Healing After an Unplanned Cesarean Birth

By Nichole on March 24th 2013

We all make plans for our births. Whether we explore the many options that we have available to us by researching, discussing and preparing for our ideal birth, or if we choose (yes, it is still a choice) for a more "procedural birth" going ahead with your particular hospital's standards or those of your attending nurse midwife or OB.

And one of my favorite birth-centered blogs is www.birthwithoutfear.com. This blog shares stories of home births, hospital births, in-the-car births, births of all types are welcome in order to build a worldwide culture where woman can truly birth without fear, whatever her choices may be and however a birth may move into reality, even in the face of a mother's best laid plans.

I was particularly touched by the recent heart-baring post by a mother named Amber. She wrote about the birth of her son, Ben, and her deeply personal journey since his birth. You will see from the photos that they shared with us that Ben is an absolutely gorgeous baby. You will read about the tenderness between Amber and her husband and how they have created a beautiful family from this place.

I share Amber's story with you here because if am I am to be honest with myself and with you, her birth story is the birth of my greatest worry while I was pregnant for my son. During my pregnancy I allowed myself to acknowledge that a cesarean delivery had to be part of my awareness, even if it was my absolute last choice among the options I had in front of me.

My husband (who was born at home) and I prepared for a homebirth with two attending licensed midwives to support me during my labor. And as far as hospitals go in the USA, I live in a particularly privileged area of the country where natural births (in and out the hospital) are the most sought after births, therefore they are more common and laboring mother gets more support in doing so.

We did have our ideal unmedicated birth at home, with all of us resting well and safely after, but I also had some peace of mind before my labor began that if a transfer was needed during our birth, or if in the weeks before the birth we learned that it was no longer a safe option for me to birth at home, then we would have been in a good hospital in the end. And as I sit here reflecting on it all right now, I realized that I never thought of a transfer at any point during my labor, that it was only something that my mind needed before the big day.

I share Amber's story with you, and some of my own story too,  to help move myself past the lingering fear that I discovered still within me two years later, made evident by the changes in my breath and in my own body as I read her beautiful and moving story. She is so blessedly raw and real, so deserving to be healed in what will best serve her, not some ideal that any of us may hold for her, or for any mother whose dreams and ideals give way to a birth other than their deepest hopes.

I share and link to Amber's story to heal myself of that echoing fear within me.  I share it in the hope to shift us all, every last one of us, into a world that is truly a place for every woman to birth without fear.

 

Reflections of Ben’s Birth {Hospital Birth}

by Amber O on March 2, 2013
After shedding so many tears, I have been stewing over whether or not to open up my heart and share my honest and reflective thoughts about Ben’s birth. One night, after reading some powerful stories about women who successfully had a VBAC or HBAC (vaginal/home birth after cesarean) I nursed my baby, and then crawled into bed weeping in my husband’s arms. In the end I decided it would be cathartic for me and help heal the pain I have been going through to let the feelings flow out of my fingers. To some, the fact that I had a cesarean surgery won’t be a big deal, especially since (very sadly) they are all too common. Of course there are bigger things going on in the world, with many people experiencing real losses that don’t compare to me having a c-section. But this is a personal hurt for me that needs to heal. It’s easy to say that we are lucky because we have a healthy, beautiful little boy, so how he came into the world doesn’t matter. Very true, but Ben would have been born healthy no matter what. And it does matter to me. Mothers matter. It’s a little piece of the way I will always define myself. I missed out on an incredibly empowering experience. I strongly believe that all normal, healthy pregnancies should happen naturally, but obviously some people would disagree with me on that point. With all of that being said, my disclaimer is that I realize doctors, hospitals, and c-sections all serve a very important purpose when necessary, and we are so lucky to have them when we need them. I’ve had friends need the services of the NICU and emergency c-sections, and friends who have had completely natural births. My husband and I educated ourselves and wanted a drug-free birth. Drugs make things harder, not easier. We took natural birthing classes and thought we were well-prepared, and I still ended up having a c-section. I continue to feel great loss and sadness over how our birth experience played out. After Ben was first born I didn’t feel upset because I was so glad he was here, but the more I reflect on the experience the more pain I feel over it. Giving birth is a normal, beautiful process. We had a plan… We had a dream for how we wanted to welcome Ben to the world. I felt confident having goals and being educated about how to meet them. Our surgery was so far out of the scope of what I expected that I am still grieving the loss of how Ben should have entered the world. I am probably being too hard on myself, but I truly feel like I let my baby down. I should have done better by him. I don’t want Ben to feel badly because I hate how he was born, so I need to find some way to move on from these feelings, if possible. I need to heal my mind and soul and come to peace with the experience. Because I have major regrets. I wanted to push and give life to my son, bring him to my chest and not let anyone take him away to poke and prod at. I wanted to nurse him and lie with him for as long as I wanted. I wanted no drugs coursing through either of our bodies. I wanted to smell him and feel him and spend as many hours as I wanted looking at him. I wanted to remember all those first precious moments of his life. I don’t know why on earth I thought these things would happen in the hospital. Those people seriously don’t like when you try to mess with their protocols. We had so much going on right after his birth that I really suppressed my feelings. I was focused on getting breast feeding going, getting us healthy, dealing with Ben’s reflux, etc. Now that some time has passed, I am in a grieving process. I wrote a version of his birth story a few weeks after he was born. I think I wrote with my rose-colored glasses on. I wanted to be polite. I didn’t want to seem dramatic or overly negative. Maybe I was embarrassed that I had been openly advocating how much I believed in natural birth and then I didn’t have one. I don’t think I had enough time to fully process and reflect on the experience. This is me digging deep and tapping into unfiltered, raw emotions and details I haven’t shared before. Some of the words I heard during the end of our labor: “failure to progress” “take the baby out” “you can’t have more time” “risk of infection is too high now.” How terrible. I left the hospital feeling like a failure. I failed to bring my baby into this world in the way he deserved. But I tried… I tried damn hard before they took us to the operating room. The ridiculous, pitcon-induced contractions were killing me. I was having back labor. I was trembling. But I was breathing. I was working. I wanted it. I was close… 7 cm. But I was exhausted. I keep going back and thinking that I could have done it if I weren’t limited on time and movement restrictions. If I wasn’t hooked up to the IV machine, and if I didn’t have to wear the fetal monitor I could have actually moved around the room. I could have swayed and rocked, and maybe got in the tub or shower. They didn’t like the position I was laboring in, and I couldn’t be more than a few feet away from the machine. Sometimes I’m not even sure if I can wholly call the surgery his “birth.” I guess he was born, but it was a surgery, not a birth, and that also makes me sad. While most of the time in the OR is really blurry, I distinctly recall lying terrified in tears, without my husband with me, on the surgery table. I overheard the medical team casually talking about baseball. Baseball! I realize I was just another surgery, just another day on the job for them. But here was a historic moment in my life, and none of the doctors in the room even talked to me. Yes, I realize their job isn’t to be lovey dovey… but it still seemed really impersonal. I was lying on my back, having powerful contractions I could still feel through an epidural. It took forever for the anesthesiologist to get my body numb, which resulted in a painful spinal tap. I do have to give major props to my LD nurse here, she was amazing and became the person I anchored to when everything else was confusing. While the doctor paced impatiently waiting to slice me open, I remember apologizing to him… as if it were my fault this was happening. I even stated out loud how awful I was at giving birth. It must have been a comment to mask the loss, but I am ashamed of myself for saying it. My tongue was numb and I became frightened that I would stop breathing. One of the nurses tried to tie my arms to the table, and of all the things that happened in that room, I am happy I forcefully said no and wouldn’t allow it. I mean seriously, I’m not a wild animal, not to mention I couldn’t even move my legs, let alone hop off the table. Where on earth did they think I would go? Justin later told me they ripped my stomach from side to side getting Ben out…it hurt him to watch. I can imagine. I still can’t feel the lower half of my abdomen. An intern in the room passed out. When they pulled Ben out, I didn’t have enough function to turn my head entirely, but I could see him to my left. He was bright pink, screaming, and so beautiful. They had me guess his weight, to which I replied “11 pounds!” They laughed at me, but when his real weight registered at 10.1, maybe they realized mama knows best (and that my baby was nearly a week overdue!) It was a surreal experience though, because I didn’t really feel part of it. I was behind a curtain, the doctors took my baby out of me, and then I was wheeled away. It was like I was pregnant, and then I wasn’t. birth without fear Can you imagine being a baby, leaving the warmth and familiarity of your mama’s womb to be ripped out of her into a cold and very bright room, and then not having the one human who you have spent your whole life inside nowhere near? Instead of letting the chord pulse and give blood to my baby, it was immediately cut, and instead of resting on the warmth and comfort of his mama’s chest, he was wrapped in a blanket. I was crying, and I got to kiss his cheek before they wheeled me away. I was in the recovery room with my wonderful nurse, but Justin and Ben weren’t there (I insisted he stay with the baby). My catheter broke and my nurse had to re-insert another one. My eyes felt heavy. The room was spinning. When Ben was finally brought to me to start nursing for the first time, he didn’t get to try it on his own. We didn’t get to be skin-to-skin, the way nature intended. My shirt was pulled down and his mouth was shoved on my breast. Then I threw up. Yes, the first time I nursed my baby, which is supposed to be this incredible bonding experience, I was vomiting green liquid over his head into a pan. All the drugs made me sick. Ben didn’t get to stay and nurse as long as he wanted, because the nurses upstairs were waiting for us in our postpartum room and we had to meet the needs of their schedule. Ben deserved better than this. Shortly after, I passed out, exhausted from the long night and the drugs. I don’t remember any of the first couple of hours with my son, because I was sleeping. When I woke up the pain from the surgery was incredibly uncomfortable. I had circulation cuffs on my legs. Despite my protests, I was given more pain medication, and then more medication to stop the nausea  At the time I felt somewhat happy. Happy that Ben was here, that the whole thing was over. But I missed out on so much. I didn’t get those first few moments when the happy hormones take over and all the world is said to be perfect. I didn’t get to be skin-to-skin with my baby for a long time. Instead, I was practically in a comatose state with my new baby lying in a plastic box on the other side of the room. Throughout the entire labor and birth experience my husband and sister-in-law were my rocks.  In no way does my sadness about our birth reflect either of them and the course of events. At first I felt like I had not only let my son down, but I must have also disappointed my husband. I really wanted him to be proud of me. I know now that he is proud of me. He knows I tried hard. But after the birth I really couldn’t let go of how ashamed I felt that I couldn’t do one of the most basic things a woman’s body is designed to do. I found comfort that Justin and I made every decision along the way together, and each choice we thought was going to be the right one. God showed my husband to me in an entirely new light throughout the hours before Ben was born. He was strong. He was protective. He cried with me. He was incredible. And then my dear sister-in-law, Marian, prayed over me, comforted me, and came up with an ingenious way to keep hot packs on my back. After Ben was born, Justin was a saint (as you may notice I mention a lot). Physically I couldn’t do much of what I wanted, and he did it all. When we got home from the hospital, nursing was tough. I was tired. Justin had to use little tubes and syringes to feed Ben. We “had” to give him formula for one day, which just about broke my heart. My milk came in late and I felt like Ben was rejecting me as his mother. I didn’t feel super connected to my baby, and that made me sad. I felt depressed, but didn’t talk to anyone about those feelings in the beginning. People don’t seem to give them much merit, because they don’t want them to be true. “Oh yes, it’s normal to feel overwhelmed…” But it was more than that for me. So I laid naked, skin-to-skin with Ben to form a bond. I kissed him everywhere. Heck, I even licked him! I breathed in his scent. I tried to make all the connections that should have happened at his birth, happen later. And it took awhile, but eventually I felt bonded with my baby, and I finally felt like he was mine. hospital birth So I’m angry. It took some conversation with my husband to figure out who I am so angry at. At first I thought I was angry at the medical system in the US and how poorly maternal healthcare is handled. Or maybe the doctor who came in with an entourage of people at the end of my labor and said condescendingly “I think you know where this is headed…” It would be much easier to blame them. I wondered, how in moral conscience can these OBGYN’s be cutting people open so freely? Or maybe I was mad that the midwife on call told us that the overseeing physician would “Have a chat with us if we refused pitocin.” Whether they do it intentionally or not, it seems they use scare tactics to force their options on you in order to protect themselves for liability reasons. Ben’s heart rate was awesome and stable throughout my whole labor and he was handling everything, even the nasty artificial contractions, with ease. But they slapped the ol’ “risk of infection to the baby is too high to let you continue…” and made me feel like there was no other avenue to pursue but a c-section in order to preserve my baby’s health. Maybe I would have been too exhausted and couldn’t have done it anyway, but I wanted more time to try. I am upset because my c-section wasn’t necessary. Ben and I were both healthy. I think Justin and I are both really disappointed in some of the early choices that we made. I think we knew they weren’t right for us, but maybe out of fear we did them anyway. We would really like to focus on a gentler and less reactive way of making decisions. Knowing what we do now, we would have made better choices for our family. I didn’t do enough research when choosing a care provider that would support us (and I think this is one of the most important things.) I switched from a doctor to a midwife halfway through the pregnancy, thinking it was the right decision. I thought a midwife is a midwife is a midwife. Wrong. Apparently we had a nurse midwife, who has a background in medicine and picks up a certification later. The midwife we had for my care (who wasn’t even on call and present at our birth) didn’t support the holistic approach we wanted. It should have been a red flag when she casually mentioned that she could “snag my bag” if I wanted to “get things rolling” sooner than my due date. Justin and I were both upset about the comment but still figured that we had enough willpower and strong decision making skills to not let them bully us around when the time came. In reality, we should have ran like crazy to the nearest birth center without a bag of drugs in sight and found a midwife who wanted the same things for us that we did. We should have given it a real shot. birth story So who am I so mad at? It’s not the doctors. They are just doing what they were trained to do. They think they are saving moms and babies, when in reality they are creating the problem with their interventions in the first place. So eventually, I figured out that I am most angry at me, and that has been the hardest thing to come to grips with. I feel like we should have known better. We were educated! We knew that going to the hospital significantly increased our chances of having an intervention or surgery. We took a 12 week natural childbirth class and learned nearly everything there was to know about giving birth. Our instructor was amazing and even put us through likely scenarios that are common in the hospital to prepare us for the battle. I turned a blind eye and figured that it wasn’t going to happen to me. We hoped for the best I guess. And now I am part of an ever-growing statistic in our country. I can’t figure out why my past self made the decisions that I did. I’m mad at myself for allowing so many things to happen that we didn’t want. I’m mad at myself for ever agreeing to head to the hospital when we did. There is a specific moment in time I would go back to if I could, and it’s truly where I believe one of the real differences could have been made. Justin and I went into the clinic, and our midwife told us we should head to the hospital. It felt surreal. Seriously? No contractions or other labor signs… I was feeling normal. We listened to her because we were excited I guess, she told us our baby would be born soon, and we thought we trusted her. We stopped to eat lunch. We casually went home and gathered our things. We picked up my sister-in-law. I was smiling and cordial and… definitely not a woman in labor. I would go back to that moment and say, “No.” I should have come home and relaxed and agreed to come back later when my body went into actual labor. I basically signed a waiver agreeing to a hospital time limit, instead of trusting my body.  I shouldn’t have even mentioned that my water was leaking. I shouldn’t have allowed her to do a vaginal exam. I have done some research about labors that are preceded by the water breaking, and the more I read, the more frustrated I feel. From what I now understand, I believe my hindwater was leaking, since my bag of waters was still fully intact at the hospital (they wanted to tear it open at one point while we were laboring, and Justin said when they cut me open there was a huge gush of water everywhere…in other words, my bag of waters never really broke). A hindwater leak occurs when only a small amount of fluid is released, which is what happened to me. Once a leak or water breaks, real labor is sure to follow at some point. This means I was probably very very close to having natural labor on my own without ever having been induced in the hospital. I have read that no matter how much fluid you have left in your belly you should stay home until contractions are strong and close together, otherwise you will be told you are at risk of infection and will be on a timetable (gee, sounds familiar.) I learned that leaks can easily reseal over several days with no ill effects. In the UK, doctors allow women to go up to 96 hours after their water breaks before being induced! Some midwives in our country allow their patients to go a few days to a week or more! The likelihood of infection is very small if you have no vaginal exams and stay home in your own environment as long as possible. I really wish we had known this. I wish we would have called someone for a second opinion. Oh, how I wish we would have just stayed home and waited. c-section birth I’m struggling with what could have been. It’s nearly impossible to not go back in time and say “What if?” But “ifs” aren’t good for healing. And it’s so easy to go back and say what we should have done. So easy. The silver lining is that now we know better for next time. We know for sure what to expect and what we want if we are fortunate enough to have another child. Sadly, having a vaginal birth after a cesarean can be tough in terms of finding a care provider who will not only do it, but also really support the goal. A lot of doctors take on VBAC patients, but don’t really care whether or not it happens for them. Also, many doctors won’t help women with a VBAC who were “failure to progress,” which is now what I would be labeled. From what I understand, the risk of having a vaginal birth after cesarean is that there is a higher chance of uterine rupture. But the risks of having multiple cesarean surgeries is also unnerving. The odds of me successfully having a vaginal birth are fairly slim, but I am going to try my hardest anyway. I think in the future we will put a lot of effort into choosing a care provider who is completely supportive of a VBAC, whether that be an OB and we end up in a hospital, or a midwife and we end up in a bathtub at our house. If we do get to have another a baby, we will absolutely do research and put together the best qualified people to help us have a better experience. I am going to lose weight, get healthy, and get fit. I want to be low-risk when the time comes to have another baby and know that my body will be up to the task. cesarian birth Phew, that was some major mending…a step in the right direction. Thank you for listening.