The scheduled caesarean section of a fellow birth photographer

Geplande keizersnede

Linda did a birth photography workshop with me, and that’s how we got to know each other. She was already an accomplished newborn and maternity photographer, and wanted to expand her work to include birth photography. If you’re not familiar with her work, then you should take a look at her website: http://lynnvriesenfotografie.nl/

In June last year Linda asked me whether I would photograph her scheduled caesarean section. She lives with her husband nick and their son Sven in Arnhem, and that is outside of my working area. But because Denny and I had already planned a holiday at that time, in February, I was willing to do it. I wouldn’t be accepting any spontaneous births for that period anyway, and since this c-section was to be scheduled, it wouldn’t be a problem. The only question was whether the hospital would allow it, but since Linda knew exactly what to say we hoped that the coming months would give us a chance to get a foot in the door!

In the meantime Denny and I had started our ICSI treatment, which Linda knew about, since she had become pregnant twice through ICSI. With her pregnancy with Sven the placenta lay directly over the exit of the uterus (placenta praevia), and in the end Sven was born by emergency c-section at 32 weeks. It was a nerve-wracking and hectic time, but after 6 weeks Sven was allowed to go home. Because of all this history, they would be doing a c-section again for this baby.

Linda’s pregnancy went smoothly this time, and at every meeting she has in the hospital she tries again to approach the idea of me being there to take photos. To cut a long story short: one day before D-day we hear that it will be allowed! I book a bed and breakfast in Arnhem, so that I can be at the Rijnstate hospital on time (8:00) the next morning, Tuesday 27 January. It will be the first time I’ll be meeting Nick, so also nerve-wracking for him! I find that I’m more nervous than usual, because I know Linda, and I’m pregnant myself. Hopefully everything will go ok in the OR…

I’m at the hospital a short while before Linda and Nick arrive, and I’m lost in thought when they suddenly appear in front of me. The adventure can begin! They have to first report to the admissions desk, and then we go on to the delivery rooms to wait until we’re fetched. Linda is relaxed, and Nick is a bit more tense. Linda has very sweetly made lunch for me so that I can eat in between, should it be necessary. We chat about all kinds of things until she is collected and taken to her room. In theory she’s scheduled for 10:30, but there has already been an emergency in between, so it may be a bit later.

Nick and Linda get settled into their room, and then the intake is done. The baby’s heart rate is traced, all the usual checks are done, the theatre scrubs are laid out for myself and Nick, Linda is given a wristband, and finally an IV is inserted. I quickly go to the toilet, and when I return I hear that it’s time to go. Oh, that was quick after all! Nick and Linda have just gotten changed, so I also quickly change into my scrubs! There’s no time to eat a sandwich any more, so I hope that my breakfast will see me through.

Nick and a nurse take Linda through the passages to the operating theatres. When we get there, we have to wait until it’s our turn. Our outfits are completed with shoe covers and a lovely cap. Now Linda is stating to get nervous too, logically…

In the end we wait for about 30 minutes. It’s more than enough time to get nervous, and you can see exactly that happening with Linda and Nick. Shortly after 11:00 Linda can go into the OR. When we get there Nick and I are given masks, and Linda is ‘installed’ in her spot. The nerves briefly take over, and Linda sheds a few tears, but she quickly regains control, and by the time she’s asked to sit up a few minutes later for the epidural, she’s completely calm – respect!

After the epidural is in place, everything is made ready. Everyone in the OR is really kind. I do get hungry now and I’m a little concerned, but when I look at the clock I think it won’t take much longer now.

Then they start with the incision in her belly. They’ve just started, and have already made a considerable cut, when it becomes apparent that Linda still has some feeling in her lower body. A horrible moment, to put it politely. I immediately feel sick, partly because I know Linda well. The doctors stop, and are faced with a dilemma. Usually they would now put her under full anaesthetic, not that this happens often. The nurse who is there says she’s only seen this happen once in 8 years. Everyone reacts to an epidural differently, and this can happen, but the issue right now is that they cannot continue. They ask Linda what she wants: another try at the epidural, or full anaesthetic. She is unsure, but eventually decides to let them try placing the epidural again (even though she’s very nervous about that). It’s a huge procedure, because everything that is sterile has to be put to one side, and the wound has to be closed up, Linda has to be helped upright again, the epidural has to be done, again, and then everything needs to be sterilised again. It takes some time, but this time it goes well, and everything is completely numb!

The only small problem now is that I really don’t feel well. I know from experience what I can do to prevent myself from fainting, but none of those tricks are working now, so it seems wisest to say that I’m not doing well. They immediately arrange a chair for me, and a nurse to look after me. How awkward! I’m now sitting on the chair, and doing everything I can to stay upright and be able to take photos. I see Nick look up at me, and I HAVE to capture the moment. Then the gynaecologist says, “I’m going to cut open the uterus now.” I take a deep breath, stand on the stool, and take photos! The nurse is standing beside me to catch me if things go wrong. And slowly the baby appears! First his head, and then the rest of his body follows. It’s a boy! Linda can also watch through a special little window made for ‘natural’ or ‘gentle’ c-sections. He’s here! They take him to the room next door, and the nurse immediately fetches a sweet drink and 2 sweets for me. They immediately help, and from that moment onwards I can work ‘normally’ again.

Nick is watching, full of emotion. He says the baby’s name is Melle. Melle is perfect. ♥ He’s perfectly pink, and beautiful! They check him quickly so that he can go back to his mother as quickly as possible. Everything looks good! Nick cuts his umbilical cord, and Melle is weighed. He weighs 3660g, and can now go back to his mama. Nicks proudly goes with Melle to Linda. There Melle can have some skin-to-skin time with his mama – wonderful that this is possible! When he’s there he keeps blowing bubbles. It looks like he has inhaled some of the amniotic fluid, but it does look very cute. The stitching all goes well, and Linda is quickly able to go with Melle to recovery.

Once they get there they try to get Melle to latch onto the breast for the first time. He is already searching, but doesn’t open his mouth wide, so he doesn’t manage to get a good latch yet. Linda is slowly experiencing more pain, and so is given some more morphine. This makes her very sleepy, but the pain doesn’t really ease up. It looks like she’s having postnatal contractions, and those are difficult (impossible?) to numb with painkillers. Melle goes for some skin-to-skin with papa, and is lying there like a prince. When he goes back to his mama he falls asleep immediately. Because of the morphine we have to wait another half an hour, and that a number of times, but finally Linda is allowed to return to her room, and of course Melle stays with her. Nick has already called all the grandparents while they were in recovery. Sven is with Linda’s parents, and they will soon be here to admire Melle.

Linda is still very sleepy from the morphine, but Melle is awake now. He looks so alert! A short while later Sven and his grandparents arrive. He can’t wait to see his mama and his brother, and is very excited. It’s so sweet. First a kiss for mama, one for the baby and then he’s unstoppable, and wants to keep giving his brother more and more kisses! The only time he takes a break is when he discovers a bowl filled with ‘muisjes’ (a sweet treat).

After a little while it’s enough. For everyone, including me. I would like to stay until Melle has been dressed, but Linda needs to rest, and Melle is so comfortable that it would be a shame to disturb him just to dress him for a photo. Linda and Nick suggest that I can head home. I take one last photo of the last kiss that Sven gives his brother (for today). A nice way to finish!

Dear Linda and Nick, it was an honour to be able to be there, and I’m so glad I managed to stay on my feet! I hope the recovery goes well, and that Sven will soon be able to cuddle his little brother to his heart’s content!

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