This birth story actually begins with a completely different labour.
I had my daughter during the first days of Lockdown One. A difficult vaginal delivery which led to some not-insignificant birth injuries - namely a 3rd degree tear, and post partum constipation leading to readmission to hospital. A delivery which quickly went from “taking a while to progress” to having a lot of medical staff around us and a recovery wrapped in Covid 19 restrictions, and a strong possibility that I would be left with faecal incontinence. To put it mildly, not the “dream birth” scenario.
Throughout my physio, and recovery from that first very difficult birth, every single health care professional said, with reassurance in their voice “don’t worry, if you decide to have more children you’ll be a candidate for elective section!” It was a done deal. Midwives. Physios. Even my GP and the nurse who did my smear test. Even my own husband, who’s own experience of that first birth meant the logical decision for future babies was, without question, a c section.
So what happens when it’s you that’s pregnant, and everyone around you is saying you’ll obviously be going down the ELCS route… but you don’t know if that’s what you want?
What if you’re scared of needles? Scared of the recovery? What if you just want to make the choice yourself and know you weren’t railroaded into it? I felt strongly that if you could guarantee I wouldn’t tear again and that I wouldn’t compromise the excellent recovery I’d made (I’m not incontinent, just for the record!) that I’d absolutely be choosing vaginal birth.
I went back and forth repeatedly. Pros and cons lists. What would keep everyone else happy? What was most practical? What would be better for recovery? In the end, realising I was getting nowhere in my own mind, I booked a private birth debrief with a completely impartial midwife and birth trauma specialist, and she helped me through my thoughts. She told me not to focus on the mode of delivery, but instead to think about how I wanted the birth to feel.
I want to be present and content.
All things I felt I didn’t get at my first birth which had quickly become chaotic, with people rushing in. I felt like an ill-informed bystander who was doing it all wrong, my punishment being that I’d miss the first hours of my baby’s life, her first nappy, her first feed, her first cuddles, whilst I was in theatre.
Then I had to identify which mode of delivery would give me that. It became clearer that whilst I’d rather not have the recovery of a section or a major operation thanks to my fear of needles, an ELCS was the route I felt most at peace with. So that’s what we did.
My community midwife was incredible. Supportive from the get go. I remained under her care until the last moment as my pregnancy meant I didn’t need consultant intervention until those final weeks. The consultant took time to answer my (many many) questions and by the time I came to my final visit to the antenatal assessment unit for pre-op bloods and MRSA and Covid testing, I was almost ready. A little wobble meant a whispered “will it be really scary?” To the lovely midwife taking my blood who kindly reassured me and gently reminded me that this baby was coming out one way or another, and very soon.
2 days later, my parents arrive to care for our eldest and before the rest of the street were up to make their first coffee, we are heading to hospital knowing we would be meeting our baby within hours. The difference to the journey this time is that I wasn't swearing at him for timing speed bumps to my contractions, and he’s not quietly praying that my waters don’t go all over the interior of his new company car.
We chatted about the most mundane things. Silly really - we knew we were leaving our daughter and our home as parents of one and we wouldn’t be home until we were a family of four. I think we discussed the roadworks, and whether either of us had reminded my parents that Grace should have a bath before bed if we weren’t back in time.
We had to be at the postnatal ward for 7.30am. And you take your postnatal bags with you. That’s weird. “Checking in” heavily pregnant, not contracting, and getting a bed on a bay next to an exhausted new mum and her hours old baby - a bit like you’ve booked a baby moon from a cheap, dodgy social media advert and what you got was very much not the luxury Cotswolds spa hotel you expected.
Once you’re there you have a myriad of people pop their head in the curtain to introduce themselves and ask questions. They all have to check the same information so after a while we started trying to beat them to it and give the details proactively before they could ask (a little awkward when it’s the tea lady and you jump the gun). You have to stay nil-by-mouth from midnight the night before. Fine at first - feels like it’s all part of the excitement - but time can start to go on a bit and then the hunger adds to the frustration, you just have to keep telling yourself it’s because you’re about to meet your baby.
At my hospital they only booked in three planned sections in a day. On the morning when everyone is booked in, the ward co-ordinator comes around to tell you where you are planned in the order - it’s all based on risk levels, so who “needs” their c section the most. I was lowest risk and so was going to be the third planned section taken to theatre. This could mean I’m the third section to take place that day; but it could mean waiting a long time as if emergency sections come along as naturally they take precedence.
Eventually, after a lot of waiting (take a book, download shows, use the time to debate names for your unborn child), we were told it was time. After 12 hours of waiting on the postnatal ward it was all systems go. I was putting on my gown and the midwife was walking us through to theatre. That’s a very strange feeling - walking yourself, naked except for a hospital gown (yep, no pants - ask for a second gown to preserve your modesty from behind ladies!), to theatre for what is most likely the biggest operation you’ll have ever had.
As we walked the very short distance, I felt myself sweating - this was really it, no going back now! I was distracted by seeing my amazing community midwife at the desk on the way past. “Helena! It’s time. I’m having my baby!” She had been such a source of comfort and help to me throughout pregnancy it was wonderful to see her there at that final moment.
Then my husband was ushered into a changing room, told to pick out some scrubs and get changed. He had to ask whether to take off his clothes or put the scrubs over them - for reference, the answer was “remove your clothes but please keep your pants on” - the only person who needs to be knickerless in this situation is the birthing woman.
From this point we were separated for a short period. My husband was taken to what I later learnt was the recovery area whilst I was taken into theatre. It was lots smaller than I’d imagined but did look very clinical. There’s lots you can ask for in an ELCS birth plan to make it feel less clinical however for me that all went out of my head. I even forgot to take my phone for photos and the playlist I’d made. I had to now hope my husband had remembered his and that he had more than just The Beach Boys available in his offline Spotify library.
The big bit was starting. I had to get my spinal block and cannula. Me. The woman who is so scared of needles she once passed out in the car park of her GP at the mere thought of a blood test. And I couldn’t have my husband with me for this bit. A completely wonderful member of the theatre team, Lisa, came and held my hand. She listened to me and put her hands on my shoulders when I said I’d need help holding still (super important!) she told me all about her dog and made me feel safe. At a time when the one person I wanted with me wasn’t allowed there, I was bloody glad to have Lisa.
Everyone introduces themselves. It’s a bit of a blur. You feel like you’re supposed to remember their names and what they do, all whilst doing lots of little head bobs with a smile and a “nice to meet you!“ moments before they are going to be operating on you. Then once the right needles and tubes are in the right place they get you laying down and the anaesthetist sprays you with cold spray. When they are satisfied you can’t feel anything it’s time to get your baby out!
One of the theatre techs asked if I had a play list; cue admitting I’d forgotten my phone and it was clearly not a priority to nip back to the bay and grab it. We decided to keep on Magic FM that was already playing and all hoped that the surgeon, whilst extremely busy, would somehow time the delivery to anything musical and not an ad for the latest DFS sale.
My husband was back with me at this point and if I’m honest, I was scared. I’d made my peace with having a section but that doesn’t make the prospect of it easy. You’re laying there, very awake and aware, in an operating theatre and you’ve had 39 weeks to research exactly what’s about to take place. I trusted those medics implicitly - but that didn’t mean I wasn’t feeling squeamish or scared.
I told my anaesthetist - who, once I was numb, positioned himself by my head and took on the job of being my voice if I wanted it - that I had pins and needles all over. He told me it was adrenaline and to try to be calm. Easy for him to say, it wasn’t him worrying about being operated on! But in an attempt to at least try and stem the nerves I decided to do some hypnobirth breathing. In for eight, out for four. By some miracle (I’d felt it did absolutely nothing for me in my first birth) it worked. The fizzing in my hands stopped and I was calmer.
The surgeon arrived. Bustling in from his previous operation, getting the key info he needed for me, and setting about the task in hand. I should add, I had a curtain in place and we had already briefed the team on how much we wanted to see and hear about what was taking place. (Nothing at all!!)
I didn’t feel anything at all during the incision but there’s quite a lot of pulling and tugging that you can feel. It’s not bad or painful just really weird. It also went on for longer than I had imagined! The midwife pointed out that the stars had aligned and the surgeon would be delivering our baby any minute to the song that had just started: Stevie Wonder, Isn’t She Lovely. We didn’t know if we were having a girl or a boy but it’s a gorgeous song and one I used to sing to our eldest daughter when she was a tiny baby so it felt like a good choice.
The theatre team were all doing a little swaying dance to Stevie Wonder when the midwife said to my
husband -' here comes the baby get ready if you want photos! Quick, stand up!' My husband dutifully did as he was told and I think saw a lot more than he ever wanted or needed but it was too late by then.
The next words I heard were from my husband. To the backdrop of “Isn’t She Lovely”, he said “Nik, it’s a girl. A baby girl!”
I burst into happy tears.
We genuinely hadn’t cared either way whether the baby was a boy or a girl. A boy - lovely, we have one of each, A girl - how special that they’ll be sisters! Unlike that first birth, it all in that one moment just felt ok.
It was all ok. She was here and safe and it had been calm and controlled. I’d been present. All the things I’d wanted. Sure I’d had to make compromises to get there (and would find out that the c section recovery was as tough as I’d expected!) but the birth itself had been exactly what I needed.
Once I’d had a cuddle, my baby was taken for her checks and I was stitched up. This bit takes the longest. It took 3 minutes to deliver my baby. And 45 minutes to stitch me up. Just as well you’ve got a baby to distract you!!
We took photos and finally settled on a name - the 9 months of pregnancy and 12 hours sat waiting to go to theatre had been fruitless but the clarity of her being in my arms meant we could make our decision.
During this post delivery part of the section my surgeon started discussing a different delivery which involved significant tearing and blood loss; I didn’t know he wasn’t talking about me. I somehow found the confidence to advocate for myself and asked him firmly if he was talking about me. He said no and I said “then please don’t discuss it. You are scaring me” - whatever your birth looks like please find a way to advocate for yourself.
Once I was stitched up the surgeon left for another operation and the theatre team took over. They moved me to recovery and helped me with some side effects - I went very cold and shaky, but nothing a little heater, an extra blanket and a cuddle with my baby couldn’t fix.
It was the calmest and most “newborn bubble” feeling I could ever have imagined. I was able to do her first feed. Her first nappy. I cuddled her at minutes old, not hours old. I knew I was one of the first faces she saw.
I may never have been 100% set on my choice for a planned section but in that moment I knew it was the right thing for us.