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A Long Road Back – My Journey Through Birth Trauma
My story illustrates the impact birth trauma can have on women. On Tuesday, September 16, 1986, two weeks past his due date, my son Jeffrey was delivered by cesarean section, weighing 9 pounds. 13 oz. I started prenatal care at 22 weeks with a doctor who was recommended by a friend. The doctor indicated that he supported my birth plan for a natural birth with minimal intervention. My doctor had privileges at two hospitals. During the third trimester, my partner and I both went on a tour. I chose the hospital whose standard procedures were less invasive; no IVs or enemas and they encourage walking to work.
A little after midnight on September 16th, my water broke. I wasn’t having any contractions at this point, but I called my doctor. He said he had a patient in pre-term labor at 26 weeks who needed his attention and that I would need to come to the other hospital instead. After a quick shower we drove there, where my partner faced the paper while I underwent the standard procedures including an enema and insertion of an IV needle.
At that time, I had strong, regular contractions. Then they took me to a labor room and put me on fetal monitoring and couldn’t walk. Despite these interventions, I managed the pain and worked naturally for nine hours. My doctor checked my progress several times, but focused mostly on his other patient. I progressed well and at 7.00, I was 9cm.
At 9.15 when my doctor checked again, I was still 9 cm and the baby did not descend. He said he could allow me to work longer but it wouldn’t make any difference; the baby was too big. After nine hours of intense contractions, a partner who spent more time in the cafeteria or sleeping and lying flat on my back staring at the walls, that’s when I lost it and started crying. In 15 minutes I was in the theater and they administered a spinal cord. At this point I was so tired that once I no longer had the pain of the contractions, I fell asleep.
I remember very little until this afternoon. My vague memories include Jeffrey’s first scream and my ex bringing me a picture of him in the recovery room. Because he swallowed miconium, he had to be observed in the nursery and I didn’t get to hold him or try to nurse until that evening. I couldn’t have the room because of the cesarean and despite the sign in her bassinet instructing the nurses she was to breastfeed on demand, she was given formula and not brought to me for hours at a time.
At the time, I was very disappointed that I had had a C-section and felt as if I had somehow failed as a woman. I was also very angry with my doctor. I felt that despite a good relationship during my pregnancy he let me down when I needed him the most. I was especially upset about the tone he used with me when suggesting that a caesarean 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 it wouldn’t do any good was intimidating. I remember later comparing this experience to emotional rape.
Because my son was in nursery 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 the five days I was in the hospital. I was also upset that the nurses had more time with my new baby than I did. I got to see him for only part of the day. I never got to keep him with me at night. Our breastfeeding experience got off to a rocky start as she was given bottles of formula against my will. It was as if the nurses felt they knew better about my baby than I did. I had lost my confidence as a new mother.
Even after we left the hospital, we continued to struggle. I had a small infection on my incision. My son had a bacterial infection that caused blisters. It started on his scalp where the monitor was placed, but soon covered the area under his small arms. She also developed a severe case of thrush which made breastfeeding a complete nightmare. It was more than two months before my sore and cracked nipples healed. I can vividly remember sitting on the couch with my son nursing and crying in pain.
Eventually I moved on emotionally or so I thought. I realized the truth when more than eighteen months later I discovered that I was pregnant once again. All my old fears and feelings re-surfaced. I sat and cried for hours; not because the pregnancy was not planned or the additional strain that another child would put on our finances or troubled relationship, but because I would have to endure another caesarean section. I started looking for alternatives and finally found a midwife who would consider a home birth. Our first prenatal visit lasted nearly three hours and was more about debriefing about the trauma of my first birth than my physical condition.
But even a successful VBAC delivery at my 7 lb 14 oz. daughter did not reduce my anger at what I thought was an unnecessary intervention. In fact, a casual comment from my midwife that my pelvis was more than adequate caused my anger to intensify. In a classic experience of Post Traumatic Trauma, this comment re-ignited all the feelings that I experienced immediately after the operation. I tried to channel my anger in a constructive way. I became a crusader for natural birth; take a midwifery course. I tried to get a lawyer to sue my doctor, but the statute of limitations had expired.
For five years after my C-section, I often wondered about the what-ifs. What if I stuck with my plan to deliver at the other hospital with its less invasive procedures? What if I walked or worked standing? What if I was not monitored continuously? Whenever I was caught in these, I would become more angry or depressed. Some people have real benefit in hindsight, but I was blessed with a chance once and for all to solve what if.
These questions were answered once and for all with my second delivery. This son was considerably larger than my daughter who weighed 8 pounds. 15 oz, but still smaller than its 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 worked straight and walked through all the first jobs. I push into a comfortable position for me. I had a wonderful support person in my midwife and her assistant. I was comfortable at home, but my son was stuck in the birth canal. The woman who experienced me said that her shoulder dystocia was one of the worst things that she had to deal with in her decades of practice. He felt that prayer was the only thing that saved my son. After birth, his breathing was depressed and his APGAR minute was barely 4. Everything that haunted me for five years was gone. It’s sad to say but it was this 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 cephlo-pelvic disproportion was not some make-up condition used by doctors to pressure their patients into unnecessary cesarean section. I suppose the permanent ridge on Jeffrey’s head where he was wedged against my pelvic floor should have indicated this sooner, but it is often easier to blame others than to accept our own responsibility. I began to accept that my c-section was the result of overfeeding during pregnancy, which resulted in a baby too big for my pelvis.
My emotional healing was completed more than a decade later with the birth of my youngest son. I planned to have a midwife assist with a hospital delivery. I was confident that I would have no difficulty with another VBAC. I stayed at home during early labor and only went to the hospital once labor was well established the contractions were close together and so intense that I had difficulty managing them. I was sure from my previous labors that the birth of the baby was imminent, but when they checked I was only 2 cm dilated.
The baby was posterior and my back labor was not dilating my cervix. I tried to work right 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 I 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 though rather than anger and resentment, I own my decision. I was confident that I was doing the best I could for myself and my baby.
The other part that has been healing for me is that in the fifteen years since my first c-section, so much has changed that many of the things I hated about the experience just don’t apply. When my son was born, he was brought to me to touch before he was placed 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 and reunited with my son; less than an hour after his birth. The nurses helped me nurse her right away. Best of all, the hospital promotes the room for all babies. My partner stayed with us even during the night and the only time the baby was separated from us was for about 15 minutes each day to weigh.
It was as if I had come full circle. Despite the fact that the procedures were the same, I was a different person. I have matured. I learned my rights and responsibilities. When faced with an unfamiliar situation, I knew the benefits and risks of all my choices and readily accepted the consequences of those choices. I was cleared by the same procedure that once left me so emotionally scared that I suffered from Post Traumatic Stress Disorder. Some of it is because I have changed and some of it is the result of changes in the medical system.
As a mother who has experienced three cesarean births, I sometimes become very frustrated with the natural birth movement. Yes, the natural birth of my daughter and despite its difficulties, even my second son was wonderful. They in some ways healed my inner woman after the traumatic first c-section, but none of them were perfect either. I carefully discussed elaborate birth plans with my midwives and both births followed their plans.
Birth almost never goes according to plan. I spent five years angry and depressed for absolutely no reason. How many other women experience this pain that gives a deeper scar than a cesarean birth? I have often wondered what would have happened if this shoulder dystocia had not happened. Would I continue to be angry at my doctor and depressed? Will my PTSD ever be completely cured? Of course, I will never know the answers to these questions. And I feel deeply for the tens of thousands of women who never had the clear answer that fate gave me.
But my experience led me to start childbirth education classes and doula services specifically for those special women and babies who choose cesarean birth. I believe that with support and compassionate care the breastfeeding rate among these families can increase dramatically 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 birth trauma.
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