Before I birthed my second daughter, I made two birth plans. A and B. HBAC or elective C section. The goal or the compromise. I had it in my mind that if I could achieve my longed-for VBAC, at home surrounded by my family, that it would feel powerful, redemptive and joyful. And if I couldn’t, I would have a scheduled c section, which would be… fine. I knew what to expect with a c section (or thought I did). I knew I could handle the recovery. It would be calm, controllable - and just fine. I was totally wrong.
But before I tell that story, I want to back up for a minute, because the context is important to understand why I made the choices I did. When my first daughter Rosie was born in 2020, it was the middle of a pandemic. Maternity services, already struggling, were further affected by staff shortages and visiting restrictions. Despite falling into a “high risk” category, I had planned to wait for spontaneous labour if my pregnancy was going well and go into the birth centre. My care team agreed at first, but from the start I felt they were looking for a reason to withdraw that plan. As I hit 37 weeks, despite everything looking and feeling good, I was told my baby would be in imminent danger if I didn’t deliver soon. Without the critical decision making and self advocacy skills I have now, I found myself in hospital, scared and alone, falling down the rabbit hole of an induction that I desperately didn’t want but somehow couldn’t escape. It was a long, difficult experience that left me significantly traumatised. After five days of struggle my first baby was born via an emergency c-section.
Of all the things that happened in hospital, my actual birth was completely fine. The surgical staff were kind, calm, and competent. Recovery was sore, but manageable. I was able to go home quickly, and escaping the hospital felt like an indescribable relief by that point. It hadn’t been the birth I had wanted, but it had ultimately been the easiest and best part of an otherwise awful experience.
Over the following years, I discovered a profound passion for birth activism. I trained as a doula, supporting people to take control of their experiences in a way I was unable to do. I educated myself, and learned how to advocate for my clients.
So when it came to planning this birth, I was very clear on my red lines: I wouldn’t accept an induction. I wouldn’t labour in the hospital, full stop. I would wait to go into labour spontaneously and birth my baby at home. And if I couldn’t, I’d be having another surgical birth. Nothing in between. I sought out a care team (including independent midwife Jane Ashwell-Carter and The Collective’s wonderful Becky Talbot, who was my own doula) who supported this plan. And everything seemed perfectly on the path for plan A. Until suddenly it wasn’t.
…
(Bump photo taken the week of my diagnosis)
I was 35 weeks pregnant when that path began to veer.
Despite being a pregnancy after multiple loss, with all the anxiety that brings, things went extremely smoothly for 8 months. My sunshine babe was growing strong and perfect, wiggling away into every evening. I felt healthy - I WAS healthy! Every test, every lab, every scan was textbook. I exercised daily to keep my body strong and flexible and found I escaped the pelvic and back pain I’d experienced with my first. I lived and breathed affirmations. I prepared a birth space, imagining each element of how my home birth might unfold. I even used to dream about it at night. I talked to Rosie about what labour and birth might look and sound like, anticipating having her in the house. We talked about her cutting the cord, a prospect she was extremely excited about. Everything was coming together. I felt incredible.
And then, seemingly overnight, I felt SO heavy. Walking became a struggle. Almost every person I saw that week said some version of “You got so much bigger!” or “Wow, you look SO pregnant now!” (side note: don’t say this to a pregnant person, unless you’ve been explicitly asked. Trust me, we know we look pregnant). My ribcage and pelvis both burned with a new stretching. My back hurt when I stood for longer than a few minutes. And more troublingly, my baby’s movements felt different. Not absent, but muffled somehow. Less.
As soon as the ultrasound machine turned on, I could tell what the problem was: huge black pockets of amniotic fluid surrounded my baby. Just a week earlier everything had been normal, but now I had developed severe and completely inexplicable (idiopathic, in medical terms) polyhydramnios.
At 36 weeks we captured this most gorgeous scan photo of my baby’s face. As delightful as this is, it shouldn’t really be possible. As babies have less free space towards the end of pregnancy, the view via ultrasound gets more restricted (this is also incidentally why late pregnancy growth scans are so unreliable). The amniotic fluid is the “window” for the waves that form an ultrasound image, and towards the end of pregnancy there just aren’t big enough free pockets to get a really good view - normally.
(Scan photo - the cheeks!)
I won’t go into the many twists and turns of the next few weeks, except to say this: people don’t often think about how much an extra litre or two of fluid weighs, especially when that weight is balanced directly on your cervix. Walking anywhere became a significant effort and every evening was marked by long runs of contractions that made it difficult to rest. My babe, finding herself with an unexpectedly larger pool, was enjoying swimming around. I felt my body was trying to move her into a better position, but the fluid made it impossible. She was too slippery, too free - she’d float and roll from posterior to anterior and back again, over and over, the locations of her kicks changing wildly even from hour to hour. My midwife could barely palpate her position, describing it like trying to feel a small doll inside a water balloon.
All through this time, I could feel this mounting knowledge inside me, pushing forward, asking to be acknowledged: despite all my work, all my preparation, this pregnancy might end in a surgical theatre instead of a birth pool in my living room. It was an immensely painful thought for me. I found myself sobbing on the couch next to my doula, in the pub with my friends, across from my therapist, even alone on the bus - every thought of letting go of my dream of a home birth brought on an overwhelming wave of grief.
But the other knowledge mounting inside me was this: the tests couldn’t tell me what it was, but something was wrong. I could feel it. My baby needed to be born, and it needed to happen sooner rather than later. And then three things happened that pushed the issue over the edge - my waters began leaking, my babies movements reduced, and then I tested positive for COVID-19. Suddenly, I knew she needed to be born NOW, today. I went to the hospital and told them so. On CTG she was doing alright, but her heart rate was a little high, which can be a sign of an infection, and a couple of hours later I was in a gown and compression stockings waiting for a slot on the surgical rotation.
Hospitals can be a little “hurry up and wait” however, and it took them quite a while to find that slot. It felt immensely frustrating at the time, but in retrospect I am grateful for the space it provided for me to process. I am also incredibly grateful for the advocacy and planning tools my work gave me, which allowed me to ask for what I needed. For example, I informed my team that I intended to continue drinking clear fluids in line with latest guidance from the royal college of anaesthetics, and requested juices etc. with sugars to keep my strength up. I stated that I would need gas and air for the placement of my cannula, as I had found this very painful and upsetting during my last labour. When things became chaotic and lines of communication from the team to me broke down, I knew I could ask to speak to the head of the midwifery team on call so we could create a plan together.
When I spoke to my surgeon it was clear that we were on the same team - to make my baby’s birth from my abdomen as gentle as possible. The request we had that was most unusual was for them to remove her placenta while still attached to her - both so she could receive her full blood complement and so we could take it home and have my older daughter cut her cord there, bringing her back into the process and reclaiming a small part of this transition as a family. The doctor said she had never done it, wasn’t sure if she could. My placenta was anterior (on the front of my uterus), which might make extraction difficult - she was worried about it coming apart as she attempted it, as placentas sometimes do in surgical births. But I explained why it was important to me and she promised she would try. That would have to be good enough.
(My pregnancy “guardian” - its ladybug tummy is an homage to our baby’s nickname)
In my bag I had brought with me tools I’d planned to use in labour at home - affirmation cards, a bead line, flags written for me during my mother blessing, a special essential oil blend, a wooden guardian whittled for me by my husband, a playlist of meaningful music. One of things I have observed about labour as a doula time and time again is how much it takes the form of a journey - a person goes inward, two people come out. I chose to make my waiting time a journey. I mentally stopped calling it a c-section and started saying to myself “I’m here for my belly birth”. I dimmed the lights in my room and put on electric candles. I talked and sang to my baby. I meditated on this change of course. I danced and swayed with my husband, Sam. I waited, unsure of when my baby would arrive, sitting in the uncertainty and the fear and the faith. I waited and I waited. Eventually the waiting became unbearable and I broke down crying - I remember sobbing to my husband, saying “I can’t do this, I don’t want to do this, I want to go home”. And then, like a miracle, they came and said it was time, time to go meet her. In retrospect, this moment felt exactly like the transition phase I’ve often seen in my clients when the end of labour is near. Maybe my body sensed something I couldn’t see. Maybe my baby did. I’ll never know. I hugged Sam tight, tears turned to joyous laughter, as Grace Petrie’s “Ivy” played in the background.
“Let’s go get our baby.”
I walked down the hall to the surgical suite and climbed up onto that table under my own power, and it is one of the single bravest things I’ve ever done.
A c-section outside of labour feels very different to an in-labour one. Nothing was go, go, go. One by one the team arrived, leisurely, chatting and joking with each other, stopping to introduce themselves to us. We went over the plan one more time. We put our music on and the whole room gently swayed - at one point I caught the anaesthetist humming along. Without the pressure of contractions making it hard to stay still, I found the placement of my spinal a breeze. He asked if my baby had a name, and when I told them he announced to the room “Okay folks, it’s time for Eliza to meet her mummy and daddy!” And then we were off.
I lay on the table feeling the numbness slowly advance, wiggling my toes and feeling them respond less and less. They checked and rechecked the block. After a few minutes they pronounced themselves satisfied, and the curtain went up. I closed my eyes and breathed slowly, allowing the tugging sensations from below to wash over me. No pain, only some pressure. This felt familiar. Manageable. Suddenly I felt a wet “whoooooosh” across my skin and heard the surgeon exclaim, a splatter onto the ground - my eyes flew open.
“Don’t worry! That’s not blood, that’s the rest of your waters going! You must have been so uncomfortable!”
Reader, it was in my HAIR. All I could do was laugh, and in the end all anyone in the room could do was join me.
And then the moment everything changes. The cry.
The curtain lowered and I could see just her head, born and gasping with her first breath.
I could hear the surgeon murmuring to her as she gently pushed on my stomach.
“Welcome to the world, angel. It’s your first day. Welcome.”
I will never forget those words, because that doctor understood something absolutely crucial: birth is a miracle. Wherever it happens, however it happens. The moment a new person breathes their life into their own tiny lungs, the world inside that room should stop turning for a second. It is sacred.
Slowly my daughter was birthed from my belly, guided by soft blue hands, and laid on my thighs. Someone marked the time down on a white board on the wall.
Then the curtain went back up and I felt the tugging sensations resume. A couple of minutes later, my surgeons face peeked over again, and she was visibly excited.
“We did it!”
“The placenta??? You got it?” I almost couldn’t believe it.
“Yep! It’s coming around with baby!”
My poor husband.
The midwife brought me my baby - as requested, she made no stops on the way. She wasn’t cleaned or dried or wrapped or hatted. She was placed on my chest, gloriously damp and covered in a thin coating of soft vernix. Her smell - heaven. And Sam, with his medical phobia and periodic fainting spells, was handed a plastic kidney bowl full of my still-warm placenta to hold for the rest of the surgery. Which he did, without complaining. That man more than earned our wedding vows that day.
I have no idea what happened for the rest of that surgery. All I remember was the feeling of my baby wriggling herself forward until her cheek rested against mine. She was so warm. Bliss.
At the end of the surgery, the midwife took our daughter, wrapped her in a clean towel, and handed her to her daddy for a few minutes while they got me transferred back to a gurney and changed out of my soaking surgical gown. I could see him gently stroking the bridge of her nose and whispering to her, letting her hear the voice she’d lived with inside me for months. But a few minutes later I was clean and dry in a new bed and she was placed back on me again, where she most belonged.
(Wheeled out of theatre completely in love)
One of the small gifts of having COVID at the time of delivery was that we needed to be isolated, so we were given a private room back on delivery unit instead of being transferred to the shared postnatal ward. Once we arrived at the room we turned all the extra lights off, creating a quiet and dim space for our golden hours. Eliza was alert and ready to feed - licking and sucking her hands, bobbing her head, kicking her feet. Her older sister had been so shocked at birth she’d just laid there - it was incredible to see the instinctive actions kicking in this time. I pointed her in the direction of my breast and she latched like a dream - like one of those informational videos you watch on breastfeeding websites. She fed greedily and fell asleep curled on my chest.
The next few hours were cycle of feeds and rests and exploring every part of her body, getting to know her. Moving Eliza was a little awkward as it involved also moving her placenta, which we had placed in a cool bag, but this meant there was very little argument against keeping her skin to skin most of the time.
(Photo we sent our doula to show the placenta in its cool bag)
I felt the sensation return to my legs and aimed to get up and gently moving as quickly as possible, as I wanted all the catheters and cannulas out. As I carefully took myself to the bathroom for the first time I told the midwife we were ready for Eliza to be weighed and checked.
Because of my polyhydramnios and fluid loss they continued to periodically check her temperature and sugars for 12 hours, which we allowed on the condition that they were able to do it without removing her from my chest, which was fine. Everything was looking good with both of us and we informed the medical team that we intended to leave at about 8 or 9 am the following morning, which would be roughly 18 hours after surgery, and asked them to prepare whatever they needed to to make that happen. The midwife said “no problem. Of course I’m required to say that we advise you to wait a minimum of 24 hours before going home, but all your medical checks are coming up clear.” They made sure we understood what warning signs to watch for at home and organised for us to collect my medicines and complete Eliza’s hearing test out patient.
Thus it was that we found ourselves being driven home by Jane, greeted at the door by Becky with croissants and homemade jam, and curled up in our house less than a day after my surgery.
We turned down the lights, stoked up a fire in the wood burner, laid blankets on the floor in front of it, and stripped Eliza down naked. My mum brought Rosie over from her house. I went to greet her at the door, expecting she’d been missing me for the last couple of days, but she was totally uninterested - all of her thoughts were bent on meeting the baby sister she’d waited for. It was love at first sight.
We had a crochet cord tie - a sunshine and a ladybug- which we used symbolically, but at that point it was sort of irrelevant. The cord was completed occluded and starting to dry already. We opened a packet of sterile surgical scissors and together my mom and Rosie cut the cord, marking the end of Eliza’s transition into our family. Then my husband got me settled on the sofa in a nest of cushions, ready to receive her back skin-to-skin, which was largely where we spent the next three weeks.
(Rosie meets Eliza in front of of the fire)
Before my belly birth, I’d said to Sam - “I know this is the right choice for us, but I’m also going to have to do a lot of work after to process the grief and disappointment I’m going to feel”. But sitting on that sofa, or reflecting in the months since, I have felt no grief or disappointment. There was and is only overwhelming joy and pride. I had thought that having a VBAC would be healing, and having another c-section would be fine. I was totally wrong.
Because in the end, my gentle, mother-led, family-centred belly birth was exactly the healing I needed.
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