Birth Story – Twin Home Birth at 42+2

I love a good birth story. And a twin home birth story? Double the fun!

I read this one recently on Chilled Mama, and knew I wanted to share it with you. It’s not a plus-size birth story, but I do think there are some relevant messages about it being the woman who does the allowing, and about how important it is to get the right support. So thank you to Cathy from Chilled Mama, and Laura for sharing this story.

Twin home birth - Caitlyn and Evelyn
Caitlyn and Evelyn

I’ll let Cathy from Chilled Mama take over from here:

Many women are told ‘you’re not allowed to …’. Not allowed to have a home birth with twins. No water birth with twins. Not allowed to have a home birth after 42 weeks.

This birth story comes from Laura, who knows it is women who do the allowing. Supported by AIMS and local consultant midwife, to have a positive home birth previously, finding herself pregnant with twins, she knew she was the one making the decisions about their birth. Her body. Her baby.

Here’s her twin home birth story:

Upon finding out out at the 12 week scan we were expecting twins ( 2 sacs, 2 placentas) I was told ( yes told!) at the time I would be attending the twin clinic at the hospital from now on for all checks etc. This immediately set me on edge. I hate hospitals; many bad experiences including the birth of our first left me traumatised even more. When I fell pregnant with our second I went through AIMS and was put in touch with the consultant midwife, previously known as supervisor of midwives, who came out to the house to talk through everything that happened first time and put me at ease about planning a home birth. Having our little lady at home went perfectly and was so cathartic for me restoring my faith in my ability to birth. 

With twins I knew a home birth would go against the grain so back to this wonder lady I went explaining I didn’t want to have my antenatal checks at the hospital, I wanted to stay with the community team and treat this twin pregnancy as a normal pregnancy until such times as we had evidence to suggest otherwise. This was arranged and we followed the normal schedule of antenatal checks. We had the anomaly scan as normal at 20 weeks showing everything was as it should be so for the time being I declined further scans as babies now just needed to chub up. 

Roll on to November we started to prep for the home birth. We discussed how early we were prepared to stay at home, for the midwives it was 37 weeks, for me I was happy at 36 but I also knew my history was long gestations so I just had to hope we’d make it to 37… we did! Everything in place, pool up, equipment here, team on call, we were all ready to go. That was 19 Dec! 

So we waited and still no babies and carried out the normal antenatal checks at the community clinic once a week, everything always as it should be so no concerns. I was always worried how I’d cope over Christmas and new year with our older two with nursery and play groups etc being off and it was definitely hard with them in the house so much. Hubby was due back to work on 1 Jan so in the absence of babies off he went not wanting to waste his leave. Getting to 40 weeks was quite surprising but again every check showed happy babies and my health remained stable. 

At 40 weeks I did start going down to the hospital to see the consultant midwife and each time we would do a trace of the babies, check BP etc everything always perfect. At 40+3 we did a scan to check fluid levels and placental flow. We also tried a sweep in the hopes of moving them along, generally I would always decline a sweep and have in the past but felt I wanted to try something. We followed this pattern checking on the babies on a Tuesday and Friday each time to check we were safe to wait a few more days. 42 weeks came… and went!!!

At 42+1 (Wednesday) the dream team midwives were coming to the house to check on the babies and discuss next steps… one had a weekend away booked, the other had commitments on the Friday and Saturday so while medically there was no reason to do anything, should the babies not be here by the Thursday night the midwives who would come would not be those I had been working with and trusted which did make me nervous. As it was in the 10 mins before the midwives arrived I thought I had had 2 contractions… one midwife had been awake 36 hours at this stage attending the birth of her grand child so she ran off home to bed. 

Contractions didn’t come to much while seeing to our older two, by 9.30pm they were starting up again so I tried to go to bed and rest. By 11 ish I had to get up, I had a feeling the pool needed started and things organised. At 12 I messaged our doula to say no rush yet but head over, I had the pool filling and the bath so I could get some relief while waiting for the pool. Not long after this I also messaged the consultant midwife feeling terrible that she wouldn’t have had much sleep but knew I couldn’t leave it any longer.

Our doula arrived about 12.30 and just quietly sat with me in the bath as things picked up. After maybe 20 mins I asked her to call the midwife just to make sure the team were on the way, unknown to me they had snuck past the bathroom door and were getting organised. Around 1 I got into the pool at last and got the gas and air going, which felt so much better. That was me in place, I could get my earphones in and my hypnobirthing CD on and go away. 

The sensations had familiarity this time and I could feel as the first baby came through my cervix and felt able to pull back and let it come slowly. Baby crowned relatively easily and again I felt able to hold and breathe while she turned. One final surge and there she was… at 01.35 such an incredibly tiny baby! I don’t think I’ll ever forget or forgive the midwife’s next statement… “Don’t tell me we have undiagnosed triplets!!!” 

One thing was for sure though, this was no overdue baby! Immediately I was so glad I’d stuck to my guns and declined induction, this wee one looked like she needed a few more weeks in the oven. 

As it was we got very little time to dwell as contractions started up again within about 4/5 minutes, seemed like no time at all. I tried to leave baby with her cord and bless them the midwives tried to hold her to me as the contractions were full on straight away but I just couldn’t cope with her there, I was worried I was going to squash or drop her. Quickly we got her cord cut and she went off for cuddles with daddy. 

I could feel the midwife trying to feel for twin 2 position, we knew it had been head down but also that it now had a lot of space to play. As it was the contractions were just coming too fast and I heard her say we’ll just need to be surprised. Again I could feel baby coming down and again tried to hold back and let it come slowly. At 02.10 we had another little lady… who behaved impeccably and stayed head down, born in her caul no one even realised she was out until I sat back and got her out the water. Obviously much bigger than her twin, she was the carbon copy of her older brother and sister, daddy has genes of steel! Again with little time to dwell contractions came back with a vengeance for the placentas.

Again I tried to hold on to baby but these were massive surges that took all my focus and again we had to cut her cord tho I think she got about 5 minutes with it. I always said I wouldn’t want a managed third stage but I did feel after maybe 10/15 mins that I was just so wiped I just wanted it done. Asking the midwife for the injection she was a bit taken back knowing I hate needles but got it sorted quickly and thankfully it was over. I have honestly never felt so depleted I couldn’t even open my eyes.

Soon after the midwife started to get a bit anxious saying she could smell the iron in the room and was concerned over blood loss and wanted me out the pool so I made it out and set up camp on the sofa. At this stage I think I downed two bottles of Lucozade in an attempt to get myself back up. The after pains were also horrific and I was sucking on the gas and air as much as I had done through their births. However after a while I really wanted a bath and the lead midwife started to look like she was hitting a wall she must have been so tired now part of me was keen to show her I was okay to give her the peace of mind to be able to go home. Sadly this is where I’d went a bit haywire….

I got up and made it through to the bathroom but was starting to feel faint so sat down in the toilet seat thinking I’ll be fine in a minute. Sadly I wasn’t, my blood pressure dropped dramatically and I blacked out… the next thing I knew I was aware of a phone call for an ambulance and they were getting me on to the floor to stabilise me.

By the time the paramedics arrived and they exchanged the information needed I was feeling a bit better again, I think lying on the cold floor actually helped me. So much so the midwives were actually saying they didn’t think it was a medical event, more a lack of sleep, not eaten and yes a little more blood loss than ideal but I had stopped actively bleeding so she said if I wanted to stay at home she was happy for me to do so as long as I could make it up to pee as my bladder was really full. However as soon as I tried to get up again I could feel how weak I was and even though I hate hospitals, even I said I think I should go in. So off we went…. two babies, daddy, 3 midwives and our doula.. we were quite the cavalcade!

Thankfully in the end all they really had to do was feed me and give me some stronger pain killers. They checked my iron levels which had dropped 3 points so they said to start taking the iron tablets again but otherwise I’d be fine with time and chance. Again the consultant midwife had made sure I was looked after and had a room to myself and all the midwives on the ward had been asked to leave me alone unless I called to give me a chance to rest. By mid afternoon I felt strong enough to make it home so it wasn’t too bad in the end. It was more of a visit to hospital rather than delivering there which I would have struggled to cope with. 

So that’s how it came to pass that we had our twins delivered at home at 42 weeks and 2 days. I’m forever indebted to the consultant midwife who could not have done more to support me and orchestrate everything to make sure my wishes were carried out right to the last. And all from a supposedly failing NHS…. it just goes to show what patient centred, evidence based care can achieve. 

Laura, Caitlyn and Evelyn

I’m in complete agreement with Cathy here. I love this story because it shows what is possible. You have to ask for it. You may have to talk to the right people. But it is possible. It also shows the value of patient centred evidence based care, as Laura says.

If you have a birth story you’d like to share with the Big Birthas audience, we’d love to hear it! You can contact Big Birtha here.

Accessing research documents for free

I’ve read quite a bit of research while writing articles for this site. But accessing research documents for free can be an issue. I understand that the publications and authors deserve remuneration for their work, of course I do, but the simple fact is if you’re trying to research your birth and maternity care options, most individuals don’t have the budget to pay for journal access. Even if we did, every article that might be worth reading seems to be in a different journal!

A friendly librarian pointed me in the direction of an article she’d written with tips and tricks to access this information for free, so here is the benefit of her wisdom:

Get The Research.org

Get The Research owl logo

gettheresearch.org is a search engine that makes academic information both discoverable and easier to digest. You can use it instead of Google.

Get The Research flags each article with its “level of evidence” when they know it. Is the article just a report about a single incident (a “case study”) or a more trustworthy analysis combining the results of many studies (a “meta-analysis”)? Click on the tags above the article titles to learn more. They rank articles with higher levels of evidence higher in the search results to make them easier to find.

Advantages:

  • user friendly interface
  • evidence based quick overviews

Disadvantages:

  • new so there’s likely some bugs to iron out
  • it’s not clear what information is updated automatically

Open Knowledge Maps.org

Open Knowledge Maps logo

Open Knowledge Maps describes itself as “a charitable non-profit organisation dedicated to improving the visibility of scientific knowledge for science and society.”

It provides a visualisation tool, demonstrating topics and the relationships between them. Use it to get an overview of the most relevant areas of a topic and papers related to those concepts.

Advantages:

  • generates visualisations for your search terms
  • it has an option to visualise results of searches just from PubMed

Disadvantages:

  • still in development
  • it only analyses the first 100 papers based on relevance ranking

Open Access Button.org

Open Access Button logo - - accessing research documents for free

openaccessbutton.org allows you to search for an Open Access version of a paper using it’s URL (web address), DOI (permanent Digital Object Identifier) or title. It’s helpful with accessing research documents for free as you can use it when you’ve found a journal article you want to read, but the publisher tries to charge you to access it.

Advantages:

  • easy to use
  • no installing or configuring, unlike Unpaywall

Disadvantages:

  • it relies on academics submitting a copy of the article

Core.ac.uk

Core Logo

Core.ac.uk is a not-for-profit service delivered by The Open University and Jisc. Institutions store publications created by their academics and CORE allows these to be simultaneously searchable through a single interface. It can be used when you have a keyword search and want a more in-depth, systematic overview of a topic or problem.

Advantages:

  • search a lot of credible information, fast
  • there’s an API for text mining

Disadvantages:

  • you aren’t searching ALL the repositories that exist in the world. It’s possible you will miss a source

Directory of Open Access Journals

Directory of Open Access Journals logo

DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals. DOAJ is independent, and all DOAJ services are free of charge including being indexed in DOAJ. All data is freely available. It’s searchable by title or article. Can be used to follow a specific journal that consistently produces articles about a topic of interest.

Advantages:

  • all of the journals included are Open Access — no paywalls

Disadvantages:

  • there is a small chance of encountering a predatory (scam) journal – however, each journal does undergo over 40 checks before it is listed.

Directory of Open Access Books

Directory of Open Access Books Logo

All books listed in DOAB are freely accessible and therefore free to read, but this does not mean readers are free to do anything they like with these books. The usage rights of the books in DOAB are determined by the license. Please check the license if you want to re-use the contents of a book. Generally speaking, all books listed in DOAB are free to read and share for non-commercial use.

Advantages:

  • avoid annoying previews, this is the whole textbook, for free!

Disadvantages:

  • the idea of Open Access textbooks is still a fairly new movement, so there’s a limited selection.
  • you will have to buy the book if you want to own a complete physical copy of the material. Printing could infringe UK copyright law.

I’m sure this won’t always work to get you access to the article you want to read, but hopefully it will bring more research info easily within reach than before!

x Big Birtha

with thanks to Sheldon Korpet who wrote the article “How to access academic papers online, for free!” on which this post is based. Licensed under CC BY-NC 3.0.

Research on Provision of Long Acting Contraceptives

Long-acting reversible contraception or ‘LARC’ describes contraceptive methods that you don’t need to use every day. This includes the copper intrauterine device (also known as the ‘coil’), progestogen-only intrauterine system (also known as the ‘hormonal coil’), progestogen-only injectable contraceptives (‘depo’) and subdermal implants (‘implant’). I recently mentioned another group conducting research on provision of long acting contraceptives. Looks like it’s a hot topic this year!

LARC is popular as it’s a highly effective method of preventing pregnancy. For some people it can be a positive option, but there are concerns that some may experience pressure to use LARC, or may find it difficult to get removed. Researchers from Lancaster University, working with the British Pregnancy Advice Service (BPAS), are studying LARC in the UK.

If you’ve been encouraged to use LARC, are over 13 and living in the UK, the researchers would love to talk to you!

Recruitment advertisement giving the details of the participant criteria - 13 yrs+, using contraception or have a need to use it, living in the UK.

For more information, please read the attached documents:

For further information, or to take part, please contact Taylor Burgess by email: taylor.burgess@bpas.org, or complete the form below with your details.

Lancaster University Faculty of Health & Medicine logo
British Pregnancy Advisory Service logo

Permission to Contact Form

Please read the project information sheet, then select yes or no to answer each question.

Pictures of 4 different Long Acting Reversible Contraceptives


Our PSG Research at the Medical Sociology Conference 2019

The best thing about ParentingScienceGang was discovering all the other articulate people passionate about the issues of high BMI pregnancy. One such woman is Dr Mari Greenfield, who presented our research at the Medical Sociology Conference in York in September. Mari has written a guest post about the experience:

Dr Mari Greenfield, who presented our PSG research at the Medical Sociology Conference 2019
Dr Mari Greenfield

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

I took part in the Big Birthas Parenting Science Gang as a Parent Scientist. I helped to decide the research question, design the methods we would use, and undertake some of the analysis.

When the project ended, we Parent Scientists had the data and the findings, but needed to decide what to do with them. My day job is a doula and researcher, and I’m passionate about choices in birth for all, regardless of BMI. Some of the stories women had shared with us were heartbreaking; stories of choice and power taken away, and of upset and trauma as a result.

Some of the stories were also uplifting, when women took power back; asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much, giving time and investing themselves by telling their stories. I want to make sure we do justice to that. 

One way I can do that is to present our findings to a diverse range of audiences. In my day job, I frequently present research to conferences of academics, so I applied to the Medical Sociology Conference. Hosted by the British Sociological Association, it is a brilliant event which focuses not on what we do within health care, but how we do things, why we do things, and how we could do health care better.

our research at the Medical Sociology Conference 2019

Pecha Kucha!

My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus on the key points you want to make. There is no room for waffle!

I wrote the both the initial application and the presentation collaboratively with Big Birthas and several of the other Parent Scientists, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working. This is quite different from the creation of most other academic and medical presentations.

The high BMI ‘box’

I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women explained how, once in this category, BMI was the only thing anyone seemed interested in. They described having serious medical conditions ignored. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but in one this was ‘normal BMI’, while the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.

Programme excerpt about our research at the Medical Sociology Conference:

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

What does it mean to be labelled as having a high-BMI whilst pregnant? How does this label affect women’s experiences of navigating maternity services?

This presentation is based on a novel user-led Citizen Science collaboration between Big Birthas (peer information and support service) and Parenting Science Gang (Wellcome Trust funded user-led citizen science project).

The results described complex journeys, where interactions with healthcare professionals revolved around conversations of BMI-related risks to the exclusion of other factors, and ignored other events of the pregnancies.

Women also reported disrespectful and shaming language from healthcare professionals, and conflict if they asserted a decision that was not in line with the healthcare professional’s views.

This led some women to decline care that they actually wanted, or avoid attending appointments, to avoid conflict or denial of choice; a consequence which was particularly apparent when we examined how those women chose to approach their second pregnancies.

The presentation and our research at the Medical Sociology Conference was well received. Questions after the talk asked about both the Parenting Science Gang methodology, our methodology, and our findings. People spoke about how our research overlaps with work they are doing.

The Parenting Science Gang’s project is over, but the journey of the stories we collected is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…

Dr Mari Greenfield

Academic researcher in maternity care, doula, birth activist. Special interests in traumatic birth and LGBTQ experiences.

Huge thanks to Mari for bringing our research to a wider audience, and for writing up the experience too!

Would you like to write a guest post for Big Birthas? Have you got experiences or a perspective that the Big Birthas audience might be interested in? Do you have a birth story you want to share? Please get in touch via the Contact Big Birtha page.