Guest blog by Emma Jean Photography
Emma Jean has been kind enough to allow me to share this beautiful blog to shed light on the safety of home birth in Australia. Midwives are trained and capable of handling challenges that may arise at a birth without interfering with the connection of mother and baby.
The birth story of Luke – a Brisbane home birth
(focus: What midwives bring to a home birth)
As the sun rose on that warm summer day Laura was laying in bed fast asleep. Her due date was approaching, only days away and she knew any day could be her last day of pregnancy. On Tuesday the 15th of October she woke to the feeling of water trickling down her legs and she knew today was the day she would meet her son.
She called out to her partner Matt who woke quickly (good job Matt!). As this was Laura’s second baby she expected contractions to start fairly quickly the way they did with her daughter Hallie’s birth, but nothing about this birth was going to be the same. While Hallie was born in a hospital with an epidural and vacuum extraction. This resulted in a significant haematoma on Hallie’s head. That is why this time Laura planned a homebirth supported by the midwives from “It takes a village midwifery”. Meg Clein was her primary midwife and Maet Pearson was her second midwife. https://www.ittakesavillagemidwifery.com
The surges starting to intensify around 1:45pm when Laura describes feeling a “crick crack sensation in her pelvis” followed by an intense surge and she knew her labour had ramped up and she needed to inform her support team. When I arrived at Laura’s home she was breathing through her contractions listening to her hypnobirthing meditation tracks, swapping between using the TENS machine and resting on the bed. However it wasn’t long before she moved into the birth pool where she stayed for the rest of her labour.
Meg arrived with her usual kit that she brings to every homebirth. I often see lots of people who haven’t had a homebirth and don’t understand what happens at a homebirth questioning “what if something goes wrong? What if you bleed, or the baby needs resuscitation or there is another emergency?”
Homebirth midwives do not arrive at births with a bit of sage to clear the air and a hope and a prayer. They are highly trained professionals who come with the equipment needed to deal with emergency’s that MAY arise. In truth there is far fewer emergencies at home births due to the lack of routine interventions that can lead to a cascade of intervention.
So what does a homebirth midwife bring to a birth? The essentials of course, gloves, blueys (large sanitary pads), lubricant gel, a doppler and or pinard. A stethoscope and sphygmomanometer (blood pressure monitor), cord clamps, sterile scissors and documentation records.
Oxygen tank, bag and mask, and suction for resuscitation purposes. Syntocinon, and retractable needles if required to help the placenta birth or in the case of a postpartum haemmorrhage. They also bring syntometrine and misoprostil which are also drugs used to help with bleeding postnatally. Catheters which can be used if a woman is unable to pass urine or is having a postpartum haemmorhage as a full bladder can be a contributing factor to bleeding. Needles for cannulation purposes if a women requires IV fluids. Suturing materials if a women requires perineal suturing.
Birthing pools are supplied to the woman if she chooses one in the lead up to her birth. A mirror to assist with seeing the descent of the babies head in the birthing pool, a torch, a water heater, thermometer, and water pump to remove the water from the pool.
Some midwives also bring a birthing stool, rebozo, essential oils like clary sage and Cyprus oil, massage oils, homeopathic remedy’s, herbs and tinctures, accuneedling supplies.
Laura breathed through each surge as they flooded through her body and relaxed down into the pool as they faded away. Hallie her little girl watched her knowing that soon her baby brother would be born. Hallie stroked her mother’s arms and forehead, trickling water down her back and offering her sips of water between surges. There was no need for her to be scared or worried as she could see her mother was surrounded by support and love.
The sun started to set and the second midwife Maet arrived.
“I continued to labour. I needed to squeeze Matt’s hands during each surge. My entire body shook with each surge. I started to feel the baby move down through my pelvis. It felt like he was coming out of my bum! Each surge had three peaks to it. I had to vocalise through these. The midwives had me take my bra off in preparation which was a relief”.
“I was nervous of the head crowning and the ‘ring of fire’. Meg encouraged me to reach down and feel my baby’s head. It was difficult as I needed both of my arms to support myself. I eventually was able to feel his head. He was starting to crown. It was all squishy and I could feel he had quite a bit of hair. His head moved forward and backwards for quite some time. I felt the ring of fire at times but it wasn’t as intense as I thought it would be.”
“ The midwives encouraged me to either give an extra push or to breathe quickly to allow everything to stretch. They told me each step of the way how much of his head was out – eyebrows, eyes, nose, upper lip. His head was all the way out. It felt like someone was wiggling him trying to get him to come out and I asked them to stop. One of the midwives replied, that it was my baby rotating and no one was doing anything.”
“He was out with the next surge. I moved from kneeling on to my back in the pool. The water was so murky I couldn’t see where he was- ‘where is he’ I asked and the midwife passed him to me under the water so I could lift him out”
At 7pm Luke was born, a beautiful big healthy boy. He had the same eyes as his sister which was one of the first things Laura noticed. Laura held him to her chest and rubbed his back to help stimulate his breathing.
The midwives helped to rub him to stimulate him to breathe as he had not yet started to cry.
They encouraged Laura to blow in his face and give him a small puff of air by filling her cheeks with air, sealing her mouth over his nose and mouth and puffing the air into him.
The midwives listened to Luke’s heart which was perfectly normal. He was still receiving blood and oxygen through his umbilical cord which remained pulsing for several minutes after his birth. Luke’s colour quickly turned to pink but he still did not start breathing on his own.
At this point the midwives placed him on a board and started giving him some respirations with the bag and mask. At no point was Luke taken from Laura as it was not necessary to separate mother and baby.
It wasn’t long before Luke started breathing on his own and Laura hopped out of the pool, still attached to Luke so the midwives could continue to monitor him closely.
Luke was now given some supplemental facial oxygen while he stabilised his respirations. Both Laura and Matt were always close to him, talking to him and being informed by the midwives about what was happening.
Finally Laura could lay down and rest with Luke in her arms as the midwives looked on closely monitoring them both and rejoicing in another beautiful birth experience.
“We got out of the birth pool and I lay on the carpet with Luke and cuddled him. After a good period of time I handed him to Matt for skin to skin while I tried to birth the placenta. I was surprised at how intense the surges still were to get the placenta out. It made me quite anxious about passing the placenta. Eventually after trying all options I chose to have the syntocinon injection to help me to get the placenta out. Only a second after the injection was given, I started to get stronger surges.”
Note the white cord which has been drained of all the blood allowing Luke to receive his full blood volume.
While Laura focused on birthing her placenta, Matt took Luke out to meet his big sister who was waiting up watching movies and playing with her Gramps who had come to look after her.
Hallie was so excited to finally meet her baby brother.
After birthing the placenta Luke was able to have his first feed snuggled skin to skin with his Mummy.
Meg weighed and measured Luke, making a full well baby assessment of his reflexes, heart beat and respiration. Luke weighed 3.91 kg. After monitoring Luke’s respiratory effort the midwives recommended to Laura and Matt that they transfer him to hospital for further monitoring as he was making intermittent grunting sounds which indicate he was working slightly harder than normal. He had no other symptoms of respiratory distress. Laura and Matt transferred to the hospital supported by their midwife who attended with them.
After spending two nights being monitored in hospital Luke was discharged home. He had no signs of infection, he always had good oxygen saturation levels and maintained his blood sugars. It was determined he had some fluid to move off his lungs and is a perfectly healthy baby boy.
A few final thoughts from Laura on her birth
“Meg and Maet had discussed with me during my pregnancy that as I was on medication for depression, despite it being a low dose this medication is known to have a side effect of some babies being slower to transition at birth. They prepared me for this possibility and is one of the reasons why I didn’t panic when Luke didn’t cry and breathe on his own immediately. They never encouraged me to stop taking my medication and were very supportive that I continue with this as my mental health was made as much a priority as my physical health. I had never before been informed that this was a side effect of this medication, but it was reassuring to know this before hand.
As Hallie was taken from me to the special care nursery following her birth, it was a great fear of mine to be separated from Luke. To be able to have him receive support breaths and then oxygen whilst still attached to me via the umbilical cord and still on my chest was very reassuring. it changed what could have been a scary event into a calm and peaceful event. I felt like I received very wholistic and thorough care from my midwives through my pregnancy. This gave me great confidence going into labour and birth. I still can’t believe that I birthed my 3.91 kg baby with no pain relief, no tears and not even a graze.”
If you would like to see more of Emma Jean’s Photography please visit her website.