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Friday
Apr092010

The Most Important Thing

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by Courtroom Mama

 I generally try not to get all butthurt over trolls, but I couldn’t contain my gasps of impotent horror as the following conversation unfolded in the comments of Emjaybee’s last post.

 

Screencaps in part:

 

 

 

 

 

Jill and Emjaybee were on it with lightning speed, of course, while I was puttering along on my phone totally unable to do anything about it. So, I thought I’d take a short break from “wallow[ing] in [my] unnecesarean grief” and voila, unpublished-reply-turned-post.

 

First of all, it bears mention that a person exposes him or herself as a troll when they ask the question in the form “So how exactly does a c-section ruin your life?” (Well, for starters, when it kills you, like folks sometimes seem to forget can be the case.)  Nevertheless, I think that there is a kernel of truth under there that needs to be addressed. I’m posting this in the hopes that someday someone will google “Why would the method of birth ever overshadow the birth of a healthy baby?” and get my very earnest explanation.

Human emotion is nuanced and complicated.  The singular nature of pregnancy and the unique relationship between a woman and her unborn baby seems to play hell on our need to simplify, homogenize, and categorize. Regardless of the headway that we have made in terms of gender equality in civil and political rights, we have a pretty rigid schema for what a normal pregnancy looks like: woman is pregnant, woman delivers baby, woman is happy.

That is not a woman, that is a paper doll.

The truth is that each of those clauses and each of those commas contain nearly infinite possibilities. The experience can be punctuated with an exclamation point, a question mark, or the silence of an ellipsis. We can acknowledge that women may meet their pregnancies with a variety of emotional responses—joy, shock, anger, ambivalence—but the idea that women might meet their babies with the same variety of emotion seems to be beyond the realm of comprehension. Aren’t babies supposed to make women happy?

I know that the question of the method of birth “overshadowing” a healthy baby is not one asked in good faith, but my answer to that sort of question has always been that women with negative feelings about their cesarean sections are, as a preliminary matter, grateful for their healthy babies and are able to experience other feelings in addition to and outside of joy and gratitude. Like when your mom explained to you that when your little sister was born she could love her and still love you just as much as she ever had.

But Dana made me think a little bit: are babies a balm that should heal all wounds? Even if we function under the assumption that a healthy baby is the most important thing in a birth (which, some people may be surprised to hear, is not universally the case across cultures or to individual women), is having even a welcome and wanted baby a substitute for the autonomy lost by a woman who has had the experience of being tied down and operated on, or the horror of seeing herself in a pool of blood in the reflective surfaces in the operating theater?

Is having a baby a substitute for posttraumatic stress? For the flinch and recoil of damaged nerves when a lover brushes her scar? For the knowledge that she may have to fight to even attempt to avoid scheduled surgical delivery even in the face of evidence suggesting that she’d most likely be able to deliver vaginally without any problem?

This is something that may be difficult for a person who had a necessary surgery, or who is okay with having had an unnecessary surgery, to understand. I’ve tried to explain the fact that the outcome doesn’t erase the pain of the journey, but there really is no metaphor. The closest I have come is this:

Imagine you get in a car to drive and see the person you love most in life. You get into a car accident on the way there, are rushed to the hospital, and the doctors save your life. When you open your eyes, your loved one is there to greet you. Now imagine instead that you get into the car, and on your way there, you’re pulled over for driving too slowly, and then taken to the hospital, where your healthy appendix is removed. When you open your eyes, your loved on is there to greet you.*

Notwithstanding your happiness to eventually get to your goal, you might have some questions—or even anger, sadness, or grief—about what happened to you on the way there. Why were you interrupted just for getting where you were going too slowly? How did that justify unnecessary surgery? Even in the first circumstance, might you not still feel trauma from the terror of fear of dying or never seeing your loved one? Getting to see that loved one might be the most important thing, but it doesn’t diminish the importance of your own physical and mental health. This is something that mothers don’t often get to hear: you are important too!

In closing, to those visitors who are not in the “choir”: nowhere on this website, or in ICAN’s materials, or in any of the countless books about healthy birth does it say that women should grieve or feel a sense of loss over cesarean surgery. In fact, my greatest wish: every cesarean a wanted cesarean. I wish that every woman who had surgery could feel at peace with it and supported and cared for by her medical team.  To express negative emotion or question the overuse of such a major medical intervention is not to condemn the women who made it through healthy and happy. Please, don’t take it personally; it’s not about you.

 

*Again, metaphor is imperfect. I’m actually having fun thinking about all the ways to tweak the image: the baby is riding with you and they pull you over for an appendectomy because they think it’s crying? Because your car has had a flat tire in the past? Because the traffic cop wants to fill a quota and go home early?

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Reader Comments (81)

My mother always taught me if I have to precede a statement with, "no disrespect," "don't take offense," then I should not say whatever I was thinking. You cannot say something disrespectful or offensive and absolve yourself of responsibility by telling the person not to be offended or disrespected.

Also, if the ends justify the means (which is what Dana was ultimately saying), then we are in for a slippery ride.

April 9, 2010 | Unregistered CommenterMeghan

Great Post Jill! Really amazing actually. I wish more people could understand it that way.....I think you need SOME emotional intellegence to imagine that something might bother other people for good reason, even if you are OK with it! Being able to conceptualize metaphors also takes more then some people have in them, and an ability to think somewhat abstractly.....I hope they can help 'reach' people though!

"My mother always taught me if I have to precede a statement with, "no disrespect," "don't take offense," then I should not say whatever I was thinking. You cannot say something disrespectful or offensive and absolve yourself of responsibility by telling the person not to be offended or disrespected." -Meghan posted that
SOOOO very true. Ugg- agree so much.

April 9, 2010 | Unregistered Commenterirene

HEY, EVERYONE LOOK AT ME! I LEFT AN ASSHOLISH COMMENT BECAUSE I WANT PEOPLE TO FIGHT WITH ME. I'M GOING HOME NOW. BYE BYE.

(This comment was replaced at 1:27 p.m. by the moderators.)


April 9, 2010 | Unregistered CommenterAmy Tuteur, MD

Dr. T, I'm sorry, but *you* don't get to decide if I'm traumatized "enough"..or if anyone else is. Period. Plus, I don't recall you being my physician OR my psychologist at any point; your degree does not give you the magical ability to diagnose people online.

I would kindly invite you to put your uninformed "medical" opinion back into the regions from which you pulled it. And leave it there.

April 9, 2010 | Unregistered Commenteremjaybee

Just out of curiosity, Dr. Amy, have you yourself ever had a cesarean for the birth of any of your own children?

I agree that not all women are unhappy with their cesareans, neccesary or not. Not all women find them traumatizing. But just because YOU don't think they are traumatic doesn't mean that another woman isn't deeply emotionally wounded from it.

I had a cesarean with my first baby and I did think it was traumatic, I mean really, I was laying naked in the crucifix position being sliced open for crying out loud! It's an experience that I had never been through before (and hopefully never again)- how could I not be scared and emotionally impacted by it? And then after the surgery, not being able to feel my legs, being so physically limitted because of the surgery....let's just say, postpartum life after a cesarean was difficult physically and emotionally. Postpartum after my VBAC was a breeze in comparisson! I think it is totally ignorant and insensitive, Amy, for you to say that "there is nothing inherently traumatic about cesareans" and that it is culturally determined by the natural childbirth culture and are restricted to those who drink the "NCB *Kook-aid* (you probably meant kool-aid, I'm sure). Do you have any research studies that prove this?

Women who desire and have natural childbirths are not wanting it and doing it to impress others, to get a medal, or whatever other ridiculous reason you could dream up. I just find it laughable that anyone would even say such a thing.

April 9, 2010 | Unregistered CommenterBri

I think it's great when people show up who think we're all whiny babies (no pun intended). Recently I have begun to wonder if they just have their own category that they literally don't want to have a birth as in tokophobia- so I say okay have at it-. I actually know a healthy woman who adopted rather than conceive because of her fear of medical procedures.

Increasingly I see that a leap is made between- unnecesareans as a result of a mismanaged labor by bad doctoring, a relinquishing of rights then an unnecessary outcome. I wanted to offer a different perspective- that I have to have a c-section it is scheduled, we are literally counting the days until it comes 27 today. VABC is not an option b/c of pre-existing health stuff that were missed last year - I lost my baby during a VBAC attempt so I wonder if we place that in this paradigm how that sounds in relation to a lot of points made in this post.

so think of my experience alongside a comment like this:

"But Dana made me think a little bit: are babies a balm that should heal all wounds? Even if we function under the assumption that a healthy baby is the most important thing in a birth (which, some people may be surprised to hear, is not universally the case across cultures or to individual women), is having even a welcome and wanted baby a substitute for the autonomy lost by a woman who has had the experience of being tied down and operated on, or the horror of seeing herself in a pool of blood in the reflective surfaces in the operating theater?"

Yes it is.

I think this comment was made in hyperbole to illustrate the points that needed to be made. I think that many women in the birth community miss that we are a diverse group of people, babies die, good doctors are not smoking cigs in the lobby and playing with a deck of dead baby cards. I have to say this to clear my own conscience- we cannot know what doctors know- unless we are doctors (except one LOL) I get irked when I see lay people acting as though they could handle these birth emergencies- come on’- you wouldn’t be able to (I mean stop a shoulder dystocia, perform a c-section etc.). So one woman finds her way here and doesn’t see the magnitude of what we see as a health crises- we don’t need to cast dispersions on whether or not she needs to heal her wounds- she is just as rightly entitled to her opinions as we are. I think she was asking a question – I ask them all the time on blogs and they are only seldom rhetorical- I really do want to know because I don’t. Believe it or not she might “care less” about birth. I have two dear friends and he said something that as shocking as it was- I had to laugh as he made the comment in jest- he said my wife, she would be like get the baby outta me (at six months) and put it on a ventilator. (whoa- I hope you get my irony) Not everyone loves birth as much as we do- the world is lucky and better because of us and our advocacy.
I know this comment may seem antagonistic-I don't mean it to- oh internet- unlike a classroom or discussion no tone inflection etc. for all to see I say this quietly, respectfully. I just see a lot of high fiving in the birth community about the erosion on rights while few are willing to even imagine that many births end tragically, horribly, and that at that point empowerment goes out the window. I happen to be one of those outliers- so into birth politics but the mother of a dead VBAC baby.I hate to have to be the one to say it- but a person really is grateful for a healthy baby and does say: at least there is a healthy baby and doesn't care about blood guts gore and craved up bellies- it is truly the “shape” of a mother and health of a baby that matters at the end. Pregnancy dos not come with an implicit guarantee.

April 9, 2010 | Unregistered CommenterSaanenMother

Amy knows the rules. She's looking to hurt feelings for her own personal pleasure. Please don't engage unless she is civil.

April 9, 2010 | Registered CommenterJill

seriously????

...."there's nothing inherently traumatic about having a C-section"

Really, whether it's traumatic or not depends on the person who's experiencing it and the circumstances surrounding it. While some may not feel that major abdominal surgery is traumatic...others may and certainly do. To spew a blanket generalization is hardly reasonable, from either side just as Jill mentioned some other generalizations like all women are or will be negatively affected by a c-section. Both are equally incorrect.

By saying that since in your opinion a c-section isn't inherently (or naturally) traumatic you are marginalizing those who have experienced it to be a traumatic experience. How unkind.

April 9, 2010 | Unregistered CommenterLee-Ann

Hey, Lee-Ann. I'm sorry she got a rise out of you. That's all she's trying to do. There's no way she was this big of a shmuck when she was seeing patients back in the day.

Oops... broke my own rule about name calling. That would be "person exhibiting shmuckly behavior."

April 9, 2010 | Registered CommenterJill

I think some people who have had cesareans and argue, "It was okay for me because my baby really was in danger and it was neccessary." need to repeat this to themselves because some part of them can't even conceive of their doctors lying to them or they might have been a victim of an unnecesarean. They just can't even think that is a possibility for any woman because then it would be a possibility for them and then they'd have to face accepting a trauma they never considered. It could be equated to a women who was date raped but she really think she asked for it because she did have too much to drink (she did want the meds), or she chose to go with that guy (she did pick her doctor/hospital), and she could have said no but didn't in a stressful moment (was told if you don't do this you could kill your baby). These women don't want to consider that they were victimized because they are already conditioned to accept the blame. Afterall, in our society childbirth is the residual punishment for Eve's original sin, women are supposed to feel hurt and pained by birth, just as long as that baby comes out and the women is punished, society is okay with it. What is sad is so many women don't understand the correlation because the resulting paradigm shift would be too difficult to transition through.

April 9, 2010 | Unregistered CommenterClarissa Jarem
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