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Friday
Apr092010

Cesareans and Grief

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Guest post by reader Natalie

 

I get upset when I hear women denying validation of grief for other women, but I will admit I was once one of them.  I couldn’t imagine “grieving” because I needed a c-section to give birth.  Really?  Grief???!?! 
 
I was smug.  You see…I thought I could give birth in any situation.  I gave birth to my first daughter, 7 lbs. 4oz, who was “sunny side up”.  I had an induction, because I was a first time mom.  I was ignorant, and was still suffering from hyperemisis after 10 months of pregnancy (she was almost 2 weeks overdue).  I pushed for 9 minutes, and ended up with a very bruised baby and 30 stitches.  If I could birth her, I could do anything.   After reading and researching I found out that her birth position was probably due to too much pitocin, too fast of a decent, and a way too fast labor.  I was discouraged by the lack of compassion, especially when I told my nurse that I was ready to push.  She stated, “Honey, you have hours to go….!” and left the room.  I started pushing on my own, because I couldn’t stop, and my husband ran out in a panic…..”I see the baby’s head!!!!”  I finally got some attention after that!!! 
 
Just 2 months after her birth I was pregnant again (yes, I was breastfeeding on demand!).  Her brother was born easily, naturally (meaning: without pain management), with a hospital midwife, and was close to 10 pounds.   He was genuinely 3 weeks “late” born via induction, and came out green with long fingernails. 
 
By this time I was done with medically managed births.  I never wanted an induction.  I wanted to know what it would be like to have a baby born on it’s natural time schedule.  I started looking for home birthing midwives, and planning on a homebirth for baby #3. 
 
When I got pregnant again, I felt wrong.  Something was off.  I had previously had several miscarriages, so I went in for a progesterone level.  It was off the charts.  I went in for an ultrasound, and they found my triplets.  Spontaneous triplets. 
 
I was distraught, for several reasons, but I won’t deny that my loss of a homebirth was near the top of the list.  You see, I have a blood clotting disorder that made my midwife leery of a homebirth in the first place.  Triplets would be out of the question. 
 
I was desperate.  I asked my OB if a trial of labor would be OK.  She said, “Absolutely NOT.”  I was heartbroken.  I LOVE the process of giving birth.  To me, it’s empowering.  It’s raw, and it’s real.  I was scared.  I made “plans” to go into labor at home, and arrive at the ER giving them no choice but to deliver me vaginally. 
 
Little did I know that I was about to have the most necessary c-section ever. 
 
At 35 weeks I developed HELLP syndrome.  I also had 3 breech babies, and I was in preterm labor.  I had a mild placental abruption, and I had no choice.  It was either a c-section, or it was a dead mother.  THIS is what c-sections were developed for.  I was a REAL case of a necessary cesarean. 
 
I was laid out on the table, after my spinal, and my husband was brought in.  I was not allowed to have video cameras in the room.  I was not allowed to photograph the c-section, though we were allowed to photograph the babies…just not the “surgical area”.  I was not allowed to watch.  I was not allowed to hold my babies.  They allowed me to see “baby B” briefly, before they were sent to the NICU (and proclaimed to be in perfect health).  I was wheeled to recovery, and was alone.  I made my husband swear that he would follow the babies where ever they went, and that left me devastatingly alone.  I ended up being allergic to the morphine that they put in my spinal.  I was itching my skin off, so they countered the morphine with another drug.  It knocked me out for 8 hours.  When I woke up, I met my babies.  I felt disconnected from them.  Who were they?  Did they REALLY come out of me????  It just didn’t feel like it. 
 
I was very, very, very sick with HELLP.  My liver was failing, and I was on many different drugs.  I couldn’t hold my babies.  I didn’t birth my babies, and nothing was helping me connect with them at all.  I attempted to nurse them, as I had my older kids, but with all of the drugs doping me up…I just couldn’t do it.  I gave up on day 6 in the hospital, and I was applauded for it.  I was feeling resentful of these babies who were keeping me away from my older children, who I missed like crazy.  They still just didn’t feel like they were mine. 
 
I finally made a turn for the better around day 8, and they let me go home with home health care nurses to monitor me, and to give me meds and blood work. 
 
It took me weeks to bond with my babies.  It finally happened, and I was in love…hook, line, and sinker.  It was different, it wasn’t immediate.  It was different.  My older kids when from inside my belly, to on my belly directly after birth.  I connected.  I nursed them within 3 minutes of birth.  My babies went from belly to the NICU, and from the NICU to bassinets beside my bed….even though I was too doped up to hold them without assistance. 
 
With my vaginal deliveries I healed within a few days, walking never hurt, and I didn’t have any staples in my abdomen.  The c-section brought me pain, a seeping wound, and a 6-10 week recovery that I was not ready for. 
 
Most of all, I learned that c-sections are a LOSS of a DREAM.  If your dream is to be cut open to give birth, that’s great for *YOU*.  If your dream is to passively let a doctor control your birth that’s great for *YOU*.  BUT…if you’ve researched, and educated yourself, and you come to the conclusion that YOU want a natural birth, or a birth at home, and for some reason you had a RARE necessary cesarean, I learned that it’s OK TO GRIEVE!!!!  It’s ok to grieve the process that saved your life (and your baby’s life).  It’s not wrong to wish that it had been different, because who WANTS to have major surgery?  Who wants to have a brand new baby, AND to recover from major surgery?  Not many people sign up for that…and it’s OK to be resentful that you needed to have it done. 
 
I can also now sympathize, get angry, and advocate for women who have had truly unnecessary c-sections….because for as sad as I am for myself, I can’t imagine the grief of women who were bullied into a cesarean that was just not necessary.  My sister had an unnecesarean, and I was angry for her.  She was *bullied* into a c-section, at a hospital with a 44% cesarean rate.  She was meek, passive, and lost her voice.
 
In the end, I find it appalling that feminists advocate for women to have the choice to terminate a pregnancy in any way they please….but it’s rare to find a women who will let a woman advocate how she gives BIRTH!  Can’t we all band together and let our voices be heard?  All we want is a choice in childbirth, whether it be an elective c-section (something I personally could never understand!), an unassisted homebirth, or something in between.  This is not a governmental decision, this is a woman’s decision. 
 
For information on HELLP:  http://en.wikipedia.org/wiki/HELLP_syndrome  (I have also become an advocate for mothers with HELLP.)

 

 

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Reader Comments (22)

Love this post, love this site.

April 10, 2010 | Unregistered CommenterElizabeth

Reading this blog has not changed my practice, c/section rate, or had any impact on my labor management (or lack therof) but it has damn sure changed the way I talk with my patients. I now make as sure as possible that my patient fully understands the reasons for her labor progress/c/section indication/induction/whatever. I thought I did before. Now I believe I do better. Is this supposed to be a self help blog? Oh, OP babies are more common in spontaneous labors than inductions. Pitocin should have nothing to do with it. Delivering OP is tougher and I applaud you Natalie. I have heard about the induction/OP association. It is a form follows function thing. OP's are more likely to go p0st-term and be induced. 42 weeks is supposed to be that break over as you experienced. 43 weeks resulted in a meconium "stained" but I am assuming healthy child. Again, you go! Hope you recovered completely from the HELLP. Just sent a patient in for a spleenectomy as her platlets still have not recovered after 6 months. She is now a chronic ITP.
Midwife - this is a great site isn't it!
Jill - still have not grown that uterus but if I keep getting amniotic fluid spilled on me I might absorb enough estrogen to grow breasts.

April 10, 2010 | Unregistered CommenterOb

OB, I wish you would comment everyday. I laugh, then I cringe at the intensity of your 16 hour work days like the other day that included 31 office patients, a section, a VBAC and a regular ol' spontanteous vaginal birth. Then I laugh some more when you call yourself an old fart. Have a great weekend.

April 10, 2010 | Registered CommenterJill

I second what emajaybee said. Feminists do not fight for any such way abortions, they generally want to keep the status quo, in which second and third trimester abortions are limited. And. it's hard enough for the women who want or need the vastly more common 1st trimester abortion when 87% of counties don't even have a provider. I am not sure why you think abortions are so easy for women to get.

Most feminists, including me, that I encounter are very aware that reproductive rights occur from before conception to after delivery.

April 10, 2010 | Unregistered CommenterMomTFH

I SO agree with what you said.

In the end, I find it appalling that feminists advocate for women to have the choice to terminate a pregnancy in any way they please….but it’s rare to find a women who will let a woman advocate how she gives BIRTH! Can’t we all band together and let our voices be heard? All we want is a choice in childbirth, whether it be an elective c-section (something I personally could never understand!), an unassisted homebirth, or something in between. This is not a governmental decision, this is a woman’s decision.

It is true we need to support women in their choices regarding birth!

I am sorry you needed a cesarean, but it was certainly a good choice given your situation. Hugs!

April 10, 2010 | Unregistered CommenterSheridan

I know exactly how you felt, Natalie. I was very invested in my birth experience with my first child. I had a lengthy birthing plan and hoped to birth in the special suite that offered a 'natural (no pain meds)' birth. At home, I had my bags packed with candles, a tape recorder with a cassette with all of my favorite songs ... and of course my birthing ball was ready to go. I was already 10 days post-date and it was a Saturday...the hospital had scheduled me to come in for a routine scan to make sure the baby was ok...and he was. As I went to sit up though, my waters broke.

I ended up never getting my bag with all of my supplies...I didn't get the special delivery suite...after 30+ hours of unproductive labor where I never dilated past 1cm, I ended up with a c-section. I'll really never know if it was an unnecessary c-section. My 9 pound 4 ounce son had a huge bruise and edema on the top of his head though from hitting up against my pelvic bones. Maybe it could have been prevented by a different position or something. I'll never know.

I went through a grieving process too. I remember feeling like I wasn't a "real woman" or mother. One of my friends came over a few weeks later and said that she had delivered her 10 pound baby vaginally and it was too bad that I didn't know what it was like to "really give birth". I still remember how devastated that made me feel. Extremists on either side of this issue can have pretty negative effects.

I was adamant about VBAC births after that and did have 2 successful VBACs. Unfortunately, the last one ended in a partial rupture. As a result, my 4th and 5th were also c-sections. Maybe I would have been ok with baby #4. I'll never know. I had oligohydramnios with #5, so that was necessary.

Great story. The only thing that made me cringe was the part about women 'wanting to be cut open'. I don't know a single mom who had a c-section who was happy about it....

Kris

April 10, 2010 | Unregistered CommenterKris

" . . . but it has damn sure changed the way I talk with my patients. "

That alone is worth gold!

Wonderful post, Natalie, I;m so glad you shared it.

April 10, 2010 | Unregistered CommenterDou-la-la

Kris- i do know at least one woman who demanded to be cut open- she asked to be induced (due to her schedule) and when it didn't work, said she wasn't going home without the baby. Her doctor actually begged her to reconsider because he really didn't want to section her (her own words). He did what she asked, though, which shows that at least he respected her right to choose. She was happy with her decision, and i kept my mouth shut :)

April 11, 2010 | Unregistered Commentersara

I completely know the feeling of grieving over a necessary c-section. In my case, I was pregnant with my first and hoping for an unmedicated birth. My son turned breech and before we could get him to turn, I developed HELLP at exactly 37 weeks. By the time I was at labor & delivery, my HELLP was so bad that I couldn't have an epidural (my blood clotting factor was so low). So not only did my dream of a vaginal birth go out the window but so did my assumption that I would at least be awake for the delivery of my son. I was whisked away to the OR while my husband waited down the hall. It just seemed like something out of the 1950s.

While I am grateful for the c-section that saved my life and my son's life, I have had a lot of difficulty coming to terms with it. I wonder if there was something I could have one to avoid it. I also fear I won't be able to have a VBAC. If I have any kind of pregnancy induced hypertension with my next pregnancy it will be an automatic c-section for me. And while I understand the risk of uterine rupture is low with VBACs, that doesn't bring me much comfort. Before my son, my risk of a breech baby was around 3% and my risk of HELLP was around 1%. Having already had two unlikely events happen with my first, I am terrified of something worse happening with a second.

I have felt more times than I'd like to remember that my body failed me. Reading all the natural childbirth literature in the end did me a disservice because during pregnancy, I focused on how a woman's body was designed to give birth and that I, too, can have a natural childbirth. After my c-section, I really struggled with what had happened because I felt like there must have been something wrong with me. Wasn't I "woman" enough? Why couldn't I have had a vaginal birth?

Meanwhile, my family thinks I'm nuts for being anything but jumping for joy at a healthy baby. And I am truly happy for that. But I definitely know the feeling of grief when it comes to my son's birth. Everyone knows that a birth cannot be planned but mine went so far off how I envisioned it, that the loss of that was something I definitely am grieving.

his is where I feel like I am at odds with the current movement against the c-section "epidemic." C-sections are starting to get so denigrated to the point that we lose sight of why they exist in the first place. I never in a million years thought I would need an emergency c-section. I also never thought I would feel guilt or regret about it either.

April 21, 2010 | Unregistered CommenterKeri

Hi Keri,

Thanks for your comment. I think that it's hard in general for people to hold the space for others to just feel "negative" feelings long enough to just work through them. That "think happy thoughts!" mentality comes up in a lot of literature, too, doesn't it? What I read that could be categorized as natural childbirth literature didn't feel overly chirpy or unrealistic, but I guess it depends on what you read. But the maxim of "your body is designed for ____" is fallacious in many ways. It sounds nice and I really appreciate wanting to challenge the dominant belief that pregnancy and birth must by default be managed, controlled, initiated and sped up artificially and with the woman as a passive party in the whole process. But that's different than saying every body is designed to give birth without a hitch, which is obviously untrue.

To whom were you referring when you said, "C-sections are starting to get so denigrated to the point that we lose sight of why they exist in the first place?" Just wondering before I reply.

April 21, 2010 | Registered CommenterJill
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