- This birth story was published in The Mother magazine (March/ April '09). - 

Elias's story is one of perseverance against all odds. I was diagnosed with a malignant brain tumour (Grade IV medulloblastoma) in December 2006. As I was pregnant at the time, my symptoms - excruciating headache, severe vomiting, nausea, dizziness, inability to walk due to loss of equilibrium - were initially put down to morning sickness or a mere "viral infection". The correct diagnosis was finally made on a gynaecological ward in a hospital in Germany by a consultant gynaecologist who had the good sense to send me in for a brain scan when I was starting to lose consciousness. At this point it became clear to everyone that my condition was far more serious than regular "pregnancy complications" and I was rushed by emergency ambulance to a neuro-surgical care unit at a large hospital in Frankfurt.  Here, they immediately performed emergency surgery on me, placing a shunt to drain access liquor from my brain which had become dangerously compressed. The tumour was in my cerebellum, near the brain stem, and it had grown so large that it was obstructing the normal flow of liquor out of my brain causing it to swell. The cerebellum is also responsible for equilibrium and orientation in space, which explains my excruciating dizziness and inability to stay steady enough on my feet to be able to walk. After my condition was sufficiently stabilized, I was scheduled for a major operation in which a surgeon would attempt to remove the tumour with the help of computerized 3D-images of the tumour location. I was fortunate enough to be in the care of a very skilled and compassionate neuro-surgeon who was successful in removing the tumour mass without harming any of the surrounding neurological structures.

However, after the operation was over I received two pieces of bad news: The first was that I had suffered a vaginal bleed shortly after the operation was completed. I was 8 weeks pregnant at the time and had been told that there was a good likelihood of the embryo surviving the operation. However, the bleed was not a good sign. The doctors reassured me that my HCG (pregnancy hormone) levels were still high but the bleeding continued for the next days and deep down I knew I had lost the pregnancy. Five days after the brain tumour operation that saved my life I had a dilation & curettage - the third operation in a week. Now came the second piece of bad news: Tissue from my brain tumour had been sent in for laboratory testing and the results were in - I had cancer. 4th grade cancer, the most malignant and fastest growing/ fastest spreading type. Some tumour cells had spread into other areas of my brain and couldn't be removed surgically. The risk of neurological damage was too high. My options now were chemotherapy or radiotherapy to try and target the spreading tumour cells in my brain specifically and to pre-empt the migration of tumour cells into other parts of my brain and central nervous system. Finally, my doctors decided on an eight-week course of radiotherapy as my best option. I was told that the treatment would significantly improve my chances of survival, but it came with a series of risks and side effects, including hair loss, neurological damage (loss of hearing, vision problems) and infertility. Needless to say, I had no choice. It was a calculated risk. At this point, only the large tumour had been removed. Since it had radiated some of its malignant cells into other areas of my brain, I still had cancer. Although I was willing to do anything it took to eradicate the cancer cells from my body and survive, I was devastated at the prospect of not being able to have any more children. I had just lost a pregnancy and felt a deep sense of yearning to be given another chance. 

The radiotherapy treatment ended in March 2007 with the best news I could hope for: A MRI brain scan in April 2007 showed no remaining tumour cells in my brain or central nervous system. I was bald, frail and weak - but I was in remission.  The doctors told me that the first 2 years after the cancer treatment would be crucial and that I was to have regular brain scans for the next 5 years. They also said that I could start trying for another baby in 12 months time, given that my fertility had returned by then. I spent an anxious 8 months without a period, not knowing whether my fertility had been permanently damaged. The radiation treatment might have harmed my ovaries, or it might have affected the centre in the brain responsible for reproductive hormone production, or possibly both. I finally had my first period since my miscarriage in December 2006 in late August 2007. Feelings of elation, hope and deep gratitude washed over me.  Now we just had to wait the remainder of the year, until the 12 months had passed, to try again for another baby. Joyfully, I found out I was pregnant again on 19th February 2008.

 
 2 hours before giving birth. (7cm dilated and smiling!)

Elias - one day old.

Kiran later told me that he came out with a peaceful expression on his face, eyes closed, just floating in the warm water, suspended in time. Then he flipped a somersault under water and was picked up by his father. Stunned, I slowly began to realize what had just happened. My baby was here. I could finally hold him, see him, smell him, touch him. He was placed on my chest, umbilical cord still attached and I just gazed at him in wonderment. I couldn't believe he was here. Everything had happened so quickly. I felt peaceful, joyful, serene and deeply grateful. Ten minutes after the birth, I felt another contraction and birthed the placenta. I was still sitting in the pool with Elias snuggled against my chest. I had birthed the baby, Charlie had caught the baby and I felt that Julie should now cut the cord. That way, a circle was created that included all three of us in the birthing process. I felt that Julie's help, encouragement and belief in me had been an essential element in this blissful birth.