do that again given how unlikely baby is to be born on that date!) but received very few “any signs of baby” messages or phone calls which was great. My midwife also didn’t put any pressure on me to have those later appointments which I think may have been due to the aforementioned email. Luckily, my work does not enforce maternity leave on the due date, so I was able to focus on work which along with the lack of chasers from friends, family and midwife meant I was pretty relaxed about when the baby would arrive.

I knew that the majority of births happened by 42 weeks so when I had zero signs of impending birth as we approached 43 weeks, I started to wonder if I was making the right decision by waiting for a physiological birth. Lucy had some fantastic links to podcasts, blogs and facebook groups containing many stories from woman who had gone beyond 42 weeks which I found very helpful. Whilst some fear was creeping in, I was able to put it aside as I listened to my gut and focussed on the fact that I was still feeling completely fine physically (and baby was moving normally). At this point I decided to stop working as part of me wondered if fully ‘letting go’ of normal life might trigger my body into labour (spoiler alert … it didn’t!).

I got a call from the head of midwifery just after 42 weeks to check if they could support me with monitoring, check ups or induction discussion. I declined all of these and received zero negativity or pressure to have them (again, thankful for that email!). We did however decide to go for a scan on the day we hit 43 weeks – something about going beyond 43 weeks felt quite scary and whilst I was able to shut out most of the outside noise (like my placenta might be failing, or that my baby was going to be a giant as the last three fundal height measurements had placed him top of the top percentile) we felt that some reassurance was needed. This could easily have backfired as there is very little data available on 43 weeks scans, so we went in knowing that we were unlikely to get a “everything is normal” response. We declined any growth measurements and requested a doppler assessment to check the bloodflow through the cord from placenta to baby, and amniotic fluid readings. The doppler assessment was fine and the amniotic fluid readings were low, however the sonographer also highlighted that there was fluid in the bladder and kidneys which was not counted by the equipment reading. I had already decided to discount any concerns re; the amniotic fluid has had done quite a bit of research on what we might be told and I knew there was very little data to show what was and wasn’t normal at this stage, so all in all we got the reassurance we were looking for. There was still good blood flow to baby, he was head down and there were no issues to worry about.

The next weekend came and went and other than reading a few reassuring “ten month mama” facebook posts, I was feeling really relaxed and at ease with our decision to wait it out. I had started to feel slightly more uncomfortable when walking so figured perhaps that was THE sign that birth was imminent. I got a few messages from 3 different midwifery staff at the start of the week asking if I was ok, if I wanted any monitoring and if I wanted to have a discussion about my plan. Whilst I brushed off these messages with a “thanks but no thanks response” and didn’t think they had impacted me, in retrospect, I think this triggered a wobble as by the Wednesday, I had started thinking about how much longer we would wait until we had an elective c-section. I had got myself comfortable with being 43 weeks pregnant, but 44 weeks felt like something much scarier. We asked Lucy to come round for a chat to help us fully understand what a c-section would look like (in all honesty, we had not given it much thought even though it was touched on lightly in our birth plan) and how we could ensure that it was as close to the physiological birth plan as possible. I tend to reduce any anxiety or stress by ‘doing’ and so I surprised myself when Lucy asked if I wanted to draft an email to send with our c-section birth plan requests so it was ready to go and I said no, let’s just wait a few days. It was then that I knew that I could continue to wait – for me, writing that email would be making the decision to get the c-section and as had a few times already, my gut was telling me there was no need.

Two days later on the Friday, as I hit 44 weeks I started to get some mild cramps and had the tiniest bloody show. It took until early evening for me to believe that this might be labour starting but I was quietly optimistic. I headed to bed early and woke around 4am with what I knew must be labour contractions every 10-15minutes. I had a bath which was lovely and as much as I wanted to sit and focus on the contractions in the hope it would speed them up, I knew that getting on with my day and distracting myself would be the best way forward. We went for a walk to the beach and saw the most beautiful sunrise over an unusually calm sea and then hunkered down at home for a few hours watching tv and snacking. The contractions slowly became stronger and more regular, coming every 5-10 minutes but were still very manageable so we decided to go out for lunch as I was conscious of making sure I ate enough to keep my energy up. When we got back, I then decided to do some baking – something that would be a good distraction from contractions but didn’t require a huge amount of focus so sent Jamie out to buy the ingredients for a cake. I ended up making a huge cake, that I totally lost my appetite for by the time it was ready!

By the evening, and over 30 hours into labour things were starting to ramp up – contractions were getting less manageable and I couldn’t stomach any food, so we asked Lucy to bring the TENS machine over and popped that on which brought some relief. After a few more hours, I decided I wanted to get in the birth pool so Jamie started to prep that and we asked Lucy to come back (luckily she lives quite close by so the people pleaser in me felt zero guilt for asking her to leave and come back again). By this stage I was having adrenaline shakes and throwing up every half hour or so - two things I was not aware were totally normal during labour! Getting in the pool was incredible – it immediately eased the contractions and I felt so much more relaxed. I started to use a birth comb when in the pool, and put in ear phones to play some pre-made playlists every time I had a contraction. We spent the night in a cycle of contractions, throwing up, Jamie or Lucy pouring water on my back and topping up the pool with hot water. I had no concept of time but was sorely disappointed when I saw light starting to creep through the curtains as realised how much time must have passed and knew that everything would likely slow down as the sun rose (as is nature’s way). I decided to get out of the pool and try to get some rest – I lay on the sofa was Lucy rubbing my back whilst Jamie got a bit of a nap.

My contractions eased through the morning and I didn’t feel like we were close to having this baby so told Lucy she could head home and get some rest as well. Lucy helped put the TENS machine back on before she left and advised I try to rest, and eat something if possible. Jamie whipped up a smoothie which I was able to stomach tiny amounts of and I nibbled on some frozen peas – randomly the only thing I wanted!

I wandered around the house, trying to find the best position to get through each contraction and found my mind wandering away from the present which triggered a major wobble. I had gone from being very focussed on what was happening in the moment, to “this might not end soon, babies are rarely born in the day, so I’ve to get to the evening at least, and then what if I labour for another whole night, the cycle would start again, etc…” I told Jamie I was done and wanted to go to the hospital to get some pain relief or a c-section. I am very grateful to him that instead of saying ok, cool, let’s get in the car he suggested calling Lucy who came round straight away (having a doula who lives 5 minutes away is AWESOME!). She arrived with her ever-calming presence and simply asked where my mind was at - I stated that I couldn’t do this for another day, it had already been 48 hours and I was too tired. I also recall that I didn’t want to have to travel to the hospital when the contractions got stronger, so had reasoned with myself that it was just better to go now. Lucy reminded me of what I already knew about what would likely happen in the hospital, and how there would probably be much more pressure than usual for monitoring etc given the length of my gestation. This brought my mind back to reality - the thought of having to deal with other people, potentially be pushed to lie on my back and likely not be able to come back home was enough to make the decision to see how things went for another hour. Lucy left again and over the next couple of hours, my mental strength returned and I knew that I could do it (even though things were starting to ramp up again and the TENS machine was become less impactful). At this point the shakes had come back and I was experiencing extreme temperature changes, feeling super hot during each contraction and then really cold.

Around 4pm I suddenly realised that I hadn’t been aware of the baby moving for a while and initially thought it was because I had been so distracted by labour so did the usual things I had done during pregnancy to get a wiggle – patting my bump, poking it a bit, lying on my side, playing music. After half an hour of not feeling anything I told Jamie and got really upset. Snotty, crying, not able to talk upset which in retrospect I think was because I thought this meant maybe something was wrong, and I would have to go to hospital and that was going to be so disappointing as I had got to the point I had convinced myself I could do it at home. We asked Lucy to come round once more and as always, she arrived with her ever-calm demeanour and full of wisdom. She asked me what I felt like, what was my gut telling me and I said I didn’t think we needed to go the hospital yet. Looking inward and listening to my gut is something I had not practiced prior to pregnancy but had come up a lot during the antenatal chats with Lucy and my instant reaction of ‘we don’t need to go to hospital right now’ spoke volumes to all of us. If I knew something was wrong, we would have been on route to the hospital already. Lucy reminded me that I hadn’t slept for 36 hours, had barely eaten for 24 hours and had been throwing up most of that time so we knew I was probably dehydrated and lacking energy and reasoned that the baby was maybe feeling a bit weak just like I was. There had been several times during pregnancy that movements had dropped when I was really tired or hadn’t eaten enough so we decided to get some food into me, and try to get some rest. I had a few grapes, managed a bite of a banana & honey bagel and downed some coconut water before lying down on the bed with Lucy’s magic massage hands on my back. Lo and behold, 20 minutes later the sugar kicked in and I felt baby move – relief! That was enough for me to know that everything was ok and we could continue to do this at home.

We sent Lucy home once more and I spent the next few hours leaning on the wall, taking layers on and off as I got too hot and cold with Jamie applying sacrum pressure every 2-3 minutes. At this stage I was completely unaware of time passing, unable to engage in conversation and was totally in the zone, taking one contraction at the time. It’s worth saying I was still having bloody show, which was getting more bloody as time went on but I still felt fine (well other than the contractions, tiredness and vomiting!) and my waters had still not broken. The TENS machine stopped feeling as effective after a few hours and so I asked for the pool to be filled again (at some point that morning, Lucy had emptied and cleaned it so it was ready to go as soon as it was needed again).

I had a sudden urge that I had to get in the pool, even though it was only half full and still a little too hot, I was seeking the relief it had brought me the night before. Within seconds of getting in, my body did something that was very different to the contractions and I genuinely thought it was a weird reaction to the pool being too hot as I had felt so cold and shaky when I got in. A few minutes passed and I realised that it wasn’t the temperature, and that I was feeling “pushy” so told Jamie to get Lucy back round ASAP (whilst I got busy vomiting and contracting…). The fetal ejection reflex is something I had heard about, but didn’t know much about and so when the contractions started feeling VERY different, I was quite shocked but knew that it felt right. Suddenly everything I had heard about how “a woman will make very different noises”, and “you will know when the baby is coming” all made much more sense. It took quite a few contractions to start to feel in control (as much as one can during labour). They had taken me aback and the different feeling had caused me to let out a bit of a scream during each one whilst also trying to catch my breath. I recall thinking that I was supposed to moo, so really focussed on lowering my tone and breathing deeply. I also managed to ask Lucy if I should be actively pushing as it felt like my body was already doing it for me – she said some people like to ‘lean in’ to the sensation and others don’t. I found that leaning into and focusing on bearing down did help at the start but as he started to move down, I could feel everything stretching and realised I absolutely didn’t want him to come too fast so actively tried to slow it all down. I was able to feel something when I reached down and realised it was the sac bulging (my waters had not broken) and recalled reading that some people had felt relief when their waters broke so took it open myself to break them but unfortunately this brought zero relief!

I was on my knees leaning over the edge of the birth pool, tightly gripping Jamie’s hands during each contraction with Lucy pouring water over my back during every contraction. I remember starting to feel very weak at one point but had no idea how long I had been going for, or how close I was to having the baby so had to refocus a bit.

I was still trying to temper the contractions so he didn’t come too fast but I couldn’t have stopped them if I tried. I had been reaching down to feel what was happening after every contraction, hoping to feel a head so knew he was close. In one contraction, he came out all in one go. I pulled him up and together the three of us gently unwrapped his cord from around the neck (I was struggling to do it without putting him back under the water and was too weak to stand on my own) and then I sat back into the pool and said “he’s alive!”. In retrospect, the outside messaging that a long gestation, and a home birth might kill your baby had clearly infiltrated my mind deeper than I realised as the relief that he was here and breathing was intense. He coughed for a few minutes (Lucy assured us this was totally normal), had a little cry and then settled quietly on my chest.

At this point I asked if the midwives were coming, having realised they weren’t there. Hilariously, we had all been waiting for the other one to suggest that we call them – I hadn’t want to ask if it was the right time to call in case Lucy said she thought I still had a long time to go, and Lucy & Jamie were waiting for me to signal to them that I wanted the midwives to be called. We decided not to call anyone until I had birthed the placenta which happened shortly afterwards when I’d got out of the pool and had a couple of mild contractions in bed whilst having skin to skin and successfully breastfeeding. Lucy caught the placenta in a bowl and checked it over and Jamie cut the cord! Jamie then had some skin to skin time while I got cleaned up and got into bed. Lucy brought us some bagels and fruit and I recall thinking at that point, this is the dream. I’m in my own bed, with only the people I want around me, eating this amazing bagel, with my son sleeping on me – what else could a girl ask for! Oh wait … I know – an amazing doula who then proceeded to tidy up everything, pack the pool away and top up our tea and water before quietly leaving a few hours after the birth. Needless to say we didn’t feel the need to call the midwives as I had only wanted them for responsive care and we were all totally fine so not only did we have the homebirth we had wished for, but an unintended freebirth and it all felt totally normal. We got an independent midwife round in the morning to check us over and do the legal admin bit and my NHS midwife came to the house to do the Day 3 & 5 checks.

As with most new parents, we had a few concerns over the next few days and Lucy was at the end of the phone for every question, worry and wobble with advice and links to useful videos or articles.

I was in the “pushing” phase of labour for 4 hours but it honestly felt like it could have been 30 minutes. I had no concept of time and was just fully in the zone. I learned afterwards that hospitals typically “let” a woman push for 2 hours and then try to expedite the process. I am certain that if I had been pressured to push rather than following my instincts and trying to slow everything down that I would have had several tears but he came slowly enough to allow everything to stretch and I had only a very minor graze. He weighed 6lb10, so not the huge baby predicted by my fundal height measurements and was perfectly healthy – no grit or calcifications on the placenta (Lucy checked it over and showed us it, talking us through how it worked which was fascinating) and no meconium in the waters (he did a big poo in the birth pool as soon as he was born). It just goes to show that following your gut, no matter how hard that is, can be the right thing to do – baby came when he was ready and we’re all the better for it.

The last 11 months have been a bigger learning curve than I ever imagined, and one that Lucy has been at the forefront of. Not only do I feel much more educated about pregnancy and birth, but I have so much more confidence in myself. I always knew I had a stubborn streak but had no idea how that was going to play out as I also am an almighty people pleaser and can be very easily swayed by other people’s opinions. The fact that I was able to stick to my guns to get to 44 weeks and still have a home birth despite a 60 hour marathon labour with vomiting & shakes is something I will remind myself of for years to come when I am doubting my abilities.