A labour of love

A labour of love: Jack Anthony Cyril Kelly
(written in early December)

It has been nine months since I gave birth to our son, Jack. Just as he took
nine months in my belly to form and become fully grown, ready to enter the
world as a newborn, it has taken me these nine months to grow into being a
mother, and this daily process of slow unfolding and developing continues.

As a new member of the motherhood club, a club that has its own
vocabulary, inside jokes and common understanding, I have noticed that many
members tend to gloss over their birth experience. In what I’ve come to know as
the style of conversation that mothers have, one that happens in fragments,
fits and starts, in between rocking babies, feeding, changing nappies, burping,
playing with and distracting their children, the women I’ve spoken with tend to
paint their story with quick brush strokes and conclude with, ‘But at least my
child is fine’.

I haven’t been able or willing to gloss similarly over what this
experience has meant for me. I think our birth experiences are important
milestones in our lives as women, and probably one of the strongest physical,
spiritual, emotional and mental experiences we will ever have.

I have often found myself reliving the events, replaying the process in
my mind and wondering whether I could have or should have done anything
differently. For the most part of these nine months since my son was born, my
birth experience has sat like a hastily swallowed over-spiced meal in my belly,
a solid uncomfortable lump. I’ve needed to chew it over, to work to digest it
and absorb it in all its lumpy fullness, because I feel that it holds nutrients
and richness which I want to claim for myself as a woman, a mother, a
writer.

So this story is my way of digesting this experience, rolling it around
in my mouth until finally it can settle within me as a precious part of who I
am now.

A home birth

From the early months of my pregnancy, Joel and I had decided that we
were keen to have a home birth. Birthing is a natural process that women have
been doing for centuries, and if all was well medically with the pregnancy, and
I was healthy, we could see no strong reasons for having to be in a hospital
setting in which the woman in labour is treated as a patient – with all the
possible medical interventions that entails – rather than someone who simply
needs to be supported in doing what comes naturally.

As the weeks passed and my belly grew and ripened, I felt a sense of
relief and comfort at the thought of giving birth in our home. ‘You’re very
brave’ was often the comment passed when we told people that we were planning
to have a home birth. Yet, rather than a choice of courage, it felt like a
nurturing, cosy option.

When we went to the gynae for our 24-week developmental scan, she questioned
us about our home birth choice, as I was an older mother, (42-years old) and in
her words, ‘Personally, I wouldn’t take the risk.’ Joel and I discussed this
when we had left her consulting rooms. We still felt strongly about choosing a
home birth and believed that we had the necessary back-up plans in place should
things not go as we were hoping.

In preparation for our home birth, I read a pile of books on birthing
and home births, talked to many different mothers and did hours of internet
research. We attended two birthing preparation workshops and obviously had
regular consultations with our midwife. As a result of our research, our
midwife’s advice and my conversations with other mothers, we decided to get a
doula (a childbirth assistant) to support Joel and I on the day of my labour,
and we booked a birth pool.

We also prepared for Plan B: if there were any difficulties with the
birth or any foetal distress whatsoever, we would go to the Active Birthing
Unit at Mowbray Maternity Hospital. And as a last resort, Plan C would be to
move next door to the labour ward should an emergency C-section be necessary.

On the night before our son was born (one day after his due date), as I
was stepping clumsily into my pyjama pants and preparing to ease my bloated
belly between the sheets, I noticed a dragonfly-like insect perched on the
shade of my bedside lamp. I wondered whether it was a sign and pictured myself
telling our child about the strange creature that came to visit on the night he
/ she came into our world. At that stage, we didn’t know the gender of the
little life that had been growing inside me.

That morning, around 3, I woke up with contractions and woke Joel. I
said in as understated a way as I could, ‘I’m having some contractions but I’m
not sure if they’re Braxton Hicks or not.’ We’d had a false alarm a few nights
before so I didn’t want to cry wolf too soon.

Joel went downstairs to get his notebook and I lay and waited for him to
come back, feeling quite important, excited and scared at the same time. He
began noting each contraction, using his cell phone to time them, and stressing
me out by asking 'How long did that one last? Has this one ended yet?' At that
stage, they still felt like the Braxton Hicks contractions I’d had a few days
before. They'd fade quite subtly so it was difficult to say exactly when one
ended and the next began. Joel wanted to call the midwife straight away but I
wanted to wait till I was sure they were the real thing. So we compromised and
agreed to call her in an hour if the contractions became stronger and more
regular.

By this stage, we'd gone downstairs, switched lights on in our sleepy
lounge and Joel had got the kettle boiling for coffee. There was expectation
and quiet excitement in the air. Now each contraction began to feel unmistakably
real and I slowly let go of the small hope that it was just another false alarm.
I finally agreed to call the midwife. She answered sleepily and I remember
saying politely, “Hi it’s Cathy, how are you?” as though I was just calling for
a chat. She didn’t answer me but asked how I was. She listened for a bit then
told us to keep monitoring the contractions and to call her again in an hour.

My body began to shiver so I curled up on the couch with a blanket but
each time a contraction came, I felt the need to stand and move around, to let
it move through me, so I soon shrugged off the blanket. As each contraction
squeezed its grip on my body, I breathed into it. Each breath brought me more
into my body and into the present moment.
A little later I rushed to the bathroom and vomited. I could feel that
my body was preparing itself for something big. I had the impression of getting
strapped into a rollercoaster as I mentally gripped the sides of the carriage
and gathered myself for that first ka-klunk
when the engine started up.

The midwife came round at about 6:30am to check my blood pressure and to
see how much I’d dilated. She seemed pleased with my progress and I took
courage from this, telling myself it was going well so far. She left and said
she’d be back just after eight, as she had to drop her kids off at school. She
advised us to call the doula.

Joel began filling up the birth pool. Because I’d just had a shower
before coming downstairs, it took a while for the hot water to fill up. I began
to feel helplessly impatient, as the contractions were getting stronger and I
was hoping for some relief. Finally the birth pool was full enough for me to
get in. I took off my tracksuit pants and stepped into the warm circle of
water. All I was wearing was my bikini top. There was a brief moment of
delicate indecision about whether I should take off my underpants but then I
thought of all the birth videos I’d watched with women completely in the buff
and I stepped out of them with a feeling of reckless daring.

I felt flooded with gratitude that we’d decided to use a birth pool,
because the warm water took the edge off my contractions, which had started to
feel unmanageably intense. I sat in the pool, feeling sweat begin to bead on my
forehead, and wondered how I would’ve managed without the pool.

At around 7 the doorbell rang and the doula arrived. We hadn’t called
her ourselves so the midwife must have. I remember feeling a twinge of
disappointment that she’d arrived so early, as I was enjoying the quiet close
unit that Joel and I were creating. She walked into our house and I said hello
(ever the polite one!) from where I sat in the birth pool. She replied with a
quiet smile and went to sit in the leather armchair in our lounge. I was facing
the wall on one side of the birth pool and had my back to the lounge. There was
a beat or two of silence and then a polite attempt from Joel to make some small
talk. This made me smile to myself, and I could hear from her quiet monosyllabic
responses that she was trying to discourage this. Then a long silence. I turned
my head around to see what she and Joel were doing. She was sitting on the big
leather armchair with her eyes closed and Joel was sitting on the couch sipping
coffee. I assumed that she was possibly centring, tuning in with us and what we
needed.

Then the next contraction began and I called Joel to come and hold my
hand.

The midwife came back around eight with all her equipment. She brought a
breeze of competence and a feeling of ‘let’s get down to business’ with her.
She asked me to go and wee so that she could check my urine, then she took my
blood pressure and did a vaginal check while I was back in the birth pool. She said
I was dilating well, and I felt a rush of pride and relief at her words. I
could feel that I was going with the flow of my body, and through my breath,
surrendering to each contraction and letting each lead my body to where it
needed to go. As each contraction laid its grip on my body, and as I breathed
deeply into the bone-moving strength of it, I could feel myself turning more
and more inward, becoming more dreamlike. I felt fully in my body and committed
to the process – there were a few jagged edges of fear at the intensity of it
but I would breathe and dive deeper than the fear.

There was a part of my rational brain that was still switched on, and
it’s this part that occasionally made sardonic comments to myself, and thought
of witty things to say to the others in the room. I chose not to verbalise
these (they probably weren’t that funny anyway!) as the two birthing workshops
we’d attended stressed the importance of not talking, of rather staying with
the wordless physicality of one’s body. Between each contraction I watched the
midwife and the doula to see what they were doing. I thought of asking what the
time was then quickly discarded that idea and likened it to being stuck on a
plane in economy class on a long flight and realising that clock-watching was
only going to make me feel more desperate and uncomfortable.

At 9am the midwife came to check me in the birth pool again and used her
Doppler to check the baby’s heartbeat. She listened intently for a while then
said calmly that there seemed to be some foetal heartbeat distress. She said
we’d give it another 30 minutes before checking the heartbeat again and added
that we might need to go to Mowbray. My heart sank and I wondered how I'd
manage contractions while sitting in the car, but I stayed silent because I was
willing to do whatever it took to get the baby out safely. Thirty minutes
later, the baby’s heartbeat had calmed down. The midwife said she wasn’t sure
why there had been distress and the doula said it could have been the warmth of
the birth pool. I felt a rush of grateful relief that the baby’s distress
seemed to have passed.

Though I'd stocked up with little fruit juice packs and healthy energy
food beforehand and Joel was standing by to feed me, I didn't once think of
food - which is very unusual for me. I asked Joel for a glass of water, which
he brought and put on the floor beside the pool and which was difficult for me
to reach. The doula brought a small stool and put the glass on top of it so
that I could easily get to it. She rubbed some sweet smelling oil into her hands
and massaged my neck and shoulders. A bit later she went to get a towel and
suggested that Joel mop my forehead, as I was sweating a lot from the exertion
and the warmth of the birth pool. I remember the lovely relief this cool towel
offered.

Every time a contraction began to build, part of me swore to myself
'I'll never do this again'. Having watched birth stories on TV since then, it
seems many women either wail 'I don't want to do this anymore' or we promise
ourselves we'll never do it again. Perhaps this is our mind's way of attempting
some degree of (illusory) control over this huge shift of earthquake-like
proportions that erupts in our bodies and sweeps us along into a space where we
have to call on our deepest strength and will.

As my labour progressed, I was in a dreamlike space, where I faced
inward and surrendered to what was going on inside me, yet I was also aware of
Joel’s comforting presence, the midwife and the doula around me, their
occasional comments etc. The voices of the three of them (when they spoke,
which was rare) felt far away. I had a similar feeling to drifting off to sleep
while watching TV, when the wakeful world around becomes fuzzy and distanced.

At one stage, the midwife put the kettle on to boil and asked me where
the rooibos tea was. I was in a deep non-verbal zone and had to make a
superhuman effort to locate the tea container in my mind and express verbally
where she could find it.

Having Joel there and squeezing his hand every time a contraction came
felt absolutely essential to me. I think I endured one contraction without him,
while he'd rushed off to the bathroom. I couldn’t wait for him to get back. When
he did, he gave me his hand once more to squeeze but the grip felt different
and 'off' so I wriggled my fingers and changed the grip till it felt just
right. This felt almost like a superstitious need to have everything just the
same as for the previous contraction. As the contraction began to build, I’d
grip the side of the birth pool with one hand and reach for Joel’s hand with
the other. I felt that my survival through each contraction was dependent on
having his warm strong hand to squeeze, and his familiar silent presence at the
edge of the birth pool. This helped me not to feel so alone with the intensity of
what was happening in my body.

Some time later the midwife said she was going to try to break my
waters. She came to me in the birth pool with a long pointed instrument and
inserted it inside me to try to nick open the amniotic sac. I felt a slight discomfort,
a pricking sensation but then she took her arm out of the water and said she
wasn’t able to do it because the baby’s head was too close to the surface of
the sac.

A while later, the midwife checked me again and said in a decisive tone,
‘It’s time to push now, Cathy. The next time you feel a contraction, give a
good long push.’

As I began to push, she explained the kind of pushing I needed to be
doing: long and strong and lasting. I gave each push my all but often ran out
of strength towards the end. I felt from the beginning of the pushing stage
that she was communicating to me that somehow I wasn’t getting it right. After
what felt like hours of pushing with all my might, the midwife said in a stern
voice, ‘You’re resisting it Cathy. The next time the urge comes, just go with
it.’

I couldn’t find where in myself I was resisting the urges to push. I
felt that as each urge arose, like the swell of a wave, I rode it for as long
as I could.

What I understand now, as I look back, is that my body was still
ripening, I was still at the beginning stages of the pushing phase and that the
midwife’s instructions were not useful. I believe that I would have responded
better to encouragement. The last two surges I felt were bigger than me, and
that’s when the process turned a corner. The readiness is all...

Afterwards, the midwife said that I struggled so much during the pushing
stage because my pelvis was narrow and Jack’s head was unusually big, which
helped me to feel better as it made it a simple case of measurements.

With each push, I began to suffer from excruciating lower back pain. It
felt like my pelvic girdle had developed blades and was cutting through the
muscles and skin of my lower back. As each contraction began, I asked the doula
to rub my lower back.

Then the midwife said I needed to get out of the pool to be able to push
more effectively. She invited me to stand outside of the pool and lean on the
rim to push. By this stage I felt I had no strength left and began to feel a
creeping sense of doubt about whether I could do this.

She then instructed Joel and the doula to leave me for a while so that I
could try to do it on my own. I heard them go outside into the garden and I
stood, legs wide apart and bent, at the edge of the birth pool, holding on to
the rim and staring into the water. My gaze felt dreamy and glazed and so I
tried to shake out of it by shaking my head. I gave myself a talking to and
told myself to stop resisting and to just do it. My mind kicked in at that
stage and began to tell an old familiar story of how I often don’t finish
things, how I often can’t go through with things on my own.....looking back now
I see that it was a whole lot of drivel, fuelled by self doubt and fear that I
wasn’t going to be able to do it.

The midwife came back in then and I felt like a failure because I hadn’t
managed to do it. She tried me in different positions: Joel sitting on the edge
of the bed and me squatting between his legs, him holding me up under my arms –
that felt good but still the pushing yielded no visible result. Then we moved
to the toilet, while the midwife knelt beside me and told me to push, Joel
crouched in the bath and the doula sat on the tiled floor. I remember wanting
to ask jokingly if everyone was comfortable. Every time the urge to push came,
I’d push with all the might I had, my voice guttural and squeezed out with each
effort. The tops of my thighs were red from my hands gripping them each time I
bore down. At one stage I gripped the midwife’s forearm and pressed my forehead
against it in the effort. I remember feeling connected to her then, feeling
like I was drawing some strength from her, but that was the only time.

Then we went back to the bed and I lay supported by Joel and pushed
again. I dug my fingers into the skin of my thighs and my legs shook from the
effort.

The midwife’s voice then got urgent and she said ‘Come on now, Cathy,
you’ve got to give a really good push, the baby’s had enough.’ And I tried, and
it wasn’t enough. Then in a decisive tone she said, ‘Ok, we need to get to
Mowbray NOW.’

There was a general rush as she packed up the equipment and they began
loading the car in preparation for the journey. The doula helped me put one
shaky leg, then the other, into my tracksuit pants. I leant one hand on her
shoulder as she knelt to help me, as though I were a child. As I began slipping
into the second pants leg, I felt a sudden urge to go to the toilet (as though
I needed to have a big bowel movement) so I mumbled this to her, and hobbled to
the bathroom. I gave one immense push once I was in the bathroom, but nothing
happened so I came back out.

The doula helped me on with my pants again. I stood ready by the door
then realized I was barefoot and asked Joel to get my sandals in our bedroom.
He rushed upstairs and for a moment, I stood alone at the threshold of our
house, while the midwife and the doula packed the car. At that moment, I felt
an indescribable urge to push that felt greater than my own body, larger than
my own will, and so I hobbled-ran to the bathroom. I squatted over the toilet
bowl and heard a guttural growl emanate from my throat as I bore down in
submission to this overwhelming push that came from deep inside me.

Now I can see that my body had been building up to this intensity of
pushing, the last two surges I felt were quintessentially different from the
previous ones: resisting them would have been impossible.

I reached down between my legs and felt a warm, hair-covered head
crowning. I called out, ‘I can feel the head!’ And no one came, no one heard. I
called out again for Joel and he came running, stuck his head into the bathroom
and I said again, ‘I can feel the head!’ He shouted for the midwife and she
came running and they helped me back to the bed.

I felt like my body had turned a corner and could feel that we were
nearly there. I lay back against Joel’s shoulder and pushed for another ten
minutes or so. By this stage, Joel was cheering me on and saying, ‘Come on,
you’re a star, you can do it!’ and there was an excited focus in the room. The
midwife said, ‘Come on, one more push’ and I gave one more push and felt a
burning sensation at the edges of my vagina and almost simultaneously, blissful
relief as I felt a warm slimy body slither fish-like out in a gush of liquid.

I looked down and saw a mop of dark wet hair and as the midwife grabbed
his head and shoulders (Joel tells me she had to take the umbilical cord from
around his neck) I saw a pair of large red testicles! This was unexpected as
I’d been convinced we were having a girl.

She turned this little creature around onto his back and placed him on
the sheet between my legs. She rapidly suctioned his nose and mouth. He lay
there, not moving, not making a sound. I remember lying against Joel’s
shoulder, watching, with Joel squeezing my hand. The midwife began to milk the
umbilical cord so that it fed him oxygen-rich blood. As the nutrient rich
liquid tailed off, Joel and I watched soundlessly as the midwife gave short
sharp instructions to the doula to assemble the oxygen tank (which the midwife
had disassembled as she packed the car), and she put it to his nose.

He lay there silent and still. I reached forward with my index finger (I
didn’t have the strength to sit up) and all I could reach was his little belly.
I rubbed my finger along his warm bellyskin and said, hey sweet thing. I kept
softly saying these little words of love as we watched and waited.

As he lay there, not moving, not making a sound, I wondered which way it
would fall. The midwife began to pump his heart with two fingers and she said,
‘Come on little guy’. I remember watching in a detached yet hopeful way. I felt
strangely at peace with whichever way he chose. My thoughts fast forwarded a
few seconds, a few minutes and I felt an acceptance if his little body never
breathed or moved. Yet there was a bated hopeful feeling in me too: a silent
prayer, please, please, please as we watched and waited. As the minutes
lengthened, I felt him moving further away from us and my heart became one big,
pulsing please. The room held its breath and none of us spoke. And then, into
that silence, muted raspy kittenish sounds as he began to draw breath. Joel and
I looked at each other in mute relief. I felt a wordless thank you flood my
heart.

Postscript

Our baby boy Jack was rushed to Mowbray ICU where he spent the first
four days of his life, with various health issues ranging from hypoxia and
renal failure to thrombocytopenia (a low platelet count: platelets are the
clotting agents in the blood). He recovered quickly from most of the adverse
effects of his birth asphyxia except for the thrombocytopenia, so the doctors
kept us in the Kangaroo Mother Care ward in Mowbray for another ten days. He
received a platelet transfusion while at Mowbray and since then he’s had
regular blood tests. His platelet count, while still lower than normal, seems
to have stabilised and the doctors are not overly concerned. He has also had
regular developmental assessments and the doctors are happy that his progress
is perfectly normal.

He is alert, bright and cheerful and doesn’t seem to have suffered any
ill effects from his difficult birth. Strangers often stop us in the shops to
comment on what a happy baby he seems!

So to end off, I’ve racked my brain for a well thought-out and carefully
weighed conclusion that will wrap it all up. But the truth is I’m not sure what
my conclusion is. I’m not sure whether now I’m for or against home birth. I’ve
looked up various statistics and there are pros and cons for both home births
and hospital births. I know that for months after the birth, because of the way
it almost ended, I cried every time someone asked if we regretted having a home
birth. I know that if we were to do it again, we wouldn’t do it at home but
would rather choose to use a facility such as the Mowbray Active Birthing Unit,
which would feel like a wise compromise between the comfort of my own space,
and the proximity of medical help.

I also know that in preparing for the birth, it was comforting to be
able to visualise myself in our home, with Joel alongside me. On the other
hand, during my actual labour I was in such a deeply internal space that I
don’t know if it would have mattered where I was, as I was wrapped up in the
process my body was undergoing. Yet again, perhaps the reason I was able to
surrender so fully to this process was because I was in my own space, and the
people who were around me respected and supported my process, without any
outside medical agenda of induction, drips, epidurals etc.

If we’d been in a hospital and I had reached the point when I began to
struggle with the pushing stage, I would probably have been given an episiotomy
and Jack would have been delivered by forceps or vacuum. This might have
relieved him of some of the distress he experienced, yet it might also have
caused other trauma. And at the eleventh hour, my body was somehow able to push
through (literally!) so that Jack could emerge naturally.

So my mind see-saws from one side of the perspective to the other but
most of all, we are so grateful that it ended well. Through having written
this, I feel more at peace with how our birth story unfolded. Something in me
has grown to trust that it all happened as it was meant to, for reasons that
are larger than my thoughts and fears. Maybe babies choose their birth path
into this world and Jack somehow needed to take a bit of time to make his
choice. Eventually, he chose to stay with us and he chose this world. And we
give thanks every day that he did!

Mowbray Maternity Hospital

A short while after our midwife had resuscitated Jack, the paramedic (Greg) arrived in a breeze of cheerfulness and capability.

While Joel took Jack to the other side of the room so that Greg could weigh him
and check his vital signs, the midwife and doula wiped me clean. The doula had
asked Joel for a cloth earlier and he’d come back with a kitchen cloth, which
made her and I smile a little. She wiped me clean with that and then helped me
dress. Then two other paramedics arrived and loaded me onto a stretcher and put
Jack, all swollen-faced and bundled in a white towel, on my chest. They loaded
us into the ambulance,

Joel said a white-faced goodbye to us and said he’d meet us at the
hospital. I had to hold Jack with one hand and hold the oxygen mask against his
nose with the other. I had a brief moment of panic when I thought I was going
to be left in the back of the ambulance alone with Jack and thought I wouldn’t
know what to do if he were to stop breathing. As Greg helped to load me in, I
asked, ‘Are you coming to sit with us in here?’ and to my relief, he assured me
he was not going to leave us.

I held Jack with both arms but they were shaking and I had hardly any
strength left to hold him. I asked Greg to put a pillow beneath my one arm to
support me so that I could hold Jack comfortably. I felt bone-deep relief that the labour was over. I held this new little strange bundle close in my arms and felt I wanted nothing more – I would have been quite happy to stay in the back of that ambulance, holding this wondrous little
being close to my heart, listening to Greg’s cheery chatter and be driven
forever.

Some of the advice from all the books I’d read came back into my head
about the importance of the first hour in mother-child bonding, and the thought
of trying to help this little being latch onto my breast became strong. I felt
reluctance to bare my breast for the first attempt at breastfeeding in the
close intimacy of the ambulance cab in front of this chatty paramedic, then
realised I would regret it forever if I didn’t at least try. So I timidly asked
if he thought it could work to breastfeed the baby and he said I could give it
a shot. I lifted my t-shirt, moved aside one turquoise bikini triangle, feeling
very earthmotherish and tried to put my nipple into my new son’s mouth. He was
too tired and not hungry yet, so didn’t latch. I covered myself up again
feeling satisfied that I’d taken my first risk as a new mother, in the
interests of my new child.

We pulled up at Mowbray and they unloaded us from the ambulance. We were
wheeled past patients, visitors and staff. I felt self conscious at the stares,
not sure of the etiquette, (do I smile, wave a little, or studiously not make
eye contact with anyone?) yet also removed in my own little bubble with our new
baby. We joked a bit in the lift and arrived at the ICU. I was thrilled to see
Joel already there, waiting. Greg went into the ICU to explain Jack’s situation
and get him admitted. He came back outside and asked me to hand him over. I
asked whether Joel could go in with him but Greg said not yet, because the
medical team needed to first attend to Jack urgently and that we’d be able to
see him later. Greg gently took Jack from me and disappeared through the
sliding doors into the ICU.

Then the paramedics wheeled me to the maternity ward for a check-up.
Joel walked into the labour ward with me and our entry was barred by a doctor
saying that Joel had to wait outside. Joel objected strongly and said, ‘I’m not
leaving her.’ The doctor explained that men were not allowed into the ward and
Joel said even more vehemently, ‘I don’t care, I’m coming with her. She’s just
given birth, our baby’s in ICU and I’m not leaving her.’ I tried to intercede
gently as the doctor was getting worked up in turn. Another doctor arrived and
she explained that there were women in labour in the ward and that men were not
allowed in. She assured Joel that he’d be able to be with me as soon as they’d
checked me. This pacified him and he squeezed my hand and went outside. I was
wheeled into a cubicle, a nurse drew the curtains and I was asked to undress
and put on the blue hospital gown. I was still very shaky and weak.

I lay on the bed for some time, listening to the hospital goings on all
around, watching nurses and doctors walking in and out. I became aware of a low
moaning in the cubicle next to mine and looked over. The curtain had not been
drawn completely across and there was a young black woman lying curled in a
foetal position on the bed, eyes closed, moaning at intervals. My heart went
out to her. She seemed so alone.

Then a nurse came in and took my blood pressure. She said she needed to
check my urine for protein and after consultation with the doctor, said she’d
have to catheterize me as I was bleeding too much to make a simple urine test
an accurate reflection. I was feeling quite brutalized from the birth and felt
my heart sink at the thought of more pain, but the nurse was very gentle and it
was bearable.

When she had finished, she left me in the cubicle and I began to plot
how to get outside to see Joel as all I wanted to do was be with him. In the
rush to get Jack into the ambulance, I had not brought my cell phone so was
unable to sms or call him.

I eased myself up from the bed and decided to pretend to head for the
toilet, which I hoped was outside in the corridor where Joel was waiting. My
attempt at Jason Bourne-like strategising was foiled when the same nurse saw me
peeking out from the curtained cubicle and led me helpfully to the toilet,
which was on the far side of the room, farther away from Joel! I told her she
didn’t need to wait as I was able to walk on my own. I waited a few moments
then opened the toilet door and headed purposefully through the ward, past my
cubicle and out into the corridor where Joel stood waiting. It was such a
comfort to stand close to him and quietly talk, while the hubbub of hospital
activity went on around us.

A short while later, my mum and stepdad arrived and we all hugged, then
Joel and I stood in the corridor with them and filled them in on what had
happened. We were relieved to find out that the Neo-natal ICU had no set
visiting hours and that parents and grandparents could see their babies at any
time. We headed upstairs to see Jack and to introduce him to his first set of
grandparents.

My heart went out to him as he lay sleeping in the warmth of the
incubator, legs and arms splayed out like a small pink frog, a tube attached to
his nose and drips bandaged to his two little wrists. We were allowed to reach
into the incubator and stroke his warm tummy, his head. I whispered hello sweet
one as I cupped his head in the palm of my hand.

A while later, I headed back to the ward and my curtained cubicle. The
nurse told me that they wanted to keep me overnight so that they could monitor
my blood pressure, as it was dangerously high. She wheeled me to the ward where
I would sleep and helped me on to the bed. I thanked her for her gentleness
with me, she touched my arm, gave me a warm-eyed smile and left.

I sat on my bed, taking in my surroundings. There were seven other beds
in the ward, all with women who had just given birth and had their babies with
them. I said a general hi, there was a short break in the loud Xhosa chatter as
each woman returned my greeting, then the back and forth conversation between
the beds resumed.

I lay on the pillowless bed, with the hospital sheet drawn up around me
and waited for Joel, my mum and stepdad to arrive. I needed to have their warm
love around me, as I felt very alone and out of place on my island bed.

My heart lifted when I saw Joel arriving. He had brought some take away
sandwiches and fruit juice, but though I could feel that my body needed fuel I
had no appetite. I was disappointed when he said that my mum and Tony had not
been allowed to come, as visiting hours were over.

We sat on my bed, a blue blanket island in a sea of shock, trauma and
worry, and quietly debriefed what we’d just been through. Our hearts were
partly in the ICU with our little boy. When he’d gone I walked along the cold
hospital corridors to go and see my son, who lay fast asleep in his tropical
warmth incubator.

When I got back to my bed, I decided to have a shower. I was still very
weak and shaky, and thought a cleansing warm shower would do me good. I was
dismayed to discover that there was only cold water in the taps! It seemed that
State hospitals were designed for practicality not comfort.

I did not sleep well, as I felt at sea on my high bed raft, surrounded
by strangers, with Joel far away and our new little son not in my arms, but in
a plastic box tied to machines.

At 4am, a woman came round with a tea trolley and served me a mug of
hot, sweet, strong tea. It’s the best cup of tea I’ve ever had. Then, as I
tried to doze off again, a nursing sister walked into the ward, slammed on the
neon light and began to talk loudly to the other nurse in an aggressive way, as
she prepared to take each woman’s blood pressure and administer the morning
medication.

I couldn’t sleep after that so I went to go and see Jack. It still
didn’t feel as though he belonged to me but I felt an enormous sense of
responsibility towards this little being whose first day in the world had been
so rough. I wanted him to feel our love, to know that we were there with him.

Most of the time when we went to see him in ICU, he was asleep. When he
was awake, he was calm, lying there quiet and looking around and did not seem
at all distressed. Remembering this helps me to feel more at peace with his
first few days.

The next morning I was discharged from the hospital as my blood pressure
had returned to normal. I spent that night at home with Joel, where the relief
of a hot shower and my own bed weighed against the guilt of leaving Jack. My
mothering instinct had not fully awakened yet: a big part of me felt that I’d
done my job; all I wanted to do was lie down and never have to get up again.
But that night, as we settled into bed, both of our hearts were with Jack - it
felt so wrong to be so far away from him.

So the next morning Joel and I decided that I’d pack a bag and that we
would camp out at the hospital that day until they found me a bed. When we
arrived Joel spoke to a sister and she said they usually only admitted new
mothers on Mondays. It was a Saturday. We replied that I’d be prepared to sleep
on a chair until they could find me a bed. She went out to investigate and came
back saying there was a bed available in the mother’s ward. This meant that I
was down the corridor from Jack and could go in and see him whenever I wanted.

The sister showed me to my bed in Room One, which was for the mothers
whose babies were in ICU or High Care. I said a reluctant goodnight to Joel
outside the ward and went to sit on the island of my corner bed near the door,
the babble of Xhosa from the seven other mothers in the room surrounding me
like a lively yet alien sea. There was soccer commentary blaring from the TV on
the wall near my bed, which made it really hard to sleep. As the newcomer, I
didn’t feel brave enough to get up and turn the TV down, so I lay there with my
eyes closed, feeling alone and out of place.

Nursing sisters came round every two hours at night to wake the mothers
to feed their babies. The sleepy-eyed shuffle along the corridors to ICU by a
succession of new mothers would have been quite comical if any of us had been
in the mood for laughing.

The next four days passed, with hours spent sitting in the ICU cubicle
next to Jack’s incubator, listening to the various bleeps and blips of the
machines to which he was attached and staring at each other in wide-eyed
anxiety when occasionally, one of the machines would emit a louder bleep than
usual. Our fears were soon allayed by the nurse who’d come in and explain that
one of the wires had been bent. She’d fix it with a reassuring smile and we’d
breathe a sigh of relief.

One of the hardest parts of those first few days was having to watch
doctors take blood from Jack. He had such small fingers and feet and it seemed
like such big vials that the doctors needed to fill with blood. Although Jack
was taken off the ventilator on the third day and on the whole seemed to be
recovering well from his birth, one of the complications was that he had low
platelets, which are the clotting agents in the blood. This, we were told, is
called thrombocytopaenia, and one of the possible causes was my high blood
pressure during the labour. But the doctors were not yet sure what the exact
cause of this was and thus needed to monitor it constantly to check that his
platelet levels did not drop to danger levels, which could have resulted in
internal bleeding or haemorrhaging. This meant that he had to get daily blood
tests.

One afternoon a young student doctor came to get a vial of blood from
Jack. Joel kept his hand on Jack’s head and I stood close and whispered
reassuringly to him, while the doctor began trying to insert the drip(?). Jack
was screaming and the doctor was obviously struggling to get it right. I had to
walk out but Joel stayed with his hand on Jack’s head. I came back a while
later, tear-drenched, and Joel told me white-faced that the doctor had tried
eight times, then left and come back to try again! Eventually she’d had to call another more experienced doctor who got it right first try.

I also spent quite a lot of the time being man-handled by a wide variety
of nurses, some buxom, some skinny, some gentle, some rough, as they showed me
how to express milk and breastfeed Jack. I’m not sure if it was due to the
stress of those first few days, and not being able to hold Jack for long
periods as he was on a ventilator and in the incubator, but it seemed that my
milk did not ever ‘come in’ as each nurse promised, while she pulled on me as
though she was milking a cow. I was assured I would soon be drenched but that
never really happened. A friend had given me a recipe for a
breast-milk-enhancing potion called jungle juice, which had a concoction of
blackthorn berry elixir, vitamin c, water and various other things. The nurses
also recommended this so Joel brought back all the ingredients and regularly
mixed up bottles of this potion for me. I’m not sure how much it helped but at
least it tasted good.

Joel printed out photos of Jack’s family, on the Kelly and Park sides,
and we stuck these to the glass of his incubator, along with a friendly message
of introduction from Jack to his care-givers. Seeing these lifted my heart and
made his little space feel more cosy and personal.

Kangaroo Mother Care

This is the ward next door to the Neo-Natal ICU at Mowbray and it is
based on the principles of Kangaroo Mother Care (KMC), in which babies (most of
them premature) are kept skin-to-skin in a pouch on their mother’s chests. They
stay like this 24 hours a day: while the moms are eating in the dining hall,
sitting on their beds, sleeping at night. The only time the babies are removed
is in the mornings when the mother goes to do her ablutions and when she gives
the baby a sponge bath on the bed.

On the fourth day of Jack’s life, the medical team decided that Jack had
made good progress and that we could move to KMC together. I carried him in my
arms and Joel and I followed the sister as she took me to the ward and showed
me the bed where Jack and I would sleep. Although Jack was a light bundle, my
heart felt heavy with the responsibility of caring for him, now that he was out
of the ICU and wholly dependent on me for everything. I had to say goodbye to
Joel as the KMC visiting hours had ended. It felt desolate to be facing my
first night with our new son without Joel. We arranged that I would sms him at
any time of the night if I was feeling overwhelmed or simply needed a sympathetic
ear. We kissed goodbye and I went to sit on my unfamiliar bed, just me and my
new little son in a sea of strangers.

There were eight beds in the ward and none of them had any curtains
around them, so there was no privacy. I said a shy hello to the women (all
African women) with whom I made eye contact. There was a stone-faced woman in
the bed opposite mine and every time I looked up, she was staring at me with
dead eyes. My white suburban upbringing made me smile politely the first few
times, but her dead-eyed stare did not shift so eventually I stopped smiling
and avoided making eye contact. Yet another outcome of my upbringing: if
something makes you uncomfortable, pretend it doesn’t exist.

That first night was a night from hell. All the other babies in the ward
were premature, so even though it was the height of summer, the windows were
kept closed and the heater turned on, as it’s necessary to keep premature
babies very warm. As the ward was a KMC ward, we were meant to keep our babies skin-to-skin on our chests. I lay back against the steel headboard and felt sweat drip
slowly down my forehead as I tried to get comfortable without disturbing Jack.

All night the nursing sister came in at two-hour intervals: at 10,
midnight, 2, 4 then 6, throwing on the neon lights overhead and singing out,
‘Ok ladies, time to feed your babies.’ For the first night feed of ten o’clock,
she sat at a table in the centre of the room and wrote in an official-looking
book, while there was a general sleepy movement as the women dragged themselves
awake, changed their babies’ nappies and fed them. I hadn’t slept much as I was
still getting used to the warm weight of a blue-blanket-wrapped bundle of Jack
on my chest. Jack didn’t have the same problem as he was fast asleep. The
sister told me to wake him so that I could change his nappy and feed him.
Against all my instincts I opened up the blanket, tickled his feet, whispered
in his ear, but still he slept on, pink and heavy limbed. I was still
struggling to wake him as the other mothers finished off their feeds and
settled back onto the pillows, with tiny bundles asleep on their chests. Soon
the room was filled with sleepy baby snuffles and deep peaceful mother breaths.
This is when Jack woke up and began to cry.

I put him on my breast but he wouldn’t latch. He began to cry harder,
red-faced, his little arms windmilling in hungry desperation. Sweat prickled on
my forehead as I shushed him and tried again to get him to latch. I tried him
on the other breast, I rocked him, I talked to him, but still he cried. The
other mothers began to stir, one made an exasperated comment in Xhosa, which
might have been helpful if I’d understood it. I got up and began to pace,
jiggling Jack in my arms as I walked. Still he cried. The sister in the ward
was very unhelpful and simply carried on writing in her book. She was an
exception, as the sisters who came on shift the following nights were all very
kind and helped me in the long nights when it seemed all Jack did was cry.

Eventually, at around 4am, Jack wore himself out with crying and finally
fell asleep. I climbed back into bed, holding him as though he were a
motion-sensitive bomb, and tapped out an sms to Joel describing the night we’d
had.

The next morning, the sisters came to do their rounds, weigh the babies,
check their blood sugar etc. Jack woke up around 6am and began to cry. Once
again, he wouldn’t latch. I sat cross-legged on my bed, put his tense screaming
little body down on the sheet in front of me, and both of us cried. One of the
sisters came over to ask what was wrong. I was sobbing so hard I could hardly
get the words out but she got the gist. She said, ‘It’s all ok, just relax.
Give Jack to me and you go and take a break. I saw your partner outside as I
came in so go and see him and don’t worry, I’ll take care of Jack for a
bit.’

I was so grateful to hear that Joel was there and just about ran out of
the ward. He’d guessed from my sms that I was barely coping and so had come to
the ward at 7 in the morning. He couldn’t have been more of a hero to me if
he’d come riding in on a white stallion (which wouldn’t have got past security
anyway). He was waiting outside in the corridor and gave me a much needed, long
hug. After I’d calmed down, I filled him in on the night we’d had. We sat and
talked for a bit then arranged that he’d come back at visiting hours. I walked
back in to the ward feeling stronger and calmer. The sister had tricked Jack
and he’d fallen asleep cradled in her arms, sucking on her little finger.

That morning, the woman from the breast feeding support office came
round and helped me get Jack to latch. They also put me on medication to try
and increase my milk supply, which improved it a bit. I never managed to reach the levels of milk that the other women in the ward seemed to have though. Every morning they would express manually and I'd surrepetitiously marvel at the sound of a steady stream of liquid hitting the sides of the plastic containers. I felt like I was surrounded by rivers of milk flowing from big black breasts, while mine was more of a drip irrigation system.

My body felt like I'd been in a violent car crash and often, gathering my strength to shower and brush my teeth felt like a superhuman effort. My stomach felt loose and empty and I'd walk around holding it, just for a sense of support. One of the African women in the ward showed me their traditional way of winding a scarf or a sash tightly around my lower belly, so that the muscles and tissues would gradually contract and go back (more or less - a bit less than more!) to what they had been.

On the whole, the nursing staff at KMC were helpful, cheery and caring.
One sister, a rounded woman with rosy cheeks and a lisp, would cheerfully
introduce mini-projects to the mothers in the ward when she had the night
shift. She taught those who were interested how to knit, and on one memorable
night, how to make a five minute microwave cake. I didn’t join in but around
midnight that night, she came round with a slice for each woman on a paper
napkin, which she placed on their bedside tables as they slept. I was awake as
Jack was crying, so she took him into her arms, sang to him and called him
‘Master Jack’ while I sank my teeth into the soft sweetness. It’s the best
slice of cake I’ve ever had.

The ten days we spent in KMC began to take on a routine: with feeds
every two hours; trying to sleep in between, while WWE Westling blared on the
tv; spending time with Joel in the family room, while he held Jack on his
chest; having visiting hours with my mum and Tony, and watching while they
marvelled at his tiny hands and fingernails; counting the minutes until
mealtimes, which were a highlight (breastfeeding makes one ravenous!), and
learning how to hold Jack in one arm and fork my food into my mouth with the
other. (Note to self: it’s almost impossible to butter and jam a slice of bread
with one hand.)

Joel was staying at a B&B round the corner so that he could be
closer to us and spend as much time as possible with Jack. After the first few
days of having to stick to the strict visiting hours, he went to see the ward
supervisor and made a strong case for the importance of what we irreverently
called KFC (Kangaroo Father Care). He managed to get a letter from her, which
authorised him to visit at anytime. He’d sit on the uncomfortable wooden bench
of the family room for hours, holding Jack asleep against his chest. It was at
these times that I took the opportunity to shower (thankfully the KMD ward had
hot water) or get some sleep.

Joel kept me supplied with provisions, fruit and bottles of water, made
me regular potions of jungle juice, listened while I cried, bought me
medication prescribed to increase my breast milk and on the whole, was a tower
of strength.

For the first two weeks of Jack’s life, Joel and I felt like we were on
a rollercoaster ride, a heart-lifting, heart-dropping up-and-down trip of good
signs (Jack coming off the ventilator, suckling strongly when he fed) and bad
news (his low platelets, not being released from hospital, having to move to
KMC).

I felt like I was reeling from shock after shock, and was dragging my tired,

sore body around. On the fifth day, after another bout of tears at yet another test that Jack had to undergo, I realised that I was feeling hard done by and victimised. Why had this
happened to us? Why wouldn’t it stop? In a brief moment of clarity while I
stood in the shower, I saw that this mindset was not doing me or Jack or Joel,
any good. I gave myself a mental shake and decided to rise above it. I had an
image of paddling in rough seas and just managing to keep my chin above water.
From then on I grew slowly stronger and felt a growing trust that we’d handle
whatever came to us.

One morning the doctor came to talk to Joel and I. She told us that
Jack’s platelets had dropped to dangerously low levels and that he needed to
have a transfusion. On the evening that he was booked for the transfusion, the
three of us were together in the family room. A Zimbabwean woman, who was also
in KMC while her premature twins were in ICU, was sitting in the room a few
benches away from us, finishing her supper. She came over to us and asked if
we’d like her to pray for Jack. We both said yes. I held Jack in my arms and we
stood in a small close circle, as this soft-faced woman with a gentle air, put
her arms around Joel and I and prayed for Jack in Shona (indigenous language of Zimbabwe).
Feeling slightly strengthened, Joel and I walked into the ICU with Jack.
A young nurse approached us and told us with a nervous giggle that the Blood
Bank had mistakenly only brought half of the platelets that Jack needed. I had
a strong urge to slap the smile off her face, and Joel gave her a taste of his
fiery Irish temper. There was a delay of an hour while they waited for the
remaining number of platelets to get delivered.

Joel and I sat close to the incubator, watching Jack sleeping while a
steady stream of custard-like liquid dripped into his veins. The next day, his
platelet count was up and we smiled with relief when we heard the news. A few
days later it had dropped again, but not to the emergency levels that warranted
another transfusion. The doctors insisted on keeping him in the hospital so
that they could monitor his platelets. I would have sold my soul to be able to
take him home. We met with the doctor in charge and Joel put forward a
convincing case for letting us go home, with promises to return Jack for
regular platelet tests. The doctor acknowledged our desperation to take him
home but insisted that they wanted to be able to monitor him closely. Then she
said that if his count did not go up, she would strongly advise a bone marrow
aspiration. This would entail a surgical procedure on his shin bone, to take
out bone marrow and test it to see whether he was actually producing platelets.
The unspoken possibility of leukaemia hovered in the room. She asked us to come
with a decision the next day.

Joel went and did extensive internet research and came back that
afternoon with his findings so that we could discuss it. The doctor had assured
us it was a simple procedure but when we asked about the risks, one of them was
the possibility of the growth in his leg being stunted. We felt like he’d been
through enough in the first few weeks of his life and it made sense to us to
wait before agreeing to such a drastic procedure. We talked the doctors round
to waiting a few weeks. Joel put forward our argument strongly (I was still in
too much of a state to be very articulate) and again, made a strong case for us
taking Jack home.

The next morning, the doctor we’d been dealing with came to my bed in
the KMC where I was breastfeeding Jack and said, ‘You can go home today.’ I had
tears in my eyes as I thanked her.