Umm 'Eesa on Having an Unplanned Cesarean

Umm 'Eesa is a British-Pakistani mother of two, currently living in the USA. 

What was your original birth plan and expectation heading into labor?

I had the inevitable and unavoidable nervousness approaching my first ever labor but I had had a healthy pregnancy mashaAllah, had done some reading and attended classes so I felt calm and ready for D-Day.  My birth plan was pretty straightforward as the general consensus in the UK advocates for natural, patient lead birthing.  I had specified that I wanted minimal interventions and only when absolutely necessary and that my husband and I be consulted in advance so we could be part of the decision making process.

Tell me about the labor.

My labor started spontaneously at home and progressed well at a steady pace.  I was over half way when I arrived at the hospital and the first midwife I met, read over my birth plan with me.  I had stated that I was willing to take gas and air for pain if I felt I needed it, but wanted to avoid any other medicated pain relief.  

This midwife however explained that having a small frame, the gas and air would likely make me feel nauseous and suggested that I try some breathing techniques to work through the contractions instead.  I HATE vomiting and the thought of it happening during labor was enough to convince me of her strategy!  After a bit of coaching, I was comfortably breathing through contractions (even nodding off in between!) and labor was still progressing well.

It was only once I was fully dilated that things got a little complicated.  I had been pushing for a while and as much as the midwives present were encouraging me (the shift had changed so my original midwife savior had left), they weren’t able to tell me why it didn’t ‘feel’ any different.  I was expecting to feel more pain or change or progression.  Anything to indicate that baby was coming out!  But nothing.  At this point, the midwives monitored me and baby and found baby to be a little stressed so decided to call the consultant to check on me.

At what point did your care givers begin advising that you have a c-section and what were their reasons for advocating it?

The consultant performed a manual examination and found that baby’s head was turned to the side.  She tried manual rotation but that failed so she advised trying a ventouse and/or forceps.  She explained that given some time had passed without any progression and that there was no guarantee other procedures would work, they needed to prep me for a c-section ‘just in case.’   

How did it make you feel to have your caregivers advocating for procedures you didn’t want and were not prepared for?

I knew myself that things didn’t feel quite right and that I needed some sort of help.  Given it was my first labor, I didn’t know what other options I could try, or even existed so the consultant’s plan seemed reasonable.  It definitely wasn’t planned by either party and seeing as all the monitoring, examination and discussion happened in quick succession, within an hour, it immediately felt like an emergency and put me in slight panic mode.

What finally swayed you into accepting the c-section?

I didn’t feel I had any choice.  Nothing else was being offered as an option, baby’s heart rate was abnormal and he had passed meconium. Nothing on my part was changing either and the labor just felt a bit ‘stuck’ so I accepted the c-section assuming it was best for my health and the health of the baby.

What risks did your caregivers disclose to be related to the procedure?

I was aware of the risks from my pre-labor reading, which is why I wanted to avoid it in the first place.  At the time, I was presented with a consent form highlighting the risks and what the procedure involved.  I was talked through it but I only vaguely remember this part.  I was in pain, feeling panicked and had probably abandoned my breathing altogether so I just wanted the next necessary thing to happen without delay.  My husband signed on my behalf.

What sort of thoughts and feelings were going through your mind as you were being prepped for surgery?

I was definitely scared and worried for my baby.  My husband is a very cool cucumber mashaAllah but I could see the concern on his face too.  There was a point where I was wheeled into theater and my husband was sent to change into scrubs so he could be present in the room with me.  Those few minutes were terrifying.  The doctors were prepping me with the spinal, a drip, antibiotics etc. and my husband was nowhere in sight.  That loneliness and having to leave my well-being in the hands of strangers was really uncomfortable but it was my opportunity for dua and there was comfort in placing my dependency in the right place, with Allah.

Tell me about the procedure. 

I was awake during the whole procedure.  Slowly losing sensation in my lower body was a very odd feeling.  I was asked to try wriggling my toes and I remember my husband laughing at me because he said on my face, I was reeeally trying, but obviously to no avail.  I for some unknown reason, asked the doctors to lower the screen so I would be able to see the whole procedure.  They lowered it by an inch, which made no difference at all so I didn’t see a thing but in hindsight, I’m glad I didn’t.  The whole thing ended up being emotionally unsettling as it was so I don’t think adding blood and guts would have done me any favors.  I felt physically comfortable as there was no pain at all but I was still worried and anxious to know how the baby was.  That was the worst part.  I was aware of my own health, could see the monitors beeping, was fully aware of my surroundings etc but didn’t have a clue about that little soul we had been waiting to meet.

My husband was present the whole time, standing by my side.  He could see over the screen and likes to remind me that he’s seen every layer of fat and muscle in me haha.  MashaAllah, he was calm and minimally described the procedure.  He told me after the event that it was stressful to watch and that it looked brutal for both my body, and baby’s but Alhamdulillah, I’m glad he had the sense to not show it at that point. 

What was the recovery period like physically, mentally and emotionally?

Recovery was tough.  Alhamdulillah, I have a decent pain threshold but had never had any kind of surgery before, never broken a bone, never needed stitches so I wasn’t prepared for that kind of physical weakness.  Aside from the regular c-section incision, I ended up needing an additional one as my son’s big ol’ head was well and truly stuck.   That incision caused me some pain for a while afterwards but worse than all of that was some muscle damage in my hip, which I believe was caused by my legs being put in stirrups.  All in all, I didn’t feel physically normal again until 9 months later.  I definitely hadn’t expected that and realized just how much I had taken a healthy body for granted.

The mental and emotional recovery was also difficult.  I had gone into pregnancy and labor, hoping for the best outcome and had no indications to suggest anything but the best.  I was looking forward to labor and can still say that I genuinely enjoyed it Alhamdulillah but when it ended in a c-section, I felt somewhat cheated, like I had lost out.  I remember apologizing to my husband for it afterwards, to which he obviously rolled his eyes but I felt like I’d failed at something that my body was designed to just do.

That feeling stuck with me for a long time afterwards and whilst it didn’t impact my general well-being or my ability to be a mother Alhamdulillah, it did take a while to shake it off.  Its only when I realized that major surgery IS major, that I became more comfortable with it.  If you’re going for a drive somewhere special and are unexpectedly involved in an accident, seriously injured and wheeled into theater to save your life (and an additional life inside of you) you would expect that it might plague you for a while afterwards.  That you might feel nervous, sick, anxious getting into a car again, that you might struggle with the physical consequences of your injuries.  An unplanned c-section is no different and I had to realize that by abandoning my own self imposed expectations of how things ‘should’ have gone and accepting the outcome that Allah had written for me before I had even given motherhood a thought.

My midwife crystallized this for me when she said ‘You don’t get pregnant so you can go through labor.  You get pregnant because you want to be a mother to a healthy child.’  Alhamdulillah, that is exactly what Allah gave me.

How was it trying to bond with your newborn while in recovery?

I loved him instantly, cried for him, worried for him and felt an overwhelming desire to protect him.  I had a difficult start because of the surgery, difficulty with breastfeeding and him being jaundiced at birth and needing treatment for it.  It was stressful and exhausting but that little ruh and amanah from Allah trumped everything.  My husband was with me for all the hospital trips and helped with everything from the get go.  We were staying with my parents at the time so my family was also at hand for anything we needed.  Having all the additional support took away all the external pressures and stressors which meant we could just focus on our new baby.

What sort of criticisms, if any, did you receive from people for accepting a c-section and how did you respond to them?

I didn’t receive criticism per se and I didn’t really talk about the labor unless somebody asked.  People knew it wasn’t planned and mostly focused on my recovery.  The thing that did get to me was that when I talked about enjoying labor (up until the c-section part), some sisters told me that I could only say that because I hadn’t actually labored all the way and that the worst part was dealt with for me.  I didn’t have much of a response for that at the time as it just gave me the sinking feeling of failure again but looking back, I should have put people in their place!  I now know for a fact that natural birth is waayyy less painful than a c-section and that they had no right to judge one outcome to be superior to another when Allah is the decision maker.

Looking back on your experience and knowing what you know now, do you think your caregivers choice to perform a c-section was out of a real medical necessity? Why or why not?

Initially, I had no idea.  Then I went through a phase of thinking they had made an unnecessary decision which affected my physical strength for some time afterwards.  Eventually I came to realize that rightly or wrongly, they made the decision they did, when they thought appropriate and there wasn’t much I could do to change it.  I know my baby and I came out of it alive and healthy and in another time, place and under different circumstances, it could have been a lot worse.  I have since focused on better educating myself about best birthing practices and doing everything I can in terms of exercise and  diet and to prevent the same outcome inshaAllah.  I think it is important to aim for best health but in doing so, not lose sight of the fact that whatever you do, however labor ends up, Allah is in control of that so ultimately, it IS best for you.

How did this experience affect your relationship with Allah?

It definitely strengthened it Alhamdulillah.  I have never been that afraid for my health and never felt so in need of His assistance.  It taught me the meaning of tawakkul.  Even after the surgery, providing for, feeding and nourishing my new baby in the physical and spiritual sense, gave me new perspective on what it is to worship Allah and how hard you have to fight to do it right subhanAllah.  Childbirth and motherhood aren’t just blessed experiences, they’re lessons that never end and a huge test which inshaAllah, bring us closer to Him and His jannah.

What advice do you have for mothers facing unplanned cesareans?

You can’t advise much for the unplanned :p  And to be honest, for all the planning you do, it can still turn out to be the opposite.  I would of course advise doing everything you can to prepare for a healthy pregnancy and labor, not just to avoid a c-section but because our bodies and unborn children have a right over us and we’re accountable for both regardless.  

After that, I would advise to make peace with Allah’s decree.  This has to be done in advance, not after the fact.  My feelings of failure and upset at having a c-section for so long after were due to my not understanding this point.  I thought the alternative was ‘better’ and that I’d fallen short of it whereas in reality, I couldn’t have done better than what Allah had already planned.  We all want health and ease but we should be willing to accept that Allah may test us with both and that our response to that should be the outcome we’re truly concerned about.

Umm Anonymous on Living With Multiple Sclerosis, Part 3

Umm Anonymous is a Muslim mother of two. In 2012 she was diagnosed with Relapsing-Remitting Multiple Sclerosis and is now in remission. To read the first part of this interview, click here. To read the second part of this interview, click here. 

At the end of the day, only Allah knows. But right now, with what you know about yourself and with what you know about MS, what does the rest of your life with this disease look like?

I don’t know. 

I don’t believe my last exacerbation left any permanent damage because my last EEG didn't show any. But I have relapsing-remitting Multiple Sclerosis so I’ll have an exacerbation and then go into remission and then have a relapse and then go into remission and have another relapse. 

And even between relapses there are other symptoms. For me, one of the symptoms is itchiness. If the shower is too warm, when I get out my whole body will itch like if I had been stung by a bee but since its under my skin I can’t scratch it or soothe it so I just have to let it run its course.  I have to shower in cold water now, I can’t wash the dishes with hot water because it will aggravate my hands.

I’m on medication, so now I take a daily injection. I have charts that show where not to inject my body because I already injected myself there last week. Every day I have to inject myself in a different part of the body because when the medication goes in, it burns. So if you keep injecting in the same place, the medication can burn the fat off of that area and you’ll have a big dent in your body. Sometimes I’ll mark Xs and circles all over my body so I’ll know where or where not to inject on a particular day. 

It’s a life of adjustment. And alhamdulilah the adjustments that I've had to make haven’t been huge. Some people have to put ramps in their house and make it wheelchair accessible. Fortunately I've not had to do that. Alhamdulilah now (in remission) I’m able to do everything that I used to do, I just can’t do as much of it. 

And I don’t know if the disease will become degenerative; that’s unpredictable. I feel fine today but I could have another exacerbation tomorrow. I don’t know when it will come, if it will come, if it does come how long it’s going to last, and if it lasts for a long period or a short period if it will leave permanent damage. You just don’t know. 

Is that something that you worry about?

No, because I have to enjoy the time that I have. 

If I were to worry about the possibility that I might have another really severely disabling experience, I wouldn't be able to enjoy my life. I wouldn't even be able to function nominally. So I don’t give it a whole lot of thought. I’m going back to school and I've made dua asking Allah to grant me health so that I can get through school. So I can’t say that I worry about it but I do make dua that Allah preserves my health and that Allah gives me the strength to deal with whatever it is that He’s going to give me. 

Has this experience changed your outlook on parenting?

One thing’s for sure: you can only do so much. 

Our culture in the United States, even the expectation amongst Muslims, is that in order to be a real woman you have to be nearly perfect. Perfect as a mother, as a wife, people expect such perfection in the fulfillment of our roles that unfortunately we fail to see the humanity in our relationships. So when we’re tired or when we have a headache or when we barely got any sleep or when we have cramps or when we have a toothache, we’re still hard on ourselves and we don’t allow ourselves to relax. We don’t allow ourselves to just say, “You know what? Don’t anybody talk to me right now because I’m not in a good mood. I'm in pain and I need a break.”

But to go back to your question, yes. Now that I have a chronic disease that poses a number of limitations, I have to recognize when I need to stop. So if I’m planning something or if someone asks to come over or asks me to do something for them, now I write everything down and look at my calendar and ask realistically if I’m going to have the energy to carry it out. If not, then my answer is going to be no. Or I’m going to have to postpone it or do some shifting.

Even when it comes to my kids, I have to know when its necessary to say no and they have to learn that there are boundaries and that mommy is not going to be able to do everything for you and nor should they expect that.

With MS, most patients look fine but the symptoms can be triggered by almost anything. For me, dehydration triggers symptoms, heat triggers symptoms, too much activity in one day or being in a room that’s really crowded and loud will just set my nerves off. I might feel faint, I might feel weak, or itchy or dizzy or that the room is spinning. There’s really no telling what I’m going to feel but I know what my triggers are so I try to avoid them as best I can.  

With my kids I have to communicate what I can and can’t do, and not just for them but for everybody.

How has this experience affected your outlook on life in general?

I think this experience really taught me the meaning of the term submission. 

The idea that you just have to allow yourself to deal with what it is that Allah has decreed for you. I can’t do a whole lot to change Allah’s decree but how I respond to what Allah has decreed is up to me. I can sit there and sob and be angry and be ungrateful and curse Allah or make statements like “I didn't deserve this” or even, aootho billah, charge Allah with being unfair. Or I can say okay this is what Allah gave me but He's also given me many other things that bring me joy, and many other things that bring me good opportunities to earn favor with Him. And this is possibly one of those opportunities.

One thing I spent a lot of time reflecting on, particularly when I was in the hospital, was that this could be an expiation for me, and I need that. This could be a way of raising me in rank, and I need that too. This could be a punishment, and that would be one less punishment that I have to deal with in the grave or on the day of judgment or at the end of my life. So no matter what this is, this is a positive thing.

And from that I came to the conclusion, not that it’s a unique conclusion I came up with like I’m Confucius or anything, but I realized that even in sickness there’s a blessing. Even in the loss of a job or the loss of a person that you love or a relationship or whatever, there’s a blessing in that. You have to be open-minded to it and pray for guidance. 

Through this whole experience, I pray for patience because, especially since having children, I realized that my patience level isn't where it ought to be. But more than anything, aside from praying for forgiveness, I pray for guidance so that I can recognize things as they are, not as I want them to be or as people are telling me that they are. I want to be able to recognize things as they are so that I know what I need to do and so I can do the right thing. 

I want this experience to be on my scale of good deeds. So that Allah can't say, “Well, when I tested you with health, you squandered it and when I tested you with sickness, you became kafr or you became arrogant or you became ungrateful.”

In a lot of ways, getting so severely sick as a wake-up call for me to recognize that I've been Muslim for so many years and there are so many things that I could have accomplished for my deen had I been focused. There was one period in my time of being Muslim where I really used my time efficiently and then there were other periods where time would fly by without me really growing as a Muslim. And anything that doesn't grow atrophies. I feel like when there isn't spiritual growth and you go through a period of stagnation, its not just stagnation; its regression because whatever spiritual conditioning you've been built up in your periods of growth, you’re not maintaining it and eventually you lose it. So this experience gave me the opportunity to really value my time and look at what I could be doing better.  

How has this experience affected your relationship with your husband?

I was amazed at how well he managed everything, especially in the weeks when I was the sickest prior to being admitted to the hospital. 

A couple of times I saw him lose his patience with the kids or with his parents or with the fact that the dishes were piled high but generally, and may Allah reward him, he was really solid. It's not that I expected him to not be reliable but I was just so impressed with how in tune he was with me and my needs and with the children and their needs. I was really impressed by his ability to sacrifice. 

The stereotype is that men really aren't that aware of things and they just kind of do things unconsciously and without consideration to other people but it wasn't like that with him in any way. So naturally, I grew in my love and respect for him. We've been married 9 years and there was a precipitous jump in my affection for him. 

When I was in the hospital I was making a lot of istighfar in how I fulfill my roles as a wife, as a mother, as an employee, as a daughter, as a daughter-in-law, as a sister, as a friend, and so asking Allah to forgive me for any deficiencies in the fulfillment of my roles and asking Allah to guide me in being better in the roles that I have. I think now I’m more likely to question my role in a relationship, regardless of who its with. I’m more likely to ask myself now what have I done to help or hurt the relationship. I know the question is specific to my husband but one thing I realized in the hospital was that these lessons really apply to all aspects of my life.

One of the duas I made while I was in the hospital was to ask Allah to guide me towards being a better wife. I wondered if I would have been towards my husband the way that he was towards me when I was sick. You don’t know what you’re willing to do or what you’re capable of doing until you’re in a situation. Everybody talks about, “oh well if it were me, I would blah blah blah,” but you really don’t know. You don’t know what you can expect from yourself and you don’t know what you can expect from the people around you.

It’s like with sins. Some people say, “Oh, I know I have iman so I can be around this certain thing and I know that it won’t affect me.” But you don’t know. You don’t know how much iman you have or how you’ll be affected by something. The fact that you’re even saying that kind of calls your iman into question, that you think so highly of yourself. You don’t know how you’re going to respond to a severe sickness or a death in the family or a stillborn baby or any other calamity. You might have it all planned out in your head but you really don’t know until it actually happens.

It all goes back to asking for guidance. Having been guided to the deen of Islam is one thing, but keeping me upon that guidance that I committed to when I took my shahada is something different. 

What would you have to say to another Muslim mom who encounters MS, either in herself or a close relative or in one of her own children? What advice would you want to share with her?

I would probably tell her the same thing the nurse that I met in the hospital told me. You can choose to be really upset about this or you can choose to focus on getting better and focus on benefiting from the time you've got while you’re here. 

Things are based upon perception. My first birth, I was scared and felt vulnerable and felt like I couldn't trust my body or my environment; I just didn't feel secure. The second time around, I birthed at home and I went into it with confidence, I went into it feeling a lot more relaxed. I was excited but I was relaxed so I wasn't as anxious and I definitely wasn't as fearful. So when  the contractions came, I didn't perceive them as disastrous or as “oh my god, this thing is gonna break me.” My attitude towards each contraction was different than what it would have been in my first birth. So my perception of the pain was significantly lessened than the first birth.

Just recently, I was with a sister, who was another homebirth mom, and we were talking to another sister who didn't have children and she said, “you know, I don’t mind the whole mothering thing, but it’s the labor that scares me.” And the other homebirth mom and I in unison said, “the labor is the easy part.” And it’s because the fear was gone.

So when you’re fearful about a disease like MS, or any disease for that matter, then your perception of what you’re going through is going to be heightened. So the bad is going to feel all the more bad, so bad that you’re probably going to miss any good that there is in it. You have to constantly check your perception and ask yourself, “do I really feel this way or is Shaytan trying to make me feel ungrateful?” And that’s his game: Calling things by another name.  When he went to Adam and Hawaa, he said “this is the tree of life.” He didn't say, “This is the forbidden tree that Allah said don’t go to.” That’s how he gets us to respond in a certain way, by calling things outside of the reality that’s there. 

So yeah, you have sickness, but there’s a reality to that sickness that it’s probably not as bad as you think. 

How has this experience brought you closer to Allah?

I used to make a lot of dua prior to getting sick but I think I know more of what to ask for now. 

Now I’m making dua more frequently and I’m making more specific duas. I’m making dua for other people more than I used to also because in having needs of your own, it’s easier to recognize others’ needs as well.

And there are different acts of worship that I’m trying to do consistently now. The Prophet, sallallahu alayhi wa sallam, said: “The deeds most loved by Allah are the ones done consistently, even if they’re small (Bukhari and Muslim).” So you know, instead of sitting down for two and a half hours to do tasbih once, sit for five minutes here and five minutes there and do it consistently. So that’s what I’m trying to do.

And these things aren't easy. They take effort. Let’s say you've memorized the morning adkhar. Just because you know it, doesn't mean that you’re going to do it. And even if you do it, you might not do it with meaning, your mind not be present. So you have to really question yourself and put in the effort because it’s not easy.  

This whole process has really been about learning to submit. Because these things are not in our hands. You plan to go to school, you plan to get married, you plan to have a bunch of kids, and you plan for their life to be this way or that way. Most of the time none of these things are as you plan them and so you have to submit and you have to adapt and you have to adjust and you still have to keep your faith intact. 

Maria Zain on the The Birth-Faith Irony: Who Are We Really Relying On?

Maria Zain never thought she would become a birth junkie after two disastrous medical births but things changed a bit when she caught baby number three on her own. Now between homeschooling her four children (yes, number 4 was also born at home), writing and editing, she is honing in onto birth advocacy with a du’a that all mothers will have their own empowering births.

This article was originally published in Saudi Life. Thank you and JazakamAllahu Khairan to Maria Zain and Saudi Life for allowing us to re-post this piece on our blog.

A Western woman from Europe approaches a woman of the East. She says, “I would think that in a country like yours, being conservative and being Muslim-majority, that there would be many more homebirths than hospital births, as it would be closer to your beliefs.”

The woman of the East – a Muslim – answers that this isn’t the case in her country – and in fact, it is completely the opposite. She continues to describe the standard birthing scene that a woman in her country has to undergo...

A passer-by, of the same Eastern country, scoffs quietly. “How insulting. And I suppose this Western woman also believes we hang from trees and bathe in mud. We ARE modern, you know.”

It is easy to feel insulted at such comments made by our Western peers, but in retrospect, there is so much truth in it. As a natural birth advocate, I agree totally in what the “Western” woman had to say. But for those who are not on the natural birth bandwagon, it may sound incredulous that homebirths have anything to do with religious beliefs.

The country I come from is a Muslim-majority country, and one that churns out babies by the dozen to boot. I nearly have half a dozen myself, but that’s not the point. The irony of the “Western” statement above is that though Malaysia comes across as conservative and somewhat religious in many ways, she prides herself in modernity and technological advancements in the medical industry – both dangerous and detrimental to her birth culture.

Birth, for natural birthers, is part of a journey for the female form, the medical industry parades it in a different way – in a very “Western” way, one might say. The majority of women birth in hospitals, not at home, and along with hospitals come intervention, protocol, fears of litigation and medically-induced complications. Why is this contrary to faith?

While for many, medicalised births seem the way to go. Why would anyone want to avoid medical interventions, when they are supposedly there to save lives? And why on earth would anyone have their babies at home when there are machines at hospitals that can gauge progress and complications? Contrary to this popular belief, there is plenty of statistical data that proves that even the minute intervention, including monitoring, causes the birth process to become jagged and disturbed, leading to a cascade of interventions that cause potential harm to both mothers and babies.

Birth is rushed along in government hospitals where capacity is usually the pressing issue. Women are admitted and treated like sick patients, hurried along a factory line, and in many cases emerge with distasteful experiences. Some wards have been likened to jail cells, with birthing mothers – in raging on oxytocin – are left strapped down in fear and doubt, causing hindrances for her baby to be born gently. These women are often engulfed in protocol and timelines, and leave the hospital as quickly as they arrive.

In private practice, where the underlying motive for the birth industry is profits, medical intervention is the cultural norm, with inductions being scheduled even weeks before the infamous EDD, regardless of the health of the mother and baby. Scare tactics also run high, as do non-emergency and elective Caesarean sections (c-sections).

Walk along any neighbourhood and throw a few rocks, at least half will hit women who have had to undergo c-sections at birth, the remaining of those rocks will probably hit women who have had traumatic vaginal experiences.

Still, this has nothing to do with faith? It does, as it does with having knowledge. The art of birth has been lost along the tresses of time in this country, Malaysia, and birth is often feared and ridiculed, associated with pain, trauma and even death. Few women are even aware that they are able to birth their babies on their own, not only without medical intervention or “assistance” but without doctors themselves. This isn’t to say that every woman who is expecting a baby should go ahead and plan an unassisted birth, but they should at least be aware how birth was designed by Allah SWT, and how they too were designed to birth, mostly without assistance. They should also at least be aware of the perils of birthing in a hospital, coupled by the hazards of medical intervention, no matter how small.

By understanding a little more about pregnancy and birth, women would be able to be better care providers for themselves rather than rely on medical judgment for non-medical conditions like pregnancy and birth. Over-reliance on hospitals in communities that are perceived as more conservative or religious is really becoming an oxymoron. There is so much more to birth than meets the doctor’s eye, and it is for us women, to try to learn and understand further, and to have faith that our bodies are able to birth our babies.

Having a little more knowledge takes us on leaps and bounds of our faith. In the Qur’an, the womb is known as “mekiynin,” defined as the term “secure receptacle,” or a powerful, sound, unshakeable, fixed object that is designed by Allah SWT. By knowing this alone, mothers would stop consenting to unnecessary inductions that usually happen out of convenience and allow babies to be born on their own accord without rushing the womb along through augmentation or even a c-section.

The one, single birth mentioned in the Qur’an was the birth of Prophet Isa (AS), where his beautiful mother, Maryam (RA), birthed him on her own, assisted only by Allah SWT.

To have the perfection of Maryam is a feat on its own, with one whole verse in the Qur’an named after her. But to come close to having that type of tawakkul – the feeling of complete submission – will allow us to have our babies in gentler, safer environments, without bright lights, without dangerous medical intervention, without prejudice and judgment... and maybe even at home. Who knows?

The compounded irony of the European “Western” woman’s statement is that the highest rates of homebirth are recorded in some European countries, and these have the best outcomes for both mothers and babies; whereas countries with high rates of hospital births have the worse effects on mothers and their babies. Yet we feel insulted when we are culturally associated with homebirths as this discredits the modernisation that is paraded by the medical industry. Oh, the irony.

We need to let go of the fear that is fuelling our reliance on the medical industry and start believing in ourselves. And we certainly shouldn’t feel insulted if an outsider thinks we should. It’s not because we are backwards or under-developed. It’s about having a shimmer of faith in what is natural and letting the gift of birth shine through as per its design by Allah SWT.

Umm Yusuf on Birthing Vaginally After Two Cesareans

Umm Yusuf is an American, currently living in Los Angeles, California, U.S.A. She is a happy wife and homeschooling mother of three.

Ever since I was a young girl, I always knew that when I grew up I wanted to be a "mom." I loved children and wanted a handful. I wanted a home that was full of life and a mini-van filled with kids and all their soccer gear. The dream of a home filled with laughing, loving, smiling children was beginning to seem impossible.
 
And here is the story of my vba2c...

My first child was born via C-section at 35 wks. It all began when I went in for the normal monitoring of contractions and fetal heartbeat, and after 4 hours of monitoring doctors declared that my child was in fetal distress. He was not handling the contractions well, and his heartbeat was dropping significantly low and on two separate occasions they lost his heartbeat completely. Doctors rushed into the room and said I had to have an emergency C-section right then. I was terrified, I asked Allah to protect him and within fifteen minutes Yusuf was delivered. A few hours later, I was wheeled out of recovery and I was able to see and hold my son. Alhamdullilah, he is a healthy handsome 6-year-old today.

At the time I wondered what was the wisdom behind it and why was Allah putting me through this. I knew that Allah puts us through trials and sometimes may give us a thing that we perceive as bad, but in truth, if we have patience that trial is a blessing.  

Almost two years later, my husband and I were getting ready to welcome our second child into this world. I had everything set for a vbac, unfortunately I went into the doctor’s office on my due date and discovered my baby had turned. He was no longer head down, but breech. I wasn't in labor or having regular contractions but the doctors said it was in my best interest and my baby's if I just had another C-section. The doctors insisted that it wasn't a good idea to wait and see if the baby would turn again, because there may not be any time and that delivering a breech baby with a prior C-section was asking for uterine rupture. I wasn't well equipped with knowledge about vbacs and a breech presentation, and I let the doctors scare me into another C-section. Adam was delivered later that day, and again I was able to see and hold him a few hours later. Alhamdullilah, he is a healthy handsome 4-year-old today.

Fast forward to the last few nights of Ramadan in 2010, early one fajr morning I found out that Allah blessed my family again, and I was expecting my third child. My husband and I wanted this delivery to be different, we didn't want it to end with another C-section. So, we read up and we researched the birthing process, vbacs, and uterine rupture. We continued with the same healthcare provider we had with our other two children, but insisted that we would not being having another C-section unless myself or the baby's lives were in jeopardy.

I had a healthy pregnancy and my midwife said that I was definitely a possible candidate for a vba2c, but she needed to send me to an Obgyn specialist, who needed to approve of it as well. Alhamdullilah, I was the perfect candidate. (I had a healthy pregnancy, my age was under 35 yrs, my last pregnancy was over 36 months ago, a tendency to deliver small-average sized babies, the placenta was attached to posterior wall, a low transverse incision, etc. etc. etc.)

At 38 wks, I went in for extended monitoring at the hospital and sure enough a doctor and med students came in saying that my child was not reacting well to the minor contractions I was experiencing. My husband and I questioned the doctor over and over. What should be happening on the monitor? How should our baby's heartbeat react? Is she in danger? Her heartbeat was low and not experiencing any accelerations during a contraction. We explained to the doctors that it was likely due to the fact that I have been hooked up to the machines all morning with nothing to eat for the past few hours. The doctors pushed that we just have another C-section while my stomach was empty. We continued to question them about the fetal heartbeat. Is it stable? Is it normal? That was very important, if she was healthy and doing well, and her life was not in jeopardy than there was no reason we would opt for a C-section. The doctors said that the baby was indeed fine, and had a stable heartbeat. We weren't going to be bullied or forced into another C-section. We said we wanted to leave the hospital and after a couple of talks with the doctor and a little paperwork, we finally were able to leave.

During my ordeal at the hospital, my husband called our nearest natural home birthing center and arranged an appointment a few days later. We knew that there was no way that the hospital was going to adhere to our wish of a vaginal birth. All the doctors saw was my previous C-section history and a chance to educate their med students on the process. So, at 38 wks we decided a home water birth with Andaluz in Portland, OR was our best option. We had appointments about twice a week to get my new midwives up to speed with my pregnancy history.  We also had all the home birthing gear ready to go at our place since this baby was coming very soon. It was during these last few days while talking with my midwives that my apprehension about a natural birth was beginning to fade, and that I was realizing this was indeed something I truly wanted. 

This natural birth would end the cycle of C-sections I was having at the hospital. It would keep me away from all the risks that come with being repeatedly cut open. With a natural delivery, there would be nothing stopping me from having more children in the future if Allah willed. It was the answer to my prayers.

On my due date, my contractions started to really pick up and I was having them every 15 minutes. The next day, the contractions were 10 minutes apart and growing stronger. The following day, with very little sleep now, the contractions started to get even closer. I was following all my midwives instructions on how to ease the pain during this prolonged stage of early labor, and it was quite painful. It was early in the morning, before fajr, that I noticed the contractions were finally 6 minutes apart, it was time to call my midwives and have them come. I called my main midwife from Andaluz, she told me to stay strong and to call back when the contractions were 4 minutes apart, since my child was in the posterior position and my progression would be slow and steady. I hung up the phone. I was in a tremendous amount of pain. I was crying. I told my husband that I just couldn't do it. He encouraged me that I could do this, and that I didn't want to go back to the hospital and have them tell us some bogus reason why they would have to cut this baby out of me. I cried. I prayed. I asked Allah to help me.

In all cases we should be praying, but there are instances in life when there is nothing else you can do but pray. When Allah puts you in a difficult and painful situation, where all your trust is now in Him and all you can do is ask. And it is that asking and calling on Him that draws you nearer to Him. 

I tried to just slow down and think, but the contractions just kept coming and I was in pain. I called my mother and told her that I wasn't sure about the homebirth and that I wanted to head to the hospital because the pain was incredible. My mother understood, told me there are blessings in everything, and that maybe the hospital is a good idea. And then I told my husband that I couldn't bear the pain any longer and that I needed to go to the hospital. My husband hesitated and wanted to be sure that I understood exactly what I was saying. We both knew that if we left for the hospital now, that I would more than likely be having my last child cut out of me. I cried and thought about my dream of that home filled with tons of children, and then a contraction. The pain was so great that I asked to be taken to the hospital. On the ride to the hospital, I began to put all my trust in Allah and I prayed desperately that I'd be able to deliver this baby vaginally there. I prayed and I prayed.

We arrived at the hospital and my previous midwife was there, and she told me that there was an excellent vbac doctor and vbac staff on-call this morning. ALHAMDULILLAH!!! I was extremely happy to hear this and then thrilled when I realized it was an all female staff. ALHAMDULILLAH again!!!! My husband was also very relieved. And so I labored a few more hours at the hospital but with an epidural. The epidural worked wonders for the pain, and I was able to get some much needed rest. When I woke I began to make du'a to Allah that this delivery would go smoothly and she would come vaginally and be a healthy baby that would grow up to be a righteous beautiful muslimah inside and out. I made du'a to Allah about all the dreams I had for my family and this new little baby.

I remember reciting Surat al Mulk (Al-Qur'an: Chapter 67: The Dominion) over and over in the hospital room, it calmed my heart and helped me focus. I hold this sura very close to my heart now because I was constantly reciting it and memorizing it with my halaqa sisters while my little baby was growing in my womb and up until the day she came into this world. Inshallah, the sura will always remain there.  

"Blessed is He in Whose Hand is the dominion, and He is Able to do all things. Who has created death and life, that He may test which of you is best in deed. And He is the All-Mighty, the Oft-Forgiving; "  (Al-Qur'an, Surah Al Mulk, Ayahs 1-2) 

Here the verses are reminding us, that Allah is the Lord of all the creation, and that He is always in control of what happens. So regardless of what the doctors had to say, Allah is ultimately in control and that eased my worries. 

Everything was going smoothly and the vbac staff were pleased with all the progress the baby and I were making, and shortly afterwards I could feel the baby drop lower and lower. And when it was time to push, I pushed. 

I was doing it, I was having this baby vaginally. I was ending the cycle of C-sections. I will never forget the moment I pushed her out, and her being put onto my chest. I held her tightly and looked down, and all I could see was this cute little purple bottom. I kept saying "She is soo warm. She is soo warm." I will treasure that moment for the rest of my life, Sarah is my vba2c baby!!! Alhamdullilah, she is a healthy beautiful 4 month old little girl today.

I thank Allah for letting me deliver our little girl vaginally. It was such a wonderful experience. There is definitely wisdom in everything, and Allah truly is the best of planners. The fact that I did have the two C-sections prior really allows me to cherish this delivery so much more. And I feel that it was from this experience that I truly understood the concept of tawakkul. Tawakkul or putting all my trust in Allah is a concept that I feel resonates with my vba2c experience. Putting absolute trust in Allah and relying solely on Him, and realizing that the outcome (whether it is a vaginal birth or another C-section) is from Allah, and that there is always wisdom behind it.

"And He will provide him from (sources) he never could imagine. And whosoever puts his trust in Allah, then He will suffice him. Verily, Allah will accomplish his purpose. Indeed Allah has set a measure for all things." (Al-Qur'an, Surah At-Talaq, Verse 3)

Remember that trust in Allah must be accompanied with action. One must put sincere effort and strive to accomplish one's intentions but also trust that whatever Allah has decreed is of benefit to him or her. This baby  and my vba2c experience made me fully grasp the meaning of Tawakkul. I did all that I could to ensure that this baby was delivered vaginally by having a strict birthing plan where a C-section was not an option. I endured as much as I could, but ultimately AIlah is the best of planners.

This birth brought so many possibilities and blessings, and I discovered that I am very interested in midwifery, birthing rights, and educating mothers about asserting their rights in a modern day system that doesn't support them. If I had the time, I would definitely pursue an education in midwifery and try to help other mothers that are dealing similar situations.  

As mothers, we want the best for our children in this life and the hereafter. We will gladly give up our own freedoms and sacrifice for the sake of our children, but we also cannot neglect ourselves. We have to treat ourselves well, take care of ourselves physically, emotionally and above all spiritually. A third C-section is not a risk I wanted to take unless I knew it was the right thing to do. I encourage all pregnant women to do research and understand their rights when it comes to a C-section, and be aware of the benefits of a natural and vaginal birth over a C-section.  

Motherhood is definitely a miraculous journey. Carrying a child in one's womb for nine months and then being able to push it out and bring it into this world is a beautiful event. An event that can only reaffirm one's faith in Allah and His infinite ability/power. Motherhood also entails everything that comes afterwards, the nurturing and raising of that child in Islam and with manners and characteristics of our noble Prophet Muhammad (peace and blessings be upon him). I ask Allah to grant me guidance and patience to fulfill those obligations and rights to Him and my family, and to earn a place in Paradise. I cannot thank Him enough for my three children, and if Allah blesses my family with a fourth child, I pray that I will have the strength to bring that child into this world naturally.

“Say: Nothing will happen to us except what Allah has decreed for us: He is our Protector: And on Allah let the believers put their trust.”(Al-Qur'an, Surah Al-Tawbah, Verse 51)

Aisha Al-Hajjar on Birthing Naturally

Aisha Al-Hajjar is an American-born Bradley Method® Childbirth Educator/Lecturer, Bradley® Labor/Birth Doula, columnist, blogger, and natural mom of eight. She currently lives and works in Riyadh, Saudi Arabia.  

What is birthing naturally? 
The term “natural birth” was coined by obstetrician Grantly Dick-Read in his book, “Natural Childbirth,” in the 1930s.  In today’s medical birth culture, natural can simply mean vaginal, rather than cesarean.  For me, natural means more than this, it means trusting Allah (SWT) and allowing ourselves to birth as we were created to do.  Birthing as Eve and Maryam (may Allah be pleased with them) must have done…completely drug free, without medical intervention or procedure.  This does not mean homebirth, although I love homebirth; rather to me, it means finding a birth attendant and birth place that will watch over you for complications and allow you to calmly birth without interventions so long as everything is going well.  This involves learning how to cope with labor and birth with natural pain management techniques as well as the physiology of labor so that the woman works with her body, rather than against it at this critical time.

Why did you decide to birth naturally?
All eight of my births have been drug-free, natural births, alhamdulelah.  My first five births were before I’d ever even heard of Islam.  Yet I somehow knew that my body had been created to birth and feed my babies.  Intuitively I knew that the drugs and interventions offered at the hospital would only complicate an event that was perfectly designed to be experienced naturally, subhanallah.

What are the different ways a woman can birth naturally (i.e. at home, in a hospital, etc)?
Natural birth can be experienced in any setting.  Of course, the less medical the environment, the less likely a woman will be pushed or encouraged to allow medical process into the event.  Having a supportive birth attendant is paramount.  But even without such support, a calm and confident mother who is able to be strong in advocating for herself and her baby can accomplish her birth goals, insha’Allah.

Unfortunately, there are no birth centers in Saudi and with homebirth there is the hassle of securing birth documentation afterwards.  My last baby was born at home, alhamdulelah, and only my husband was present to assist me.  It took us four months to get her birth certificate, but we did get it, alhamdulelah.

In your experience, what are some of the greatest obstacles women face when they attempt to birth naturally and how can these obstacles be overcome?
In my opinion, the woman is her own biggest obstacle to completely natural birth.  Unfortunately, in the medical birthing culture that exists today, most women just go to the hospital and turn their bodies over to medical process like a car to the mechanic.  Doctors are used to women who seek to be “rescued” from their births.  Rarely, if ever, do they see a woman who took the time to get educated and prepared (physically, mentally, and emotionally) for her birth.  It takes trust in Allah (SWT) and HIS perfect design of our bodies to calmly and confidently ignore the media’s portrayal of birth as a medical emergency and let the process work naturally.

What are the risks of birthing naturally?
Birth is never without risk, subhanallah.  But frankly, the routine and elective medical procedures we are given (and often ask for) set up a chain of unnatural birthing that require even more medical interventions to manage.
There is far greater risk in any procedure initiated by well-intentioned medical staff than in allowing the natural process to unfold.  This is assuming there are not real complications (about 90% of births would be without complications if left alone) and the woman has learned how to cope naturally with her pain and how to work with, rather than against her own body during labor and birth.

What are the benefits of birthing naturally?
First of all, it’s safer than medically interfering in the process.  Secondly, if we avoid starting elective procedures (pain meds, routine IV, fetal monitoring, inductions, etc) we also avoid the domino effect that these procedures often times cause.

For me, the greatest benefit is the recovery time.  Mothers who are able to birth without any medical interventions usually feel great after the birth, when it counts most.  As compared to women who have undergone procedures and taken medications, who are often miserable, nauseas, and need time to heal and recover.

Personally, I am up and about within two hours after delivery, alhamdulelah.  I feel great and I am joyfully caring for my infant.  I also advocate for delayed umbilical cord clamping to ensure that my baby’s blood is returned to his/her body, rather than lost in the cord when cut quickly.  My baby, who was not subjected to narcotic medications or abnormally strong contractions (brought on by induction or labor speeding drugs) is alert and active and nurses within one minute of birth.  In my opinion, this is what makes it all worthwhile.

To whom would you recommend natural birthing and why? 
I recommend natural birth to any woman who has the confidence and determination to learn and prepare for it.  This does not mean birthing without the watchful eye of experienced birthing professionals.  Complications, although rare, may require the skilled hands of rescuers for mothers and babies in need.  My advice is to prepare for normality until true abnormality strikes.  In this way, we maintain a balance between nature and technology and only employ procedure when truly needed.

To whom would you NOT recommend natural birthing and why?
I cannot recommend natural birth for women who have no interest in preparing for their birth and who do not believe in their body's design and ability to birth naturally.  I feel sad for such women, but not everyone is able to ignore the media portrayal of birth as an emergency, nor see past the hospitals’ and medical communities’ views of birth as a business.

What has natural birthing taught you?
Alhamdulelah, the miracle of natural birth is really a confirmation of my trust in Allah (SWT).  HE is the perfect designer and creator of our bodies and our ability to carry, birth, and feed our babies.

What advice can you give to women who may be scared to try natural birthing?
Seek as much information as you can.  There are tons of resources on the internet, alhamdulelah.  If they can find childbirth classes (I offer such classes in Riyadh), enroll and go to all the classes offered.  Enlist someone to be their coach (husband is my preference, but mother/sister/aunt work well too).  Hire a doula to assist them during their labor and birth; doulas have a lot of knowledge and can help the woman understand the process and decipher the medical world of birthing during the heat of the moment.  Discuss their preferences with their doctor well ahead of time to ensure that he/she will support their choices in birth.  Don’t wait to the last minute and don’t be afraid to change doctors or birthplace if they are not satisfied with the support they will receive.

Any final comments?
Obviously, natural, non-medicated birth was the way of Mother Eve (may Allah be pleased with her) and all women until just this past century.  Knowing this fact, I can confidently state that natural, non-medicated birth is Sunnah, as this is all there was at the time of the Prophet Mohammed (Peace be Upon Him).  Many medical procedures save lives, alhamduelah, but in the end, it’s all Qadr Allah and regardless of where we are or what we plan, HE is the master planner.  If our births are meant to go smoothly they will, if they aren’t they won’t, subhanallah. Trust Allah, tie your camels with education, preparation, and  birth where you feel safest (be it home or the hospital).  May Allah bless us all with healthy easy pregnancies and births and may our babies be pleasing to HIM and his/her parents…Ameen.

To read more from Aisha Al-Hajjar, visit her blog at www.saudibirthstory.blogspot.com and her Motherhood column on Saudi Life at www.saudilife.net/motherhood