Eight weeks pregnant, for those not already privy to insider knowledge on the matter, is when the exhaustion hits. In fact it’s a bit like lockdown 1 for your energy levels, and you can be sure that pregnancy has a few more planned before you get to meet your baby. The nausea that had been niggling at the back of my mind in recent weeks had pushed its way to the front and reminded me daily that I was growing a human inside of me. 

Suddenly, everything got much easier. Up until then I'd had 3 school runs a day. Trying to get 5 young children out of the house by 8:15am each day is no small thing. After school was a rush from one commitment to the next, dropping children off at extra-curricular clubs before heading off to classes myself as a children's Spanish teacher. Even the weekends gave little respite. We had a full morning of back-to-back swimming classes with the children every Saturday, and on Sundays we attended our gorgeous local church where we were married and where all of our children have been Baptised. 

I love being busy - I thrive on it - but the first trimester joys of nausea and exhaustion have always taken their toll and having an extra child to look after each time only compounds that. Alongside that, as someone who experienced miscarriage before ever knowing a healthy pregnancy, the all-consuming fear of what might be has always weighed heavily on me during those first 12 weeks, so I wasn't sorry to be told we had to immediately apply the brakes and stay home.

A few weeks later, and just two days before my dating scan, I turned 40 - a big deal for anyone, but especially so for a woman who has not finished building her family. Everything changes at 40. It is a significant, and in most cases final, decade for pregnancy, and even though the growing embryo within me had come from an egg who was still in its 30s, statistically my risks were immediately increased just for blowing out those candles.

My husband has been with me for the first scan of every pregnancy, including the one where we found an empty uterus. He held my sick bowl when I wondered how I would make it to the scan for my eldest daughter in the face of hyperemesis. He was there when I had no sickness at all with our eldest son and had convinced myself they would say the baby had died. 

When I booked an early scan due to bleeding with our 2nd daughter, he again sat with me, holding my hand when I didn't dare to believe they would find a heartbeat. Through every pregnancy, he has always been there to hear the heartbeat for the first time, and for the anomaly scan where I always hold my breath, desperately hoping everything looks as it should. 

Due to COVID restrictions, I was alone this time. I asked the sonographer if I could film the ultrasound for my husband, or even video chat with him so that he could meet his baby too. My requests were denied. So it felt cruelly ironic, alone at my dating scan for what is almost certainly our final baby, to be told that there might be a problem. I had walked in with an increased risk of trisomy defects because of my age, but where usually the scan would reduce these risks, this time it had increased them. It was a borderline finding, something was 0.1mm outside of what would be accepted as a normal measurement, but it mattered. COVID restrictions also meant that my booking bloods, normally taken a couple of weeks before the first scan so that all the risk factors can be calculated, were only taken on the day of my scan. They would be rushed through, but it would be a day or two before anyone could tell me whether they made a genetic defect more or less likely. I returned to my car, where I had expected to phone my husband to tell him everything looked great, and instead I phoned to tell him that we weren't sure. That it could go either way. That more tests were needed.

The successful dating scan, as for many parents-to-be, is the point where we excitedly gather our families to share the good news, and although it’s fair to say that delight gave way to a degree of ambivalence in our families some time ago, we still had news we wanted to share. But this time it wasn’t so simple. It wasn’t simple because we couldn’t invite everyone round, as we usually would, and it wasn’t simple because we couldn’t be sure things were going to work out for this baby. We had 5 young children to protect. Was it better to tell them they had a sibling on the way, and crush them with bad news later? Or should we keep quiet even as my bump became ever more obvious, saving them any heartache, but also denying them the knowledge that there had ever been a baby. As the fog of that first scan gradually lifted, I was sure I knew what I wanted to do. We had always spoken about our November baby, who we lost almost as soon as we knew I was pregnant, and the children are all aware that their eldest sibling, for reasons we can’t know, never got to be born. It felt wrong for us to keep this from them. So just as we have done each time, we sat them down, showed them the scan picture and shared the exciting news. Now…even in a national lockdown it would be optimistic to expect 5 children under 7 to keep a secret that big, and in any case I felt baby 6 deserved to be announced and shared just as enthusiastically as our other children. Whatever might come next, we would want the support of our loved ones.

Some wonderful outcomes of lockdown life were the innovative ways that people found to connect with each other. A local photographer was offering socially distanced photoshoots to provide a sense of community at such an isolating time and I asked to be involved. She took a gorgeous doorstep photo of our family, with baby 6 peering out from the scan photo, and we used it to share the news with our families, and our wider circle through Facebook. We also shared our hesitation: that we weren’t sure yet whether we would get to meet this baby who we already loved so much, but that we wanted his or her existence to be known and enjoyed. Locked away in our house at a time when everyone felt so distanced, we felt so much love pouring in from those close to us.

The 10 weeks that followed that first scan were a rollercoaster ride. Statistically we were very unlikely to come through every possible complication unscathed. There were many extra appointments, all of which I had to attend alone, and many difficult conversations with the midwives, which then had to be repeated when I got home. I had never had a pregnancy like this one. It was terrifying and isolating, and COVID made it so much harder. Perhaps one day I will write more about those weeks, but to keep myself vaguely on track [spoiler alert], we were one of the lucky families – it all worked out okay. At 23 weeks gestation, the Consultant told us our baby looked as healthy as any other baby might look. If there was anything wrong, he couldn’t pick it up through his many tests. The pregnancy bumped itself back onto the tracks and the weight of the world lifted from us. 

Previously I’ve always given birth in hospital, or in the hospital grounds at least (another story that deserves its own blog post one day!). My Consultant felt very strongly that it would be a good plan this time too. By now, the fact that I was 40 and having my 6th baby had been bolstered by the news that I was Group B Strep positive and soon afterwards I was found to have Gestational Diabetes. Both diagnoses were new to that pregnancy. Mix in a healthy dose of global pandemic and there seemed to be a number of compelling reasons for me to agree to a due date induction. 

I should probably introduce some background here, that for the past few years I have been training in various areas of perinatal work. My learning journey (my husband will be rolling his eyes at that word!) has taken me to the edges of my comfort zone and really made me examine my values and my reasoning. Homebirth, in particular, has always drawn me in, as compelling to me as the clear medical view that I was not a suitable candidate. With each baby that I have brought into the world, the evidence for my need to give birth in hospital has seemingly strengthened. Yet with every new course I attended, every new piece of research I devoured, I became more and more sure that homebirth was something we and our baby would benefit from experiencing. I will, no doubt, talk more about homebirth at another time, but for the moment I will say that it was not a conversation anyone wanted to have with me. My husband wasn’t thrilled with the idea, my midwife felt I wasn’t suitable for the Homebirth Team, and by virtue of the fact I even had a Consultant, I wasn’t ticking the low risk boxes that typically lend themselves to giving birth at home. But in my mind, the cogs were turning. 

COVID restrictions had relaxed a little by the time I reached the third trimester, but as my due date approached, the second wave was very much upon us. New mums were emerging from hospitals with stories of being alone for induction, of having to consent to invasive examinations before their partners could be permitted to accompany them, and the idea I was hanging onto, that I might have two birth partners instead of one, was categorically off the table for me. For a while I tried to reconcile myself with what sounded like the sensible plan. We knew that I would labour fast, that the baby and I would both need some hospital attention after the birth, and that being induced at my due date allowed for all of this to happen in a safe environment. Yet the voice in my head got louder with each passing day. I wanted to be at home. I wanted to have my husband and my Doula present, and whilst Government guidelines allowed for this, hospital guidelines did not. 

In my 5th birth I had tested a theory, using my natural oxytocin to manage my postpartum haemorrhage, and I felt confident that in a safe, familiar environment, on my terms, I could probably offset many of the potential risks which a hospital birth might exacerbate. Yes, a hospital was the safer place given my risk factors, but it was also a risk factor in itself. Induction, on a day when my baby might not feel ready to be born, in a hospital filled with restrictions and masks, and without the support partners that I wanted, felt as inappropriate to me as my suggested homebirth did to my Consultant. A huge part of my time as a birth worker is spent empowering parents-to-be to examine their options, to ask the questions, to make the decisions which feel right for them once they are suitably informed and armed with the facts. It is still a far easier narrative to preach than to follow. I had read the studies. Yes, I was older, and a grand multip, but actually compared with a younger woman experiencing her first birth, my risk of an adverse outcome was lower. That said, the NICE Guidelines were clear when it came to Gestational Diabetes. In my particular circumstances, it was ill advised to go beyond 40+6 weeks. I suggested to my Consultant that we could schedule an induction for then and I would try everything in my power to kickstart labour before then. Of course, lockdown and Group B Strep had removed many of the techniques I would typically have turned to... 

My Consultant did his level best to talk me down. We reached an impasse and I agreed I would come in for monitoring at 40+3 weeks, the date at which he felt it was best to induce me. “I’ll see you on Friday for induction”, he said. “For monitoring?” I replied, “yes, see you then”. At 40+2 weeks, we entered a second national lockdown. It was bonfire night but all firework displays had been cancelled. Before bed, I took a long bath and listened to the pops and bangs of a few local fireworks being set off by the neighbours. I felt strangely calm. I was expecting to see my Consultant the next day and had all my evidence printed out, ready to make my case for expectant management. I’ll never know what it was that brought on my labour spontaneously. Perhaps it was the tiny silver balls my reflexologist had taped to the acupressure points in my ears and on my ankles a week earlier. Perhaps it was the knowledge that I needed to give birth before my induction/monitoring appointment later that day. Perhaps my inner confidence had created the perfect oxytocin storm. Perhaps my baby boy was just ready to enter the world. 

At 2:58am on the day of my appointment, I woke to the unmistakable sensation of my cervix dilating. I feel as silly saying that now as I did then. I can’t describe it. I just knew that was what I had felt. I woke my husband and we waited. Five minutes later the sensation returned. I texted my Doula. “Are you awake? I think this might be it”. I didn’t dare to ring in case I was wrong. The text might not disturb her. I asked my husband to go and turn the heating on in our shed, and I waited to see what would happen next. Another five minutes passed and I had a third contraction. By now I was clear that was what they were. I rang my Doula and she answered within 3 rings. It was a little after 3am, I had had three contractions, it felt real. She said she would make her way over. 

My labours have always been fast, my quickest birth having happened 11 minutes after a midwife had examined me and declared my induction unsuccessful. I was confident it wouldn’t be long until we met our baby. Once I had spoken to my Doula, I made my way downstairs and into the garden, towards the shed which I had set up for the homebirth I so desperately wanted. The freebirth I had decided was the right decision for me. I stopped a few times as the contractions surged through me and the familiar sensation of a rapidly progressing labour took hold. Time galloped on without my knowledge and I have no idea how quickly my Doula arrived, but I remember the first thing she asked was whether I could still talk during a contraction and that I said no, not really. I was close. At 4:16am, 78 minutes after I had woken up to that first sensation, my son slid into this world. I remember saying ‘someone catch the baby!’ and then bending down to scoop him up myself from the cushioned floor of my empty birthing pool where I had promised my husband I would give birth to avoid making too much mess. And then we all just sat there, in the low lighting of the shed, basking in the absolute glory of my son’s safe arrival. A short while later, the placenta was born, safely and without incident. My son’s birth was perfect. 

My husband woke our 5 other children so that they could come and meet their brother, and once I was sure nothing could interrupt the beauty of his arrival, as promised to my husband, we sought medical help. My son and I were kept in hospital overnight, as I knew we would be. We were monitored, I had some minor repair work (the definite downside to each of my 6 very fast births) and the following day we were back home. My Doula is also a birth photographer and the images she captured for me that November morning are so very special to me. They pay testament to the power of a woman. The physical power but also the emotional power. I only have to look at them to vividly remember the sensations of my son’s labour. 

AUTHOR'S NOTE

A study in April 2020 found a 72% increase in the number of people, in their third trimester or postnatally, who had considered freebirthing due to COVID-19 restrictions, with the LGBTQ+ community being disproportionately affected. 

As an informed, empowered woman, approaching my 6th birth, with a good knowledge of my rights and how to access evidence to base my decisions on, pregnancy during the COVID-19 Pandemic was difficult. Not only because of the specific details of my own pregnancy, but because of the bigger picture. It was disempowering and upsetting to be told I must attend my antenatal appointments alone, and it was an absolute deal breaker for me that having a hospital birth restricted me to only one birth partner. Ultimately this was the reason behind my decision to freebirth. I was fortunate to be in a position to make that decision from a position of knowledge and understanding. 

I can only imagine how it must have felt, must still feel, to be a first time parent in the current climate. Improvements have crept in as the pandemic has progressed, but restrictions remain, and as someone with the luxury of comparison, I feel sad for those who are experiencing pregnancy and birth for the first time under the restrictive and limiting conditions that currently exist.