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My First Birth was nearly in the Leeds Lotus Midwifery Unit
You can't write about one without the other! My first birth was a classic case of a 'low risk' pregnancy and commercial birth preparation which doesn't really scratch the surface of what you really need to know.
I did an NCT class, an online hypnobirthing class and attended a tour of the hospital which included a short antenatal class in the Leeds General Infirmary (LGI) part of the Leeds Teaching Hospitals. a university hospital in Leeds.
I wanted to use the leeds lotus midwifery unit which was advertised for use by 'low-risk' women, this should be defined as women who don't have specific clinical needs which means they have chosen to birth in the labor ward, but in reality, it covers a lot of women as it is difficult to get to the end of pregnancy without a high-risk label!
The Lotus Midwifery unit has three home-from-rooms including two water birth rooms and an active birth room. Some of the rooms in the labor ward in the LGI do have birth pools to allow for a hospital water birth but the rooms themselves are more clinical.
You can take a virtual tour on the hospital website or request an in-person one.
I won't get into the definitions of high and low risk here, but please know if you feel that you want to use the Lotus midwifery unit but you have been labelled as high risk, you can still do so, ask your midwife for an out of guidance plan to be put into place!
I had a neurological condition so I had worked hard in this pregnancy to get confirmation that I could use the birthing centre.
I passed my due date and my waters broke at 41+2, I labored at home (for not long enough on reflection) and headed into the Maternity assessment center in the maternity unit in the LGI.
I had a vaginal exam and admission CTG, I was 3cm so could not be admitted to the Lotus suite yet, I labored in the Maternity Assessment Center (MAC), we did our best to find a birth ball and keep active.
At the point where it had been 24hrs since my waters broke, I was advised I needed continuous monitoring and would need to go to the labor ward for a potential induction as I was not yet in active labour. Thankfully my mum challenged this and I had another vaginal exam which proved I was in active labor and I was finally admitted to the Lotus unit.
I remember the room being lovely and laboring on a beanbag on the floor, unfortunately, at this point, things started to go wrong quite quickly. You can find out more about the cascade of intervention in the below blog post, I ended up being transferred to the labor ward, but on continuous monitoring and then the fetal scalp electrode, coached pushing on my back, a postpartum hemorrhage, and a retained placenta.
Needless to say , this was not what I wanted and I felt traumatised and I carried this feeling into a very stressful postpartum.
Second Birth - Planning
If you were to ask me now what my biggest regret is about this birth it is without a doubt that I didn't plan a homebirth instead of a hospital birth.
I knew that it was what I wanted, but I still had medical professionals in my ear about my postpartum bleeding and the retained placenta. With a 3-year-old at home, I also struggled to understand how I could make my house into a calm oxytocin-filled space.
So I followed in the pathway of my first birth and planned to use the Lotus Midwifery Centre again.
To my credit, I did MUCH more work, including stepping away from commercial one-size-fits-all courses and doing my own research,
My birth partner and I were much more informed and I felt confident that I and I would be able to advocate for ourselves to avoid a lot of the situations that happened last time!
We had a solid birth plan, we felt confident and ready!
Prodromal Labor
This was our first challenge, I started getting contractions that progressed in intensity and then fizzled out! This happened for 3 days, we were determined.
We popped in and out of the maternity assessment centre in the LGI, but went home as we were determined that we wanted to labor at home as much as possible!
On reflection, I think that because I had decided I was going to give birth in the birth center I wasn't able to fully let go at home, this became obvious in what happened next.
Potential Induction - Artificial breaking of waters
On day four of 'false labor' we decided to go in and discuss our options, I was having intense contractions but I was sure that they would probably fizzle out again.
We got to the assessment unit I had an exam on request and I was told I was 3cm, and that they would recommend breaking my waters. They agreed that I could have this done in the Lotus Midwifery Suite and so we just needed to wait for a room to be available.
This is when things started to progress, I think it was because I knew mentally I was staying here and I could let go, my contractions intensified and I was moved to the birthing center as I was clearly in active labor.
As I had i my birth plan I wanted to use a birth pool I was given a water birth room.
Birth Pool in the Lotus Midwifery Center
It was time to get in the pool and it was amazing! I couldn't tell you how long I was in there but in the water, my contractions felt manageable and I was so relaxed.
I had my diffuser and playlist on, the room had mood lighting and affirmations on the wall, it was perfect.
One of the things that had de-railed my previous birth was that my heart rate and BP began to climb, now I know that this is normal for me when I am in pain, but we hadn't thought to challenge it in my first birth when we were told I was dehydrated and would need an IV drip.
This time round my husband was on it with offering my fluids and recording how much I had drunk, and I made sure to tell everyone I had been for a wee (yes in the pool!) so they knew I was going regularly.
So when we were inevitably told my heart rate and BP were high we could evidence I wasn't dehydrated and advocate to stay in the birth center and in the pool.
Your pain relief options in the Lotus Midwifery Centre are more limited than in the labor ward, epidurals are not available but I was able to use the birth pool for pain relief and gas and air.
At some point it was suggested that I should get out of the pool as my contractions had reduced in intensity, I wish I hadn't listened, I think I just looked too relaxed!
Active birth in the Lotus Midwifery Centre
Once I was out of the pool I was very active, I tried sitting on a birth ball but I felt like there was too much pressure in my pelvis to do this, I tried the toilet but again this was very intense.
I ended up walking up and down the corridor from my room into the labor ward and back, taking my birth comb with me and using gas and air when I was back in the room, this went on for a while but I was happy!
Artificial Rupture of Membranes without informed consent
THIS is the single most annoying thing about this birth, I consented to a vaginal exam and unbeknown to me because I had previously consented to have my waters broken (when the clinical picture was very different!) the midwife had the equipment with her.
When I was vulnerable on my back with my legs open she said 'Shall we break your waters now?' and I think I must have indicated yes, but all of a sudden I was in agony as she wiggled a plastic hook into my cervix. Now this should not be offered in a normally progressing labor as there is no evidence it speeds things up, and there is evidence it can make things feel more intense.
Whilst doing this the midwife cut my cervix and my waters were tinged with bright red blood, so a transfer to the labor ward was suggested, however, we used our decision-making tools and chose to stay where we were, we knew it was my cervix and not a placental abruption which was what they were worried about, the midwife herself knew it as well, but she had to follow guidance suggesting transfer.
Transition
After my waters were broken I pretty quickly went into transition, there was no gap in between the contractions and they were very intense, I was shaking and I began to panic.
My husband looked to the midwives for reassurance but they didn't really offer any, I started asking for an epidural (it was the adrenaline talking not me!).
The midwives suggested that it wasn't too late for an epidural (I was only 7cm when they broke my waters) so we started walking a few doors down from the lotus midwifery suite to the delivery suite.
Delivery
As we approached the doorway of a room in the labour ward my body started to push, the midwives didn't believe me until one of them examined me whilst I was standing.
They started to panic and tried to get me onto the bed (in the labor ward room that was in no way set up how I wanted). Noah was already in my pelvis so I couldn't move my legs and I knew at that moment I wanted to birth standing.
With my husband supporting my weight from behind my body pushed my baby out, It was a million times better than the hours of coached pushing I went through at my previous birth.
Not so golden hour
Unfortunately, we were now in a brightly lit clinical room, I got on the bed and Noah was placed on my chest, however,r one midwife felt he needed assistance and asked me to cut the cord so they could check him over, it was white but it was not the delayed cord clamping I wanted.
He was quickly returned to me, and the clock was started on the placenta, I had the injection but it didn't budge - The transfer to the clinical room and the removal of my baby from me had had a huge effect on my natural hormones.
I do wish I had waited longer, but I also feel that in that environment I was never going to get back in my bubble.
I decided to go straight to the theatre for a manual removal but advocated for my husband and baby to come with me, this was much less traumatic than the previous birth where I had various attempts at manual removal before heading to the theatre alone.
Once out of the theatre, we headed to the postnatal ward.... that is a whole other story, postnatal care is not prioritized in the NHS!
Reflections
Yes I wish I had planned a home birth, maybe I would have been able to let go at home if I knew I was planning on staying there.
If I was at home I would probably have stayed in the birth pool when it was suggested I get out.
If I was at home, It probably wouldn't have been suggested that I have my waters broken, my transition may have been less intense.
If I was at home it wouldn't have been so 'easy' to transfer somewhere during the transition, I would have given birth in a calm cozy environment.
If I was at home maybe my golden hour would have been uninterrupted and my placenta would have come out on its own.
BUT
I went into labor spontaneously.
I used gas and air and a comb and didnt need any other pain relief.
I had the majority of my labor in the lotus midwifery center which was beautiful.
I got to experience the fetal ejection reflex
AND
We used our power to avoid transfer twice, once for BP and once for 'bleeding'.
I am very proud of myself when I look back, I had come so far from my first birth, that I wasn't ready to take that final step into homebirth.
I felt so empowered by my birth that even though I had a tricky postpartum with feeding issues I was able to cope with it, I felt like if I could birth my baby with that much power I could do anything.
The Birth of The Smart Doula
It was this birth story that showed me the difference being informed and being able to advocate could make even in a medical setting.
Both of my birth stories are part of who I am now, they both give me experience and power!
I started The Smart Doula so that I could help other women virtually make informed decisions about their birth, however, their birth looked.
If you are interested in working with me you can check out my website below.
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