Like his sister, his is an international tale. :-) Let's begin at the beginning. (This will make for a L-O-N-G post, because as you know birth stories are not just about the birth, they are about the journey... and this babe had QUITE a journey!) We found out we were pregnant on the 31st of January... so this birth has been the whole year so far in the making. We had just returned to Zambia on the 17th of January after a few months of home assignment in Scotland. After finding out that our 3rd child was due on the 5th of October, we had to start making plans right away for where this baby would be born. The 5th of October was a bit of an awkward date, to be honest... the College's academic year would close on the 4th of October with the Graduation ceremony, and either way, whether we stayed in Zambia for the baby's birth or not, it wasn't likely that we would be able to attend Graduation. We knew that this would be a severe disappointment to our graduates. But we also knew we had to figure out what the best place was for baby's arrival.
We already had tickets booked to depart Zambia on the 22nd of October for a few months of home assignment again in Scotland. But obviously that wouldn't work either... even if the baby arrived BANG 'on time' there was no way that we could get a passport in time to travel with the baby on that date. Our tickets specified 'no changes allowed' so initially we thought 'Well, we don't have the option of leaving the country' (because we couldn't afford to buy new tickets) and so we decide to look into the possibility of having the baby in Zambia.
We asked a LOT of people for their advice and experiences. We asked for hospital recommendations. We looked into housing. We spent a couple of months researching our options and praying about it. To make a long story short, while we were in the throes of having to make the decision whether to risk having a baby in a hospital in Lusaka or whether it wasn't worth the risk to us... we found out that our tickets COULD indeed be changed! For a very reasonable fee, which was FAR FAR more affordable than the cost would have been to pay out-of-pocket for baby's birth in a Lusaka hospital plus rent on a house in Lusaka for a couple of months. We knew that if we went back to Scotland as was originally planned, we could have the baby in a place where we would have support from our sending church and our friends, our housing would be provided, and we would be under care of the NHS which meant that we wouldn't have to pay out-of-pocket. We truly felt that this was the Lord's answer to our prayer and His provision for our family. So we paid the necessary fee to change our tickets and instead of flying out on 22nd Oct, we arranged to fly out on the 3rd of Sept.
During my pregnancy I can't say that I had the continuity of care that I did while pregnant with Ketzia. It was complicated, and it wasn't always enjoyable to keep bouncing from person to person. I went for my first antenatal appt at 16 weeks, to a private clinic to Lusaka. I saw the same OB/GYN at the same clinic for my appt at 25 weeks. In between, at 22 weeks, I had an appt at the mission hospital out in Eastern Province, an hour from our house, because we couldn't travel all the way back to Lusaka that month just for me to have an antenatal check-up. So I got a referral letter from the OB/GYN in Lusaka explaining my situation and asking for someone at the mission hospital to give me a routine antenatal check-up. Then at 32 weeks I had to visit a different hospital (another private clinic in Lusaka) to get a generic doctor's letter from a specific doctor that KLM required me to see in order to be 'cleared to fly' while pregnant. I found this to be really annoying, having to see a totally strange doctor who didn't know me or my situation, and also found it really odd that they would send a generic 'form letter' (totally not applicable to pregnancy, asking things like 'does the passenger require oxygen? can they use the restroom without assistance? are they contagious?' etc..) to be filled out by a general Dr. (not an OB/GYN) who didn't do anything to examine me at all but simply sent me for a hemoglobin count and a urinalysis. Anyway...! Then I was hoping to see the first OB/GN from my initial appt before I flew out, but she wasn't available for an appt, so in the end I arranged to see my friend Christine whom provided my antenatal care during Ketzia's pregnancy. I saw Christine at 35wks+4days, the morning of our flight to Scotland! (our flight left around 11 that night.)
Meanwhile, while I was bouncing to and from between doctors in Zambia, I was having difficulty arranging my antenatal care in Scotland because we didn't know where we would be staying yet. Our missions committee was having trouble finding a place for us to stay. The time for our departure was getting closer and closer and we still didn't know where we would be staying. We were hoping that we could be somewhere on the mainland, ideally even back in Glasgow where Elijah was born in 2010. I am still a member of the Glasgow homebirth group and managed to track down the contact details of Caroline, the NHS homebirth team midwife who attended Elijah's birth at our home in Glasgow. I contacted her to say 'Hey! I'm coming back to Scotland to have my 3rd child and if we end up in Glasgow, I'd love to be back under your care again!' She responded quickly and was a brilliant support to me and I was so relieved to know that I had a contact within the NHS midwifery care system.
The saga continues... on the 6th of August (less than a month before our departure date) our missions committee told us that they had arranged for us to stay in a house in a village in the north-western corner of the Isle of Skye (for those of you not familiar with Scottish geography, Skye is connected to the mainland by a bridge so at least you don't have a ferry crossing to contend with!). I immediately started chasing up my contacts. My hope was to be able to have a 3rd homebirth (you can read about my previous homebirths here and here). There are a number of reasons why homebirth is so important to me, but I also wanted to be sensible about it. I knew that if I was too far away from hospital (in the event of an emergency) or if the local midwifery team was too nervous or inexperience with homebirth situations to provide me with care that I could be fully confident in, then I would not be in an ideal situation for a homebirth. But I needed to do my research, and I needed to have a contact 'on the ground.' I felt very strongly that it is NOT wise to try to arrive somewhere at 37 weeks pregnant, and try to get into the NHS system when no one knows your situation or your history. That is NOT the way to find good support or positive care. So I contacted Caroline, my NHS midwife contact in Glasgow, and she got me in email contact with the Skye midwifery team! I also contacted friends who lived on Skye to get a feel for the general support of the midwifery team there and to find out more about the area where we would be staying. I heard back from the Skye midwives and felt very positive. We felt like the location where we would be housed was not ideal (remote, not close to hospital) but having made contact with the midwives there and knowing that they were aware of my situation, we felt that it was possible. The only thing which worried me was simply the distance to the hospital. The nearest hospital (35 minutes away) didn't have labor and delivery facilities, so we would have to go to the other hospital (an hour away) if that was necessary. They were willing to consider a homebirth situation but had a number of 'hoops' to jump through before they could be comfortable agreeing to it. If anything went 'wrong,' I would have to leave the island and travel to the bigger hospital in Inverness, which was 2-3 hrs by car from Dunvegan. Not exactly an ideal situation. But I was determined to make it work.
And then, by the grace of God, I was just feeling like everything was falling into place: and we received an email. The arrangements for the house in Skye had fallen through. It was the 17th of August. I was 33 weeks pregnant. We were leaving the country in just over 2 weeks, ready or not... and we didn't know where we would be staying. Suddenly all my carefully-laid plans and the correspondence with various midwives who would have been supporting me in labor came crashing down. I knew I would have to start all over again. I cannot express how I felt that week. I was so shaken.
Our missions committee scrambled to make alternate arrangements. What could be arranged at such short notice was housing on the Isle of Lewis, in the Outer Hebrides. Someone in one of the Lewis congregations had a furnished house we could stay in, in the village of Fivepenny in the district of Ness. However, this house was only available to us until the end of September. Another house on the other side of the island, on Point, was arranged - but this house was only available starting the 30th of Sept. So either way, we would have to move house the week that our baby was due! Naturally you can imagine we were not thrilled by this scenario, but after some inquiry it was clear that we had no choice. At this point in the process, so close to our departure date, I just wanted things to be finalized, no more curveballs, I wanted to know exactly where we would be staying when, so that I could get the process in motion of preparing for our baby's birth!
As soon as it was confirmed that we would be staying on Lewis, I contacted a friend of mine who lives on Lewis but used to serve as a doula in China. Since she was active in the birthing community on Lewis and knew many of the midwives there, I knew that she would be an excellent resource for making contact with the midwifery team and trying to make arrangements for a homebirth situation. And I was right! Yolanta has been a brilliant support to me. She gave me the contact details for the supervisor of the midwives, Catherine MacD, and I emailed Catherine from Zambia to introduce myself, share my situation and my medical history (thank goodness, pregnancies and deliveries without complications!) and say that I hoped to have a homebirth on Lewis. Catherine was brilliant from the start and not put off by my unusual circumstances or the fact that I would be arriving under her care at 36 weeks pregnant. She was happy to hear from me, and told me to contact them as soon as I arrived in Lewis. I was so, so, so thankful to the Lord for arranging things so that I would easily have a contact within the Lewis midwifery community and that they were expecting me and looking forward to supporting me!
So... you've already read about how the last couple of months worked out, in my last post. :) We arrived in Ness on Tues the 10th of Sept. I phoned Catherine and she came to see me immediately, on the Thursday morning! When she came, not only did she visit me at home and did my routine antenatal check on the sofa, but she brought all the homebirth kit with her and delivered it to our house... In other words, she was confident that I knew what I was asking for when I said I wanted a homebirth, and she was willing to take the first steps in supporting me in a homebirth before she had even so much as taken my blood pressure. :) Now, homebirths here on Lewis are not only provided with all the necessary equipment (resus equipment, pain-relieving drugs, a whole bag of medical supplies) but they will also provide you with a birth pool if you want it! I was absolutely amazed... and to think that some people told me that you couldn't have a homebirth on Lewis. :) Not only can you have one (it is a legal right), but they have a stock of birth pools and all the necessary equipment for any women who are interested!
I know that when I mention the word 'homebirth' some people's minds automatically picture a woman curled up in the fetal position giving birth under her bed as if she is a mama cat, shutting herself away from the world and wanting to be alone in her bedroom. Or else screaming 'No doctors! get the doctors away from me!' and locking the door. Well, this is a misconception. My experience of homebirth has been that I am supported by two highly-trained, excellent supportive midwives in the privacy of my home, I have their complete attention, and they come with all the necessary equipment to support me medically if there is a need. Having a homebirth does not mean that you are giving birth without access to life-saving medical equipment. (Nor do you have to give birth without pain medication! That is available, too!) The local ambulance crew was even aware that I was attempting a homebirth, so that if anything did go wrong, they would be able to respond even quicker, because they already had a note of my address, D.O.B. and blood type!
Anyway, I had excellent antenatal care from Catherine and her team when I arrived on the island. I had a couple of home visits from them while we were staying in Ness in September. My due date was 5 October so Catherine drew up a 'rota' of midwives from the maternity ward who were interested in helping with a homebirth, and they went on call for me beginning two weeks before my due date. There were two midwives on call for each day. Catherine knew that we would be moving house on the 30th of Sept if the baby hadn't arrived by then, and she didn't bat an eyelash. She gave me so much support. When we moved house, the midwives came back by and picked up the homebirth kit, birth pool, and all the other supplies which they had dropped off two weeks before, and took it over to the house in Point for us! So we only had to move our own things, and the midwives took responsibility to help us with the movement of all the birth-related supplies. That was such an enormous blessing. I had a couple of home visits after we arrived in Point on the 30th of Sept, and we just waited for baby to come. :) I was pleased to see that it was clear that every midwife on my rota had looked at my birth plan to see what my preferences were.
Unlike when I was expecting Ketzia, I had hardly any 'twinges' in the days approaching delivery. One night I had a few contractions for about an hour or so in the middle of the night, so I knew I was getting close. My mom arrived from the USA on Thurs the 3rd, after a long journey - flying to Inverness and then traveling by bus to Ullapool and taking the 3-hr ferry crossing to the Isle of Lewis to stay with us! And we were so happy to see her. She had been present at Elijah's birth in Glasgow in 2010, too! My 'due date' came and went, Saturday 5 October. On Sunday the 6th David was preaching both services in the Point congregation! There was 'back up' available (he had insisted on it) in case I went into labor that day and he needed to be with me, but I was clearly not in labor, so off we went to church as a family! I was feeling absolutely fine, so there was no reason to stay home!
That night we went to bed at a reasonable time, which was good because it meant David got some good rest after preaching before I woke him up in the early hours of the morning. :) I woke up around 2am or so (don't know for sure what time it was) with a contraction which was painful. I tried to go back to sleep but kept having contractions. They were far apart, about 10 minutes apart, which made me feel like maybe it could be a 'false alarm' but they did hurt! After trying unsuccessfully to get back to sleep, I really could not get comfortable and I kept having to get up to use the toilet. At some point I decided to go downstairs to see if I could curl up and get comfortable on the sofa instead, so as not to disturb David. I was very, very tired and desperately wanted to go back to sleep, but it was clear my body was NOT going to sleep. :) Finally around 4am I went and woke up David... I let him sleep as long as I could, but knowing that the birth pool wasn't fully inflated yet, and that there was some work to do to get the house ready for a birth, I knew we would need all the time we could get. So I woke him up, and bless his heart, he didn't murmur or complain. :) He came downstairs and started getting the living room re-arranged and tidied to become 'birthing central.' The birth pool was partially inflated and stored in the room my mom was sleeping in, but she was already awake having heard me moving around the house. David was brilliant at getting the shower curtains, sheets, and towels laid on the floor to protect the carpets, and then finished inflating the birth pool. I was wanting help to get my TENs machine on, and finally managed to get him re-directed onto that after a while. :) The TENs machine, as before, I found to be really helpful to get me through the contractions. I labored kneeling upright supported by a birth ball.
It must have been around 4:30 that I phoned the maternity ward to let them know I was in labor. I don't know what I was thinking, I was expected to be treated like I was when Elijah was born, and I had to phone into Maternity Assessment at the regional hospital, and I was just one of many women in labor that night and had to basically 'prove' over the phone that labor was progressing far enough that I could convince them to send the midwife out. I guess subconsciously I was expecting to have to convince people here, too, that I was really in labor. My contractions were continuing at 10 minutes apart but very regular, but the maternity ward didn't hesitate, they said someone is coming out to you NOW! :) I guess by the time it's your 3rd baby, they realize you know what you are talking about. :) And obviously things can go a lot faster the 3rd time, too!
I don't know what time the midwife showed up, I was still kneeling against the ball. She came shyly into the room, it was the only midwife I hadn't met in person yet. :) Her name was Annemarie and she was a young midwife enthusiastic about homebirth and had hoped to have one herself in the past, but had ended up transferring into hospital. She was really sweet and immediately I knew I was in good hands. She was the primary midwife for my birth. Just after Annemarie arrived I felt nauseous and then vomited quite badly, but it was really special to have David, my mom, and Annemarie all supporting me at the same time... holding me, bringing a wet cloth, and rubbing my back.
Not long afterwards afterwards Catherine MacD arrived, who is Annemarie's supervisor, and she very much functioned as the 'back up' midwife. She stayed in the kitchen for the duration of my labor, chatting with my mom, and just keeping an eye on things in case Annemarie needed support. but it was Annemarie who was with me as I labored. I thought it was very special though, that Catherine MacD, who I had been in contact with all the way from Zambia to arrange my homebirth, was the one on call the night I actually went into labor, so she got to be there for the grand finale after the weeks of preparation. :)
Around 6:30 in the morning we heard the little pitter-patter of feet upstairs and David went up to investigate. Ketzia (21 months) was awake. He managed to get her to lie back down in her bed but it was clear that the day had started and we would have a toddler invasion any moment. I had arranged for our kids to be sent over to a friend's house who has a bunch of kids and whom they would be happy to play with for hours without missing Mama too desperately much... so we phoned her and she said she would be there at 7am to pick them up and take them over to her house. So David went upstairs and got both kids dressed and completely ready to go, with my mom's help, and ushered them out the door (took them out the front door, so they actually didn't come through the living room at all and didn't see me at all, so that they wouldn't get upset about leaving!) and with the help of some Cheerios, they were off. Our friends kept them for the whole morning and they were returned to us after lunch. :) It was lovely to know that they were being well looked-after and that helped me totally relax and focus on what I needed to do! There is no way that I could have given birth with a toddler climbing all over me, and I am so thankful that we have friends who were willing to help us out in this way!
By the time the kids were headed out the door, I knew that things had progressed far enough that the TENs machine was no longer having enough effect. In my previous deliveries this has been the cue for me to get into the birth pool, so I climbed in. Annemarie knew from my birth plan that I didn't want any internal exams, but I was really thankful that she didn't even suggest it. She knew it wasn't necessary. So I was left in peace. I climbed into the pool and immediately felt relief.
There isn't really much more to say. I labored in the pool, supported by David and my mom who continually brought me cool washcloths.
Annemarie drifted in and out of the room and checked the baby's heartbeat every 30 minutes or so, but baby was obviously perfectly happy. Annemarie was excellent at checking in with me to ask me how I was feeling, and I was happy to be able to tell her that by the 3rd time through, I could actually track my own progress in labor and could feel the baby descending. She was very non-invasive and totally respected my space and my ability to birth my own baby, but she was also very affirming and supportive and was taking very good care of me.
Everything went as smoothly and as peacefully as I could have possibly wished... I felt unbelievably blessed. And at 9:25am, Titus Tyndale Lachman made his entrance into the world! It was definitely my easiest labor so far. I can honestly say that the last 5 minutes were the hardest, but the labor itself progressed fabulously well and I was able to stay focused and relaxed thanks to the peaceful and supportive atmosphere of my home.
We didn't know whether it was a girl or boy, but had been told at a scan that it was likely a girl... they were wrong!! Our sweet boy Titus surprised us. :) He was 7lbs 13oz at birth, so about half-way between Elijah and Ketzia's birth weights.
I relaxed in the pool for a few minutes and cuddled Titus, just resting, as I felt absolutely knackered in the minutes immediately following his birth. Titus was amazingly alert from the very second he emerged from the water and we were all marveling at how he was already following our voices and trying to hold his head up.
After we got of the pool (with difficulty, as the umbilical cord was VERY short, but it was a team effort!) Titus immediately went for a feed and boy, did he take to his food! He nursed for more than an hour and a half! I delivered the placenta naturally but it did take quite a long time and I was very uncomfortable, more so than I had been with my previous babies. While I was lying on the sofa waiting for the placenta, David and my mom were busy clearing up the living room and by the time I delivered the placenta (maybe 45 minutes later?) everything was completely tidied up and the birth pool was cleaned and deflated and put away! My husband has obviously got this down to a science! :) Meanwhile, as I was still lying on the sofa recovering and nursing the baby and the midwives were scurrying around tidying up, my friend Yolanta, the doula who had introduced me to Catherine MacD and the midwifery team, arrived to congratulate us. She had been hoping to support me as a doula in my delivery but by the time she arrived the baby was already born. I can't tell you how grateful I am for Yolanta, though, because even though she wasn't able in the end to support me during the birth as we had both hoped, she has been a tremendous friend to me both before and since the baby was born.
Once the placenta came, I was feeling well enough to slowly make my way upstairs for a shower, with David's assistance, while my mom fell asleep cuddling Titus. :)
Feeling more human after my shower, I settled down in bed upstairs and Titus was brought up to me. David went on over to our friend's house to pick up the kids who had stayed for lunch there, and we got some sweet videos and photos of them coming home and meeting their baby brother for the first time. :)
In the days following the birth I was well looked after. Annemarie came by to check up on me and we had a good discussion about my homebirth, which was the first homebirth on the Isle of Lewis in 2 years and the first homebirth in the village where we are staying in 53 years! Titus has really become a statistic! :) Annemarie found my birth very special and was actually in tears in our kitchen after Titus was born, overwhelmed by how peaceful and simply amazing the whole atmosphere was. She told me, 'This is the way birth ought to be.' We were blessed to be supported by such a conscientious and caring midwife, and really Catherine MacD and her entire midwifery staff at Western Isles Hospital were fabulous beyond words.
We are so thankful to the Lord for orchestrating all the details of Titus' birth, from the smooth progression of a healthy pregnancy to the arrangements for our stay in Lewis and the excellent care we received from the midwives here! The Lord is faithful beyond our imaginings, to Him be the glory!
"For the grace of God that bringeth salvation hath appeared to all men, teaching us that, denying ungodliness and worldly lusts, we should live soberly, righteously, and godly, in this present world; looking for that blessed hope, and the glorious appearing of the great God and our Saviour Jesus Christ; who gave himself for us, that he might redeem us from all iniquity, and purify unto himself a peculiar people, zealous of good works." Titus 2:11-14
