The Letter I Wish Someone Had Written Me

The Vessel

I was twenty-one. First baby. I knew, the way pregnant women know, that I wanted to give birth at home. I had read enough to know it was safer than the cultural panic around it suggested. I had a body that worked. I had a husband who would have been with me.

But I was twenty-one, and everyone with an opinion had an opinion. The midwives I spoke to wanted me at the hospital. My family wanted me at the hospital. The friends I had wanted me at the hospital. After enough conversations in which I was told, gently and not so gently, that I would be selfish to put my baby at risk for the sake of an experience, I stopped trusting myself and went.

It took forty hours. Forty hours of strangers walking in and out of the room, of being checked by people who did not introduce themselves, of decisions being made above my head between the midwife and the doctor and the nurse on shift while I lay on the bed and watched the ceiling. My husband stood by the wall. He wanted to say something. I could see it in his face. But he did not know what he was allowed to say, or who he was allowed to say it to. So he said nothing. And I said nothing. And we both watched the people who were running the room run it.

I was a vessel. That is the word I came back to over the years, when I tried to describe what had happened. The baby was a procedure to be completed. I was the place she lived. My job was to hold still and let them get her out.

She came out, eventually. She was healthy. She was beautiful. Everyone was relieved. I was relieved. But underneath the relief was a quieter feeling I did not have language for, which was that something had been taken from me and I had handed it over freely because I had not known I was allowed to keep it.

It happened to me. It took me years to put words to it. The word I eventually found was not a clinical one. It was a sentence. I was a vessel she lived in.

Finding the Midwives

I got pregnant again quickly. I do not remember exactly when I decided, but somewhere between the first positive test and the second prenatal appointment, I made the decision. I am going to have this baby at home. No matter what anyone says. No matter who tells me I am being reckless. This time it is mine.

The challenge was finding midwives who would actually fight for me. Most of the ones I called wanted to talk me out of it, gently, the way doctors do when they have decided what should happen and are working out how to get me there. The two who said yes, after I had explained what I wanted, were the ones I worked with for the next four babies.

What changed when I worked with them was not the medical care. The medical care was good in the hospital too. What changed was who I was in the room. With them, I was the person giving birth. They were there to help me do it, not to do it to me. If I wanted to walk, I walked. If I wanted to be in water, I was in water. If I needed silence, the room was silent. If I needed someone to hold my hand at three in the morning while a contraction tried to take me apart, one of them was there.

Number two took a long time. It was complicated, in the way labour can be complicated. But every decision that needed to be made, I made. Or my body made, and they noticed before I did and asked me what I wanted. She came out at home, in a quiet room, with my husband next to me and two women in the corner who were paying attention to me, not to a screen.

Number three was harder. Real complications. The kind that, in another room with another team, would have ended with a code being called and a doctor pulling rank. With these midwives, the complications were noticed early, named, and worked with. They kept me informed at every step. They told me what they were worried about. They told me what they thought we should do. They asked me what I thought. We agreed. He came out at home, healthy. A boy.

Number four was the easy one in that stretch. Nine hours. I was two weeks past my due date and not in a hurry. The midwives did not pressure me. The system would have. They did not. Healthy. Home. Done.

Three home births in a row, all with the same two women in the room, all with my body doing what bodies do when nobody is interrupting them. I started to understand what the difference was. It was not the location. It was not even the lack of intervention. It was that I was the subject of the story, not the object.

The Pool

By the fifth baby, I knew what I wanted, and my body knew how to do it.

We had set up a birthing pool in our living room. Nothing elaborate. Plastic, heated, the kind of thing that looks ridiculous in a house until you climb into it during a contraction and understand exactly why it is there. My midwives knew the pattern by now. They had three of my previous births in their hands. They knew me. They knew how I laboured, what I needed, what I would refuse.

When I called them this time, they got moving. But the baby was faster than they were.

My contractions started, established themselves, and within twenty minutes were the kind that meant a baby was coming. Not soon. Now. My husband phoned the midwives and tried to describe what was happening, and on the other end one of them was already in her car. The other one was further away and would not make it.

He came out in the water. My husband almost delivered him alone. I was in the pool, my husband behind me, and the first midwife arrived twenty minutes before he was born and the second one walked in just as he was being lifted out of the water. Two of us, and then him, in the living room I had been pregnant in for nine months.

There was no rush. There was no fear. There were no decisions made above my head. There was a woman who knew her body, a man who knew his wife, and a baby who knew when to come.

I am not telling you to give birth at home. I am telling you what happens, in a body that has not been frightened out of trusting itself, when the room around it lets it work.

The Trauma

Then came the sixth, and we had moved.

I had had a conization a few years before. They took a piece of my cervix away. Every midwife I had ever asked about it had told me it should not matter for birth. The cervix is good at what it does. It opens for babies; that is the whole job. A piece missing was not the same as a job undone.

The hospital where I gave birth to number six did not agree. They were scared. They were scared of me, and of the size of my babies, and of the lines on a chart that had nothing to do with the woman in front of them. They wanted to induce me at thirty-seven weeks. They wanted to put me on my back. They wanted to watch a screen instead of watching me.

I should have walked out. I did not.

I was further along by then. Six children in. I knew what I knew. But I was tired, and I was alone in a country whose language I did not speak well enough to argue in, and the doctor in front of me did not look like someone who would be moved by anything I said. So I lay on my back. They put the CTG belt on. They told me to stay still. They turned the lights up. They started a clock.

Seventeen hours. I cried for ten of them.

This was not labour the way I had known labour. This was labour interrupted, every twenty minutes, by someone walking in to check a number on a machine. Labour interrupted by suggestions, then instructions, then ultimatums. Labour interrupted by my own body trying to figure out what to do under the kind of light no animal would lie down under.

When he finally came, it was with a tear that went almost all the way through. Grade three. A hemorrhage that scared even the doctor who had run the room. Surgery to repair what had ripped open. I went home a few days later with a haemoglobin of eighty and a baby I did not feel I had given birth to, exactly. I felt I had survived him.

Eight years later, that is the baby whose bond with me I am still repairing.

I want to be clear what I am saying. There is nothing wrong with my child. There was nothing wrong with me. The birth itself, biologically, was the kind of birth bodies can do and have done for two hundred thousand years. What changed was who was running the room. What changed was that I was no longer a woman giving birth. I was a problem being managed. And the months after, when I should have been falling in love with a new baby, were instead months of trying to recover from the way I had been treated.

That is the part most people do not know about birth trauma. The body heals. The tear heals. The blood comes back. The numbers on the chart go where they are supposed to go. The part that does not heal as fast, sometimes does not heal for years, is the part of you that was watching while it happened to you. The part of you that knew it was not supposed to be like this, and that no one in the room was going to listen if you said so.

I am not asking you to be afraid of hospitals. I am asking you to know what we are talking about when we talk about how birth goes. The way you are treated is not separate from the way you remember it. The way you are treated becomes part of the way you parent. The way you are treated, in those hours, follows you home.

I did not know any of this before the sixth birth. I thought a healthy baby was the goal and everything else was decoration. I was wrong. The mother coming out of that room matters as much as the baby. They are coming out of it together. If one of them is broken, both of them are.

The Referral

Number seven, I cried myself a referral.

I was still living in the country that did not allow home births, by then. Pregnant again. Already knowing what I had survived the previous time. Going through the system trying to find a way to give birth that would not end the way the last one had.

I asked. I asked nicely. I asked again. I asked less nicely. I cried in offices. I cried in waiting rooms. I cried at the kitchen table at night with my husband trying to figure out what to do. Eventually, after enough crying, I got a referral. They would let me give birth in Sweden, where I had given birth before, where it was familiar, where I could plan it.

We drove. We checked into the hospital. My husband went looking for a midwife to tell about the birth plan, the bath, what I had decided I would and would not have done to me. He had not finished the conversation when twenty minutes after we walked through the doors, the baby was out.

There is something almost funny about how that one went. They had not even gotten me to a room properly. They had not started a chart. They had not had time to suggest a single intervention. The baby simply arrived. Twenty minutes from check-in to birth. The midwife who caught the baby had only met me ten minutes before.

And then it went wrong. The placenta would not come. The bleeding did not stop. I had to go straight from the birth room into surgery. They had to manage the hemorrhage with anaesthetic and instruments, the way you do when there is no other option left.

I came out of surgery in a recovery room, alone, knowing my baby was somewhere in the hospital with my husband but unable to reach either of them. For an hour, maybe more, I lay on a hospital cot in a room I had not chosen with no one I knew within reach, while my new baby was somewhere I could not see. I have never felt more separated from a person I had carried for nine months.

When I think about that birth now, I do not remember the pain. I do not really remember the birth at all. The birth itself was fine. It was fast and it was easy and the baby came out healthy. What I remember is the hour after, alone in that recovery room, trying to understand where my baby had gone.

The birth was not the trauma. The birth was easy. Everything around the birth was the trauma. That is what people miss when they ask whether a birth was successful. Success is not just whether you both made it out alive. Success is whether you made it out together.

The Redemption

Number eight was the one I had been working towards for twenty-four years without knowing it.

They wanted me in the hospital again. The fear this time was not about the cervix, or the size of the baby, or the country we were in. The fear was about how many babies I had had. The medical name is grand multipara. Eight pregnancies. The risks, they explained, were real. Hemorrhage. Uterine fatigue. A labour that might go too fast, in the car, in the kitchen, in the bathroom.

I let myself be talked into the hospital. But I did not let myself be talked into the version of the hospital that had broken me last time.

I wrote a birth plan that took weeks. I read every line back to my husband. I added every contingency. I added the words for the conversations I did not want to have, so that I would have those conversations on paper instead of out loud while I was in labour. I added what would be done, what would not be done, what would only be done with my explicit yes. I had it printed. I had it laminated. I had it with me in the bag.

I met with the midwifery team. More than once. I asked them, by name, in writing, who would be on shift the week I was due. I made them promise certain things. I made them write down their answers. By the time I went into labour, I had what amounted to a contract.

When I arrived at the hospital, I was assigned a midwife who was wrong for me. I knew it within the first five minutes. The way she came into the room. The way she talked over me. The way she looked at the chart and not at me. I asked her to leave. I did not negotiate. I said this is not going to work, please bring me someone else. There is a version of me from twenty years ago that would have died before doing that. That version was not in the room.

The second midwife walked in and understood me without me having to explain. I do not know how she did it. She just did. She read the birth plan. She nodded at the things on it. She asked me one question, which was what I needed first. I told her. She started doing it.

She kept the doctor out of the room. That is the most important thing she did. She did not refuse to consult the doctor. She did not refuse to escalate if it was needed. She simply, by being competent, by being calm, by trusting the woman in the pool in front of her, made it unnecessary for anyone else to be in the room. I gave birth in the water, in peace. The placenta came on its own, calmly. I bled almost nothing.

Hospital walls, home conditions. That was the one I had been chasing.

Most hospitals cannot promise you one midwife who is yours, who is with you, who is paying attention to you and not to the room next door. The ones who can are doing something rare. The ones who cannot are doing what they have time for. When I tell women I work with that this is what to ask for first, they sometimes look at me as if I had told them to ask for the moon. But it is not the moon. It is the single intervention with the strongest evidence in the entire body of birth research. It is the thing the system was designed to make impossible. It is the thing that turned my eighth birth into the redemption it became.

What I Know Now

Eight births. Four at home. Four in hospitals where I learned, in different ways, what the difference comes down to.

It is not the building. It is not the equipment. It is not the country, the protocol, the technology, the credentials. I have given birth in three buildings and two countries, with midwives and with doctors, in pools and on beds and on backs, with the lights up and with the lights down. The thing that changed each time was the person sitting next to me and what they believed about my body.

If the person believed my body was a problem to be managed, everything in the room arranged itself around that belief. The chart came first. The screen came first. The clock came first. I was the slowest part of the operation.

If the person believed my body was already doing the work and only needed to be left to it, everything in the room arranged itself differently. I was the centre. Everything else was around me.

These are not abstract differences. They are operational. The same body can produce a smooth eight-hour birth in one room and a seventeen-hour ordeal in another. The body did not change. The room did.

What I want women to understand, before they walk into their own delivery room, is that you have more say in this than the system likes to admit. You can ask. You can write things down. You can refuse. You can request a different person. You can take your laminated birth plan in with you and read it out loud if you have to. The room will arrange itself around what you make it arrange itself around.

This is not a problem that has not been studied. This is a problem that has been studied for fifty years. The findings are clear. The system, on the whole, has not been built around them. It has been built around something else, and that something else is not you.