free or unassisted birth is the term used to describe a birth without medical support
Sarah was 35 weeks into her twin pregnancy when her husband contacted me seeking information on their decision to birth their babies naturally as they had exhausted all efforts of finding any medical support for their desired birth. I reassured them that legally, they were not doing anything against the law by free birthing. She was being scheduled for a caesarean section for the birth of her twins the following week, 36 weeks gestation, based on the fact the she had had a caesarean section 11 months earlier. She and her husband were desperate to avoid an unnecessary c/section especially as both babies were a good size and presenting head down. Along with my doula colleague Heidi, who I had insisted be part of their birth team as she had previous experience supporting a fba5c(free birth after 5 cesareans) we finally met face to face 3 days before the date of the scheduled caesarean. She told us the story of the birth of her first child – The outcome was not good. Her account of his birth is included below. Please note that while it may be upsetting for some, this is her very personal story that she has been brave enough to share. It was very clear to me that they were fully aware of the risks they were taking, choosing to birth out of the hospital, but what was even more overwhelming was how much they trusted Sarah’s body. These babies. This birth. How could we refuse to support them?
This is Sarah’s story…..
Pregnant for the second time
When I found out I was pregnant for the second time, I had a rough time accepting it, the whole first trimester I just ignored it, expecting that I was going to have a miscarriage, as it was only 3 months since my c section, but mainly because I was so very heartbroken and sad, I felt my body had let me down and that nothing viable would ever be able to come through my womb....
Israel’s birth story. (This is Sarah’s account of the birth of her first born, Israel)
I wake up Friday (26 September 2014) morning and feel an ache in my lower back and abdomen, I have been sore in my lower back for a while, so I don’t think more about it, I just go about my normal day, a bit silly as my due day was 5 days ago. The day goes on and I have a long nap in the afternoon, I make dinner in the evening but am now quite bothered by the pain, I’m finding it difficult to find a comfortable position, so I start to think that it could be that labour is finally here.
I tell my husband that I think something is happening, we agree that I go to bed and try to sleep, a few hours later I get up again as I just cant get comfortable, I tell my husband to sleep as it will still be a long time and there is no reason for him to not get his rest. In the early morning I call my midwife and tell her that something is finally happening, I then wake up my husband and we start to prepare the room and our bed, we have planned a home birth with our certified midwife.My midwife arrives at around 7 and she examine me and the baby, heart rate is good, but I am only one cm dilated so she goes for a walk and I take yet another warm bath, 3rd one since last night.
She comes back at around 9 and I am still only 1 cm dilated, so we decide to rapture the water to get things going. So the water breaks and there is a lot of it, and it is very green, we have to go to our back up maternity hospital as the midwife will not deliver the baby when it is under stress, especially when there is still so long before the delivery.
So we drive to the hospital, at this point I am scared and stressed as things are not going according to plan. We arrive at the hospital and I get examined and they monitor the baby’s heart, it is not looking good, the baby’s heart rate is very high under and in between contractions. They do a vaginal examination I am only 2 -3 cm dilated and they think the baby is face first, they recommend a c section. I really do not want a c section but they are afraid for the baby as it is very stressed and there is still hours before the baby will be delivered.
We agree to the c section, and are taken to the operating room immediately everything is going so fast, I am laying there on the operation table with my husband sitting by my head holding my hand. We wait and nothing happens, there is just complete silence, I don’t know that much about c sections, but I know it is quick, and I’m not hearing my baby cry, I rationalize, “some babies don’t cry” , “maybe they have not started yet” and more like it. My midwife comes to us and tells us there is something wrong with our baby, my first thought is “it does not matter, give me my baby and I am going to love any problem away” As there is still no crying I ask if the baby is breathing, and she answers, “Yes for now the baby is breathing on its own” This is when I realize that it is serious.
My husband goes to see the baby and the next thing I hear is this terrible cry, like a deadly wounded animal, I realize that it comes from my husband, I call him, I want him to come to me so I can protect him, to take him away from the pain. I call him again and again. After what seems like an eternity he is by my side again, he put his face so close to mine, kisses me several times and tells me that our baby does not have a skull and a brain... I want to laugh, because surely there is something he misunderstood. There is no such thing as a baby born without a brain. I am confused, and just want them to bring me my baby, they are all mistaken, and they must give me my baby right now, or so help me God I will go get my baby myself.
My midwife comes with my baby and puts the baby on my upper chest, I see this beautiful little face, little lips so close to mine, I kiss them again and again. I can feel small breaths on my lips, and I kiss them some more, my husband tells me that we have a little boy.
Our Son is born on Saturday 27th September at 12.00. I tell my son that I love him, and that I am so happy to be his mother. My heart has just doubled in size with love, at the same time as it broke in a 1000 small pieces. Finally after this long pregnancy I get to hold my long awaited baby and at the same time I know I will have to say farewell to him soon.
My midwife comes to take my son to measure and weigh him, after that my husband sits with him while they finish me up and move me from the operating table to the bed. We spend some time in recovery before going to the maternity ward, where we are fortunate enough to be allocated their isolation room, we have some privacy, just our little family, my husband, my son and me. We give our son his name and ask God to bless him and hold him. My son is now on my chest skin to skin. I can feel his breathing with my whole being. My heartbeat is his heartbeat ones again.
Gradually his breathing is getting weaker and weaker and then more and more irregular. I know he is slipping away. He is now only grasping for air every now and then, and he is getting seizures where his little body goes all stiff, I rub his back and hold his little hand, I tell him that I love him and always will. That I am so proud to be his mother and that one day I will hold him again. And I tell him that it is okay for him to let go. After a while I tell my husband that our baby is now gone. He looks at the watch and it is 19.20. We keep our son for a bit longer, pray for God to look after our firstborn. We then call the nurse and she calls for the doctor.
At 20.30 our son is declared dead. I wrap his little body in a blanket and my husband puts him in the crib, the nurse takes his body away. I will not see him again before his funeral on the Wednesday.
We drive to the grave side, before the burial we view his body, I touch his cheeks and I pull my hand back in shock, his cheeks are so cold. I don’t know what I had expected, but I am mortified that he is so cold. I want to take him out of that coffin and carry him under my heart forever, to keep him safe once again and for eternity. Instead I tuck the blanket I had knitted for him while he was still in my belly tightly around his little body, I give him my old teddy that followed me my whole life and pictures of us, his parents, happy pictures, so he will know how we look when he sees us again. My husband then closes the coffin and he is lowered in his grave, my husband ministers over his funeral, honestly I don’t remember a single word, I am just looking down at this tiny coffin in that deep dark whole and know that, that is my baby down there.
Our son was born with a neural tube defect, incompatible with life, he was born alive. I had him skin to skin. We loved our son for 7 hours and 20 minutes before he passed away. After a lot of reflection I am so happy we chose not to have the scan, carrying my son for 9 months under my heart and the hours we had with him is, to this day, the best times in my life. A scan would have easily diagnosed his birth defect, but nothing can be done and most babies with his diagnosis are terminated.
Second pregnancy continued…
I reached the end of my first trimester and was still pregnant so I had to start dealing with it, I got an appointment to get a scan, I felt that I just had to know if the baby was sick before I could allow myself to feel excited or even just accept being pregnant. I went for the scan, I was so nervous and tense, the doctor scanned and scanned, she was all over my belly again and again and it took forever, finally she says, “there is something I must tell you, but you must promise me you will not freak out” Well I’m already freaked out and her saying that did not exactly help, she then says “you are expecting twins”....... I’m like, what???? By the way this was April 1, my first thought was how unprofessional and cruel to play a joke on me, especially knowing my history. But it was no joke, and she shows me two babies on the screen. So I’m pregnant with identical (MoDi) twins, this really just made me even more anxious, I was warned against googling too much, so as not to add even more concerns to my already long list, all I can say is, I did not listen.
I was being monitored closely from there on, every two weeks I had a scan and everything looked good, the babies were growing well, and there was never any signs of problems, from about 26 weeks the babies turned head down and stayed that way. This whole time I wanted a VBAC, but was recommended a c section, reasons being my first c section not even a year ago and because it was a twin pregnancy. However I felt strongly that these babies must be born naturally, and as time went and everything continuously looked good and all the possible complications never materialized I got more and more adamant that it had to be a natural delivery. At my 35 week check up I was told that my c section was to be scheduled for the following Tuesday, at 36 weeks. I refused, and as the hospital refused any other birth plan for me I discontinued their care.
By the grace of God (It really must have been) My husband and I got in contact with Lana Petersen and she agreed to be my doula at an unassisted homebirth, she recommended that a second doula Heidi also be present and now my homebirth was falling into place. We waited, not so patiently, and finally it started.
Free Birth After 1 Cesarean of Twins
I woke up past midnight on the 9.9.15 with contractions. They were regular and somewhat painful but manageable. I tried to rest as much as possible for the remainder of the night. In the morning I had a warm bath which helped nicely with the back pain and contractions were still regular. I had a 2 hour nap during the day where the contractions had slowed down quite a bit. In the evening I made soup and then went to bed to try and rest, I did get some rest, but after a few hours I could not lie down anymore because of the back pain and contractions.
At about 3am in the wee hours on the 10th I had called for my two doulas, Lana and Heidi, as I felt contractions were getting strong. They arrived and brought along with them a birthing pool and warm bean bags (those two things became my best friends in the hours ahead), the pool was set up and oh bliss it was so nice being in the water. I had steady contractions throughout the day, but was not making much progress. I was only dilated to about 4 cm in the evening when I checked. I was feeling incredibly tired and discouraged after two full days of contractions and only so little progress. (Sarah was very in tune with her body and able to assess her own cervix) This was my absolute low point, I had had regular and painful contractions for 2 whole days and had not had a good nights sleep for four days, and I was absolutely exhausted, I could hardly hold my own head up. At this point I think the only thing that kept me going was pure stubbornness.
Early in the morning on the 11th Lana and Heidi went home to get some well deserved rest and spend some time with their families. I still had steady contractions throughout the day, I spend a lot of time relaxing between contractions in the pool, rested on my bed and bouncing on my birthing ball, at some points I only had maybe four contractions an hour and was able to get rest in between, I regained my strength and felt up for it again. Despite having all these contractions, I felt that there was not much progress, so during contractions I started to push real hard to try and break my water so there could be some more pressure on my cervix, but I was scared of tiring myself out, so I stopped doing it again.
At about 9pm Heidi came to help me with the contractions, and finally my water started to leak very slowly, I felt so incredibly relieved, that the birth was finally progressing. I went to the toilet and now the water came gushing out. We refilled the pool and I went back in the water. I Phoned for Lana to come, and she arrived around midnight. I had heavy contractions and enjoyed being in the warm water, but with time, I needed the water to be warmer and warmer to dull the back pain, it was getting overwhelming for me, so I got out of the pool to cool down a bit, I remember asking for just a short break to collect myself, but contractions were heavy and fast. There were no more breaks to be had. After some time standing in the kitchen, the coolest room in the house, with hot beanbags on my back and Lana and Heidi helping me through the contractions, we went back to the living room, I wanted to relax a bit on the sofa, but there was no relaxing. In between contractions I would sit on the sofa and during contractions I squatted while holding the back of a chair, with Lana and Heidi one each side of me helping me up and down, as I was too tired and sore to lift myself. Eventually I ended up sitting between them on one each of their thighs, as I could feel the urge to push. At this point I was feeling rather irritated as I could feel the mood in the room change, Lana and Heidi were saying stuff behind my back that I could not hear, and my husband was looking at me very intently.
Because the labour had already been so long, I was preparing myself for having to push for hours, so when Lana told me she could see the baby’s head I was quite surprised. The next thing I know I’m on the sofa with a screaming baby in my arms, ohh what a beautiful sound. Baby was laying on the left side of my tummy, on top of Twin B whom was still in the womb, after a couple of minutes I had another contraction and I asked to have twin As umbilical cord tied and cut so I would be able to birth the next baby, however there was no time as twin B came flying out with the next contraction, without me even pushing. Twin B came out 6 minutes after twin A, and was complete in the sack, first being caught by Lana, then bouncing on to Heidi’s hands, where the sack finally burst and out came a second beautiful little baby, they were now both on my belly, both still attached to the placenta, and after a little encouragement twin B also let out the most beautiful and persistent cry.
Both babies were so ready for the boob and suckling their little hands. Twin A’s umbilical cord was at this point done pulsating and was tied and cut. Twin B’s was left a little longer before it was done pulsating, in the meantime we checked the babies and found out that we were blessed with little girls. The placenta was delivered a little later. After a while on my belly Lana weighed and measured the girls. Twin A, Daniella, born 12 September at 3:05am weighing 3020 gram, and 48,5 cm long Twin B, Elisabeth, born 12 September at 3:11am, weighing 2480 gram, and 46 cm long The placenta was delivered at 3:19am weighing 808 gram After the girls had been weighed and measured my husband went to bed and had skin to skin with them while I was cleaned up a bit. We treated the small tear I had with nori (seaweed)and I was then carried to bed by Lana and Heidi, I was so tired and my muscles was cramping from all the squats I had done the last 3 days, so I could not walk myself. My husband and I were now in our bed and cuddled with our daughters, Lana helped me with latching the girls on the boob and they were now happy suckling away. Lana gave my legs a bit of a massage to help my poor muscles. Wonderful Lana and Heidi packed down the pool and did some general tiding up before they left.
I was definitely blessed with my dream birth. There is nothing I would have changed. I believe my labour was so long, as my body needed that time to make sure my girls were safely delivered. There is no way I would have been able to achieve my VBAC in a hospital setting, I now realized it was a blessing that the doctors denied me VBAC care. Even though my girls ended up being born on the sofa, I could not have done it without the birth pool, but the most important ingredient in my dream birth was definitely my amazing birth team.