My Home Birth Story Part 2: why you must protect your birth space (even at home) and the importance of the third stage.

If you read my previous blog post (part 1) you will know that Iris was born before the arrival of a midwife. The words I have used to describe that experience are amazing, incredible, empowering, elated, in awe, proud. Never once did I feel panicked or scared or anything negative about her birth experience. I was calm and I trusted my body and let it do its thing. And all was well.

What came next left me with the opposite of those feelings and I think it is really important to share this part of my experience too in the hope that it will help others think carefully when making choices about their birth. 

So the midwife arrived around half an hour after Iris was born. And without sounding too dramatic, she completely sabotaged my home birth from that point onwards. It went from a calm experience to complete and utter chaos. 

Firstly, the midwife couldn’t find the clamp to allow her to cut the cord. I had wanted to ‘wait for white’ and by the time she had arrived the cord was already nice and white so I was keen for it to be clamped and cut at that point so I could go to the toilet easily and get myself into a more comfortable position. 

It took 1.5 hours to find it (actually my husband found it in the end). When I say that she literally emptied out every single box and bag and packet onto my living room floor, whilst I sat on the couch with my new baby, I am honestly not exaggerating. You could barely see the floor. Now I’m not one for mess at the best of times, it really triggers my anxiety so you can imagine by now I wasn’t feeling too calm and relaxed. Plus the ‘big light’ had now been turned on and not only that but whilst looking for the clamp she kept stepping on other items from the boxes and breaking things. 

In amongst all this chaos she was also extremely panicked that the placenta hadn’t made its arrival yet. I mean it was hardly a surprise with the amount of adrenaline going through my body by this point was it. So half an hour after her arrival and an hour after the baby was born she proceeded to call in for a transfer. Without any discussion with me and without asking for consent to this. I interrupted to say I wanted to stay home longer and see if it would come away on its own. At that point everything was still attached and I felt once the cord was cutI could get up and try using the toilet and see if gravity would help. 

Eventually around two hours after the midwife’s arrival I got to go to the toilet and the placenta started to come away, although it wasn’t keen to fully budge and there were some ragged membranes which the midwife gently teased out and it all came way in the end (or so we thought). In reality about a week and a half after the birth I noticed a terrible smell, I actually kept thinking the baby needed changing but she didn’t, then when I was in the bath the next day a huge piece of the placenta plopped out into the bath. There is a picture below if anyone is like me and likes to see these things but I must add a warning that it is pretty disgusting. To say I got a fright was an understatement and I ended up with an infection which needed to be treated with antibiotics. Thankfully I avoided needing to have surgery, which had been talked about as a possibility. It could have been much more serious than it was but it should never have been this way in the first place. I fully believe this happened due to the care I received.

Over the course of the morning various other calls were made about a number of different things. The midwife was clearly unsure about many aspects of my care and her panic was palpable. The second midwife arrived and again various conversations and calls ensued about whether the midwife had been sent to the wrong birth, the placenta issue, the fact I’m rhesus negative and they couldn’t get blood from the cord to test and nobody seemed to know what to do about that. And so on. They were both loud, clearly panicked and completely disrespected my home, the birth space and most importantly the physiological birth process and the conditions required for this. 

But the thing was, they did it with a smile, they were kind and came across as caring. I’m pretty sure they are both really nice people. Isn’t that so often the case though? So when we are in our most vulnerable moments it can become really difficult to use our voice to say ‘this is not ok’. So I kept quiet. And if you know me I am not someone who keeps quiet when I’m not happy about something. Eventually after about three hours I went to my bedroom away from them and left them downstairs - I could still hear the loud conversations but I felt much more peaceful out of the way - I wished I had done that sooner.  

So why am I telling this story? Don’t I tell my clients to avoid negative and traumatic birth stories and focus on positive ones? Well yes and no. I would highly encourage my clients to familiarise themselves with ‘normal’ birth, to read positive stories, to watch positive videos. All of this is aimed at replacing the messages in your brain about birth being a terrifying event. To build trust in your body that you were designed to do this and you can do this. But we also can’t live in a vacuum and we need to be aware of what can happen. And in the overly medicalised maternity system under which most of us will be cared for - it’s actually really important for us to know how the physiological birth process works but also how it can so easily be sabotaged. From disrespecting the birth space and not facilitating the physiological process to a myriad of unnecessary interventions designed to keep things moving along as if we are part of some sort of factory production line. If you are giving birth in this system you are at risk of physiological birth not being facilitated - so if your dream birth is free from intervention (which it doesn’t have to be, its your dream birth) its important to know about these risks. That way you can plan to mitigate them as much as possible. 

So what could I have done differently? Well firstly, I would like to be clear that I don’t blame myself for what happened. I blame the midwives specifically for their lack of respect on a personal level; but more so I blame the system under which they operate where physiological birth is becoming less and less of a priority. And what I want you to know is if anything has happened to you in your birth that you don’t feel happy about it is not your fault, ever. There are a few things I have learned from this experience that I think are helpful to others. 

Firstly, the third stage of labour, where you birth the placenta is JUST as important to plan for as the other stages. I think we think once the baby is born that’s it and the rest will take care of itself. I know I was guilty of glossing over this part and didn’t really think about it in my birth plan. In reality all of those conditions we need to facilitate the contractions which allow us to birth our baby (dark, quiet, calm, private) are also required for the third stage of labour. So I would absolutely suggest that you address this in detail within your birth plan. State the conditions you expect. And make sure your birth partner is fully versed in those needs. This allows your birth partner to then act as your voice and say ‘this is not ok’ if those wishes are not being respected. At a time where it might be difficult for you to use your own voice.

Secondly, a big take away for me is that it is still possible for the physiological birth process to be sabotaged even in a home birth. We often talk about home being a safer environment for women to give birth in. And the research shows this to be the case with less risk of intervention when planning to birth at home. I do think because of this I was quite complacent, especially because my previous homebirth had been facilitated well, so I didn’t really consider this as too much of an issue. I would urge you to think very carefully about who you want to invite into your birth space and how you can protect the physiological birth process as much as possible. Again, your birth plan is key as well as having someone to advocate for your wishes.

So should we all just freebirth our babies to avoid these risks? Well I mean that is of course an option. It’s certainly one I would strongly consider if there were ever to be a baby number five (unlikely). But I appreciate that this is pretty radical by most people’s standards. So my advice to clients would be to think about what your ideal birth looks like and exactly what needs to be put in place to make that happen - including what might potentially stop that from happening. A lot of people don’t make a birth plan because they worry they will feel disappointed if it doesn’t happen. But I would say this is absolutely essential. And if you think you sound like a diva for asking for low lighting and quiet and people not to enter the room (or whatever else you want) then who actually gives a shit if you get the birth you want at the end of it? I say do absolutely everything you need to towards that dream birth. And that’s not to say completely ignoring possible twists and turns, I would say plan for them too and that way if they do happen you’re much less likely to agree to things you don’t want and much more likely to feel positive about the experience even if a change of plan. 

I really hope this helps someone in planning for their own birth and acts as some food for thought. As a side note I did report my experience to NHS Lothian Home Birth Team and some new procedures were put in place as a result including additional staff training, rhesus protocol and a redesign of the home birth boxes so that they were all the same so easier for the midwives to find everything. So there is progress and I definitely see the addition of that team as a good thing.

Now if you’re squeamish I would suggest you stop here - if like me you like to see gross things feel free to keep scrolling to see the partially retained placenta that plopped out into the bath that day - you can imagine the fright I got.