This is the tale of my two different births: 1 emergency c-section and 1 VBAC

In 2008 we lived in the Netherlands, the world centre of natural home births. When we found out I was pregnant we were very happy to embrace the all natural approach. In fact we specifically found a midwife practise that would support us in a home water birth.

We went to the classes and prepared ourselves for the big day. The midwives dropped off a box of things at our home they would need for the birth and immediately after. The rented birthing pool arrived and we had a practise fill. We had a plastic sheet on the bed a supply of large clean towels ready.

On the 18th of September, about 7 days before my due date, I awoke at around 3am with strong contractions. I got up, without waking hubby, and walked around to see if the contractions would ease – they didn’t. I timed the contractions which were regular, lasting 30-45 seconds and around 2-5 minutes apart. I was still not sure and hate waking people so I didn’t call the midwives yet. I did go and tell my husband I thought things had started. He opened one eye and told me to try and go back to sleep – as we had been told in the antenatal class. He managed it with no problems, but lying down made things feel much worse for me, so I gave up trying. I sat myself backwards on a chair and attempted to watch a movie, pausing it for each contraction.

At 5 am I called my mum in the UK and told her to get on the first plane out. By 7 am the contractions were very similar in length and strength as they had been at 3. I called the midwives who said they would come over and check things out. Meanwhile hubby filled the bath and was sent out for doughnuts and crisps which I felt I couldn’t live without. When he returned I took one bite and couldn’t face the rest.

When the midwife arrived she said I was only 2-3 cm dilated and so said she would come back later. I was told I could get into the bath for maximum of an hour to try and relax and make the contractions more effective. That hour was wonderful and I was extremely reluctant to get out when my time was up.

She returned a few hours later and checked me again. This time I was 3-4 cm dilated but she expected, given the strength of the contractions, that I would have progressed further. At this point the contractions had been squeezing me and baby for about 12 hours. She said we should go to the hospital. The midwife was worried that because of the slow progress, and strength and regularity of the contractions, I would be too tired to push when the time came.

Until this point we had not been worried and were happy to let things take their natural course. Once I had made it down three flights of steps and out to the car in my dressing gown (getting very funny looks from the people cycling past) we headed for the hospital and here things diverged from our envisaged birth experience.

At the hospital the midwife handed us over and the doctors took charge. I was put on my back in a bed and they immediately started throwing drugs at me. They gave me things to increase the contractions and other things to block the pain. At no point was I asked if I actually wanted these things or did anyone do anything to help other than check my progress and shake their heads, or encourage anything other than lying flat in the bed.

After about another 7 hours I had only got to about 7 cms and a nurse suggested I try lying on my side to help things along. 24 hours after the contractions started, a scan to check the baby’s size and position (all fine as far as they could tell), and many drugs, I was at 8 cms dilation. One hour later I was at 9 cm but with no urge to push. This was when the doctors decided on a C-section. This was despite no signs of distress from baby and my tearful pleading to wait longer. 10 minutes after the decision was made I had been roughly shaved (that hurt) and was being wheeled out to theatre. I had to have the needles changed and my husband was not allowed to accompany me for that. I was shaking quite a lot at this point but the staff said I had to sit very still as they inserted the large needle into my spine – that terrified me and I felt vey lost, alone, and out of control. As they wheeled me into the operating room I remember feeling in shock and disbelief that they were going to cut me open.

My husband joined me in theatre and my arms were strapped out, crucifix style to allow the drips to be inserted. 10 – 15 minutes later a purple squirming thing was held above the partition for a few seconds and then taken away. I could hear him (I think I was told the baby was a boy) screaming and so, in panic, told my husband to go with the baby. I was then left, strapped out, violently shaking and alone in theatre while they stitched me up. I didn’t know if the shaking was normal, if I was OK, if the baby was OK or what was happening. Occasionally a face would appear over me and say ‘you’re fine’. No one asked me if I was OK or took any notice of the tears. Since it was in the Netherlands and I don’t speak Dutch I had no idea what was going on.

40 minutes, that felt like an eternity, later I was wheeled into the recovery room. I still had not seen my baby. Sometime after I was parked they wheeled a crib next to my bed with a bundle in it. I couldn’t see if there was a baby in there and couldn’t move to look. I started shouting to get someone’s attention. When a nurse appeared (looking annoyed) I asked them to please unwrap the baby and put him on me. Thankfully they did this and I finally got feel, if not hold, my baby.

The recovery was slow, painful, and emotional. I felt like I had failed as a woman, that I had not tried hard enough, or had done something wrong. It took a while for me to feel like myself again and to relate to the baby. Although I was very glad to have a healthy baby, whenever I thought about the birth I was reduced to tears. In fact, even three years later, if I had to talk about the experience I started to cry.

So when we discovered I was pregnant again we read up as much as we could find about our birth options. This time we were living in Botswana where there are far less health care options than in the Netherlands. After asking around we went to the best gynae’s in Botswana to monitor the pregnancy. On my first visit I asked about the possibility of a VBAC and was told we could discuss that later when we saw how the pregnancy progressed.

Around 20 weeks, everything was going well and we had what can only loosely be described as ‘a discussion’. The Dr started by asking what I knew about VBACs (Vaginal Birth After C-section). I told him what I read and was then, sarcastically, told ‘oh well then you know all about it’. He then proceeded to outline all the negatives and possible risks of a VBAC without mentioning any of the potential problems of a C-section. When he saw he was not getting anywhere with me he told me ‘women should not have natural births as it damages their bodies’. This blew my mind and, I am afraid, irrevocably damaged my faith in him as my doctor.

I then started asking around with friends and on the internet about doctors who would support our decision to try for a VBAC birth. This was complicated by the facilities available in Botswana and the vastly differing opinions on them.

After hearing endless varying opinions and a lot of soul (and bank account) searching we decided to go to South Africa for the birth. Although we had a generally positive outlook, we thought that should anything go wrong we needed to know we had given ourselves and our baby the best chances of survival. It was at this point that I contacted Heather at Midwives Exclusive in Pretoria. From that very first phone call (with Esti as Heather was at a birth) I felt these ladies were the ones for me. They were friendly, helpful and positive about my request. Emails went back and forth and help offered with trying to find accommodation while in Pretoria waiting for the birth. They were always friendly and positive.

At my final scheduled check in Botswana, a month before the birth, the Dr told me I was 3 cms dilated and should go to Pretoria IMMEADIATELY. This threw me into a spin. I had planned on packing for myself, my 3 year old and the new baby in that last week. My mother-in-law, who was accompanying us, was great at helping me throw stuff into the car before waving farewell to my husband (who had to stay and work) and heading south. At the border the immigration officials were eyeing me worriedly as if they thought I was about to deliver on their office floor.

We got to Pretoria and our B&B cottage (1010 Clifton Avenue, Centurion, for any of you looking for somewhere suitable!) without mishap and the following day saw Heather. She calmed me down, arranged for some reflexology, and reassured me that all was well. That was the start of a very long month of waiting. I used the time to catch some live rugby at Loftus, buy some baby things that were not available in Botswana, and get to know my Doula, Rosalia.

Heather had suggested we use the services of a Doula in our previous communications. I was worried I was not going to have any support during labour since all my important people were either a long way away or already busy. My husband was going to have to drive from work in the bush, across the border, and to Pretoria (an eight hour drive at best), my mum was due to come out from the UK but not until the due date, and my mother-in-law was scheduled to look after our 3 year old. Therefore the services of someone experienced at the whole labour thing, to look out for, and after, me seemed like a good idea – especially someone who could massage back and or feet and perform other miraculous tasks like acupressure and homeopathy!

I have to admit, at this point that I was concerned about the money. Our health insurance pays for the medical side of things but not for Doulas and our bank account was already taking a hammering, what with the B&B and the inevitable costs of new baby stuff. During my previous labour I hadn’t wanted my husband to touch me and so was wondering, if I felt the same way again, what would a Doula actually do? I talked to my husband and my mum and thought hard about things. I figured I was not at home, I may well be alone in labour, and had previously had a bad experience so any help I could get was welcome.

Heather put me in touch with Rosalia who, despite the short notice, said she could fit me in – what a relief that was. We met several times and discussed my previous experience and my hopes and fears for this birth. Rosalia runs the South African VBAC group and was positive yet realistic about my

hopes and chances of a natural birth. She explained her role and her previous experiences (including a very helpful info sheet about the life of a Doula). I felt safe in her very capable hands.

Time passed and no baby arrived despite plenty of practise contractions, hot curries, exciting rugby matches, walks around the zoo and various parks, pineapples and wishful thinking. The day of my due date I was fed up and feeling terrible. One of the lovely reflexologists who works with Heather gave my feet a really hard press in all the relevant places (ouch) to try and get things going and the support gynae stretched my cervix during his routine examination (ouch again). I went to bed fed up and hoping for some movement during the night. The next morning at 6am when my son snuggled in bed with me nothing had happened. I got my laptop and put on ‘The lion King’ to cheers us both up. An hour in, as Simba was struggling with his Uncle, I suddenly remembered exactly what real contractions felt like. I called my husband to tell him to get in car and drive, I asked my mother-in-law to take over movie watching, and waddled to the bath to see if the warm water would sooth the contractions away. In the bath things only got stronger so I called Heather in a panic. I couldn’t remember what I was supposed to do when and where. She told me to get my bags and make my way to the hospital. I then called Rosalia and told her what was happening.

Panting and contracting I directed my newly arrived mother through the Pretoria traffic in my mother-in-laws car (I’m not sure who was more scared her or me!). The car park at the hospital was full, so mum dropped me at the entrance and went to find somewhere to park. I waited for a contraction to pass just outside the entrance (stupidly refusing the help of a kind passerby) and then staggered across the threshold. The security guard on duty, no doubt experienced in such things, took one look at me and rushed to get a wheel chair. They wheeled me into the labour room where I wailed that I had lost my mum and didn’t know where Heather or Rosalia were. Luckily they all turned up very quickly and things got underway.

I am not sure about timings or orders of events after that. Only that I felt cared for and in safe, experienced hands. I was massaged, reflexologied, homeopathied, stroked and monitored. At one point (transition), I was convinced I couldn’t go through with it, I wanted to be knocked out and sleep through the rest of the birth! Happily Rosalia talked me through, kindly but firmly, and reminded me of my ultimate goal of holding my healthy baby after a natural birth.

At some point, during my float in the birthing pool Heather realised that, although the baby was head down, his face was pointing the wrong way. Heather and Rosalia helped me out of the bath and using what looked a lot like a south American hammock (Reboza) around my bum, managed to turn him around. Once this was done, and the waters broken, things happened quite fast. He crowned when I was back in the water and the ladies got me out onto a birthing stool to allow gravity to help with the last part of the labour.

7 hours after I felt my first contraction I was holding a very chubby 4.2kg baby, happily sucking while my mum and I watched with amazement. My husband arrived 35 minutes later to hold his son. In some ways it was sad that he missed the birth process but in others I was actually quite glad; the female power I felt in the room with these amazing ladies was awesome, also (selfishly) I was glad to have all their attention and not have to worry about him worrying about me going though pain (the ladies had all lived through it themselves and so knew I would survive).

I did have stitches and they were sore but it was nothing compared to recovering from surgery. Also I had not had any drugs and so was not hung over, or coming down, or feeling in any way compromised. By 6 o’clock that evening I was back at the B&B eating a take away, chatting to friends and family on the phone, and feeding my relaxed new son.

It was great! I could not have asked for more or better care. I would highly recommend a Doula. Rosalia was utterly amazing at talking me through and knowing just what to do where and when, to get me physically and emotionally over every step along the way. Heather and Christel (the back up midwife) were fantastic, supportive, professional and all I needed from the medical profession. For us the decision to have a natural birth with midwives, not doctors, and the help of a Doula was utterly perfect.