Birth stories · Episode 10

From home birth plan to pre-eclampsia: taking back control of an induced birth

Isabel planned a home birth in the Azores. At 36 weeks, pre-eclampsia meant an induction. With Pepe by her side, she still had the birth she wanted.

Born to be Wild · 2026-09-28

Listen to the episode

Isabel, a marine biologist from Cartaxo, and Pepe, a photographer from Santa Maria in the Azores, live in a windmill Pepe restored himself. Isabel had always known she wanted a home birth: she read the books, took an online doula course, and found a midwife.

At 36 weeks, a diagnosis of pre-eclampsia changed everything. On episode 10 of the Born to be Wild podcast, they told Aviva Markowicz and Irene Jaspers how Isabel stayed connected to herself in a place she never planned to be, and how Pepe protected her bubble.

Why Isabel wanted a home birth

Around her, Isabel had seen too many sisters and friends with difficult hospital births: wishes not respected, babies taken away straight after birth, episiotomies and pushing that weren't needed. What frightened her most was the cascade: one intervention leading to the next.

"My friends normalised the trauma. They didn't even want to talk about it."

She contacted Raquel Cajão, the midwife who had supported Irene's home birth, and planned to give birth on São Miguel, since Santa Maria has no maternity unit.

Pepe was never fully convinced. He felt that on an island, a planned hospital birth might react better to an emergency than a transfer. But he understood: "It's her body." And he saw how well prepared she was.

Pregnancy on an island

After the fire at São Miguel's hospital, Isabel's appointments were on Terceira, with a doctor close to retirement, "old school" and not very emotionally attuned. Isabel was fine with that. She only needed to know the baby was well. For the rest, she informed herself.

She organised her pregnancy around rest: good food, exercise, no stress, and the move into the windmill in October.

Listen to your body: high blood pressure at 36 weeks

On Santa Maria, Isabel had an episode of high blood pressure. Arriving on São Miguel, she couldn't get an appointment before 38 weeks. She knew something wasn't right and cried at the hospital. A social worker gave her the key advice: go to the emergency service, where you'll have priority.

That same night, with high blood pressure again, she went, and was diagnosed with pre-eclampsia.

Pre-eclampsia is a pregnancy condition, usually after 20 weeks, that causes high blood pressure and can affect the kidneys and other organs. It's serious, but manageable when caught in time. It requires close monitoring and often means the baby needs to be born earlier (NHS; NICE).

Know the warning signs: a severe headache, vision problems, pain under the ribs, sudden swelling of the face or hands. If you notice any of them, or a high blood pressure reading, get checked the same day (NHS).

Accepting the change of plan

The doctor told her she would be induced at 37 weeks. Isabel cried: it was the opposite of everything she had imagined. She found the doctor harsh. Pepe saw a doctor facing denial and doing her job, since with pre-eclampsia, guidelines recommend planning the birth from 37 weeks (NICE).

Isabel gave herself two days to digest it, talked with her doula, and made a decision:

"If I need a caesarean, it's because my baby is at risk. But I'll do everything I can to have the birth I want."

Induction with prostaglandins, then her own oxytocin

The induction started with prostaglandins placed near the cervix. Isabel sent Pepe home to rest. Contractions woke her at 3 a.m., and Pepe arrived at 4.

At 6 a.m. she was 2 cm dilated, her cervix soft, and she felt it was going well. The team wanted to add more prostaglandins and start synthetic oxytocin. Isabel said no, thank you: labour was progressing.

"If it's going well, you don't need anything else."

What followed was her own work:

Moving freely: walking, stretching, going to the toilet often.
Vocalising and breathing through each contraction, in a meditative state. The staff heard screaming. Isabel heard her mantra.
Pepe as her oxytocin: music, jokes, singing along to the baby's heartbeat on the monitor.

When a nurse asked Pepe to make Isabel quieter because another father was getting scared, he refused. When a doctor said, "if she's like this at 4 cm, imagine at 9", Isabel decided: this is about them, not me.

Transition, and a baby who came very fast

Around 9 cm, Isabel told Pepe she couldn't do it anymore and asked for an epidural. That's the transition phase, when many women feel they can't go on. The anaesthetist tried twice, but it never actually took effect.

In the delivery room, a nurse who loved physiological births let things happen without directed pushing. Isabel felt her body pushing on its own. Pepe placed her hand on the baby's head. In a single contraction, Agostinho was born.

He didn't cry straight away. The nurses prepared to cut the cord to call the paediatrician. Isabel asked them to wait. Seconds later he cried, and the cord was cut only once it had stopped pulsing, 10 to 15 minutes later. Delayed cord clamping benefits the baby's iron stores (Cochrane, 2013), but a baby who needs help breathing takes priority, which is why the team was ready to act.

"I felt like a tiger. Don't touch my baby."

After the birth: a postpartum ward of nine women

The hardest part was the postpartum ward: after the fire, nine women and nine babies in one room with a single toilet, and partners allowed only four hours a day. After three nights without sleep, Isabel chose to go home and monitor her blood pressure there.

Pre-eclampsia can persist or even appear after birth, so follow-up matters (NHS). If you're thinking of leaving early, discuss safe blood pressure monitoring with your care team first.

Their message to other couples

"You can have a respectful birth in hospital. But you need to be prepared: know your options, know your rights, and know when to say yes or no."

Pepe adds a partner's perspective: work with the staff, not against them. When they feel you trust them, it's easier to steer things in the direction you want.

Frequently asked questions

Can I still have a home birth with pre-eclampsia? No. Pre-eclampsia requires close medical monitoring and a planned hospital birth (NICE). Many elements of a birth plan can still be respected there.

Can I decline synthetic oxytocin during an induction? Yes. The law guarantees informed consent and informed refusal (Lei n.º 15/2014). You can ask why it's proposed and discuss waiting, especially if labour is progressing.

What does the transition phase feel like? It's the last part of dilation, often very intense, when many women feel they can't go on. It usually means the birth is close.

Sources

What our guests share comes from their own experience and practice. The medical and legal information in this article is based on the sources below. It doesn't replace advice from your care team.

Listen to the full episode

This article is based on episode 10 of Born to be Wild, the podcast: Isabel & Pepe, a home birth plan, pre-eclampsia, and taking back control. Listen on Spotify.