Birth Story in Africa: a birth without fear

Guest post written by Sarah S.

homebirth in Africa

In order to tell the birth story of my firstborn, I have to back up a bit. Actually, I have to back up a lot. For as long as I can remember I have been afraid of pregnancy and childbirth. My mother threw up the entire nine months of all four of her pregnancies. She was even hospitalized for a week while pregnant with my youngest brother because she was so dehydrated from all the vomiting. I was certain that I was doomed to face the same fate if I ever became pregnant.

When I was nine years old I watched a video of a family friend giving birth to her 5th child. Although I remember the mother being radiant and calm and even excited enough to ask to see the placenta after it was delivered, I was horrified by the reality of giving birth. Can you blame me? Every TV show or movie that shows a woman giving birth shows her writhing in pain at the first contraction and eventually screaming at the baby’s father while he stands there like an idiot, completely helpless.

So, by the young age of 10 years old, I decided that pregnancy and childbirth were not for me. I absolutely loved babies, but decided that I would acquire all of my own babies through adoption. I continued to stand firm on that decision until I actually got married. Deep down I knew I would probably feel differently if I ever got married. But, I was still full of fear about pregnancy and birth.

A few days before my 2nd wedding anniversary, my husband, Sam, and I moved to the Democratic Republic of Congo in Africa for two years. A few months before our 2nd wedding anniversary we felt strongly that we wanted to start a family. After a lot of [reflection], seeking counsel from older, wiser people and several tears, we decided we were going to stop using birth control. If I became pregnant while living in Congo, then that was what was supposed to happen. We moved to Congo in July and I found out I was pregnant with our first baby in November of that same year.

We were extremely excited and extremely nervous. The Democratic Republic of Congo has one of the worst reputations for healthcare. We lived in a teeny house with no running water and limited electricity. The closest hospital with decent care was about a three hour drive away on horrendous roads and also had no running water and limited electricity. Prenatal care was very basic and attending a childbirth class was not an option. Although most women in Congo labor and deliver at home with a midwife, many mothers and babies die during the birth process because of limited resources in an emergency. There were many things in my situation that had the potential to add to the existing fears I had about childbirth, but Sam and I knew that our only choice was to trust our situation to overcome fear. So we continued to surrender.

It was decided that I would give birth in the neighboring country (Central African Republic) with an American doctor who worked at a hospital with much better resources and more staff than the hospital in our area. Medical resources would still be limited and an epidural would not be available to me. A Congolese doctor friend of ours visited me once a month for prenatal care which really only consisted of weighing me (if there was a scale available), listening to the baby’s heart (with an old-school pinard horn like they use on the TV show Call the Midwife) and measuring my belly. So Sam and I decided to learn everything we possibly could before the birth of our child. A midwife friend of mine suggested I read Ina May’s Guide to Childbirth by Ina May Gaskin. I devoured that book in the first few months of my pregnancy and my husband read a few of the chapters as well. We read and worked through a used Bradley Method workbook and managed to get our hands on the book Husband Coached Childbirth by Dr. Robert Bradley a couple of months before my due date. We read and talked about childbirth and practiced relaxation exercises every day. I wanted to know everything I possibly could about managing pain during birth since I would not be able to have an epidural if I wanted one. Sam wanted to know everything he could in order to help me relax and manage pain and be my coach and voice during the labor and delivery. I prepared my body for the “big day” and we both prepared our minds.

A month before the due date we left for Central African Republic and stayed in a guest house and waited for our baby to be born. Dr. Tim, the doctor who would deliver our baby, lived a short walk from the guest house and we met with him several times. He told me I could deliver the baby in the guest house if everything went well and he agreed to everything we wrote in our birth plan. If there were any problems, the hospital was about 200 yards from the guest house and I would quickly be moved there if a cesarean was necessary.

The day before the due date I started to have a “bloody show” and the Braxton Hicks contractions I had been experiencing for a few weeks were increasing throughout the day even though they weren’t painful. By about 2:30pm I started tracking how often the contractions were coming and they were irregular at that point but coming consistently. That day was Sam’s birthday so we made dinner together and I stopped every 10 minutes or so to breathe through a contraction. After dinner was over we realized the contractions were coming every 5-10 minutes and were getting stronger so Sam went down to Dr. Tim’s house and let him know what was going on. Dr. Tim checked me at about 8pm and I was 70% effaced but hadn’t dilated yet so we had a long night ahead of us. I did feel a bit discouraged at that point because I hadn’t dilated yet and had no idea how long everything would take. We attempted to use Dr. Tim’s phone to call our parents back in the States to let them know labor was starting. The reception was terrible but we managed to chat for a couple of minutes. Dr. Tim, his wife Ann, and Jan (the wife of the other American couple who lived there and a nurse) came down to the house to set up a bunch of medical things in case I did deliver there and then they left us alone for a couple of hours.

We both attempted to sleep and Sam did for about 45 minutes, but my contractions got more intense and I walked around the house a bit and then just laid down to relax and breathe through each contraction. We spent the rest of the night in the bedroom with the lights low, mellow music playing (I had made a “labor and delivery playlist” on iTunes for this exact occasion) and Sam sat at my side next to the bed watching my every move, massaging my legs and back, and applying pressure to my back during the contractions. He coached me through my abdominal breathing and was the most incredible support, even though he was exhausted.

Dr. Tim checked me around 11:30pm and I was already at 5cm, which surprised all of us. He came back around 1AM and just stayed the rest of the night in our living room which allowed Sam and me to labor in the quiet bedroom in privacy, with little interruption. Sam talked me through everything as the pain increased and consistently encouraged me. I didn’t need anything or anyone else in that room to keep me focused and relaxed. Around 3:00AM I was at 7cm and Dr. Tim said we might have a few more hours ahead of us and he wasn’t sure if we would deliver at the hospital or in the guest house.

Starting at about 4:30AM the contractions and pressure in my pelvis became very intense. I was having a hard time breathing and staying relaxed during these big contractions that were coming about every 3 minutes. Sam was particularly amazing during this time to keep me breathing from my abdomen and relaxing my muscles when I felt like I couldn’t control what my body was doing. When my mind began to wander to a fearful place, thinking, “How long will this last? I can’t relax!” he calmly reminded me to breathe from my stomach. I started to lose feeling in my arms, hands, legs, and feet because I was hyperventilating a bit and then my hands began to spasm. This part was the only “scary” moment because I couldn’t make my body relax. Dr. Tim came in again around 5:30AM (I think…things were a bit fuzzy around this time) and with surprise in his voice announced that my bag of waters was about to break and he needed to gather his delivery team. As he got up to leave he said, “If you feel the urge to push… don’t push until I get back!” (By the way…that is the worst thing to say to a woman in labor!)

Within minutes Dr. Tim, Ann, Jan, and Julien, an African maternity nurse, were in the room getting set up to deliver my baby right there in the bedroom. I repositioned and Sam sat on the bed behind me for my main support and I began pushing through the contractions. The adrenaline rush during this time was incredible and a relief. I could finally work with my contractions and it felt amazing! They broke my water and Sam held me up, helped hold my legs and coached me through about 4 more contractions with pushing and then my first daughter, Hannah Margaret, appeared at 6:40AM! I held her right away and Sam was behind me the whole time as we ooed and awed over our beautiful daughter. I felt like Sam and I had both worked to get Hannah here safely and that was one of the most incredible feelings…to know that Sam was just as much a part of the process as I was.

homebirth in Africa

A couple of hours after Hannah was born, I clearly remember telling Sam that I would like to do that again. (Not immediately, of course). My experience of giving birth to a child was nothing like I had feared. It was peaceful, smooth, and while it was intense, it was nothing like the pain I had always seen depicted on TV shows. We truly felt peace overcome fear during the entire process. And because we had learned the specifics of what was going to happen to my body during labor and delivery, we felt empowered during the process and therefore able to focus on keeping my body relaxed.

homebirth in Africa

Hannah is almost three years old and Sam and I still talk about her labor and delivery often. The memory of working together to birth our first child is an incredibly sweet and intimate memory that I imagine we will talk about for the rest of our lives.

Guest post written by Sarah S.

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