Canterbury Homebirth Association

By Juliana

I don’t know why I thought of homebirth. Perhaps it was partly because I had given up trying to find a recommended midwife. I was already in my 14th week of pregnancy and the midwives I was recommended were all fully “booked” so to speak.  Perhaps partly it was because I had been in NZ for such a short time, and I knew looking for a baby sitter for the other 4 children while I went into labour would not be too easy.  What better than to be able to go into labour and still have an eye on the other children I thought. I could almost see myself screaming in pain and screaming at the older 4 to stop squabbling!

I was determined to find out how “sound” home birthing was as I had no experience of one. As a working nurse, I was inundated with “oh please” and “for goodness sakes” when I expressed the potentiality of home birthing to my colleagues. Being married to a doctor was no help either.  My husband’s “enthusiasm“ knew no bounds… he made sure he had a full intubation kit for the baby long before I was due to deliver, and he also bought a Doppler for the foetal heart reading!

Thankfully, the eventual monthly visits by the friendly midwife helped me with my exposure to homebirth and what it may/would be like. I had weeks to contemplate it, and even videos of home births to watch. I highly recommend that even if one does not have older children to prepare for the birth, that they themselves view the “older children kit” video if they have never experienced birth or are from another country where home births are unheard of, as these materials are very useful. With my previous experience of childbirth I couldn’t fathom what a homebirth was or how I wanted my birthing to be, since the first four had me flat on my back in a hospital.

You see, up until recently, we had been living in another country and had all 4 of our other children there. A country which was called the hub of medical excellence of Asia... a world of monthly scans, followed by weekly scans, and a world where homebirth is unheard of, where pool birthing is a rarity, and where an early full triple test to check on abnormalities of the foetus is a basic norm (and a world of disposable underwear post birth!)

One squeak to my mother that I was intending homebirth, was all I needed to do to set off alarm bells. I clearly recall the horror on her face, and the question “do they realize that they are going backwards here?” Huh? Backwards? Forwards? Wait! Let’s think this through before we decide.

Birthing, after all must be the most natural thing ever.

It was a little complicated as I am a Beta thallassemia minor carrier, with my haemoglobin reading always hovering at about 100. But homebirthing IS SO sound, they have proper guidelines and anything less than 100 would have sent me straight to the hospital for the birth. Also, coupled with a recurrent disc prolapse I was quite the candidate for potentially ending up in the hospital anyway.

I had a reputation for having my babies early; this wee one was probably “my longest tenant”. We hardly hear of any pregnancies pass 40 week gestation back home, it’s not common. We have them, well, what we call, “socially induced” by 40 weeks if we don’t see the bubs.

Haneen-Aleyna came 38 weeks +1 day.

It was a Sunday evening, almost 7 pm, and as it was summer the family was out in the yard playing. I was on the swing, the hubby and the lot having a round of rugby. I felt, what was to me, two Braxton Hicks contractions which were stronger than usual. I felt movements in the lower part of my uterus and almost immediately followed a sudden slight squish. I immediately sprung up off the swing, and that was enough indication for my husband to round up the kids! I called Lynda (midwife), but wasn’t too alarmed as there were no other indications that the baby was coming so very soon. There were no contractions following that, and the leaking liquor was clear.

Lynda arrived anyway. Jodie the student midwife was also there and they checked me over, checked the baby's heart rate etc. Lynda left giving me clear instructions to call her when I needed to do so. That’s the thing about home birthing, it’s the “do what is natural for you” bit.

Allow me to point out some of the vast differences in patient management between the country I had lived in before and New Zealand, to fully appreciate the scenario. I come from a world where “confinement” still exists.

Confinement is a period of time (usually a few weeks) when there are taboos for the mother of a newborn, and they range from something not too significant like not to do too much work, or not to leave the house for a few weeks, to the extreme of not being able to have a proper shower or baths for at least 30 days post delivery.

Being a rebel, confinement was never my cup of tea, and if anything, the older generation’s attempt to “confine” me would have driven me up the wall and round the bend (aka suicidal), so it’s just as well I am now here where I do not have to make excuses (for the 5th time!) not to fulfil the “confinement obligations”.

With all these traditions and rather old-fashioned ways, it is then somewhat contradictory that I should also come from a world where c-sections are pretty common choice, and where episiotomies are done almost all the time on crowning to eliminate the possibilities of natural tears. My world was also one that saw a patient pretty much “tied” down to the bed as soon as being admitted in labour, regardless of stage.

As a nurse, I can appreciate that this is the medico-legal side of things. No healthcare professional wants to spend the next two hours being interviewed by the managers of the department and having to write copies of incident reports following a fall of a patient! So it was always the bed rails up, call bells and the bedpans for hours of labour. In complete contrast here I now have a midwife telling me that I am free to do as I wish and to deliver as I wish. What a change! 

The first stage of labour saw me walking around the house and ensuring that everything was ready. I think the nesting instinct hadn’t worn off yet. I felt I had to keep going to the toilet as if I was down with diarrhoea. I recall having this for my other hospital births, even though an enema was given to me, regardless of whether I needed one or not, and how I really ticked the nurses off because of this, and how guilty I was made to feel. So it was a great comfort to have Lynda explain to me that it was my hormones kicking in and my own body clearing the passageway for the impending need of space!

Another interesting contrast I found was that I was allowed to just be myself. Lynda repeatedly asked me to let her know when I felt contractions. I recall her saying “because I can’t tell by just looking at you”. In my previous experience it was more a case of my being better off keeping as much to myself, in terms of reactions, as there was always a possibility of being told off for ”being myself”. How reassuring and reaffirming for me to be allowed to just be myself, to express myself freely, and not have to worry about fears of recriminations at a time when I felt quite vulnerable.

Additionally, Jodie started applying hot towels on my lower back, which much to my surprise worked really well.  This had never happened in any of my other deliveries, with the over reliance on pain relief through medications.

The last time I went to the toilet I didn’t have to even sit on that bowl, I immediately realized that it was the baby coming. I went out and straight to Lynda and Jodie and said, “I think this is it?” Again, out of previous experience, where my every movement needed permission, I asked if I could sit on the couch and have my baby there and the positive response again proved a great comfort to me.

At some stage, Lynda called for the second midwife, and Michelle joined us not long into the second stage. I was lucky to have 3 people at hand. I was so blessed to have three voices of calm encouragement to help me through my home birth. The second midwife, to me, fills up the gaps, so to speak. I realized later that things ”appear” and get “done” in areas where it was impossible for Lynda to have managed with equal alacrity unless she could be in two places at one time!

The dim lights were also great and everything from then seemed to happen so quickly. It was only 16 minutes of the second stage that I had to “contend” with, 7 heavings in all. My 13 year old daughter stayed with me as the other three children slept in their beds. As my body was blessed with the ability to be at heights of spacelessness, almost an out of body experience, my thoughts slowed down, my reactions slowed down, and information seemed to take its time to disseminate.

All the help I received from the people around me was so timely and appropriate. Suggestions were clearly offered to me, encouragement where necessary was a great comfort, and all seemed to fall into place. My new baby was placed on me, as I followed the suggestions as much as I could. I can’t begin to express my gratitude towards Lynda, Michelle and Jodie, and I doubt any amount of “thank you’s” would suffice.

From a logistics point of view, home birthing has many advantages for me.  It eradicates the need for admissions and discharge paperwork, the lining up at the finance billing office after the birth (yes not all countries foot the cost of healthcare and deliveries), it removes the worry of any possibilities of not having a “bed” at the hospital when you are in labour, or having to be transferred to another hospital following the labour for the same reason. It lets you be in your comfort zone - imagine your own bed waiting for you right after!!

Being from a world where midwives are there to just assist the obstetrician delivering your baby, I never knew who they were up till the minute of the birth. There were no personal touches and precious little time spent with another lady of experience and knowledge of birthing. I found out what those personal touches were like when I had a home birth. For the first time, out of 5 births, I was able to ask someone how the labour was, from the other end obviously! No use asking your husband unless he is a midwife, as husbands are usually too excited to really remember much in detail. It was nice to be able to ask, not when you are still in delirium and experiencing heights of excitement from the birth itself, but the next day and the day after, when you are calmer and things are settled.

As a nurse with almost 2 decades of experience under my belt, I have come to realize there are things that I can do and things that are out of my league…midwifery is  definitely in a league of its own, and lies pretty much outside my range of abilities.
I take my hat off to midwives everywhere, thank you for being there.

Published in Birthplace Magazine - Spring edition 2009

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Last updated 28 October 2009.