What is at stake? What’s the problem with another caesarean? Can’t I adopt kids? I had three caesareans and I’m a happy person, they say. No. Everything is at stake. My fertility. That is not secondary. That is the life-giving power I share with GOD. No, you can’t cut into my life-giving organ if I don’t want you to. No, you can’t limit my childbearing possibilities to three because your operations are medically “safer”.
This sounds a little angry, but it was more fearful. Fear of the unknown, of pain, of not being capable. Fear of it all being in God’s hands and of not being able to control outcomes.
This time around we felt more educated and more prepared. We did a weekend course with a doula, which was a changing experience for us. We had friends who had had natural births and good experiences, who inspired and helped us. We have a wonderful doctor who not only does her job really, really well, but was an angelic, compassionate supporter the whole way though. Finally, we had a great book (Deliver! By Julie Dubrouillet) which we read together, slowly, and which is balanced and practical. I cannot recommend this book more. Plus, we had the author of this book available to answer questions by email.
First, there was the question of positioning. Adelaide had been breech (head up) and this baby certainly had to be correctly positioned to even think of avoiding a repeat caesarean. I worked hard to have good posture, never recline, and do some yoga positions, as the aforementioned book suggests. However, what I’m sure did the trick was an entire convent of cloistered nuns praying for this specific request, thanks to a clever and thoughtful friend of mine.
There were a few other things we were hoping for. We wanted to stay home as long as possible. We knew the hospital setting made me uncomfortable and that being at home, especially taking showers, was what relaxed me, which is essential for good labor. Labor progresses and goes well when the woman is relaxed and releases the hormone oxytocin. Adrenaline and fear stop the labor process. If we could only get into active labor before getting to the hospital, no one would want to interfere with that process.
I started preparing weeks before and was anxious to get it over with. I really benefited from the affirmations and birth stories on an app called Gentlebirth. I typed out the affirmations and kept adding some of my own. This is called brain training, and athletes do it too. I was feeling lots of painless contractions weeks before, which seemed to intensify. Everything seemed to be going well and at 37 weeks my doctor asked a colleague at the hospital to check the baby’s weight and position on the ultrasound. He was deemed “average size” (3.1 kilos) and in perfect positioning for a vaginal birth after caesarean. Everything was ready to go.
And then nothing happened. And then nothing happened some more. “You should walk”, they said, “did the trick for me every time”. “Relax and go on dates.” We tried, but 41 weeks came and went. I was terrified because Adelaide was born at 40 weeks + 6 days and I was convinced this baby couldn’t take longer than the first. My doctor didn’t say anything when I went in for tests, until I was 41 weeks and 2 days. She asked distractedly, “how many weeks?” A bolt seemed to go through her when I said 41 weeks. Every doctor in Portugal induces at 41 weeks. My heart sank. Could it be that she had just gotten distracted? Would we have to go against our doctor’s better judgment now? Would this baby come out on his own or NOT?
That was a Thursday and she tried to see if there was “room for me at the inn”, but the hospital was full so they wouldn’t induce me that day. Phew. Not that they wanted to induce me anyway, she was just trying to prevent them from scheduling another caesarean by trying a “light” induction first. She asked me to come back the next day for more tests to make sure everything was okay. I was considering fleeing the country, I was so panicked. The next day (Friday) my husband went with me and we were prepared to make decisions. The doctor checked and said everything was okay, including amniotic liquid, and went to talk to the head of obstetrics. I breathed the biggest sigh of relief when she came back and said she had jointly decided with the head doctor to wait until Monday to induce. She said the head of obstetrics was also very in favor of vaginal birth and thought it was okay to wait to see if I would start labor naturally, so as to avoid caesarean. Our doctor seemed very pleased and this was an exception to their normal hospital procedures. I breathed the biggest sigh of relief ever.
Coincidentally or not, I started having a stronger period pain and what I thought were the beginning of real contractions as soon as I walked out the hospital door. My husband (who was also my doula ;) ) made me climb five flights of stairs to reach our apartment. This pain continued until evening and the contractions intensified. Could it be? Was labor beginning? I packed my bag, made sure everything was in order, used my pilates ball, and started talking with my husband and mom about plans for that night and the next morning. The pain was pretty constant, but tolerable. It would intensify with contractions, but would never go away, which I wasn’t expecting. I wasn’t able to rest in between contractions, as I had expected. I was overjoyed that labor was beginning and that my water hadn’t broken, so we could stay at home as hoped for. I took a shower. I already knew that showers relaxed me, but had no idea it would be so much. The pain disappeared completely in the hot shower. I went to bed early and it was difficult to stay in bed, but I made up my mind to lie down and rest, even if I didn’t sleep, until midnight. It’s important to rest as much as possible in the early stages of labor. I was able to stay in bed until three in the morning, sleeping a bit here and there but not more than a couple of hours total. I came into the living room, lit our “birth prayer candle” and again offered the intention I wanted to ask for during this labor. I tried to internalize my affirmations again. Eventually I took another shower. I had the smallest bit of spotting, which made me happy because I knew the cervix was dilating. I thought I could feel it. Although the pain and contractions were regular, they didn’t seem to intensify. Morning came and I was still in the same condition, with tolerable pain. I had expected to be having the baby in the morning so this was a letdown. I was tired.
My husband insisted we go to the hospital as we had planned with the doctor, to make sure everything was okay. But I had already started labor and wanted to stay at home so it would progress, I protested. (This is why I had the previous caesarean… my labor didn’t “progress” at the hospital.) Even more so, insisted my husband. We had to make sure everything was okay, then we could come back home. We sent our daughter to my in-laws’ house with her bags packed. I was angry at my husband. They would find some reason to want to keep me there, I was sure of it.
Sure enough, the doctor on call took one look at “41 weeks and 4 days” and seemed to shudder. Sure enough, the amniotic liquid was low. It was at level four, and anything under five is in favor of oligoamnios so the doctor suggested staying at the hospital for them to monitor me. They didn’t have to induce until the next morning, seeing as I was having contractions. They could just monitor me during the night and see if my labor progressed. “We’re in favor of vaginal birth too,” she said, “but safe vaginal birth.” I was heart-broken. Of course my husband wanted me to stay. He’s a doctor! I expressed very clearly that I didn’t want to, but we decided to call our OB/GYN. We waited anxiously for her to call back. When she did, she said my amniotic liquid had been high the day before and for it to drop that much in a day meant I should stay to be monitored. I could “defy” my husband, but I couldn’t argue with our trusted doctor. Tears started streaming as we walked back to the hospital and they didn’t stop all afternoon.
My OB/GYN, who was not on duty that day, came to the hospital personally and talked to the team on call, reiterating my wish for a vaginal birth after caesarean. She seemed as worried about it as we were. The doctors said my contractions were more regular, which was a good sign. Maybe things would progress during the night, they tried to comfort me. I couldn’t feel my contractions anymore though. Or even pain. I went to bed at 11 or 12 pm and slept. I woke up at 2 am with an achy back but nothing else. I cried a little because I was sure labor had stopped. Oh well, we had tried our best.
When I got up to go to the bathroom, I felt water rushing down just like you see in the movies. My waters broke! I called the nurses and they checked to see if I was dilated. I wasn’t dilated yet (just 2 cm… as I had always been, and past which I hadn’t progressed with the previous birth), but as soon as she touched me I saw fireworks. I started having intense, painful contractions, pretty close together and was again overjoyed. This was happening. My body knew what to do, just like I had written in my affirmations. I endured the pain for what seemed like a lifetime lying down because they had to do a cardiotocogram (CTG), to make sure the baby’s heart was okay. “Can I please stand up or walk?” “No, we have to get a good run of this test.” It seemed like endless torture. I set a goal: the shower. If I could endure the pain as long as possible now, then they would send me downstairs to the active labor rooms and I would be able to take a shower. Then I was sure I would not only be relieved, but labor would progress a lot because I relax in the shower.
I sent a message to and then called my husband, even though they told me not to yet. I kept asking when they would stop the endless testing and send me down. I was trying to relax through the pain and remember all the things I wanted to remember. A nurse came in and asked the other nurse, “Did you send her down to the active labor rooms yet? Her husband is here and asking for her.” The other nurse answered, “No, of course not. (To me) You didn’t call him yet, did you?” I tried to act nonchalant, “Oh I sent him a message. But I didn’t tell him I was down there yet!”
Finally, they said it was time to go down. Would I like to go on a stretcher or could I walk? I really didn’t feel capable, but I jumped at the chance of walking. I knew walking and moving my hips from side to side would help the baby go down. So I walked very slowly and in pain, slowly swiveling my hips and bending over during contractions. The nurse that accompanied me seemed annoyed at our slow pace. “Would I be able to take a shower when I got down there?” I was able to whisper. I could only think, feel and see SHOWER, SHOWER, and SHOWER. The nurse seemed surprised, “No, when you get down there they’ll give you an epidural.” I tensed, “I don’t want an epidural.” “You DON’T?” She seemed to gulp down her surprise and then answered professionally, “Okay, I’ll let my colleague know your preferences.”
When we got down to the room, the nurse that was there was in a bad mood. Or just a rude person. “Why did you bring her? You know we don’t have room down here,” she asked the nurse that brought me.” “She’s 4-5 cm dilated.” (I was happy to hear this. I had progressed more already than with the previous birth!) “We’re in the middle of changing shifts though. You should have waited.” (I was happy to hear this too. This meant this rude nurse would be leaving soon.) Before the other nurse turned to leave, she remembered to say, “Oh, and she doesn’t want an epidural.” “JUST what we needed!” she wailed.
This new nurse started to hook me up to the same “torture” machine I had been on before to check the baby’s heart. My heart sank. “Do we need to do this again? I’ve been doing this upstairs non-stop,” I asked. The nurse seemed happy to make me suffer. Oh no, they did their tests upstairs and we had our tests downstairs. They needed their own data for my “file”. Then she asked me some aggressive questions about the epidural. “Did you make religious promise?” (a bargain with God). “No.” “Hmm. Well did you do a course to know how to do this without epidural?” “Yes,” I lied through my teeth. Well, where was the course? Who taught it? Did I know what I was doing? Yes, yes, yes. And before she left me there, writhing in pain and lying down attached to the machine I asked, “Could I take a shower after?” That really sent her up the wall. Oh no, no shower. They would see how the baby was doing but his heart rate was not good. It seemed to be deaccelerating. I couldn’t take a shower with a previous caesarean, was I crazy? They had a woman there, she was actually an OB/GYN, with a previous caesarean who had taken a shower and had uterine rupture in the shower. Don’t you remember, she asked another nurse in the room. Oh yes, she was relaxing in the hot water when there came a strong contraction and BOOM! Her uterus burst. No, no shower for me. At least not until they saw how the baby was doing.
At that point I lost my goal and my heart sank once again. The shower was a big deal for me. It was one of the reasons I had chosen that hospital. If they didn’t let me take a shower I would ask for an epidural and that was it. I left it in God’s hands. I had no other way to mentally deal with the pain.
The rude nurse came back once or twice to check on the test and then she changed shifts with a male nurse. Thank God for male nurses, we had a great experience with all the male nurses we found there (could have been a coincidence). The tests look good, he told me all of a sudden. I had mentioned a shower, would I like one? “YES!” That moment felt like salvation. “Let’s take a walk”, he said encouragingly. He even let my husband come in the bathroom with me during the shower (standard procedure is for my husband to have to go to the waiting room and then be called back). During the shower, a few people came to say he couldn’t be in there. I asked my husband to time 30 minutes for me to be in there. I felt that was a reasonable time they would let us stay in there (I would’ve stayed hours if I could!)
The pain was very bad but I wouldn’t say it got especially worse than when it started at three in the morning. There were a few contractions interspersed that were so bad I felt like crying. But mainly what was scary was not knowing how long it would last. I felt like I could mentally handle one more hour of contractions if someone had assured me that was it. But what if it really didn’t progress? I couldn’t handle more. What scared me was not knowing. At every moment I thought I might ask for an epidural.
The shower helped a lot. I tried to relax as much as possible, move my hips to help the baby come down, breathe and remember my affirmations. I tried to remember labor would go quickly if I was relaxed. I thought about a lot of things. I thought about Jesus’s passion of course. I offered my intention again. I thought about people all throughout the world and all throughout time that are tortured. How could you do that to someone? How can someone tolerate being tortured? There was that element there of not knowing when it will end.
Finally the half hour was up and there was a nurse at the door insisting for me to come out and that my husband couldn’t be there. We obediently went back into the room where she strapped me up for more of the heart testing. No more showers for me, she announced. The baby’s heart was not doing great. This time I wasn’t upset about lying down. I felt like I couldn’t move anymore anyway. From that point on I stayed on my side in fetal position. I was worried about not having gravity to help, but I also didn’t feel strong enough to stand up. I had a new goal now: surprise the doctors and nurses and go quickly into full dilation. I had read countless birth stories with outcomes like this. Our new nurse also had a problem with the no-
“Do you not want an epidural ever or just not for now?” “Just not for now” (I
had been advised to say this to nurses and doctors so as not to seem
“extreme”.) “And if you have to have another caesarean you want general
anesthesia?” “No, of course not, in that case I’ll have an epidural.” “Hmm.”
A “team” of doctors came around to check on me. They also scoffed at the fact that I wasn’t having an epidural and asked me the same question, did I not want it at all or just for now? They checked me and said that my pelvic floor was excellent and the labor was progressing wonderfully. Who did my previous caesarean? Everything seemed to be going great. That made me very happy. The head doctor said menacingly, if labor didn’t progresso, though, she would have to administer oxytocin and then it wouldn’t be “natural” anymore. Okay fine, I said.
They said my fever was rising (37.7 C) and our nurse started talking about what she would administer when my husband piped in and said, “Let’s not give her anything until she has an actual fever.” They all turned toward him and asked aggressively, “What is your profession?” “I’m a doctor,” he admitted. We hadn’t wanted to mention that so people wouldn’t red-flag us and doctors wouldn’t feel more inclined to intervene. The doctors were pleased though. “Oh, we’re talking to a colleague! Oncology! Oh, then you know all about pain-killers! Yes, yes, we’ll only give her medicine when the fever gets to 38 degrees, of course!” Although the doctors were overjoyed, the nurses had the opposite reaction. From then on, our nurse jumped on him every time he talked. Any time he would say something she would say to let me talk. She said it seemed like it was him who didn’t want me to have an epidural and not me. Later, after the birth, she admitted that she had told the other nurses my husband was arrogant and “he might be in charge in the hospital where he works but not here”.
From then on, I focused on breathing and my husband helped me a lot with that. He reminded me to breathe during contractions and I felt encouraged when he said the baby’s heart rate was doing great when I breathed. Those moments when I was laying down, both of us trying to breathe and just survive, were the most intense of all. The night when we got back from the hospital, afterwards, my husband acted it out while he was sleeping. It was scary. It was that time thing, about not knowing how long it would last and knowing we wouldn’t be able to handle it for long. I tried to keep focused and imagine it was almost happening. I heard other babies crying and being born, which was comforting. I couldn’t wait to see mine. That was my new goal after the shower, just get him out.
I started having contractions in which I felt a pushing motion. I had read a birth story in which she described the contractions as an upside-down vomiting, an involuntary motion. It felt like it was progressing. Thankfully we had some time alone during this stage. The nurse had said to her colleagues, “If they want it natural, leave them alone.” When she finally peeked in again, I asked for her to check. Both Daniel and the nurse seemed surprised. Was I sure? Did I feel the urge to push? Sometimes, I lied. I wanted to surprise them. She asked me to lie on my back and I was sure I couldn’t.
When I did lie on my back and when that surprised look came on her face and she said, “You can push whenever you feel like it,” THAT was the best moment of the entire labor and delivery for me. I HAD DONE IT. I was soooo happy. I said I wanted to push now and was also happy when she didn’t call any doctor or anyone else. She started looking for her gloves. And sat down comfortably. The moment of expulsion was the scariest for me and I was scared they would intervene with vacuum because they most usually do, especially after caesarean. I had told my husband I didn’t want episiotomy and he voiced that at that moment, to which the nurse responded aggressively, “We don’t do that here”. I was even happier with that answer.
The nurse put on a different “persona” during the delivery stage which I had heard about nurses doing and had hoped someone would do that for me. She gave me confidence. She said “this labor is MINE" and "this baby will be born". And I felt confident she was there to help get the baby out. I was proud when she asked me if I felt her fingers and told me where and how to push. I was happy I hadn’t gotten the epidural even if just for that moment. I was happy my husband got to witness that beautiful stage of the baby crowning, the anticipation that he was almost there. My husband was euphoric, like a little boy on Christmas day. It was a birth just like I had dreamed.
Our baby finally came out and I never felt so relieved in my life. The nurse said, “Oh, what’s this? MECONIUM!” and suctioned him and sent him away. Someone said, “Call the pediatrician.” My husband asked, “Can I follow the baby?” Even though they seemed alarmed, I wasn’t. I was sure the baby was going to be okay, if we had been able to get him out God was with us. A little later they brought him to me and he calmed down (he had been crying) on my chest. He was very big, 4 kilos (8.8 pounds), which also made me happy. I had somehow dreamed of having a big baby. The nurses were all shocked by his size. He was making little grunting noises while breathing. The pediatrician came and informed us that he wasn’t sure if he had breathed in the meconium, especially because of the difficulty he was having breathing. He said all sorts of things about how if he didn’t want to breastfeed or continued to grunt while breathing what might happen. Thankfully, his breathing got better and he is a champion at breastfeeding.
Speaking of which, he was born the day Portugal won the European soccer championship!
They didn’t have room in the post-partum ward so we spent a wonderful afternoon and evening alone in our private room. The baby slept, we listened to the playlist I had made for labor and we were in awe of the amazing experience we had just had. The nurse came in and talked to us for long periods of time, always expressing her opinion about how I should’ve gotten an epidural and we were lucky because “there were so many close calls”. There was a point when my husband got upset with her and almost asked her to leave, but then he calmed down and we were all friends in the end. She even came and visited us the next day. Our doctor also came and visited us while we were in that room. She was like an angel floating in; she really did mediate for us in so many ways. “4 kilos, who would’ve guessed, huh?” She was glad it had gone so well.
Thank you for reading this until the end! Even though it was a pretty factual account and I feel like it can’t describe the profound emotions and rawness of the experience, it was long!