Lizzie's positive HBAC birth story

Lizzie has kindly shared her epic birth story with me, she had to traverse some tricky situations to achieve her amazing home birth after caesarean, but she was just totally incredible and determined throughout, it was a privilege to support her. I'll let her take it from here!

"In November 2022 I gave birth to my son with an emergency c section in a birth I felt no control over and on reflection doubt it was even necessary. Flash forward to autumn 2024 when I fell pregnant again, I decided to try and avoid the cascade of intervention I was subjected to before and give myself the best chance of a physiological birth so I quickly referred myself to the home birth team at my first appointment.

My home birth midwife Ellie was amazing. She truly made me feel listened to and my experiences and feelings feel valid when it came to planning my birth for this pregnancy. I knew I would be in for a fight to advocate for myself for a home birth because not only was I trying for a HBAC which I found out at that appointment comes with it's own risk, but I also have a rare swelling condition which could affect the birth. However, I felt instantly, whatever my decision would end up being, that she would support that decision 100% and give me evidence based advice to help me to make that decision.

Throughout this pregnancy I was frequently counselled about the risk of home birth after a caesarean from a wide variety of medical professionals and on occasion felt I was shamed or scared with very scary sounding statistics that didn't necessarily reflect the actual relative risk of uterine rupture (0.5%chance*). I think for anyone deciding on an HBAC, you shouldn't be scared into that decision but be given the facts without opinion warping them. I think sometimes this counselling was done with the best of intention but is still an important learning point for people in maternity care who need to remember that no mother makes these decisions lightly. Ellie was brilliant at this and I felt informed with evidence. She also supported me in giving feedback to medical professionals when they perhaps did not counsel me in as supportive a way.

All the way to the end of my pregnancy I knew in my gut I wanted a home birth but I also had the option of giving birth in the midwife led unit too if I felt I wanted to on the day. It was at this point I decided I wanted a doula there to support us too and reached out to Leanne at Birth hood who said she could do shared care with her and Amy of Twelve Moons which is how I met Amy too. My consultant made an extremely comprehensive birth plan for both scenarios and this was shared with all of the home birth team and my doulas who also helped me to edit this plan to reflect what I wanted. I went into the final weeks of pregnancy having had a smooth pregnancy and growth scans coming out as normal.

A week before my daughter was born I went into the triage for some pain in my lower abdomen which they thought was ligament pain. They decided to monitor me on the CTG machine and basically my baby decided to do somersaults for 45 mins straight and so they ended up seeing some strange readings meaning at one point a consultant came in and said you need to have an emergency caesarean now and they were concerned my baby would not cope with labour.

Panicked was an understatement, especially as my readings had been pretty normal up to that point and my symptoms which I went in for had been put down to ligament pain. Amy came to join me as soon as she could followed by my husband. She really helped keep me calm, fed me well with snacks and advocated really hard for me when the readings were normal again (including at one point when the machine ran out of battery and started the whole thing again). Eventually I was signed off by a doctor to leave but they wanted me to come in for another ctg the next day.

To be honest I did leave the hospital a bit traumatised and the next day was made to feel extremely guilty by the midwife on the phone when I decided not to return for another ctg. I had done lots of research and there is so little evidence that CTGs improve outcomes as it is simply a snapshot of baby and I was worried the same thing would happen again and I would be pressured into something that was not needed.  Instead, the home birth team came round the following day and listened to baby and just generally eased my anxiety, including noting on my notes to come and check baby early in labour as I felt anxious after this experience with the initial consultant that baby would be ok.

The midwife was just so lovely, calm and again reassured me so well that my baby was ok.

I woke about 3am Saturday morning before my due date to what felt initially a bit like period pain in my lower back and gradually started to become more pronounced, waking me each time I fell back to sleep. I tried to stay calm and left my husband and son to sleep as I thought if this is the start of labour I and my husband particularly will need all the sleep we can get.

My son woke up about 6, at which time the tightening was becoming more frequent and painful. I ran a bath to ease the pain and tried to distract myself. I managed 1 hour of sleep before giving up and heading downstairs. At this point I thought I had ages and we had planned to take my son to the hairdressers so initially started getting ready for that but the tightening were getting more frequent so we cancelled and I managed a bit of breakfast.

The tightenings got to the 2 every ten minutes lasting about 2 minutes so I called the maternity advice line so they could let the home birth team know. I knew my midwife Ellie was on shift as we had an appointment late that afternoon and she called shortly after and we decided to get her to come over and check everything was ok.

When Ellie arrived she checked me over and listened to baby and reassured me that everything seemed to be going as it should. She set me up with the tens machine which helped a little and she stayed a little while to help my husband set up the pool. After some deliberation we sent her away so we could have a little time together. However, what felt like 10 minutes later it all seemed to be ramping up even faster so we called Ellie back and called my doula Amy to also come over.

From then on things get a bit more blurry as I focused on my breathing through the contractions. I felt all my contractions in my lower back so my husband did lots of hip squeezes which helped a lot during them and Amy put the hot flannels on my back and poured water on which helped lots too.

I was worried that the baby was back to back but when Ellie felt my stomach she said the baby was to the side and that it was just likely I feel my contractions in my back. Everything went so much faster than last time but I didn't feel pressured in any way, no need for examinations or constant monitoring - something which took over my first birth for the worse.

My body was simply allowed to do what it had to do.

I remember thinking very early on in the afternoon that this was as far as I got with my first birth and it didn't seem far at all, and yet I was given no pressure to have examinations, no pressure to hurry things along. I could just feel safe in the knowledge that my body knew what to do. I held off as long as possible to go in the pool and knowing gas and air was the highest pain relief at home, left it until the contractions seemed to almost roll into one another before getting it.

I felt I had been pushing for a long while and my waters still hadn't broken. I went to the bathroom to change positions and they broke, so I made my way back to the pool and 15 minutes later my daughter was born. The time after I just felt euphoric and so grateful to the midwives and to Amy who was just a quiet reassuring presence and just quietly recorded the birth which I am so grateful to have.

While we were having our golden hour, we also noticed that the cord had a true knot in it which everyone was very excited by as it is very rare and if detected pre-birth usually results in intervention. However, in our case it clearly had no impact on my beautiful baby girl.

Birthing the placenta took a while and I was a bit scared to have the injection and have pain again. Amy took me upstairs to the bathroom for a bit more privacy and calm and I birthed the placenta easily with a few different positions and didn't feel any pain at all. Although we had to be transferred to hospital for stitches in the end, my birth felt so amazing and I am just so grateful to all those involved in my care."

Thank you so much to Lizzie for sharing her positive HBAC birth story, and to the NUH home birth team (particularly midwives Ellie and Pia) for giving such supportive, balanced and individualised care.

*A little addendum on the risk of scar rupture, it's actually even lower than 0.5% if we don't include the VBAC's that have been induced. Here is the RCOG guidance which breaks down the scar rupture risks with induction as well as spontaneous physiological labour.

If you are planning a VBAC or HBAC and are thinking about doula support, it's kind of my thing! Get in touch if you'd like a free consultation to see if we might be a good fit. And if you are looking for an antenatal class that gives you space to explore all your options and helps you grow the confidence to navigate the maternity system, check out Birth, Unpacked.