My fourth pregnancy was quite difficult as I suffered with obstetric cholestasis (OC), causing itching and disturbed sleep. I was visiting the hospital at least twice a week for monitoring in the last trimester and expected to be offered induction at around 38 weeks. Although a little nervous about induction I felt it was probably a sensible decision based on the research I had done. Most medical guidelines on pregnancy complications can be found on the NICE website (http://www.nice.org.uk) but not OC and so I read the Royal College of Obstetricians and Gynaecologists (www.rcog.org.uk/guidelines) green top guidelines which helped me to understand the risks associated with the condition and what treatment may be effective.
As it turned out I didn’t need an induction as I started labouring one evening a few hours before I reached 37 weeks. It took a little while for me to realise that I was really in labour as I was preoccupied with making a birthday cake for my eldest daughter’s 8th birthday, due the next day. Fortunately, my Mum had the foresight to pack an overnight bag and when we called her at midnight she came over to look after our three girls so my husband and I could go into hospital. One of the risks associated with OC is merconium aspiration (when the baby is distressed, they poo and then breathe it in) and it was recommended that our baby be monitored during labour in the hope that if this happened it would be spotted and acted upon. Labour did not feel very urgent, however, and I saw no advantage to going in too early. I was happy listening to my Natal Hypnotherapy labour companion and relaxing birth music CD’s and felt very calm. Although the contractions were intense, I found positions which made them manageable and my husband found a good massage technique.
At around 2.20am we decided it was time to go in to hospital and as we got ready to leave my waters broke and I knew from experience that I would soon be pushing out our baby. I estimated about 20 minutes until birth and about a 30 minute journey to hospital and also realised that there was no way that I was moving from the position I was in, crouched on my bedroom floor. Fortunately there were some dressing gowns and towels hanging nearby which we hurriedly threw on the floor under me and rang the hospital to let them know we were not going to make it on time. They suggested that we call for an ambulance crew who would assess the situation and call a midwife if necessary (although a planned homebirth is considered as safe as giving birth in hospital, an unplanned one may not be). I did not feel concerned about these events as I had previously had a homebirth and knew that even if my baby was struggling the quickest way out was now to be born on the bedroom floor so I concentrated on what I was doing, relaxing and letting labour run its course.
Within a few minutes an ambulance crew arrived, and despite lots of noise, questions, general chat (about torches!) and multiple offers of pain relief, I was able to continue with what I was doing and push out the baby. The first comment I heard after our little girl was born was ‘Ohh it is not like that on one born every minute!” which made me smile. I think the ambulance crew were used to arriving at the scene of an accident where the injured need conversation to keep them conscious and immediate pain relief – not necessarily what I needed during birth but fortunately I was able to turn my music up loud enough to ignore them. The midwife arrived soon after and sent the ambulance crew downstairs for a cup of tea, much to my relief, and I was able to have some quiet, calm skin to skin cuddles with my baby whilst waiting for my placenta to come out.
Our baby was grunting a little when she was born and had merconium around her face and so we were advised to go into hospital so she could be monitored for 24 hours in case she had breathed some in. It was now about 4am and so we asked a few questions and found out that the monitoring consisted of taking her temperature and recording the number of breaths per minute every four hours. We felt confident that we would recognise any signs of illness in our seemingly very healthy baby and decided to wait until morning – about 4 hours after the midwife had done these initial checks)- to go into hospital. This meant we could spend a few hours resting before being able to introduce our new daughter, Sophie, to her three sisters. The oldest, Joanna, being the most excited as she had arrived on her 8th birthday. Sadly, we did spend Joanna’s birthday in hospital but all was well with Sophie, and we left at tea time with lots to celebrate the next day.