Call the midwife: a Home Birth in the Holly Cottage

Right so - those of you who are squeamish or who have no interest in the intimate details of getting a baby out of a woman's body...feel free to stop reading right now. All others, continue at your peril...

So. You're having a baby. You'd like to have a natural birth. You're forty. You've read all the stuff about how the scale of interventions and C-section in hospitals in Ireland are on the rise, and the odds of having a natural birth plummet sharply once you walk through those gaping doors of the nearest maternity unit. You're still wincing from the memory of the episiotomy (Google it boys...and cross your legs in solidarity with your women folk) first time around. Where do you go? Who do you turn to?

Call the midwife. 

And I did. I called a few in fact. And they were all wonderful. Forget the consultants. They are useful for when there are problems, real problems. The midwives are the superwomen, and supermen (of course). 

Having explored a few different avenues I settled on Neighbourhood Midwives, now known as Private Midwives Ireland. From week 30, after a few very debilitating and frustrating visits to the consultants in the HSE (I promised myself I wouldn't go on a rant about that here but I'm open to hours of such ranting if anyone wants to indulge me!!!) all my antenatal visits were held in the kitchen of our home, Holly Cottage. Tea being one of the important opening rituals of all the appointments, this was quickly followed routine checks, paperwork and the wonderful listening in to the baby's heartbeat. That was my favourite bit. Relief, joy, love - all those emotions rolled into those precious moments when baby Oscar - who was just baby at that time - was revealed to us by wonderful technology. No long hospital queues, no impersonal rigmarole, no processing line. The midwife visits were as easy and as casual as that, yet markedly professional and deeply respectful. I also have to mention the support from UK Birth Centres team - Linda in particular. This is the mothership behind Neighbourhood Midwives and the backbone for the limbs in Ireland. Even when my mother passed away five weeks before Oscar was born, Linda was there supporting me in my decisions and being a welcome friend from afar. 

So we got to know each other, a little bit at least, the midwives and the residents of Holly Cottage. And that was important, as delivering a baby is a pretty intimate act and one certainly needs to feel safe in the hands of the ones doing the delivering. And I did, we did. Sure there were moments when the scaremongering peeked it's ugly head into my steady thinking - but that's why I told only those few people around me who knew us best and knew to trust our decision. Who needs negativity at a time of such positivity?

And so, the due date came and went. Despite strong opinions that he would come early, Oscar arrived fashionably late on a bright and sunny afternoon. When the pains started at 3am, I called our primary midwife, Madeleine, immediately, and she was over in a flash - although I'd love to say she flew as superheroes do, she did arrive by car. And she watched and waited, and watched and coached patiently and discretely as I continued in very casual labour up until about midday...and that was when the fun began. 

Love Love Love

Pain is relative and while some would say it's in the mind, it sure as hell is manifested in the body. What worked for me? Breathing through the pain, letting go of each contraction one at a time, not thinking about the last one or the next one, not thinking, just being. Just breathe. And pressure from the man on the main action area for me, my lower back. With a few hours to go I sank into the birthing pool. OMG. These should be mandatory for all births - home and hospital, and anywhere in between. Such sweet relief and comfort in all that balmy heat. So I stayed there for the next couple of hours, breathing and doing plenty of oohing and aaaahing. Thank the universe there was no video! Tea was made and drank, the neighbours kids went and came home from school and I could hear them playing in the garden next door as Oscar pushed through for his final descent. Surprisingly and incredibly, I actually did try to escape in those last minutes - to who knows where, and to what purpose not even I know, but I did - it seemed perfectly rational at the time. And just as all about me had convinced me that an escape might not be such a good idea, the final descent was over and our little man was there in my arms. All eight and a half pounds of him. He was expertly guided out at 3.59pm on May 16th 2016 by Midwife Madeleine (no tears, no dreaded episiotomy - phew!) while Midwife Gail whispered affirmations in my ears and held me steady. Literally. 


And once he was out...well there was only great joy and celebrations. More tea was made, a placenta delivered and cord cut only when the last of the goodness was transferred back to Oscar. Holly finally relaxed outside once my distressing vocals subsided, Alannah came home from the minder and wondered why mumma and dadda had been messing about in a paddling pool in the kitchen without her all day, and who the hell was that bundle of joy pressed against my breast? And life just settled back quickly to its easy pace from there on and we all stared as the tiniest and newest of us quickly captured our hearts and our minds and it was like he had never not been there before. Baby Oscar. Beautiful, beautiful boy...as John Lennon might sing. 

And as we settled in to the music of his coos, our beautiful midwives packed up their bags, tidied up everything, and said their farewells. Midwife Angela tidied up the main man Oscar and checked him over - that was the last bit - and then they were gone. And four became five.

There's plenty of detail glossed over here but for the purposes of this piece here's the take home message: call the midwife. If in doubt, call the midwife. If not in doubt call the midwife. Call them anyway. They have the power to ensure that one of the most important events in your life is one that is safe, calm, peaceful and natural. What a gift and what a great skill to have. Use it! 

Beautiful Oscar

Pregnancy yoga – a beginner’s experience

Me and yogi bear 

This article was published in Yoga Therapy Ireland's Winter 2013 issue (Issue No. 56); this is the unabridged version and probably one just for the ladies, although the men might learn something too ;) 

Last December – just in time for Christmas – we found out that I was pregnant. Thus began the journey through nine months of pregnancy, to the moment of delivery of Baby Alannah Marie.

As I look back now, the nine months seem to have passed in the blink of an eye, although there were times when I felt I would be pregnant forever and I was impatient for the birth to come. But growing a baby is a very intricate process and it’s not something to be rushed! The whole pregnancy experience for me though was amazingly smooth - no back pain, no SPD or swelling, no restricted movement – except of course in the last four weeks when sitting anywhere comfortably becomes a challenge in itself (get a birthing ball – it will transform your life!). Other glamorous features that seem to be unavoidable for most women are piles and varicose veins, and the increased pressure on the pelvic floor. There were times during the last few weeks when I would get crippling darting pains in my groin area – and that’s when you realize that the pressure of a baby’s head bearing down on that ‘hammock’ of muscle is something that’s going to need some attention to ensure recovery of its function once all that pressure comes off – think pelvic floor exercises as often as possible before and after to counteract any potential problems post-partum.

One of the main things that helped me through the pregnancy, and now three weeks into the post-partum phase, was participating in the YTI Pregnancy Yoga training course between January and March this year. In terms of physical and mental preparation, understanding the whole process and changes to come in my own body, learning about the kind of problems that pregnant women in general can experience – not least how to adapt my own and my class’s yoga practice – the course was fundamental. Every woman would benefit from taking part in the course, and especially yoga teachers who need to understand how to help pregnant women to move, breathe and cope throughout pregnancy, labour and delivery, and what comes after.

I really understand now the whole thing about emphasizing plenty of cushions (for sore bums!); about being super conscientious of the softening of the pelvis in every move; and the superpower of being present in the moment – aided by deep breathing (pranayama) and meditation, along with relaxation (savasana). You don't really understand it (as I found) until it happens to you, as is the case with so many things - the classic learning by doing. But in having completed the pregnancy yoga course in my own first trimester, I had the benefit of learning from the years of experience and insight of the course leader Trish Malone and participating midwife Aileen Murphy to guide me at every stage. And pregnancy is very much an experience that changes as you go through the trimesters so you need to be aware of how your abilities change in response to your physical and mental changes over 40 weeks and more.

Never under-estimate the need and the power
of relaxation....

From about week 35, I really started to prepare myself for labour and delivery. The first stage of labour (effacement and dilation of the cervix) is about pain management and that is where breathing and relaxation coupled with a few valuable poses come in. The second stage – the actual delivery - is less about pain and more about effective pushing. As for the first stage and the contractions – wow, such pain I have never experienced before, but all positive of course. It started in earnest on a Thursday morning and by lunchtime I thought we were in well-established labour - but no! I was only 1cm dilated when I landed in Mullingar Regional Hospital at 4pm - but the cervix was completely effaced and they kept me in. We sat in a room and waited, and waited and then walked outside to the shop (probably weren’t meant to - but I knew they wouldn’t kick us out) - the walking was good and helped me feel like I was keeping the whole process moving.

From about 10pm the crippling back pain began and we realised labour was only then well established even though I had thought the pain couldn’t get any worse. The baby had started to turn her head for some unknown reason and while she had been perfectly poised for delivery for at least 5 weeks previous, this turning resulted in serious lower back pain. I couldn't walk. The midwife was 100% supportive in helping me with a natural birth as much as possible and suggested a hot bath. I actually couldn’t get into it with the pain and ended up heaped on the ground beside it instead. The best position I found for this phase was kneeling on the floor over the birthing ball, with my husband putting direct pressure on the lower (very lower) back pain area. It was difficult to keep the breathing going but the midwife was great in reminding me - she wasn’t taking any nonsense and just kept saying Breathe Catherine breathe. You really need to hear it as opposed to relying on yourself to do it when you're in that kind of pain, and you need someone to be firm and authoritative – so bear that in mind when you’re preparing with your birthing partner.

I managed to get sick at this point and it was then that I reluctantly agreed to take pethidine, as I was still only 2cm dilated by 10pm. The pethidine didn’t take the pain away entirely but it softened the blow. That was when the magic started and because I was more relaxed, I went from 2cm to 8cm by midnight. Once we got installed in the labour ward I was given a small dose of sintocin to progress the last few cms, and I was making the most of the gas and air. When the time came for pushing, the pressure was unbelievable as the baby worked her way down - it was five contractions and three pushes with each and she was out. I did have to have an episiotomy at the last minute, but I didn’t feel it. It didn't frighten me at the time and I just went with it.

After the delivery early Friday morning, I didn’t sleep really until Saturday - home by Sunday, and since then every day is a learning curve. The stitches were very sore in the first week but daily baths with tea-tree oil and a strict policy of taking it easy helped me through. Now at nearly three weeks I can take a short walk but I realize that I must take the time to let my body recover so as not to hinder its long-term recovery. I am limiting myself to relaxation, breathing and meditation for another three weeks and no rushing back to headstands or ambitious poses that I might think I can get back into, but why would you stretch your body when it is still in self-healing mode?

In other aspects, the breathing helps for the initial stinging pain as herself latches on to a tender breast in the first weeks, and those difficult first bowel movements when you realise that sometimes going to the loo can be far worse than labour and delivery - it’s probably the thoughts mixed with the physical so best to think happy thoughts on the loo!

Having shared our experiences during the YTI Pregnancy Yoga course, and now having experienced the whole thing first hand, it is more apparent to me that every person has a different experience of pregnancy and labour and that really the mental preparation (relaxation, breathing and meditation aids) is probably as important if not more important that the asanas in the pregnancy yoga classes. Overall I found the following worked for me - regular walking at all phases of the pregnancy; daily breathing and meditation (about 20-30mins) and at least 15-20mins asanas - either while gardening or outside or a dedicated indoor session, which wasn't always feasible time-wise or physically. I was basically chopping the tops off the spuds and working in the garden up until the day before labour and I had plenty of strength in my legs, arms and mind - enough to go the distance and enough to go beyond that if necessary. I found the contractions during effacement and dilation of the cervix the most difficult – keep up the breathing and the asanas to maintain your mental and physical strength – endurance is necessary, while the pushing was easy enough (if there was an easy) and I put this down to squatting from the beginning to the end (I was deep squatting up until 36 weeks).

And the prize for all this pregnancy yoga and preparation and investment? Well, I just have to look at Alannah Marie to know that it was all worth it and that I’d do it all again in a heart beat. And I look forward to sharing the experience and helping other pregnant women on their journey through my own pregnancy yoga classes.

Catherine Wilkie is an ecologist based in the midlands, working to restore and rehabilitate degraded wetland, peatland and woodland habitats, both in Ireland and also within the global context. She completed her Sivananda TTC in 2008 and took part in the YTI Yoga pregnancy course in 2013, inspired by her own pregnancy. She loves to write, stand on her head, walk in the woods with new arrival Alannah, and spend time with her husband and their dog Holly in their kitchen garden. She writes about all these things in her blog www.hcottage.blogspot.ie