From MIDWIFERY MATTERS, Issue No.95, Winter 2002
Kate
I was an avid follower of events on the homebirth site while awaiting the arrival of my son Isaac. I had numerous hassles with my intention to have Isaac at home and my ongoing saga was relayed daily on the homebirth list - first they told me that I was unlikely to be allowed to give birth in water at home, and I was even given dates when I could not go into labour. I have already made one complaint about the fact that I wasn't given the support required for a home water birth, and the letter I received back more or less said, "Well you got what you wanted in the end so why moan?" OK it was a lot more polite than that, but in fact I did not receive the service I wanted and so here is my story.
I would welcome any thoughts on how I might complain effectively - I would like to find the energy to do this as I want my experience to become as useful as it can be.
I remember trying to make sense of my feelings a few days after the birth - everything still confused in my head - all I knew was that I didn't want the midwives to come near me - and then it came to me - I felt abused. I told my husband about this and as I started to explain how I felt I realised that this experience had left a very deep gaping wound.
Isaac John Pavey was born on 14 March, 2002.
I think I'm at a place now to be able to communicate my home birth experience with little Isaac. He is now six days old and it has taken me this long to understand how I feel. I went into home birth full of expectation and the hope that I would have an unhurried, relaxed, as near natural experience as possible. I wrote my birth plan thinking that I would be understood by those who were caring for me and that they would endeavour to carry out my wishes.
I came out of the experience feeling cheated, robbed and confused. After a couple of days of practice contractions, I finally went into labour at about midday on Thursday 14th March. The contractions were mild and about 20 mins apart so we decided to take a trip out to the toy library to borrow a slide for my daughter. We then went for a MacDonalds and headed home.
My DH said something about going into work the next day and I told him that the baby was coming tonight and that we had better start getting ready for him.
At about 4 pm I noticed that I had a trickle beginning below and put a pad in. Next thing mid-contraction while kneeling on the floor my waters went. I said, "My waters have gone," and burst into tears. I hadn't wanted them to go so early.
Thinking we should inform the midwife, DH phoned the labour hotline. First mistake! I had no idea that the midwife would turn up 20 minutes later, giving us no time to talk and prepare the scene.
Midwife 1 arrived quickly and I burst into tears again - she seemed lovely and reassured me. She then proceeded to spread her paperwork all over the floor in the lounge. Second mistake. I should have asked her to use the dining room table, then at least she would have had somewhere else to go and the relaxing scene I had anticipated wouldn't have been cluttered with paperwork. Still we had candles and music, the lights were dimmed and the pool was being filled.
Midwife 1 informed me that Midwife 2 was to be arriving soon as she had attended only one waterbirth before. (I later found out that the baby had nearly drowned!)
DH was attempting to time contractions and massage me through them as he had done during my daughter's birth, but the midwife had started to get in the way. She went through the birth plan and told me that it was all fine and then went through several scenarios where she would feel it necessary to transfer me to hospital. One of the reasons for transfer would be if labour slowed down. When I questioned her as to why she gave me a look as if to say, "Why are you questioning me?" She didn't really have a plausible answer but muttered something about the fact that my membranes had already ruptured.
She wanted to examine me now even though I had requested to no internals. Third mistake - I allowed her to examine me and endured a very painful internal which left me sore, 3cm dilated.
By now my DH and I had lost the flow - but persevered even so. From this time on in things started to happen very quickly. The contractions got closer and closer together and I had gone very quickly from every 20 minutes to every 3 minutes.
Midwife 1 was reluctant for me to get into the pool and I assured her that I would wait until I really needed to. When this point arrived she wanted to examine me again and also wanted to phone for advice. Mistake no. 4 - I allowed her to examine me again. I was now 5 cm so she 'allowed' me into the pool.
Thinking back now, she very quickly crushed my belief in myself - everything I said about labour and waterbirth she slightly contradicted, always putting herself at a greater power differential. I am annoyed that I allowed her to dictate what I should and shouldn't do from so early on: I allowed her to follow me to the toilet and I allowed her to snatch my DH's role away from under his feet.
Once in the pool I felt calmer, but the contractions were now coming thick and fast and I was finding it difficult to focus. The atmosphere seemed chaotic to me. Midwife 2 had now arrived with her 'expert' knowledge of waterbirth. The midwives talked loudly amongst themselves. In between contractions they chatted about insignificant nothings; they answered their seemingly constantly ringing mobile phones noisily and within earshot. All these things I had outlined on my birth plan as no-nos. OK, I didn't specifically refer to mobile phones, but please.......
I spent my contractions in the pool, leaning over the side moaning into DH's chest, more to block out the noisy background than to express pain. At one crucial point I shouted at someone to turn off the music - perhaps now they would realise - I even said, "Shsssssh, be quiet!" - but no-one seemed to hear me.
I soon felt unable to cope with the intensity of each contraction and willed my body to stop - to give me some respite, to slow down. I was out of control and wanted to regain it. Soon the contractions had started to wane slightly - but I could feel my baby moving down even between contractions.
Then I first picked up on the panic - Midwife 1 began to fuss, touching my tummy during contractions - talking to me, asking me if the contractions were as strong - was this a real contraction? She checked the baby's heart beat and it was fine - there was no distress. I knew why the contractions had slowed and I was glad - I didn't want to carry on - I wanted space and quiet.
Then the bullying began - I suggested that I got out for a while - I was conscious that they might want to transfer me if this carried on. They began to make what seemed like frantic phone calls to ask for advice. Then they had me marching up and down the stairs.
Mistake 5 - another internal might speed things up. I now felt useless, totally unconfident in my body's ability to do its job. I allowed Midwife 2 to do an internal and while she had her hand up me in mid contraction she informed me that she was going to sweep my membranes. Ouch!!!!!! I never even consented to this!
Then the contractions took on new fervour and I felt unable to cope - I re-entered the pool and flailed around uncontrollably. They kept nagging me to tell them if the contractions were getting more pushy. Now I felt as if I was manufacturing everything and I was desperate for it to end.
Eventually I could feel the head with my hand and they told me to push - I wasn't even aware any more of where the contractions were at - I just pushed with all my might. His head was born quickly and sat there. After checking for the cord they nagged me to get the body out. Midwife 1 started pushing on my abdomen and then her hands went down to try to pull him out of me. At this point I turned on her and said, "Please leave it alone," so they withdrew and instead instructed me to push and pull.
My one saving grace was that I had pulled him out myself.
I managed without pain relief until moments before the birth when I had had a few lungfuls of Entonox, which helped me relax, if nothing more.
When I got out there was more nagging for me to expel the placenta and Midwife 2 even resorted to squeezing my nipples - again without my consent - in an attempt to get baby to suckle! So you see how I must feel. It took me two days to finally feel some attachment to my son - after the birth I just didn't even want to hold him.
Now that my hormones and my emotions have settled down I feel a lot more positive. Midwife 1 came to visit and I hid - I couldn't face her so DH explained to her how I had felt about the experience.
DH felt bad because he hadn't picked up on my cues and hadn't told the midwives to leave me alone. As I got out of the pool I told him, "I never ever want to go through that again." How different from my birth experience with my daughter.
I can honestly say that we had more privacy in hospital than at home. I can fully appreciate now why people go for unassisted births.
For me, if there is a next time, I will hire an independent midwife and make sure she fully appreciates my needs and wishes.
I haven't spoken to the midwives concerned as I still don't think I could face either of them personally - you have to understand that as a midwife you have a huge amount of power over a woman in a very vulnerable place - I am usually quite forthright and not afraid to say what I think (ask my friends) but both times when I have been in labour I have been quite the reverse of this.
My DH did speak to the midwife, however, and went some way to explain how I was feeling - she basically didn't get it at all. Friends who have also been in her care have informed me that she is very much hands on and a bit of a control freak - which I guess is a little understandable.
I spoke at great length with my community midwife who understood my feelings but wouldn't comment. I find that most health professionals nowadays go to great lengths to cover their backs and admitting any failing is a no no. I felt basically that everyone I spoke to was saying, “Well you have a healthy baby and a normal delivery at home, which is what you wanted - so what's your gripe?”
I want to complain because I feel that what is being totally overlooked here is the environment in which I wanted to birth my baby. I made this clear - but, as my DH said, these midwives need retraining away from a medicalised approach. I made it clear that I wanted a dark peaceful environment and conversations to be made out of earshot - as far as I can see and from reading the notes there was nothing to indicate the need for talking loudly joking about daughters playing netball etc. etc.
I felt usurped of power and undermined in my body's ability to do the job it was made for.
A panicky midwife is no good to a woman in labour - so why send one who was totally terrified of water birth because she had nearly witnessed a death?
You could see the relief on her face when the baby was born.
LW updated February 4, 2005