Natasha’s Home Birth Following a Premature Rupture of Membranes (PROM).

Having taken a hypnobirthing course Natasha decided upon switching to a home birth and I am sure that you will agree that her birth team were absolutely wonderful. She had some tricky decisions to make regarding the early rupture of her membranes but she was well advised and was able to move and relax at her own pace.

I very much love her description of needing to ‘let go’ to enable labour to work productively. It is perhaps the first ‘letting go’ of many that we will face with our children throughout their lives.

I really enjoyed reading this positive birth story and I know that you will too.

My husband and I did a digital hypnobirthing course with Melanie in early 2022 - a couple of months before my due date. We then had a one-to-one session with Melanie at our house, where we talked through some of the concepts in more detail. I had already been thinking about having a home birth, after a friend recommended our local home birth midwife team. And after our work with Melanie, the decision to give birth at home felt like the right thing for us. 

We had our first appointment with the home birth team at 34 weeks and we immediately felt we’d made the right choice. All our antenatal appointments from this point were at our house and were really friendly and relaxed. 

At our 38 week appointment, the midwife confirmed the baby's head was engaged. She explained that this didn’t mean things were imminent, just moving in the right direction. However, soon after she left, I felt something pop. I stood up and my waters had broken, in that Hollywood way they tell you doesn’t happen in real life!

The midwife came back that afternoon and talked through my options. My waters had broken before labour had started, which is known as premature rupture of membranes (PROM). She explained that their hospital's policy is to offer an induction after 24 hours if labour hadn’t established because there's an increased risk of infection (to an albeit still very small risk). However, she was great at explaining this in a way that didn’t make me feel pressured to make a decision either way. She also sent me some resources from Dr Sara Wickham about making a decision about induction for this reason. She told me to eat and sleep well, relax, and wait until the next morning to start thinking about what I wanted to do.

At around 4am, I woke up with contractions. I had a bath, bounced on my birth ball, and tried to watch Netflix to distract myself. I was in our bedroom for most of the day, with the lights low and the curtains closed.

My husband cooked dinner that evening, but as soon as I came downstairs and smelled the food I knew I couldn’t eat anything. I went back upstairs and got into bed. At this point, we started timing my contractions. I soon felt really uncomfortable in bed so I moved over to the corner of the room where I could push against the wall as the contractions came.

My husband called the emergency midwife number at around midnight and a midwife arrived soon afterwards - she checked and found I was 5cm dilated. She told my husband to fill the birthing pool. I got in and it felt amazing! I asked for gas and air to use in the pool - I’m not sure if it helped with the actual contractions, but it did make me feel super sleepy in between each one.

The next morning, the midwife who had done my 38 week appointment arrived - it was lovely to see a familiar face! However, things had slowed down a bit and I was utterly exhausted. In hindsight, I think I was still in my head too much and wasn’t allowing my body to go with what it needed to do. I was nervous about what would happen and how it would feel if I truly let go.

At around midday, the midwife explained they had noticed the baby’s heart rate had risen slightly over the last hour. Plus it had now been 48 hours since my waters broke, so the risk of infection was increasing. And because things had slowed down, they wanted to do another VE. If I was fully dilated, they would help me push my baby out. If I wasn’t, they would transfer me to hospital. She explained that home birth midwives need to act on amber warnings and not wait until they get to red. So we weren’t in an emergency situation and the way she explained everything made me feel safe and in control. 

The VE showed I was fully dilated, so one of the midwives said she would coach me through pushing my baby out. This wasn’t how I’d planned to give birth - all the prep we'd done talks about breathing your baby out gently, and going with your body. However, I knew I really didn’t want to be transferred to hospital so this felt like the right decision for me and baby.

Two ambulances arrived and a couple of paramedics came upstairs to see how things were going. I heard the midwife tell them that we were going to see how things progressed, and to wait outside. I think, subconsciously, this was a bit of a confidence boost. Plus the second midwife helped me to move position, eventually getting me comfortable leaning over the birthing ball which was pushed up against the wall. My husband also really helped by repeating positive affirmations and giving me little sips of Lucozade.

It was only when I completely let go and pushed down into the pressure in my pelvis, like my body wanted to, that there was any sense of the pressure easing. And this is when things quickly changed. I was fully bearing down now, making very loud groaning sounds, when the baby’s head started to crown. The midwife helped me slow down my pushing, and used a compress to reduce any tearing. Once the head was out, the body came out quickly and the sensation was the weirdest thing I’ve ever felt! My husband told me to “look down” but I was still in shock and couldn’t believe that I really had just given birth. It took me a moment to look down and move so that the midwives could hand me my baby.

I sat on the edge of our bed with my baby on my chest, wrapped in towels. I was in total disbelief still, and had to keep asking for reassurance from the midwives about whether she was ok. She was completely ok!

After a while, the midwife asked how I wanted to birth my placenta. I wanted to wait to see if I could birth it naturally, and I started to get small contractions. I was pushing with each contraction but a couple of blood clots came out so the midwife gave me the injection to help manage things. It then came away quite quickly but they estimated my blood loss to be 700ml which is more than they would have liked to see. Because of this, and because of the PROM and the baby's earlier raised heart rate, the midwives explained they still wanted to transfer us to hospital. 

My baby and I were wheeled out of the ambulance on a stretcher and through the corridors of the hospital, with people stopping to say congratulations. It felt surreal and beautiful!

All our observations overnight were completely fine, and I hadn't had any tears during the birth so I didn't need any stitches either. Walking out of the hospital the next day with our tiny new baby felt miraculous.

I still can't quite believe I pushed my baby out without any pain relief - just gas and air during the contractions. I truly believe that giving birth at home allowed me to relax into what my body needed, along with the loving support from my husband and the excellent care from the midwives.