SOPHIE'S BIRTH STORY

Location: homebirth
care provider: rachele meredith private midwife

When I became pregnant my husband and I were thinking about starting a family but thought it would take a bit longer than it did. I hadn’t done much pre-planning or thinking in terms of the care I would want and so when I had my pregnancy confirmed by my GP at 6 weeks, that was the first time I became aware of my care options in the Illawarra. MGP was my first choice for care but I was disheartened when I heard how competitive it was. I really desired a model that provided continuity of care, and so booked with one of the local obstetricians as I believed this was the next best thing.

Private midwifery care was not mentioned to me as an option.

Something about this decision didn’t feel right though, and I’m so glad I listened to my intuition. I continued to research my options independently and found Amelia Coleman (The Illawarra Doula) and her guide to care options in the Illawarra. It was the first time I learnt of private midwifery care as a possible alternative. The more I researched it the more it sounded like the right choice for me and my family. I contacted local midwife Rachele Meredith, we had a chat and the next day she visited me at home. I wasn’t planning a home birth at first and knew that she wouldn’t be able to deliver my baby should I go ahead and birth in hospital. She was, however, able to provide me with both my ante and post-natal care, giving me with the continuity of care that I wanted. I rang up and cancelled the obstetrician the next day without ever going in for an appointment.

I didn’t consider home birth as an option initially because I only knew one person who had ever chosen it and at that point, like a lot of people, I was fearful that something might go wrong with either my baby or I, so hospital was the safest option. As my pregnancy progressed though, and I had a chance to do some of that reading and researching that I had planned to do before conceiving, the stories of home birth were the ones that reduced me to tears (for all the right reasons). Intuitively I began to feel that this was what was right for me and my baby. On a more practical level, I began to research everything I could about birth: what happened, how and why. What evidence was there for or against different interventions and what influenced the most positive outcomes for mum and baby.

I also discovered the Mother and Babies 2018 report, which contains the birth statistics of both our local hospitals. To someone who was planning a normal physiological birth, they were pretty disheartening. Water immersion was also not an option for pain relief at either hospital at the time and that was a deal breaker for me. I must have been about 12 weeks pregnant at that point and we committed to having a home birth. My family was supportive, especially two nurses who are very close to me and both happened to work in special care/NICU at the time. I know there were people around us who maybe didn’t understand or thought it was a dangerous choice, but they never expressed their concerns with me directly. I knew I had made the right choice because after I committed to birth at home, I finally started relaxing and enjoying my pregnancy, and that inner voice was the only voice I listened to.

As my pregnancy progressed, I really saw the value of the model of care I had chosen. Rachele respected my choices and authority over my own body. I was still offered all the regular tests and scans, allowed time to research and discuss the pros and cons, then choose to accept or decline without any pressure. Most of our appointments were like having a chat with a good friend. Looking back, I can see how over time Rachele was building up my confidence and trust in both my body and my baby.

I never once heard that my baby was ‘too big’ or ‘too late’ or that my care provider had any doubt I would birth my baby the way I planned to.

We discussed with Rachele our wishes so if we did have to transfer to hospital for any reason, she would be able to advocate for us and felt confident in her abilities to manage most situations at home with her years of training and experience. We were also supported by Rachele for 6 weeks postpartum, with daily visits in the first week. I developed a UTI a few days after giving birth and instead of making an appointment with a random doctor (my own GP has a long waiting list), having to put my brand new baby in the car and drive somewhere when I was still having trouble just sitting properly, Rachele was able to collect a sample for pathology and prescribe an antibiotic for me at home. I was also able to text her in the middle of the night when I passed a large clot.

From a psychological care perspective, choosing to birth within a continuous care model enabled me to debrief my birth with the people who were present. I felt really positive about how everything had gone, but had something happened that I wasn’t satisfied about, I had the opportunity to explore how and why this had happened with my midwife. Even hearing her observations about the birth influenced my already positive perceptions of the experience.

My labour started spontaneously at 3.30am at 40 + 3. Apart from some contractions the previous night, I had had no other discernible signs of labour in the lead up to it actually starting (despite over-analysing every single little thing my body did for weeks). I actually find it hard to talk about labour, because it’s such a personal experience. I couldn’t possibly describe what it felt like, but I do remember I was confident and excited when it started. I spent most of the morning baking a ‘birth-day’ cake, making sure I was moving and staying vertical so labour could really establish itself. When I could no longer talk through my contractions, about 11.30am, Rachele arrived.

I guess at that point is when most other labouring women would travel to the hospital and it was such a relief to know that we weren’t going to have to travel anywhere. It really allowed my body to relax and start doing the hard work of active labour. I walked or kneeled for most of my labour. I used water immersion in the pool and shower for pain relief, as well as counter-pressure provided by my husband and heat packs. Not being immobilised by any monitoring machines or IVs allowed me to move around and listen to what my body needed me to do. I guess it was painful, but I remember it more as ‘intense’. When I was pregnant, I devoured Dr Sara Wickham’s ‘Gentle Birth, Gentle Mothering’, in particular, the chapter on the function of hormones in labour. As the sensations got stronger, I knew my body was producing more and more oxytocin in response, and oxytocin is what gets that baby out!

Being at home also meant we were able to keep the house dark, quiet and private - all important for helping oxytocin flow and labour progress. Rachele and the second midwife Trudy were present, but mostly out of the way. They provided moral and physical support when needed, but that was more towards the final stages. I pushed for 1-2 hours (I can’t remember exactly) and Maggie was born at 7.38pm, a healthy 3.9kg/53cm. As is the norm in home births, our golden hour together was respected. Complete skin-to-skin, physiological third stage and delayed cord clamping. After that first magical hour, Maggie had some skin-to-skin with her dad so Rachele could assess me and suture a small tear. Prior to birth, Rachele had discussed non-essential - as opposed to some newborn checks that definitely are essential - common post birth interventions for baby with us and as parents, we were given time to look at the pros and cons and ultimately the decision of whether to accept them was up to us. We were able to establish breastfeeding that first night and allowed some time to bond with our daughter whilst the midwives monitored us from a distance and cleaned up. When everyone else left around 10.30pm, the three of us got into bed together and spent our first night as a family of three.

If I could only use one thing to encourage home birth to others, it’s that we were able to stay together as a family that first night, all three of us together in the same bed we had got out of just 12 hours before, except this time my baby was in my arms, not my belly.

Here’s why I’m so passionate about home birth.

As much as there are good people working in our hospitals (midwives especially), despite what evidence tells us, hospital policy simply does not support normal physiological birth in all its variations. There are inherent risks involved in birth, but overwhelmingly hospitals choose to manage the chance of very rare but catastrophic risks with common interventions that are not without risks themselves. If you are ‘low risk’, evidence tells us that you and your baby will fare better outside the hospital.

The continuity of care that a privately practicing midwife is able to impart is also proven to provide better outcomes for mums and babies. No one told me this, I had to find it out for myself. This kind of information needs to be accessible to everyone, not just people like me who have more than half a decade of higher education and research experience. I’m also passionate about empowering women to trust their intuition, their bodies and their babies. When I talk to other people about home birth, overwhelmingly the response is ‘good for you, but I’d be too scared something would go wrong’. I’m lucky I grew up in a family where my mum talked openly and positively about her three experiences of normal physiological birth, and I see now what a gift this was.

Like all first-time mums I definitely had a bit of fear, but once I started to listen to my intuition and trust the process, it was more fear of the unknown than fear of birth itself. If I think about restoring faith in birth as an overall issue, it can feel very overwhelming and dire. However, by sharing positive and empowering stories about birth (like I hope this one is), my hope is we can start to change the tide.