|Dora's Birth - The Grandmother's Tale|
The moment my daughter Lily knew she was pregnant she asked me to be with her at the birth. Of course I said yes, I was thrilled by her news and touched that she should want me there. But I was concerned too from the first that her husband was happy about it and that my role did not in any way usurp his.
Quite early on I mentioned to Lily that I hoped she would think about trying to find some way of having continuity of midwifery care. I really wanted her to have the same person throughout her labour and birth - preferably someone who had given her pre-natal care too and had become trusted and familiar.
Initially Lily was adamant that she would go into the local hospital, as her friends did. Some were happy with their treatment some appalled but she was willing to take her chances and didn’t want to be special. I doggedly went on suggesting she at least look into the alternatives. Then to my amazement she told me she intended to have her baby at home because that was the only way to guarantee that she could have a water birth - something she knew she really wanted. I was full of admiration and a little trepidation. At this point I hadn’t actually managed to leap that hurdle in my own mind - the mantra that all first babies are better born in hospital. But in fact, the more I thought about it the more I felt that hospital is the last place to ensure the kind of unhurried, woman-centred and continuous care, particularly necessary for a first baby when the new mother is at her most vulnerable and unable to resist the external pressures brought to bear on her.
Lily was recommended Elke Heckel, an independent midwife. From the time she first spoke to Elke she seemed to be filled with a calm confidence that what she and Nick intended to do was right and they and their baby would be fine. As Elke seemed to embody for Lily some of the maternal nurturing qualities that I felt she was seeking by asking me to be present during her labour, I wondered if she’d feel crowded and would rather not have me present after all. Nick and Lily still insisted they wanted me there and so we worked out that my role would be practical back-up, making tea, feeding the workers, decanting cooling water from the birthing pool and filling it up with hot, managing the clean towel supply and fielding any inadvertent visitors.
When they told Elke she said she’d like to meet me - to vet me I’m sure, as I can imagine what a nightmare a mother of a labouring daughter could become - panicking, criticising, interfering with the midwife’s decisions - or shouldering aside the cowering son-in-law! On the day that I was meant to meet her at one of Lily’s ante-natal check-ups, I drove up to London: Elke arrived at Lily and Nick’s flat in Hackney in the early evening, a warm brilliant presence, she blew into the room on a great chuckling laugh. She was wonderfully colourful with bright turquoise eyes and thick wheat-coloured hair. I was struck hearing her talk by how passionately she felt about all areas of midwifery and yet she was so keen to hear from Lily and Nick what their ideas were on their baby, their birth and the way they would like her to proceed. She was not ideologically driven even though she obviously felt very strongly about the merits of different ways of doing things.
I think I passed her vetting process. She certainly passed mine - with flying colours. I left that day feeling a terrific relief that my beloved daughter was going to be in the best possible hands. It meant I could look forward to her labour with confidence - such a difference from the anxiety and then pity I felt (much coloured by my own highly medicalised first birth experience) when my son and daughter-in-law went into hospital for their first baby’s birth five years’ previously and I half-slept with the phone by my pillow for two nights - and in fact they felt very alone as various midwives came and went and the whole gruelling experience, together with a threatened emergency caesarian, was only redeemed by the advent at last of their gorgeous daughter.
In the week of her due date Lily had been having strong Braxton Hicks contractions and so by Thursday I thought I’d drive up from Bath, laden with bobotie (South African trail food, an idiosyncratic meat loaf) that my family loved, as many clean towels as I could find - and some sewing and books I needed to read for my own work so I had something to do if there was a waiting time as I didn’t want to put any pressure on Lily to perform. We all went to bed. At midnight I woke up to hear voices downstairs and I found Elke in the sitting room taking notes with Lily supporting herself against a chair and Nick rubbing her back. Elke looked up and said in a quiet voice, go and get some sleep, it’s not imminent. What prophetic words they would turn out to be.....
Of course I couldn’t sleep but I tried to doze until the early hours when Lily came into my room and we pulled the duvet and pillows off the bed and onto the floor so she could kneel and lean over them while I rubbed her back and Nick tried to get a bit of sleep. The contractions were coming regularly and quite strong: Elke returned that morning and stayed. Much of the time Lily and Nick were on their own in various parts of the flat while Elke and I sat in the kitchen and had tea and talked. I sewed an old kimono I had shortened. And we provided food and drink and support when they needed it to the two labourers who were working as a brilliant team in their bedroom or in the sitting room and even in the hall. This was one of the joys of a home birth, every space in the flat was used at some time and we weren’t all cooped up together in a hospital room, crowding and intruding on the labouring mother.
By the afternoon, Elke thought the labour well-established enough for them to be able to get into the birthing pool. This was a great big oval pool in the sitting room, quite deep and filled three quarters’ full of warm water. When I saw Lily climb into the pool and lie back in the water with a great sigh of relief tears of sympathy and pity sprang to my eyes. I realised how hard it is to see one’s daughter in pain, even though it’s all positive and productive of the baby she has longed to meet for 9 months.
By now the second midwife, Nina, had arrived, affectionate and calm, and the fact that she had been called in lifted Lily’s spirits, it was a sign that things were really moving and perhaps it wouldn’t be too long now. But we were all aware that Lily just wanted to be left alone with Nick in the pool and not have an audience. The midwives and I decamped next door to the kitchen and just popped back to Lily and Nick in the birthing pool to offer high energy bars, bananas and lucozade. Elke was also monitoring the baby’s heartbeat and listening attentively to the noises Lily was making, waiting I suppose for the telltale change in tone that suggested she was approaching second stage. Everything Lily ate and drank was also monitored, along with her trips to the loo, and notes were continually being kept up to date with the all-important baby heartbeat rates as well.
At Lily’s request the clocks had been covered but we had one in the kitchen and I remember looking up in the late afternoon thinking she’ll have a Friday baby. I mentioned the old rhyme, Friday’s child is loving and giving. Elke said, "Lily has told me she’d hoped for a Libran like herself". I said that the sun didn’t move from Virgo into Libra until nearly 6 o’clock on Saturday morning, the 23 September. Elke said, "Don’t tell Lily, we hope this baby will be born before that!". "Saturday’s child works hard for her living" - Elke was to say to me once this little baby was eventually born that we’d have to change the rhyme to "Saturday’s child gets everyone else to work hard for her living!"
And on and on, it went. Elke was keen to try different postures and activities to let gravity help this baby on its way and also to try and get the baby into a better position. So the pool had to be temporarily abandoned. Lily and Nick amazed me with their endurance, their calm focus during painful and powerful contractions and it was moving to see what a terrifically bonded team they were.
Friday passed and by the early hours of Saturday everyone was exhausted and growing dispirited. Elke decided to do an internal examination to see what was happening. When she found that the baby’s head was not ideally positioned and Lily was only 7 cms dilated after all this effort, there was a plunge in energy all round. Lily said to me, grey-faced, "Mum, I don’t think I can go on", and I said "I know, darling, and I’m not surprised, it’s been so hard and you’ve been magnificent. But you can go on and you will be all right." But I sounded much more sure than I felt. It was a dark night of the soul, where all my confidence was shaking - could this baby be born naturally? Would Lily have the energy to go on much more - she’d been so amazingly courageous and strong but was obviously weakening? At what point would Elke say she needed to go to hospital and what would that entail then?
I was really concerned that we couldn’t see the way out. It was this point when I thought "I’m too old for this kind of exhaustion and strain.....Thank god I’ve only got one daughter and will never have to go through this again...Thank god Lily will never have to go through this again, a second labour could never be so hard"...and then I thought of Elke - who’d be an independent midwife? - with this kind of stress and responsibility on your shoulders!
Elke had firmly suggested I go and snatch some sleep, alongside Nina. Iwas very reluctant to go but felt transparent with tiredness. I also felt guilty trying to sleep while my daughter was still in the rolling grip of these big contractions and was having at the most only a few minutes rest at a time. After an hour or two I returned to the fray. Nick also was exhausted and suddenly fearful, and left the room so that Lily would not see him wobble. Elke followed him and talked to him about the situation. She went off and sat alone at the kitchen table and thought about how best to proceed. She was remarkable because she never once pretended to know all the answers, but her confidence in Lily’s and her baby’s strength did not falter. She also involved us in her thinking processes which helped maintain our confidence in her and the situation.
Elke was certain the baby was absolutely fine and unstressed. She said she wanted to try a small manipulation that could help the baby’s head to shift into a better presentation, if Lily was happy to let her try. This involved putting two fingers against the baby’s head in the middle of a contraction for the baby to have something firm on which to pivot. She did this - and said she could feel lots of baby hair, which immediately brought everyone’s focus back to the positive - there was a baby at the centre of all this relentless effort and pain. Elke then went to lie down (she’d been up for 24) and Nina, Lily’s second midwife, took over. After an hour’s rest Elke came downstairs her face radiant with relief - Lily’s deep guttural moan with each contraction told her that things had changed and were progressing beautifully, she was approaching second stage.
Spirits rose fast. A feeling of optimism and purpose replaced that of stagnation and despair. Breakfast was snatched by everyone. We fed Lily more banana and lucozade and the pool was prepared for the last leg of this marathon. Buckets of cool water were handed out to me by Nina and steaming hot hose-piped in. A whole relay of towels had been washed and dried, Nick was told to gather up baby clothes and a nappy in the sitting room where the pool was, ready. All these ceremonies made everyone feel the long long road was turning and home was in sight. There was also something reassuringly old fashioned about the imagery, the steaming kettle, the cups of tea, the mountains of towels, the consoling domesticity, the cat coming and going.
Second stage was still incredibly prolonged (babies don’t run to timetables Elke said) but Lily was managing brilliantly. This slow birth was totally untroubling for the baby whose heart was being monitored every second contraction or so and never skipped a beat. Lily was working very hard but could see the end was near. She was in a remarkably calm, centred place where she was utterly concentrated on what she and her body had to do. For me, having started off not wanting to in any way intrude on the birth itself, I was amazed to find that it was completely natural in these last stages to share with Nick and my daughter the quite extraordinary miracle of bringing a child into the world.
Lily was in the pool with Nick, lying back in his arms in between contractions, the room very low lit, mainly with candles: I was outside the pool, with my arms out to my daughter so that she could grab my wrists when the contraction started and pull herself up to squatting position to push. Elke was beside me with a mirror and a torch to watch under water that the crowning of the head was slow enough, giving Lily encouragement the whole time. Nina was feeding Lily lucozade and water through a straw in between contractions and keeping the notes up to date. The baby’s heartbeat continued as regular and relaxed as it had always been. In the deepest focus and responding to the demands of the contractions, Lily was rocked back and forwards between the two people who loved her most, her husband and her mother, and this seemed so absolutely right. It was wonderful that the midwives stood back and made this family team work possible.
It was Saturday teatime when at last the longed-for baby was delivered, in water and fished by Elke up and out like a glistening salmon, to be placed in Lily’s arms. Everyone cried and Lily, after 42 hours of hard labour and no real sleep, laughed and gazed in wonder at her baby and smiled and murmured to the beautiful little face looking up at her. Nick wept, hardly believing the baby was here at last. Mugs of tea appeared, probably thanks to Nina. The baby was gazed at in a kind of awe - at last to see that child you have all speculated about and longed for is just miraculous. Dark curly hair, beautiful long fingers, long legs, "A big baby" says Elke, "Over 9 lbs I should think". Amid all the tears and wonder I turned to her and said, "Do we know what sex this baby is?" and it epitomised her unintrusive, family-centred care when she replied, "That’s for the parents to find out". Instead of having it announced by some hearty doctor or midwife, how right that it should be Lily and Nick who discover if they have a son or daughter. Having gone through her pregnancy thinking that she was having a boy, told by everyone that her shape, etc meant it was probably a boy, but secretly hoping to first have a girl, she looked down and whispered, "I can’t believe it, I’ve got a girl. Is she really a girl, Nick?"
They stayed in the pool holding their daughter until the cord stopped pulsating when it was cut by Nick. Then little Dora was passed to me to wrap in a lovely warmed towel while Lily and Nick went upstairs to deliver the placenta. I was alone with the daughter of my daughter. I sat with this beautiful alert little girl in my lap just gazing at her hardly believing she was here at last - as euphoric and thrilled as I felt when gazing down at my own daughter nearly 33 years before. It is one of the joys of my life that I could hold my breathtakingly lovely granddaughter, only half an hour old, waving her long-fingered hands while her dark eyes looked wonderingly around. I think the pleasure was intensified by the long rollercoaster of emotions and effort that her birth had entailed. How extra valuable are those experiences we have to struggle and work for.
The placenta delivered, the new parents promptly went to bed with their daughter tucked up between them. Lily was suddenly famished and I went quickly to cook her some pasta, while Elke and Nina, exhausted but beaming, cleared up downstairs. After eating, Elke showed us the placenta and the membrane that had enclosed this baby for nine months. Such a modest-looking support system had grown this exquisite, perfectly formed and healthy child. Later that evening the cry from the bedroom went up for bacon sandwiches - Nick had been trying to get a bacon sandwich for the last 2 days but his labour duties had always got in the way. Now at last, his job well done, he could really tuck in, with cups of tea to wash it down.
Dora Caroline (tall at 9 lbs 1 oz) has continued as peaceful and beautiful as she was when she was born. Feeding, everything, has been a doddle for her and I am so grateful that Lily and Nick chose the kind of birth that gave them a chance to be empowered and bonded for ever, like explorers who had set off into the unknown to face fear, suffering and triumph together and then return as heroes. I think they really feel they produced this baby together - Nick gave every ounce of his love and energy to Lily, who in turn was magnificent. I've always thought my daughter quite young, still a girl, but she has proved me completely out of date with this - I am full of awe and admiration at what a strong, courageous woman she truly has become. I am also so grateful to have been there and allowed to be part of a fantastic team, along with her two kind, wise and brilliant midwives. When I left Nick and Lily and Dora to begin to make their new life as a family, I had absolute confidence in them and in the fact that Elke and Nina, now friends, continued their exceptional care for another 4 weeks. I drove home truly exhausted, yet ecstatic and inspired, an emotion and a memory that cannot fade.