In his Heart a Man Plans his Course but the Lord Determines his Steps.

There are many factors in our lives that lead up to the choices we make. For me, having a home birth was influenced by my previous birth experiences. I don’t think I would ever have chosen to attempt having a baby without medical intervention if I had not gone through the process of labour and delivery before. The story therefore starts 9 years earlier.

I was a young wife of 24. My husband and I were expecting our first baby, a son. It was perfect. We had decided to name him Seth – the appointed one. We attended ante-natal classes and met Mariana, a lady who was to play a vital role in our lives. Mariana prepared us for labour, birth, parenthood. She exudes calm and confidence.

I felt the first light contractions at 3 am, a week after Seth’s due date, went to hospital at 4am without even being dilated at all. The doctor prescribed Pethidine to relax me and I slept through most of my contractions. My doctor broke my waters at 7 am when I was about 2 cm dilated and said that he would check back at 12. The contractions became stronger and by 8:45 am I felt the urge to push hard! I had to fight the natural birth process until my doctor arrived. Seth was delivered at 9:07 am on a Monday morning. An entire new person, the most overwhelming feeling!

After giving Natie a couple of uninterrupted days to bond with his firstborn, my mom arrived to help. She stayed for two weeks, just as in awe as we were with our precious baby boy.

Less than two years later, we announced that we were pregnant again. This time we expected a girl and decided to call her Amelie, which means industrious and hard-working, just like the girl in the movie. Two days before due date, again at 3 am, I started feeling light contractions on the Sunday morning of a weekend that my parents and sister were actually visiting us. Foolishly thinking that I had this covered, I told my dad and sister that they would still meet our daughter before heading back to George in the afternoon. My mom stayed to look after two-and-a-half year old Seth. Well, in the absence of Pethidine, my labour seemed not to progress at all, so when the nurse checked how far I was dilated at 12 pm, I told myself that if I were less than 5 cm, I would opt for an epidural. I was only 1 cm dilated! The anaesthetist came and hooked up everything required for the epidural. I remember thinking it was crazy for him to tell my to keep completely still as he stuck the needle in my back, while I’m having contractions! The epidural wreaked havoc with my naturally low blood pressure, and at one point it hovered at 63 over 36! It was not a good experience for me, leaving me anxious and faint. Nevertheless, at 4:09 pm Amelie was born, beautiful and healthy.

We had a boy and a girl, the perfect family. We were done. But two years later, we made an impulsive decision to try for another baby, a last one. We fell pregnant rather quickly and expected another girl. We named her Nina, loving the various meanings of her name: little girl, mother, grace, mighty. This time, I asked for Pethidine. Nina was one day overdue, but I was tired of pregnancy, and my mother had arrived a few days earlier to look after the other two, so we went in to be induced. My doctor broke my waters at 7 am that Thursday morning, and that was enough to induce labour. At 12 pm I said I wanted the Pethidine injection, and at 2 pm I was ready to push, again with no doctor in sight because of the speedy progression. My doctor arrived and after one mighty push, Nina was out. Safe and healthy, beautiful.

After the birth of each of our children, we would take them to Mariana for their immunisations. She was always excited, passionate about each one, interested to hear the birth stories and give encouragement and praise. It was after Nina’s birth that she said I would have been an ideal candidate for a home birth. Obviously in retrospect, since we were done having babies!

My mom was the perfect grandmother. She was in love with her grandchildren, and they were absolutely crazy about her. Then, when they were only 7, 4 and 1, my mom tragically died in a car accident. A loss not easily explained.

One year after my mom’s death, we discovered that we were pregnant again! When it was just a possibility, it was a scary thought, met with resistance and worry. Natie was the voice of reason, he said that if the pregnancy test was positive, then we’d be too. I was reminded of a verse that my mom had often quoted raising us: “In his heart a man plans his course, but the LORD determines his steps.” – Proverbs 16:9.

It was hard to be excited through the extreme nausea and Paarl heat, but as time wore on, I loved the baby inside of me more and more. It was during the first trimester that the thought of home birth first came up as a discussion point. Natie was cautious, but supportive. He had the mindset of “let’s see how things go”. We talked with Mariana and she was keen, as long as we were up for it. Home birth is not something she was going to push anyone into! We talked to our gynea and he was willing, knowing my history of births and having experience of Mariana’s expertise as well. I was excited, but had one condition: Pethidine! It took a whole lot of organising, but in the end my doctor was able to prescribe the Pethidine, I was able to pick it up from the hospital pharmacy and keep it with me for the big day.

Our baby turned out to be a girl, and we decided to name her Jodie, a name derived from Judah, meaning praise, as well as Joseph, meaning God will increase. She was due on August 15th. Natie joked and said that our house is so overrun with women, he was sure she would arrive on woman’s day! Sure enough, on that public holiday Tuesday, the light contractions started. We drove to Mariana’s house so that she could check whether this was the real thing and she administered the Pethidine at 8 am. We arranged for the kids to spend the day with friends and dropped them off on the way home. The ideal was that Jodie would arrive at around 12 pm, as the Pethidine would be sufficiently out of my system by then that it would not have an adverse effect on her, but just for incase there was another ampule handy as a kind of antidote. I can’t even remember the name.

We got home and I went straight to bed, feeling comfortably drugged. Natie felt the need to keep himself busy to while away these nervous hours, and started a huge pot of chicken soup. I remember sleepily thinking that the contractions were not progressing and that this might very well have been another false alarm. I felt anxious and disappointed, knowing I would not be able to get more Pethidine. Natie was in bed lying next to me when Mariana phoned to hear how things were. I remember pretending to sleep so that I could escape having to admit that I was fooled again by a false alarm. She asked if she could come over. I thought she would just come and check on me, but she stayed. She broke my waters at about 12:30 pm. The effects of the Pethidine had worn off by then. It was a wonderful intimate afternoon with me, Natie and Mariana. We chatted, we laughed, we sat in silence. We were downstairs for a while after she had just broken my waters. I remember swaying from side to side on my legs as I felt the contractions getting slightly stronger. The anxiety had left when Mariana came in. Her calm and confidence was bigger and stronger than any negative feelings. When the contractions started getting heavier, we moved upstairs as Mariana didn’t want me to be overcome with pain, unable to climb the stairs later. I moved around quite a bit, sometimes lying on the bed, sometimes kneeling next to it, at stages lying in a soothing warm bath, with Mariana gently splashing the warm water over my stomach. With each stage of labour, I would remember it from the previous times I had given birth, thinking to myself that I had forgotten how intense it gets! I remember feeling like an inquisitive, but naive child during the whole thing, not knowing the pain that was ahead.

Mariana rubbed my back and encouraged me. Natie brought me things to eat and drink. I remember not being able to eat the chicken soup or the jelly sweets on my bedside table, but wanting instead a big, refreshing glass of soda water with lemon and ice. Mariana definitely had experience with pain relief, because her back-rubbing was especially soothing. There was a stage when I was in the bath again, when I said that I could feel it was nearing the time when I would have to start pushing. Mariana asked me to just give one push so that she could determine how strong I push. I obliged and she asked me to rather get out of the bath and into the bed (I didn’t particularly want a water birth). Once back on the bed, she said that I could push if I wanted to. I hadn’t started feeling that heavy urge to push yet, but I thought I might as well push if she’s fine with it. Natie told me afterwards that he was worried that it was too early. I pushed hard and Jodie’s head crowned. Mariana asked me to stop pushing at one point to prevent me from tearing and after that I could slowly push her out with one controlled effort. That last bit burned like hell, I thought I had teared in the front, but it was just that normal burning sensation that I had forgotten about with the others. When her head was out, Mariana quickly and calmly told me to wait, as the umbilical cord was wrapped around Jodie’s neck. Natie later told me that it was wrapped around twice very tightly and that Mariana took an expert finger underneath and cut it within seconds. Jodie was the only one of my four babies that I had to actually push the shoulders out as well, she has quite broad shoulders! First the one, then the other one and she was out just after 5 pm. She gave that first scream and Mariana handed me a very blue and slippery baby. I took her. As with Seth and Amelie and Nina, that first moment when I held her was quite overwhelming. A whole new human being! Mine and Natie’s! Our blessing, our privilege, our responsibility! She didn’t want to suckle at first, refusing to even take my nipple. As the feelings of anxiety and helplessness crept up again, Mariana tricked her by giving her the dummy and then pulling it out and quickly putting in my nipple. She latched immediately and started suckling. Her APGAR score lacked the nod for ‘appearance’ because she was so blue at first, but everything else was perfect!

When we were settled and cleaned up, ready for a rest, Mariana quietly departed. Natie went to fetch the other kids and they came home to admire their beautiful new little sister.

Thinking back to that day, I am overwhelmed. It was intimate, it was relaxed, it was personal and loving. Mariana was my mother for the day and when I think about the whole Pethidine-thing, I am reminded that God had other plans as He said right in the beginning of the pregnancy with that verse in Proverbs. I feel honoured and blessed to have had a home birth experience, and cannot help but smile when other moms think I’m a rock star for doing it! I would not have done it with any other midwife, and I am glad that it was only us three who welcomed Jodie into the world, I didn’t want any strangers around during the process. I would recommend home birth for anyone who is up for it, but I would also remind them to be content with however things work out. After all, God determines our steps.

by Ilse