Because of the threat of premature birth, I’ve been on edge for so long—not just figuratively, but literally. Now I suddenly have to let go…

My Birth Story 🤍 It’s 5:17 a.m. and I wake up with a start. A strange feeling comes over me. I give my belly a gentle poke. Where are you, little one? Normally, I would have woken up long ago from your kicking, but tonight it’s quiet—too quiet. Even after poking you repeatedly, there’s no reaction. A cold shiver runs through my body, so in a panic I reach for my Doptone. You’ve been quiet these past few days, too. But then the reassuring sound of a heartbeat—135 beats per minute—echoes through the bedroom. I take a deep breath, and after a while, I feel him move. There you are. I drift back to sleep.

In the days that follow, I notice that he really is moving less. I can still feel him, but he’s nowhere near as active as before. Of course, I take this seriously and go to the hospital every day for a CTG. The CTGs look good, and so does the blood flow in his umbilical cord. Still, the uncertainty continues to gnaw at me.

On June 7, the gynecologist does another ultrasound. I can see his little heart beating, but she keeps moving the probe over my belly and says nothing else. I start to feel anxious—is something wrong? Does she see something I don’t? After a few minutes, she says, “I don’t see him moving at all on the ultrasound either…”

The First Attempt at a Comic Strip

At the hospital, they’re recommending induction. Induction—such a definitive step—even though his heartbeat is still so strong and all the tests are normal. Isn’t he just calmer because he has less room? I find this difficult, especially since I’ve been doing everything I can for weeks to keep him inside. And now he’d have to be brought on early, even though the daily checkups are normal. But on the other hand, I’m no longer confident that he’s comfortable, and I’m noticing that, slowly but surely, I’m becoming more anxious.

On June 7, I decide to have the amniotic sac stripped. Maybe an induction won’t be necessary at all, and my body will take care of it on its own!

The first attempt at stripping only causes some nagging pain in my lower back, but otherwise everything remains calm. The daily checkups continue, and on June 8, everything seems fine again, although his heart rate shows a slight dip now and then. This could be due to the umbilical cord being wrapped around him or a little one who likes to squeeze his umbilical cord. That evening, we try stripping again, but it results in nothing more than some mild rumbling.

The next day, June 9, I have another checkup at the AMC. The echocardiogram looks good, but he remains still. Every day I relied on his movements, but now I feel that certainty slipping away. Although I still feel him every now and then, something else is going on—something my intuition can’t ignore. It’s time to make a decision. I’m proud of how far we’ve come, but I don’t want to take any unnecessary risks. His safety comes first. That’s why an induction is scheduled for June 11, exactly on the due date. My body will still have a little while to go into labor on its own, as long as I feel okay and the checkups continue to go well.

After my checkup at the AMC, I drive home and ask in the family chat group if anyone feels like going for a short walk. Walking, acupuncture, foot reflexology, sage tea, raspberry leaf tea—anything to give my body a little boost.
I’m walking through the woods with my dad. Along the way, I feel some cramps, but I keep walking at a steady pace. At the end of the afternoon, my dad goes home, and I decide to eat something, even though I’m not very hungry. Around 8:30 p.m., I send a quick text to my dear colleague (who’s my care provider) to let her know that the hard contractions are coming every 4–5 minutes and are starting to feel a bit more intense. It feels different, but not quite like contractions yet. I potter around the house, watch TV, and wait to see what happens.
11:00 p.m.: The third attempt at stripping the membrane has helped, because the contractions are now coming regularly and are strong. I do notice, though, that with every contraction I tighten my pelvic floor, as if I still need to hold it in.

Because of the threat of premature birth, I’ve been on edge for so long—not just figuratively, but literally.

Now I suddenly have to let go and relax, and I’m barely managing it. After an hour or two, I decide to get into a warm shower. The contractions are really radiating into my lower back, and the warm water brings some relief, but my legs quickly start to feel heavy. I try to find a comfortable position on the tiles, but I can’t, so I step out of the shower. Lying down? Not comfortable. Sitting? Not that either. I keep pacing restlessly, searching for a position that offers relief.

3:00 a.m.: The contractions are so strong now that I’m starting to wonder: how dilated am I? Since I’m a midwife myself, I decide to check: 3 cm. Still in the latent phase. I try to reassure myself: Take it easy, Manon, this is normal. You’re doing great. I listen to his heartbeat for a moment and go back into my bubble.

3:40 a.m.: Suddenly, something strikes me. When was my last contraction? I grab my phone and start timing them. The time between contractions is suddenly irregular, longer. No, don’t let up! I try different positions, but nothing helps. 7 minutes, 5 minutes, 13 minutes… Time keeps ticking by, but the contractions are all over the place. Around 4:15 a.m., I give up and lie down in bed. I can’t fall asleep, but I do doze off for a bit.

5:00 a.m.: The contractions are coming every 3–4 minutes again. Lying down doesn’t feel right anymore, so I start walking around again. I have my breathing well under control, but finding a comfortable position is difficult. Since the contractions aren’t just in my abdomen but also radiate strongly into my lower back, I decide to use the TENS machine—what a relief!

5:30 a.m.: I’m tired and feeling uncertain. Why did it just go off? I can’t seem to clear my head, so I text my sister.

5:30 a.m.: “Are you awake?”
5:31 a.m.: “Yes.”

I call her right away and burst into tears. She asks if she should come over, since she’ll be at the birth. But I’m not sure. What if the contractions subside again? She just started a new job, and I don’t want her to take a day off for nothing. But maybe it would actually be good to have someone with me? In the end, my sister calls our mom so she can head my way at her own pace. Meanwhile, the contractions are getting stronger. I put in my AirPods, turn on my birth playlist, and lean over the coffee corner. Whew, these contractions are intense!

Fortunately, the TENS machine eases the back contractions a little, and I try to cope with them as calmly as possible by listening to the same song on my AirPods over and over. The best song to listen to while standing and swaying through these contractions is “Hold Me” by The Teskey Brothers.

Around 7:00 a.m., I call my coworkers to arrange for someone to come see me after the shift change.

Then I listen to his heartbeat for a moment with the Doppler—thank goodness, you’re doing well; that puts my mind at ease.

Around 8:00 a.m., my mom walks in. I’m so wrapped up in my own world that I don’t even notice her because of the music. She stands behind me and gives me a big hug, which makes me burst into tears again. Tired and uncertain, I tell her that I’m afraid I can’t do this, that I can’t let go, that maybe this isn’t really happening yet. She encourages me, and I put my earbuds back in. Okay, bring it on! I try to ride out the contractions as calmly as possible.

My colleague arrives around 8:30 a.m., but I don’t notice that either. After a while, she decides to say hello and wants to listen to the baby for a moment. I’d like to know how things are going, too, so we go upstairs—4 cm dilated. Ugh, that’s a real letdown.

I know the latent phase can last a long time, and the contractions were a bit irregular for a while. But how am I going to keep this up? Together, we decide to break my water, in the hope that this will give my body the nudge it needs.

9:13 a.m.: My water breaks, and wow, there’s so much amniotic fluid! It just keeps coming (goodbye, featherbed—I wish I’d used a mattress protector). I walk to the shower, but even the paper pad between my legs can’t handle all the amniotic fluid. Then a contraction hits—holy shit! I immediately feel intense pressure on my anus, and the pain shoots down my legs. Nooo, not leg cramps!

In the bathroom, I turn on the shower while my coworker stands next to me. The contractions are coming fast and I start to groan and moan. These are really intense! Because of the enormous pressure, I tighten my pelvic floor even more. “No, Manon, you have to let go,” I tell myself. But I can’t. I just can’t handle these intense leg cramps. Even between contractions, my legs keep hurting—a kind of terrible nerve pain that shoots through them.

I feel nauseous… I have to throw up! Leaning over the toilet, with a contraction coming at the same time, I keep retching, even though my stomach is empty. How am I going to keep this up? With every new contraction, I notice that I’m building up more resistance. Even though I know that pain plus resistance equals suffering, I can’t stop it. This is really unbearable! By now I’m walking back to the bedroom and realize: we can’t stay home much longer. With my history of heart problems, I have to give birth at the AMC. The next contraction is already coming, and I scream: “No, not another one!” My legs—my legs hurt so much! My mother and colleague try to help me get my breathing under control.

10:00 a.m.: With every contraction, I scream and then try to relax again—breathe, Manon, you can do this. But the next contraction throws me back into total resistance. My mom helps me get dressed, and suddenly my sister is there too. She decided not to go to work but to come see me—thank goodness she’s here! Around 10:15 a.m., we drive through the pouring rain to the AMC. The 35-minute drive is hell. Those leg cramps are already unbearable, and now I have to sit in a chair on top of that. I keep my eyes closed the whole way and tell my sister that I really can’t handle this. My legs hurt so much—I can’t do this.

When we arrive at the parking garage, my sister fetches a wheelchair. I’m standing next to the car with two maternity pads and a cellulose pad in my underwear, and I can still feel amniotic fluid running down my pant legs. With the TENS unit around my neck and a red bucket on my lap (thanks for nobody saying anything to me), I keep my eyes closed as I’m wheeled into the delivery room. My colleague is already there, and I’m wheeled into the room. I stay standing next to the bed and shout, “I want pain relief now—I can’t take this anymore.”

My colleague checks: 5–6 cm dilated. “You’re doing really well, Manon. Don’t you want to take a quick shower?” I shake my head vigorously. No way. I want an epidural right now. I can’t stand the pressure and those leg cramps anymore.

My sister and mother are massaging my back to relieve the back contractions, and the TENS machine stays on “boost” mode whether I’m having contractions or not. The back and abdominal contractions are intense, but it’s my legs that make it unbearable. Nothing helps. It’s a kind of terrible nerve pain that radiates from my hips and groin down into my legs. Those back and abdominal contractions are nothing compared to this. On top of that, with every contraction I keep feeling an intense sense of pressure… The despair, the frequent and intense contractions, the feeling of pressure: it all feels like the final stretch, but it isn’t. I really, really want pain relief. The contractions are coming one after another at breakneck speed, and every time, panic strikes again.

The CTG is hooked up, and thankfully the baby is still doing well. Two nurses and a midwife come in, but I keep my eyes closed. They can do whatever they want, as long as I get that pain relief soon. “Hi, I’m Ellen. I’m going to set up an IV.” I keep my eyes closed, nod, and think: go ahead, just as long as I get something soon. Now I’m waiting for the anesthesiologist. I still need to empty my bladder, so off to the bathroom. Another contraction. Leaning against the wall and screaming, I ride it out, and shortly after, the next one hits.

1:00 p.m.: Fortunately, the anesthesiologist arrives quickly and the epidural is administered right away. I don’t feel a thing, and the pain subsides. Finally, I can catch my breath for a moment. But during the contractions, I keep feeling a lot of pressure on my anus and pelvic floor. My colleague decides to check anyway. Could I suddenly be progressing to full dilation? No, still 5–6 cm…

Around 2:00 p.m., they want to start the oxytocin since the frequency of the contractions is decreasing because of the epidural. Sounds good to me. It turns out Jurre really doesn’t like the oxytocin at all. His heart rate dips during and after the contractions, so the oxytocin has to be turned off, on, off, on—and can’t really be increased. Around 3:00 p.m., the clinical midwife comes back into the room. The baby is responding quite well to the contractions, and she checks my dilation again; still 5–6 cm… I try to put my medical thinking aside, but I can’t.

I ask the clinical midwife if she can insert a catheter so I can be sure my bladder is empty and that a full bladder isn’t the cause of the problem (a full bladder often prevents your baby’s head from pressing effectively against the cervical rim, causing dilation to stall and/or contractions to weaken). My bladder is emptied, and since Jurre’s heart rate is still dipping frequently and for long periods, I roll onto my side. He seems to prefer the right side. For a moment I wonder: is he positioned correctly? But I try to let it go again.I tell myself: you don’t give birth with your head, Manon—let go of that medical thinking for now.

In the hours that follow, it remains difficult to increase the oxytocin dose. Jurre really doesn’t like the contractions and is reacting strongly to them. The oxytocin is therefore turned off.

Around 5:30 p.m., another clinical midwife walks into the room—and I’m so happy to see her, because she’s someone I know! We chat a bit, and I tell her I’d like to know how dilated I am: still 5–6 cm… shit!! I ask how he’s positioned, and she says, “I think he’s in AAA (occipital presentation with the back of the head behind, or ‘stargazer’).” An ultrasound machine is wheeled into the room, and she places the probe on my lower abdomen. Sure enough, two eye sockets immediately appear on the screen. It turns out Jurre hasn’t positioned his chin properly against his chest either, so he’s not in the occipital position, but in the crown position (with the back of his head facing backward). That explains the feeling of pressure and the stagnation… Plus, there are also leg cramps—because, fortunately, women almost never get leg cramps, but when they do, it’s often due to the baby being in an abnormal position.

From that moment on, the midwife in me really kicks in. I don’t want a C-section; I want to deliver this baby vaginally. I ask, “Can’t we turn off the epidural?” I know that changing positions often helps the baby push down more effectively and/or get into a more favorable position (with the chin on the chest or rotating around its axis). That epidural is limiting my freedom of movement. And even though Jurre has probably been in this position for quite some time (even before the epidural), I still want to try to get him to turn.

She says that it’s now also a problem with the strength of the contractions, so they decide to restart the oxytocin. They’re keeping a close eye on Jurre, and we’ll have to wait and see if he can handle it. We decide to wait and see how things go until 7 p.m. and then figure out what to do next.

I’m feeling very emotional, but I want to do everything I can to avoid a C-section. We briefly discuss turning off the epidural: More contractions and less pain relief with those leg cramps—will I be able to handle that? I really need to relax my pelvic floor muscles, too. So the epidural stays in, and we’re going to see what positions work with it. Lying on my side works anyway, but I’d really like to get on my hands and knees. It works! I lean over a pillow at the head of the bed and try to relax as much as possible.

The right side of my body is completely numb from the epidural, so I can barely move it; on the left side, I still have some feeling and therefore some strength. But after a while on my hands and knees, my legs do get really tired. Okay, what now? I don’t want to lie on my back, because then it would be completely impossible for him to turn. We adjust the bed so I can sit up straight.

Jurre really doesn’t like this position at all. His heart rate drops to 80 beats per minute and doesn’t recover. We wait a moment to see what happens, but no. This isn’t working for him. Back on my side—left side, then? Still no recovery in his heart rate. Poor sweetie! I’m starting to get worried. Right side? Thankfully, his heart rate climbs back up nicely to 145 beats per minute.

7:15 p.m. Another check: same as before, still 5–6 cm… f***!

Tears are rolling down my cheeks. We’re discussing a C-section, and all I can think is: nooooo! I know there’s nothing I can do about it, but it feels like a failure, and I’m so dreading it. Not the C-section itself, but I know the recovery is going to be tough. Because of the risk of premature birth, I’ve been so dependent on others since 25 weeks into my pregnancy, and now I’ll be that way all over again during my postpartum period. Six weeks of not being able to lift anything, not being able to drive, and being in pain. I don’t want a C-section…

But then what? I’ve been at 5–6 cm for hours now, and we’ve basically tried everything. Jurre is doing fine without the synthetic oxytocin, but he doesn’t react well to it (his heart rate goes up quite a bit), so we can’t make the contractions any stronger either. I ask the OB-GYN if it’s possible to do a microblood test (MBO) to check his reserves—to see if we still have time and can still consider starting the oxytocin. The OB/GYN says this is possible, but that it will likely mean we’ll have to repeat the microblood test several times to monitor how he’s doing. She also honestly (and very kindly!) points out: “But how long are we going to keep this up? Right now he’s doing well, but are we going to keep going until he’s really no longer comfortable in your belly?” Until the MBO isn’t good? Then it’ll be an emergency C-section, possibly resulting in a baby with a moderate or poor start. Right now, everything can proceed calmly. She’s right.

I’m screaming inside, shaking with nerves, and big tears are rolling down my cheeks, but it’s okay. That’s just how it is. I did everything I could; I’m bummed, but she’s right. At 7:50 p.m., I’m checked in for surgery. They get me ready at a leisurely pace, and since there’s an emergency in the delivery rooms, it’ll probably take a while. That’s okay—it gives me time to get used to the idea.

Around 8:15 p.m., the epidural starts to wear off on the left side of my body. The contractions are still radiating intensely into my legs, and I can feel that fully on the left side again. I try to breathe through each contraction calmly. I can press a button myself to administer an extra bolus, but by now I’ve pressed it so many times that the right side is completely numb. Unfortunately, it’s not doing anything for the left side. It’s frustrating to feel everything again during this final stretch and to still have to wait before we can go to the OR, but I’m okay. Fortunately, I can remind myself that the person in the other room—or in the OR—needs help more urgently right now. I can still handle these contractions.

Week after week, I cope, I sigh it away, but I feel more and more pressure. Pressure that I’ve felt before, but now more intensely . Around 9:30 p.m., I ask the clinical midwife to do another internal exam since the pressure keeps increasing. It gives me a glimmer of hope; maybe I’m not dilated any further after all? Can we cancel the OR? But no, still 5–6 cm, and everything is much more swollen. Tears roll down my cheeks again, but I pull myself together. The kind words from the wonderful clinical midwife (whom I also know personally) help immensely. They give me strength. I nailed this—it’s not a failure. There’s nothing I can do about it.

In the meantime, I’ve been prepped for the OR. My sister will be present for the C-section, and Anne, the birth photographer, is also allowed to come along. That’s so nice! My father is now at the AMC as well and will wait there with my mother until we return. My greatest wish in this situation is that Jurre will be allowed to stay with me in the OR and in the recovery room. Unfortunately, there isn’t enough staff (to care for Jurre in the recovery room) to ensure that he can stay with me after the C-section. My sister is a doctor, but we don’t want to put that responsibility on her. So we’re arranging for my dear colleague to come to the recovery room after the surgery and stay there to keep an eye on Jurre, so he can stay with me. That’s so nice!

The minutes are ticking by, and I’m still having contraction after contraction; it’s getting more and more painful. I’m tired, and I’m starting to get impatient myself. But at 10:40 p.m., the time has finally come. We’re allowed to go to the OR. I give my mom and dad a kiss, and we walk down the hallways toward the operating room.

The bright lights in the operating room make me nervous; adrenaline is rushing through my body, and I’m shaking. I’m shaking from exhaustion, from tension, and from emotion. I’m lying on the hard table while my abdomen is being disinfected, and my sister is sitting next to me the whole time.
11:09 p.m.: They cut open my belly, and at 11:13 p.m., they lower a sheet so I can watch as he’s pulled out of my belly. There’s his beautiful little face! There he is! He’s already crying while his little body is still inside my belly. He’s so beautiful! It’s immediately clear that he wasn’t positioned quite right, because the caput succedaneum isn’t on the back of his head but near the crown, and it’s not centered either. He’s placed against the plastic for a moment, and tears roll down my cheeks; he’s here!

My sister cuts the umbilical cord, and Jurre comes along for a quick checkup with the pediatrician. Everything is fine, and he comes to lie down next to me. I think I tell my sister at least 20 times: “Isn’t he beautiful?” And I also keep asking, “Is he okay? Is he breathing?” Despite his lovely pink color and my knowledge as a midwife, I keep asking. Every time, they reassure me: “He’s doing great, Manon. Look how beautifully pink he is.” He’s looking around with wide-open eyes.

At 11:56 p.m., my sister sends my parents a text to let them know that everything went well, but that we’re still in the OR. My mom replies right away: “A photo?!!!! I’m so glad everything went well. I’m so curious to see him and find out his name. Xx, see you later.” We decide not to send a photo just yet—they’ll see him soon enough, and I think it’ll be more fun if I can see their reaction right away. So my sister texts back: “Not allowed yet. But he’s gorgeous!” To which my mom replies, “I wouldn’t have expected anything else. Hair?” Hahaha! My sister replies: “Yes! I can’t say any more than that, haha. But that’ll make it even more fun later.”

Jurre is being weighed; 2980gr, that little tyke. He’s being dressed in his lucky shirt from Italy (camicia della fortuna)— that’s a tradition in our family. During my pregnancy, I received one from my dear aunt. The message conveyed by this onesie is the hope that the newborn baby will have a long and happy life. After that, he’s dressed in his newborn outfit, and my parents give him a quick cuddle. Anne takes a few more photos, and I take some with my phone too, and then I see an incredibly sweet text from the clinical midwife (whom I also know personally) who guided me through the final stages leading up to the C-section. What a night, what a day, what an experience. It’s all still sinking in, and I’m bummed about the C-section—I really wish things had gone differently. But at the same time, I’m bursting with love! He’s here, and he’s doing well. My biggest wish has come true; I’m a mom! Manon de Graaf

Manon de Graaf – Midwife, Trainer & Owner of Bevalwijzer

Instagram: Spartaanstudio

Birth Photographer: Annewesterveld_fotografie