The Birth of Hope Elena Entwistle 31 /12 /20

At the start of lockdown due to covid – 19 in 2020 we had four children under the age of eight and really weren’t looking to expand from there. I wasn’t really sure where I was going in life anymore as all of my attempts to get into midwifery seemed to be being met by closed doors, so I was retreating from the birth world and training to be a dance teacher. But none of it felt quite right and I felt lost. As I was walking to an osteopath appointment one morning I experienced a really strong, dull, yet at times almost sharp pain in my left ovary area. “Bloody endometriosis” I thought to myself, as I was certain that this was the cause of my twinges. Because whilst I acknowledge that natural family planning is not without its pitfalls, my cycle had been regular for years and we’d struggled to conceive for a while with our two planned pregnancies. Pregnancy was not on my mind. Yet something in the universe led me to do a test that afternoon and lo and behold, positive.You see, whilst it may seem strange to write so much about the pregnancy in this birth story, I really feel that it’s all so interlinked that it’s part of it.For a long time I wasn’t sure if we should have this baby. We were busy, overcrowded and unemployed due to covid. Surely not the right circumstances to bring new life into the world. Yet I knew in my heart of hearts that this soul was destined to be with us and for the first time ever in pregnancy didn’t worry about losing the baby much at all. Something deep within me felt that this was the girl we never thought we would have and she was coming for a reason. You could say she started to direct me back to my hippy self, a part of me that I had buried following miscarriage and various forms of heartbreak.But I was terrified. Birthing Chester into the world had been a mostly good experience that I really had to fight for, I didn’t think I had it in me to go through that fight again. I didn’t know if I even wanted to experience birth again, I was trying to walk away from all things maternity and the relationship between myself and the trust I volunteered for and birthed within had for the most part broken down due to a number of reasons. I wasn’t even sure  if I could birth safely within the trust because I felt so disliked. On top of that, Gray and I started to encounter marital problems that I didn’t see coming and when I reached out via Facebook for help (in a lockdown remember so the only way really to reach out), somebody made a call to children’s services about me, no report was carried out, but the experience scarred me badly. I started shopping around various trusts, but decided that most of the midwifery led units were too far away. There weren’t any independent midwives locally able to take me on either due to indemnity insurance issues. Which left me with the option of no antenatal care, or my own trust that I was wary of. The one golden nugget that I knew our maternity team to have is a continuity of carer team called The Ivy Team. So I decided to give them a shot and plan for a homebirth, despite knowing that at that time homebirth services had been removed. One of my fellow birth worker pals knew very well what my anxieties were and my obstetric history, said to me “hopefully The Ivy Team will be good for you, you need a revolutionary midwife, you need E”.I had only ever seen E in passing during my breastfeeding support days on post natal ward, but knew her to be good by reputation. I also knew that she had undergone training on Ina May Gaskin’s farm, so figured she wasn’t likely to be too many miles away from my wavelength. She sounded like the perfect midwife for me, but life doesn’t work that way does it?!But sometimes it does! One day, just as I was in the middle of a huge crying fit over my strained marriage, my phone rings and it’s E calling to say that she was going to be my midwife. That conversation basically consisted of me crying and snotting down the phone about why I was an emotional wreck, but also that I was so happy to hear that it was her calling me! Her words to me were something along the lines of “we’ll get you through this together”. Day one of life with my named midwife! Thankfully not all correspondence would look like that, although the night before Labour did!So the pregnancy ticked on and it was tough going for scans alone, especially with my history with scans. But E was such a support. She always did her best to find a way to ease my anxieties and was at the end of the phone whenever I had any questions or concerns.As the end of pregnancy approached and we started making birth plans we discussed any plans I had that ‘went against the grain’ and I was able to share any research I had found without any judgement or Coercion. It’s always good to talk birth geek stuff! With home birth having been back on the cards for some months I started to look forward to bringing this baby into our crazy family home. But I really felt the need for privacy. Gray and I were working hard in our marriage and I believe really getting stronger, I certainly realised just how far my love for him stretched and I really felt the need to turn inward with him and protect our family. As a result I decided I didn’t want any student midwives at our birth. I did wish for our eldest child Felicity to be present at the birth, but wasn’t entirely sure how that would pan out. During a year where contact with people was minimal, my midwife visits were something I looked forward to, as opposed to something I didn’t particularly enjoy in doctors surgeries. I declined consultant appointments and the pregnancy quietly progressed without any alarm or fear. Due to the quick nature of my births and my in ward turning I started exploring the option of freebirth. When I envisaged this birth, I saw myself and Gray peacefully bringing this baby into the world in a dark corner. I had such faith and trust in E that she would sometimes be a part of that vision, but I tried not to allow her into it too much as I knew it was highly unlikely that she would be at the birth, it would be another member or two of The Ivy Team. I think I felt that I needed to freebirth over having strangers at this birth. My connection to this baby and my husband had become something more spiritual than I had ever experienced.
As is usual for me, pre-labour grumbles started at 36 weeks, but Christmas and my due date came and went. I also sat and watched the rising local covid numbers in our area and could feel the closing off of homebirth services closing in. The day before New Years eve I started using homeopathy to gently nudge things along before my home birth could be taken away.  At around 5pm that evening, as I was serving the kids their dinner, my phone rings, it was E to tell me that home birth was now off the cards again, with no exceptions. Que the big, bawling, snotty mess me again! I was seized with such terror. Please no hospital, no coercive doctors, no canulas, intervention, bright lights, midwives I either know who dislike me or ones I don’t know who don’t trust and understand me. Poor E was trying to soothe my fears on the other end, but I was a warbling mess. However, what I did hear her say was “if you go into labour tonight, call me, I am on call”. Let that sink in.
I then hang up and proceed to call every local independent midwife I know to see if anybody could take me on at 40+3. I eventually made a plan with one, the plan being to book with her at 10am the next day. But that would mean that if I went into labour that night I would need to go into hospital or completely freebirth. Apart from the fears I already had about a hospital birth, I’d be lying if I said I wasn’t also nervous about covid.I had an emergency hospital bag packed, but decided I should probably check it and pack it properly just in case.
I went to bed exhausted, but calmer. I messaged E with the plan and the closing words “I’m not too worried if I have to come into hospital tonight if you’re there. I trust you”.
I slept for maybe an hour or two before the twinges started as usual just after midnight. My bowels emptied and I felt heavy pressure everywhere in the lower part of my torso. At 1am on New Year’s Eve I noticed my bloody show had started, very light, but there. I messaged E “this could be interesting, my bloody show has started”. I could feel more pressure and gradually more pain with the tightenings, but they really weren’t regular. After a couple of hours of trying to, but failing to sleep, seeing to our five year old who decided to wet the bed out of the blue and pacing around making frequent toilet trips I decided that baby was probably going to come and called my mum to come and camp downstairs. I had encountered many uncomfortable car trips in labour and didn’t want to leave it too late. I wasn’t sure of when to call E as I knew she hadn’t read my message from 1am and so assumed that she had either been called out, or was sleeping, in which case I didn’t want to disturb her unless necessary. But those tightenings…. Not significant, but there was just a feeling. I kind of knew in my heart of hearts that this would be how it would turn out. So I called. No answer. OK, I thought, I’ll give it half an hour before calling triage. But E sent me a message asking if all was ok, so I phoned back and explained the situation. I figured that my labour usually kicks forward a few places in the car, so we made a plan to meet at the hospital and see where things were at. An interesting and new experience for me considering I wasn’t planning on having any vaginal examinations and I knew how odd my contraction pattern must look.Labour did increase in the car enough for me to realise that baby would be born on the clip end of 2020, but we had timed it earlier than we usually would as I wasn’t climbing the walls when we arrived. But then again I had already decided that I wouldn’t let myself get into a situation where I would be climbing the walls either.My emotions were so mixed as we entered the hospital, sadness at having to birth in hospital, relief at being met on the door by a midwife who I trust, but also anxious that the Labour might stop and all of this would be for nothing and I’d be so near, yet so far from having E at the birth.
But the room….. The room! I know these birth rooms well and I did not recognise it. We later realised that this room could have been a trigger because it is where I was taken seven years ago during my placental abruption. But it really wasn’t a trigger, it was beautiful! Tea lights, low, atmospheric lighting, bed pushed right to the edge of the room really just housing towels and blankets, music playing, mats on the floor, birth Ball, bean bag and most amazing of all a filled birth pool! I had never, ever been ‘allowed’ a birth pool, the excuses had always come out with every birth, no matter how many tick lists I went through pre – Birth. I mean, if I had to birth away from home, this was the way to do it, in this beautiful room with just my husband and my named midwife.So I set to doing what I knew I needed to do. I paced, urinated a lot, found various stopping points in the room for during contractions, drank water. From a clinical point of view my blood pressure was taken and that was it. No continuous monitoring, no cannula inserted, no emergency pack pointed out to me, just me left to do my thing. It amused me to realise that I must be one of few people who labours quicker with adrenaline than oxytocin! All of those weeks where I’d been encouraging oxytocin release to give birth at home and then BAM! Homebirth option taken away, huge surge of adrenaline and labour kicks in! Also, usually by the time I’m in hospital surrounded by bright lights, needles, monitoring equipment, Coercion and multiple medical staff, labour is intense and I’m well on the way to transition.This time was different, in fact I barely felt in labour and yet the pressure down below and the increasing pain during what were still short, irregular contractions told me that I was. As I started to feel the contractions getting more intense I decided to get into the pool. It dawned on me that I had no pool wear, I hadn’t planned on using one. I think had I not been in a room with people I knew and trusted this fact may even have prevented me from using the pool. Because as much as I’m not shy of my body, being a sexual abuse survivor, nakedness really does have to be on my terms and I didn’t fancy the discomfort of a cold, wet t-shirt. So I stripped and hopped in….. And out…… And in….. And out because my bladder was working overtime. I wallowed in there for ages, aware that whilst I could feel that this was labour, I didn’t really look like I was in labour. My biggest weakness (or not) in labour is the need for entonox (gas and air). As much as I always aim to just use hypnobirthing breathing, I just find that I find my pace better with entonox as it takes off some of the sharp edge on the climb up of a contraction. But I learnt from my first midwife during my first birth to use it sparingly and only on the climb, to stop using it at the peak to give the body chance to catch up and avoid too much nausea and light – headedness. I didn’t need it with every contraction and more than once I sat there wondering where this would go! The strong contractions were so infrequent. E left Gray and I alone a lot, perfect, but she was never far away. At some point during this unusual labour pattern I felt a shift in pressure during a contraction and asked Gray to call E in. I can’t really describe what I was feeling, I just felt I wanted her near by. I was also aware that we had no idea what my dilation was and I could actually be just 2cm. We all had a little chuckle about this. From here things picked up. From out of nowhere I had a strong, pushing sensation contraction and thought to myself ” I can’t do this, I need drugs”….. Then I thought “odd, to be thinking that I must be in transition. But this is not intense enough surely”?Then I’m vocalising, pushing and within a very short space of time baby is out, floating between my legs. It takes a while for my brain to catch up and I can hear E saying “reach down and pick up baby”!I shuffle back from my knees, the position I’ve been in the whole time and see the top part of baby. I reach down and grab her under the arms and feel the rest of her slide away from my body. The cord is wrapped around her neck and E helps to remove it as I lift her out of the water. I’m in awe looking at this baby who’s here and yet not quite of this earth. It took her a little while to respond to being earthside, but I wasn’t worried, it was like watching a slow, peaceful and delicate transition into this world. She literally seemed to be at a gate where she could decide to come and meet me, or decide to retreat back to where she came from. It was natural and beautiful. It was the art of life itself and there she hung in the delicate balance of it all. She decided to stay and began to respond to her environment. At this point I absolutely could not believe what had just happened and gave the gawkiest, most surprised, geeky expressions and exclamations! I had seen babies being born into the waiting hands of their parents in water many times, but never, ever dreamed that it would become a reality of mine! It was all so calm and the intimate experience it needed to be. The best part is, Gray caught much of it in pictures for me to obsess over for years to come!
And now for the part that I knew caused most midwives and doctors anxiety with my births, the placenta. One of my biggest concerns about having a hospital birth was that I would be coerced into a managed third stage delivery. I had never had a physiological third stage before and so wasn’t sure myself with how it would go, but after doing much research during pregnancy I was convinced that it would be the safest option for me. A gush of blood into the pool told me that separation was likely starting so I opted to get out so we could monitor blood loss a bit easier. I’m not going to lie, it was uncomfortable pacing around waiting for the placenta. I couldn’t sit because the cord between my legs felt uncomfortable. I couldn’t recline at that point because my contracting uterus was more painful in that position. Hope had already latched on voluntarily to feeding, but I couldn’t hold her up too high because of the cord. But it felt really good to know that she was getting all of her blood from the placenta. More than once I considered caving in and having the injection, but E knew how important this third stage delivery was to me and she really, really helped me keep with it. She had plenty of ideas up her sleeve for encouraging that physiological third stage to happen without the need for intervention. So, I guess around half an hour or so later, Hope’s placenta was born. No drama, no haemorrhage, just as it should be. We didn’t hurry to cut the cord and took photos of Hope with her amazing placenta, lotus birth style. We used the cord tie we had bought instead of a clamp after Gray cut the beautiful white cord. It was a learning process for us all and another eager midwife came in to help us as they don’t see it much in a clinical setting and she was very enthusiastic about them.The rest, really just is. No tears, no scars, no trauma, no feelings of resentment over a lost home birth. Just a huge feeling of heartfelt thanks to E, The Ivy Team and the staff on labour ward at The Conquest Hospital that night /early morning. As somebody involved as a service user on our trusts’ maternity voices partnership I felt such joy at what our team had managed to do for me. There was hope for everybody! And there’s that word again…. Hope, the name that our daughter absolutely had to have, along with her middle name being our midwife’s name, something I simply knew I had to do if she were to be at our birth after such good antenatal care.  It’s obvious that really it was never meant to happen any other way. This baby knew what and who she needed to facilitate her calm entry into the world and it didn’t have to be at home. Poetry in motion.
Also, I can’t speak about my births without mentioning what a wonderful birth partner Gray is. He doesn’t panic and I know that if we needed to fight our corner, he absolutely would have done it. But fortunately we already had a brilliant gatekeeper at our door in E, so he could just chill and endure the odd hand crushing!
Full points to E and then later E2 for taking over my care before going home, The Ivy Team in general and the maternity team at ESHT for providing such an amazing continuity of carer team. It’s been a tough year and we’ve not always seen eye to eye. But I always give credit where credit is due. I am forever thankful for the care I received during this pregnancy and birth. 
Perhaps I’ll find my way to midwifery eventually after all. It may be a broken NHS system, but these things can work and when they do it’s wonderful. 

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