My First Unnecesarean

When I first became a doula I was quite naive.

Yes, I had been given all the information and statistics during my training but there was a part of me that smugly believed I could ‘save’ any birthing situation with good intentions, homeopathic remedies and aromatherapy oils.

*humble blush*

I attended my first unnecesarean very soon after becoming a doula.

I met with a young couple who were keen on a natural birth but in hospital. She had originally wanted a home water birth with midwives but he did not trust midwives and therefore they had chosen a female doctor who seemed to resonate with the young woman’s wish to birth physiologically. They had chosen (or rather, their medical aid had chosen) a hospital which was nicknamed Caesar’s Palace due to its alarmingly high c-section rate (anywhere between 80 – 100%). We went through their birthing plan, which was beautiful, and it was decided that I would join them at home in labour and that we would go through to the hospital once labour was strong and well established. They felt optimistic that with the birth preparation they had done attending an antenatal class and with the support of their doctor and myself, their birth plan would be successful.

Simple right?

They called me one early morning to tell me that  her waters had broken and that the doctor had told them to come in to hospital as she needed monitoring. They would keep in touch with me. Luckily for her, her contractions started soon after her waters had broken and when I arrived at the hospital, she was already contracting regularly. I was taken aback by what I saw though, she was in a hospital gown (her birthing plan had explicitly expressed that she labour in her own clothes) and she was attached to a drip which was administering antibiotics (to ward off infection now that the waters have broken, I was told). Despite these obvious discomforts, this young woman used the breathing techniques she had learned and practiced in her antenatal classes and walked about the room, pushing the drip stand around as she laboured. At least she was not continuously strapped to a foetal heart monitor, but she did have to lie down every hour for twenty minutes or so to be monitored which was extremely uncomfortable for her. At one point a doctor came in to examine her. It was not the doctor she had built a relationship with, her doctor was unavailable and  this new doctor  (all in black and wearing a pearl necklace) would be taking care of her. My client tried to hide her disappointment and muttered that at least the new doctor was female. The new doctor examined her patient and declared that my client was already 4cm. The doctor congratulated my client on her progress and said she would be back in a few hours to check on my client again. We were pleased and for the next four hours, as the contractions grew stronger, the young woman continued to use her breathing techniques, and walked about the room listening to the music she had so carefully chosen for this special event. I rubbed her back and chatted to her husband who was sweetly supportive. A nurse came in every half hour or so and monitored the baby’s heart rate, checked her blood pressure and took her temperature and pulse. Labour seemed to be progressing, we were feeling positive. At one point I excused myself and went to the en suite loo. I heard the doctor coming in and when I came out of the bathroom and I was washing my hands, I could hear that she had already performed the vaginal exam. As I lathered my hands with soap I heard her say to my client,

“You are only six cm, this labour is not progressing, we will have to do a caesar before your baby goes into distress.”

I could not believe what I was hearing, my ears did the equivalent of a double take. I was frozen to the spot, the water from the tap pouring over my hands.

” I’m just going to get my little team together and I’ll see you in theatre,” the doctor quipped and she swanned out of the room.

I rushed to my client’s side. She was in shock and confused. I told her that she did not need to consent to a caesar at this point. That she was doing well and so was her baby. That she could ask for more time. But her husband put up his hand and said that they had discussed the possibility of this scenario already during the pregnancy and had decided then already that if the doctor felt a caesar was necessary then they would go along with the doctor’s recommendations. So before I knew it, I was in a green gown in theatre, holding my client’s hand and by 7pm she was snuggled up in bed looking dazed and her husband was holding their baby looking happy and in love.

The rest of us could all go home.

I still think it is interesting that the doctor decided to caesar just before 5pm.