Surita Carstens from South Africa described her first baby’s birth as, “…one of the most traumatic experiences in our lives.” We published that story in 2012 and it moved many of us to tears with its senseless cruelty. At the end of it she wrote, “I hope that one day I can have a VBAC to empower me and feel like the woman I was born to be.”
Almost a year ago, Surita’s daughter Sandra Maria was born. This is the story of her birth.
“It all started with the birth of my son, Nicolaas Mertiens Carstens. His birth was a traumatic experience, filled with a lot of unnecessary interventions. It started with my water breaking, a rush to the hospital, a lonely night bound to a hospital bed with no contractions, a forced induction and after five hours of labour, being scared shitless, an emergency C-section at almost five centimeters due to “failure to progress”. That day I made a choice: never again would I get a C-section unless it was really necessary, and I would be informed enough to know when it was necessary.
Before my son’s birth I never knew about VBACs. But when I started talking to people I heard differently. Then on a Facebook forum I met a lady, now my friend, who had three natural births after a C-section. And then I learned about water births, home births, midwife births and so much more! Things that we thought were “old aged” but that were coming back.
My dreams were focussed on home birth after reading several home birth stories and because I was so scared of another medicalised birth in a hospital environment. So we started searching for a home birthing midwife. However, soon we found that in the small town we lived NO doctor would support us for a home birth, no midwife would help us unless we had a doctor’s support, and also, there were no midwives in our town.
I emailed many, talked to doctors (and I wasn’t even pregnant yet). Finally we found one midwife who would help us. We met with her and liked her, and then we got her price rates. Shocker! We could NOT afford her and as she didn’t use medical aid, there was no way for us to pay her at all. We started searching once more. After months of searches our General Doctor told us he would help us, so we settled on him. We trusted him and thought he would be a great choice, the birth happening at his offices one block from our home.
When our son was 21 months old, I told my husband Jp that I really wanted to get pregnant. It was a Saturday evening, I knew I had the perfect cycle and was ovulating the Monday, so we started trying. When I tested 10 days later we had a BFP. We were pregnant! On our way to having our next baby!
When we talked to our GP again he told us that, since he wasn’t getting any clients for births anymore, he had cancelled his birth insurance the previous year. He couldn’t help us anymore.
The search started all over again.
Finally at eight weeks pregnant we found a gynaecologist in another city who was reputed for doing natural births. His secretary told me he would allow a VBAC, so I made an appointment. He could only see me for the first time at 15 weeks, but I was OK with that, having learned from my research that I preferred not to have a lot of scans early in pregnancy.
The doctor asked how my son was born; I said it was an emergency C-section and his reaction was, “Oh, OK, so we will do a C-section again.” When I told him that I wanted a VBAC he got upset and started talking about how ‘dangerous’ it is. I told him I had the facts, and got out my research and handed it to him. His reaction was, “We’ll talk about it later.” Next up, he wanted to do an internal exam, which I also refused. Another fight, because according to him he needed to do internal scans with every visit to ensure baby was healthy. I said NO!
So we did a normal scan, but according to him he couldn’t a) say what sex it was without an internal, b) look for any birth defects without doing an internal and c) he only gave us the approximate weight at that stage, didn’t check lengths of the femur, head circumference or anything else. After the scan I brought up the VBAC again. His answer was, “I will do an internal check at 36 weeks and then I will decide IF I will MAYBE allow you to do a VBAC, else you will have a C-section between 37 and 38 weeks.” I told him I refused to have a C-section early, and wanted to go into labour naturally. Again he refused, and told me to come back in three weeks so he could do an internal scan to look for defects.
I walked out super sad and feeling beaten. After two years of waiting, everything was falling apart. Another two weeks of phone calls started, calling every and any doctor that I could find, fighting with the medical aid in emails and on the phone and searching, searching, searching.
And then my miracle happened!
Jp and I drew a bank statement of our savings, which to our surprise, were over R7000! And when talking on a Facebook group, a midwife mentioned that if I could come to the city my parents lived in she could help me with a birth and a payment plan over six months. Wow! We started making sums, but I couldn’t finalise anything until end of November when I got my bonus. When it came it was much smaller than expected but we decided to go for it anyway. I also really wanted a doula as well and had met one in October, but finances would just not allow it. Then a Facebook friend heard of my problem. Being a doula herself she said she would help me for free. I was way past happy!
However, there were a few glitches. Number one, the midwife was over two hours’ drive away so I would only be able to see her maybe once a month; I would need someone closer to home for more visits. Two, if an emergency arose I had to have a doctor near our home who could help. Three, because of our financial situation, a home birth at my parents’ place was out of the question – we needed the medical aid to pay for the birth. So another round of fights started about the hospital I should birth in, some of the operators stating the medical aid would pay and others stating it would only pay a certain amount and even more stating that it wouldn’t pay at all. I got the promises to pay in writing via emails.
We planned, we budgeted, and we planned some more. What was clear was that I had to birth at a hospital or else they wouldn’t pay at all, and we found out that my medical history with Myasthenia Gravis and epilepsy meant I had to have a paediatrician on standby in case my baby had breathing or heart difficulties. We never even knew this with my son.
Finally at 22 weeks I went to visit another GP in our town who did do births (mostly C-sections and he refuses all VBACS) for another scan and at 23 weeks we saw our midwife for the very first time.
I loved Heather from the very first minute. She had this way of just making you feel confident in yourself and in her. But she also had a softness and kindness that made me feel at home. Most of all I loved the way they did the examinations. It was so much softer, kinder and more intimate than at the doctor’s. Instead of feeling like just another number I felt accepted and for the first time I wasn’t scared of going for a check-up! And thus it was settled, we would use Heather and any of the other midwives who work with her and we would pay financially as we could, when we could.
I couldn’t see her in January, but saw her again the first Friday of February, March and April. My due date according to ovulation was 15 April, but last menstrual period said the 18th, so we met her three times in April, the last on the 15th.
The baby was still not engaged. She was very low already, but I showed no other signs of imminent birth. I didn’t want any interventions, preferably not stretch and sweep and most definitely no breaking of water or induction, so we decided to wait two weeks before doing anything. My doula, Anina, suggested that I start looking into using pressure points for induction and gave me a site to visit for help. That evening hubby started using them. We also started with evening primrose oil and several other non-invasive natural induction methods, including sex, bouncing on a birth ball etc. The days passed without anything happening. Every morning I would get Braxton Hicks contractions and every evening I would have prodromal labour, contractions 10-12mins apart and lasting 30seconds from 6pm till around 9pm, but as soon as I hit the bed they would stop. We waited.
My other birth companion was to be my best friend, Erika. On 17 April she came to visit so we could chat one last time before the birth and she would know what I expected from her. Three times during the day she and Jp did some pressure points and that evening I ate some pineapple, joking with my mum that I hoped it would induce my labour. Then Jp dropped off Erika at her home and I put our son to bed. The prodromal labour was worse than before and my mum was getting worried, she kept saying I was going to go into labour. I didn’t want to get my hopes up. After days of prodromal labour I was just not hoping anymore and thinking my body was failing me. So I went to bed and Jp stayed up watching a movie. I was sad.
Our son woke me just after 3am to go to the loo. I wasn’t feeling well but didn’t want to wake hubby for “not feeling well”. At 4:15am I woke up again, my tummy was hurting and I thought it might need to go as it had woke me the two previous nights; so I went to the loo – nothing – got back into bed and it started hurting again. Went to the loo again, still nothing and back to bed. When it hurt for the third time I looked how late it was (4:35am) and started timing. Every seven minutes, lasting 30-40seconds and I was…resting? This was different.
At 5:30am I woke hubby telling him I thought I was in labour. I stayed in bed until 6:10, as the contractions moved to five minutes apart, lasting for 30-40 seconds. I went to tell my parents and called Heather. My mum got stressed, wanting me to go to the hospital, saying her contractions were like that with my brother and he was born shortly after. Heather, however, said to wait until they were regular at four to five minutes and lasting over one minute long. So I helped my mum to leave for work and then crawled back into bed trying to sleep. The contractions weren’t really sore, just uncomfy. We all dozed until just after 8am when I got up and started breakfast and washing some clothes. I wanted my son to be sorted with clothes while I was in hospital.
Hubby decided to take a shower while he still had the chance. While he was away I was hit by a contraction and while breathing through it my son decided he wanted to drink some of my mum’s cleaning agents. When I opened my eyes I saw what he had done and rushed to him, smelling the cleaning agent in his breath. The ultimate stress! A friend phoned just at that moment, said she would help and get back to me. During these moments my contractions came every two to three minutes! One hour later we had finally learned that it wasn’t terribly poisonous but to watch him for vomiting and nausea. I was relieved but the episode had stalled my labour and my contractions were back to being seven minutes apart. My mum, a crèche teacher, decided to pick our son up and take him with her to work. Hubby and I went for a walk, hoping it would help get things back on track. But my contractions went to every 10-12 minutes and almost non-existent in length. Just great.
Told hubby labour was gone and I wanted to take a nap. It was 10:30am and I was feeling unsure. So hubby went to watch a movie and I rested. I woke at 11:15am to a hard contraction! We were back on track, every five minutes and lasting 30-40 seconds once more. I got up and went to join him, bouncing on my birth ball, breathing slowly through the contractions, enjoying the new sensation of it. They still didn’t really hurt and I was in heaven knowing my body was working to birth my baby. My doula sent me a message asking how I was and suggested I take a bath. At just past 12pm I got into the tub. Immediately my contractions increased, and by the time I got out they were two to three minutes apart and lasting up to one minute. Hubby got a little worried so I decided to get out and eat something. I ate some wonderful leftover carrot soup, but the labour slowed down again. The contractions still didn’t really hurt, I used hubby to breathe through them and I was just enjoying it, so when Anina phoned I told her I’d let her know when I needed her.
By 2pm my contractions were four minutes apart and lasting just under a minute. I phoned Heather who suggested waiting another hour before we decided what to do. I wasn’t worried yet, was just enjoying the ride and was sure it would be some time still. Then suddenly I felt a change. I couldn’t sit still during a contraction anymore. I had this peculiar urge to kneel and sway my body during the contractions and they felt stronger, harder than before. I had three very close together like this and at 2:45pm told hubby I think it’s time to leave, something had changed. We phoned Heather and Anina and got into the car to leave. Heather told me that she was in another city and it would be some time until she could get to the hospital but she would get a colleague to meet us. The car drive hurt, a LOT. Sitting still in one place was sore, I couldn’t kneel and sway, couldn’t bounce or anything except breathe through the contractions and they were coming over and over on top of one another.
At 3:15pm we stopped at the hospital. While getting out of the car I had another contraction and the security guard rushed to my aid while Erika supported me. She immediately wanted to fetch a wheelchair but I said it wasn’t necessary. Inside I booked in with the hospital and another security guard got super upset that I didn’t want a wheelchair, telling me that if I fell I would get hurt. (Erm, you’re SUPPOSED to walk during labour.) Erika just brushed them off and we went to the midwives’ labour and delivery suite.
When I arrived I was met by Christelle, the other midwife, and within moments Anina also arrived. While hubby fetched the bags Anina supported me during contractions and Erika took photos. First I sat on the birthing ball bouncing while we all chatted and Christelle put up the monitor to see what the contractions were doing and how they affected bubs. My labour had stalled after the car drive. After a while of bouncing we went for a walk through the parking lot, stopping every once in a while for the contractions where I would hold onto hubby and breath through them. Anina encouraged me to sway my hips and would put pressure on different parts of my back to help with pain. I can’t say that it was hurting at all – though I did have to concentrate and breathe through them. I was envisioning circles in a water pond, opening up growing bigger and bigger.
After a nice long walk and some chats and laughs we went back inside. Anina suggested listening to some music and that hubby and I dance to get some oxytocin flowing. Hubby put up Celine Dion’s CD which immediately got me into tears and we were swaying together, holding onto each other. We have been through so much lately and it just was too much for me. Again it was Anina who made the suggestion that I relax a little in a warm bath. Heather arrived and asked to do a doppler check first. The baby’s heartbeat was doing great so I undressed and got into the bath where I just relaxed and chatted while holding onto hubby during my contractions. Still it didn’t really feel like I was in labour.
After the bath Heather suggested some stretches to help with bringing baby down into the birth canal and we went for a walk. Every time the contractions hit I would sway and bend my legs pushing down, breathing through them, concentrating on baby coming down and in between contractions I would do the stretches. I was surprised to find it was dark outside; I had lost all sense of time.
When I re-entered the birthing rooms I was tired, so tired, I just wanted to sleep. Anina helped me down onto the birthing ball. I wasn’t resting very long when Heather asked if she could do an internal exam. It was almost 7pm and she felt it was necessary to know how far I was as I was so relaxed. This was the one part I had been dreading – after my son’s birth I was scared of internals and I was scared of what it would tell us! I was scared I wasn’t dilating enough and would have to go in for a C-section. Heather knew this and she was so kind and helped me to relax and breathe. Hubby helped me down onto the bed and to lie back, another contraction hit and Heather waited it out with me. When it was over she did my internal.
I was at 8cm, almost 9cms!
WOAAA!!! This was really happening! I burst into tears. After the hard long road, I was birthing my baby. What a feeling!
When I got off the bed I felt something shift and change again: the contractions were suddenly so much longer, more painful, more intense and I was feeling different. It was as if I was there, but also not there at the same time. Heather went to get a hot water bottle and poured my bath and Anina helped by applying pressure on my hips. Heather returned and stood behind me, hubby sitting on the bed in front of me. I was bending, swaying and doing things without thought, and I was moaning. Heather applied pressure with her hands on my rectum pushing upwards and at the same time pressing on my back down, both definitely helping, and next thing I knew I felt this bursting sensation. My waters had finally burst. I remember thinking, “Oh no, I just messed myself as well!” But I hadn’t.
Everyone was excited, but I felt this rush of tiredness. It was as if all my energy had drained away and I could barely breathe.
Anina asked if I wanted to get into the bath, but I was so exhausted, tired, I couldn’t even answer. After she asked for the third time hubby made the decision to get me into the bath. Between him, Anina and Heather they almost carried me to the tub a few meters away. The relief of the pain was immediate.
At first I sat hunkered forward on my knees. But this caused a problem. My baby’s head was pressing down so hard that I immediately felt the urge to push and push HARD, but I wasn’t fully dilated yet and was hurting myself. Hubby and Heather both kept asking me to try and stop pushing, which I just couldn’t do! My contractions weren’t even one minute apart and they hurt a LOT.
After a while Heather suggested that I turn around and sit leaning against the bathtub. I didn’t have the energy between the contractions to do it myself, so they had to lift me up and do it for me. But it brought immediate relief. The urge to push was gone and the contractions didn’t hurt as much. I was so grateful to have a little breather.
After a few minutes, Heather announced that baby’s head was moving down the birth canal and that I should start pushing when I felt the urge. I followed her instructions and I was LOUD, making lots of noise, sometimes almost screaming with the pushing. Everyone was encouraging me to push harder, push more and in between Heather asked me to not scream as loudly as it interfered with my pushing. Suddenly Heather realised I couldn’t concentrate through all the noise and asked everyone to just keep quiet and told hubby that he was to tell me when to push and how to push. He sat, holding my hands, lifting me up when the contractions hit and talked to me into my ear, encouraging me. In between contractions everything was quiet. Sometime, someone had put up Josh Groban’s music and I heard him singing. It gave me the courage to go on.
Baby started crowning, and damn that hurt. It felt like my clitoris was on fire and I instinctively wanted to close my legs and shut out the pain, but then I couldn’t push. Hubby leaned over me and held my legs open while I pushed. Heather encouraged me to feel her head crowning and took my hand and guided it to feel her. It felt soft and I could feel a little bit of hair. But every time, just when she crowned her head would pull back in. It felt like ages passed and I just had to keep pushing. Heather suggested that I continue to push just a little between contractions to keep her head crowning. Again she guided my hand down. I could feel our baby’s entire head now and could feel my perineum stretched over it. I pushed, but it didn’t want to come out. I really didn’t want to tear or be cut, so I started praying, asking God to help me, and in between I talked to our baby, encouraging her to come out.
Then the next moment I felt her head pop out! Wow, she was there! Then with the next contraction her body just slipped out and after a few moments Heather lifted her onto my chest, covering her with a towel. I was in ecstasy, I had done it, I had gotten my VBAC! When every doctor, every person I talked to, had told me I couldn’t, not with my history. I had proven them wrong. My baby was there and I had birthed her myself. At 8:30pm, after about 30 minutes of pushing, she was born weighing a nice 3.3kgs!
No words can describe how I felt. Minutes later the placenta was born and I could join hubby and baby on the bed. I got to breastfeed her immediately and my parents and sister could see her moments later. My son, however, had fallen asleep while waiting for us.
I only had three very tiny tears on the inside of my vaginal wall, no tears on my perineum. It was the most amazing and empowering feeling ever!
I am so grateful to Heather, Anina, hubby and Erika. Every wish I had expressed in my birth plan was followed by Heather. I achieved every dream I had and I can never forget how amazing that felt. Thank you to everyone and mostly thank you to my Lord Jesus for helping me! I am a woman, I have given birth and I am a mum!”