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Sunday, March 27, 2011

X Factor judge's birth agony: After 20 hours of labour, Dannii Minogue realised her dream of a home birth was over

By Dannii Minogue


No place like home: But Dannii Minogue's plans to give birth at home were dashed after discovering baby Ethan was in the back-to-back position


At 6.39pm on July 5 last year, our little boy, Ethan Edward Minogue Smith, came into the world weighing 8lb 3oz.

My partner Kris and I were now, officially, Mummy and Daddy, and we were overjoyed.

But typically for me, nothing about the birth went according to plan.


For a start, Ethan arrived ten days early, and then we discovered he wasn't in the correct position for a smooth delivery.

So, after 20 hours of excruciating labour, my plans for a home birth went out of the window and I ended up having Ethan in hospital.

Contrary to reports of me being rushed to hospital in an emergency, my amazing home-birth midwives, Nicola and Helen, helped us carry out a smooth transfer to the Royal Women's Hospital in Melbourne.

The staff at the hospital were great, and worked with our midwives to make my little boy's birth the wonderful and happy experience I'd hoped it would be, even though I wasn't at home.

I'd had my heart set on having Ethan at home after talking to my friends Jasper and Lynne, from the UK, who were really positive about the idea and had done lots of research.

Lynne had given birth to my goddaughter, Amelie, at home, and her second baby, Theo, and she had loved the experience.

I really believe that a woman should have the right to have her baby at home if that's what she decides and medically it's safe for her to do so.

There's no right or wrong, for me it's about choice. But it's a constant battle for mothers and professional midwives alike to get that point across.

Another major factor in choosing a home birth was my residual anxiety about hospitals, as my recent memories of them had not been particularly pleasant.
There had been my sister Kylie's cancer treatment, and then I'd watched my best friend Laura go into hospital, again with cancer, and never come out.

I just wanted some comfort and privacy and, for me, that meant giving birth in my own home.

When my contractions started I was fairly serene - it was everyone else who seemed to get into a flap.

As I said, Ethan decided to join us early, so when my waters broke after I'd ambitiously tried to cram myself into a pair of jeans, I called Kris, who was playing golf.

He, in turn, called my mum, Carol, who happened to be on her way over anyway. I was quite calm, but I worried that Kris might drive too fast or miss a red light in all the excitement while dashing back to the house.


Centre of Attention: Dannii with partner Kris and baby Ethan (left) and Auntie Kylie gets to grips with the new arrival


My friend Ben Pauley, who was visiting from Los Angeles, was also at the house, and he and Mum made a hysterical double act during my labour, running around my kitchen, bumping into one another, repeating: 'Right, what do we do? What do we need?'

But several hours into my labour my initial serenity had evaporated. Because Ethan was in a posterior position, meaning his back was in line with my back and his arms and legs were moving freely across my tummy, I was in absolute agony.

Nicola and Helen have since told me how brave I was during those long hours of labour, but not having had a baby before I had no idea at the time whether it was bravery or delirium that saw me through.

I do remember walking up and down the stairs, holding on to Kris, and being told to lift my legs as high as I could. This was not something I was especially in the mood for at that stage, but as it can help to turn the baby to the correct position I wanted to give it a go.

Then the midwives showed Kris some acupressure points in my back he could press on to alleviate some of the pain and told him not to be afraid to press as hard as he could.

After several hours of this, at every contraction Kris asked Nicola if he should stop. 'Only if she's got quite a deep dent in her back,' came the reply. 'Keep going, you can't press too hard.'

Following in mum's footsteps: By the time he was born, Ethan had swum with a dolphin, walked the red carpet, been photographed for magazines, sat on the judging panel of TV talent shows, flown in a private jet and launched a clothing range


I didn't feel a thing at the time, as there was too much happening on the inside of my back, but I had bruises afterwards.

By the time I was transferred to hospital the following morning I'd been in pain, without any numbing medication, for a long time, so an epidural was very welcome.

When Laura was dying in hospital, I would rub her feet and when I was in hospital having Ethan, one of the nurses came to the end of my bed and did the same to me. I burst out crying. I felt Laura was there. I wanted her so much to be there with me and meet my little baby.

But when I held Ethan for the first time, the pain and worry melted away. Kris and I couldn't believe that we'd made another person together.

When you are first handed your baby, you try to take in every feature, every finger, toe and eyelash. I remember thinking: 'Who are you? How did you get here? I can't believe you've been in my tummy all this time and I'm finally meeting you.' It was wonderful.

By the time he was born, Ethan had swum with a dolphin, walked the red carpet, been photographed for magazine covers, sat on the judging panel of two TV talent shows, flown in a private jet and launched a clothing range. I guess pre-school will have a lot to live up to.


Mothers have the right to choose, but those at risk need to be in a hospital
By Clive Spence-Jones, Obstertricdian and gynaecologist

Dannii is not the first celebrity mum to opt for a home birth. Demi Moore had her three children at home, and model Gisele Bundchen, Davina McCall, and Charlotte Church chose to do the same.

None of these successful women were shy to advocate the benefits of delivering at home.

But Dannii's honesty is to be admired, admitting that her dreams were shattered by the unpredictable nature of birth.

Are there lessons to be learned from her story?

The National Institute for Clinical Excellence recommends that all women should be offered options about where to give birth.

But home is still an unusual choice. Last year, 18,000 women in the UK gave birth at home (2.7 per cent of the total) without medical intervention.

Numbers have declined dramatically in the past 50 years. In 1960, one in three births in England and Wales was at home, but the figure has hovered around three per cent for the past 15 years.

Yet in the Netherlands a third of women have home births. Campaigners say this is the model we should aspire to. And it is not hard to see why. At home the mother is surrounded by familiarity, and there is no risk of a hospital-acquired infection.

Working together, midwives and obstetricians have developed guidelines to identify mothers we would not advise to choose home birth. It is not safe, for example, for mothers with high blood pressure (pre-eclampsia), a history of heavy bleeding after previous birth, and women whose babies are in the wrong position in the womb, to deliver at home.

But, even for women who should be eligible, the reality for those reliant on the NHS is different. Two midwives are needed to supervise a home birth, one for the mother and one for the baby.

Dire staff shortages in some areas mean this is not possible. Indeed, some Primary Care Trusts ask women to visit their hospital to see a midwife.

Unfortunately, it's not just staffing levels that make home delivery potentially unsafe.

Research in the U.S. has shown that the average mortality rate of babies born in hospital was 0.3 per 1,000 births, but one in 1,000 births for those born at home.

In the UK, even with careful selection of low-risk mothers for home delivery, a third of women who plan a home birth end up being transferred to hospital due to complications.

Dannii's labour failed to progress because the baby was in the occipito-posterior position (back-to-back) - the most common cause of delay in first labours.

Do try this at home: Demi Moore (left) gave birth to her children at home, as did Davina McCall. But while every woman should have the right to choose how she gives birth, it's important to consider the health risks


It is very difficult for the baby to move through the birth canal in this position, which can be excruciatingly painful for the mother.

Birth is a dynamic process, and how it progresses depends on the baby ' s size, the strength of the muscular contractions of the womb and the mother's weight.

Ten per cent of babies turn back round by themselves, but in the other cases we have to intervene or the baby will not come out.

Sometimes we give drugs that make the contractions strong, and this is enough. In other cases an epidural - an anaesthetic injection into the spine that numbs the lower half of the body - helps the mother's pelvic floor muscles relax so that the baby rotates naturally.

If labour has progressed to the stage where the cervix is fully open, and the mother is pushing but the baby won't deliver, options include manual rotation of the head or help with a ventouse suction device or forceps. In some cases, none of these approaches work so we have to deliver the baby by caesarean section.

The biggest problem, even with the most carefully planned home birth, are the complications which need medical interventions within minutes but can not be predicted.

Shoulder dystocia (when the baby's head has delivered but the shoulders are stuck in the birth canal) and babies who fail to breathe because of the cord round the neck which tightens just before birth, are examples.

It is mandatory that all health professionals involved in maternity care work together to provide for a happy and saf e birth.

And all mothers should be aware of the potential risks and benefits of the choices they make.



source:dailymail

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