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. 

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.

Know your options dear mama!

I was when I found out I was pregnant… I wanted a caesarean! I was so terrified of even the thought of birth. Then I educated myself, learnt the Hypnobirthing technique and then had a home waterbirth. I’m now a doula and teach Relax Into Birth and my whole life has changed since the birth of my son… His birth taught me so much; that my body is amazing, that women don’t have to fear birth, that women have options and should know about their options, that because I was now empowered I had to share that with others. Even though birth is the most intense thing you will ever endure – and will push you out of your comfort zone, YOU can do it. It is worth a try…. You never know until you’ve tried. Leave no room for questions or regret afterwards… Choose a Midwife, get a considerate pro-options/pronatural gynae and a doula and then if a Caesar is called at the end of it all you know it was a necessary one. 😘😘

Birth Options Midwifery Team Statistics 2017

I’m about to share the the latest statistics from 2017 for the Birth Options Midwifery team – and they are unbelievably good!

The team is comprised of Glynnis Garrod, Susan Lees, Angela Wakeford and Bernice Jehring Down.

Birth Options Independent midwives can attend both home and hospital births at Vincent Pallotti and Melomed Tokai with gynae/ obstetrician backup at those allocated hospitals. Ayla Nowell of Birthing Naturally, another wonderful independent midwife, has back up support from Vincent Pallotti and Constantiaberg Mediclinic. So women have the option of birthing at home with the support of Independent Midwives (with gynae back up support in case of emergency) as well as to birth at these allocated hospitals under the care of an independent midwife (with gynae back up support in case of emergency). We also have traditional midwives in Cape Town, who use various government hospitals for back up support. It pays to know your options and that you have choices available to you!

It says a lot about these doctors at those hospitals (Vincent Pallotti and Melomed Tokai) and their view on promoting a natural approach to birth, where caesareans are only called for when necessary. This is a rare breed of doctor in South Africa and should be taken into account when choosing your care provider/back up gynae.

Independent midwives specialise in normal, low risk pregnancies and birth and will do all within their capacity to help you have the most positive birth experience, whether that is a natural, vaginal birth or a necessary Caesarean in the end.

Without an independent midwife, you will have hospital midwives attend to you in private hospitals. Hospital midwives change shift, so you might have multiple midwives for the duration of your labour and birth time. Hospital midwives are also not allowed to deliver babies, (but sometimes they do as a baby may come quickly!:-)) as that role falls to your obstetrician, who is called to come in when you are near being fully dilated. Many hospital midwives are underappreciated for their hard work and loving care of mothers in labour, and burn out can be a very real challenge facing all birth workers.

My wish is for women in South Africa to start seeing independent midwifery care and doula care for Pregnancy and birth to be the norm, so that we can also lower our exorbitant rate of 90% caesareans in the private sector… Of which most were likely not necessary… and, to choose their doctors and hospitals more carefully too. You only have your one birth, so make choices that will facilitate a good birth experience without regret in the end.

So, without much ado, here are the fabulous stats from Birth Options.

Birth Options Midwifery Team Statistics 01/01/17 – 31/12/17

  • Total number of clients: 147
  • Total no Caesarian Section 21/147 = 14%
  • Number of clients who labored with the Team = 136
  • Spontaneous Vaginal Birth 115/136 = 84.5%
  • Kiwi Ventuse Delivery 4/136 = 3%
  • Emergency Caesarian Section 16/136 = 12 %
  • VBAC 7/10 = 70 %
  • Primigravida (first birth) 55/136 = 40 %
  • Waterbirth 15/136 = 11% (many more labored in water)
  • Epidural12/136 = 9%
  • Episiotomy 14/136 = 10%
  • Induction of Labour 15/136 = 11 %
  • PPH 500-1000ml 9/136 = 6.5% (post partum haemorrhage)
  • PPH over 1000 ml 3/136 = 2 % (from a retained placenta)
  • Third degree Tear 1/136 = 0.7 %
  • Neonatal Unit Admission at Birth: 2/136 = 1.5 % (1x 34 weeks, 1x signs of sepsis)
  • Births @ Life Vincent Pallotti 73/136 = 53.5%
  • Births @ Melomed Tokai 29/136 = 21 %
  • Home Births 34/136 = 25 %
  • Transfer to hospital from home birth 3/34 = 9 %
  • 7 births not with the team – care taken over by back up Obstetrician: X3 persistent Breech Position after 37 weeks for elective c/s, 1x 37week early labour with breech position, 1x 31week premature labour breech position, 1x previous Caesarian Section, Term, SROM with meconium, unfavorable cervix, baby weighed 4.6 kg, X1 transfer from homebirth in labour for c/s ( CPD) to Christian Barnard Hospital – care handed over to Gynae as we don’t have an SLA there ( prior arrangement )

So there you have it. In a world where unnecessareans are on the rise, it helps to know your options and who will support you in your preferences.

And remember, no matter what turn your birth takes, there are no unnatural births. ❤️

Meet Christa Bussack

bty

Here I am pictured with Christa Bussack … a little tired, an hour or two after midnight, but still looking fresh (maybe a bit too optimistic?!) 😀 Even through the early morning hours, Christa maintains her sense of humour and effervescence in the maternity ward.

If you have stayed over at Vincent Pallotti, you will know her kind face and voice and her bubbly giggle… She is one of the nurses whose focus is to help mothers adjust to life with a newborn and breastfeeding. I am always happy to see her on the floor, because I know my client will be in loving hands  Christa has been at VPH since the year 2000. 

“Mothers always seek help in various areas when it comes to mothering, as they are beginning to experience a newfound love for their child. Mothering comes as an instinct, but guidance is still needed, as each mother is unique. No case is the same,” she says. “I have a passion for helping new moms, as there was a lack of guidance and help in my own personal experience as a young mother. It all comes down to giving the mothers the best support possible and to help them enjoy a positive start to motherhood, which will filter through into the time they are home.” Christa is also a proud mother of four kids, all who have already completed Matric level. She also has four grandchildren and counting. So, next time you see Christa on the night shift, say hi! #relaxintobirth #charleneyaredwest #empoweringbirthandnewparents