It is widely accepted in British culture that pregnancy past 42 weeks is 'dangerous' and that maternity services 'won't let you' stay pregnant that long. Induction of labour is supposed to be offered as an option, alongside the option of expectant management, but most of the time women and birthing people experience strong pressure to be induced and resisting it can be hard.
E's birth story is about her experiences reisisting induction past 42 weeks, making informed decisions and, ultimately, getting the birth she wanted.
These are her words; I have merely shared them here with her permission.
My birth story
"From the beginning we’d always expected that this baby would be late. Our first baby was induced at 40+8. It was a long process and he was finally born at 40+10, 20 hours after my waters were broken and 2 and 1/2 days since I had the pessary inserted. Although, the birth wasn’t traumatic, it never felt like my own; I feel strongly that neither baby or me were quite ready for labour and delivery.
This time I was determined to do things differently and from the beginning my husband and I said we would decline induction. For this reason (amongst others) we decided to hire a doula. Added to this our local trust had recently formed a home birth team. Both of these made a huge difference to our story.
My due date came and went and unsurprisingly the baby didn’t arrive. The days kept ticking by and there was still no baby. At 40+6 I reluctantly accepted a consultants appointment, which was scheduled for the following Monday, when I was 41 + 4. (In our local trust it’s routine to be induced at 40 + 12.)
At this appointment the consultant was very clear about the risks of declining induction and continuing the pregnancy post dates but I stuck to my guns and declined induction. The consultant strongly recommended that I have a scan before the end of the week (because my fundal height measurement had dropped and she thought baby might be small, I was sure it was just because baby had engaged) and it was scheduled for 42 weeks.
At the scan baby was estimated to be ‘big’ and they suspected he weighed 9lb 4oz at that point. I saw a registrar after and they stressed the danger of continuing the pregnancy with a big baby and especially stressed the risks of a home birth. However, I was accompanied by one of the home birth team midwives and was feeling empowered so once again declined induction and opted to continue waiting.
I attended monitoring at 42+4 and baby was clearly happy and healthy, confirming what I already knew. Based on this I also declined further minitoring 3 days later, asking one of my midwives to come instead to my house for a routine antenatal appointment.
By this point, at 43 weeks, I was beginning to reach my limit. My pregnancy was continuing way beyond where I’d expected it to and the pressure from all sides (medics and family) to have the baby meant I was struggling to relax and I felt continually on edge.
My midwife arrived and (as discussed with my husband) we started to talk about booking induction for the middle or end of the following week (by which point I’d be 44 weeks). Midway through the appointment my midwife took a phone call from her boss. She came off the phone with an offer. A non-standard offer to use a balloon catheter to try and induce labour and allow me to come home for 24 hours. This sounded like a good idea and it was booked for the Monday, when I was 43+4. Over the weekend my husband and I met our doula again and also escaped for a meal out on our own where a new plan was formed and emailed to our doula.
The plan was as follows:
Option A: balloon catheter, labour at home
Option B: if balloon catheter does not induce labour, have water broken and labour on birth centre
Option C: if labour does not progress by a pre-agreed time (I was thinking 4-6 hours, consultant agreed to at least 12), have a gentle CSection.
On the Monday, the balloon catheter was fitted and we met with the same consultant I’d seen 2 weeks earlier. Accompanied by my doula and home birth midwife (both of whom knew my plan and supported me) I asked the consultant if they’d support my hopes for the next few days. Surprisingly, she agreed to all of my requests bar one and also agreed to an additional request made by my doula (to be able to go home after my water were broken & ring home birth midwives if I laboured). The one request she didn’t agree to was having my doula present for a csection (this was my hope of labour did not progress after my waters had been broken).
So I went home with my balloon catheter, slightly uncomfortable, and set in to wait. Not much happened but perhaps it helped ready my cervix for the next stage (although I think my body with all its Braxton hicks and pressure had done some of that already). The next day (at 43+5) I went back in the evening to have my waters broken, this time with my husband accompanying me and also my other home birth midwife. My waters were broken, baby was monitored and it was agreed I’d come back about 15 hours later (so it wasn’t the early hours of the morning), if I didn’t labour overnight.
On arrival home I noticed a few tightenings, decided to ignore them and eat my tea. After tea I went to bounce on my birth ball and my dad started to talk to me about mobile phones. Now my dad is not someone who is familiar with birth and oxytocin so I can’t blame him but right at that moment I could have thumped him. Knowing I only had until the morning to get this baby moving if I wanted to birth at home, I decided to take my diffuser, clary sage oil and iPad upstairs to my bedroom and relax.
In the hour and a half I was up there I started noticing some surges. Nothing I couldn’t cope with and they weren’t taking my attention away from the programme I was watching. They also weren’t overly regular, so I assumed they weren’t going to lead to much or at least weren’t leading anywhere imminently.
At about 10 I decided I’d better get some sleep but before that I though a shower might be good, so I stood up with the aim of going to tell my husband what was happening and what I planned to do. Well gravity and baby’s head on my cervix soon changed my plan! 3 contractions later I made it to the kitchen and told my husband to get the birth ball!
After this it’s all a bit of a blur. The contractions were coming about every 2 minutes lasting most of a minute and when I realised that I’d had 17 in half an hour I told my husband he could ring the midwives and our doula (which he’d wanted to do for the last 15 minutes). The doula arrived soon after 11 and soon got started on filling the pool. Around the same time, the toddler woke up, which meant my contractions were less intense. However, we soon got the toddler settled with granny and a pile of books in a dimly lit bedroom and we managed to get back downstairs.
The midwives arrived just before 12 and asked me some questions and then suggested I get in the pool.
I’d really hoped that I’d get some instant relief from being in the pool but I didn’t. My labour was all in my back and although the pool felt good it wasn’t helping as much as I’d hoped, so my poor husband had to get in too and put pressure on the small of my back during every contraction. He did such a good job he’d bruised my back by the end!
It didn’t feel like very long until I remember realising I was in transition. I had this feeling of being totally overwhelmed. The labour had progressed so fast, I wasn’t ready to give birth, where was my gentle build up? That was followed fairly quickly by a realisation that I’d started to make ‘pushing nosies’. They definitely weren’t me. They were definitely totally my body taking over. In fact I remember saying, ‘I think I’m pushing. That noise wasn’t me.’ This feeling brought a real sense of achievement. I was in the pool, in my dining room, with my fairy lights and I was going to birth this baby. And birth the baby I did. After just over half an hour of my body and baby working together to get baby out my not so little boy arrived at 2:01am on 25/09/19. I clearly remember pushing, beginning to feel a burning sensation of his head, realising my body wasn’t quite ready for the head to be delivered and holding off. I’m quite amazed by that clear message from my body and my ability to do that.
I did have one minor disbelief in my ability when his head was there but my body had a 6 minute rest before the next contraction and I tried to push without a contraction, which I’m pretty sure is what led to my tear. That said I’m pretty proud of myself for delivering a 9lb 3&1/2oz baby without pain relief (expect water and my husband) in my dining room and only needing 3 stitches."