Because she was pregnant with twins, Scarlett had done “a tonne of research” before deciding that she wanted to have a home birth this time around. She felt she had a complete understanding of “any and all” risk factors in her case and wasn’t willing to accept the blanket ‘no’ women pregnant with twins are often faced with when requesting a home birth.
Scarlett had wanted a home birth with her son, who is turning three in March. She had a long labour at home, was transferred at 9cm dilated to the hospital and gave birth in the labour ward, with forceps used. One of the things Scarlett was keen to avoid for her second birth experience, was the uncertainty around a home birth. Towards the end of her first pregnancy, she was repeatedly told her home birth team might not come. “This caused my body to go into fight or flight mode,” Scarlett said. With her first birth Scarlett was twice told no one was available when she called the hospital, which Scarlett said stalled her labour. At one point hospital staff told her partner to prepare to deliver the baby himself. The midwives finally arrived at her home after the third call Scarlett made to the hospital.
As a result of such a difficult experience, Scarlett decided on a free birth with her next baby, something she said she would not have considered if she had had the commitment of a home birth team attending. At 16 weeks Scarlett instinctively felt something was different about this pregnancy and went for a private scan. The sonographer told her she was expecting twins.
“The sonographer said ‘it’s such a shame you can’t have a vaginal birth, you need to call the hospital immediately’,” Scarlett recalled. “She was very pushy and made me feel suddenly that my uneventful pregnancy had turned into something very risky”.
Scarlett felt all her dreams of a redemptive birth experience being ripped away.
Scarlett spent the next three weeks in turmoil, trying to decide whether or not to contact the hospital and enter the system. The sonographer had told her she would need to schedule a caesarean, something Scarlett later found out was entirely untrue, but which delayed her contact with the hospital.
Finally, she made the decision to write to the Head of Midwifery about her decision to have a home birth, and if this is not supported, she would free birth. Scarlett was contacted by a Consultant Midwife, had an online meeting and, to Scarlett’s shock and disbelief, agreed to all of Scarlett’s wishes. She said she would go away and speak to the team and come back with a plan for the birth.
Scarlett remained concerned, as she knew no one else at her Trust had had a home birth with twins. She emailed the Consultant Midwife every two weeks for five months, often going weeks without a reply. A lot of meetings were promised, but cancelled and the weeks went on without a solid plan. Despite this, she attended scans and gave bloods when asked.
At the 27-week scan the consultant midwife, who had initially agreed to her home birth, caught Scarlett in the corridor and informed her that the obstetrician was forcing her to write Scarlett a letter, stating that they are worried about a home birth her because a twin had died in a neighbouring county during a home birth.
“This felt very coercive and scaremongering as well as being highly inappropriate,” Scarlett said.
She soon received a letter which set out a number of risks, despite many not applying to Scarlett given the progress of her pregnancy, scan and test results and said that unless she attended the birth centre there was a real chance of her babies dying. Scarlett spotted inaccuracies in the letter, which made her feel some of the contents had been cut and pasted from elsewhere.
She said: “it included the line ‘we are concerned you may have a haemorrhage like in your last birth’ but I did not haemorrhage in my first birth”. This is when she got in touch with Birthrights’ advice team.
After five months Scarlett eventually received an apology from the Consultant midwife saying she had felt under pressure from the obstetrician. Scarlett found this alarming. After some time they promised to have staff on call throughout December and January to facilitate the home birth.
However, once again, when Scarlett went into labour, she was told there was no team available. She ended up giving birth in the birth centre and had “two amazing birth experiences”. However, Scarlett still felt deeply let down. “To spend five months arguing and then have them agree to a homebirth which ultimately again, was not attended due to ‘staff shortages’ was again a big let down after all the promises made.” Scarlett felt that despite the notice the Trust had about her home birth not enough was done to prepare sufficient staffing nor to think about alternative provision such as funding an independent midwife.
Initially, Scarlett had been told twins must be induced, cannot be born in the pool, must have continuous fetal monitoring with an epidural in place, must have a caesarean date booked “just in case”, none of which Scarlett agreed to. She had 90 minutes between her twins, something again she was told wouldn’t be allowed because the NHS only “allow” up to 30 minutes between twins. Scarlett said her work advocating for herself meant that eventually her wishes and personalised plan was followed in the midwife-led unit.
Scarlett said: “I just want twin mums to know that it is possible to have their birth wishes supported. It goes without saying that mothers don’t want to put their babies at risk, but we are often made to feel like we do for not agreeing to standard blanket policies.
“Many twin parents I have spoken to online are feeling the same: scared and almost resentful of the fact they’re having twins because they are expecting a negative birthing experience with the NHS as a result.
“It is such a shame I had to spend most of my pregnancy arguing and fighting for something so basic such as to be treated as an individual, with the risk assessment based on my pregnancy and not on generic guidelines for twins which assume everyone is high risk. I am very happy with the outcome but do still feel disappointed it took such a fight to get there”.