A C-section in Rotterdam

Marcel and Maurice are colleagues, Maurice is the father of Daan, whose birth I had photographed in September 2011, and this brought Marcel and Yvonne in contact with birth photography.  I received and email from Yvonne saying that she really wanted to do a photo shoot of the birth but also a pregnancy shoot.  Yvonne says she wants to do this because “my partner has colour tattoos fully covering both arms, and I think it would look really cool in combination with my bump”. So that’s how it all started.  At 38 weeks pregnant Yvonne and Marcel came to Middelburg to meet me and get on with the pregnancy shots. It was lovely weather and Yvonne had various outfits with her.  It was a fun afternoon with great photos. You can see a selection of these photos here.

During our discussion, Yvonne indicated that she wanted to do things naturally, without pain relief. She had a down to earth approach and was planning to let things take their own course. “Tough guy” Marcel was not as tough as he looked and announced that he was already feeling nervous. He could get tattoos done, or a piercing, without flinching, but to see his wife give birth, pain and blood: that was something else 🙂 !

In the weeks leading up to the due date (13th September) Yvonne was already having some mild contractions, this eventually led to her being 3cms dilated by Wednesday 12th September.  So, a  3cms “head start”. With this in the back of my mind, I didn’t want to wait too long to get driving, if these  3cms came so easily, then the rest of the birth could be just as easy….Besides Yvonne was super fit, a good sign.

On Wednesday night I get a call just before 1am.  I have been asleep for just an hour. I can see it’s Yvonne, but when I pick up I hear nothing. She rings again and I try to call her twice, but I hear nothing, not even the phone ringing. I don’t understand, there’s nothing wrong with my phone! My phone rings for the fourth time (which I do hear) and then, suddenly, in the dark, I feel what the ‘problem’ is, my headset is still plugged in and I try to just speak and listen through the phone. Wake up, Marry! When I eventually do hear Yvonne, she tells me that it looks like the contractions have really started. If they’ve been coming every five minutes for an hour then they can call the midwife. I ask her to call me at the same time and then I’ll decide what to do.

I fall asleep again and am woken up by my mobile at 2.38am. This time it’s Marcel, they’ve just called the midwife because the contractions are a good bit stronger now and coming quickly after each other. We agree that he’ll call be back when the midwife is there and we’ll see. We hang up and I roll over, but I fret. The last few births I’ve photograph went pretty quickly, Yvonne was already 3cms dilated…what if it turns out she’s already 7cms dilated by now and I still have to drive. I can’t sleep for worrying, so I deicide just to go. Better too early than too late. I don’t rush, in the hope that Marcel rings back before I leave (I can always go for another lie down, haha). I make sandwiches, get my stuff together, but there’s no phone call. So, I’ll just drive. I send Marcel a text to say that I’m on my way. As I’ve just got going I get a reply: “midwife has just arrived, we’re not going to the hospital yet, waters broken and 4cms dilated.  Hmmmm, I could have stayed in bed then. Oh well, nothing so unpredictable as a birth, and it’s nice that I can drive there without any time pressures.

At 4.30am I arrive in Hoogvliet. The whole street is still asleep, but there is one house where the lights are on. Marcel opens the door and straight away suggests that I can nap on the sofa. Maybe that’s sensible because now it doesn’t look to be going as quickly as I previously thought.  Yvonne is upstairs and is finding it tough. She decides to come down stairs so that she doesn’t have to tackle the stairs later on.  Marcel has set up a mattress downstairs (the kitchen is downstairs). Once they are downstairs and I’ve made a few photos, I decide to make use of ‘the sofa offer’. I go for a lie down.

From where I’m lying I can follow what’s going on downstairs. I don’t really sleep because I’m half listening to whether everything is going okay. Yvonne is finding it harder still. She’s puffing the contractions away well, but she says more and more often that she doesn’t think she can keep going. I keep hearing her say: ‘it hurts so much’. Eventually she can’t keep it up and just before 5am Marcel rings the midwife. I get up from the sofa to wait for the midwife with them. She arrives quickly and it turns out that Yvonne is now 6cms dilated. She’s doing fantastically! She doesn’t have that idea herself however, she wants pain relief and keeps feeling guilty about it. The pain gets worse and now and again a swearwords pops out, followed immediately by a ‘sorry’. We keep saying: “You’re doing brilliantly and you don’t have to apologise”.

Marcel’s father is woken from his bed and shortly after is standing at the front door ready to take them to the hospital. I drive behind them.  Just after 6am I arrive in the room at the IKAZIA hospital in Rotterdam. Yvonne is hooked up to the CTG (Which measures the baby’s heart rate and the contractions). They need half an hour of CTG readings to decide what kind of pain relief will be given. I explain to Marcel what you can see on the CTG, the lines on the screen are a bit more interesting if you know what they indicate. The midwife has already forewarned Yvonne that it might be too late for an epidural. Once dilation has gone so far an epidural will no longer be given. We have arrived at a bad time because it is ‘shift change’. The night workers are being replaced by the morning team.  A doctor comes to check the dilation and I’m really hoping that she’s past the 6cm mark. That would mean that there’s a good chance of the baby arriving in the next 2 hours…but it’s not to be. She’s still at 6cms. For Yvonne this is good news on the one hand, because she can have an epidural, but at the same time a disappointment. Because there’s no anaesthesiologist, we have to wait. Yvonne is finding it really tough and Marcel finds it hard to see her like this. She really depends on him being there.  When he needs to go to the loo and she has a contraction she begs him to come back. Therefore it’s also hard for him to find a moment’s rest. He’s also missed a night’s sleep and he now knows what a tough cookie Yvonne is and in how much pain she must be in.

Now and again Yvonne makes funny comments. A new nurse arrives who asks if she wants something to drink, but instead of giving an answer Yvonne says: “What’s your job? Are you from the buffet car?” We have to laugh. What’s not so funny is that we have to wait ages before she can finally go downstairs for the epidural.  By now, she doesn’t know what to do with herself and she apologises to everyone who comes in.  She has the feeling that she not doing it right. Everybody’s answer is the same: “you don’t need to apologise, you’re doing a great job!” Personally, I think Yvonne thinks we’re only saying this to keep her spirits up, but that’s really not the case. She’s doing really well and the fact that she wants pain relief doesn’t in the least mean that she’s ‘failed’.  Sometimes you just have to do whatever it takes, and the dilation is just not progressing this way. Eventually, she and Marcel go downstairs just before 8am. People are usually back within an half hour or so. This takes longer…At 9am no-one is back and I start to worry, I just hope it’s going okay. ..I watch a bit of the news, which is all about the Dutch elections results, I nod off in the chair and eventually at 9,30 they come back!

I can tell straight away from looking at Marcel that it’s not good news. He looks extremely worried and it seems like he’s been crying. I quickly understand why. When Yvonne was given the epidural their little girl didn’t like it very much. Her heart rate dropped quickly and for a long time. Marcel thought he would lose his mind. If you’re hooked up to the CTG the baby’s heart beat reverberates through the room, if that suddenly goes really slowly or stops then it is suddenly horribly quiet. Marcel tells me: “I thought I was going to throw up there and then. Your wife’s in pain, the heartbeat of your baby stops and you can’t do anything.” Whoa, I can well understand why he’s a bit red around the eyes! It makes me shiver. It had been a bit of a panic downstairs, but with some drugs to stop the contractions, the baby’s heart beat had recovered.  Yvonne is still feeling the contractions, albeit less sharply with the help of the drugs, and she is totally exhausted.  Marcel is desperately in need of a cigarette and I think that it’s a good idea for him to get some fresh air. I put my camera down and take ‘his place’ next to Yvonne, with her hand in mine. While Marcel is away the doctor comes along to say that he wants to do a test to see if the baby has enough reserves for the birth.  Via a rather uncomfortable procedure they take some blood from the baby’s head to see what the Ph value is. Marcel returns halfway through the test and it seems that the cigarette hasn’t really helped him. He looks totally helpless. I would like to hold his hand too, but the doctor’s trolley is in the way. He and Yvonne blow each other kisses and he very sweetly makes a heart shape with his hands. Shame that I don’t have my camera to hand. The test goes well, the first blood test shows that the baby doesn’t seem to have suffered from the sudden heart rate drop and for now, has enough reserves for the birth. The doctor decides to wait a bit longer.

Marcel takes up his place again and I decide to get out my knitting, it could still take a while. I keep an eye on the CTG but this doesn’t make me any happier.  I go to the corridor to look for the doctor.  I’m getting ahead of myself, but if I’m reading it right there’s a chance it will have to be a caesarean and if this has to happen quickly then no-one will have time to ask if I can go along. So, it’s better to ask now. The doctor (everyone in fact) is really helpful and pleasant. He rings straight away to see if it would be possible (to me this seems to prove that I have interpreted the CTG correctly).

At 10.45 he comes to have another look how the dilation is going. He explains very calmly and clearly to Yvonne and Marcel that the CTG is not looking so good and that if the dilation hasn’t advanced then it will be a caesarean. Yvonne and Marcel are fine with this, they just want a healthy daughter. Unfortunately she’s still only 6cms dilated 🙁  it will be a caesarean.

There is relief and disappointment.  Now we get lots of sorrys from Yvonne and some tears. She feels like she has failed, but she’s not at all to blame. Sometimes nature just doesn’t co-operate, but that is small comfort. It’s still a damper if you’ve been trying all night and all morning for nothing. Dreadful.

The contractions are slowed down more and Yvonne is prepped for the operating theatre. The nice doctor comes back to say that I can go along to theatre too. Good! Marcel is happy about this too; he can be totally focussed on Yvonne.  Now that the contractions are minimal, their little girl is doing fine again too. But, since they are no longer a real emergency we have to wait until there is room in the theatre. Eventually at 11.50 we can go downstairs. We get decked out in our blue theatre suits and have to wait again. The contractions are slowly starting to come back. Now it really has been enough. Yvonne mumbles a few more sorrys and Marcel tries to keep her spirits up even though he’s shit scared himself.

At 12.34 we can finally go into theatre. Yvonne is prepped and everything is laid out ready. With the help of the theatre staff I choose myself a good spot. Marcel and Yvonne disappear behind a blue curtain and I stand with my camera poised at the other end. The doctors want a few nice photos of themselves at work, so I do that straight away. It’s still a little bit tricky to get the baby out of the bump, but then, at 12.55, after a whole night and a whole morning, a beautiful little girl is born.  It’s a wonderful moment. Later, Marcel says that “Yvonne’s face switched immediately from anxiety to relief and happiness”. Because of the masks, I can only see Marcel’s eyes. But, they speak volumes, they are wet there is still some disbelief in them. He is a father. Wow!

The little girl is given the name Kaitlynn. She’s doing really well, it doesn’t seem like any of this has bothered her. She’s wrapped up warm and then she can go and snuggle next to her mother. Yvonne is so happy. Sadly, this is just a short moment and then Daddy and his beautiful daughter have to go back upstairs. Mummy stays in the theatre until she’s recovered a bit. I go upstairs with Marcel and Kaitlynn.  She can lie skin to skin with Daddy. It’s very touching, such a big tough Daddy with his arms covered in tattoos and such a tiny, very awake little one. She really reacts to his voice. If I want to make photos with her eyes open, I only have to ask Marcel to talk to her. Lovely.

He’s enjoying his sweet, beautiful daughter, but at the same time he’s keeping an eye on the clock. When will Yvonne be back? However, lovely it is with his daughter, he wants his girlfriend there too. Understandable. Time creeps by, but no Yvonne. It takes ages. Longer than I am used to. We ask a couple of times if anyone on the ward knows anything, but no-one does. If there was a problem, they would have been told. So why is it taking so long. Eventually, Marcel has really had enough. He asks me to hold his daughter. I trifle for a moment, she’s not even dressed, but I can well understand him. He’s been sitting here for two hours with no news of Yvonne. Rather angrily he walks into the corridor to demand information but at that very moment Yvonne is being pushed up the corridor. Finally!

Marcel quickly picks up his daughter to let her lie in her bare skin, nice and warm, next to her mother. It really is great that she’s back. Meanwhile, Kaitlynn has fallen asleep and is cuddled up with her mother. Yvonne is enjoying her daughter, but she is also exhausted and like her daughter can hardly keep her eyes open. She says sorry again…now we really don’t want to hear it anymore: just look what you’ve brought into the world, Mummy! She is beautiful!

Dear Yvonne and Marcel, enjoy it!

Special thanks to all the docters and nurses from IKAZIA hospital. Thank you for your hospitality and allowing me in the OR.