Welcome to the World
Vicki Wil iams shares the story of her sixth child, a home birth after two sections
Ilike best to call the birth of my sixth child 'free', a previous caesarean scar. Our baby held out until 33 because that is the closest word the English language weeks and a day, when I had a massive bleed and called 999. It didn’t really stop and it was clear that the onlysafe option was an emergency caesarean, where it was In medical/legal speak it was unassisted, I had no discovered that my scar had separated and the placenta medical assistance, yet there are a number of people who was in my abdominal cavity and also wrapped round and assisted me, directly and indirectly, by giving help with embedded into my scar. It was a mess and I lost more practical tasks such as preparing my bir th space, than 3 litres of blood. We were lucky to sur vive, many preparing meals for my children, teaching me, writing mums and babies are not as for tunate, placenta accreta about their own bir ths and about the process of kills and has a ver y high hysterectomy rate! mammalian bir th. In medical/legal speak it was alsounattended, as I was not attended by a medical Baby Bob was fine, I recovered, and I was lucky that the professional, yet I was attended by the most loving surgeons had the time and the skill to repair my uterus.
companions I could hope for, Patrick, my life par tner, who The surger y was scar y, but less traumatic than the first is both husband to me and father of our baby, and my time as I felt that I was well informed and in the best daughter, who was 12 at the time. In early labour I was hands possible in the situation. The after-care and the also attended by my own mother, who nur tured and NICU experience were less positive, and again we were nourished us all as best she could, who soothed my other faced with professionals who had only a limited grasp of children and helped me to clean my nest before gracefully evidence-based care. I desperately grieved for both my granting us peace to rest and then get on with the task of bir th and for the pregnancy, I felt that all the chance to bringing a new life Ear thside. My bir th was free, it cost us prepare for my baby and to enjoy that special growing nothing, there was no financial or emotional price, yet it was wor th ever ything I had and ever will have. The wordperfect simply does not even come close.
I desperately grieved for
Journeys star t long before you set out. This stor y star ts a long time before I got pregnant. My stor y begins with both my birth and for
two well-suppor ted midwife-led bir ths, empowering andenlightening and joyous, then with a move to a new place the pregnancy
and a cascade of inter vention which led to an unwantedand totally preventable caesarean. The experience oflosing my par t in the process of making decisions aboutmy body left me feeling traumatised and violated, and In my follow-up visit the consultant (not the one who with a huge loss of trust in those who were supposed to did the surger y, sadly) was ver y clear, she star ted with have our welfare at hear t. I have no doubt that they ‘No more babies.’ I asked why and she said that I could thought they were doing the right thing, and that they have another, but I would have to have another section or were scared when I tried to decline to follow policy, but I would die. I didn’t bother to pursue that line of that is little excuse for the bullying to make me comply conversation any fur ther. At that point I was happy with with care plans which paid scant regard to best evidence.
five children and not planning another in any case.
After that followed a planned born before arrival VBAC However, nature did not seem to view the situation (vaginal bir th after caesarean), and baby number four with the same prophecy of doom, and I fell pregnant arrived peacefully at home, on his due date, totally against before I even knew my cycle had returned. Right from medical advice. The stor y was published in AIMS Journal that ver y first moment, I knew that this pregnancy was going to be fine. There was none of the regular bleeding,cramping, spotting and dragging exhaustion that I had felt After that things got more complicated. I had a late before, I was tired but felt well. I knew that all would be miscarriage, which was induced with misoprostol (cytotec OK. I also knew that no amount of searching would in the US), which may be a significant factor in what was provide me with medical evidence of that, and I would to happen next, one of the most dangerous complications struggle to find any medical professional who believed in of previous caesarean surger y, a pregnancy with placenta my body, and in the health of my baby, the way I could When I found that I was pregnant again we were There was no way I wanted to come out of bir th feeling delighted, but from the outset it was difficult. I had like I’d been par t of a train wreck again.
regular and heavy bleeding throughout, no cause wasfound, but the placenta was low-lying and on the front We had booked a summer holiday, a road-trip across wall of my uterus. Right over the most likely location for Europe, with five children and a caravan just before I Twitter @AIMS_online
realised I was pregnant. We sur vived the holiday, and I my body and my baby, and only seek help if something figured that if I could manage travelling thousands of miles felt wrong. The bir th we wanted was one where only with young children, unpredictable food, strange water peace and love had a place. Nothing to draw my and morning sickness I could sur vive most things.
attention from the job I had to do, and nothing toprevent me hearing my body and my baby.
I had no accurate measure of how pregnant I was, but made an educated guess based on the date of a positive My pregnancy passed uneventfully, and with a serenity test, and the day I could feel my uterus above my pubic that comes from a deep sense that all is and will be well.
There was no external fear, no undermining of that innerwisdom, no pressure to make decisions that were not By about 20 weeks I had begun to feel regular movements and there was no sign of any bleeding. Ibegan to feel more confident that my pregnancy was going to be uneventful and that my baby and I were in a I planned my blessingway for the Saturday after Patrick good place. I began to plan for the bir th I wanted.
finished pantomime, his commitment was finished andmine was to begin. I knew I would not bir th before I hadhis suppor t, and I hoped that I would have several weeksof his help to get my nest in order. The day was I began to plan for the
wonderful, a much needed reclaiming of my sacredfeminine space, both outside and within. I was birth I wanted
wonderfully nur tured by a group of ver y special women,all of whom I knew I could trust to suppor t my plans tobir th my baby alone without fear or question. This wasnot a time to be explaining my plans or my motives, or to As a doula I am a frequent visitor to my local maternity be tr ying to allay any fears that were not my own. I was units and to antenatal appointments with the women I blessed and blissed, the female energy and the love I felt suppor t. I knew the drill. No, you can't VBAC after two was amazing, and I can't say strongly enough what a sections; No, we can't suppor t HBAC; No, you can't use water if you come in… If I'd asked for a midwife who Eventually ever yone headed home, and being the would suppor t all of that, would I have got one who was wonderful and in-tune women they are, they left without confident and happy looking after me? If I did, how hard leaving a trace, well, to be fair, they left the place cleaner would the super visor have been breathing down her than it star ted and they left my body coursing with a massive, loved-up oxytocin glow. I was tired and happy, I couldn’t help but feel that no suppor t is far and away and I went to bed early. During the night I woke with a better than fearful suppor t, and I believed in my body slight, but unmistakable, pop and a trickle of fluid. That way more than anyone else I spoke to. I was ready to take full ownership of the health and safety of my child.
I’d also been in the position of having a bir thingemergency and needing to call 999, where no amount ofplanning for the time of bir th would have made the As is normal for me,
slightest bit of difference, and I knew that if I needed totake that route again I could do it.
I had no contractions
I knew that I could only bir th with those I trusted and loved around me, and that the only way I would feel, andbe, safe was to take full responsibility for our health andthe bir th myself. I had to trust my deep instincts, because As is normal for me, I had no contractions, and I there is no way of gaining that knowledge from the decided it was probably a 'wet show' and went back to outside. I knew that it was vital that I had privacy and bed. I slept late. During the morning it became obvious space to labour and bir th as was right for my body and that this was more than a trickle of cer vical fluid, it was my unborn child, and that any fear or disturbance brought water, and it leaked ever y time my baby moved more into my bir thspace would bring more danger to us both than a little kick. A hindwater leak then. I could feel my than it would relieve. I explored the option of baby ver y low in my pelvis and I was not worried about Independent Midwifer y, but that did not make me feel any infection as I had no intention of having any internal safer, it still felt like inviting a stranger and an intruder into my innermost soul. It simply did not feel right for I decided to get my pool ready, just in case, and my me. I talked to Patrick, who agreed that I should dance eldest son was in his element pumping air, arranging our dance alone, and only call on others if and when I hosepipes and moving furniture. The room was ready, the needed their advice. The sense of relief and release that pool was up, the liner was in, I'd already admired the view decision brought me was immense. Like a weight was from within and decided I was happy with it, and so, well, lifted. I felt no need for antenatal testing, as no matter why not put in a little water, just to see how quickly it what was found, it would not alter our plans to love our filled. Quite quickly. Well, since it was full of deliciously baby whomever we were sent. I was happy to listen to AIMS HELPLINE: 0300 365 0663
Saturday was hormonal melt-down day. I was irritable and shor t-tempered. I was craving space and sleep, thechildren were craving attention. I ended up with a stropand a cr y, and then I did manage to get chance to sleepduring the afternoon, which helped enormously, but itbrought me no more contractions until the middle of thenight. Again, by dawn they stopped.
On Sunday I needed to rest, I was ver y tired. Patrick amused the children and I slept. Then I meditated, I askedmy baby what was needed, but I didn't feel that I had aclear answer. All I could hear was time, I didn'tunderstand, but I did know that ever ything was OK, andso I waited. It was now eight days since I star ted leakingwaters, and I have to admit that I was more than a littletired of the 'wet nappy' sensation. My mum cookeddinner, I tried to help but I was next to useless in thekitchen, I could not concentrate on anything much. Mybaby was so low in my pelvis that I could not sit properly warm water, and the room was ready, why not get in and on a chair, and so I ate half perched on the edge, half have a float. It was bliss. Absolute bliss. I stayed in the leaning and kneeling. I was not feeling contractions but I pool for most of the evening, and when I got out to go to knew there were now waves of energy flowing through bed I pulled over the cover and hoped that I would be my body at regular inter vals. I was hopeful but resigned Monday dawned. The children went to school, my baby Mum helped put the children to bed, Bob, our just two- was ver y low in my pelvis, the trickling was all but year-old would not settle, so he sat on Daddy's lap, the stopped, and I went about my day. By evening I was tired others went slowly to bed, my mum left and I felt a deep and so we topped up the pool and I floated until I was need to be back in the water. I put some music on my relaxed enough to sleep. I slept all night.
phone and stretched out in the water. It felt so good.
The waves of energy were still there, but there was no Tuesday I did not want to leave the house, I was feeling pain or pressure, just a dull ache in my lower back. I ver y insular and nesty, I wanted to only see those I love decided that I would get out of the pool, change my deeply and I wanted to clean ever y last inch of my home.
earrings (I have no idea why that was impor tant, but it I did venture out briefly to the local jacuzzi dealer to buy was) and watch a little of the Oscars before bed. I sat some water cleaner as I wanted to leave the pool ready down to watch and Bob crawled onto my lap to feed and waiting. My parents and my brother and his lovely himself to sleep. That was when I was belted by the only wife-to-be came to dinner, I was ver y spaced out and not contraction I can describe as painful, and boy did it hur t.
really able to follow a conversation, but not contracting Enough, I shot up like a scalded cat and literally ran and either. Again I spent the evening in the pool, and again I Back to bliss, the music was still playing and I was back Wednesday brought no change, but during the night I to feeling calm, relaxed and not really in labour, although star ted to feel contractions that died away as the sun the waves now had much more energy and were coming about ever y song and a half. Gradually the energy built, I On Thursday I had a visit from my lovely AIMS was talking to my baby, 'Are you ready little one? Let's colleagues bearing lunch, and we had a planning meeting do this thing.' I was aware that the energy was rather like round my kitchen table. I felt far happier doing that than a pressure cooker, I was making noises at the height of I would have felt travelling any fur ther than the end of my each wave because that was an effective way of releasing driveway. I still wanted to stay in my nest and avoid the 'spare' energy, but I honestly cannot describe it as strangers. My baby was dropping ever lower and that evening Patrick and I made a belly cast. I look at it now I felt my baby plummet, and deep within my pelvis and I can see just how ver y, ver y low my bump was by ever ything changed. I knew that this time things would that point. Again I had irregular contractions all night, and not be stopping and I was close to meeting our baby. I called for Patrick. Bob had just gone to sleep, the timing By Friday I was weepy. I was beginning to question could not have been more perfect, or perhaps my body's myself. My early labour was a dark and desperate fight response to what was happening could not have been with my internal demons. A long talk to a doula sister more finely tuned. Patrick called Libby, she wanted to be was what I needed, and then another float in my pool.
with us, and she came straight down. I was aware and at After a night of more meaningful contractions I was the same time in another world, I was between worlds, beginning to get tired and I was more than a little low- my baby and I, straddling the gap between now and spirited when they once again stopped at the first rays of eternity, dancing our own special dance, watched only Twitter @AIMS_online
We danced a while, I have no idea how long, and then the urge to push came, my whole being pushed, with no Imagine a woman.
pain but a great sense of opening my body and my mind.
I could feel a head, now barely contained within my body.
Then came a change of song, and The Waterboys, The Imagine a woman who believes it is right and Stolen Child, star ted to play and then crowning began. I wanted to say so much, about what I could feel, what was A woman who honors her experience and tells happening within my body, that I wanted my husband and daughter to witness this amazing event, to tell them all Who refuses to carry the sins of others within the wonders I was experiencing, but all I could manage to actually say was, 'This is the bit that hur ts the most.'With that my baby's beautiful, moulded head slid out,rapidly followed by the rest of his body. My baby, a boy, a son, a brother, a grandson, a nephew. I scooped him from the water and sat on the pool seat with him in my arms.
A woman who listens to her needs and desires.
He took a deep breath, let out what sounded like a Who meets them with tenderness and grace.
contented sigh and opened his eyes. The wisdom of ageswas in those eyes, and they were only for me. He sought Imagine a woman who acknowledges the past’s my face, and then my nipple. His little blue body turned pink as he searched and then latched, he didn't cr y, it was A woman who has walked through her past.
warm, dark, peaceful and there was simply no need.
I looked, for the first time in days, at the clock. 11.55, a Sunday baby, just. My other boys came down, I am not Imagine a woman who authors her own life.
sure if they woke or were woken. Grandparents were A woman who exerts, initiates, and moves on called with the news, the champagne was opened, the cake cut and the new baby admired by his family.
Who refuses to surrender except to her truest Some time afterwards the placenta was born, with little effor t or mess, and I admired it in all its glor y. Wecontinued to enjoy the warmth of the water and the Imagine a woman who names her own gods.
space yet privacy of the pool, but eventually it star ted to A woman who imagines the divine in her image cool, and I decided that I wanted a bath and to go to bed.
I had planned a lotus bir th, but I had a ver y strong sense that I didn't want to go to the effor t of preser ving my Who designs a personal spirituality to inform placenta when I had a baby to gaze at instead, and I really and truly felt that its job was done. The surface of thecord was star ting to dr y, and it had been white and floppy Imagine a woman in love with her own body.
for a long time. I was ready, and so we cut the placenta free, it is now buried in our garden, returned to the Who celebrates its rhythms and cycles as an Bath and bed, more milk and a lot of love, what more does a baby need to star t his life as a free man? I felt so utterly amazing, like I could climb Everest. We Imagine a woman who honors the body of the called him Edmund, it seemed to fit.
Goddess in her changing body. A woman whocelebrates the accumulation of her years and her wisdom.Who refuses to use her life-energydisguising the changes in her body and life.
Imagine a woman who values the women in herlife.
A woman who sits in circles of women.
Who is reminded of the truth about herselfwhen she forgets.
AIMS HELPLINE: 0300 365 0663


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CURRICULUM VITAE PRESENT POSITION: Board-Certified Dermatologist Lubbock Dermatology and Skin Cancer Center ADDRESS: POSTGRADUATE TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER, Lubbock, Texas TRAINING: Dermatology Residency - July 1997 – June 2000 UNIVERSITY OF TEXAS MEDICAL BRANCH, Galveston, Texas Pediatric Internship - June 1996 - June 1997 GRADUATE EDUCATION: UNI

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Landesamt für Besoldung und Versorgung NRW- 40192 Düsseldorf - Tel. 0211 / 6023-01 M e r k b l a t t Beihilfe - Land Sehr geehrte Dame! Sehr geehrter Herr! Dieses Merkblatt soll Ihnen die Beantragung von Beihilfen erleichtern und eine Übersicht der wichtigsten beihilferechtlichen Bestimmungen des Landes Nordrhein-Westfalen (NRW) bieten. Rechtsansprüche können Sie hieraus nicht a

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