Do you have the pregnancy glow?

In pregnancy, your skin can exude a truly healthy glow because of a combination of factors, such as greater blood volume, which can give the cheeks a flushed look and more sebum on the skin, which can make the skin shine. While every woman experiences hormone changes in pregnancy, not every woman will get that pregnancy glow. It is well-documented that pregnancy brings with it a whole new set of skin concerns – not just the most common of problems, namely stretchmarks. Charlene Yared West spoke to Life Fourways Hospital Gynaecologist, Dr Abigail Lukhaimane, Life Mercantile Hospital Dermatologist, Dr Zinzi Limba and Genesis Maternity Clinic Maternity Coach & Spa owner, Tsholo Bless, to find out more about skin conditions in pregnancy.

Acne-oh-no!

What is it? “Acne is very common in pregnancy, especially in the first and second trimesters and in some cases can be quite severe. When your hormones settle by the third trimester it can subside for most women, but this is not always the case” says Dr Abigail Lukhaimane. “I do my best to reassure moms that it is a natural , cosmetic condition and that it will get better when hormones stabilise.” 

Primary cause: Dr Zinzi Limba explains that increased levels of androgen hormones, believed to be important for cervical ripening at full term, as well as for maintaining a healthy pregnancy, can cause acne. 

What can you do? “Managing acne in pregnancy can be tricky because many prescriptions and over the counter treatments are contraindicated for pregnancy and can cause birth defects,” says Dr Limba.  She encourages moms to talk to their doctor to plot the best and safest way forward before taking any acne treatment. 

Tsholo Bless recommends some easy drug-free options for managing zit outbreaks:

  • When washing your face, use an oil-free, alcohol-free cleanser, limiting washes to twice a day. Avoid over-cleansing as this stimulates the oil glands in the skin to produce more oil.
  • Change your pillowcases often – use cotton pillow cases which encourage the skin to breathe.
  • Keep your hands away from your face so that you do not spread bacteria from your fingers to your face. This goes for your mobile phone too – a device dripping in bacteria, even on the best days!
  • Avoid the temptation to squeeze or pop your pimples, as this can cause re-infection and scarring.
  • If you have clogged pores, treat yourself to a professional salon facial.

Chloasma: The Mask of pregnancy

Dr Lukhaimane explains that chloasma, also known as melasma, is a common skin problem where the condition causes dark, discoloured patches on your skin (hyperpigmentation).  Most common on the forehead, nose, cheeks and chin.  According to the American Academy of Dermatology, 90% of people who develop this condition are women.
Primary cause: “Estrogen and progesterone sensitivity often accompany this condition and can trigger it,” says Dr Lukhaimane. “Usually it is self-limiting and will fade after the pregnancy. Sun exposure can also predispose melasma. In addition, darker skinned people are more at risk than those with fair skin.” 

How do I know I have it? A visual exam of the area is often enough for your care provider to diagnose it, says Dr Limba. “However, dermatologists can perform a bed-side test using a Wood’s Lamp – a special kind of light that allows the doctor to check for any bacterial and fungal infections to determine how many layers of skin the melasma has affected.”

Living with melasma: Not all cases clear up with treatment, but there are methods of behavioural changes that can help minimise the worsening of the condition.  “Visit your doctor to discuss prescription options that are safe to use for pregnancy,” says Tsholo.

  • Use Paraben-free makeup if you are self-conscious to cover up areas of discolouration.
  • Wear Sunscreen containing Titanium Dioxide & Zinc Oxide – every day!
  • Wear a wide-brimmed hat and protective clothing when you are out and about in the sunshine.
  • Seek out support groups for your condition.

The Pregnancy Line

The pregnancy line is also known as linea nigra and is a normal and natural part of pregnancy. It is brown and darker than the skin tone of the woman and is a vertical line running down the middle of the belly, between the belly button and the pubis, explains Dr Lukhaimane. 

Primary cause: “It is understood that the linea nigra and the darkening around the nipples is caused by the hormones estrogen and progesterone, which stimulate the production of melanin, the pigment which darkens and tans the skin in pregnancy,” says Dr Limba. 

Does it fade? After pregnancy and birth  it goes away on it’s own – you do not need treatment. 

Stretchmarks? You earned your stripes mama! 

“Stretchmarks are very common in pregnancy, affecting about 8 out of 10 women –  and do not cause harm to the mother or baby, but can cause itching on the area for some women,” says Dr Lukhaimane. 

Primary cause: Dr Limba explains that skin is highly adaptable and can stretch and contract, but during pregnancy, the skin does not have enough time to adjust, which causes the skin to tear, which in turns results in a scar that forms – and this is known as a stretchmark. 

Who gets stretchmarks? “Lighter skinned women often get pink stretchmarks forming, while darker skinned women will have lighter stretchmarks than the surrounding skin area.  Stretchmarks can occur anywhere; on the hips, thighs, belly breasts, lower back and buttocks,” says Dr Limba. 

Treatment: Tsholo says that there is no absolute treatment for stretchmarks, but that women can be comforted to know that they will fade into paler scars and sometimes become less noticeable, but will not go away completely. “The best advice would be to make sure that you keep the skin well nourished and a cream or oil made from plant oils rich in Omega 3,6, & 9 can be very useful. A study published in International Journal of Molecular Sciences by T.Lin et al showed that the topical application of some plant oils can have anti-inflammatory and skin barrier repair effects. This also means that the itching is reduced. So it is wise to seek information from your skincare therapist,” she adds. 

TOP TIPS

Sunscreen is imperative. 

When pregnant, all medication should be cleared by your physician / gynaecologist. 

Own your birth: Why you need a birth plan

The birth plan: a tool pioneered by childbirth activist and midwife, Sheila Kitzinger in the 1970s, who believed that women and not their caregivers, should be the focus of childbirth and be able to advocate for themselves with this document, which detailed their wishes for the delivery. In the wake of birth plans, the Better Births Initiative was formulated as a way of educating caregivers on the general care of women in labour. The initiative was also rolled out in South Africa and expected to be adopted by all hospitals by 2015. Amongst the guidelines, it encourages respect, privacy and companionship for women in labour, pointing out that women should be able to labour and birth in whatever position they feel most comfortable, with as many birth companions as they choose to have. By Charlene Yared West. 

Birth plans inform and educate 

“Birth plans have become common practice now, as expectant mothers are more informed about their birth choices,” says Marié van Heerden, midwife and hospital manager at Genesis Maternity Clinic. “It is a good exercise for each expectant parent to inform themselves of their options through compiling a birth plan, so that they understand what they can expect, as well as benefit and risk of procedures and medication – and know where they can make certain choices. This applies to any type of birth, whether it is for a natural or planned caesarean section.” Laura Sayce, doula and lactation consultant at Genesis agrees; “I help my clients to compile their birth plans as a way of helping them make informed decisions. It also encourages them to do their own research into each element of the birth and then to make choices based on this information.” 

What should a birth plan include? 

According to a research paper Birth Plans, the good, the bad and the future by J.Lothian (2006), the focus of birth plans should be to answer three patient-focused questions: What will I do to stay confident and feel safe? What will I do to find comfort in response to my contractions? Who will support me through labour, and what will I need from them? “I encourage all my patients to write out their birth preferences and to make copies of it, one of which is placed into their file at the hospital and extra copies for the hospital midwife on duty for the day they go into labour,” says Dr Sean Drew, gynaecologist-obstetrician at Life Hilton Hospital. “It helps everyone onto the same page about what the parent’s intentions are for the birth, but it must also leave room for what happens in the event of having to resort to ‘plan b’ option, which is often not detailed in the plan, but should be.” Dr Drew explains that as medical professionals, their first obligation is to the safe and healthy delivery of baby and mother. “First we want to ensure life, then we can look at incorporating all the ‘quality of life’ elements from the birth plan. This is not to say we don’t observe what is written in the document. It is quite the opposite. We do try to fulfil the mother’s wishes to the best of our ability, within our scope of practice.”

Most important birth plan elements

Life Hospitals aim to work in an evidence-based way. Sister van Heerden points out that it is helpful to speak to your care provider and to do a hospital tour, so that you have a clearer insight into how the births are conducted at the hospital you have selected to birth at. “Once you have done that, you are ready to write your birth plan. There are so many templates on the internet, but here are some important factors to include,”: 

  • Labour and birth: freedom to eat and drink in labour, play music, dance, make labour sounds without inhibition, use aromatherapy oils (safe for labour and birth), have freedom to move into any position and birth in any position on the floor, or the bath or the bed. A mother should be allowed access to a doula or birth companion of her choice, who will provide non-medical pain relief options, including hypnobirthing, massage and general encouragement. Delayed cord clamping after the baby has emerged to allow for all the baby’s blood to be drained from the placenta to the baby. 
  • First hour: Uninterrupted, immediate skin-to-skin contact with the mother or the father (if the mom is unable to). Assistance with the first latch if requested, otherwise the baby should be allowed time to attempt a breast crawl. Weighing and measuring to be done after the first hour of bonding for the family. No separation of mother and baby unless absolutely medically necessary. 
  • Postnatal: Rooming in with your baby, no formula unless there is informed consent of the mother, provision of pain relief if medically necessary and assistance with breastfeeding. 
  • Plan B: In the event of an unexpected caesarean, there are still choices. The mother can request immediate skin-to-skin with the baby in the theatre after the initial checks by the paediatrician and no separation unless medically necessary. Early initiation and assistance with the first latch. If the baby has to go to the neonatal ICU, then the father may accompany the baby. 

What are the roles of each of the professionals present at a birth? 

  • Obstetrician-Gynaecologist: A medical doctor who is the primary caregiver for your birth and there to deliver the baby when it is time to push the baby out. He/She may also conduct vaginal examinations during labour, but this is more often performed by the hospital midwife on duty. It is also the role of the doctor to perform the caesarean sections either scheduled or emergency. 
  • Hospital Midwife: The hospital midwife performs nursing duties during labour and ensures the medical needs of mother and baby are taken care of by checking foetal heart rate, mother’s well being,blood pressure and other medical checks. She/he may also conduct the vaginal examinations, under the instruction of the primary caregiver, the doctor. In private hospitals in South Africa, the baby is delivered by the doctor and not by the midwife, unless the baby is born before the doctor’s arrival at the birth. The midwives at Life Healthcare hospitals are however trained to conduct normal deliveries. In government hospitals, the hospital midwives are permitted to conduct deliveries. 
  • Independent Midwife: She/he fulfils the same role as the hospital midwife, but may also deliver the baby and call on the obstetrician-gynaecologist in the event of an emergency. Independent midwives may also conduct homebirths, hospital births on low risk pregnant women, with confirmation and back up of a supporting gynaecologist-obstetricians. 
  • Doula: A doula is employed privately by the parents themselves and works independently of the hospital. She is non-medical and is there for the mother’s physical and emotional support throughout the labour process. She may not advocate on the mother’s behalf to her caregivers. Research supports the use of a doula for a more empowered and positive birth experience, no matter what turn the birth takes, whether the baby is born vaginally or abdominally.   
  • Anaesthetist: The anaesthetist is called in if the mother requests an epidural during labour and is also there for caesarean births to administer the spinal block and for ensuring adequate pain relief after the caesarean. 
  • Paediatrician: The paediatrician is called in after natural births to check on the wellbeing of the baby. They are also present during caesarean sections to ensure the health of the baby. 
  • Lactation consultant: Although the mother receives breastfeeding advice and assistance from the midwives in the maternity unit of the hospital, a lactation consultant is extremely helpful to ensure long-term breastfeeding success. 

The basics of car-seat safety

In 1769, the first steam-powered car was invented, with subsequent improvements as better automobiles were built throughout the years. It took almost 200 years later for the first safety belt to be invented by the mid 19th century. It was only in 1966 that an Act was enforced, requiring all vehicles to comply with certain safety standards. In 2015, the South African National Road Traffic Act enforced the regulation that all infants (0-3 years) be restrained appropriately when travelling in cars. By Charlene Yared West. 

The danger of being unrestrained in cars

According to the World Health Organisation, children who are not restrained during a car crash can either be thrown against the interior of the vehicle or be ejected from the vehicle. The use of seatbelt and child restraints is the most effective action of preventing the severity of injuries during a car crash. Chances of survival increase drastically when restrained appropriately. The World Report on Road Traffic Injury Prevention states that the use of child restraints in vehicles reduces infant deaths by about 71%. A study conducted in Sweden showed that about 50% of fatally injured children aged up to 3-years had been involved in side impact collision. 

What car seats are age appropriate?

The main determining factor for choice of an appropriate car seat is the child’s weight. Older children who are above the height and weight specifications for using car seats require a properly fitting three-point lap and diagonal seat-belt when riding in a vehicle. A review of various studies has shown that child safety seats that are correctly installed and used for children aged 0-4 years can reduce the need for hospitalisation by 69%. The risk of death for infants is reduced by 70%, and that for children aged 1–4 years by 47–54%.

(Table extracted from the American Academy of Pediatrics http://www.healthychildren.org

Protecting vulnerable travellers

The skulls of infants are far more malleable before 24 months and so they need less force to sustain a brain injury, explains Anna Bizos, physiotherapist at Life New Kensington Clinic. “Travelling at a speed of 60km/h can inflict horrendous injury on the unrestrained child. The acceleration is too great – and it has been shown that an adult holding a child in the backseat, will not be able to hold onto them at the moment of impact, but will release their grip, which means the child will be flung around the car or be ejected from the vehicle. The airbags, if deployed, can also cause suffocation for the child on the adult’s lap,” she says. The bottom line is, children cannot be unrestrained in cars! Parents must be consistent and model good car safety habits – for everyone in the car, every time, even if there are tantrums.” CEO of the QuadPara Association of South Africa, Ari Seirlis agrees; “The consequences of a spinal cord injury especially for children and young people, are too dire to contemplate,” he says. “QASA promotes that seat belts are essential to use in a vehicle and our road safety programme has the slogan buckle up, we don’t want new members.”

Rehabilitation Paediatric Programme at Life Hospitals

Life Healthcare’s Rehabilitation paediatric programmes are focused on providing holistic, interdisciplinary individually targeted interventions that are developed for each child, based on a variety of standardised and internationally recognised assessments, says Nomsa Mbuyisa, Nurse Manager at Life New Kensington Clinic. “We hold interdisciplinary team meetings weekly to assess the child’s progress and, based on this, whether any adaptations should be made to the programme.”

<Sidebar> Sister Mbuyisa shares her top car safety tips for infants

  • Everyone in the car must always buckle up! 
  • Always check that the car seat is correctly installed. 
  • Ensure that the child is in the correct age car seat. Infants need to stay in a rear facing seat in the back seat, making sure to install the seat at a 45-degree angle to help support the baby’s head and back.
  • Make sure your car seat works in the type of car that you have. Not every child safety seat is compatible with every car.
  • Replace the car seat after a crash. Even a minor accident can compromise the structure of the seat. Avoid buying used car seats since you don’t know its history.
  • Never leave a child alone in the car as they can overheat quickly when it’s warm. 
  • Never share a seat belt. Do not use one seat belt to buckle two kids.
  • Ride in the backseat. Children who are younger than the age of 12 should always ride in the backseat. In an accident, the airbag can injure a small child. 
  • Stay calm. Teach kids to be quiet and calm in the car. They must not jump around, yell or  

scream in the car as this can distract the driver. This can put everyone in the  car at risk.

In the unfortunate event of a car accident, the Road Accident Fund is able to assist with medical expenses, loss of support, funeral benefit and general damages for pain and suffering. To lodge a claim, claimants can contact the Call Centre on 0860 23 55 23. 

Caesarean birth: Safety is the priority

When planning for your birth, you must consider your options; an attempt at vaginal birth, which may or may not result in an emergency caesarean, or choosing to have a caesarean, also called a Caesarean Delivery on Maternal Request. Charlene Yared West spoke to Dr Jacky Searle, an obstetrician-gynaecologist at Life Vincent Pallotti about the risks and benefits of caesarean section. 

Reasons for a planned caesarean include: 

  • Placenta praevia (a low-lying placenta)
  • Breech presentation
  • Previous caesarean section 
  • Previous shoulder dystocia 
  • An elective caesarean delivery, also called Caesarean Delivery on Maternal Request (CDMR) in the absence of a medical or obstetric reason for avoiding a vaginal birth.

Reasons for an emergency caesarean include: 

  • Cephalo-pelvic disproportion (baby’s head does not fit through the mother’s pelvis) 
  • Fetal distress
  • Congenital malformations of the baby
  • Pelvic abnormalities
  • Infection of the mother
  • Situations where labour isn’t recommended such as; eclampsia (seizures resulting from high blood pressure) or prematurity of the baby

BEFORE: Preparing for a Caesarean

“For a scheduled caesarean, a protocol is followed, which includes not eating or drinking for six to eight hours before surgery and shaving the bikini area where the incision will be made.” Says Dr Searle. “On arrival at hospital, there are forms to fill out and the anaesthetist will meet you and make a pre-operative assessment before surgery. You will also meet the attending paediatrician shortly before the procedure.” Dr Searle adds that women may choose to have a doula to accompany them for their caesarean. “She will often arrive with you at the hospital and pamper you before going into theatre. This can help a mother relax and connect to her baby and the imminent birth.”

In the case of an emergency caesarean, the surgery is usually done within 30 minutes of the decision being made. The mother will be accompanied by her partner, and her doula, if she has one. “This can be stressful, and even traumatic for the parents, but an adequate explanation of the necessity of the caesarean should always be provided, enabling them to understand and process the experience. All pregnant women should understand that the outcome of labour is unpredictable, but a caring team can support her through the process of childbirth and help her to feel cared for and held throughout.”

DURING: In theatre for a caesarean

In theatre, the mother will have a drip inserted and anaesthesia is almost always regional (awake) – either spinal or epidural. A urinary catheter will be inserted once the anaesthetic is working. “Women, especially those who have not chosen a caesarean, are often pleasantly surprised to find that caesarean birth can be a truly beautiful experience for a mother and her partner,” says Dr Searle. 

A gentle caesarean

A ‘gentle caesarean’refers to minimising the medicalisation of the process where possible and enhancing the gentleness. “I am proud to say that this is routine at Life Vincent Pallotti,” says Dr Searle. 

A gentle caesarean includes;

  • Limiting unnecessary noise and chatter
  • Dimming the lights, playing the mother’s choice of music
  • Not removing the baby from its mother after birth
  • Early skin-to-skin contact and early latching 


AFTER: Post-recovery form a caesarean

A regimen of analgesia will be prescribed to ensure that any post-operative pain is manageable, explains Dr Searle. “Mothers generally recover well post-caesarean, as they are motivated to get up and moving, and are distracted from post-operative discomfort by their baby! Breastfeeding is encouraged and assistance is provided for all new mothers in the maternity wards at all Life Healthcare hospitals. Mothers usually stay in hospital for four days/three nights after a caesarean section,” she says. 

VBAC: Vaginal Birth After Caesarean

“It is appropriate for any woman who has a single pregnancy, with a baby in the head down position, and who has had one previous lower section caesarean, to consider a VBAC,” says Dr Searle. “A successful VBAC is more likely in women who have also had a previous vaginal birth, taller women, women less than 40 years old, where labour occurs before 40 completed weeks, and where birth weight is less than 4kg.”

<Case Study>

Sam Suter’s empowering emergency caesarean

I had always wanted a natural birth, although I am hesitant to use that word now, as no birth is unnatural. A birth is birth, no matter how a baby comes. At 39 weeks pregnant, I was induced to attempt a vaginal birth, because my blood pressure reading was climbing and continued to increase to dangerous levels. This was around at 10am in the morning and at 10pm at night, although contractions had begun, they were ever so slight and my blood pressure was rising. The decision to have a caesarean was made because of the risk of a stroke.

 I believe all birth experiences have an element of trauma, and this is all part of it – but for me the euphoria and the memory of seeing Tom for the first time, far outweighed any trauma. What I didn’t know is that even if you’ve had a caesarean, nature takes over and the ‘love and bonding’ hormone oxytocin is released – in both mom and baby. I was definitely feeling the oxytocin and looking back, the experience is such a happy one. Happy is in fact not the word to describe it… It was the most incredible human experience I have ever had. 

The whole birth experience was not ‘perfect’ or how I had envisioned it, but I had to go with the flow, what was best for my baby and I, and I think that is a huge learning for parenthood overall.

Medication & pregnancy

Knowing what medication is safe to take in pregnancy is very important when considering over the counter and prescription medications. There will be times in your pregnancy when you simply don’t feel well – and wonder if it’s safe to take the same medication you took before you got pregnant. Life Healthcare delves a bit deeper into this topic, making sure you and your baby stay safe during pregnancy. 

Why is it important to know the facts about what’s safe and what’s not?

In the late 1950s the drug ‘Thalidomide’ was released as a non-addictive sedative, which could also effectively treat morning sickness in pregnant women. It was distributed to 46 countries and what followed was a medical disaster where over 10,000 children were born with a range of severe debilitating malformations. “That was one of the most devastatingly tragic events in medical history – one that should never be repeated. However, it is rare for something like that to happen again in our day and age, where women are more informed about what’s safe and what’s not – and do question everything,” says Dr Billy Joseph Jacobs, gynaecologist and obstetrician at Life Glynnwood. “We encourage all our patients to clear the medications they were on with us – and if they are experiencing symptoms, to check with us what medications are safe to take now that they are pregnant,” he says. “The greatest risk to the baby is in the first trimester of pregnancy when all the organs are forming. Oral medication used for acne is especially dangerous then. It is best to avoid all medication in the first trimester, unless prescribed by your doctor.”

Clinical Practice Pharmacist at Life Eugene Marais Hospital Kashmiri Ganas, agrees; “During pregnancy, many medications and supplements can be passed via the placenta directly to the foetus,” she says. “Some medications and supplements can cause harm or birth defects to the unborn child, so it is of utmost importance to consult your doctor before taking any medication or supplement. The same holds true once your baby is born and if you are breastfeeding.”

Medication to avoid in pregnancy

According to Dr Jacobs, medication containing alcohol and pseudoephrine, which is found in common cold and flu preparations, as well as aspirin and anti-inflammatory agents such as Ibuprofen and Diclofenac are not safe in pregnancy and should not be taken, unless directed under the supervision of your treating doctor. “Each medication has a risk factor classification associated with it and it is on an individual basis that safety is established,” he says. 

Chronic medication in pregnancy

Pharmacist Kashmiri adds that it is very important to also inform your doctor of any chronic illness that you may have. “Your doctor will then decide on the risk benefit ratio when deciding whether to continue treatment or not. Conditions that require treatment such as epilepsy and depression must be treated adequately, as failing to do so may result in a risk to mother and baby,” she says. “The doctor will review all medication taken to treat the chronic condition and establish whether it is safe to take whilst pregnant, if it is deemed to be harmful during pregnancy an alternate drug may be prescribed or collaboration with a physician may ensue.” Dr Jacobs agrees, adding that it is imperative that all medication is taken as prescribed, at the correct dose, quantity and frequency as deviation in any way may cause harm to you or your baby. “Always read the label and look for allergic reactions, expiry dates and warnings – and be wary of side effects. In addition, be careful not to mix up your medications or skip medications when you should be taking them.” 

<Sidebar> Dr Jacobs and Pharmacist Kashmiri share their advice on how to alleviate some common pregnancy conditions from A to Z. 

Common Pregnancy ConditionsSafe medications and remedies Advice: 
Allergies-Allergex-Loratadine-Nasal decongestant spray-Nasal steroid sprayMay be used with caution in pregnancy, consultation with doctor is preferred. If allergic reactions last longer than a day or two, see your doctor.
Constipation-Movicol
-Glycerine Suppositories.
Increasing fibre and fluid intake may help relieve constipation, as well as adding dried fruit, prune juice and bran to your diet.
Common Colds and Flu-Salex Nasal Spray/Rinse-Prospan Cough Syrup -ParacetamolIf a respiratory infection is suspected, your doctor should be consulted.
Diarrhea-Kaolin-Pectin-Imodium-Smecta -RehidratContact your doctor if diarrhea is severe, if there is blood in the stools or if symptoms continue for longer than 24 hours. Most diarrheal illness last only a day or two without treatment. It is important to replace fluids lost with a rehydration solution.
Fatigue-Prenatal vitamins-Folic acid -Magnesium. Get plenty of rest, elevate feet, and eat a well balanced diet. If the problem is persistent, contact your doctor as this may also signal low iron levels. It is also very important to take folic to prevent a condition known as spina bifida in the baby.
Faintness and Dizziness-Don’t self treat. Fainting and dizziness that is not relieved by sitting down or lying down must best be assessed by your doctor. It may be a sign of either high/low blood pressure or glucose levels which may cause harm to the unborn baby.
Hemorrhoids-Anusol-Preparation HConstipation aggravates the symptoms of hemorrhoids, so ensure a high fibre diet and increase fluid intake. Don’t delay going to the bathroom. Sitting in a warm bath may help alleviate some symptoms.
Headache-ParacetamolIf pain is not alleviated, contact your doctor, as this may be a sign of elevated blood pressure. It might also be an indication of dehydration so increased fluid intake may also help. If you have a fever, contact your care provider immediately. 
Heartburn & Indigestion-Gaviscon-CitroSoda-Rennies-MaaloxSteer clear of foods which can exacerbate symptoms. 
Insomnia-Antihistamines listed above for allergies have a sedative effect.-Sleep eazeTake a warm bath before bed, try different sleeping positions or a maternity pillow, or ask your partner to give you a massage before bedtime. 
Muscle Strain-Slow Mag Slow Mag is considered safe and is especially effective for leg cramps that are common during pregnancy.Taking a warm bath may also help.
Nausea and Vomiting, morning sickness-Asic-After 8 weeks pregnancy; ZoferIdentify foods that may trigger these symptoms. Starting the day off with a dry bland meal such as toast may also relieve these symptoms. Eating smaller meals more frequently. Also easily digestible and less fatty meals.
Rashes-Allergies medication-Mild steroid creamsYour Pharmacist will be able to advise on a suitable topical treatment or consult with your doctor. Identify the cause, skin irritation, food allergy, contact dermatitis. Mild steroid creams for a day or two is safe.
Urinary Tract Infection (UTI)-CitroSodaContact your doctor as a UTI may cause harm to the unborn baby. Citro Soda relieves burning only. If persistent, see a doctor.
Yeast infection-Canesten CreamContact doctor as a Yeast infection may cause harm to the unborn baby. Use a probiotic like Interflora when recurrent.

‘Surrogacy gave us the gift of twins’

Tasha and Wayne McKenzie wanted a baby even before they said their vows on their wedding day. After four years of trying to fall pregnant naturally and after six unsuccessful rounds of IVF, their friend Lee-Ann Laufs said she would be their surrogate. Charlene Yared West sat down with Tasha, Wayne and Lee-Ann to learn more about their surrogacy journey. 

Surrogacy chose us

Wayne and Tasha felt that they had exhausted all their options to have a baby, save the adoption route. Their friend, Lee-Ann Laufs worked closely with with a safe house for abused and abandoned children called Miracle Kids in Cape Town. “I emailed her to get the details and she called me back saying that she had been telling my wife Tash for months that she would be our surrogate – and that she really meant it. I was blown away by what she said and wanted to laugh and cry simultaneously. I knew this could finally be it… We could have our baby!” 

Tasha recalls how she got to know Lee-Ann in her beauty salon; “When she came for treatments, we got to know each other and would start chatting about where I was in fertility treatment. She always mentioned wanting to be our surrogate, but sometimes people say things they don’t really mean and I wasn’t sure if this was one of those times, so I left it at that. She gave birth to her second son and after the caesarean messaged me from the hospital saying she would do this for us. She told us to be patient and wait a little while longer until she had healed and was ready to be pregnant again. We left it at that and I still didn’t believe her!” 

It was only after Lee-Ann and Wayne had spoken that the offer of surrogacy became real to Tasha. “Unless you have been through the process, you will never know the heartache of infertility and I was terrified to allow someone else to carry my baby.” adds Tasha. “It was the best news to hear that both eggs survived and we were expecting twins. Prof Thinus Kruger from the Aevitas Clinic dealt with the embryo transfer and making us pregnant.”

Lee-Ann recalls how during the pregnancy, Wayne started calling her “Smeg”, which was a code word for oven. “That was exactly how I viewed the pregnancy; I was an oven for their babies. Simply put; their sperm and eggs, my uterus. The babies don’t receive anything from the surrogate mom except food and a warm comfy womb.This is known as gestational surrogacy,” explains Lee-Ann. “There were no feelings afterwards of ‘I wish they were mine.’ The joy it gives others is so worth it and helps erase all the heartache they went through to finally have their babies.”

The medical side

“The surrogate and the commissioning mother need to sync their monthly cycle,” says Professor Thinus Kruger from Aevitas Fertility Clinic in Cape Town. “Hormone injections are administered to the surrogate to stop her from ovulating at this time. Her uterine lining also needs to be a certain thickness so that the embryo can be transferred into the lining to grow.” He explains how the commissioning mother’s eggs are stimulated to get as many as possible and are then grown until they are mature enough to be harvested and then fertilized by sperm from the father. “The laboratory scientist selected eight eggs based on quality and and then fertilized those. They are then grown and allowed to undergo cell-division outside of the body between three and five days. Not all the eggs will go through these stages of cell division and then another selection process takes place where only two embryos are transferred into the surrogate’s uterus at this time. After the transfer, there is a waiting period of ten days before seeing if the pregnancy is viable.” Prof Kruger explains that there are variations to this process and it is not successful at every stage.

Gynaecologist and obstetrician Dr Gary Groenewald was chosen by Lee-Ann to continue his care as her primary caregiver. “Lee-Ann is an extremely giving person and to do this for friends – to undergo pregnancy and surgery via caesarean section – is a major sacrifice. It really takes a special, very generous person to do this for someone else,” he says.

Since the McKenzies’ case, Life Healthcare developed a very practical and sensitive protocol to deal with future surrogacy cases. Wayne shared how special the caesarean was at Life Kingsbury and that he and Tasha were allowed to be there as well as Lee-Ann’s husband, Shaun. “It was the best day of our lives and we are forever grateful to Lee-Ann for what she did for us. We are adjusting to life with our baby girls, Lea and Madi and being parents,” says Tasha. “It has been an amazing journey and all the pain and disappointment of infertility is slowly fading, but it still feels like a dream sometimes… but then I see my daughters and I am so proud and happier than I could ever have imagined possible.” 

Surrogacy Quick Facts 

  • According to Surrogacy.co.za, women who want to be a surrogate need to have had experienced pregnancy and birth and have at least one living child of their own. 
  • A surrogate also needs to be in good physical, emotional and mental health. A thorough medical and psychological examination is carried out to ascertain suitability of the surrogate and the parents. 
  • Since 2010, new laws about surrogacy were passed and women wanting to be surrogates may no longer gain financially from the process. However, all medical bills for the pregnancy must be footed by the commissioning parents. You may only be a surrogate for altruistic reasons. 
  • Commissioning parents opt for surrogacy because they are unable to conceive their own child via fertility treatment or otherwise. Many gay couples who want a child of their own often look for a surrogate to help them achieve this. 
  • As a surrogate you have no rights to the child after birth. 
  • A contract is drawn up with the Surrogate Lawyer so that your surrogate does not run away with your unborn child. In the contract it also states how many IVF processes the surrogate is willing to do and how many IVF processes the parents to be are able to afford before cancelling the contract. 
  • Check out www.surrogacy.co.za for more info. 

Ruwarashe’s Birth Story

Ruwa was nervous at our first meeting. Soft-spoken, she asked about my role as a doula for her birth. I walked with her in pregnancy and birth and when she went into labour, I met her at the hospital. Her birth changed everything. She was shown how powerful her birthing body was and that she could do anything. Here is her story of the birth of her son…

My name is Ruwarashe and I am 21-years-old and I come from Zimbabwe. I’m currently studying at UCT. I became pregnant in September 2018. Pregnancy was going to be a hard journey for me, as I didn’t understand anything about birth and even worse, I was a long way from home where I had friends and family to guide and support me. In Cape Town, I have little support. So many people recommended I get a doula, especially since I felt quite isolated in Cape Town without my family near. 

Choosing a doula for me was so important, because I needed someone compassionate and soft and when I went onto Charlene’s website, I knew she was the doula who would understand my fear and confusion of becoming a mother. ( I hadn’t even met her in person yet, but I just knew.) 

I remember I wasn’t sure if I was going to have anyone close to me at my birth, because my family and fiancé stayed so far away… And I had so many fears of becoming a new Student  mom. Charlene reminded me that she was going to be there for me – and that I would be ok, no matter what turn it took. She said this at our first meeting.

Charlene engaged with me every week reminding me to trust the process of the journey I was on, offering me her kind support along the way. I was at school from 8am to 5pm everyday and I was at school until I was 9 months pregnant.

She also made sure we were able to meet close by to where I lived, as I did not have a car. She did this without hesitation – and it was so kind of her. When I felt low, I would message her and we would chat and she would encourage me to keep my faith and to be strong. 
I think what especially helped were the Relax Into Birth visualisation tracks. Listening to them regularly helped me realise that birth wasn’t just an event, it was a process – a beautiful process… Finally I was learning to trust the process – and trusting myself to do it! I felt strong enough to birth my baby boy. The strength seemed to come from within me. A deep knowing. 

The Relax Into Birth classes made me realise I wasn’t just doing a duty a woman is required to do; no! My body was giving life to a soul, another human being. Although it was about birth, it also somehow helped me establish what type of mom I was going to be to my little boy. 

When I finally went into labour, the emotional support for me and my fiancé was tremendous! She always made sure I was as comfortable as I could be in those circumstances. When it was time for me to deliver, I remember I was very tired – and our doula Charlene never once wavered, always trying ways to help energise me and encourage me to bring my son down to earth.

During my visits to the doctor, I was told we had to schedule an induction, because they didn’t want me going over my due date, which was the 26th of May. I wasn’t so sure I wanted an induction considering the potential complications. It was really not what I wanted.

In my 39th week, I went for cervix check to prepare for my induction. I was notified that soon I was going to be in labour – and that it was likely I would not need an induction. On Thursday 23 May, my waters broke as I was going to bed. I remember I kept my calm. I took an Uber with my fiance who had arrived from Zimbabwe, even though my contractions hadn’t kicked in properly yet. I didn’t want to stay at home after that because I didn’t want to be under pressure to rush to the hospital when it became necessary. I didn’t want something dramatic! Charlene did join us at the hospital when my contractions got regular and intense. She was there the whole time and I held onto her. She created such a calming environment in such a tense situation. I remember I had moved 1 cm in 4 hours and all I wanted was an epidural. I asked the nurses for an epidural, but was refused by them, saying it was too early to administer. In the face of that, my doula encouraged me to keep going and to stay strong as I was birthing my angel.

We used other forms of natural pain relief. We used the shower and we counted together and breathed together and finally at 7 am they decided to insert a dose of prostaglandin gel to help my cervix open. Once that was given to me, five minutes later I was standing to go poo in the toilet and another five minutes later I was walking myself to the tub in the delivery room. During that walk I definitely felt my baby was coming! I got into the tub for a few minutes and notified both my fiancé and Charlene that the baby was indeed coming.

The delivery room not prepared by the hospital staff (as they didn’t expect me to push so soon), they quickly put me on the bed, and there was my baby crowning! They quickly set up the room as I involuntarily pushed him out. A few pushes and I had birthed my baby.

My birth taught me to trust my body and trust my baby. I have never felt as strong or as empowered as I did in those first days. I was blessed to have such a positive, empowered birthing.

Pip’s Birth Story

Hailing from New Zealand, I had never met Pip in person, but she was referred to the Relax Into Birth Hypnobirthing course by a dear South African friend of hers, who had also completed the course a few years earlier. She was so excited to share her story with me after she had given birth, because the techniques had been so helpful. Here is her letter to me after her birth.

Dear Charlene,
I just wanted to give you an update on how I have been doing and let you know our little baby girl “Niamh” arrived safely with us in hospital at 10.07am on the 8th May 2020 at 6 Ib 15 oz and we are all doing great! I am sorry I haven’t been in contact sooner – I just wanted to sit down when I had some time to fill you in properly. I have emailed you because if I sent you a voice over on whats app I would be in tears!

Just to give you some background on myself, I had extreme anxiety about labour for as long as I can remember and this soon got worse when I became pregnant. To give you an example I had previously passed out from getting cervical smears done and I am just not good with that kind of stuff! – ironic really considering I am a horse vet! 

You couldn’t have come at a better time for me as the anxiety was getting the better of me as time progressed. I remember around 26 weeks in tears at my midwife appointment feeling completely overwhelmed and not knowing what to expect.  I spoke to my dear friend Felicity Meek who put me in touch with you. As soon as I started listening to your affirmations and then doing your course from around 33 weeks my mind set started to change and I began to relax ! Your course allowed me to understand the process but in a way that wasn’t scary but beautiful, something to look forward and that my body was going to do it! I had no idea how powerful hypnobirthing could be but it was the best thing I could have done to prepare myself ! I can not thank you enough Charlene – you are incredible and what an amazing birthing experience you and your course have given me.


Now for the gorey details………… well there aren’t any! Haha! I went into latent labour on the 4th May ( my due date) with mild contractions every 10-20 mins for about 20 seconds in length on / off through to the 7th May when the contractions gradually got stronger and longer. I had a “Show” over this time too which I admit did freak me out a bit but I had your voice saying “Show time!” in my head which helped to ground me and stop me panicking. 
I laboured at home for as long as possible and made a wonderful area in my sitting room with candles, diffuser with lavender oil, exercise ball, cushions, fairy lights etc …. with my husband, 2 dogs and my favourite movies on.

It was really beautiful and my husband was absolutely amazing using some of your massage techniques on my lower back and making sure I was eating/drinking. I used a water colour painting of a lotus flower to remember your affirmations and a colour card to look at to help me focus on the rainbow breathing technique. During contractions I would also think about your lovely knitted uterus which helped me visualise and understand what mine was doing!

 By the 7th May from 6pm the contractions got stronger and lasted longer until  I was getting contractions every 3-4 minutes lasting a minute by midnight –  I was in/out of the bath at this point which helped a lot. 

We made our way to the hospital at this point and got screened at the entrance for COVID-19. We entered the maternity ward and the corridors were lined with pastel balloons and fairy lights which was wonderful! I was examined (I was apprehensive about the examination) and found to be 8 cm dilated. My waters broke at this point – I was delighted thinking ” not long to go now!”

I went into a bath  and my husband and midwife set up some led candles and my affirmation cards. I stayed in the bath from about 2 am to 6 am . I was examined a few times and found to be 10 cm by 4 am but my contractions started to get weaker and further apart. I got out of the bath and tried sitting on a squatting stool but that didn’t really bring things on.

Up to this point everything was 100 % perfect but I started to feel anxious and willing for more intense contractions! I was examined by an Obstetrician  at 6.30 am – he was astounded that I had no pain relief and I remember the midwife saying proudly “she’s using hypnobirthing!” The obstetrician confirmed with the midwife that all was well with baby and there was no reason why she shouldn’t come through my pelvis.

It was discussed with me to go on a Pitocin drip to get contractions going. My platelets were low so it was not recommended to have an epidural, but I remember feeling so exhausted and the thought of pain relief sounded good! Your affirmations grounded me through this process and helped me focus and I just continued to breath, eyes closed and I just went into myself. Once the drip was in and monitor put on baby head I was allowed go on 4’s on the bed. The contractions came – I took gas as I found them heaps stronger than my own ones but I could tell we were making great progress.  I remember feeling my baby head turn and pop through my cervix. An incredibly visceral and alive feeling I had – I think I shouted out “Fecking hell!!!” and “How close are we now?”

Then I felt the wee burn feeling and I remember thinking “We are nearly there!” My midwife got me on my back at this point, one of my legs was wrapped around her neck. I couldn’t believe how much pushing I had to do along with the contractions. She got me to really push with my breath. At this point I remember taps going on and her telling me try not to push at the moment. She was putting hot flannels on me. Then the last contraction came and she warned me she may give me an episiotomy (I didn’t care at that point !) but she didn’t  have to  in the end and Niamh’s head came out followed shortly by the rest of her and up she went onto my chest – total magic!!!

My husband Josh cut the cord and she stayed on my chest for an hour.  I got a small superficial tear that was stitched (about an inch or so long), but that was it. I passed the afterbirth and I remember the umbilical cord some how slid up between my bum cheeks and I said “Guys – the cord is giving me a wedgey!” , then I proceeded to wiggle around on the bed trying to pull it out. 

I walked out of the delivery room an hour later feeling completely elated and so proud of myself. I had a beautiful and empowering birth experience and when one of my fears of having interventions occurred I was able to process and deal with it thanks to you and your course. 

So Charlene, I can not thank you enough. Every first time mum should be doing this as it has honestly helped me beyond belief. I really think it should be offered to all expectant mums at their first midwife/doctors appointment. A huge thank you from the bottom of my heart.
Love from Pip.

Want to find out more about Relax Into Birth Hypnobirthing? Enjoy a more comfortable, empowered birth and click below to enroll and find out more. Relax Into Birth is an Online Birth Preparation Course, of international standard, teaching women and their partners Hypnobirthing techniques and deep relaxation methods for a more comfortable and manageable birth experience at home or at hospital, for natural or caeasarean birth.

Tamlyn’s Birth Story

What a pleasure to be Tamlyn’s birth doula. From the moment I met her quite early in her pregnancy, she embodied a certain positivity and exuded a confidence I rarely saw in a first time pregnant mama. She shares her story of trusting the process for her home birth.

I’m a new Mamma, my baby boy Charlie is 4 months old. I’m just starting to emerge from my cocoon of love and bonding, embracing a new way of being and living, finding balance between motherhood and my purpose of serving you. What an incredible journey I’ve been on, from the start of my pregnancy to today, it’s been life changing on so many levels and I am looking forward to sharing it with you. 

It all started on the 8th of March at 2.30am when I woke up to a pop, and my waters releasing. I couldn’t believe it was the start of the journey to meet my baby boy. I wanted a natural, intervention free home birth, I was excited and had no idea how things would unfold but had a deep trust that things would happen as they should, a trust and surrendering I’d spent several months cultivating during my pregnancy.  

I spent the months leading to my baby’s birth doing the work to birth a new part of myself, a mother. I meditated, visualised, went to healers, coaches and massage therapists, did family constellations work, hypnobirthing, re-created my own birth, did inner child work, went on yoga retreats, painted, walked, prayed and wrote every day. I learned so much. (I have many pregnancy and birth related resources if anyone would like them, please just reply and ask. )

I knew that my pregnancy and birth would have a deep impact on me and my baby and I wanted to go as natural as possible.  I had many fears and doubts and whenever they would show up, I would go within and do the work to release them. I’d remind myself to pray for the highest good for all, to let go of control and to remain open to what life would present. 

The work for me here was about letting go of the outcome, of control, and also not putting it in the hands of someone else, but to lean in, trust myself, my body, my baby and nature. This was a pattern I’d been playing on repeat most of my life, forever trying to control the outcome of situations or just putting my head in the sand and letting someone else take over. This was my biggest test yet. This time I really wanted to be intentionally conscious of what I wanted to co-create and at the same time know that whatever the outcome, to remain open to what life was offering. 

For this reason, I chose my midwives and Charlene Yared-West from Relax Into Birth as my Doula. The moment I met with them, it felt right, very natural and mother and baby-led. I met Charlene at the The Birth Hub Antenatal classes and just loved her segment and felt so comfortable with her. I would highly recommend Charlene as a Doula, I couldn’t have done it without her. Throughout my pregnancy I formed such a beautiful bond with them all and I felt so safe and held with them as my birth team. 

So, back to my birth story…

After my waters released, I had very mild intermittent rushes which were not painful at all so I tried to sleep and in the morning I let my midwives know that things could be happening soon. I spent the day painting, watching funny shows and walking in nature to ground myself. I let go of trying to predict what was happening and allowed myself to fold into the experience.  I remember thinking to myself, this is easy, I’ve got this. The mild rushes continued on throughout the day and evening and at 10pm that night I told my midwives things were still the same and would get in touch in the morning. As I snuggled up to go to sleep, a strong surge rushed through my body, so strong I had to get on my knees. 

A few minutes later, another, I knew it was time. I told Matt to let my midwives and doula that things were progressing. I moved to my birth room where we’d set up the birth pool, affirmations, playlist and positive imagery. I knew now was the time to get out of the way, to let go and let my body and my baby do the work. I instinctively knelt on the floor in the corner of the room on my knees, my upper body resting on my ball. I focused on spiralling my hips and moving back and forth to help the baby move down. The room was dark and quiet and all I could hear was the beautiful kundalini music from my birth playlist which helped me go within. 

The surges were coming in heavier and faster now and I was struggling to breathe through them.  It was so intense so quickly. (My midwives later told me, I must have had a very good production of Oxytocin as things progressed very quickly in my active labour.) I was beginning to get more and more vocal, my groans and primal sounds getting louder and louder. Matt was sitting with me encouraging me gently, holding my hand which I was using to bear down on with each rush. At about midnight my Doula, Charlene arrived, I was so grateful to see her. By then I didn’t want to speak and was so focused on the surges. She knew exactly what to do to support me. I held her hand she began massaging my lower back which felt so good.  

In the meantime, Matt was preparing the birth pool. After a few hours of intense surges, I asked Charlene when she thought I would have my baby, she said soon soon, before the morning which encouraged me. I asked to move into the pool as the rushes were starting to feel unbearable. The moment I slid into the water it was a beautiful relief. It was so warm and took a lot of pressure off my back. However, when the next rush came, I’d forgotten all about the lovely water and roared through the rush. Nature had chosen wild and windy night for my birth which matched exactly what I was going through. 

I spent the rest of my labour in the birth pool, on my knees spiralling back and forth while resting my head on the edge of the pool. For each surge I needed to hold someone’s hand, I needed something to push down on, something strong.  My doula and Matt stayed by my side for most of my labour alternating for breaks. Giving me water, apple juice and honey to keep up my strength.  Charlene let the midwives know when they needed to come and they arrived around 2am, a few hours before my birth. I was hoping they could tell me how close. I asked my midwife, how much longer, and she said ‘’let’s wait and see’’, this was not what I wanted to hear. I wanted her to say any minute now.  I had chosen my midwives because they were very trusting in natural birth and in my body to birth my baby, with as little interference as possible however in that moment I wanted answers, my mind wanted to know the outcome, how much longer…! I knew they were doing exactly what they needed to do. I went within and let go.

I had no physical checks during my labour, my midwives spent most of my labour in the other room listening to my labour and doing the occasional listen to my baby’s heart rate which remained steady throughout.  My dog Zesa popped into the room a few times wondering what all the noise was about which made me smile to know he was there for me too. 

As time went on, I was getting more tired, I really needed him to be close now. My doula Charlene asked Matt what his name was, Matt said we hadn’t decided yet (which we had but he didn’t want to say). She said, if you knew his name you could call him and encourage him out. When I heard that I shouted CHARLIEEEEEE, and they both started laughing, I guess we knew the name after all. I started talking to him, encouraging him, telling him how much he was loved and wanted and that it wasn’t long now. That really helped me. It gave me a new boost of will power and determination. It was like I knew his birth was near. What also helped me was Charlene reminding me to relax and let go of each surge, this really helped me rest in between without tension. She would say one down, one less to go.  I could feel he was close now, I muscled up every bit of inner strength I had and focused intently on allowing the birth energy to move through me. I connected with the galaxies and imagined that energy spiralling through me, I knew I didn’t have to do anything, I just need to let go and allow. I looked up at my affirmations and read ‘’I feel the strength of all woman’’. I knew if millions of women had done this before me then so could I.  I had no idea who was in the room, and what was happening behind me, I was one with my body and baby. 

In my pregnancy I had also done a lot of work listening to Charlene’s Relax into Birth Tracks. In the labour I could hear her voice, saying those calming words over and over again, ‘’relax….open….peace…’’, reminding me to breath ‘’down and out’’.

The next rush brought a new sensation, an excruciating stinging and burning which was incredibly intense. I had read about this in many birth stories but experiencing it was a whole new story. I moaned to Charlene, ‘’IT’S STINGING’’. I remember the song playing at that exact time, ‘’The Power Is Here Now, By Alexia Chellun. 

The words to this song were divine timing…

The power of love is here now 
The power of now is here now 
The power of you and me is here 
To create magic on earth 
Let the water wash away your tears 
Let the fire burn away your fears 
Let the wind blow into your life such faith and trust 
Let the earth hold you, take care of you and nurture you

This song gave me the strength to get through the final few rushes. I didn’t need to be coached or told what to do. I just listened to my body and my baby. The body truly is built to show you how to birth your baby if you trust it and let it show you the way. Just like in life, you are always being guided, are you listening to that inner guidance.

Finally, after an intense surge, and a crazy burning and stinging sensations, my baby’s head came out, and immediate relief came flooding through me, this was it. I then had to stand up and get out of the birth pool and and gave one almighty push and Charlie was born at 4.25am on Monday 9th March weighing 3.92kgs. He slid out into my midwife’s arms. I remember her saying, hello baby, hello baby and rubbing his chest. Charlie was born to the song, Grace of God by Gurunam Singh. It was a special synchronicity that out of my entire playlist Charlie was born to two of my favourite songs and that they came on in the perfect time when I needed them most.

My midwife Lana and Doula Charlene helped me to lay back on the bed and passed my little baby Charlie to me. Matt was by my side through it all. I was completely exhausted and overcome with relief that it was over, and awe that my little man, baby G was finally here. Tears welled in my eyes as held him skin to skin and spoke softly to him. I had done it, we had done it, I had given birth just as I had intended to, at home, naturally, surrounded by love and all was well. 

The next few hours were pure bliss. Charlie never left my chest and Matt and I cuddled up in bed and just gazed at him and studied his tiny body. My midwives and doula were incredible, they made our morning even more special. They tidied up around us, brought us tea and left us to bond for a few hours until everyone had had some rest. A few hours later my midwives did all his checks while he lay on Matts chest. I cut the cord and saved my placenta to bury one special day. The next few days were just as incredible getting to know this little soul. He was feeding well, sleeping well and I was in good hands with my midwives coming back every day to check up on us. It couldn’t have been a better first week. I felt so grateful to be a mum and was loving every moment of it. Charlene also came back the week after and gave me the most beautiful foot massage, I felt so taken care of. 

Although my birth was pretty close to my dream birth. It wasn’t what I expected. I thought I would breath him out in a blissful meditation.  It was way more painful and intense than I ever expected. I could see how woman in hospital would end up with interventions and pain medication and I was just grateful that I was at home and none of that was available. It was just me and my baby working together. 

My midwives gave me homeopathic remedies including calendula and seaweed to help with the minor stitches. Charlene made me some beautiful bath salts to soak in.  It took me a few weeks to get my energy and strength back, but I am grateful I never had any baby blues or any baby problems. While I was tired, I woke up each day feeling sunshine in my heart so happy to see my little baby. He spent the first week in our bedroom and we didn’t leave home for 40 days. We had minimal visitors, (thanks to Covid-19) and spent our days sleeping, relaxing, singing and getting to know each other. I massaged him daily and he got daily skin to skin and sunshine. We bonded deeply with him and both had the best possible start to our new journey together. 

Charlie is now 4 months and thriving. He’s happy, calm, sleeps and feeds well, we’ve never had any issues. I’m so grateful he was born just before lock down, I’m grateful for the bubble it gave us. Just Charlie, Matt, my mum and me. My mum was supposed to be here 3 weeks and ended up being here 4 months, which again was divine planning. I don’t think we could have asked for a better start.  

I am incredibly grateful to my birth team. My midwives and Lana who joined on the day and my Doula Charlene. I couldn’t have done it without them. The space they held with me throughout my pregnancy, birth and the days and weeks that followed made this the most incredible experience for me. Their encouragement and trusting approach is what gave me the trust and faith to birth my baby and to be the mum I knew I could be. 

I am grateful to Matt for being a non-judgemental support through it all. His help doing everything else allowed me to focus on what I needed to do. We were also so lucky that he got to work from home and still is for this first part of Charlie’s life. 

I am grateful to my mum for the 4 months of being here throughout lockdown, her early morning time with Charlie helped me catch up on my sleep, her cooking, cleaning and care, really helped us thrive during these first few months. 

I am grateful to my baby Charlie, for being the gift of love and grace that he is. Thank you Charlie for choosing us. We love you. 

Thank you for reading my birth story and for joining me on this life-changing journey. A new chapter has begun in my life and I look forward to sharing many more lessons and learnings along the way in the hope that they will too inspire you to live your happiest life.

Petra’s Birth Story

Petra is a very strong mama who I met when she was pregnant with her first baby. Firm and determined, she never gave up all through her two birth experiences. It was lovely getting to know her as a mama also living in the Valley and this is the story of her second birth, where she attempted a VBAC. Thank you Petra for sharing your story!

I met Charlene in 2015 while pregnant with our first. My husband and I attended her hypnobirthing antenatal course. We were very keen on a natural birth and even changed service providers from a doctor to a midwife after doing a lot of research and weighing up all our options.

Unfortunately, our baby had other plans and presented in Frank breech, which is a breech position with the legs extended straight up towards the head. We were told by our supporting gynae that there was no chance of a natural delivery, and so we ended up scheduling a c-section. Our baby had other plans again: I went into labour the night before the c-section date, and our daughter was born by emergency caesarean at 03:30 in the morning.

3 ½ years later we found out that we were expecting again and to our delight our gynae suggested a vbac without us even asking. We agreed that this would be our preferred birth option, provided that everything was favourable. 

I have a deep desire inside of me to birth my babies, and not just be delivered of them, which is why I felt somewhat “left out” with the c-section birth of our first child. And this time around I was determined to make sure that this baby would not be positioned in breech!

The pregnancy progressed well, without any complications and our baby turned head down and stayed head down – I was so thrilled!

We decided to make contact with Charlene for a refresher course, and chose her as our doula, to ensure that we have someone by our side who knows her way around natural birth.

At this point I need to mention that I turned 43 about 5 weeks before the birth of this baby and, whilst I feel much younger than this, my gynae would not allow me to go over 40 weeks for possible age-related complications. This means we have a scheduled c-section booking in case I don’t go into labour by that time. He also tells us that I cannot be induced, because it is a vbac, but he can rupture membranes for me the day before the booking, which might induce labour. If that doesn’t work, then I will have to stay in hospital overnight and have the c-section the next morning.

Week 38 has me seeing a midwife for a stretch and sweep. She tells me that my cervix is 1-2cm dilated and my body is definitely preparing to go into labour. Yay!

Week 39 and my gynae does another stretch and sweep, telling my husband that our weekend plans might just be in jeopardy. Great! Monday comes without any signs of labour and the booked section day is Wednesday. Oh no! We have a final check-up with the gynae, and he tells me to check into hospital at 3pm the following day so he can attempt to start my labour by rupturing the membranes. This being a vbac, we also agree that if there is foetal distress at any stage or if I start bleeding (which can be a sign of uterine scar rupture) then we will change plan and do an emergency caesarean.

Tuesday 21 May – the day before our c-section booking
I wake up feeling calm. Too calm! Not a surge in sight. I chat to Charlene and she suggests that I ask the gynae if we can check in earlier, so that I have a better chance of not labouring through the night.

So there I am at 13h00 hooked up to the CTG, listening to Charlene’s birth affirmations and waiting to have my membranes ruptured. 

The procedure is successful, my water breaks and an hour later labour has started, and I am having regular surges roughly 5 minutes apart.

My birth photographer is there and Charlene has also arrived, and worked her magic in the room, transforming it into a much friendlier place.

The surges quickly become more intense and very soon they are 2 minutes apart. Charlene and my husband take turns massaging my lower back through the surges, which is where I am feeling the most pressure. 

I need to be hooked up to the CTG a lot and for this I have to lie down on the bed, which is much more uncomfortable that sitting on the birth ball or standing and swaying my hips through a surge.

At some stage I have to go to the toilet, which is outside of the labour room. It takes a lot of courage to venture out of the room and when I finally do, I take Charlene with me. I simply cannot bear to face a surge without someone by my side. (Which not-so-clever person designed these labour rooms and didn’t include a toilet..?!)

There is quite a bit of blood and we think it is a good show.  As labour progresses, I can however feel that there is fluid leaking out at the end of every surge, and I assume that this is amniotic fluid.

At 17h00 my gynae comes to check up on me again, and notices that I am haemorrhaging. “Why is there so much blood?” I hear him asking the midwife. So that is the fluid that I feel at the end of every surge! He also checks the foetal monitor printout, and then comes to tell me that I am 7 cm dilated at this stage, but I am also bleeding, the foetal heart rate is declining, and he is not happy about either of this. Those are the 2 things that we agreed would mean a change in our birth plan.

A decision is made quickly and calmly that we will proceed with an emergency c-section. Both baby and I are fine at this stage and there is no panic. I keep breathing through my surges, still lying on the bed and connected to the CTG, while Charlene and my husband keep massaging my back.

At 17h40 my gynae comes back to take me into theatre and I am pleased to discover that the assisting doctor also assisted with my previous c-section, and the anaesthetist is the one we requested for our booking the following day – this helps to put me at ease even more.

Charlene once again works her magic and soon there is beautiful music playing in the theatre, which helps to create a light and calm atmosphere.

15 minutes later we’re ready to start the c-section and at 18h00 our baby is born! Because we didn’t want to find out the gender during the pregnancy, the gynae lifts the baby up for a gender reveal: it’s a girl!! My husband has tears in his eyes when he turns to me and says, “we have another girl!”.

I really try to be more present to all that is happening than I was with my previous c-section. The gynae tells me that my scar is fine and wasn’t the cause of the bleeding, and that he cannot see where the blood was coming from. We assume that it could have been from the placenta starting to detach and this confirms that a c-section was the right decision. The baby was also facing forward and that was causing my back labour.

Once the paed finishes his check-up, she is placed on my chest skin to skin and we get to cuddle a bit while we wait for the surgery to end. There is a happy atmosphere in the theatre with lots of smiles, we have a healthy baby girl and all is well!

Charlene accompanies us to our room and helps to get us all settled in before leaving hubby and me to bond with our little girl, who is breastfeeding like a pro and soon falls asleep right there on my chest.

The next day starts off well, I am up and able to take a shower. I feel fantastic, with hardly any pain at all thanks to the pain meds, and I am looking forward to our “big sister meets little sister” visit that afternoon.

It is truly one of the best moments of my life, watching my older daughter meet her younger sister, and our lovely birth photographer captures some amazing pictures for us. I love every moment of it, and in the excitement of it all, I get up far too often and move around far too much… by the time my husband leaves with our daughter, I am in a lot of pain and can hardly stand up straight. I am now very annoyed with myself, as this is not my first c-section and I should really know better than behaving like I have just done! I also need to empty my bladder but try as I may, I can’t go. It is just too painful!

The pain gets worse and eventually I am in complete agony with what feels like one large abdominal spasm, almost like a labour surge that peaks and never ends! A nurse comes to measure my blood pressure and temperature, telling me that both are raised – I get annoyed with her, because it doesn’t take a genius to figure out that all this pain is causing the raised measurements. At this stage the spasm pulls up on the right-hand side from my abdomen into my shoulder and I am desperately trying to find a comfortable position to lie in. I’m clinging on to the bed rail and moaning through the pain! Finally, after what seems like an eternity, my gynae comes to check on me. I am in tears and tell him that I think I might have torn something with all my movement earlier. I feel completely responsible and am so disappointed with myself, and I am in so much pain. He gives me a voltaren injection, the nurse reinserts a catheter and eventually the pain fades. I am able to have a fairly restful night.

The next morning my gynae pops in on his rounds and tells me, that he thinks my bladder might be punctured, and that I will need to go for a scan. Baby stays with the nurses while I head off to the radiologist. Not much later we have confirmation: my bladder is leaking and will need to be fixed.

At lunch time my gynae returns with the urologist, and together they assure me that this is not my fault and that nothing I did could have caused the bladder puncture. It must have happened during the c-section and gone unnoticed. Surgery is scheduled for 19h00 that evening. Until then I am not allowed to eat or drink anything… not great, as I trying to establish breastfeeding.

Later that afternoon I have another abdominal spasm with pain as bad as the day before, and this leaves me exhausted and more than willing to go back into theatre just 49hrs after having a c-section.  My baby does an hour long feed and then falls asleep just before her daddy arrives to look after her, while I go in for surgery.

The urologist checks on me outside theatre, and once again assures me that it was not my fault and that he will fix my bladder for me shortly. I am tearful and sore, feeling very sorry for myself and heartbroken for being away from my 2 day old baby. A theatre nurse walks past and sees me lying there looking miserable. She stops to come and console me, stroking my hair and telling me not to worry, that all will be fine. Sometimes angels don’t have wings and wear scrubs instead.

Surgery takes an hour and much to my relief I really do wake up without any pain. After recovery I return to my room to find hubby sitting peacefully in the easy chair with a sleeping baby girl skin to skin on his chest. She slept through the entire thing! 

I spend 6 days in hospital with 2 catheters and went home with the suprapubic catheter strapped to my leg with a “pee-pee bag” as my daughter called it. Not the most comfortable thing to have but at least I was mostly pain free. Charlene also came to visit me at home for a doula check and a long heavenly foot massage, where we talked and talked, and I had an opportunity to debrief.
The suprapubic catheter was removed after 11 days and I was mighty glad to be rid of it.

So in the end my deeply desired vbac turned into another emergency c-section. Not what I had hoped for but this whole birth experience taught me one thing: “Surrender, it is what it is.”

 I kept on repeating that phrase to myself, and I also kept looking for the blessing in each situation:

I look at the photos of our daughter’s birth, I see myself during those few hours of labour, actively participating in the birthing process, and in the end, we had a calm and joy-filled c-section birth with lots of smiling faces.
I would never want to go through the pain of the abdominal spasms again, but I treasure the fact that my husband got to spend those hours bonding with his little girl, while I had to have another surgery. Precious time that he would probably not have had otherwise.

Hospitals are by no means a restful place, but I had 6 days alone with my baby, before we went home to a very excited 4-year-old sister. 

I am at peace with the turn my birth took and Charlene sums this up beautifully in one of her poems:

Even when things go in the opposite way of what was intended. 
It’s that most sacred of moments.
When she locks eyes with her babe for the first time…
Skin to skin now on her chest she lies. 
“You must be mother. You are, this place – is my home.” 
She holds her closer and adjusts her position to bring her closer to her breast. 
The noise and voices and bustle of the hospital dim all around her… 
Yet, she suckles… and the circle is complete.