Ella* works in the NHS as a psychologist, supporting new parents and babies. She has a girl toddler already, who she gave birth to in the birth centre. However, Ella has a real fear of hospital settings based on being in hospital as a child, and knew with her second pregnancy that she wanted to give birth at home.
Her first birth also compounded her anxiety around hospital settings. Ella said: “Medical settings make me feel really stressed and anxious. My experience in the birth centre was poor, they based their assessments entirely on the dilation of my cervix rather than what I was telling them, which was that my body was pushing. I subsequently spent most of that labour in a triage room with no midwifery care and I found that terrifying. I had a very quick first birth – around 5 hours in total, despite being told I wasn’t dilated enough. And when I did end up giving birth in the birth centre, my midwife didn’t notice at first even though I said my baby was coming – my baby was born in the pool and the midwife hadn’t noticed. I thought the silence from her meant that there was something wrong and I was too scared to look or ask, I was frozen with fear and shock.
“Looking back, that felt quite traumatic and had a knock on effect to how I felt during the postnatal period, my bond with my baby and how I was with my family. ”
“So for my second birth I was clear in my mind that I would rather be at home, the place where I feel safest, in order to have a more positive birth experience the second time round.”
“As with my first birth, I had a very low risk pregnancy, and I made it clear from my booking appointment this time that I wanted a home birth.”
“My midwives along the way were backing this decision and everything seemed to be progressing as planned.”
Ella attended pregnancy yoga throughout her pregnancy and was in her third trimester, around 32 weeks pregnant when she heard from a heavily pregnant woman in her class that her home birth had been cancelled. The woman lived close to Ella, so she immediately contacted her community midwife who confirmed that it was the case and that all home birth services were being suspended.
Ella said: “I was devastated. I felt so upset and stressed at a time in pregnancy where you would hope that you would be feeling happy and excited to finally meet your baby. I remember thinking, ‘I can’t go into hospital to give birth, I just can’t do it. What am I going to do? What if I have an even quicker birth this time and it happens in the car?’ For me, it wasn’t just a preference to birth at home, even though that is enough of a valid reason within itself, it was also grounded in my fear of being in hospitals. It felt so unfair for women who were so close to giving birth that their choice to birth at home had suddenly been taken away from them. I remember crying to my partner when we found out and deciding that we weren’t going to give up on a homebirth just yet.”
“Luckily we both work in the NHS so we have an understanding of the system and how to navigate it.”
“Without that knowledge, and without my partner by my side filling me with strength when I was exhausted, I would have been too afraid to fight.”
Ella contacted Birthrights, and took advice from others in her local area.
“I remember contacting one well known doula online, who used to be a midwife, and her advice was not to waste my time and energy writing letters as it wouldn’t get me the home birth I wanted. At the time, I wanted to believe that she was wrong, but ultimately, she was right.”
Ella and her partner wrote to PALS NHS and asked for that letter to be sent to the Head of Midwifery and the Chief Executive. They asked if there was any other option they would consider – from funding an independent midwife to being more flexible and considering her individual circumstances given the hospital trauma to asking other nearby hospitals if they would attend an out of area home birth. Ella had already had therapy in her first pregnancy to try and become more comfortable in hospital settings.
Unfortunately the Deputy Midwife told them they couldn’t facilitate a home birth. Ella and her partner even wrote to the Integrated Care Board to ask if they would consider funding a home birth midwife but they declined.
At this point, Ella only had a few weeks left until her due date. She said: “I needed some kind of certainty in my mind about the birth and had very little energy left to continue seeking the homebirth I so desperately wanted. Birth is so uncertain and unpredictable anyway, but to have all that additional uncertainty around having absolutely no idea about where I would give birth was really stressful. To protect my own well-being and that of my baby and family, I thought I am just going to have to accept that the birth wouldn’t be at home at that point, and that’s when we gave up.”
She had a meeting with the Head of Midwifery, Deputy Head and Matron of the birth centre (a different birth centre to her first birth). They listened to her concerns and promised to put together an Individualised Care Plan to try and meet her needs.
In the end, they followed through with this, and her birth was extremely quick – from waters breaking to her son arriving it took just two hours. Ella said the midwives were really flexible and mindful of her anxiety and put plans in place to try to mitigate her anxiety. They were all apologetic that her home birth had been cancelled.
However Ella still had to give birth in the birth centre, a hospital setting, despite this being a traumatic association for her.
Ella said: “It’s the system isn’t it. You have absolutely no choice. Either you give birth at home without a midwife, which comes with risks, or you have to go into a setting you’re not comfortable in to have the midwifery care.”
“My first birth in that hospital setting felt retraumatising. What feels really sad for me is that I don’t know if I’ll have another baby, that might have been my last birth, and so I may now never get to experience giving birth at home where I feel safe. There’s a lot of grief and loss connected to that, which only other mums will truly be able to understand.”
*Ella has chosen not to use her real name.
Read our report ‘Access Denied: Restrictions on Home Birth in the UK’