Fertility & IVF · Episode 7
IVF alone, a premature birth and a healing caesarean: Rita's story
Rita became a single mother through IVF in Portugal. Her son was born at 28 weeks; her daughter came via a mother-assisted caesarean that helped her heal.
Born to be Wild · 2026-09-28
Rita is 43, Portuguese, a veterinarian by training, and the mother of "two children with me and three in heaven". After 14 years in France, she came back to Portugal to try for a baby on her own, through IVF.
On episode 7 of the Born to be Wild podcast, she told Aviva Markowicz and Irene Jaspers about miscarriages, fertility treatment as a single woman, an emergency caesarean at 28 weeks, and the mother-assisted caesarean that let her close the circle.
Before IVF: healing the body first
After early-stage cervical cancer in 2010, treated successfully, Rita stopped the pill years later and her periods didn't come back for a year and a half (hypothalamic amenorrhea). A doctor suggested she might be in early menopause, "which is quite nice if you don't want kids".
Rita refused to accept that at 38. She worked on her health holistically, with sleep, rest and nutrition, later with the help of a functional medicine doctor in Portugal. Her cycle came back.
Three miscarriages, and a question nobody was asking
Rita went through three miscarriages, and a round in which none of her nine frozen eggs survived. Doctors kept testing her, sometimes with invasive exams.
"Having a baby is a matter of two, not one."
After months of insisting, her then-partner was tested too, and there were problems on his side. For Rita it was an important lesson: it wasn't all her fault, and it was never a matter of fault in the first place.
Choosing to become a mother alone
After the relationship ended, Rita decided not to wait. When a doctor suggested she might meet someone, she answered that dating "with a clock ticking" wasn't how she wanted to live. In early 2023, a round of IVF produced three embryos. The first transfer worked.
Throughout the process, she kept up psychotherapy, which she describes as essential to balancing hope and self-protection.
26 weeks: "I'm feeling him less"
Around 26 weeks, Rita felt her baby moving less. She went to the maternity emergency service in Coimbra, where she was reassured and sent home. She went back two days later, then again when she couldn't feel him for a whole day.
Over a long weekend of CTGs, the team saw that the baby's heart rate dropped with every Braxton Hicks contraction and was slow to recover. He was small, and there was little amniotic fluid. She received corticosteroids for the baby's lungs (Cochrane, 2020) and magnesium sulphate to protect his brain (Cochrane, 2009), standard treatments when a very premature birth is expected. Then came the choice she calls "an option without an option": go home with twice-weekly checks and no guarantee, or deliver now.
Trust yourself: if you feel your baby moving less, get checked the same day, and go back if the feeling persists, even after being reassured (NHS; RCOG, 2011).
An emergency caesarean at 28 weeks
Her son was born by emergency caesarean at 28 weeks and 5 days, three months early. Her uterus contracted around the tiny baby, and the surgeons had to extend the incision vertically as well as horizontally. She didn't hear him cry. She asked a doctor to take a photo on her phone and met him five hours later, surrounded by cables.
"It was so natural. I never had any fear of having him in my arms."
He stayed two months in neonatal care instead of the three expected. Rita stimulated breastfeeding the whole time, and he latched well. Analysis later showed the placenta wasn't working properly, and tests found thrombophilia mutations that made a future pregnancy high risk.
A second pregnancy, and a decision to make
Rita moved back near her family in Portugal and did one more embryo transfer. It worked: a girl.
Because of the previous incision, she was told a vaginal birth carried a high risk of uterine rupture. After this type of incision, guidelines generally advise a planned caesarean (RCOG, 2015). She consulted six or seven doctors. One left the door open to a vaginal birth, but under many conditions. Rita decided to plan for a caesarean, on her own terms, rather than hope and feel something was taken from her again.
The public hospital's plan was a standard surgical caesarean at 38–39 weeks, with no skin-to-skin in the operating room. Then an obstetrician at a private hospital described a different approach: dimmed lights, gentle care, and the option for Rita to lift her baby out herself.
The mother-assisted caesarean that healed her
Her doula, Inês Alvim, stayed with her throughout, alongside two nurses from the doctor's team. Rita cried as they prepared her: from nerves, and from happiness at having made it to the end.
- Rita was dressed in sterile gloves so she could enter the sterile field.
- Once the baby's head was out, the drape was lowered and Rita lifted her daughter onto her chest.
- The team waited for the cord to stop pulsing (delayed cord clamping, which benefits the baby's iron stores (Cochrane, 2013)), and Rita cut it herself.
- Her daughter stayed skin to skin for about four hours and was breastfeeding before the surgery was even finished.
"Her first cry was in my hands."
Rita knows MAC isn't for every mother. For her, it was peace after trauma.
What Rita wants other parents to know
- Do your homework. Culturally, we don't question doctors. But you can ask questions, discuss alternatives, and decline an exam that doesn't make sense to you, as Rita did with routine cervical checks late in pregnancy.
- Keep looking. Sometimes you find "unicorn doctors" whose way of working matches yours.
- Get support. Psychotherapy, a doula, and family nearby all made the difference.
Learn more about how it works: Mother-assisted caesarean (MAC), explained by Dr Koen Deurloo.
Frequently asked questions
Can a single woman do IVF in Portugal? Yes. Since 2016, medically assisted reproduction in Portugal has been open to all women, regardless of marital status or sexual orientation (Lei n.º 17/2016).
What should I do if my baby moves less? Contact your maternity unit or go to the emergency service the same day. Don't wait until the next day, and go back if you're still worried after being reassured (NHS; RCOG, 2011).
Can I have a mother-assisted caesarean in Portugal? A few obstetricians offer it, mostly in private hospitals. Ask your obstetrician, and consider a doula to help you explore your options. Find a doula near you.
Sources
What our guests share comes from their own experience and practice. The medical and legal information in this article is based on the sources below. It doesn't replace advice from your care team.
- McGoldrick et al. (2020). Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Review
- Doyle et al. (2009). Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Review
- NHS. Your baby's movements
- RCOG (2011). Reduced fetal movements (Green-top Guideline No. 57)
- RCOG (2015). Birth after previous caesarean birth (Green-top Guideline No. 45)
- McDonald et al. (2013). Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Review
- Lei n.º 17/2016 (access of all women to medically assisted reproduction)
Listen to the full episode
This article is based on episode 7 of Born to be Wild, the podcast: Rita, IVF alone, a premature birth, and the MAC that changed everything. Listen on Spotify.