My fourth birth was planned as a homebirth due to previous hospital trauma. I engaged a doula and attempted to hire a privately practising midwife, however there were no homebirth midwives available in my region. Distance and cost made this model of care inaccessible, leaving me feeling I had no real options except to labour at home and potentially freebirth.

From 38 weeks onward, I experienced ongoing prodromal labour for approximately one week, which was physically exhausting. At 39+4, my hindwaters ruptured (30 September 2025). I attended Mildura Base Public Hospital (MBPH) to confirm rupture of membranes. At that time, I was 1–2 cm dilated and not in active labour. I was offered an induction for the following morning, which I declined, choosing to return home and await spontaneous labour. With informed support, I also declined prophylactic antibiotics due to significant adverse reactions I experience with all antibiotic types.

Approximately 15 hours later, contractions recommenced and began to intensify. Around 27 hours after rupture of membranes, active labour established. Although we had planned to labour and potentially birth at home, I became physically depleted due to prolonged labour and underlying anaemia, and made the decision to transfer to hospital for additional support.

On arrival at MBPH, I was in advanced labour — on my hands and knees in the car park, barely able to mobilise, experiencing an urge to push but with a strong sense that baby was not descending effectively.

**Significant Concern – Birth Suite Allocation and Trauma Awareness:**
Upon entering the birth suite, I was placed in the same room where my nephew had previously been stillborn. This triggered an immediate and intense trauma response. I became hysterical and overwhelmed. Despite this, I was informed no alternative room was available. This experience significantly impacted my emotional state during labour and highlights a need for improved trauma-informed care and room allocation processes where possible.

**Significant Concern – Timing of Consent Discussions:**
During an active contraction, after I had declined Hepatitis B and Vitamin K for my newborn, a senior doctor entered the room and requested I sign a waiver. This occurred at the peak of a contraction, when I was not in a position to provide informed or considered consent. This was distressing and inappropriate timing for consent.

I laboured for a further six hours. I felt that progress was slower than expected compared to my previous births, where second stage is typically rapid.

I requested a vaginal examination. Findings indicated baby remained high, and my forewaters were still intact. There had also been a brief drop in the fetal heart rate (which recovered), however I felt strongly that something was not progressing optimally. I requested artificial rupture of membranes. Upon rupture, thick meconium-stained fluid was present.

Labour intensified immediately. I laboured in a side-lying position using a peanut ball. After approximately nine minutes of pushing (2–3 contractions), my daughter was born.

She was born with her hand beside her head (compound presentation), slightly asynclitic, and with a loose nuchal cord. I sustained no perineal tearing.

Initially, she was placed skin-to-skin on my chest. My husband and doula were emotional; however, although my daughter was alert and making eye contact, she did not cry. Within moments, her colour deteriorated and her tone reduced. The atmosphere in the room shifted rapidly and a Code Blue was called.

**Significant Concern – Cord Management and Equipment Limitations:**
Despite my clearly expressed preference for delayed cord clamping, I was informed that immediate intervention was required. The cord was cut and my baby was transferred to a resuscitation trolley away from me. I would have strongly preferred that resuscitation be attempted with the cord intact using a mobile resuscitation trolley; however, I was informed this was not available at this hospital. This represents a significant limitation in supporting physiological birth practices.

I was unable to see my baby during this time and could only hear the emergency response.

She was subsequently transferred to Special Care Nursery while I birthed the placenta. After approximately one hour, I was reunited with her. She was pink, stable on CPAP, and resting.

**Positive Feedback – Advocacy and Breastfeeding Support:**
When I requested skin-to-skin contact and to initiate breastfeeding, staff initially expressed concern that she could not safely feed while on CPAP. A nurse strongly advocated on my behalf, encouraging the medical team to allow me to try. This was a pivotal moment in my experience.

My baby was placed skin-to-skin and immediately self-attached, latched, and breastfed effectively while maintaining stable oxygen saturations. This demonstrated the importance of supporting maternal instinct and early breastfeeding, even in higher acuity situations. I am deeply grateful for this nurse’s advocacy.

My daughter was treated for transient tachypnoea of the newborn (TTN), suspected meconium aspiration, and possible infection. Her CRP was elevated initially; however, she improved rapidly — coming off respiratory support within hours and feeding well. Chorioamnionitis was ruled out, and placental histopathology showed no abnormalities.

We remained in hospital for five days before discharge.

Post-discharge, we experienced some breastfeeding challenges including tongue tie, however she is now thriving and exclusively breastfed.