I am a mother of three.
Twins and a singleton.
All girls, both births caesareans. One emergency, one elective.
I am a midwife and I am sub fertile. Three and a half years and two miscarriages saw me into my first successful pregnancy, followed quickly by another. Four years and another two losses, one early and one late, and I am finally staring at two beautiful blue lines on a pregnancy test. It’s funny because David has decided that he has had enough of trying to conceive, and I had reluctantly agreed.
In those four years, I have read, talked and empowered myself with information and strength, to attempt what I have always wanted – a vaginal birth. I am in a good place and believe with all my heart that I can do this.
David is unsure but will support whatever I want. I seek out people who will encourage me and believe in me. I find Carolyn, our friend and midwife and we start out on this journey, the three of us…actually, the four of us.
Our antenatal care is perfect. Carolyn comes to our home in the first few weeks, to see us through the early stages of pregnancy because we have miscarried many times. David is amazed and feels, for the first time, as though he is a part of this wondrous thing called pregnancy. Carolyn draws him in and explains everything in depth because it is one of David’s many issues with previous births – not understanding the process, feeling excluded.
We hit the magical 12 weeks and we meet the next two people who will see us through the pregnancy and birth; Cassie, who is a student midwife and Andrew, our doctor, who is an advocate of VBAC. I like them both instantly, although the meeting with Andrew is brief and scattered, I feel that he wants what I want.
Our antenatal checks become dinners and discussions. We talk about many things, including our previous births and our feelings surrounding them. I feel traumatised by both births, although very different and feel as though I have missed out on an important rite of passage. We talk about our fears and hopes and believing in ourselves. We are falling in love with Carolyn, our son and the idea of a beautiful birth.
Our morphology scan is done at 19 weeks, the sonographer tells me my dates are wrong; that our little boy is only 17 weeks gestation. I feel confused, as a veteran in trying to conceive, I know my dates and know when conception occurred. She cannot visualise the heart properly anyway, so we reschedule. By the time I return, William is measuring 21 weeks, exactly to my dates. My pregnancy resumes its low risk profile.
As a midwife, many people tell me I am crazy, that I am effectively, killing my baby in a selfish attempt to birth vaginally. I am shaken by this and retreat into my thoughts and change my place of work, to a low risk unit, with Community Midwives and gentle approaches. I try very hard to stay grounded. We have spent many hours talking with our girls, making sure they understand that birth is a normal thing. We read books together and watch birth videos. The girls are particularly captivated with a water birth DVD and wonder if William will be born that way. It is peaceful and family oriented. They take part in the antenatal visits and listen with the doppler for William’s galloping heartbeat. Everything is wonderful. My girlfriend, Anita has agreed to come to the birth also and I feel surrounded by love and people who believe in me.
William has been breech for a few weeks now and I am due to go to the hospital for the 36 week check up. Carolyn asks me to write my fears surrounding this pregnancy and birth down and to bring them to the visit. She tells me that a breech baby is often a sign of unresolved fear.
I think about this for a few days and find myself writing about my fear of males and my brothers and my father, my fear of having William taken away from me, as my other babies had been, my innate fear of cot death, my fear that I will fail and let everyone down. I take these to my visit, where I meet Val, another midwife. She is so kind, with a gentle face and asks permission to feel William’s position so that she can get to know him. David and I like her immediately and feel as though we have known her forever.Carolyn asks me to read my fears out loud to her and to Val. By the end of it, I am sweating and shaking. I have never talked about these feelings with anyone. It works though, because when I go for my next visit with Andrew, William has turned into the cephalic position, head engaged.
At the same time that I am addressing these issues I start to have dreams that William has died. Not of the baby dying but of walking away from the hospital with empty arms. I wake often, crying, feeling as though something is very wrong. I talk to David and to friends, who calm me and tell me that it is normal to have bad dreams during pregnancy but I have never had nightmares before and I feel frightened and threatened. I confront Carolyn with the dreams, which have been coming two and three times a night for a couple of weeks. We are on our way to meet Tina, an amazing woman, who has had successful VBAC after two caesareans, just like I am hoping to have. Carolyn listens and talks to me about letting go of old pathways and accepting a new way of thinking, this is how she interprets the dreams. I struggle with this but accept that it is just fear creeping in, so close to the birth.
At 38 weeks my blood pressure begins to play up. Everyone is getting anxious, especially me. There is one day when William hardly moves but I am too scared to call Carolyn; she is coming for an antenatal visit anyway, so I tell myself I will let her know then, if he is still quiet.When she arrives I tell her and she is angry with me. She feels that I have broken the trust we had between us and after asking me to calm down, talk to William and prevent the adrenalin from making him sleepy, I start to feel him move. I feel guilty and sad that I have upset the balance of things. She asks me to go to the hospital the next time I feel William is not moving as he should and so for the next few days I go in after the nightmares and reduced movement to see Val.
I feel as though my VBAC is spiralling out of my reach. I feel uncomfortable with Carolyn and spend nights questioning my need for a vaginal birth.
At 39 weeks, I start pre-labour. I niggle and tighten for a week. I am worried and scared. Carolyn has not been in contact for what seems like ages.Out of the blue she calls. I apologise profusely and talk about how I felt when I thought I had betrayed her. We talk about the pre-labour and how I am feeling about this. I have been into the hospital again. Val has told me she is going to leave my notes in delivery suite. She feels that I will be back in either this day or the next. Andrew has offered to break my waters, to which I have refused. Carolyn asks me if I am ready, if I have made peace with what is about to happen, whether I have invited William to come. She feels there is something holding me back. Again we discuss fears and address issues about my father.For the first time in a while I feel peaceful.
We have dinner with friends and joke that William is very comfortable inside and doesn’t want to come out. Not long after that, I notice my niggles are coming every seven minutes.
At midnight, I need to shower. I have had a very bad nightmare. I am in a boat with David and two year old William. He has blonde, fly away hair and big blue eyes. The water rises and I feel the drowning sensation as I dream but soon the water recedes and David and I are left in the boat, alive but William is missing.
I tell Dave, who is fast asleep and doesn’t respond. I try to go back to bed but I am so uncomfortable I am soon out again.
I go to the toilet where I find a huge clot of blood and proceed to pass two more golf ball sized ones into the toilet. I scream for David. He comes and I cry. He rings the delivery suite and we are told to come in. We ring Carolyn, my mum and my friend, who comes to mind the kids.
We arrive at the hospital at around 5am. Carolyn is already there. She calms us down, put things into perspective.Labour continues through the day and slowly everyone arrives, including Val.
The labour, for me, is beautiful. I am in the bath, eating, drinking and breathing. I am happy. I have never felt more loved than I do at this moment. The contractions come and I feel the need to make noise. Everyone is around me but I only see David. The bath can’t be hot enough. There is monitoring and observations quietly being done all the time but I am oblivious to them.
I feel pressure but things don’t progress. I am examined, to find I haven’t dilated much at all. I feel like a fraud. It’s getting close to 1pm. I lose control and express my fear; Andrew and Carolyn are around me. I am checked again, now I’m five centimetres and Andrew asks me if I want a caesarean. I shake my head, after asking if there is an indication to which he answers, ‘no’, and tell him…”I deserve a normal birth”.
They push David out the door for some lunch.People are talking to me and I answer but all I can hear is my breathing. Carolyn asks if I can visualise my cervix opening. I think about a big blue donut getting thinner.
Time gets away from me and the next thing I know my waters break. There is meconium; only light. I have this all consuming urge to push and I hear the familiar guttural sounds but they are coming from me this time.They ask me to get out of the bath and I try, I think that I am getting out but I am not moving much at all.
Where is David? Get David! There is rushing in my ears and an ache across my belly.
Now I am on the bed and I hear the familiar thump of William’s heartbeat but it is very slow. Faces are swimming around me.Andrew is suddenly in front. ‘Tiff’, he says, ‘William’s in trouble’.
All I can think is that he called me Tiff (something that my friends call me) but then I hear him call for the ventouse. ‘No’, I hear myself say, ‘not the vacuum’!
Both Carolyn and Val yell ‘Then push’! I try so hard. I see my belly move but nothing happens. The urge to push has gone and in my infinite midwifery wisdom I think it is just the latent stage, the calm before the storm.
I see the cup of the ventouse and I scream.
Andrew applies the vacuum for the first attempt. It slips away and he puts it on again. Anita’s face is in front of me and I can see David’s hand on my shoulder as white as the hospital walls, grey almost. They look panicked. Andrew gives another pull and it flies off William’s head.
I look at Anita. My blood is splashed across her face.
Andrew says something about forceps and lots of blood, before I know what is happening he gives one almighty pull and I feel William leave my body.
Anita cries, ‘he’s here’!
I see nothing except William.
He is very still.(What have I done?)
They take him away, there is no noise just people moving and William hunched into the foetal position, he looks like he is in pain to me (What have I done?)
They start CPR and I see the mask go over his face. I know it’s not good.Andrew brings me back to him. There is a lot of blood.We need to see where it’s coming from.Things are getting blurry and I think I am moved away from my baby.
I feel nothing at first but then a slow burning in my shoulder. A ruptured uterus is my worst nightmare.I know what has happened and I tell Andrew about the pain. Then there is nothing.
When I wake up I know things are bad.
Everyone is here, even my Mum.
William is not good.
Deprived of oxygen for over twenty minutes, they think.
He is fitting.
I can’t touch him or see him.
Faces are grim.
Days blur and all I hear is that I did this to him, that I should have known better.
We are given one beautiful day, when all is good but there are other problems, a major heart abnormality; critical stenosis.
Cardiac specialists, NETS, trips to Westmead but it is all too late.
William is in a coma and is going to die.
My world closes in on me.
The only person I see and hear is David.
We do all the perfunctionary things, call in the relatives and say our goodbyes.
Carolyn is there and Anita; this is very important to me.
We switch off the machine.
David carries William into the April sun to take his first and last breaths, without a ventilator.
As he walks, William’s hands turn blue and my mind says he is cold. I fuss like a mother does to cover him up, scold David for not keeping him warm. Stupid, I think, for a split second, he’s not cold, he’s shutting down.
I hear crying, I look around before I come to the understanding that it is me. People everywhere, keeping vigil, helping William’s spirit move into whatever lies beyond our world. It is horrible and beautiful all at once.
An hour goes by.
William is pronounced dead.
Slowly, everyone moves away and we leave the hospital.
I feel as though I am floating.
It is very surreal.
I want to run back and grab William, breathe life into him but I can’t. I just keep walking, wishing for the entire world that it was me who had died and not him.At home there are chocolate chip cookies that our girls (so full of life) have made. I sleep heavily, almost on top of David, and do this for the first six months, while I deal with nightmares and guilt.
Months spin by and I am barely present for any of it, then one day, I notice the trees and the spring sky. I feel the beauty and for the first time I think about William without crying.
I look outside and see the children playing in the yard.
I think my healing has started.