The Living Room

A Birth Story

Tobias John - September 2024

Toby rolled over for the first time yesterday. It was an accident, we think. More likely a byproduct of his thumb-sucking which causes him to lean this way and that, than a concerted effort on his part. He was so startled by what unfolded that he started to scream, shocked by his new reality! Within moments Owen picked up him and returned him to his usual position on his back, where he chuckled to himself. He does that a lot.

Four months ago I gave birth to Toby at home, in the same room he’s just learned to roll over in. Giving birth at home is uncommon in the UK, where only 2% of births take place outside of a hospital or birth centre. At the time I meant to write down some thoughts and impressions of that experience, but life with a newborn and a toddler took over – so here we are.

My memories of the night Toby was born are fluid and alterable. Viewed one way, it was a pretty scary experience which resulted in us getting transferred to hospital. And yet when I think about that night I don’t remember feeling afraid, I mostly remember the dual feelings of calmness during labour and ecstasy shortly after. Toby’s birth revealed to me the sanctity of labour, the quiet heroism of midwives and the utter fragility of human life.

When I was pregnant with my daughter I spent lots of time reading other women’s ‘birth stories’. I’m not sure what I was looking for—perhaps just evidence that it was possible. If you are pregnant and reading this, please go gently and stop if you need to. If you are pregnant and looking for evidence that it’s possible, please know that it absolutely is.

THE LIVING ROOM

1. Kundu

That afternoon I had been to see my midwife, Emma, who offered to perform a stretch and sweep. This had triggered labour with my first baby, so I decided it was worth a shot this time too. I trusted Emma completely—’say stop if it’s too much’ she said. I climbed up onto the bed and opened my legs so that she could try to detach the sac membranes from the wall of my womb with the tips of her fingers. It was more painful than I remembered, and felt similar to the time I’d (unsuccessfully) tried to have a coil fitted. I gritted my teeth, determined that the pain would be worthwhile.

We had planned a to visit our local ice cream parlour after our appointment, but it was closed, so we drove straight home instead. This was a good thing, as I felt tender—like someone had been rummaging around inside of me—and this meant Owen could pick up some ice-cream from co-op instead. He returned ten minutes later with Ben and Jerry’s Cookie Dough, an extravagant choice! We always go through the pretence of only having two scoops, as if the thought of finishing the whole tub has never crossed our mind. ‘More?’ asked Owen. I nodded, duly playing my part in the charade.

Since the beginning of September we’d been working our way through seasons of the West Wing, so I put that back on as I ate the ice cream. I bounced blithely around on my birthing ball as we watched Jed Bartlet grapple with his response to events unfolding in the (fictional) African country of Kundu. ‘Why is a Kundanese life worth less to me than an American life?’ he asked his advisor Will Bailey, ‘I don’t know, sir, but it is’ Will replies.

In the kitchen, Owen prepared dinner. Enchiladas, which he loves, and I was keen on because of the chicken. I’d been craving chicken throughout the final months of my pregnancy, in fact, meat of any kind was fine by me. Etty was just starting to get into wraps, so she had her own little wrap filled with chicken and cucumber. At the dinner table she wanted to sit on my knee, and I let her because it was probably the last time she would do so for a while. But it was difficult to balance her with The Bump, it protruded into the space where she would normally lean into me. Across from us, Owen was adding hot sauce to his enchiladas. We add hot sauce to everything in our house, but on that night I demurred. (Thank God).

2. Dialling In

Once Etty was in bed I started to feel twinges in my abdomen and told Owen I was going to try and sleep upstairs in our bedroom. They say this happens. That your body waits until your child is asleep before it decides to enter labour wholeheartedly. But in the moment I wasn’t getting excited and thinking I was about to have a baby. One of the peculiar things about labour is that you spend lots of time waiting for it, but when it arrives it’s easy to dismiss as backache or braxton hicks. An hour or so passed and after several rounds of sensations which *felt* like contractions I went back downstairs and told Owen that I thought my labour was starting. Our (mutual) response to this was to ignore it for as long as possible, as my first labour had been a multi-day, multi-locational affair. In the living room the Kundunese saga still rumbled on in the background, but I paid it little attention as my contractions had started to settle into a rhythm that I recognised from my first birth: building and building and building before a painful creschendo that almost immediately undid itself. I’d then be able to rest for about five or so minutes before they started again. And again, and again. And again. Labour is a relentless endeavour.

We had been planning for a homebirth for various reasons. Mostly because of the lengthy labour I’d endured with my daughter, which was extended by multiple trips back and forth to our local hospital. Each trip had taken 45 minutes which disrupted the natural rhythm of labour. I was eventually admitted on our third trip to hospital, by which time I had dilated to 8cm. This time I wanted my labour to progress in an environment I felt comfortable in, and without (multiple) car journeys between Somerset and Bath. Giving birth at home made sense to me, and so we’d had a visit from the midwife, and hired a birthing pool which arrived in a large brown box that was waiting patiently in our kitchen.

Back in our living room I took to my knees and started to concentrate on getting through my contractions. Dialling in, I called it. I used an app to count them, which swiftly suggested that I was in established labour and should contact our medical team. We were sceptical, but called the homebirthing hotline anyway, who told us that the midwife assigned to me had just been sent to another homebirth so I might have to go to hospital. I panicked a little. And at some point during this phonecall was sick. I’m not sure if it was the shock that labour was happening so quickly, or the pain of the contractions, or fear of going to hospital. After half an hour or so the hospital called back to say that another midwife was on her way and would be with us shortly.

From this point on I felt my body relax a little – and the contractions grew even closer together. In the palms of my hands I held two black combs which I would squeeze every time I felt a surge beginning. In the background other things were happening, my mother-in-law arrived to take Etty away, and Owen started filling up the birthing pool. The pool was bigger than I’d envisaged, taking up pretty much all the free space in our living room. The midwife also arrived carrying large backs of equipment with her. I continued to rock back and forth on my knees against our grey sofa, and the midwife would occasionally use a doppler to check that the baby was doing ok with labour. ‘Everything is fine’ said the midwife to her colleague on the phone ‘contractions are getting closer together, mum is coping well.’

Once she got off the phone she encouraged me to get into the pool, helping me get to my legs and step over the side. It was a blissful feeling, sinking into the warm water. For some reason I’d imagined that it would be colder, but it was much more akin to getting into a warm bath or jacuzzi. Getting into the pool was the first time I felt able to move around a little more. Owen put some music on and the labour continued to progress. By now I was using entonox (gas and air) to breathe through each contraction. I think I wearily asked the midwife if there was anything else I could have to take the edge off the pain, but she shook her head. Just the gas and air. This was the plan.

The next couple of hours passed pretty uneventfully. We listened to A Song For You’s album Home. At one point I asked for the Rowntrees ice lolly which I’d bought especially but only managed two licks of it. At about 11pm my original midwife, Sarang, arrived, relieving the midwife who had come out to cover her. She brought a student midwife with her too. Owen made them some cups of tea and offered them tortilla chips leftover from our evening meal. I was so glad to see a familiar face and knew that everything was going to be ok. After a little while Sarang suggested I get out of the pool and labour standing up for a period, as staying in one position for too long can slow things down. She held my arm and whispered into my ear, reminding me to breathe. I swayed to the music and trusted Sarang completely. It was all a bit surreal.

Moving from the pool seemed to work, and the contractions became incredibly intense from that point on. After my waters broke I started to struggle, moaning and screaming and wanting to hold onto Owen’s hand tightly for relief. I had been fairly quiet until that point, but the shift into ‘transition’, where the cervix is fully dilated and baby is almost ready, felt unlike anything I’d experienced before. At one point I remember thinking to myself that I just had no choice but to surrender to this process, which was both within and completely outside of my control.

Far sooner than I anticipated, Sarang encouraged me to get back into the pool and prepare to deliver. Another midwife was stood behind and asked if I wanted photos (yes! I answered, not remembering that I was butt naked). I crouched over the side of the pool and felt the baby emerging from within me. Sarang calmly said that if I wanted to push at the next contraction, I could. After a couple more contractions, during which I felt like my whole body was about to emerge, Toby was delivered into the water of the birthing pool and quickly scooped up by Sarang. I felt in utter shock and elation at what I had just done. They put Toby on my chest and used a towel to dry him off a little. He looked up at me woozily and we gazed back at each other. It was the hardest, most exquisite moment of my life.

3. Silence

It was at this point that I realised that he hadn’t screamed yet. The midwives were encouraging him, but he seemed too relaxed. They quickly cut his cord and took him into the kitchen. I remained in the pool, waiting to deliver my placenta and unsure about exactly what was happening. It transpired that Toby couldn’t breathe independently and required nine rounds of resuscitation to get his lungs working as they should. Still high on the entonox I don’t think I was really conscious of just how serious the situation was. Owen and the midwives walked between the two rooms, trying to reassure me that everything would be ok. Toby was on the kitchen table. There was nothing I could do.

An ambulance was called out to our house. This meant that I had to deliver my placenta quickly, so I had an injection and delivered it on my sofa. I felt the midwives tugging at it. Far from ideal, but at this point I really didn’t care. (For a couple of weeks after the birth a large reddish stain remained. I felt quite sad when Owen cleaned it up. I’d no longer be able to point at the sofa and say ‘that’s my placenta!’). The ambulance arrived within eight minutes, and a harried looking male paramedic walked through the door with an oxygen tank for Toby.

By this point, the sense of panic that had been palpable in the midwives just moments earlier was subsiding. Toby was starting to turn a corner, and was now breathing with the support of his oxygen mask. I put some pyjamas on, grabbed some frozen syringes of colostrum I’d put in the freezer, and walked out of the house behind the paramedic. I felt a pang of shame that it was ending this way. Of course the beautiful birth was too good to be true. A couple of weeks earlier my midwife had updated me on the latest medical guidance; expectant mothers on the anti-depressant sertraline were now advised to give birth in hospital due to a (minor) increased risk of complications during delivery. We’d discussed it and agreed that the risk was so minimal that we would press on with the home birth. I’d not told Owen at the time, and now felt a searing guilt at what had unfolded.

In the ambulance Toby was placed on my chest with his oxygen mask and a heated blanket to keep him warm. On my notes I’d requested for my placenta to be preserved, so it had been duly put into a Chinese takeaway box and came with us. At some point in the journey the lid of the box came off and my placenta spewed forth into and onto the back of the van. ‘I’m so sorry'!’ shouted the midwife to the driver ‘I’ll clean it up!’. There was now blood everywhere, but I think we saw the funny side. In my arms was my little boy, breathing on his own. He was going to be ok. We were going to be ok.

4. What the Living do

We were trolleyed off the ambulance and taken to the maternity ward at Bath hospital. It was all purple and lilacs and the same horrible lighting I remembered from before. The room that we were put in felt familiar, and somewhat bizarrely the ambulance technician commented that it was the same room she delivered her baby in. ‘Happy memories’ I said, trying to sound happy for her, but all I could think about was the fact that my baby wasn't breathing just a couple of hours ago. Owen arrived, having driven behind the ambulance. He looked anxious.

A jolly paediatrician walked into the room and explained that they want to perform lots of tests on Toby. ‘Are you worried about brain damage?’ I asked. ‘We will check for that’ she said, ‘we’ll probably keep you in until the end of the day.’ The next couple of hours were spent with both of us being poked and prodded. I had a slight tear during the birth so needed to be stitched up. A nurse called Alice arrived and asked if I wanted gas and air—‘yes please’. I started breathing in the gas and very quickly got high, going on a trip for what felt like a couple of hours, but was probably a couple of minutes. I fixated on a name badge the nurse is wearing that said ‘My name is Alice’, and I also became convinced that I had uncovered a grand conspiracy which was somehow linked to the copy and paste shortcut on a keyboard.

When I came round, Owen was stood over the incubator that Toby had been placed in. He was looking at our baby boy. Tearfully I explained about the medical advice not to have a home birth. But everything was ok. Our baby was here and he was breathing. He was doing what the living do.