Breech

Karen Hiemer

I live in Germany but I was born and raised on Martha's Vineyard. Nine years ago today (9/29/19) I had a planned C-section. It wasn't necessarily my choice to have one, but more of a medical necessity. I was an “older” woman at the age of 39. I had read at the beginning of my pregnancy that many older women need to have a C-section. I remember this because I had asked my doctor early in my pregnancy if that would be necessary for me. He had answered that only time would tell. When I was approximately 7 months, one day I felt a very strong pull on my belly button from inside. It was still hurting two days later and I hadn't felt my baby move since then. We called my doctor (my husband actually, I was still not very proficient in German) and my doctor was on vacation. I was referred to his substitute. We went and the doctor did an ultrasound. In the middle of the ultrasound my baby started to move again. We were naturally relieved. The doctor told us everything would be fine but that I should take it easy. We left that day with a great gift, not only that our daughter was still healthy, but also a 3D picture of her.

As my pregnancy continued and my baby grew inside me, she moved and kicked a lot. But it was getting very uncomfortable for me. Her head was up under my ribs on the left side and her feet on the right. As it got closer to needing to prepare for her impending birth, my doctor referred me to the doctor at the hospital where she would be born. We thought nothing of this and only that this was normal procedure. When we got there, the new doctor advised us that we would have to have a planned C-section. He then offered us a few dates. In my limited German I remember his first date offered (yes, I did listen to all of them) was Wednesday, 29th September. I actually did not remember the date exactly at the end of his three other options. I only remembered that Wednesday was the earliest date possible. I answered, again in my limited German, that Wednesday was a great day to have a baby. After I gave that answer I asked (or tried to ask) if it was not possible to wait until my water broke and then have the C-section. I had a moment of worry, did I choose a date too early, it was a date after all two weeks before my expected due date. Maybe it wouldn't be her time. Maybe she wouldn't be ready to join the world as a living breathing being. But in the end I do not think he fully understood what I was trying to ask. That I was trying to ask would she be ready? Couldn't we wait and let a little bit of “natural” work it's magic? His answer to me was a clear no. He advised that there was only one doctor in all of Germany who would even try to do this as a natural birth delivery. Yes, only one doctor in the entire country! And he was in Frankfurt, a minimum two hours drive away from us. We did not understand this. This is when we found out that my daughter was not going to turn herself, that she would stay in this inverted breach position. We didn't even realize that that is what she was. The Doctors had not ever told us this was not a normal position. Nevertheless, we stayed with the chosen date.

Fast forward a few weeks (if memory serves correctly it would be 6 weeks) and the 29th of September arrived. My husband and I had made bets with each other as to what time she would be born. We hadn't told anyone the planned date, that we wanted to keep to ourselves. We were told to be at the hospital for very early, 6:30 am. I had been told to shower that morning and had been given a special disinfectant soap to wash with. I was told to wash “head to toe”, not head and face, the legs and feet and midsection, but very important to do head down to toes. We had been told that upon arrival the “Hebamme” (German for midwife) would shave me and prep me with a catheter. Somehow, even though I couldn't see myself, I managed to shave myself in the shower that morning before washing in the order of head to toes. This saved us some prep time at the hospital. I had never had a catheter before. The midwife warned that it would feel like I had to pee but it was normal. I said I don't think it is normal because I feel like I am really going to pee. She said I should just let it go. It turns out that the catheter was not placed correctly and I peed myself. She corrected it and cleaned me up. It was then time to be transferred down to the operating room.

Upon arrival in the operating room, my husband knew one of the assisting nurses. I had seen her around the neighborhood but I didn't really know her. It was a blessing that she was there. It was nice to have a friendly and familiar face there in the room. We had opted for me to be awake. This meant that I would receive an injection in my back to numb me. This also meant that my husband would be allowed to stay with me. I was afraid if he wasn't with me I wouldn't understand anything. I desperately wanted him to be there with me to help me understand what was going on. I wasn't thinking that if I had been put to sleep I wouldn't need to understand.  I was worrying about all the information they had given me in the event that something was wrong with the baby. That something went wrong with me. The baby would be sent to a different hospital. The hospital where we were is small and doesn't have an ICU for babies and I would be left at the hospital without my baby. If it was something with me I would be sent to another hospital and separated from my baby. All of this was running through my head, and I just knew I needed my husband to be there for me. At this particular moment in my thinking I was worried for me. Selfish perhaps but it was a few seconds thinking like this. I then did think that I know how much he wants to be a part of this and that I needed him there for that too.

I had to bend over so that they could give me the injection. I had such a big belly that I looked like I was carrying twins. I could not bend over enough. They said if I couldn't bend over enough then they wouldn't have a choice but to put me to sleep. I told my husband to push me down. He didn't even hesitate and the doctor was able to do the injection. Yay, it meant my husband could stay.

The surgery started. My husband was sitting next to my head. He was holding my hand. A cloth was draped in front of me. It also meant that my husband couldn't see. But he would look around it all the time. I couldn't feel the cut, but I could feel the hands inside me. It was a surreal feeling. It wasn't painful. I could just feel things being moved around. Next thing I knew they were showing me my baby. I saw her for a few seconds before they took her away. The midwife started checking the baby. She cried finally. My husband kissed me as he was ordered out of the room. They showed me my baby one last time and baby, husband and midwife all disappeared. This was known that they would return to the birthing room as the surgical room is too cold for the baby. I would need to stay behind. I was put to sleep to finish the surgery. I woke in the recovery room. After waking my vitals were checked and I was finally able to go to my baby. Everything was fine. We all could stay together. While I was still in surgery and recovery my husband had called everyone to say that Analiesa Marie Hiemer was born at 08:46 am on 29th September 2010, weighting 3490 grams and measuring 51cm.

What we did not know was that my daughter had the umbilical cord wrapped around her neck three times. The doctors had all clearly seen this, but did not tell us, most likely to keep the worry away from us. This I believe is what had happed way back when I had felt the tug on my belly button. Still to this day it is very sensitive to touch, more so than it had been before.

The very next day after the birth, the nurse came into my room very early, I think about 7am, which had felt like I had only been asleep for 15 minutes and she pulled open the curtains. She asked if I had stood already. I said of course not, I had just had surgery the day before. She tried to make me stand, but I played the language card. I could get away with this until my husband arrived a little while later. The nurse returned when he was there. I now didn't have a choice, I had to get up. I advised my husband I still had the catheter in. That didn't phase this nurse at all. She marched right over, took the covers off me and pulled the catheter out so quickly I didn't have a chance to say “boo”. I was then told to stand. Immediately I felt blood pouring out of me. I sat down, they got me some special underpants that are basically diapers and I was cleaned up. I had to walk that day, and right then. This nurse was from this moment on known as nurse Ratchet to me. First she wakes me up, then she rips out the catheter and then makes we walk to the bathroom. Clearly she had no sympathy whatsoever, or so I thought. However once it was done and over with she left me alone. I was told to ring the nurses when I had to go to the bathroom, at least when my husband wasn't there, which he was there every day the whole day until dinnertime when he went home to our dog. He did everything with the baby. He dressed her, changed her, bathed her, all before me. He was wonderful. Here in Germany I was allowed to stay in the hospital for five days following the birth.

Fast forward a few weeks and we were home. I had stopped breastfeeding the second day home. My daughter never latched on. The entire stay in the hospital I had to pump. The pump in the hospital was much more powerful and it didn't take long. Additionally my milk was not enough for my daughter and she continued to lose weight beyond the initial couple days. We had to supplement with formula in the hospital otherwise she would have to have stayed longer. I have since read that statistics show C-section births often do not breastfeed as long. It was ok. My baby got the first 6 days of my breast milk, meaning she got the crucial time which has the most antibodies to pass on. However, I digress. Healing of the C-section was doing well. Though my body rejected the dissolve-able stitches and started to push them out. Each day my husband had to cut a little piece off. He wanted to pull them out but I wanted to wait and show the midwife at her next scheduled home visit (in Germany they support you for up to 8 weeks after the birth with home visits). She looked at it and explained she had never seen or even heard of such a thing happening. A couple days later my husband had decided he had had enough of cutting it every day and decided to pull, and yes against my initial wishes, but more-so against my knowledge. It was still more than 3 inches long! But all was well, my body could really heal now. My baby was doing well, I was healing and we were overjoyed and blessed with a beautiful baby girl. I am lucky to have my girl. She is my miracle and I am for one very happy that science has brought us so far in the last 50 years that we have ultrasound and because of ultrasound the doctors were able to save my life and more so that of my daughter. After learning that the umbilical cord was wrapped around her neck, and as I mentioned we did not learn of this before the birth from the doctor, we actually only learned this from the attending nurse who my husband knew, today's science afforded us the opportunity to have a life-saving surgery that was planned and necessary. I hope my story will help a future mother. Many blessings to those future mothers who may have to have a C-section. Just know, you will be ok.