After finding out that April is Cesarean Awareness Month, I felt compelled to share my story. The highs and the lows, but with a very happy ending. I just felt I should add that now before you read on.
First, a bit of birth history…
I got pregnant with Khaya about three months into my relationship with my wonderful man. The pregnancy was awesome, the birth was even more awesome. It was quick, easy and relatively pain-free. My labour started around lunchtime on a Wednesday, and Khaya was born at 6.54pm that evening! In a way, I wonder if this easy process added to the problems I had later with post-natal depression. Was it too easy? Had I been spoiled? Did I therefore expect everything to be perfect or, at the very least, easy and natural? I have been playing that all over in my head a lot over the past few years.
Fast-forward to our rather risky trip to Swaziland in November 2016. I was 7 months pregnant when we left, and the plan was for me to return to the UK in my 36th week of pregnancy, just before Christmas. I had a letter from my GP to say that I was fit to fly, and it was OK with the airline. Nothing could go wrong, right?! Well, how wrong was I…
When we left for Swaziland, I was in the process of selling a flat I owned with my ex-husband. It was stressful. I didn’t want to be in contact with him, but there were things that needed to be done in order to get the process underway. We had some viewings, some interest, and then we had an offer. It was slightly lower than I wanted, but it would still mean a little bit of a profit for us both and, most importantly, closure. Being so far away, and having minimal access to the internet, was tough. I was able to contact the agents as and when I had reception (most of the time from a local bar/cafe in Mbabane – Thank you so much to them for their help!). I remember some rather stressed conversations with the agents as a result of my ex-husband dragging his heels on some paperwork, although he denied this at the time. I then had a heated FB Messenger conversation with him about it all, and it was not a nice experience. Being 7-months pregnant and having to deal with all of this as well as the soaring heat in Swaziland was not the best situation for me to be in. I rested as much as I could and Khaya, then a toddler, was upset that I wasn’t playing with him as much anymore. I felt miserable at a time when I should have been happy.
I woke early one Monday morning, around 3am, with a very wet patch around me in the bed. I went to the bathroom and realised I was leaking fluid. At this point I wasn’t sure if it was urine or amniotic fluid. Had I just lost control of my bladder?! I was only in my 35th week of pregnancy. The baby wasn’t due yet. The fluid kept coming, so my partner found the number for a clinic to get some advice. He called the Women and Children Hospital in Manzini, a city about 20 minutes’ drive away from where we were staying with my partner’s aunt (in Lobamba, a beautiful rural area with mountain views and lots of peace and quiet, except on Sundays when all of the churches in the area would have their services). The hospital said I should rest and sleep until the morning and then make our way to see them for an examination. Khaya had woken up, too, so we could all do with a proper sleep for a few more hours. The leaking subsided a bit but it was still coming out. We got up later in the morning, got dressed and made our way to the hospital in the family car.
Manzini’s Women and Children Hospital. I swear we spent longer in this waiting area than in the hospital itself!
As we arrived at the hospital, it looked really nice. New, clean, with a TV in the waiting area. I was happy that my partner had chosen this hospital for our check-up, despite it being a little further away than other clinics. They asked for money when we arrived. We couldn’t see a doctor until we paid. So we paid and we waited. We were called in and I was examined. The doctor confirmed that it was amniotic fluid and that I would need to be admitted because I was probably about to go into labour. After much negotiation with the receptionist and accounts administrator about fees for the admission, we finally got in to the ward where I was given a bed. They told me that I would be in for the night and would just now need to wait for labour to start naturally before they decided on what to do next. By the next morning, nothing had happened. I was induced. Nothing. Then I was induced again at lunchtime. Things then started happening. I was feeling contractions and they were getting more intense. I remember the doctor saying to me, ‘Why are you smiling and laughing? You should be screaming in pain!’. I replied, ‘I’m about to meet my son, why wouldn’t I be happy?’. But, upon examination about four hours later, the doctors found that I was fully effaced but only 1cm dilated. My son didn’t want to come out yet. He wasn’t ready! The doctor told me the words I really didn’t want to hear – ‘We are going to have to go into theatre and get this baby out. It has been too long now since your waters broke. We will need to prep you now for a cesarean’. Shit. My happy, laughing self turned into a wreck. I was completely nervous. I felt so vulnerable – A complete flip from my first birth where I felt that my body had this, that it was working well to get the baby out naturally. Now I felt as though I had failed. My body had misread some signals and thought my son wanted to come early when, in fact, he was totally happy in there. It makes me sad to write that, you know. I still feel very sad about that.
Waiting for our son to arrive naturally the night before he actually did!
So, I was prepped for theatre. It was the first time in a while I’d been shaved ‘down there’, which I managed to joke about to the lovely nurse who had that awful job! I also remember not having any more contractions. It was as if my body knew it could stop now. Perhaps my son knew that it was futile trying to do anything about getting out. Perhaps he just didn’t want to. I was given a gown to wear and I had to take off all of my jewellery. My partner had to sign a consent form to say he was happy for the operation to go ahead. He always tells me how frightening that was. I was wheeled down to theatre with my partner by my side (Khaya was staying at the house in Lobamba with his auntie and cousin). In the theatre I met the anaesthetist – A lovely man with a bubbly personality which really helped at a time when I was feeling so scared and nervous. Both doctors who I’d met and got to know were performing the operation. I felt safe and looked after. I was lifted on to the table and I started telling the anaesthetist how scared I was about having an epidural, as I’d heard that they really hurt. He reassured me, and we went through the process. It didn’t hurt nearly as much as I thought it would, so I was relieved. Then I lay down and started to feel the pins and needles and numbness as it happened. First in my feet, then up my legs, then finally up to my waist. I only recall bits and bobs about what happened next, mainly involving me talking to the staff about complete nonsense and being extremely nervous. I didn’t let go of my partner’s hand the whole way through. I said to him, ‘Let me know when he’s out’, and he replied, ‘He already is!’. He had been watching the operation, like the brave bastard that he is. I saw a very long baby being brought over to us for a kiss, then he was whisked away to be checked. My partner went in to check how he was doing (asking for my permission, bless him) while they sewed up my wounds. The doctor said that she would only put a couple of stitches inside as she wanted it to heal more by itself, and then she stitched up the outside with more sutures (One of which stayed in there until a couple of months after I returned to the UK – I went to the doctor to find out what this vein was that was running across the underside of my section scar, and she found out it was a long blue suture that had been left in there after the removal of my stitches). I remember saying to the doctor that I could feel something putting pressure on my chest. It was overwhelmingly painful. She told me she didn’t know what that could be, as she was dealing with my uterus at the time. And then I started to get the shakes. Really badly. I was shivering, my teeth were chattering, and I couldn’t speak properly. They were worried about me, but I kept cool, took deep breaths, and all was OK in the end. It took a while to wear off. I think my body was in shock. My partner told me that our son was OK, but needed some help with his breathing. His lungs hadn’t fully matured, so he would need to go into ICU for at least the rest of the night. His birth time was recorded as 7.24pm, exactly half an hour after his big brother was born 21 months before, almost to the day. Once I was stitched up, I was lifted back onto my hospital bed and wheeled back to the ward. I was told I couldn’t have a pillow and that I had to keep lying flat without lifting my head for the next 24 hours. This was to avoid some major headaches, which were a side effect of the anaesthetic they had used.
Baby Nkosinathi, only minutes old.
For those 24 hours, I mainly slept. My partner was told to go home as there was nothing he could do now. I would be asleep, and our baby was being well looked after in the ICU. My partner needed to be back with our other son at home and could come back in the morning refreshed. Poor Khaya was probably wondering what had happened to Mama, and whether there was a new baby yet! As I lay down that night, without really being able to move, I heard babies crying in the ICU. I wondered if any of them were my baby. I later found out that the staff weren’t able to pick the babies up to comfort them, and this really made me sad (Still does). When my partner came back in the morning, he went into the ICU and took videos and photos of our baby so that I could see him. He also got some updates on his progress. They thought he would be able to join me the next morning, which was great. By then I would be up and about and we could start on the feeding.
One of the photos taken of our baby son while he was in the ICU without his Mama
That night, it was time for me to get up and start walking. I had a catheter inserted during my operation and recovery but this was removed when the anaesthetic wore off. I was then expected to try to walk to the bathroom by myself. The most wonderful nurse was on duty that night – Sister Emma. I will never forget her. She and my partner helped lift me up to sit, which was extremely tough. Then I had to step down from the bed and walk across to the bathroom by myself. I needed so much help. I was broken! Not only had I been opened up to get my baby out of me, I had also been lying down, pillowless, for 24 hours. And, yes, I still got those awful headaches which the doctors assured me would be much worse if I hadn’t laid so still for that long.
My body hadn’t caught up with the event that occurred the previous evening. I didn’t have my baby with me! My milk hadn’t started coming in yet. But, the next morning, he was back with his Mama, still connected to a drip. This tiny little skinny thing with a dented chest. He looked so unready to be here. He even seemed a bit pissed off about the whole thing. If you know him now, you could understand that – He’s a feisty and stubborn little boy! We worked on the feeding all day, and started our bonding process. It was lovely. Then, my partner brought Khaya in to meet his little brother for the first time. He thought the baby was really funny each time he moved. It was also the first time that my partner could hold his new son. We discussed names for quite a few days. I wanted one of his middle names to be chosen by my partner’s aunt, as she had been so good to us, looking after us during this hard time. In the end, we decided that the name she chose for him would be his christian name – Nkosinathi, meaning ‘God is with us’. We shortened it to Nathi.
We were in hospital for a week. I was discharged on the Friday and Nathi was discharged on the Monday. I had to make an appointment to come back to have my stitches removed and we had to come back after two weeks with Nathi for a check-up. It was all very expensive. The bills were huge. We had been told the cost of a c-section when we arrived and it wasn’t much more than a natural delivery. It was affordable. But, they added on so many things, even each pair of latex gloves used. Even way after we left they added more and more fees. We had to borrow money from all of our relatives to pay the fees.
At this point, I want to tell you what I know about births in Southern Africa. I have heard many things, but the main thing I hear over and over again is how doctors try to convince you to have a caesarean. The reasons they give probably include increased health, safety, precision, no potential unnecessary trauma, knowing the day your child will be born… The real reason is that they are able to get all of their buddies some scheduled work. The surgeons, anaesthetists, nurses… All of them would be able to book the operation into their calendars and be guaranteed a wage. Most people in Southern Africa have Medical Aid, a health insurance that covers most of their medical needs. Some people cannot afford this monthly payment towards their healthcare. These people have to use the government hospitals which have less reliable care. Obviously, the Medical Aid only covers so much. I know a family in South Africa whose twins were very premature and ended up staying in hospital for over three months. Their Medical Aid only covered a portion of the total cost of the care and the total bill came to millions of rands. I wrote a blog post (Why We Need To Vote To Save The NHS) in June 2017 about how important it is for us to save the NHS for this very reason. I have learned in our international family living that there are so many differences, pluses and minuses of both lives. The NHS is a huge plus to life in the UK and we really need to know how bloody lucky we are to have such a reliable service for those scary and nerve-wracking times in our lives – Times when reliability and reassurance are most vital.
During Cesarean Awareness Month, I will be thinking of my experience which, despite the fees and the downsides, was actually a mostly-positive experience. We were well looked after, we were safe, and we had amazing support from everyone around us. Despite all the ridiculous claims that a cesarean birth isn’t a real birth (I blame Shakespeare for this – All that shit about ‘none of woman born shall harm Macbeth‘ – It turns out Macduff’s mum had a c-section), or it’s the easy route, it is important for us all to share our stories about our own experiences with cesareans and how it really isn’t ‘the easy way out’. It has just as many ups and downs as a ‘natural’ birth and should not be seen as a failure. It took me a while to see this, as I was disappointed that this was the path we had to take in order to have our second son, but I have no real reason to feel this way. He was born, he is healthy. He might not have made it if we’d carried on trying to do it the natural way. I might not have made it either. Surely, that’s the important thing here. If there is a way to do this safely, with the best and healthiest outcome, you’d surely have no choice but to do it this way.
I hope that this somehow has a positive effect on my readers. I would hate to think that I might put people off cesareans after hearing my story. I admit I still have moments, and writing this post has been hard, but I was already suffering with anxiety, depression and stress at the time of Nathi’s birth. That aside, the birth went really, really well. My physical and mental scars have practically disappeared, and Nathi is a fantastic, hilarious and extremely strong little boy.
Nathi today. Two years old and stronger than all the rest of us put together!
Thanks for reading, and please support/share/encourage others to talk during this month of awareness. For more information, please visit: the International Cesarean Awareness Network.