Interview 24

Age at interview: 25

Brief Outline: Became pregnant in a another country where care philosophy was very interventionist. Returned to UK at 7 months and had a successful home birth with an independent midwife.

Background: Children' 1, aged 3 weeks at time of interview. Occupations' Mother- English language tutor, Father- journalist. Marital status' married. Ethnic background' White British/US dual nationality.

It was exciting to discover she was pregnant, but hard to imagine herself having a baby.

How did you feel when you discovered you were pregnant?

Great, really great. We'd actually had, I, I felt really great when I discovered I was pregnant. My husband was really excited too. We had had a few false alarms a couple of months previously and that had really got us warmed up for the idea of being pregnant. And we'd actually been disappointed when the tests had come out negative on previous occasions, so that when it came out positive on, on, on the occasion it came out positive, we were really excited.

In the very early stages of your pregnancy how were you feeling physically?

I think I was running on adrenalin during the early stages of my pregnancy to some extent and from my reading I know that, that the early stages of pregnancy can be really tiring for many women. But I, I experienced tiredness definitely and my friends told me I was looking tired, but actually I didn't feel as tired as they said I looked. So, it wasn't too bad.

What about emotionally, I mean what sort of hopes and fears did you experience at the outset?

I would say at the outset of the pregnancy I experienced, well, as I say, great excitement and hopes for the child. And, and a few, a few reality checks were necessary to really try to realise that this was real and to, to imagine, imagine myself not just as alone any more but as hosting another human being. And at the same time I was concerned about motherhood and whether or not I was ready for it, because many of my friends would, would say that I would be too young, even though in my opinion I'm just the right age, I'm 25 years old.

She chose to employ an independent midwife. Continuity of care and trust were important to her.

When I came to the UK, in order to hook into the system I had to register myself with a GP immediately on arrival. That got me into the NHS system. But actually we were hoping to have a home birth with an independent midwife, and so I needed to hook into another system as well, which is the Independent Midwives Association system. They have a website which allows you to search by region for an independent midwife, which I had done before I had left the country I was living in previously. And I had been trying to do as much research about the options open to me as possible before I arrived so that I could click straight into the system instead of having much of a delay. Obviously at seven months there's potentially not much time to waste. And so I had been in touch with a few different independent midwives and come up with a shortlist of people I would like to speak to. And I did only one interview with an independent midwife in this country before I found someone I thought was highly suitable, and went with her.

Okay, so you were, I take it then you were planning to interview a few and pick the one you liked the best?

Yes.

Right, so what were your criteria, what, what did you want your midwife to be like?

Well, I placed a high priority when selecting a midwife on, an independent midwife, on the way that our personalities related to one another, because I think that giving birth is a highly personal experience, highly private experience and you need someone who is going to mesh with you in that, in that way. You need someone that you can trust. And that was definitely one of the factors in choosing to have an independent midwife as opposed to giving birth within the NHS, because I wanted that continuity of care, that was really important to me, that I would know the person who was going to help me give birth. Also she had to be experienced [laugh] and, and up to date in all her training obviously, I think that goes without saying.

NHS classes were very practical and NCT more about emotions. She was the only person in her...

Had you gone to any antenatal classes or anything before?

Yes, I had gone to two different antenatal classes, one which was conducted by the NHS local practice, and another which was run by the NCT, National Childbirth Trust. And again they were quite different, the, the approaches were very different. I would say the NHS class was very fact-based and it was very useful in its way, but it, it was not really encouraging us to approach labour and birth as, as an emotional thing, only as a physical thing, as a physical procedure to go through. But it, but the information that it provided was excellent. And the National Childbirth Trust classes, I think, were a bit more holistic in their approach, because they helped you to consider not just the physical practicalities of the labour but also life after the birth of the baby, and also encouraging support among the different people who were attending the class, and that was really good.

Were there other people in either of your classes that were planning a home birth or were you the only one?

We were the only people planning a home birth in either of our classes, so we stuck out like sore thumbs. But it was good, it was good because it gave us an opportunity to, to discuss the reasons why we were having, deciding to have a home birth, and just to encourage other people to think about it a little bit more.

Her GP and independent midwife supported her choice of a home birth, but her family were doubtful.

When I indicated that I wanted to have a home birth there were very interesting responses. I must say from the medical side in, when I arrived in this country, it was a very supportive reaction. My GP was, was behind me 100 per cent, and that I really appreciated. But from family it was a bit of a different story. My own mother is quite sure that if I hadn't been born in a hospital I would not be around today. And that's, that obviously affected her view on the matter, and she was a bit worried and advised me not to go for a home birth. My own husband was also not too sure and his family was also not too sure. So the reactions all around from family were, were pretty negative. But I was pretty sure of what I wanted and I, and I stuck to it, and did lots of reading, so I armed myself with information to argue against these sceptics. And it was also really helpful that I knew someone who had recently had a very successful home birth and so I could, as well information I could use her story to convince them.

How difficult was it to persuade your family that you were going to do this and it was going to be okay? I mean, how much pressure did you feel under?

Well, when I was trying to persuade my family members that it was a good idea to have a home birth, I would say I did feel under some pressure to change my mind. But the way that I dealt with it was basically not to discuss it with, with my wider family, but just to discuss it with my husband. And after the reading that we did together, he came round, he came round to it and I think that he decided that the, if, whatever I was going to be happy with was going to be the best option. So that was decided on. But there was quite some pressure, I would say, from family. It's just a matter of whether you take it to heart [laugh].

What was the midwife's advice about a home birth?

The midwife's advice about a home birth was that she was 100 per cent behind me, I would say 200 per cent behind me. Independent midwives are really used to delivering babies at home and I would say that's their main work, actually. And so when I asked her, for example, because this was my first child, 'Would that be an indication that it would be risky to have a home birth?' she, and the other midwives that I spoke to as well, said, 'Absolutely not', that, 'There, there are hardly any indications that would prevent you from having a home birth'. 

Women in her family have long pregnancies. She was pleased there was no pressure to have an...

Yes. Well, in my family there is a long history of ten-month babies. I myself was a ten-month baby. And people in my family said to me from the start, 'Oh, yes, well, you won't be having your baby the month you think you'll be having it. You'll be having it the following month'. And they were right as it turned out. The NHS policy, as I understand it, is that anywhere between 10 and 14 days after term you're strongly advised to have an induction of birth, of labour. And I, that's something that I really wanted to avoid in keeping with my philosophy that I wanted to have as natural a labour as possible, and, as, and a birth as possible. 

And I'd, from my reading I'd just learned that if you start down that path you may end up with a lot more interventions than, than you planned on. And I, so I just didn't want to start down that path in the first place. I was really impressed with the NHS care in that regard, because even though they have this guideline in our area that after 12 days after term you should be induced, they were quite flexible with that, with that guideline in accordance with my wishes, which I really appreciated. Instead of using, instead of inducing, the alternative that we used was to monitor the baby after 42 weeks, because the pregnancy went to 42 + 3 I think, and to use the health of the baby as a reason to go forward with the pregnancy, instead of just to induce according to any guidelines, but to look at the individual case. And fortunately my baby was healthy up, right up until, until birth, even though he was so late.
 

Relaxing in a birthing pool helped her rest during labour, but she wanted to get out for the...

The midwife unfortunately arrived right when the contractions had slowed down, and that meant that the inf-, on the information that she received when she arrived home she concluded that I was in early labour, which I wasn't. But that was, that was, I was definitely showing the signs of being in early labour because I had slowed right down and, but so I misled her a bit there, and she went off to have breakfast. And we ended up phoning her in, well, my husband ended up phoning her, I should say, in a bit of a panic about 45 minutes after she went to get her breakfast elsewhere, away from the house, because I really began to feel that I needed her. I needed her for some advice about when to get into the birth pool, and I needed her because I was a bit, I was a bit frightened by the fact that I was feeling these urges to push and I knew that it, it wasn't time yet, but I needed help in restraining myself.

So she quickly came back from breakfast and advised me to get in the pool, which helped me to resist these urges to push. It helped enormously. All the time I would say that the pain was great, the pain was great but I never really thought about using any pain relief. It was a huge relief to me to get into the water but at no point did I feel that it was out of control and that I really needed any, any extra help. The support of my husband and my sister and the independent midwife who was with us was, was really helpful as well.

So is the baby actually born in the pool?

The baby was not born in the pool. I came to a point during the labour and, after having been in the pool I would say probably an hour, although my memory fails me slightly, that I was basically dead to the world. I was flopped over the edge of the, of the pool and I had expended all my energy in trying to resist this urge to push for such a long time. I was very tired and my midwife really helpfully suggested that, if I could, 'Go and sit on the loo for a while, just have a change of, of scenery, and drink a little bit of water and have some honey on a spoon'. And that, that helped me a lot to get my, to get my energy back. Probably just the effect of having been in warm water for such a long time. If you imagine taking a bath for an hour, really nice warm bath for an hour, it does wear you out a bit actually. So, so that was really helpful to just have a change of scenery. And once I'd been out of the pool for a few minutes it had served its purpose, I was up and running again and with a lot more energy. And then, then I was ready to push and the, and the second stage of labour really started in earnest.

Having a home birth in familiar surroundings with good support was a very positive and fulfilling...

Well, if I were offering advice to someone who was considering a home birth, I would say, unless there's a real medical reason not to, 'Go for it'. I found it a really fulfilling experience and I really appreciated all the choices that I was offered. I didn't feel like I was part of a system that was grinding on regardless of me. I really felt like an individual person during the whole process, and that was really, that was just really great. I've spoken to some of the people with whom I was taking prenatal classes and they, they say things like, 'Yes, I had a dreadfully long and difficult and painful labour. And is there really any other way?' And actually there is another way, and I experienced that way. I'm just really grateful for my experience, I just can't believe, it was, it was beyond my wildest dreams really. Having a birth at home allowed me to be in my own setting, where I felt comfortable, and to have the people around me that I wanted to have around me, in their own setting as well or a setting that they felt comfortable in. And, and it just allowed me to make those free choices. And that gave me exactly the kind of birth that I wanted. And as many things as I was worried about that could go wrong, none of them did.

Now I know that a home birth may not be for everyone, there may be reason, medical, real medical reasons why it's impossible. But, but I think that on reflection the, the number of medical reasons that are given for why people couldn't have home births may be larger than the actual real number of women who wouldn't physically be able to give birth at home. And it's a matter of, of deciding whether or not the reasons you may have been given that home birth is not the right option for you, are they valid reasons or are they not?