A home birth in Jamaica
It’s a week since my baby girl Julia landed, and I wanted to share how and why I choose to birth at home here in Jamaica. It’s an unusual choice here, in Kingston anyway… I’m sure country mamas are popping out pickneys at home in the Jamaican countryside every day! It’s definitely disapproved of by obstetricians. But, once I’d made up my mind it’s what I wanted, somehow all the details fell into place. Two good previous deliveries plus two years of teaching and practicing HypnoBirthing certainly helped give me the confidence I needed to go ahead. I had fantastic support, and I’m delighted to say the birth went perfectly.
Why did I choose a homebirth?
I woke up when I was about 6 months pregnant suddenly sure I wanted to have a home birth. I was so excited about it I wanted to wake my husband and make him help me research it right there and then. I managed to resist, and I also quickly discovered there was no information available online about how to go about organising it. None at all.
This was my third pregnancy. My first two children were born quickly, one in Jamaica and the other in England: both labours were around 3 hours from start to finish, and because they were so quick, I went through intense dilation while driving to hospital / getting checked in etc. This time I wanted it to be different. I didn’t want to be puking out the car door at traffic lights and stuck on a cramped back seat in labour again! Let alone dealing with meeting new labour ward staff and checking into a hospital in between contractions. I nearly had my last baby in the hospital reception!
I never had any doubts with the first two, that I wouldn’t be able to manage, that I would need medication or that there would be any complications, and I was very lucky with two quick and straightforward labours. Some of that confidence came from within, but from the moment I read Marie Mongan’s book, ‘HypnoBirthing’, I knew everything she was saying made sense. The less frightened you are, the easier it is for your birthing muscles to work, and the more likely you are to have a better birth.
Saying that, there were details about my first two deliveries that I was deeply disappointed in, felt violated by, and now think were unnecessary. The only way I felt like I could insure things were going to be different this time, was to be at home.
My first labour with Mikey was quick and intense. I gave birth in Andrews Memorial Hospital here in Kingston. I laboured at home and we drove to hospital when contractions were about 5 minutes apart. I felt in control of my labour, and able to use all the HypnoBirthing techniques right up until the delivery phase, at which point, I had to waddle from the lovely natural light of the labour room I’d been in, into the bright lights of the highly surgical delivery room / operating theatre. At that point, I suddenly felt terrified, lying back legs akimbo on the slab under the huge overhead lights, with gowned up doctors slapping on plastic gloves, surrounded by instruments and machines, and I felt fear and pain overwhelm me. What woman in the world can relax with her legs splayed under a UFO sized light surrounded by sharp instruments and strangers?
Mikey was born within a few pushes, but in no way did I feel in control, just terrified. In shock! I am sure it was the medical, surgical environment of the delivery room, plus the fact that the nurses had me lie down on my back, though I’d found that position intolerable throughout labour and been much happier standing or on my knees. My doctor, Dr Shaun Wynter, had told me during our prenatal visits that he had never delivered a woman in any other way than lying on her back in his 40 years of practice, and if I wasn’t lying back he didn’t know if he would be able to ‘protect my perineum’. As a first time mum, I believed him, and I wish I hadn’t!
There is a huge amount of research to show that almost any other position than lying on your back in fact takes pressure of the perineum and makes tearing less likely. Being on my back made the labour pain excruciating, and left me with quite a severe tear, that I feel sure wouldn’t have happened if I’d been able to stay up on my knees, which is how I had coped beautifully up until that point. Also, despite having agreed in prenatal visits to not do ‘coached pushing’, Dr Wynter ended up telling me to bear down during the delivery phase, count for 10 etc, which in retrospect I think was unecessary and ended up in adding to me tearing.
I was also appalled that in Andrews they insisted on taking Mikey away from me while I had stitches, so he was in the nursery for at least 45 minutes of his first hour of life, even though I was crying out to have him returned to me. There is no reason he couldn’t have been either on my chest or in his daddy’s arms while I was being attended too. Also, I was repeatedly offered formula for him during the first 48 hours. The nurses said the baby was hungry and my milk hadn’t come in. That’s very tough for a first time mother to refuse, and I think malpractice in a hospital that considers itself pro-breast feeding. Is it any wonder so many Jamaican mothers that I’ve met gave up breast-feeding very early on because they didn’t believe they had enough milk? One week later, when I returned to Andrews to get Mikey’s BCG injection, I was the ONLY mother in a line of 20 breastfeeding their newborn. That is a tragedy.
My second baby, Daisy was born back in England. We’d been to huge trouble and expense to make sure I had everything set up differently this time – for a more natural approach and hopefully a water birth in a birthing centre. I’d flown back at 36 weeks with Mikey, now a two year old, and stayed with my parents. I was now a qualified HypnoBirthing instructor and felt pretty sure I would have a fantastic birth this time. I was registered to deliver at a birthing centre within St Richard’s Hospital in West Sussex, a midwife run unit with birthing pools etc. and a great attitude.
I had another super quick labour: 3 hours from start to finish, though again I went through the most intense part of labour in the car! I had Daisy in 40 minutes after arriving in the hospital! So there was no time for the birthing pool. Still, it was a great delivery, I can only describe it as ecstatic, I delivered her in the natural light of a labour room, with just my husband and a young Spanish midwife present, I stayed on my knees and, though there was some fairly serious swearing, I felt in control, literally on top of the pain, and ecstatic as Daisy arrived into the world.
But then it all went wrong. After 10 minutes or so of basking in the glory of a beautiful birth with my little girl nursing happily at my chest, the midwife began to ask me to bear down to bring out the placenta. But it never came. So I had the Pitocin injection to stimulate contractions to help it along. But still no sign. After two hours of lying on my back with my legs apart and still no sign, I was wheeled into theatre where I had a full spinal block (like an epidural) and a horrendous procedure called a manual removal of the placenta. It took nearly an hour, and left me bruised and battered for a week, unable to sit down, and feeling pretty violated after such an amazing birth!
Since then, I’ve felt that the hospital got all this very wrong. As I was to find out after giving birth to my third child, Julia, the simple act of just changing position, to a squat, along with light tugging from the midwife, might have been enough to dislodge the placenta and bring it out with no problem. What a simple solution! Why on earth wouldn’t they know to try this first in a hospital? No one ever suggested to me to move at all, and perhaps a simple squat could have entirely prevented the horribly invasive procedure that bruised my kidneys and left me bleeding for weeks. How much basic common sense has just been swept aside with tendency towards intervention in modern medicine?!
So with all these experiences in mind, I just knew this time I wanted to be supported by a midwife at home, where no one was going to poke me, tell me which way to labour, when to push, get me under bright lights, hook me up to machines, or interfere generally with what I consider to be the perfect complex orchestration of uninterrupted natural birth. From the moment a woman sets foot in a hospital: having to deal with staff she’s never met before, examinations she doesn’t need, advice that doesn’t help, options that she hasn’t even considered, it seems to me that the whole process of birth starts getting unbalanced, and in so many cases, starts going a bit wrong, sometimes catastrophically so. There’s just so many people trying to help, that it is easy to lose sight of the fact that women’s bodies know exactly what it is they are supposed to do. There’s nothing brave or amazing about choosing to deliver at home – with the right mind-set, support and home birth team, for me, it felt like the safest option by miles!
How did my homebirth go?
Two days after my due date, I had a day feeling crampy and nauseous, both highlyunusual for me. I took it easy and lay down when I could, in between looking after my other two children. The next morning, I woke at the usual time (5.45am) to realise my waters were breaking, something I never expereinced until nearly delivering my first two babies! I grabbed a towel and waddled about feeling delighted, excited, hyper even; and a bit concerned that I had no signs of contractions, only mild cramps, as I had had the whole previous day. By 6.30am, I was vaguely experiencing cramps – enough to tell they were maybe 15 minutes apart, but still not strong enough to justify calling the midwife; I had experienced stronger warm contractractions a few days before! By 7.15am I was getting my son ready for school, making his lunch etc, and in between tasks, finding myself having to stop and bend over and do deep breathing.. I was in established labour. I texted the midwife that I thought today was the day, but not to hurry, there might be hours to go yet!
At 7.30am I asked my husband to start filling the birthing pool, thinking I was probably being too hasty and that we’d probably end up wasting all the water – and that gives you an idea how quick the whole thing progressed, as the baby was born an hour and a half later! The midwfie and her team arrived at 8.15 / 8.30am by which time my contractions were coming thick and fast and I just was getting into the pool as they arrived. The immediate relief of the warm water was astonishing, and actually made me worry that it would slow down my labour. But no, it just massively reduced the pain of contractions, but they kept coming fast. I breathed my way through them, my doulas and Ed supporting me, staying mainly up on my knees hugging the side of the pool.
Suddenly at 9am, I felt the first massive rush of the delivery phase, I couldn’t believe it was happening so soon. I yelped, ‘I’m gonna poop!’ as I felt that massive pressure bear down against my bum, and then – and this is hilarious that this has somehow ingrained itself into my subconscious, I yelled, ‘BABY A COME‘ as I felt her head crowning all within that first surge. Apparently I shot my bum up out of the water, so I was in a sort of downward dog position, and her head emerged completely with the next contraction. Turning round onto one knee, I can vividly remember cradling and touching her head in amazement, my body shaking, every sense in hyper-drive from the adrenalin coursing through my body. Encouraged to wait and breathe by the midwife, I tried to quieten my breathing waiting for the next contraction to come and as it surged through me, baby Julia was born into the midwife’s waiting hands.
Joy, relief, ecstasy and obviously a massive whack of endorphins lifted me sky high as I gathered the baby’s little wet body to my chest, my husband kissing my head, me laughing ecstatically not even knowing if she was a boy or a girl for a few wonderful minutes. My baby was here! I’d done it! At home!
She didn’t cry out at all. She opened her eyes within moments. She looked alert and calm – grubby from the birth – but unimaginabley beautful. Our birthing team left my husband and me, and the new baby alone together and we experienced that wonderful peace, relief and calm that comes after the birth, celebrating a truly ‘happy landing’ as they say here in Jamaica.
About 20 minutes after giving birth, my placenta had not come again, but with NONE of the drama of my last delivery, my highly experienced midwife Tioma simply helped me into a squatting position, and lightly tugged the cord, and I immediately felt as though I could bear down, and out it came.
Allowing plently of time for the cord pulsations to cease; me, the baby and the placenta in a bowl, were helped up onto my bed, bathed in the warm jamacian morning sunshine and feeling full of love and happiness. How incredible to be in the privacy and comfort of your own home, aware from the glare of hospital lights and surically gowned strangers for such a moment as this.
How did I set up my homebirth?
In an amazing coincidence, about 3 days after I’d decided to go for a homebirth, a wonderful local private midwife, Tioma Alison, rang me! She’d heard that I was running HypnoBirthing classes and wanted to make contact. I was delighted and set up our first prenatal appointment. Tioma had a wealth of experience, lived near by, could provide a birthing pool and home birth supplies from a site online, she had contact numbers for doulas, everything!
I was thrilled. I approached my obstetrician, Dr Michael Abrahams at Ruthven Medical Centre, to ask him to be my back-up should any problems arise and I was transferred to hospital. I naively thought he was going to open minded about it; Dr Abrahams had seemed quite progressive about birth (some women I had taught hypnobirthing too had highly recommended him; one lady even getting him to deliver her in the dark at Andrews!) Anyway, he absolutely refused me point blank. He said he couldn’t support me in a home birth, it was all too risky, and immediately began to recount all the disaster birth stories he’d been involved in. I cut the meeting short, in all the examples he’d given there had been other complications and all his fear-mongering was the last thing I needed to hear. I needed to either find someone else who would support me, or lie!
So I approached Dr Freddie Smith at Winchester Women’s Health, whom I had seen during my pregnancy with Daisy. I planned to lie to him; to pretend I was aiming to deliver at Andrews Hospital so I’d have it all set up in case I needed it, but then go ahead and have my birth at home. As the weeks went on, I decided to risk asking him what he thought about home births. He amazed me by being strongly supportive, saying he thought homebirth was a great option for women, and seemed interested and open minded about meeting Tioma, who came with me to our next appointment. I was delighted: I had my perfect home birth team AND a doctor on hand on the remote chance I needed to be transferred to hospital. We would only call him if we needed him.
In the unlikely event I did need to be transferred to hospital, I had registered to deliver at Andrew’s. I managed to waive paying the deposit (50,000 JMD) by explaining that I was intending to deliver at home. If I’d been transferred, we would have been able to pay the deposit on the day.
Are you interested in planning a homebirth?
If you are in anyway interested – start researching it now! Birth should be an ecstatic, transformative experience that leaves you feel empowered and joyful! It is of course possible, but much harder to have that in a hospital. At home you are surrounded by your familiar things, you can be in the shower, eat what you want, have whoever you want there with you, cry, laugh, scream – it is your house! I can’t recommend it enough.
The most important thing is having the self-confidence to believe and trust in your body’s amazing power to give birth naturally, and if this belief isn’t rock sure within you and your partner already, reading the HypnoBirthing book or going along to HypnoBirthing classes can certainly help with that.
If you want to find out more, you are welcome to contact me or any of the fantastic team I used.
Midwife: Tioma Alison – 466 7555, Meskhenet.firstname.lastname@example.org. Tioma has delivered nearly 2000 babies at home, mainly in New York where she worked for over 20 years. Calm and confident, she has seen all sorts of presentations and filled me full of confidence that she would be able to manage almost any situation at home.
Doula and Massage Therapist: Natalie Reid – 483 4994, email@example.com. I saw Natalie for weekly prenatal massages running up to the birth. It was wonderful to form a close bond with someone I knew would be there on the day and amazing to have her on hand should I have needed (or had time for!) a massage during labour.
Doula: Stephanie Brennan – 478 7088, firstname.lastname@example.org. Stephannie is a fantastic doula from Florida and also a qualified yoga instructor offering private prenatal classes to help you keep in shape.
Photographer: Sabriya Simon – 369-2630, email@example.com. Sabriya was amazingly unintrusive yet caught every moment of magic on her camera. Also was a very hands on member of the birthing team, able to join in with whatever needed doing and has worked with Tioma and Natalie before.
Obstetrician: Dr Freddie Smith – Office: 906 1931. Dr Smith was great throughout my prenatal visits and appeared to be supportive of my home birth, and agreed to be my back-up doctor should something go wrong and I needed to be transferred to hospital.
GP: Dr Mary Sloper – Office: 968 3897, firstname.lastname@example.org. Originally from the UK, Dr Caroline Mary Sloper is absolutely fanstastic, worth the wait at her clinic in Nutal Medical Centre and can do home visits. She also is reassuring up to date with NHS research and trends, as she practices in the UK for a number of weeks each year. She’s looked after our whole family while we’ve been in Jamaica.
Paediatrician: Dr Judy Tapper – Office: 987 0907. Dr Tapper is thorough and kind and most importantly, the kids love going to see her!
Ambucare, 204 Mountain View Av. Kingston 6, Jamaica 978-2327 / 978-6021 / 978-8253 / 927-5337 – Luckily I never had to use this service, but this is the company we would have used should I have needed an emergency transfer to hospital.
HypnoBirthing: Currently I am the only qualified instructor in Jamaica, but this is to set to change this June, when Marie Mongan herself is hopefully going to be visiting Jamaica to train new instructors. I will be running my next classes in May / June and I can be contacted on email@example.com
When you give birth, you will feel at your most vulnerable. With the right mindset and support, you should also feel at your most powerful. Choose where and with whom you give birth carefully! Then let your body do the work. Enjoy the magic 🙂