I chose to have a home birth for a number of reasons, the first being that I wanted the experience to be as organic as possible. The research I did explained that the hormone responsible for the progression of labour, oxytocin, also known as the ‘love hormone’, is the same hormone that is released when you experience an orgasm. It is a ‘shy’ hormone and is only released when the labouring woman feels most comfortable, safe and secure e.g. at home in familiar surroundings. It is believed that when the labouring woman feels threatened, anxious and/or fearful this stops the release of oxytocin and halts the progress of labour. I am an introvert and felt the potential threat to the progress of my labour, by unfamiliar surroundings and strangers in my personal space, to be a very real one.
I did not want to birth my baby into the artificially lit, cold, clinical confines of a hospital ward, in a building housing sick and suffering people. I believe that the act of birthing a baby is a natural physiological process, that the body is intrinsically equipped for and that it is not a medical condition. I also did not want my brand new baby to be handled roughly by birth attendants who did not view the process as spiritual but merely as routine.
I was also alarmed by the fact that the overwhelming majority of, otherwise healthy, young women I knew, were having their babies delivered by Caesarean section and not by choice. This made me very sceptical of the mainstream medical fraternity’s motivation for performing C-sections. I was afraid of possibly having to undergo major abdominal surgery because performing a C-section made more financial sense or because my labour was taking ‘too long’ to progress. I did not want to feel disempowered by having my right to choose encumbered.
Another motivating factor was the experience I had with my first pregnancy, which ended in a retained miscarriage in March 2014. My gynae, at the time, gave me pain medication and medication to dilate my cervix on the Friday afternoon and instructed me to administer it on the Sunday but did not properly explain what would happen between then and the Monday morning, when the evacuation procedure was scheduled. It was very painful and traumatising for my husband, Ya’eesh and me, but that was just the first personal let down. It was followed by the poor treatment we received post-op, in the recovery room. Ya’eesh had just gotten into the bed with me in a private ward, to hold and console me, when a nurse came in and told him to get out of the bed, as it was not allowed. That, for me, was the final nail in the coffin, for a hospital birth.
So when we found out that we were pregnant again, in January this year, I started doing research on the local homebirthing industry, birthing centres and MOU’s. I searched the web for information on local homebirths and found the site homebirth.org.za, which had a directory listing midwives, doulas, birthing centres and antenatal classes. I read the local homebirth stories on the site. I joined local pregnancy and motherhood groups on facebook and subscribed to pages, blogs and email newsletters. I downloaded a pregnancy app to my phone. I read books, pamphlets and magazines on pregnancy, birth and motherhood, as well as many online articles. I recommend reading The Needs of a Woman in Labour by Ruth Ehrhardt and The Womanly Art of Breastfeeding by La Leche League.
It was through an online article that I discovered the concept of lotus birthing, where the placenta remains attached to the baby until the umbilical cord dries and detaches naturally, usually within 3 to 5 days. There are many health benefits associated with delaying cord clamping to allow the transfusion of blood from the placenta to the baby, to complete.
It also tied in with the theory of birth without violence, where it is believed that our birth affects the rest of our lives and I wanted the birth experience to be as gentle, welcoming and reassuring for our baby as possible and therefore, the decision for my husband to catch him was also a natural one. If we could and hadn’t needed the reassurance of experienced birth attendants, with this being our first baby, we would have chosen to do an unassisted birth, as the baby was conceived with just the two of us and the birth was the culmination of that intensely private process.
When I broke the news to my family that we wanted a home birth, it was met with much resistance and judgment. They were concerned for mine and the baby’s safety, believing that hospitals were the safest places to birth. I initially succumbed to the pressure and booked with the local government MOU, where I went for most of my checkups. Every time I attended an appointment, a different midwife would perform my checkup. It felt very impersonal. With the large volumes of women attending, it would take most of the day and we would be herded through the hallways, to the various rooms, like cattle.
It was only during the latter part of my second trimester, as fate would have it, that I connected with Lana Petersen, one of the founders of Home Birth South Africa. I was a student teacher in her youngest daughter’s Montessori pre-school class and we had celebrated a classmate’s birthday. Her parents had been invited to share special moments from her birth and each year of her life to date, and her mother had mentioned that her birth was attended only by midwives and no doctors. It was then that Lana’s daughter mentioned that her mother is a doula. That same Thursday afternoon I took the opportunity to speak with Lana and she invited me and my husband to a home birth gathering that Sunday.
We attended the gathering and got to meet midwives, doulas and couples interested in or having had homebirths, who shared knowledge and experience and assuaged concerns. We got to watch a most amazing video of a home waterbirth, which was so beautiful and serene and moved me to tears. It was wonderful to be surrounded by like-minded people and not feel judged for our choices. The whole experience was very affirming and at the end of it, we decided to have Lana oversee our homebirth with Sr. Lydia Du Toit as her mentor. This choice felt natural, as I was keen to build a relationship with my birth attendants, to help me feel more secure during the labour process. This was accomplished through visiting Lana at home for my checkups, with my husband joining me for most of them and later having her conduct home visits with us, for checkups. I also went to Sr. Lydia for a few checkups.
We also discovered that we needed to have a medical facility as a backup, in case there were any complications, so having booked at the MOU was not in vain. We needed to get the green light for a home birth from the resident Ob/Gyn at the MOU, as well, which we got, as I was low risk and my vitals had been normal for the duration of the pregnancy. I believe that I maintained healthy vitals through watching my diet and not indulging excessively in the sweet things, I craved so much. I also swam regularly and went for walks in the forest with my husband and when I needed to, in the last month before I gave birth, I rested as much as I needed to.
In preparation for the birth, Ya’eesh and I attended a hypnobirthing antenatal workshop, entitled “Relax into Birth”, that dealt with the physical, mental and emotional aspects of labour and birth and provided us with useful information and coping mechanisms. I also attended a Johnson’s Baby Sense seminar with my Mom, which softened her up to the idea of homebirthing and meant that I had greater support from her.
With all the information I had gathered and with the support structure I had, I felt confident that I would be able to get through labour and birth my baby. I felt like I had a high enough pain threshold, having been very active and participated in endurance sport, having done lengthy swim sessions both in training with the Marine Unit at Law Enforcement and having run many half-marathons and a full marathon.
My estimated due date, according to the first day of my last menstrual period, was the 27 September but according to the ultrasound it was the 6 October. Sunday, 27 September came and went with no real signs of labour, except the painless Braxton-Hicks contractions that I had been feeling for the last month and the waiting game was nerve-wracking. Then Saturday night, 3 October, after Ya’eesh had gone to sleep, at close to midnight I started feeling painful contractions that were around 15 minutes apart and lasted the whole night. I was able to quietly get through the contractions by practising a breathing technique and expanding my belly to give my uterus the space it needed to do its job. At 3 am, Sunday 4 October, I felt a small bubble pop and my underwear was wet with blood-tinged liquid, which Lana later confirmed was a hind water leak and that I thought was my water breaking. I woke Ya’eesh up at that point and we covered the mattress with plastic sheets and linen savers, just in case.
By 7 am, when the sun was out, the pains subsided. I managed to sleep for 2 hours. Lana suggested that I go for a walk in nature to get things going again. I felt tired from the night’s exertions and only managed to bounce on the birthing ball for a while around 11 am. By 5 pm I mustered the energy to pull out my stepper and stepped for 40 minutes and danced for another 20 minutes. I worked up a serious sweat and had some fun in the process, felt a bit silly gyrating with my huge belly! It helped though because I had painful contractions that kept me out of sleep the whole of Sunday evening. I managed to breath through them.
When Lana came to checkup on me at 9:15am, Monday 5 October, she felt that I was 4cm dilated. The contractions had subsided again by the time the sun was out. It seemed my contractions were light sensitive till they got going again late Monday morning. I let my mom know and she got home just after midday and helped me by massaging my tummy and rubbing my back through my contractions. I had to get up and walk to get through them. They were quite painful and I kept Lana in the loop about their frequency which averaged about 9 minutes apart until 5:30pm when they spaced out to about 15 minutes apart again. Lana explained that my body could only do little bits at a time. Ya’eesh was home by then and he took over monitoring me and rubbing my back. By about 7pm they were down to 7 minutes apart again and by 8:30pm to 4minutes apart. The pains would start at my lower back and increase in intensity and move like a wave round the front and up my belly. I had to empty my bowels regularly since the previous night and the contractions would intensify while I was on the toilet.
Lana arrived at 9:30 pm to me pacing the room with each contraction. When she checked I had only dilated another centimetre. She got Ya’eesh to light candles and place them all around the room and bathroom. I started to seriously fatigue around midnight and started rocking back and forth in the chair in my room. I told her that I wasn’t sure if it was the fatigue or the pain intensifying or a bit of both, but my resistance was fading fast. She suggested that I get into the bath. She ran a hot bath and I transferred to it while she sat on the birthing ball next to me and poured jugs of water over my abdomen with each contraction and put pressure on my lower back. In between contractions, she would wipe my forehead and the back of my neck with a cold cloth. Ya’eesh made tea for the two of them and brought me a glass with cold orange rehydrate that I sipped through a long, bendy straw.
The night seemed to draw on forever with the pain intensifying and my back feeling like it was breaking and my tummy feeling like it was on fire, with each contraction. By 2 am I started wailing, tearless, high pitched wails, while still rocking back and forth like a patient in a mental asylum, anticipating and dreading each contraction. I was doing the exact thing I was taught not to do. I started feeling fear and anxiety and it only increased my pain. Lana coached me to make low, guttural sounds, but it was of no use. I was too far gone and started begging to be taken to the hospital because I needed the pain to be numbed.
She suggested that I get out of the bath and try to rest on the bed but every time I tried to recline on my side it would trigger the most excruciating pains, so much so that I threw up the foamy orange rehydrate and started panicking even more. She tried to reassure me that it was normal for the body to purge. I started shaking and shivering uncontrollably and then she suggested I get back into the bath. I was so fearful of the pain at that point that Ya’eesh got into the bath with me to try and reassure me and put pressure on my back to try and lessen the pain. Another couple of hours of pure torture passed and I started to feel pressure in my rectal area and then felt a bubble pop, this time it was my waters that broke. I think the thought that things were finally progressing, reassured me somewhat and gave me new reserves of strength.
Lana had made contact with Lydia, who arrived shortly, at just after 5 am, Tuesday 6 October. They both checked the bath water with torches and confirmed that my waters had broken. Lydia then requested that I get out of the bath so she could check me. She then started coaching me to push, while I held onto Ya’eesh for dear life, first laying on the bed then squatting on the floor being supported under both my arms. She told me to push like I was sitting on the toilet. I was repeating that I couldn’t do it and squirming through the pain. She spoke with authority and demanded my attention and explained to me what it was she needed me to do and how she needed me to do it. I obliged and started feeling my baby move into the birth canal and started feeling the urge to bear down spontaneously which happened simultaneously me making a low guttural sound.
Lana had let Leah, the photographer, know that labour was well underway and she arrived around 6 am, I think. Lana had put us in touch with Leah, a few weeks prior and we had met personally on one occasion to discuss expectations for the birth photography, for which she wanted to build up a portfolio. Ya’eesh and I had agreed that we were willing to allow her into our birthing space as we would love for the momentous occasion, of the birth of our first born, to be documented. After meeting with her and getting to know a bit more about her, we were reassured of our decision.
She arrived, greeted and quietly slipped into the room. I was feeling quite drained again by that time, but my body was taking breaks to allow me to recuperate between pushing. I remember someone telling me that my baby has dark hair. I think Lydia asked me if it would be ok for Leah to take pictures of the baby crowning and at that point I was really ok with anything.
I remember Lydia coaching me on how to push again, saying, “I’m going to talk to you loudly and you can hit me afterwards but I need you to do as I say”. She got Ya’eesh to sit on the edge of the bed and had me face him and squat. I pushed that way for a few minutes and felt the baby’s head descend further down the birth canal. It felt like I had a huge poo and I exclaimed as much! Then she asked me to turn around with my back towards him while she and Lana supported me under my arms. I gave a few more long, hard pushes and felt an intense burning sensation as I pushed his head out. Someone told me to feel my baby. I reached in between my legs and felt his head, which felt unusually soft and squishy. I heard him make a sound too. Then a few more pushes and his body followed quite quickly. I remember hearing, “Quickly, the baby’s coming!”Ya’eesh caught him and I heard him crying then I got told that he would be passed through my legs.
The moment I saw him I was overcome with emotion and laughed and cried and kissed him at the same time. It felt as if everything disappeared for that second and it was just us. He was covered in slimy blood and I was kneeling in a puddle of blood and goo, but none of that mattered. I looked over at Ya’eesh who was crying and kissed him and looked up and saw my mom, who it seemed, had appeared out of nowhere and she was crying too. It was a beautiful and emotional moment and it made the pain disappear in an instant and breathed new life into me.
We three were then ushered back to the bathtub, where we rinsed and I asked bewildered with a baby in my arms, “So what do I do now?!” and Lana showed me how to put him to my breast and it was so amazing that he, the brand new little person, knew exactly what to do and latched immediately and started suckling. A few more slight contractions and then out popped the placenta. I had to get a few stitches for the superficial tearing that I experienced.
I am totally satisfied with the whole experience and believe it couldn’t have happened any other way. I got my natural home birth, with the support of two phenomenal, experienced women, whom I could not have done it without and my husband got to support me and catch our baby and my mom got to see her grandson as soon as he was born and this amazing event was documented for us to share with our beautiful boy one day.
by Shakirah Allie
Photographs by Leah Hawker