Category: Birth Story

Healing from incontinence

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Urinary incontinence is common in pregnancy and is reported by about 60 percent of women. For these women, the severity of their condition can increase during the course of their pregnancy, especially peaking in the second and third trimesters. Of these women who experience incontinence in pregnancy, 70 percent go on to resolve the condition postpartum – and within the first year, the prevalence of incontinence drops down to 11 to 23 percent. Dr Bongi Makhubo, obstetrician gynaecologist from Life Anncron in Klerksdorp sheds more light on the topic. 

Early incontinence is normal

Pregnancy can affect the normal way your urethra relaxes and contracts and many women, particularly those who had a vaginal birth, can experience incontinence after childbirth. “The pubic and pelvic muscles and the anal sphincter can be injured in up to 40-80% of births and so, leaking a little bit after birthing your baby vaginally is quite within the normal range, but it is not normal if it lasts for months afterwards,” says Dr Makhubo. “Directly after birth, using a thick maternity pad helps to absorb the leaks, but once you have stopped bleeding and incontinence persists, you might need a specialist appointment to discuss the problem further.” 

Stress incontinence is also quite common in new mothers and affects roughly a third of women in the first year after birth. Stress incontinence leaks happen when the mother laughs, coughs, sneezes or goes for a run. Lifting heavy things can also cause these leaks,  which are due to increased intra-abdominal pressure and a defective urethral support or closure.

<FACT BOX>What causes incontinence after birth? Dr Makhubo shares the facts: 

  • Weakening of the pelvic floor muscles or injury to the nerves supplying the structures of the pelvic floor, due to a prolonged or difficult labour. 
  • Carrying a bigger than normal baby in utero, leading to difficulty in delivering or stretching and compression of the pelvic floor.
  • High levels of elastin, a hormone which allows for more stretching of the skin and connective tissue, can cause prolapse and in turn, incontinence (as opposed to collagen, which is decreased during pregnancy).  
  • Assisted delivery, especially with the use of forceps. Research shows that there is less injury and urinary incontinence noted with the use of ventouse in comparison. 
  • Maternal age; the higher the age the higher the association with urinary incontinence.
  • Parity; incontinence is more common with parous women, however of note is that the highest risk of incontinence is with the first delivery, then 10% risk increase with each subsequent birth.
  • Vaginal delivery definitely predisposes women to a higher risk of incontinence and most women will be incontinent for a few weeks; however most will be normal within a year.

What can help?

“Pelvic floor muscle training or kegels exercise are by far the best way to combat the problem postpartum, although the research differs as to how much of the exercises should be done. However, these can be done anywhere, and one way to remember to do them is to pick an anchor which will remind you to do them. For example, when stopping at a robot or boiling the kettle: each time you do one of these activities, do some pelvic floor exercises too,” says Dr Makhubo. 

She suggests that physiotherapy can also help in some cases. “A physiotherapist will give you cones or a pessary that can be used to squeeze and strengthen the pelvic floor muscle.” Dr Makhubo also encourages lifestyle modifications, such as drinking less coffee and alcolhol and stopping smoking. Decreasing BMI can also help improve incontinence issues. “If lifestyle modifications have been made and incontinence persists, then medical treatments can be offered,” she says. “The last resort is surgery.”

Medical treatment and surgical options

  • Medication:
    • Estrogen creams, duloxetene and even botox can help to alleviate incontinence. 
  • Medical devices:
    • A vaginal pessary, which can be used for prolapses. It is a ring-like device and acts as a support for the bladder. A disposable urethral insert may also be prescribed and serves as a leakage barrier. 
  • Bulking agents:
    • Bulking agents are injected into the urethra to help plump up the tissues where urine is released from the bladder and help to hold it in. 
  • Surgery: The underlying principle of surgery is to support the urethra, so that the bladder can work effectively. 
    • “Retropubic urethropexy ( Burch’s Colposuspension ) is used most common surgery for this condition. It is an abdominal procedure, where the pubocervical fascia is attached to a copper ligament or to the pubic symphysis (pelvic bone),” explains Dr Makhubo. “This helps lift the anterior vaginal wall and tissues surrounding the urethra and bladder, which helps to alleviate incontinence. 
    • Slings: There are various kinds of slings and they are all made of mesh. The use of mesh has been approved by the FDA and the South African Urogynaecology Society endorses and supports the use of this method for incontinence. A ‘hammock’ is created using mesh and tissue to support your urethra and can be done under local anaethesia.
      • Pubovaginal slings, mid-urethral slings, mini-slings and micro-slings are used as a means to help incontinence, but implanting mesh where it is needed, in and around the urethra. These range from being quite invasive to non-invasive. Your care provider will help you decide on the best approach for you. 

Own your birth: Why you need a birth plan

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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. 

Caesarean birth: Safety is the priority

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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.

‘Surrogacy gave us the gift of twins’

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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. 

Multiples: A dream come true through IVF

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If you have been trying for a baby for more than a year, but have been unsuccessful, you are one of at least 50-million couples who experience infertility worldwide. The number of children being born in South Africa is also on the decline and according to the Recorded Live Births 2013 to 2015 report, the number of birth registrations decreased by 6.8% from 1.6-million in 2013 to 1.08-million in 2015.  As a result, many couples are turning to infertility treatment to fulfil their hopes of having a baby. If you’re a good candidate for In Vitro Fertilisation, it may be the only way to help you grow your family unit from husband and wife to three… or even four… or more! 

Multiples and IVF

“IVF treatment can result in multiple births because, often, more than one embryo is transferred into the uterus of the mother,” says Dr Henk Burger, gynaecologist and obstetrician at Life Carstenhof in Gauteng. “The chance of having multiple births can be reduced considerably by only putting one embryo back into the womb.” The cost of IVF ranges from R30k to R50k per attempt, which explains why many couples opt for implanting more than one embryo to increase their chances of a successful pregnancy the first time around, explains Dr Burger. He notes that sometimes a termination of one of the embryos is requested after implantation, but this is very difficult and dangerous for the embryo that stays behind. 

Multiples and risk

We all know how adorable twins are – and they make for an instant family unit, but they also come with a certain level of high risk in pregnancy. “Around 30% of multiples are prone to prematurity – and born before their due date. There is also the risk of intrauterine growth retardation, birth defects and miscarriage. The mother is also five times more likely to get pre-eclampsia and six times more likely to have polyhydramnios and antepartum haemorrhage,” says Dr Burger. “Mothers carrying multiples must ensure they attend each and every antenatal consult; every four weeks up to 20 weeks, every two weeks up to 28 weeks and every week up to birth thereafter. The aim is to get the mother to carry her baby to at least 36 weeks, but this is often not the case.” He also advises mothers to eat a  balanced diet, not to smoke and to take antenatal supplements. “Simple things like positioning of the safety belt in the car when driving are also important to remember to reduce risk,” he adds. 

Natural or Caesarean birth for multiples

According to Dr Burger, birth by caesarean section is the safest for multiples, because of the risk, especially for the babies born after the first one. “There is positional risk such as breech or transverse positioning, especially for the second baby. There is also the risk of premature labour, placental abruptia, fetal distress and even early closure of the cervix,” he says. “There was a case reported where the cervix closed after the mother had naturally birthed the first of her twin babies. Her cervix remained closed for 56 days before she birthed the second one! It is the longest reported period between delivery of the two babies.” 

Breastfeeding your babies

Dr Rebecca Makate is a paediatrician at Life Carstenhof and is experienced in helping parents adjust to life with their new babies. “Breastfeeding for any baby offers major health advantages such as less infections and better neurodevelopment. The breast can make enough breastmilk for two or more babies as breastfeeding is based on supply and demand,” she says. “In other words, the more you breastfeed the more milk your breast produces. It is also possible to breastfeed twins at the same time on different breasts. Having said that, having more than two babies can come with huge challenges during feeding time.Even if you breastfeed, occasional supplementing your babies formula will give you some much needed freedom and sleep.”

<Sidebar> So what is life like with multiples?Despite some challenges and drawbacks, having multiples is a great joy, says Dr Makate. “There is a level of convenience and efficiency in parenting children simultaneously; some of the unpleasant aspects are sleepless nights, feeding times, potty training and teenage troubles which all have to be endured at once. Mostly though, there is a great pleasure and enjoyment in parenting multiples, every moment is multiplied and every simple joy is magnified,” she says. Dr Makate lists the following challenges couples should consider before IVF:-Pregnancy and birth risks when carrying multiples.-Fetal complications and time in the NNICU.-Lack of sleep.-Difficulty bonding.-Economic impact on the family unit.-Relationship with your spouse is put under pressure.-The need for extra help with caring for the babies. 
<Sidebar> What are Monozygotic and Dizygotic multiplesMonozygotic multiples: In monozygotic multiples, the embryo splits and the babies are born identical. In utero, they share one placenta and one amniotic sac. Dizygotic multiples: In dizygotic multiples, there are two separate embryos, each with their own placenta. Monozygotic multiples are higher risk for a few reasons: Placenta abruptia: where the placenta tears away from the uterus during birth and deprives one or more of the babies from it’s life source of oxygen and blood. Cord prolapse: where the umbilical cord of the second baby born prolapses out of the mother’s vagina. Twin-to-twin transfusion syndrome: where the babies share a joint blood circulation through the placenta, which contains abnormal blood vessels, where blood is transfused disproportionately from one twin (the donor) to the other twin (the recipient).
Lindy and Michael’s* story
We fell pregnant after many, many years of trying to conceive – almost ten years. Initially we tried naturally, then Artificial Insemination and then only In vitro Fertilisation. As I am an older mom it was necessary to go this route. It’s a very drawn out process with lots of steps and checks and balances. One needs to eliminate the options that are not viable first and the doctors are all very cautious and considered in how they approach IVF in South Africa. It is a very expensive process, but we were committed to being parents, and I was not willing to give up, so we just kept on trying until we had a positive outcome. We first attended the Cape Fertility Clinic but after no luck there, we moved to Aevitas which is based at Life Vincent Pallotti. Prof Kruger and Prof Siebert from Aevitas were absolutely amazing, as were all the sisters that worked with them in their team. A number of eggs were fertilised and the best quality eggs were implanted and we were very lucky that two fertilised eggs resulted in our gorgeous twins, Jacques and Stella. It was a very long and stressful process. We lost a baby at full term, Ruby Mae, who was stillborn at 41 weeks.  Soon after this loss, we tried again to conceive and with the help of Aevitas got pregnant with the twins who were born on 1 May 2015. It was amazing and unbelievable to find out we were pregnant with twins after losing our previous baby.  We were elated and also scared as twins are a major change in one’s life. On the 13th of January we felt our first big kick after steak strips with Szechuan pepper and salad for dinner, it was wonderful! We made it through to 38 weeks and delivered them with the help of Dr Marie Pienaar and her team and Panorama Mediclinic. We love them to bits and they entertain, inspire and motivate us each day to be better, kinder parents. Its tough with two but the highlights are by far in excess.  It is stressful and one learns how to cope. Support makes all the difference, whether it is grandparents, siblings, night nurses, nannies or friends. Also each baby is so unique and has their own personality and it’s such a joy to experience the gift of twins.*Names have been changed. 
Vanessa and Philipp’s storyWe had been trying to conceive for a long time, but I knew that with my pre-existing conditions of Polycystic ovarian syndrome and Hashimoto’s Thyroiditis, it would not be without some challenges. In 2015 I had a molar pregnancy – very rare – where a non-viable fertilised egg implants in the uterus and grows as abnormal tissue.In that time, we had been in touch with an adoption agency to come ‘kangaroo parents’, which are like safety parents for babies under 3 months old, where we would care for them for up to 90 days until they were transferred to their forever homes. When we started the paperwork, I found out I was pregnant and we felt it might be too much to go through with the adoption agency, but then later that year, I miscarried and this broke me on so many levels. After that I left for Europe and shortly after we received a call from the adoption agency to know if we were perhaps keen to foster twins who were 6.5 months old. We slept on it and the next morning we decided that we would do it and eight days later they arrived. We lost our hearts completely to the babies and decided to start the process of legally adopting them. We still kept our sights on having our own biological child one day, so we kept on trying naturally at first and then decided on IVF at the Aevitas Clinic at Life Vincent Pallotti. On the day of the transfer they implanted two eggs and at the 9 week scan we heard three heartbeats! The two boys shared one placenta, but each had their own sac and the girl had her own placenta and sac. I honestly felt as though I lost the ground under my feet and the world was spinning… we would be parents to five children now, the twins included! My pregnancy was easy until 26 weeks when I started having contractions and had to have bedrest at Life Vincent Pallotti until my caesarean birth on the 24th of April at 30 weeks pregnant with Dr Jacky Searle at Life Vincent Pallotti. My precious babies weighed 1290g, 1220g and 1540g at birth and now we are a beautiful family of seven. I am thankful for blessings in abundance and the good health of all my children. 

Ruwarashe’s Birth Story

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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

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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.

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Tamlyn’s Birth Story

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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

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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.

Aimee’s Birth Story

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It was my honour to walk beside Aimee and Ryan for the birth of their baby girl Kenzy. Here is their story…

When I think back on my “Birth Day” it was nowhere near what I expected, despite all my reading and “scenario-planning.” And to be honest, I wasn’t convinced I needed a doula in the beginning. I went to the Relax into Birth workshop which was incredible and empowering. Then I listened to the tracks every single day, and after a month I’d realized something. Not only did I now want a doula, but I only wanted Charlene. I couldn’t actually imagine giving birth without her there. I didn’t know my water had broken on Saturday. It just felt like I’d wet my pants. On Monday a confirmation call for Tuesday’s gynae appointment became the green light to come into hospital *with my bags*… There was some urgency as it had been almost 40 hours since the water breaking and I hadn’t experienced any contractions. But the phone call was pleasant and relaxed; and when I hung up I had a little joyful cry and some reflective me-time while I waited for Ryan to come home.At the hospital, a litmus test for amniotic fluid was positive and the gynae started a Propess induction immediately. (According to my Birth Plan, I hadn’t wanted to be induced, but by then it had been 45 hours since my waters had broken, and I was completely at peace with it). I was told it would take a while, and we could just relax! Great! The baby would be coming that night or in the early hours of the morning (it was only 2pm at that point). We were excited, joyful, “floating”! So we started sending some messages to the family and we told Charlene that she could come in after the traffic died down. 

Half an hour later, I was in agony and I couldn’t bear to lie down on my back. The baby’s heart rate was high. She was in distress – fetal tachycardia. The Propess was removed and I needed to have an emergency caesarean. My gynae was so kind, gentle and professional. She knew I had wanted to have a vaginal delivery, but we talked through the situation and I felt like we were always on the same page. Physically, it was agony, but emotionally I felt cared for and respected. I even felt quite content about going in for the surgery, knowing that my baby needed it. (We learned later, during the surgery, that it was all because her umbilical cord was wrapped around her neck twice. I am so glad I trusted my doctor.)

Then it was a whirlwind to get prepped for surgery. Even though our time schedule had changed drastically, I was mostly just feeling excited to meet my baby. Charlene arrived just in time! I was relieved to hear her voice: the same calming voice I’d been listening to every day.  She put on some beautiful music and came to massage my shoulders, which was just what I needed then because I started to really feel a lot of pain. It felt like I was being bullied internally, my organs being pushed and pulled. Tears were rolling down my face and I could hear myself groaning with every surgical touch. The pain was too much and I agreed to a general anesthetic. I know I was hyperventilating, but I felt Charlene’s firm grip around my shoulders and chest guiding me to breathe slowly while the gas was administered. Despite the intensity of it all, I felt safe. I closed my eyes and woke up to see my beautiful healthy baby 45 minutes later.


Five months later I filled in that missing 45 minutes. Charlene had captured the whole birth on video on my husband’s phone! It was such a gift.

Ryan and I hadn’t spoken through the “sedated-scenario” and by that stage he was quite traumatised by my pain. He was so worried about me that he didn’t even watch the birth; he just held my hand and kept watch over me. When Kenzy was born, he didn’t know what to do or expect.  (And that was exactly why I had wanted a doula: Someone to be a guide for us both, to be on our “new parents” team, our coach.) Ryan was particularly grateful to Charlene for talking him through those first moments of our daughter’s life. A funny moment comes up in the video where we hear Charlene saying “take off your shirt” and Ryan looks so surpised! He thinks she’s joking. But because he listens, the nurse brings Kenzy to put on Dad’s chest right away for skin-to-skin. I bet she didn’t expect to get a mouth full of hair while looking for her first drink! He really cherishes that time he got to share with his daughter.

Ryan bonding with his baby girl for the first time

It was an unexpected arrival in most ways, but I am so grateful I was prepared for every surprise step. I praise the Lord for modern medicine and how swiftly and professionally the whole team worked!