As I lay on the hospital bed with my maxi dress hurriedly thrown above my waist, it was hard to ignore the flood of disappointment I felt knowing this was how I was going to deliver my first baby. So much for the water birth I’d been envisioning for the previous nine months. I ended up giving birth around 24 hours after feeling my first mild contractions, and mere minutes after I’d arrived at the hospital. If I’d left my house ten minutes later, I’d have delivered in the passenger seat of my car.
I’m one of many women who were either sent home from the hospital during labor, or told to wait at home after calling the hospital for guidance. When I finally decided to ignore the midwives’ advice and went to the hospital, I was nine centimeters dilated and fighting the urge to push (the cervix is fully dilated at ten, meaning it’s time for the baby to make their entrance). Thankfully, I made it in time. Other moms like Anika Offergeld can’t say the same.
After her waters broke at home in the early hours of the morning, the 32-year-old university researcher called her midwives. They told her to come in later unless she began feeling contractions every five minutes lasting a minute each. “I went back to bed but after a little while my contractions started. They were only three minutes apart but less than a minute each in length, which left me confused about what to do,” she said.
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“We got to the hospital at about 10 AM where a midwife assessed my progress and advised us that I was only two centimeters dilated and that I was coping ‘too well.’ She also doubted that my waters had actually broken and since the baby was back to back [lying with their back against the mother’s back], and said labor would take ages and become way more painful before anything progressed. I was told to go home and come back if I wasn’t able to smile anymore. This strange assessment knocked my confidence, so when we arrived back home and things got a little harder I put it down to me being less sure of myself.”
Back home, Offergeld labored in and out of the shower with the support of her partner. “I never realized how far I was, what with it being my first baby. I also didn’t want to go to the hospital only to be sent home again like a stupid little girl, but at about 12.30 PM we decided to go anyway.”
On the way to the car, she began feeling the need to push. To her horror, she felt the head emerge between her legs. “We made it back to the house and within five minutes our little girl was born on the living room floor. Over the next few days different midwives came by to check on us and one got angry saying this happens way too often and I should’ve had more support.”
England’s maternity units are under immense pressure due to staffing shortages and lack of capacity. Birthrights, a charity that campaigns to improve the experience of childbirth in the UK, told Broadly: “Managing early labor well is a challenge for stretched maternity services and innovative approaches that facilitate individualized care in early labour are welcome.” Research from the National Maternity Review’s Better Births report revealed that women are ‘’not being offered real choice in the services they can access, and are too often being told what to do, rather than being given information to make their own decisions.”
Being sent home from hospital while in labor can result in women giving birth in any number of unsuitable places. In 2017, a London woman named Lizzie Hines literally gave birth in the middle of the street. So how do women in labor get turned away from hospital? Mandy Forrester, Head of Quality and Standards at the Royal College of Midwives, says: “Generally when women are asked to go home it is because they are in the latent stages of labor. During the latent phase, the muscles of the uterus (womb) contract and make the cervix shorter, thinner, and softer. This prepares the cervix to dilate to allow the baby to be born.
“Women in the latent stage of labor are better to be in their own home environment where they can relax, rest and prepare for full labor. Therefore it is not unusual for a woman to go into her hospital or midwifery unit before her contractions have become established and be asked to go home again. However, at this point the woman should be assessed by a midwife before being sent home.”
Anna Holmes, 25, learnt this the hard way whilst in labor with her first baby. After arriving at hospital, the stay-at-home mother was sent home without being examined. “Basically, they said it was my first baby so it was going to be ages before things started happening and they sent me home saying there was nothing they could do.
“Once we arrived home the pain only got worse and I had to start pushing whilst hung over my bed and kneeling on the floor. My husband had to call the ambulance and was told to lay down some towels. I felt something between my legs which I thought was the baby's head but instead it was the sack of my waters dangling out. The ambulance arrived to take us to the hospital and my son was born as soon as we got there."
Jenna Marshall, 29, had a similar experience. “I was almost turned away for ‘not looking like a woman in labor,’” she says. “The midwife refused to do an internal examination when I turned up at the maternity assessment unit as I was able to talk to her and didn’t seem to be in enough pain. She tried to send me home and wouldn’t give me any painkillers. I was so upset that I panicked as I knew I was further along in the labor than she believed me to be. In the end my husband demanded they check me which they eventually agreed to and they saw that I was five centimeters dilated with my waters bulging.”
A Birthrights spokesperson told Broadly: “While some women may be happy to go home in early labor, others may feel very anxious about this—particularly if they live some distance away, or if they feel that their labor is progressing quickly. This can go on to affect the rest of their labor, slowing it down or stopping it altogether in some cases, or alternatively lead to the woman giving birth without medical assistance which can be very frightening. Furthermore, we are aware that women who do not have a stable home situation to return to, can literally be left walking the streets."
Every labor is unique and should be treated as such. A one size fits all approach to managing births may work most of the time, but it’s just not good enough for those who are turned away and end up delivering their babies without the appropriate medical support. For some, thankfully, there are positives that can be taken away from situations like these. “The unusual birth was empowering for us,” Offergeld says of her and her partner. “Now we’re confident we can master parenthood together.”