Chris' caesarean

Chris tells how her first child, Madelyn, was born by c-section in May 2002 in the USA. Although she was thrilled that her baby daughter had arrived, she explains how it had become one of the worst days of her life.

I had long planned for a natural birth. I am a nurse practitioner and I went to school with many women who planned to become midwives. They instilled in me the belief that pregnancy and birth are healthy, wonderful, and natural events. I chose a group of midwives and planned to have my baby at their birth centre. I am a healthy appropriate weight woman who is in shape and has no medical problems. My pregnancy was wonderful until the 34th week when I started having pre-term contractions. My cervix never dilated, but I did go to the hospital and was given terbutaline to stop the contractions. This was one of the many decisions I now question, because I have since learned that the use of terbutaline after 34 weeks has never been shown to prolong pregnancy. At 35 1/2 weeks, my blood pressure was up to 140/90 and I had gained 5 pounds. I am sure the weight was inaccurate, but the blood pressure was still a concern. I often wonder if the stress of the preterm contractions and taking a horrible medication like terbutaline may have precipitated the elevated blood pressure.

Out the window went my "healthy" pregnancy. I began having frequent blood tests, lab work, ultrasounds, and was on bedrest. It was at this point that I felt my care by the midwives fell apart. I saw a different midwife every visit and there was no clear plan for monitoring my case. Different people gave me different instructions, from "take it easy" to "strict bedrest". During my 38th week, they started talking about induction because I also had protein in my urine. I agreed to the induction, or rather, they told me they were scheduling it and I didn't object. No one discussed risks of induction, but kept saying that with the protein in my urine we had to get the baby out as soon as possible. I knew that my risk of interventions was increased with induction, but I was scared about my baby's well being so I didn't question it. They told me that the Cervidil (prostaglandin gel) they would use to ripen my cervix might put me into labor. I hoped for that since I didn't want Pitocin (oxytocin drip). Little did I know that cervical ripening still has it's own risks.

Prior to the problems and the decision to induce I felt empowered as a pregnant woman. I was a strong woman with a big belly. My body was nurturing this beautiful baby inside of me. Suddenly, I became a patient with a medical condition. An obstetric time bomb. My body was now endangering my baby's well being and she needed to be forced out of my toxic womb.

At 39 weeks and 2 days I went in to the hospital for Prostaglandin induction. Within an hour of having the pessaries placed, I started having strong contractions. My water broke after 5 hours or so and I was 3 cm dilated. The midwife sent me home, saying that it was better for my mental health and labor to be at home for early labor. I returned to the hospital that evening at about 10 pm. I was only 4 cm dilated, but I was having strong contractions. They admitted me and strapped me to that damn monitor. My blood pressure was up. I don't remember exactly how high, not alarming, but they wanted me in bed. They had promised me a room with a tub and guess what? Not available. Almost nothing went right - the tub not being available was one more reminder of that. My labor got stronger and I was in a lot of pain. My husband was very supportive, but I was having so much trouble coping with the contractions lying in bed. I kept telling the nurse I had to urinate because they let me go the bathroom and I felt good being up. I started throwing up, enough that the CNM (Certified Nurse Midwife) wanted to give me an IV. I said OK even though I didn't want it. I don't know why I didn't question it. They also gave me a shot of something for the nausea that stung like crazy. Funny how now I remember the pain of that injection more clearly than I remember the labor pain.

About 4 hours later, at 2 am, I was only 5 cm and I couldn't tolerate the pain any longer, so I asked for the epidural. I had so badly wanted to avoid it, but I was in agony. The thought of continuing in that pain at the rate of 1 cm every 3 hours was unbearable. I will never know how much the decision to get the epidural impacted my labor resulting in the c-section, and I will question that for the rest of my life. I guess I have to take responsibility for that decision because no one forced the epidural on me. But being in bed for so long with those machines and the IV attached to me made me feel even more helpless and frustrated. My coping mechanisms had gone out the window. The midwife didn't make any suggestions to help me cope better. She finally let me get in the shower but it was too late for me. I'm angry at myself for not using more of my coping techniques and angry at my labor support people for doing nothing more than telling me I was doing a good job.

After getting the epidural I dilated relatively quickly to 10 cm and my blood pressure had gone down. I guess that was the only benefit of the epidural. This is where the problems really started. The midwife said the baby was still high up, so she would let me "labor down" the baby. With the epidural my urge to push was minimal, so the contractions would lower the baby and make me push less and save my energy. They kept checking me every hour and the baby wasn't moving. There was some discussion about decelerations of the baby's heart rate. They had a doc come in (whom I didn't know) and he said they could let me try pushing. But they wanted oxygen on me because of the baby's heart rate; and then they wanted an internal monitor. I agreed because I thought that something might be wrong with my baby.

So before I even got the c-section, my desired natural, intervention free, any-position-I-wanted birth ended up being an induced labor, with me lying in bed with an oxygen mask on my face, an IV in my arm, a blood pressure cuff on my other arm, an epidural catheter in my back, a monitor around my belly and a monitor through my vagina in my baby's head. I shudder now when I think back to all the things they did to me in labor. Instead of healthy woman letting my body do it's work, I was a patient with every possible wire, tube, and machine attached to me. I feel very angry that I went to a group of midwives who gave lip service to natural birth and avoiding interventions, but then "managed" my labor in the way they did. Even if my baby had come out of my vagina, it wouldn't have been a good birth. I didn't feel like I was making any decisions. Risks and benefits weren't explained to me, things were just done. I was being sucked into the system, the cascade of interventions that I knew was leading me to a place I didn't want to go to. And the funny thing is that as each one of these things was done to me, I felt more and more helpless. I think I knew deep down that I wasn't going to birth this baby.

I pushed for an hour and no movement. The doctor came back in and checked me. The baby's head was still transverse and she hadn't moved. I remember him standing there looking tired and frustrated and saying, "There's no safe way to birth this baby vaginally." I immediately started sobbing uncontrollably, saying no, no, no. My husband was right next to me and he reached over and hugged me. I grabbed him and held on as tight as I could, sobbing. The midwife asked everyone to leave the room and then left us alone. That was the only moment I felt like someone actually cared about my feelings, but it was too late at that point. I remember sobbing and sobbing. The midwife came back in and I said something like "everything I didn't want to happen did and now they have to cut my baby out of me."

I really never stopped crying. The doctor came back with the consent form, and the nurses started shaving me and putting in the catheter. I just remember crying and crying. I felt so defeated; like everything I had ever dreamed of had just been crushed and the worst possible thing I had ever imagined was happening. I had dreamed so often of birthing my baby, holding her and looking at her, and here I was being dragged to an OR (operating room). That was one of the darkest moments of my life. I had done everything I thought I needed to do to have a safe and satisfying birth experience and it was all taken away from me. My dream of birthing my baby had been crushed. My heart had never hurt quite as much as it did at that moment.

I remember them wheeling me down the hall, watching the lights go by overhead and feeling like a death row inmate being taken to where they do the lethal injection. To add insult to injury, one nurse said "it's not THAT bad" to me, and the anesthesiologist yelled at me because I grabbed the side of the railing when I had a strong contraction. Did I mention my epidural was awful and I had this excruciating pain in my left hip and buttock?

The OR suites were right past the area where they did all the antenatal testing, which I had been to many times. I remember knowing that was where the OR was as I went to all my tests, and thinking that those swinging doors led to a very bad place where they cut babies out of women. I was now going there to have my baby cut out of me. As they opened the door to the OR and rolled me in, I remember thinking about a friend who had a similar labor and c-section to mine and subsequently suffered a pretty severe case of PPD (post-partum depression). I imagined that to be my fate for the next year or more of my life.

They prepped me and the midwife and my husband came in to be with me. I was still crying and just looking at the lights over my head and feeling so miserable. I just wanted to die. I couldn't believe that this was the place I was going to become a mother. I felt like such a failure. I remember feeling them wash my belly and I hated the feeling of them pushing and pulling on my beautiful big belly.

When they made the initial incision, I could feel it. It wasn't excruciating, but it hurt. When I said that it hurt, they said, "No, you are feeling pressure." I said, "NO, I am feeling pain." I go back to that moment often. When I feel the twinges in my incision site which happen at least daily, I clearly flash back to that moment. It wasn't just the pain, it was the symbolism. My body was being violated by a knife. A knife that was cutting my flesh and uterus to forever leave a scar, cutting my baby out of me, cutting away my hopes and dreams.

Looking back, I don't remember how much it hurt. Sometimes I wish I hadn't said anything and just lived with the pain, because they gave me a sedative that made me even more out of it. I still remember feeling some more pain as they pushed at the top of my belly, but it wasn't that bad. The good thing was that the whole procedure seemed to last only 15 minutes because I was in and out of awareness. I'm glad I didn't have to be awake through the whole thing, but I had such feelings of detachment from the situation and my baby. I hate the fact that they had numbed my body and my mind while they cut my baby out of me.

I often find at night that if I try to lie on my back, I go back to that OR and how I felt lying there. It's like being in that position on my back brings it all back. I see that stupid screen in front of my face, and all the sensations, smells, sounds, feelings and emotions come right back to me. And I remember the feeling when they cut me.

I had heard you could ask the doctor to lower the screen so you could see the baby at least being lifted up, but I was so afraid I would see something I didn't want to see, I didn't ask. I regret that. I remember feeling that this was so far from what I had hoped for it didn't really matter anymore. I remember hearing the baby cry and the midwife saying "I was wrong" (she had guessed it was a boy). I said, "It's a girl?" and she and my husband said "yes." We both said "Madelyn" since we had decided on the name ahead of time. I remember being happy for about a half a second thinking about my little girl. The doctor held up this strange baby for about half a second to the right of the screen. That was the first view I had of her. I could still hear her crying and I told my husband to go be with her.

I think I will always get sad when I think about how I didn't feel my baby leave my body, how this strange surgeon flung this little baby over my head for half a second to show me her, and how all these strangers handled her before I even got to hold her. That was my introduction to motherhood. The only thing I feel good about is that my husband went to be next to her. There is a picture of her with her little fingers wrapped around her Daddy's finger as they weighed her. At least one of her parents was with her. I hope she knew her Mommy would have held her if I could have.

The next thing I remember is my husband standing next to me with this beautiful baby all wrapped up with a hat on. It still makes me crazy that I didn't get to see her naked until days later. She had this pink little face that was so precious and still had some blood on it. I tried to sit up and hold her, which of course I couldn't do. I don't remember how long she was there, but when they took her to the nursery, I made my husband go with her. I wanted at least one of her parents with her. The next thing I remember is the CNM (certified nurse midwife) saying "It's all done, Chris" and I thought, "Yeah, it certainly is."

I don't know if that's when the shaking started but it was horrible. I felt so cold, and I was so exhausted that it hurt my muscles to shake so much. Everyone kept saying that it was normal, but I felt pretty far from normal. Is it normal to numb a woman from the chest down and cut her baby out of her? Isn't the shaking just one more way to tell us that cutting a baby out of a woman is a horrible thing?

In the recovery room I felt like my entire world had come crashing down. It was so far the worst day of my life, but it also was the day I became a Mom. I still don't know how to come to terms with that. I just felt so defeated and miserable. I had to call my Mom because she had been waiting up all night to hear. I wanted to call her so badly because I knew she was worried about me and waiting to hear, but I felt like such a huge failure and was embarrassed to tell her that I wasn't able to bring her first grandchild into this world without being cut open. I told her she had a healthy granddaughter, but that they had to do a c-section because she got stuck and wouldn't come out. She said she was sorry and hoped I was OK.

They brought my daughter in so I could nurse her, which I appreciated, but I honestly didn't really care very much. I had expected the moments and hours after my baby's birth to be the most important and wonderful moments of my life, and they were the worst. I nursed on one side for a few minutes and when they told me to try the other side I said no. I didn't even care that I was a Mom and that I had a healthy girl. I wanted to die. I was embarrassed, felt like such an enormous failure, and hated myself and my body for what had happened. They took her to the nursery and I lay there with a hole in my abdomen and uterus that would heal in a few weeks, and a hole on my heart that will never heal.

© Chris 2002

In October of 2004, I gave birth to my son, at home - a glorious VBAC!!

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