Waiting to Exhale: My childbirth Experience in Kenya

My pregnancy had been complicated physically, mentally and emotionally. Having undergone nearly eight months of the gruesome hyperemesis gravidarum (HG) meant that I could not take any more extensions with it. I was desperate to evict my in utero tenant; before notice or on the due date. However, this child had a set mind of its own, with different plans on how he/she would enter the world.

The estimated day of delivery (EDD) was May 26^th, 2013, yet it came and went with no sign of labour. Anxiety was beginning to mount, and worse was the sheer physical exhaustion that I felt. This baby had to come. I knew that I was taking a substantial risk with the option of a natural, unmedicated, vaginal birth, given that I not only had multiple fibroids, but the baby was in a breech position (at least according to the last antenatal scan). I had limited options though because an epidural was not on the menu of my birthing hospital in Nyeri.

EDD – where is my baby?

There is nothing more dreadful to an expectant mother than being sent back home by your birthing hospital because, either your labour is imagined, the cervix has not dilated, or your baby has not engaged. Such was the case with my EDD. I had no visible signs of active labour. The child in utero was still actively kickboxing my ribs, pushing my bladder, and making me walk like a penguin. Perhaps I was one of those women who didn’t go into labour, or maybe I was about to have silent labour? I kept entertaining these strange thoughts. In my opinion, every mammal that births a youngling has to undergo labour; the only difference is human maternal labour is notoriously rough on the mother-in-waiting. Well, this labour along with the baby that I was carrying, was very unpredictable.

I was desperate to meet my child. He/she had decided to remain anonymous by not revealing its gender during all previous ultrasound scans. Nothing extraordinary happened on my EDD, expect my frantic nesting. I went about cleaning the house, arranging and rearranging baby’s clothes in drawers, unpacking and repacking my hospital maternity bag. Mother was concerned. She felt that I was wearing myself out. She repeatedly asked me to relax, in her opinion; I would need the energy to survive labour.  The nesting mode was a necessary distraction against the dread of carrying this pregnancy into another fortnight.

Silent labour

I kept telling my mother that I was praying for short and quiet labour. I was unsure of my pain threshold. I have a severe trypanophobia, how is it then that I would survive tokophobia? The scenario was different; a baby depended on my strength for a safe delivery. I kept dashing to the toilet to check for signs of the elusive mucous plug. I was anticipating something earth-shattering dramatic – water breaking with a splash and a bloody show. Like how they show it in the movies. Expectant mothers in Hollywood films always seem to have their water break somewhere in a mall, taxi, or in a fancy restaurant, for the extra dramatic measure.

I went to bed that night feeling downcast, but was woken up around 2 am by menstrual-like cramps; a quick run to Dr Google revealed that these could be a sign of false labour. I wanted active and fast labour. I was impatient, and frankly, quite miserable. The crampy feeling did not wane. Instead, it continued at very lazy intervals.

By 8 am, my mother’s anxiety was palpable. It seemed like she was pregnant by proxy. On the other hand, I was too relaxed for her comfort. I agreed to ring Doctor Samuel Njuguna, my gynaecologist in Nyeri to appease and calm her nerves.  I explained to him the intensity of my contractions, how I had self-diagnosed it to be false labour.  The Doctor’s response startled me. “Let’s meet in the hospital, now!” The urgency in his voice brought reality home.

I need to use the ATM

I could hardly believe it, in my quest for something more dramatic, I nearly gave birth at home! My mother had remained hawked eyed on me, insisting on standing outside the door every time I went into the toilet. She did not want to take chances; there is no way I was going to give birth to her grandchild, in the loo. I thought her paranoia was comic. My mother is a funny person, and so was my labour.

No sooner had I managed to drag my expanded belly out of the house, then I decided it was of utmost urgency that I go to the bank and queue at the ATM. I needed money since I was not sure the hospital would accept payment by Card. By now, my darling mother was beside herself with irritation and simmering impatience. She thought I was talking about the whole situation too lightly. I thought Hakuna Matata. I am still waiting for my dramatic moment.

I walked up to the ATM; huge baby belly in front, and a larger behind. As soon as the men ahead in the queue saw my clenching walk, arms akimbo, the bulging baby bump, tired eyes, and heard my intrepid breathing, they took quick retreating steps and let me cut the line. I do not know what they were most perturbed by; the wrath of a constipated, pregnant, woman, the possibility of me going into labour right there and then, or perhaps it is the sight of a pregnant waddling woman that brings out honor, even in the most macho of men?

Precipitate labour

We reached the hospital at around 11.am. By now, the contractions had begun to intensify in their sting and frequency. In retrospect, it finally dawned on me that I was giving birth only after I arrived at the hospital. I went in for my first vaginal examination (VE), much to my surprise, my cervix had dilated to 5 cm. I was in the active stage of labour. The midwives scolded me for taking this birthing too lightly and immediately sent me to the labour for admission, but first, they made me walk a long flight of stairs that felt like an 8-mile trudge. I have climbed hills and a mountain before, but that walk up the stairs (I think they were 20 flight of stairs in total), during labour, was sheer torture. My Mother came to the labour ward at 11.30am, in time to witness the beginning of the precipitate labour.

In short, I was about to undergo a maternal phase of birthing madness. The pain I had been waiting for finally came with such overwhelming, unusual and rapid intensity. It left me confused, hyperventilating, and with no epidural or gas to ease me into the transition phase of labour. Everything was unfolding so fast. A midwife came in time to massage my back, and relieve my poor mother from the stress of my screaming and crying; she also showed me how to breathe rhythmically through the pain and contractions. A technique that saved me from the – angst, delirium – that would have caused me to utter all manner of Kikuyu profanities in that labour ward.

It is time

At 12.00 pm, the midwives came again and asked me to accompany them to the Delivery room for another VE which revealed a 9cm dilation. I could hardly walk. A penguin waddle would no longer suffice to take me from the labour ward to the delivery room. I wanted to crawl on my fours. I begged for a wheelchair. I cried to my mother, who by now was crying too. Exasperated and fraught with hormones, I surmounted some maternal superpower and glided myself against the wall. The cold white wall felt good on my hot flushes. Back to the delivery room, my mother resumed her praying, cold air fanning and lower back massaging duties. By now, I had crossed my pain threshold.

My water had not broken by the time Dr Njuguna got into the delivery room. He tried to engage me in some little-hearted banter, as he prepared his paraphernalia. I could barely remember his name. I kept referring to him as Dr Ndirangu.

Finally, I screamed out, “Dr Ndirangu, let us get this baby the fuck out of me, or I will die!”
No holds barred, I was ready to push this baby out, with or without the help of my Doctor.

The pain was driving me mad. I couldn’t take it when he asked me to calm down, and let him perform the last VE. I had had enough of people poking their fingers into my vagina. I was becoming increasingly hysterical and panicked too. The doctor instructed the midwives to give me some laughing gas aka Nitrous oxide to help calm me down, but it had little effect on my flared nerves. I began to push.

“Judy, please do not push!” Dr Njuguna implored.
I was grunting like a wounded lion.
“Judy, kai ugwiciarithia?” (Judy, are you going to self-birth) asked my mother, her voice dripping with concern and panic.
I damn well would. The Doctor and midwives had just made me mount on and off the birthing table. This labour seemed to have caught everyone off-guard.

Every time someone said, “Don’t push the baby”, I would push. I was overcome by “temporary insanity”.

“Judy, you are going to put your baby in distress if you keep pushing without the aid of contractions.” Dr Njuguna attempted to sneak reason into my defiance.
My breathing calmed, and for a brief moment, I let my mind wander into the beautiful blooming Jacaranda trees that dotted the skyline. It was the calm after a storm. Suddenly, I felt a gush of water between my thighs. The Doctor broke my water.

I knew this was it. It was time to push out my Earthling out. I had to listen to the Doctor’s instructions since self-birthing was not my forte. I sat in a semi-upright position, propped with extra pillows for comfort, the doctor instructed me to touch each ankle, and look down at my navel for focused breathing and pushing.

“Would you like to have an episiotomy?” the doctor asked.
“No, I prefer to tear naturally,” I replied, completely unsure of the decision that I had just made.
“Ok, now 1, 2, 3…and push!” he instructed.
I pushed, and out came a gush of poop. Nobody warned me about the likelihood of releasing stool on the birthing table. It was not only embarrassing, but it also felt like I was doing more of number 2 than giving birth. Everything was following the law of gravity; from that morning’s breakfast to blood, pee, and the baby.
“Judy, it is no big deal. Let it all out; we shall clean everything for you.” The kind doctor reassured me for the umpteenth time.

I finally threw caution to the wind and agreed to defecate publicly. The medical personnel, comprising of total strangers who were keenly peering into my womanhood, had probably seen it all, and even worse. There is no shame on the birthing table. Indeed, the more this baby pushed onto my nether region, the more the contractions intensified. He/she crowned with every poop and push.

Four hard pushes later, and the baby was out. He screamed his way out — a pink, wrinkly, adorable little boy. Everything, from labour to birth unfolded rapidly. I had not anticipated that it would all start with such intense madness, then end with delirious joy. I was a first-time, clueless, mother.

Today, two years later, I look at our son Fadhili; the feisty, kind, sweet, handsome boy that he has become, and all I can recall is the wrinkly yellow-eyed boy he was at birth. The pain and trauma of childbirth remain safely tucked into some amnesia part of my brain. I can recount the details, but I cannot feel the pain, for in its place is an overwhelming sense of love and devotion to this little boy who chose me to become his mother. The entire birthing episode was remarkable and unforgettable, but watching my son grow has to be one of the most beautiful experiences life has accorded me.

Fadhili