LAST week the Health Service Executive issued statistics in relation to various birth interventions in Ireland. A stark reality that emerged was that Ireland's Caesarean section rate was way above the 15pc national C-section rate recommended by the World Health Organisation (WHO).
Rates across maternity units in Ireland vary wildly. In Sligo General Hospital the C-section rate is 19.13pc, the lowest in the country but still almost 5pc over the WHO recommended rate.
The majority of hospitals fell between 25pc and 30pc for their C-section rate with St Luke's Hospital Kilkenny topping the list with a 38pc C-section rate.
I am part of these statistics. I have three kids. Each of them arrived into this world via my abdomen despite my absolute desire to give birth normally. My first decided it was a good idea to turn breech -- ie the wrong way around at 39 weeks -- less than a week before my Christmas Day due date.
It emerged at a regular antenatal appointment that at some point in the previous seven days she had done a 180 degree turn -- and to add to the drama, my waters were very low and I was advised that we should get the baby out there and then. I was immediately prepared for theatre and my first was born and in my arms for a memorable Christmas stay in hospital.
On my second, I was all set for a normal delivery. It appeared that all was on track when at two days past my due date, my waters went with a gush. Unfortunately my little man was not so enthusiastic about making his entrance and 26 hours later and with induction not recommended, I was marched off to theatre again.
My final trip to the same theatre was on my third. With the support of my consultant I had been planning a normal delivery -- not very common to go for a normal delivery after two sections but all was on track for most of the pregnancy until, when a few days overdue, I had to make the decision to head off to theatre.
It was a tough choice -- head versus heart -- but with the medical advice being that with two previous sections, baby high, placenta degrading, induction contraindicated and my cervix long, closed and posterior, that we get baby out, I arrived for theatre less than 24 hours later.
I'd like to think that with my experience of C-sections I have learnt a few things about them along the way. The first is that no matter how much you plan for a normal delivery things can go awry. While no mum-to-be should plan for things to go amiss, I think that all should certainly be prepared for the possibility of a C-section and what that would involve. I mean, I don't buy car insurance and plan an accident.
With hindsight, I look back on my first pregnancy, during which I read all the books and attended my antenatal classes, but never imagined lying on an operating table. I guess I kind of skipped over that chapter and the C-section word was never uttered at my antenatal class -- it was all stage one, stage two and stage three of labour, breathing techniques and little models of baby seamlessly popping out of makeshift mammy. Of course, with hindsight, it is bizarre that the notion isn't addressed in more detail -- or any detail for that matter -- particularly in light of the statistics.
My first walk to theatre was a trip into the unknown. I really had no idea what to expect -- it was definitely a moment I had wished I spent more time reading the C-section chapter in the pregnancy book. Before it all kicked off I was dressed in a surgical gown and given some highly attractive compression socks and shower cap style headwear. There were some quick blood and urine checks, consent forms signed and a quick chat with the anaesthetist who explained I would be getting a spinal block -- an injection into my back that would numb me from the chest down so I would feel no pain but would be awake.
Sitting on that operating table leaning forward knowing that they were about to inject into my spine and then cut me open was petrifying each time but I was super excited that I would be holding my new baby in a matter of minutes -- a thought I tried to focus on rather than the procedure.
Lying numb on the operating table, unable to move, my surgical gown was raised and I remember feeling so exposed -- literally and metaphorically. It was a feeling I didn't expect, I just felt so vulnerable, but the team just got down to business and before I knew it my abdomen was washed, monitors attached, catheter inserted and I was ready.
It was only at this point my husband was allowed enter, all changed into surgical scrubs -- a funny sight. He always took his place sitting beside my head as we awaited the delivery of our babies.
A memorable moment on my first was when the monitors starting alarming. Of course I thought I was finished. I had obviously watched too many hospital dramas. I always like to prepare any mums-to-be heading for theatre for the first time about this.
The actual delivery is scarily quick. Within five to 10 minutes, baby is out -- although on my second it took a little bit more tugging to dislodge him. I had no hospital bag or any clothes for my first baby as this was a very much unplanned trip to theatre so after the customary checks and tagging they wrapped my little girl in a towel and handed her to my husband who looked on, a little pale, at this tiny new being.
By my third section, I managed to get skin-to-skin contact -- the theatre midwife just popped a nappy on my latest little lady and laid her on my chest with a towel over her as they completed the surgery. It was a truly magical moment and certainly distracts from the surgeon putting you back together -- which seems to go on for an age compared to the actual delivery -- but really it's only about 20-30 minutes.
After each section I was brought to the recovery room. I managed on two of my three sections to keep baby with me -- on my third, I was curtained off and spent time with my new little girl breastfeeding and enjoying those special first few minutes of life. The only thing distracting me from this lovely moment was a really bad itchy nose. I just couldn't stop scratching. This was a side-effect of the spinal block that thankfully wore off quickly.
After recovery I was always brought to my post-natal bed and given a cup of tea. I don't drink tea but for some reason always did in the hospital. A few hours later and feeling had returned to my body.
The nurses were adamant each time about me getting up and having a little walk around -- although it was really only after 24 hours, when the catheter was removed, that I began to feel in any way human. From there it was just a battle against the pain. On my first I would tell the nurses I was fine and pass on some offers of pain relief. By my third I was ringing the bell asking for it whenever any niggle of discomfort was brewing. I certainly learnt that being a martyr gets you nowhere.
Bowels are not something you really want to be thinking about when welcoming a new baby, certainly not your own, but unfortunately between surgery and strong pain relief my bowels became a little sluggish (to put it politely) after all three births.
I definitely learnt the hard way not to get blocked up - not pleasant when there is scar lurking so close to that area. By my second and third I was practically drinking laxatives post-theatre.
Once we got home after my five days in hospital it was a little scary, particularly the first time. Still recovering from major surgery yet just let off on our own with this tiny being.
This was definitely a time when the housework got shelved. On my first I did try to keep things in order with all the visitors that were calling but after my second and third C-sections not only did I not keep everything in order, I minimised the visitors too.
I concentrated on getting those around me to help with creche or school runs, letting me take some naps or running some errands that I couldn't do while I couldn't drive for more than three weeks.
While I was physically mostly back to normal after about six weeks it probably took the guts of six months before I felt myself again -- albeit left with a scar.
My scar is my battle wound of childbirth. It was red and tender for the first few weeks, but now it is barely visible. Because I had the more common bikini cut I can get away with the slinkiest of underwear or bikini without the scar being seen.
The one part of recovery I found most difficult was the emotional recovery. After my first it wasn't so bad. I just felt all the normal post-birth hormonal highs and low. After my subsequent two births I felt a failure. I had desperately wanted to give birth normally and despite my efforts I didn't do it. There was such a huge sense of disappointment.
After my third, which I intend to be my last, I felt a real sense of loss for the birth I wanted. I did face some comments such as how I was lucky not to have had to endure the pain of labour -- as if being cut open while awake is in some way the easier option.
I sat and cried my eyes out with my consultant at my six-week check-up. He advised me to keep an eye on my feelings and to go to my GP or back to him if my feelings did not lift.
While I will always lament the loss of my dream of a normal delivery, I can finally say at this point, two years after my last section, I am now content and proud in my status as a C-section mother.
I like to think that it was an act of true motherhood to, on my third, make the decision to abandon my own dream for my baby and I wouldn't change the fact that all three of my children are here, safe and sound, for anything.
This article is based on a number of C-Section-related posts on Lucy's blog www.learnermama.com. In addition, Lucy has set up a Facebook Group for Irish C-Section Mammies to provide a supportive place to chat about all things C-Section-related.