Part 17 - The Caesarean Birth

There’s no denying the fact that I was nothing short of terrified as we arrived at the hospital that gloomy November morning for the birth of our baby.

I’d barely slept the night before and while I’d managed my much needed early morning yoga practice, no amount of conscious breathing was really going to ease the edginess I was feeling.

I’d read extensively about ‘birthing without fear’, yet here I was, feeling exactly the opposite, so that I was most definitely going to be birthing with fear.  Not that I felt that I was really going to be doing much birthing; I just had to show up and the birthing bit was going to be done for me.

There was a certain finality to leaving the cottage that morning, as I knew that life would never be the same again. I was excited of course, but also extremely nervous about the unknown and consumed by the anxiety of whether we’d have the chance to witness our baby being born.

We tried to stay jolly during the short drive to the hospital and onwards on the walk up to Loveridge Ward, the maternity unit at the Princess Elizabeth hospital here in Guernsey,  where I’d been born too. As requested we arrived at the ward at 8am, which still seemed ridiculously early, especially as we then spent the next few hours sitting around waiting for something to happen.

I was allocated a bed close to the central nurse’s station, although the curtains were drawn around it so we had some privacy. There was nothing much we could do aside from sit around and wait, me on the bed responding to work emails on my blackberry and E attempting to read a magazine as he sat on a chair beside me drinking tea. I was nil by mouth from midnight and envious because I was desperate for a cup of tea!

It felt that there was an assumption we knew the routine of being here on the ward, but it was all new to us.  We weren’t familiar with the ward, nor the manner in which it was run. And while an initial midwife was allocated to us, she was quickly whisked away to an emergency and replaced with another one instead.

This second midwife had recently moved to Guernsey so we chatted about life on the Island as I was keen to establish a relationship with someone who might be with us during such a life changing event. She ran through the preliminaries for the Caesarean section and handed me a gown which I would need to wear to go down to theatre.

My friend had already warned me about the need to shave the upper part of my pubic hair so I’d done this earlier that morning, saving the midwife a job. However, I hadn’t been warned that painted toenails are not allowed in theatre, so the midwife removed the nail polish for me. I felt a bit awkward her doing it for me, but my bump was so huge it would’ve been tricky trying to do it myself.

We had been allocated a theatre time and were preparing for this, but then there were a couple of emergencies which understandably took precedence over us. It was therefore just a waiting game and yet more sitting around becoming increasingly anxious, and of course hungry.  It also meant yet another change in midwife as the second one was also called away to one of the emergencies.

I was then reminded that what we resist persists, because for weeks I’d been going on and on about the fact that I absolutely didn’t want the one and only male midwife on the ward assigned to me.  In my small minded way of understanding how things were at the time, I had concluded that a male midwife would have zero empathy or indeed awareness of my needs as a woman.

It was inevitable therefore that I was allocated the male midwife, only to discover how very wrong I was! And needless to say I quickly learned that despite my initial resistance, he was everything I needed that morning, a true gift from the angels. He cared, he listened and he laughed helping to keep the energy light. The funny thing was the fact he wasn’t meant to be working that morning and had been called in at the last minute to help out.

The Goddess of the Moon was dancing and for the first time during that pregnancy, I smiled at the manner in which events were unfolding.  I’m pleased the Universe gave me the opportunity to recognise this, and to realise how judgmental I was being despite considering myself an open minded and non-judgemental individual!

It wasn’t long after he was assigned to me that, all of a sudden, they were ready for me in theatre. I had changed into a gown by then and removed my jewellery. I rushed off for yet another pee with my kidneys now definitely in fight or flight mode, before settling myself on the bed again. A porter arrived to wheel me down to theatre, which seemed a bit ridiculous as I could have quite easily walked.

I was upset to leave E and I recall looking back at him as I was wheeled out of the ward and silently praying that he would join me soon. I didn’t like the fact that we were separated at this scary time and I felt sorry for him left on the ward on his own. I was grateful for my male midwife who did his best to keep me humoured during the short journey.

Arriving into the waiting area was terrifying.  While I’ve had surgery previously, I don’t recall being in the theatre environment, so it was all new to me and it felt like entering another world that I knew nothing about. I didn’t recognise anyone, which is unusual here in Guernsey and it felt really busy with the the theatre staff rushing around doing their thing.

A theatre nurse was assigned to me and she checked my name tag and asked me to confirm my name. I was trying to keep it all together, trying to smile and trying to take it all in my stride but it was challenging, my mind was in overdrive concerned about the uncertainty of what lay ahead. My male midwife kept checking I was okay and the theatre nurse asked me questions about yoga to try and keep me calm.

I found it difficult to concentrate though as I had this myriad of ridiculous concerns going around in my head.  Should I still be wearing my pants? No, and the kind nurse helped me to subtly remove these. Would my midwife definitely retrieve my placenta for me? Yes, he was primed with a plastic tub, I didn’t need to worry. Would E be joining me soon? Yes, as soon we were settled in theatre.

I was handed a plastic hat to wear and we joked about this because we were all wearing them and it’s not the most attractive look.  To reduce stomach acids, I was given an antacid to take orally. I wasn’t happy about having to take anything which would impact on the balanced state of my gut, but I was aware that stomach acids can, in very rare cases, leak into a woman’s lungs during a Caesarean section, and the treatment is necessary.

Soon it was time to go into the theatre. It certainly wasn’t the environment I would have chosen for the arrival of my baby into this world.  It was bright, clinical and noisy with the sound of equipment buzzing and the theatre staff busily preparing for the procedure. I was shifted from the ward bed on to the theatre bed, which made me feel awkward as I didn’t like to think that I wasn’t capable of moving myself.  I’ve never been so nervous and fearful.

My memory is a little hazy of the exact course of events but I believe an intravenous line (IV) was placed into a vein on my right hand.  This was used to deliver medications and fluids etc. during the surgery.  It was also there if needed for a blood transfusion and I was reminded that blood was available for me in the theatre if necessary.

An oxygen monitoring device was placed on my finger and a blood pressure cuff was placed on my upper arm to monitor my blood pressure. I can’t recall now whether wires connected to heart-monitoring equipment were attached to my chest, I just remember there being an awful lot of wires and equipment generally.

As soon as I was settled, I was then helped onto my left side so that the anaesthetist could apply the spinal anaesthesia. I was wearing a gown that opened at the back so I felt exposed and vulnerable in front of a whole room of strangers. It was now that I became absolutely consumed by fear, especially that the anaesthetist might not be able to administer the epidural and me then requiring a general anaesthetic.

I was aware I needed to stay still to assist the anaesthetist but I was shaking uncontrollably. It was horrible because I just couldn’t seem to make it stop. A kind nurse held my hand and talked me through some deep breathing to calm me down. I thought it was ironic that I had to be reminded of this, especially being a yoga teacher but regardless, I was grateful for the support.

The focus on the breath made all the difference and I dropped my awareness deep into it, using Ujjayi breath as this calms me down almost instantly. It was a very present moment experience that I can still recall to this day, simply because of the manner in which I was desperate to stop the shaking, and was doing all I could with the breath to stop this.

I don’t remember feeling any pain as the anaesthetist injected into and around the nerves of my spinal column, near the middle to lower back, I was just focused on being as still as possible.  I was aware that once administered the anaesthesia would give a rapid and complete numbing sensation, relaxing all the muscles of the legs and abdomen and preparing me for surgery.

It was the strangest feeling, especially when I had to touch various parts of my body at the anaesthetist’s request to check whether the spinal had worked. My friend had already warned me about this because she said that while she was touching her own body, it felt like she was touching chicken breasts.

She was right, it felt very odd.  It also felt very odd that I couldn’t move my legs and I wasn’t entirely comfortable about this, as it made me feel a little claustrophobic. Still, this meant that the spinal had worked and with that I felt an incredible sense of relief. My greatest fear had not yet been realised, and hopefully E would soon be able to join me.

I was aware of activity around me. The specialist in his surgeon capacity was busying himself to the lower right of me and the anaesthetist was positioned to my right chest, monitoring the screens.  Soon a screen was placed over my chest so that I couldn’t see what was happening in front of me. My focus however was back towards the door behind me, and I kept crooking my neck around to look out for E who was supposed to be joining me.

A nurse mentioned that they needed to move my legs to enable them to insert a flexible tube, a Foley catheter, into my bladder to drain urine and keep my bladder as empty as possible during the surgery. This was also a strange feeling as I knew my legs were being moved but I couldn’t actually feel them.  Fortunately, I was too distracted by the door behind me to realise that this meant that my vagina was once again on display.

Finally, the door opened and there was E, dressed in his blue theatre attire with the regulation plastic hat on his head.  I could have wept with joy; it was an incredible relief that he was now able to join me. He was a little bit emotional himself at seeing me lying on the bed attached to all the wires and machines and the theatre staff primed for the birth, and quickly held my hand to comfort us both.

My relief was short lived however as I started to feel really sick. It probably didn’t last long as the anaesthetist reacted quickly, but it was long enough to send me into a minor panic. I felt helpless as I was lying on my back, unable to move, and concerned that I was going to vomit. I quickly figured that I could turn my head to the side if necessary so I wouldn’t choke, but nonetheless it was a very scary feeling.

The anaesthetist explained that my blood pressure had dropped and she did what she could to balance the level again and with that the sickness eased. I wasn’t very aware of what else was going on at that stage and I was trying to focus on my breath to steady myself, while gripping E’s hand.

E was standing to my left side and watching the procedure over the screen in front of me.  He later told me that it was incredibly graphic, but fascinating too as he saw the different layers of muscle and fat as the surgeon operated. It wasn’t long before I was told to expect some sensation of tugging and I could certainly feel this but it wasn’t painful.

Shortly after the tugging I heard mention of the need for forceps and went into another minor panic because it hadn’t crossed my mind that forceps would be needed during a Caesarean birth. I expressed my concern to E but he assured me that they were needed and were being used in a gentle manner. I shall never know if this was the case and fortunately I didn’t have a lot of time to reflect on the use of them because moments later the baby was born.

We didn’t know the sex ahead of the birth and we’d asked the specialist that E be the one to determine this. I remember E peering further forward over the screen as the baby was lifted out of me. I was impatient to know the sex and was asking him “is it a boy?” as this is what I had suspected throughout the pregnancy, and him nodding, before verbally confirming, with tears in his eyes, that our baby was a boy.

The name had chosen itself months beforehand. It had jumped out at me in the Baby Naming Book, E had agreed that he liked the name and it just stuck.  It wasn’t a name I would ever have imagined myself choosing, but it fitted very well. Here he was at 11.34am on Tuesday 12 November 2013 thrust up in front of us above the screen for a very quick peak, our new born son, Elijah Iain McInnes.

One of the meanings of the name ‘Elijah’ is ‘miracle’, which seemed appropriate to us as he was certainly our miracle, beating the odds by being conceived on our first attempt at IVF and staying safely in utero to 38.5 weeks despite the placenta previa. The other meaning is strength and power and that seemed appropriate too, he certainly felt strong and powerful, not least to beat the odds but also with all the kicking he’d done in the womb.

We gave him his middle name ‘Iain’ after E’s Dad who had passed away a few years before E and I met. We wanted to include him in Elijah’s life in some way and hoped that by giving him his name, it would connect him somehow.

I have to be honest I can’t remember which came first, my first glimpse of my son lifted up above the screen or hearing his cry. I was told that babies don’t need to cry upon birth, that actually if their birth is peaceful, they need make no noise at all. However, I had also read that a good cry lets a baby test out his/her lungs for the first time.

Before a baby is born, it takes in oxygen through the placenta via the umbilical cord, but the moment the baby leaves the womb, it’s on its own, so to speak. Natural instinct then kicks in and the baby does the only thing it can; it gives a good scream, the lungs fill up with air and for the very first time expand to their full capacity.

Furthermore, the baby’s first cry helps them to get rid of any amniotic residue in the lungs, mouth and nasal passages. This can also be suctioned out by the nursing team if required and everyone depends on that first cry to indicate that the baby is breathing well on its own. Our little boy certainly seemed to have healthy lungs and I welcomed that first cry.

I’m not sure of the exact sequence of events with the cord cutting either. Prior to the birth I had read extensively about the benefit of delayed cord cutting, which include a normal, healthy blood volume for the transition to life outside the womb; and a full count of red blood cells, stem cells and immune cells. For the mother, delayed clamping is said to keep the mother-baby unit intact and can prevent complications with delivering the placenta.

However, as I had placenta previa I had been told that there was no time for delayed cord clamping and with that the loss of all the researched benefits.  I knew this before going into surgery so I had already had time to process this, but it still seemed desperately unfair that my little boy wasn’t going to gain these additional benefits having been plucked from my womb before he was ready.

Still at least E was able to cut the cord. He had been resistant to this initially but now the opportunity presented itself he was more than happy to get involved. It’s often seen as a rite of fatherhood or the first stage of forming a relationship between father and baby and a Portuguese study found that the process aids emotional bonding between father and baby too. Whether it helped or not I’ll never know but I was pleased E was involved in the process.

After the cord was cut and Elijah had had his initial checks, our little miracle was soon brought to me as I lay on the bed while the specialist removed my placenta and stitched me up again. Fortunately, my placenta was retained by my midwife as the wild yogini within me wanted to plant it in the garden to nourish a tree for Elijah – and so the cycle would continue with the tree providing oxygen and nourishing us all that way too.

I’ll never forget seeing Elijah properly as he was placed skin to skin on my left side under my gown. He was wearing a pink and blue knitted hat, and looking so unfamiliar to me. I remember thinking, “This is my son, but I don’t recognise him, I don’t know him and yet he’s come from me”.

I lost all sense of time after this. My blood pressure dropped again and I have no recollection of being moved from the theatre to the post-operative recovery area. E tells me that we were there for a good hour or so as I was stabilised, but to me it felt like minutes.

All I remember is staring at Elijah and having the itchiest nose I had ever experienced. I just couldn’t stop scratching it because the itch just wouldn’t go away. The nurse administered an anti-histamine, which finally relieved it, but by then the damage had been done; I’d scratched my nose red raw and it was scabby for days after.

Once I was stabilised and back in the land of the living, I was wheeled up to the ward, Elijah swaddled and asleep beside me, and E beside us.  We had left the ward separately E and I and here we were returning as a family of three.  It was surreal but extremely exciting, I was now a mother with a healthy baby boy, it was a dream come true!