Born in a bakkie

This mom wanted a quick-and-easy natural delivery with her second child. But she wasn’t planning on a drive-through!

As told to Margot Bertelsmann

Pretoria couple Annandé, an attorney, and Gavin van der Merwe, a civil engineer, have two small children: Annabelle, 3 years old, and baby Kenneth, who is 10 months old. Annabelle was born in a hospital – and Kenneth was born, well, outside a hospital. Here’s how that happened…

Like many first-time mothers, Annandé relied on her gynaecologist during her first pregnancy for advice and information. She felt she’d like to experience the female rite of passage of a natural vaginal delivery. This instinct was not something she believes her (male) gynaecologist could understand. “When I told my doctor I’d been researching natural delivery options such as hypnobirthing, he asked me why I didn’t want to enjoy my delivery. He said it was extremely painful and that I should consider an epidural. What did I know at the time? I thought that sounded reasonable.”

At 39 weeks and 4 days, on a Thursday, Annandé and Gavin had a consultation with their doctor, who said he noted some calcification of the placenta. He suggested they do an induction that very evening in order to deliver the baby the next day. Despite her reservations, Annandé agreed. Unfortunately, she proceeded to have a traumatic birth: “They gave me induction drugs twice, and finally my water broke and the baby was quickly delivered Friday morning, but I had four third-degree tears and I was bleeding uncontrollably. My poor mother saw the doctor running out of the delivery theatre screaming for assistance. She thought I was dying. My husband was in the delivery room, white-faced, holding the baby. Afterwards, I was in so much pain and had terrible baby blues. I lasted four days of breastfeeding. I developed terrible scar tissue as well, which made intercourse very painful. Nothing was as I had hoped for.”

“Given that background, I was quite traumatised when it became time to think about having a second child.”

But Annandé did become pregnant again, and found she still yearned for the peaceful, intervention-free birth she wishes she could have had with her firstborn. This time round, though, convincing Gavin was an understandable uphill battle. 

“I had changed doctors and gone to a female gynae this time round, but at about 34 weeks she started with the same script as the last doctor: think about inductions, epidurals…”

It took a lot of persuading Gavin, but in the end at about 35 weeks along Annandé signed up with Midwives Exclusive. Her mother was horrified, she recalls. She and Gavin took a 5-day hypnobirthing course, and that’s when Gavin started to be able to understand his wife’s deep desire for a peaceful birth.

“That’s a big reason why this labour was so relaxed – and how we ended up giving birth in a bakkie!” Annandé says.

She says despite this being her second baby, she had no idea what the beginning of a natural labour felt like. “I had to ask my midwife what it might feel like, as I hadn’t gone into natural labour before.”

At 40 weeks and 5 days, Annandé woke up knowing her labour had started. “My midwife had described it as a sort of burning feeling around your midriff, and that’s exactly how it felt. I didn’t even wake Gavin, I just bounced on my bouncing ball, and drew a bath and spent some time in it.”

“I was tracking my contractions on an app and our midwife was saying they were still irregular. I was feeling in control – and then suddenly, in the space of an hour, I wasn’t. Everything was suddenly too intense and I needed help. Now bear in mind the hospital is a good 20-minute drive away. Let’s just say it was one intense drive,” Annandé recalls.  

“And then my water broke.”

“I was shouting at my husband that I’m not coping, I’m not going to make it. I later realised I must have been in transition. He’s telling me not to push, I’m shouting back that this is not something I can control, it’s like a force outside my body and this baby is coming!”

“Baby’s head is crowning. Gavin is ramping pavements with one hand out of the window, shouting. Cars are getting out of our way. We arrive at the hospital gates and the poor guard wants to take our details before he lets us in. Well, when he saw our faces…” laughs Annandé.

“The hospital staff sent us straight round the back to Casualty entrance instead of booking into maternity ward. Our midwife is by this stage also on her way. But: she is herself 31 weeks pregnant and she has a broken ankle – there she comes, racing down the road on a moonboot to the back of the hospital.”

“But the minute she got to me, she just took control,” Annandé says. “I told her, I think the head is out, just help me take my pants off, I can’t get them off by myself.”

“My midwife is saying: OK, let’s just take a minute to understand that this is where we are now. We are going to do this right here, right now. She’s telling the staff this, and the nurses all rushed around covering the car up and surrounding us with privacy dividers. It was so lovely that they did that.

“After my midwife had talked me down, it was one or two pushes and the baby was out.

“I got a standing ovation from the bystanders!” laughs Annandé.

“As I walked into the ward, one sister told me, ‘Usually they walk in as one and come out as two. You sommer walked in as two!’

“And that’s the long and the short of it.”

Annandé says her second delivery was actually less traumatic than her first. “Looking back, Gavin and I realised we were not frightened for one second. Even though Kenneth at 3.5kg was bigger than his sister, it was still a better experience than the induction, and I didn’t tear, and didn’t bleed.”

“After the delivery, the support from the midwives was unbelievable as well. This time round, I could even breastfeed. This birth experience ticked all the boxes I wanted to tick.”

What to do in a situation like this?

We asked obstetrician and gynaecologist Dr Bronwyn Moore for advice for what she says doctors call “BBA”s – Born Before Arrival. She starts by stating that, like in all medical emergencies, the Van der Merwes followed the protocol of 1. calling for help and 2. making sure subsequent actions are safe.

“If you are not a first-time mom, know that subsequent labours tend to be shorter and make plans to go into your facility earlier,” Dr Moore advises. “The same applies if you have a history of quick labour. Once your waters break, things often happen quickly, so even if you’re not having strong contractions yet, anticipate that things will ramp up once this happens. 

“Secondly, if it feels like things are progressing too fast at home, don’t drive. Rather phone for an ambulance. The paramedics can then get you to the hospital and help along the way if need be.” 

If you are already travelling, and it feels like you are about to give birth in the car, ask the driver to pull over. “First call your caregivers so they know where you are and can get to you,” says Dr Moore. 

You could consider sharing your location on your smartphone with your doctor or midwife from about 36 weeks onwards. 

“Now the mom should try get comfortable, perhaps lying across the back seat,” continues Dr Moore. “The truth is that in low-risk uncomplicated deliveries Nature does what needs to be done.” Whoever is with you might derive some solace from that. 

“When the baby is born, the assistant should use a shirt or a towel to rub the baby dry and stimulate him or her to breathe. Now place the baby skin-to-skin on the mom’s chest. Once baby is breathing and with mom tie the cord. Use what you have: dental floss, a shoelace, a hair elastic – you don’t need to cut the cord, just tie it. And the most important part: keep them warm by covering mom and baby with a towel, blanket, shirt, or whatever you have to hand. Wait for help to arrive.”

This article was first published in the June/July 2020 issue of Your Pregnancy magazine.