“So, no more children then,” remarked my husband, sat across from my hospital bed on the high dependency unit. “I guess not.” was about the most I could muster in response, as oxygen flowed into my nasal passage from a tube and cannulas sprouted from each hand. These were practically the first words we said to each other after our first child’s birth back in 2015.
I’d recently woken up from a general anaesthetic following emergency surgery to stem a life-threatening bleed. Our new baby was doing well, but he was being looked after by my parents in some distant room in the hospital. I was delirious with fear and terrified of falling asleep. Not surprising really, since the last time I’d slipped into unconsciousness a kind anaesthetist held my hand, yet couldn’t promise me I’d survive.
It took months to move on from what we’d experienced that April Fool’s morning. And, for a long time, we were convinced our son would be an only child to protect ourselves from the possibility of such a terrifying ordeal again.
But the subject of future children came up around a year later. We’d arranged a meeting with the consultant obstetrician who’d overseen my emergency care for a ‘debrief’ session to help us unravel what had happened:
“In light of your traumatic experience we’d be able to offer you an elective c-section next time — if that’s the route you’d like to take.”
Her words took me by surprise. I’d never even considered that an elective c-section could be an option. It made up my mind instantly. There would be another baby — or at least we could try. And, this time, the birth would be different. We’d have more control, know what was happening and, above everything, we’d have the positive birth we missed out on before.
Yet, since my traumatic experience, the phrase ‘positive birth’ really…irked me (of-course, I now understand that the word I was searching for is ‘triggered’ — though at the time I had no idea I was suffering from PTSD). In the months following our son’s arrival, if I read or saw anything about how to prepare for a ‘positive birth experience’, I’d get uncharacteristically angry and upset.
I felt it was borderline irresponsible to tell women they were in control of what would happen. The way I interpreted it — via the lens of my trauma — it was as if I was being told that my near-death experience had been my fault. I had to constantly remind myself that, regardless of all I’d done to mentally and physically prepare, my rare and undetected form of placenta accreta — when the placenta embeds too deeply into the lining of the uterus despite no risk factors — meant that an intervention-free birth was always going to be a medical impossibility. In truth, the fact that I’d survived, and with my womb intact, was as positive an outcome as anyone could’ve hoped for.
Fast forward a year and a half and I’m pregnant. And the niggles of fear are beginning to creep in. But — as I kept telling myself — it was all fine, because I had my elective c-section signed off in writing.
What I hadn’t realised was that, even if a consultant at one hospital approves a c-section in advance, it doesn’t mean a consultant at another hospital will also agree to it.
A few months into my pregnancy, off I trundled to my new hospital, clutching my c-section letter. The fact that I’d gone to this appointment alone, without my partner for support, says a lot about how unprepared I was for what was to follow. I fully expected everything to be signed off within the hour so I could crack on with the rest of the pregnancy worry-free.
Instead, I stumbled out of that appointment in a teary daze, the word “shame” reverberating through my mind:
“It would be such a shame for you to have a c-section.”
Those were the midwife’s exact words. And as soon as she said it, all of my suppressed fears and anxieties rushed to the surface. In that instant I realised I hadn’t successfully overcome my trauma after all, I’d merely cloaked it; from myself and the rest of the world.
As she reeled off statistics about c-section risks and inductions and midwife-led units, all I could feel was terror. I could almost hear the emergency alarm blaring and see the people everywhere, shouting about needing o-negative blood NOW NOW NOW when they couldn’t confirm my blood type.
I could remember the pain.
It was going to happen all over again. And this time I wouldn’t survive.
I was so angry at the midwife for making me feel like this. Surely she understood how traumatic my previous birth had been?
With the benefit of hindsight, I can see how my smiling face and inane chitchat as I strolled into the meeting room that day — as is my natural disposition when I meet new people — didn’t tally with what she read in the letter. So, in her mind, she needed to see my trauma for herself to justify an NHS c-section. And blimey, she saw it. Because I dissolved in that room.
As I sobbed and struggled for breath, she began to write her notes in my pregnancy book. And when she read aloud what she’d written — including the phrase “she clearly displays secondary tokophobia” (which means a pathological fear of childbirth following a previous birth experience) I realised that a c-section was still a possibility. But she wanted me to have counselling and at least consider a natural birth. In short, she was asking me to earn it.
So I resolved to do so. But I was going to need help. I found it from a number of sources: from the NHS counsellor I was referred to. From the excellent, shame-free book ‘Your No Guilt Pregnancy Plan’ by Rebecca Schiller. And, crucially, from the local doula I found. Not once did Zara question our decision to have an elective c-section. Instead, she helped both my husband and I find the strength to embrace our choice and prepare for it — positively.
For me in particular, it was about shifting my mindset from relentlessly imagining everything that could go wrong to allowing myself to think about what it would be like if nothing at all went wrong. I started to visualise what my ideal birth would be like, and it felt like a foreign luxury. How I’d be treated by the medical team, how I’d feel when I held my daughter for the first time and how I’d treasure those first few hours together.
These positive thoughts didn’t stop the negative ones, but they made a dent in the din. My CBT helped me to realise that, to help lessen my worrying about things beyond my control, I needed to focus on what was within my control. And it turned out that a lot was.
“What if I go into labour early and can’t get to the hospital in time for the c-section?” So I contacted my nearest hospital and they went out of their way to help me develop a contingency plan.
“What if they can’t figure out my blood type again?” So I asked to meet with a consultant anaesthetist in advance and put my blood type in big, bold letters on my birth plan.
My birth plan itself was a revelation. Instead of ticking a few boxes on an NHS form, as I’d done with my first pregnancy, I used the guidance in the aforementioned book to write a concise yet personal account of my history. The document clearly detailed mine and my husband’s wishes and made it clear what support we’d need and why. The relief when I got all of this out of my head and onto one A4 page was immense.
Any insecurities I had about coming across as neurotic or over-prepared with such a detailed birth plan were quashed when every single health professional who read it expressed their delight at having all the information they needed to hand.
I’d done everything I could. I was ready.
Our daughter’s birth coincided with the end of summer 2018’s sweltering heatwave. Much like the first drops of rain that cut through weeks of inescapable heat, her arrival — which went without a hitch — released a torrent of relief. But that experience didn’t happen because we’d prepared for it. It happened because, this time, there were no unforeseen complications.
What we had achieved, however, was to establish positive mindsets which helped us to experience the pregnancy itself differently. So when the time came to welcome our daughter into the world, we were in best possible place to receive her.
My c-section helped me to finally understand that a positive birth doesn’t have to mean a natural birth without intervention, it means having your choices respected and listened to. It means feeling empowered to have trust in yourself and, in turn, in others.
But the sad truth is that, all too often, we — women — have to work to make this happen. Indeed, my final pregnancy (and there’ll never be any more babies — we’re done) often felt like a full-time job. The counselling, the research, the meetings, the admin of it all — it took so much time and effort.
And I know that if I’d been even slightly less sure of myself, or without such a strong support network around me (some of which we paid for, because of our privilege), it would have been all-too-easy to have ceded to that senior midwife’s pressure. To have given in to the inevitability of a pregnancy full of panic attacks and nightmares. To have absorbed the word “shame” and allowed the echo of my previous trauma to reverberate even further into our futures.
Our c-section was exactly what we needed. But the amount we had to invest in order to make it happen is symptomatic of our wonderful yet overstretched NHS.
An hour or so after the c-section we had a surprise visitor: the midwife who’d floored me so entirely whilst pregnant.
“Happy?” She asked, in a curt tone which I’d come to recognise as her natural manner.
It would’ve been impossible to choose just one word to describe how I felt in that moment. Calm. Proud. Relieved. Strong. Absolutely flooded with love.
And yes, so very happy.
After another minute or so of brusque chitchat, off she went to continue her rounds. To help the countless other women facing their own personal battles that day. Doing her job, within the confines of the limited resources available to her, and under her own unique pressures. I may not ever agree with her methods, but I did eventually find the courage to understand them.
Because, otherwise, would I have ever put in those hours to heal what had been broken? Maybe. But it would’ve taken another event or word for the true extent of my buried anguish to have unveiled itself to me.
Having both our children were battles in very different ways. After my son was born I battled to survive. And before my daughter was born I battled to be heard.
But we did survive and, eventually, we were heard. We are so, so thankful for everyone who saved us, and listened.