My story illustrates the impact that the trauma of childbirth can have on women. On Tuesday, September 16, 1986, two weeks after his due date, my son Jeffrey was delivered by C-section, weighing 9 pounds. 13 ounces I started prenatal care at 22 weeks with a doctor recommended by a friend. The doctor indicated that he supported my birth plan for a natural birth with minimal interventions. My doctor had privileges at two hospitals. During the third term, my partner and I toured both. I selected the hospital whose standard procedures were least invasive; no IVs or enemas and encouraged walking during labor.
A little after midnight on September 16, my water broke. I had no contractions at this time, but I called my doctor. He said that he had a patient in preterm labor at 26 weeks who required her care and that I would have to go to the other hospital in her place. After a quick shower we drove there, where my partner took care of the paperwork while I underwent his standard procedures, including an enema and IV needle insertion.
At the time, I was having strong, regular contractions. Then they took me to a delivery room and put me on fetal monitoring and I couldn’t walk. Despite these interventions, I controlled the pain and plowed naturally for nine hours. My doctor checked my progress several times, but he was mainly focused on his other patient. I made good progress and at 7:00 I had 9 cm.
At 9.15 when my doctor checked me again, I was still 9 cm and the baby had not descended. He said that he could allow me to work longer, but it wouldn’t change a thing; the baby was too big. After nine hours of intense contractions, a couple spending more time in the cafeteria or asleep and lying on their backs staring at the walls, that’s when I lost control and started crying. Within 15 minutes I was in the operating room and they were giving me a spinal cord. By this time I was so exhausted that once the pain from the contractions was gone, I fell asleep.
I remember very little until that afternoon. My vague memories include Jeffrey’s first cry and my ex bringing me a picture of him in the recovery room. Because he had swallowed myconium, he had to be observed in the nursery and I was unable to hold him or attempt to nurse him until that night. I was unable to room-in due to the C-section and despite the sign on his crib telling the nurses that he should be breastfed on demand, he was given formula and not brought to me for hours.
At the time, I was very disappointed that I had a C-section and felt that I had somehow failed as a woman. I was also intensely angry with my doctor. I felt that despite a good relationship during my pregnancy, he had let me down when he needed it the most. He especially angered me at the tone he used with me in suggesting that a C-section was necessary. I felt that the tone of voice he used when he told me that he could allow me to work longer, but that it wouldn’t do any good, was intimidation. I later remember comparing that experience to emotional rape.
Because my son was at daycare most of the time and my partner was at work, I was left alone in my hospital room for most of the day. I cried often during my five day hospital stay. I was also angry that the nurses had more time with my new baby than I did. I was able to see him only part of the day. I never got to have it with me at night. Our breastfeeding experience got off to a rocky start because she was given bottles of formula against my wishes. It was like the nurses felt like they knew more about my baby than I did. I undermined my confidence as a new mother.
Even after we leave the hospital, we continue to have difficulties. I had a mild infection in my incision. My son had a bacterial infection that caused blisters. He started at her scalp where the monitor had been inserted, but soon covered the area under his fat little arms. He also developed a severe case of thrush that turned breastfeeding into a complete nightmare. It took over two months before my sore and cracked nipples healed. I can clearly remember sitting on the couch with my son to breastfeed and crying in pain.
I eventually moved on emotionally or so I thought. I realized the truth when more than eighteen months later I found out that she was pregnant once again. All my old fears and feelings resurfaced. I sat and cried for hours; not because the pregnancy was unplanned or because of the added strain another child would place on our finances or troubled relationship, but because she would have to endure another C-section. I started looking for alternatives and eventually found a midwife who would consider a home birth. Our first prenatal visit lasted almost three hours and was more about reporting the trauma of my first birth than my physical condition.
But even the successful VBAC home birth of my 7 lb. 14 ounces my daughter did not lessen my anger at what I thought was unnecessary intervention. In fact, an offhand comment from my midwife that my pelvis was more than adequate only intensified my anger. In a classic PTSD experience, that comment reignited all the feelings she had experienced right after the surgery. I tried to channel my anger constructively. I became a crusader by natural birth; taking a course in obstetrics for laymen. I tried to find a lawyer to sue my doctor, but the statute of limitations had expired.
For five years after my C-section, I often wondered what if. What would have happened if I had continued with my plan to deliver at the other hospital with their less intrusive procedures? What if you had walked or worked standing up? What if I was not continuously monitored? Every time I got caught up in those “what ifs,” I would get angrier or depressed. Few people have the true benefit of hindsight, but I was blessed with the opportunity to resolve all these questions once and for all.
Those questions were answered once and for all with my second home birth. This son was considerably larger than my daughter and weighed 8 pounds. 15 oz, but still smaller than his big brother. I had a very short and intense labor of less than two hours. I had what many would consider an ideal natural birth. I will plow upright and walk during early labor. I pushed into a position that was comfortable for me. I had a wonderful support person in my midwife and her assistant. I was comfortable at home, but my son got stuck in the birth canal. My experienced midwife said that her shoulder dystocia was one of the worst she had faced in her decades of practice. She felt that prayer was the only thing that saved my son. After the birth, her breathing was depressed and her one-minute APGAR was a mere 4. All the question marks that had haunted me for five years were gone. It’s sad to say, but it was that experience that allowed me to release the anger towards my doctor that I had been carrying for almost five years.
It was this experience that made me realize for the first time that cephalopelvic disproportion was not some made-up condition used by doctors to pressure their patients into unnecessary C-sections. I suppose the permanent ridge on top of Jeffrey’s head, where he was wedged against my pelvic arch, should have indicated that sooner, but it’s often easier to blame others than to accept our own responsibility. I began to accept that my C-section had been the result of overeating during pregnancy, resulting in a baby that was too big for my pelvis.
My emotional healing was completed over a decade later with the birth of my youngest son. She had planned a midwife-assisted hospital birth. He was sure that he would have no difficulty with another VBAC. I stayed home through early labor and went to the hospital only once labor was well established, the contractions were close together and so intense that I had a hard time controlling them. Based on my previous work, I was sure the baby was imminent, but when I was checked, I was only 2 cm dilated.
The baby was in the posterior position and my intense back work was not effectively dilating my cervix. I tried to plow upright in the shower. I tried to walk. I tried lying on my side. Nothing worked. The pain was more intense than any of my previous jobs. I knew that if I chose to have an epidural it would significantly increase my chances of having another C-section, but the pain was so intense that I made the decision to have it anyway. Several hours and several interventions later, I did indeed have another C-section. This time, however, instead of anger and resentment, I took ownership of my decision. I was sure that she had done the best she could for me and my baby.
The other part that was healing for me was that in the fifteen years since my first C-section they had changed so much that many of the things I hated most about the experience simply didn’t apply. When my son was born, they brought him to me to touch him before placing him in the warm bed. My partner, his mother, and Jeffrey were able to touch and talk to the baby while the surgeons stitched me up. Then they took me to the recovery center and I was reunited with my son; less than an hour after he was born. The nurses helped me take care of him immediately. Best of all, the hospital encouraged rooming-in for all babies. My partner stayed with us even overnight and the only time they took my baby away from us was for about 15 minutes each day to weigh him.
It was as if he had come full circle. Even though the procedures were the same, I was a different person. had matured. I had learned my rights and responsibilities. When faced with an unknown situation, I knew the benefits and risks of all my choices and readily accepted the consequences of those choices. I was empowered by the very procedure that had once left me so emotionally scared that I was suffering from Post Traumatic Stress Disorder. Part of it was because it had changed and part was the result of changes within the medical system.
As a mother who has had three C-sections, I sometimes get very frustrated with the natural birth movement. Yes, the natural birth of my daughter and, despite her difficulties, even my second child was wonderful. Somehow they healed my inner woman after the first traumatic C-section, but neither of us was perfect either. I carefully wrote and discussed elaborate birth plans with my midwives and none of the births followed the plans.
Births almost never follow plans. I spent five years angry and depressed for no reason. How many other women have experienced this pain that inflicts a scar far deeper than a cesarean delivery? I have often wondered what would have happened if that shoulder dystocia had not occurred. Would I have stayed angry with my doctor and depressed? Will my PTSD ever be completely cured? Of course, I will never know the answers to those questions. And I am deeply sorry for the tens of thousands of women who never have the clear answers that fate provided me with.
But my experience has led me to start childbirth education classes and doula services specifically for these special women and babies for whom cesarean delivery is chosen. I believe that with compassionate care and support, breastfeeding rates among these families can dramatically increase, and more importantly, we can help them heal faster both physically and emotionally. This is my unique vision and mission; my long journey back from the trauma of birth.