This post is dedicated to all the women who have given birth by cesarean section (or traumatic vaginal birth) who have either not allowed themselves to grieve or who felt ashamed for feeling sad and angry about the birth. It is dedicated to all the mothers who thought or believed that they should "just be happy" their baby was healthy and that the baby's health was the ONLY thing that mattered no matter what trauma they endured as women in body and soul. This post is also offered as a verbal "empathy suit" to women and men who have never experienced a cesarean section.I share my cesarean stories here as part of my own grieving process. In mourning the means of Jude's birth, I realize that I never fully mourned the means of Katherine's birth. I was mostly shocked and awed from it all, especially the part about almost dying from asymptomatic HELLP syndrome. So, in sharing this story, I allow myself to grieve both cesareans so that I can more fully embrace the joy of childbirth that I did experience.
When I wrote in October about
my desire for a natural vaginal birth, I focused on the beauty that an uncomplicated, natural, vaginal birthing experience is for many women. What I didn't emphasize, and had probably subconsciously chosen not to remember, is the equally motivating desire to avoid the trauma of another cesarean.
There is a reason the good Lord did not put the baby door in the wall of the female abdomen!
C-sections are so common in our day and, with modern medical advances, relatively safe that we forget they are major abdominal surgery. We treat it like ice cream flavors: Which would you prefer chocolate or vanilla? Vaginal birth or surgical delivery? As if it were a mere matter of taste or preference. As if not getting a vaginal birth was like not getting some minor preference in a personal birth plan. As if a vaginal birth was an aesthetic choice like lighting or background music.
It is mind boggling to me that many women elect to have a voluntary cesarean and skip labor.
I've done more than my fair share of both labor time and c-sections, and I have to say that I'd take hours and hours of painful labor over surgery and recovery HANDS DOWN.
Here's my story from Jude's birth:
When my trusted and beloved obstetrician informed me that "The baby is making the call" and that we were headed for surgery, I was shot up with contraction-stopping drugs. At first I couldn't even tell the contractions had stopped because the said drugs made every muscle in my body shake violently.
I was lying flat on my back on the table being wheeled to the OR. My legs were bent and my knees were knocking wildly together. My neck and head were wobbling. Every muscle from my head to my toes was tensing uncontrollably. It was a terrifying, helpless sensation.
"I can't stop shaking," I said to anyone and no one.
I was surrounded by a swarm of medical people I'd never met before, and who, thankfully, I would probably never have to see again. No family, friends, or support are allowed in the OR while the patient is being prepared for surgery.
I was scared that the anesthesiologist would not be able to insert the needle for the spinal tap because I was unable to hold still. I was afraid that I would jerk involuntarily just as the needle approached the spinal tissue. I knew of people who had become paralyzed as a result of misdirected epidural and spinal tap needles.
But my obstetrician was kind to me. While the anesthesiologist debated about whether to lay me on my side or have me sit up for the procedure, my doctor said he would hold me. He helped me into a sitting position and put his arms around my arms, gently squeezing above my left elbow for reassurance as I rested my chin on his shoulder. The shaking mercifully stopped and the spinal was easily started.
They lay me out flat on the operating table arms spread to either side like a fallen crucifix. As the warm numbing sensations of anesthesia started in my feet and legs and began working their way up my body, a team of masked people exposed my nakedness as they flitted around "prepping" me.
Somebody, I didn't see who, scrubbed down my upper pubic area and abdomen with an antiseptic solution. An equally anonymous person, or maybe the same person, shaved off pubic hairs. At some point the screen went up so that my head and chest were separated from the rest of me, blocking my view of the surgery.
Various contraptions were affixed to my body in various places: IV, catheter, pulse monitor, random nodules. (I found one metal node still stuck to my side under my arm a couple days later. "What's this?" I asked my postpartum nurse. "Oh!" she said, half amused and half embarrassed. Then she yanked it off. I could still see the round mark embossed on my skin two weeks later.)
The anesthesiologist sat at my head. I heard his voice occasionally checking in with me, but I couldn't see him.
Gary was escorted in and also sat near my head, but closer so I could see him.
Gary mentioned later that the doctors were casually talking about sports as they began the surgery. He felt reassured by this casual attitude that Jude and I would be fine. I didn't even notice what anyone was saying as I was completely overwhelmed and fatigued.
The anesthesia continued to creep up higher and higher. Just as with Katherine's birth, I began to be afraid when the tingling numbing sensations crept up my neck and into the lower part of my face.
"Tell me if you begin to feel nauseated," the nameless anesthesiologist said, "Don't wait until you feel like you might be sick, okay?"
A few minutes later I told him I wasn't feeling well. His invisible self produced a vomit-catching pan out of nowhere and placed it on the table along the side of my face. I turned my head slightly to the side and lamely coughed into the air above the pan. Nothing came out, and the nausea subsided in a few moments.
I could feel tugging and pushing sensations in my midsection, but no pain, as the doctors sliced through five layers of abdominal skin, tissue, and muscle, manually separating muscle down to the pubic bone, separating my organs from the surgical area with "spatulas," cutting through the uterine wall, and pulling out the baby. Surgical assistants held my skin and tissue apart while the surgeon worked.
The most intense pulling and tugging probably came from them pulling Jude "
by the neck backwards out of the pelvis and then by the head through the incision in the uterus." (In case you were wondering, C-sections are NOT any less rough on babies than vaginal births.)
Somewhere in the dreamy surrealness of the experience, a baby was held over the screen and cried. His face was all red and scrunched up from being held by the arm pits while his head hung limply forward on his immature neck. In a flash, he disappeared again.
"9:44." Someone called out the time of birth.
I heard them whisking Jude across the room for his initial exams and procedures.
"Go with him, Gary," I said.
"Are you sure?" he asked.
"Yes. Go with him."
I lay there for another 20 minutes while they scraped out the placenta, set my uterus on my stomach to sew up again, pushed my uterus back inside me, flushed the abdominal cavity with water, and sutured me up.
Gary and Jude waited for me during this time in the recovery room. When I was rolled into the room to join them, along with all the accompanying paraphernalia (IV, pulse monitor, catheter, etc.), I was high from the narcotics and itchy like crazy from the spinal tap.
The over 24 hours of severe itching was almost as bad as not being able to move post-surgery. Every inch of my skin itched uncontrollably. As after Katherine's birth, I found myself unable to stop rubbing my face.
Knowing all about the itching thing from before, I asked for Benadryl immediately. That sort of helped. When they added Nubain to my drug cocktail, it was a bit better. I had to keep asking for both over the next 24+ hours whenever I felt the effects of them wearing off. I lay awake the first night or two unable to sleep much because of the itching.
You may or may not have noticed that almost every normal movement you make during the day involves your abdominal muscles.
Those would be the muscles that I had just had sliced through and man-handled.
Sitting up? Rolling over? Walking? Reaching? Stretching? Bending? Twisting? Lifting? Pooping? Passing gas? Laughing? Coughing? Sobbing?
Out of the question.
When I wanted to hold my baby, I had to ask someone to hand him to me as I was unable to reach his bed and equally unable to lift him out of it.
As you can imagine, nursing and cuddling a newborn when you cannot move your body is not an ideal situation. When Katherine was born, this was a source of tears on more than one occasion. It was still frustrating and maddening with Jude, but at least I knew how to make the most of the breastfeeding positions most conducive to the situation.
Thank God the hospital beds are electronically adjustable or I would not have been able to sit up for more than a day.
For the first 12 hours I just lay on my back using the hospital bed to raise and lower me into and out of a sitting position. Even if I had been physically able to roll over or stand up, I wouldn't have been logistically able because of the plethora of tubes and devices attached to me. I still wear the residue from the tape that held the catheter to my inner thigh.
When it was time for me to take my first walk 12 hours postpartum, it required two very patient nurses to help me out of bed and across the room to the toilet.
"Look straight; don't look down," the nurse kept reminding me. "Straighten your knees. It's okay to bend a little at the waist. Do you feel lightheaded or dizzy?" I did.
I shuffled one foot a few inches forward and then the other, a nurse supporting me by the arms. An assisting nurse wheeled the IV pole along next to me and held open the bathroom door for us.
Crossing those few feet constituted a long journey.
God bless the good, gracious nurses who humble themselves to the basest of jobs and simultaneously, miraculously manage to leave some of your dignity in tact. One of my postpartum nurses was a saint in this regard while another made it obvious that she was put out by the fact that I couldn't do it myself.
It is very humbling to require someone else to clean your bottom and to be at their mercy.
After 24 hours, I was finally tube free and able to shuffle around a bit by myself. Moving continued to be awkward and painful for several days. Even after we were home (we requested an early discharge after two nights), I had to ask Gary to help me get into a side-lying position in bed and to help me get out of bed.
A request heard more than once at our house: "Gary, will you please move my bottom hip one inch toward the closet so my hips are perpendicular with the bed?" I felt utterly pathetic and weak.
It is hard not to feel depressed when you can't even move your own hips an inch to the left or right.
I lay face down into my pillows to sob so that my belly would be supported like a splint against the bed. Otherwise, it hurt to much to have a good cry.
The first week of recovery was pretty dark. The second, not so bad. I continue to experience itching around the incision and where they shaved and have pain and tenderness in varying degrees. I am informed that "Incision pain may occur constantly or intermittently for up to a year. Feeling may be regained on the incision site, or nerve damage may result in permanent lack of sensation." I also struggle with parenting Katherine since I am instructed not to lift anything heavier than my baby for five weeks postpartum. And, as after Katherine's birth, I mourn the loss of choice and options I now have for future births.
I am so glad both my babies are completely healthy, and I would have FIVE more cesareans if either Katherine or Jude required it. Their well being is truly the most important thing.
However, I cannot pretend that what I experienced in the birthing process was insignificant. I cannot pretend that experiences like these don't leave lasting psychological as well as physical scars on a woman who lives through them.
If someone told me truthfully that in order to save my children's lives I'd have to submit to be bludgeoned in a back ally, you can bet I'd do it. But no one would ask me to "just be happy" my children were okay.
I've been bludgeoned in the OR by benevolent folk who have kindly given me anesthesia and narcotics. It still hurts. And I still feel like half a person having suffered through the indignity of it all.
It is humane to save a child's life. It is inhumane to subject a woman to the bludgeon of a cesarean section. Thus, a cesarean is benevolently and humanely inhumane.
I give myself permission to feel all the conflicting emotions of such a paradox. I give myself permission to feel all the joy as well as all the grief, sadness, and anger I need to feel to process the two events which happened to occur simultaneously: the joyous birth of my beautiful son and the physical and emotional trauma of an emergency cesarean.
On this Thanksgiving Day, I offer thanks for two utterly adorable, perfectly healthy children; for the opportunity to experience labor with both of them; for kind, skilled professionals who safely delivered them, for the opportunity to grieve here, and for you dear readers.
Thank you for reading and entering into my experience with me. Your words of empathy and understanding from the previous posts have already been a healing balm for my soul.
Now that I have given words to some of my grief, I already feel lighter. There is more room for joy expanding in my soul.
Excuse me while I go smother my son in kisses. I take advantage of these first few short months before he can object to such vigorous displays of motherly affection.
