My pregnancy had been relatively easy and problem free, and I had had my heart set on a home water birth from very early on.
I had had a difficult birth with my first baby 2 years ago. Despite being fully dilated in a MLU pool using my Hypnobirthing training and techniques, my baby became stuck in brow position, and I ended up on the syntocinon drip, and then with a forceps and ventouse- assisted delivery. I had been proud of how I had managed the first part of the labour, but left disappointed with the way things had turned out at the end.
So this time around, after studying my previous birth notes in depth and gaining a real understanding and acceptance of what had happened, I was determined to aim for the birth I wanted this time, but also kept an open mind as I now knew how unpredictable labour and birth could be.
So now armed with all the new confidence and extensive knowledge from the course, I was really excited about the birth and the prospect of being able to practice hypnobirthing once again.
Everything was going really well with my pregnancy, until at 36 weeks, I started to get really itchy skin all over and I would scratch myself throughout the night. Knowing this was a symptom of Obstetric Cholestasis, I went to get it checked out, and after several blood tests, it was confirmed that I did have it.
Knowing that this could throw a ‘high risk’ status over me and my natural home birth plan, I researched the stats and guidelines thoroughly, knowing that I would have to fight against a push towards an early induction.
I challenged initial midwife and consultants suggestions, used the B.R.A.I.N.S. framework, and had my blood and bile acid tests repeated.
My bile acid levels increased from 13.5 to 130 in just one week (0-14 being normal, anything over 14 indicating Obstetric Cholestasis, and anything over 100 being extremely severe In which case a urgent induction at 37 weeks is strongly advised)
Despite being incredibly sad at the prospect of being induced in hospital, having researched the stats, I knew that my baby and I were at risk, and an induction at 37 weeks was clinically justified in my case. This helped me come to terms with the situation very quickly.
Only having 2 days to prepare for the induction, I quickly reframed my mindset, read the whole of ‘Why Induction Matters’ by Rachel Reed in one evening (as recommended by Katharine – a fantastic book with excellent evidence based information) and practiced all of my Hypnobirthing techniques, along with spending some lovely relaxing time with my husband and 2 year old son. We went for meals out and watched some of our favourite films. I treated this time as ‘early labour’ and did all that I could to get my own oxytocin flowing.
I was determined to have a natural delivery this time, my one dream, and I truly believed that If I could control my mind, my body and own oxytocin could work with the induction process, and I could achieve it.
I knew I wouldn’t be able to have my husband with me until I was in established labour, which was another stress factor, so I really had to fill myself with positivity and confidence.
Whilst awaiting the induction process to start (I was waiting around on the ward for most of the day – it was a busy day there and the ward was understaffed) I watched uplifting videos, listened to lovely messages from friends and family wishing me well, ate a lot of my favourite snacks, sat outside in the late afternoon sunshine (it was a beautiful day) and looked through family photos of my husband and son. This all made me feel really happy, relaxed, full of love and positivity and I just had a feeling that my oxytocin was flowing and I was on the verge of labour already.
I was induced with the pessary at 10.30pm on Sunday evening. On the first consensual vaginal examination with membrane sweep prior to this, the midwife found my cervix to be anterior and very ‘favourable’ with my plug coming away instantly – I believe that this was partly down to the natural oxytocin I had produced throughout the day.
This was a great start, it meant that the sweep was not painful at all, and I was once again filled with confidence that this induction would continue to be positive.
Within about 10 minutes of the pessary being inserted, I was experiencing surges. They intensified very quickly, with hardly any rest period.
I started to lose blood (which they believe was my cervix reacting to such intense and fast progress)
Because of this I had to be monitored constantly from the start and had no time to get up, move about and arrange my things (luckily I had most of my birthing bag next to me and in reach) I really did miss having my husband at this point. The midwife was great, but she was incredibly stretched and I would be on my own for long periods.
I used my up breathing with my sunrise visualisations the entire time, this kept me calm and relaxed whilst dealing with the intensity of the surges on my own.
The visualisation I had practiced throughout pregnancy was a sunrise in the Maldives (where me and my husband spent our honeymoon) this always evoked happy memories, and during labour, without thinking I added an image of my little family watching this sunrise – me, my husband, my little boy and my new baby. I visualised this scene with every surge and up breath, and this image for me served as my own positive affirmation and a goal to aim for – the completion of my family.
This became such a powerful tool for me.
Despite being strapped up to the monitors, I managed to move onto all fours, holding on to the head of the bed. I kept moving through the surges, using my pregnancy yoga moves that I had learnt and practiced for months.
Due to more blood loss and the rapid pace that I was progressing, they transferred me to the delivery suite at 3cm dialated (around 1am) and called my husband telling him he should start to make his way (due to having to wait for childcare to arrive for our son – my mum) it was going to take him about an hour to get to me.
In the delivery suite, the surges had cranked up several notches again, but I kept breathing through them and remained on all fours. It took a bit of extra effort to maintain this position due to the short cords on the monitor straps restricting me, but I was determined not to be on my back.
At 2am, my husband arrived. With more blood loss, several doctors were called to examine me. I was still only 3cm dilated, which knocked my spirits and I started to doubt I could carry on without pain relief (I had had nothing up until this point- no time to get the TENS machine out and set up, and I had refused gas and air due to it making me feel sick)
But after consenting to having my waters broken, things sped up instantly. Within 40 minutes I went from 3cm to fully dilated.
My midwife was incredible, having seen her several times in the Day Assessment Unit during my cholestasis monitoring, she knew me and my birth preferences, and knew how important being mobile and off of my back was to me.
I was so lucky that this same midwife was on duty on the labour ward that evening and she made a special effort to come and be my primary carer. She helped me stay mobile.
Due to me moving, the monitor straps began to move around, meaning that baby’s heartbeat kept being lost. As I was struggling to maintain a cooperative position for the monitor straps, my midwife quickly suggested that she use the fetal scalp electrode as she was worried about the loss of heartbeat monitoring. I had to get on my back to have this attached, which I reluctantly agreed to, as I was worried I wouldn’t be able to get myself back up again, but I knew I had to In order to find baby’s heartbeat.
This was quite a fraught time, especially for my husband. Due to not being allowed to any of my pre-natal appointments and any of the early labour, he was almost coming into established labour blind, with no briefing and not knowing what was going on. For him, he had just heard the words “significant blood loss” and “loss of heartbeat” without any background or the correct context, so naturally he was extremely worried. However, I remained relatively calm and focused throughout.
Despite the situation for my husband, he remained my rock and I feel so lucky to have had him there to support me and hold my hand for the last stages. To anyone reading this due to give birth with COVID restrictions preventing their partners being there for all or part of labour, yes your birth partner is important, but you can also do it all on your own too – filling yourself with information and confidence beforehand to essential. “Hope for the best and prepare for the worst” became my mantra during the whole process.
Soon after the FSE was attached, I began to feel transition and the pressure in my bottom.
My breathing automatically changed and I felt myself breathing really hard and downwards into my bum, it was so instinctive and felt incredibly powerful and primal.
I was still on my back, but I couldn’t move and my body just took over. I then felt the head crowning and knew my baby was coming. She had come so quickly, my midwife told me to stop pushing and to wait for the next surge. I panted and with the next surge I breathed down and pushed her out. Due to this management, I was left with only a very small first degree tear, which I didn’t even notice. My recovery since has been really quick and I felt back to normal pretty much straight after.
My daughter, Cici Josephine Nodwell was born at 04.27am on 21st September 2020, weighing 6lb4 at 37 weeks gestation. The total length of labour was 6 hours.
She was put straight onto my chest, with my husband announcing the sex (we hadn’t found out previously) and cutting the cord after delayed clamping.
We had a beautiful golden hour with breastfeeding being established. I ate a much needed snickers bar and just embraced the most incredible moment with my beautiful baby girl, feeling like an absolute superhero!
And that is my birth story, one which I will cherish for the rest of my life.
Courtney x
