London - MY first child, Daniel, came into the world nearly ten years ago after an agonising 27-hour labour and almost every intervention imaginable.
Dazed with exhaustion and stitched up like an old teddy bear, I was certain of one thing: next time I would insist on a Caesarean section.
Two years later, I found myself back in the antenatal unit, pleading my case for an elective Caesarean. But, natural optimist that I am, I somehow let myself be persuaded by the registrar that second births were a walk in the park compared with first births, and agreed to have the baby - my daughter, Isobel - naturally.
During a full day and night of excruciating contractions, however, I wished I had stuck to my guns.
Friends and my sister had been so lucky, I told myself, to escape all this pain and have their babies delivered via the “sun roof”. But the saying “be careful what you wish for” became horribly pertinent when, in March 2008, I gave birth to my third child by emergency Caesarean in circumstances so traumatic they made my first two deliveries feel more like trips to Disneyland.
Yes, in emergencies, Caesareans undoubtedly play a vital role in saving the lives of both mothers and babies.
But according to the World Health Organisation, women who opt for them are ten times more likely to be admitted to intensive care, which is where I ended up after giving birth to my third child.
A quarter of women in Britain now have babies by Caesarean, with women in the more affluent South-East most likely to request one. They think, as I once did, that Caesareans are a breeze compared with vaginal deliveries.
Now the government”s National Institute for Health and Clinical Excellence has decided that, despite costing at least £800 more than vaginal births, C-sections are so safe that all women should be given the choice of giving birth surgically, even when there is no pressing medical need.
Perhaps my story can be an example to all those who are tempted to take up that offer, and who think of Caesareans as “an easy option” - with the added benefit of avoiding the damage to your continence and libido that natural birth can sometimes cause.
Easy? Let me tell you, with a gash across your middle and a catheter bag trailing down your leg, that will be the last word that comes to mind.
I had been in labour for 16 hours when the obstetrician at the Whittington Hospital in North London realised that my baby’s head was facing the wrong way. No matter how hard I pushed, he would not come out.
The ventouse (suction cap) and forceps had failed to work this time, and so I was whisked into theatre to be cut open, silently thanking God that my labour was about to end without any more hard work from me.
As I’d already had a numbing epidural and didn’t want to be unconscious for the birth, I begged not to be given a general anaesthetic. Seeing our baby boy being handed to my husband, Dillon, I thought it would be only a matter of minutes before I’d get to hold him and revel in that wonderful early bonding I’d so enjoyed with my older children.
But after allowing me a quick glimpse of our son, covered in my blood, the midwife ushered Dillon (whose complexion by then matched his green surgical gown), babe-in-arms, to the other end of the operating theatre.
A screen placed strategically in front of me meant I could hear but not see what happened during the two-and-a-half hours that followed. It was the stuff of nightmares.
The first sign that things were going horribly wrong came when the obstetrician called for support in the shape of a more senior consultant obstetrician and gynaecologist, Ms Friedericke Eben, who arrived in a flash.
There were mutterings among the medical team, but I found it hard to make anything out until I heard the next call go out: “We need more blood - urgently”.
Panic rising, I asked the medic beside me what was happening. The cuff from the monitor was hurting my arm and adding to my distress, so I pleaded for it to be loosened.
“That’s the least of your problems right now,” came the reply.
Suddenly hysterical, I began to hyperventilate and an oxygen mask was clamped over my mouth. Was I about to die?
Would I never hold my newborn baby? Would I ever see my other children again?
We had decided to call our baby Christian if he was a boy, but in those stricken moments my mind raced, searching for a middle name for him. In a panic I called out: “His second name is James!”, fearing it might be the last thing I would ever do for our son.
I was brought back to grim reality by the voice of the senior obstetrician shouting to someone to page a consultant urologist. I heard her explain that my bladder had ruptured and needed urgent repair.
“We need to remove the uterus,” were her next words.
“What?” I screamed, horrified that, aged 39, I might be about to undergo an emergency hysterectomy. “Just to repair it,” Ms Eben explained reassuringly, bobbing her head around the shield.
Christian was mercifully quiet throughout, but I remember thinking with sadness that I should have been breastfeeding him - something I had done within minutes of my first two children being born - and not lying in a pool of my own blood.
Dillon - an academic who is renowned for his squeamishness - told me later that my bladder, bowel and uterus had all been on the operating table at different points. He, too, had genuinely feared I might die.
Somehow, thankfully, I survived, but I spent the next five days in a hospital bed in so much pain that I could barely move, despite taking a cocktail of drugs.
I was told that my uterus had ripped in all directions as the baby was being pulled out: I had lost an enormous amount of blood, and my bladder had been ripped open. For ten days I needed to use a catheter bag, to allow my bladder to repair.
Despite regular doses of morphine, it felt as though someone had plunged a knife into my stomach every time I tried to pick up my baby.
I needed my husband at my bedside day and night to get Christian into position for breastfeeding, to help me sit up and, humiliatingly, to wash me.
Severely anaemic from the blood loss, I wasn’t in a fit state for our older children - then aged six and three - to visit until four days later. And it was many months before I could manage to walk without the aid of heavy-duty painkillers.
But at least I was alive. In my attempts this week to establish the mortality rates for elective Caesareans compared with vaginal deliveries, I was passed from pillar to post by several government departments.
Worryingly, the information could not be provided by the NHS, the Department of Health, the Office of National Statistics or the Royal College of Obstetricians and Gynaecologists.
The risks of Caesarean include accidental cuts to the bladder, bowel or gastro-intestinal tract, infection in the incision, uterus or bladder, greater blood loss, and a longer recovery time.
And, of course, the dangers are multiplied with an emergency C-section like mine.
Mary Newburn, head of research and information for the National Childbirth Trust, sums it up: “A Caesarean is major surgery.
“Many go smoothly, but there is always an additional risk of complications.”
When I spoke to Ms Eben, the consultant who’d dealt with my son’s birth, she said it was important not to extrapolate from my experiences of childbirth, and assume that other women suffer in the same way.
“Your Caesarean was dreadful, but other women are out of hospital in two days and say: ‘Can I have another one?’”she added.
In Ms Eben’s view, one reason for the rise in “maternal-request Caesareans” is that women are frightened by their friends’ stories of undergoing emergency C-sections such as mine, and want to pre-empt matters by taking the elective route from the start.
But if the demands of three children had not been enough to deter me from having a larger family, being told that the damage to my womb means I will always need C-sections if I have any more children certainly was.
I understand that elective Caesareans are not as risky as emergency C-sections, but all mothers-to-be should be aware that surgery in any circumstances carries risks.
Risks which, in my case, proved to be almost fatal. - Daily Mail