Birth Trauma From A C-Section
It's Not Always About the Surgery Itself
Alexis Barad-Cutler
It wasn’t so much the fact of the cesarean-section itself that was traumatic — it was everything I didn’t know about it going in, and everything that happened immediately after.
We had done everything within our power (as we understood it) to prevent a c-section birth. When I had found out that I had gestational diabetes, I switched up my diet drastically to decrease the risk of a c-section. When my baby hadn’t settled into “head-down” position by about 36 weeks, I tried all the yoga positions suggested on the internet — and even burned a candle at my toe (look up moxibustion; its a thing) to help move him in the right direction. When the natural remedies didn’t work, I gritted my teeth while a doctor performed an External Cephalic Version (ECV) — a procedure in which a doctor manually turns the baby from breech position into head-down position. And yes, it was excruciating.
Here is the only thing that stands out from what the lady from our 5-week-long birthing class taught us about c-sections: “Expect a lot of clanging sounds.” We were shown a three minute video about the procedure, but were encouraged to close our eyes if “surgery made us uncomfortable.” No one watched the video, including me.
My water didn’t exactly break before I officially started to labor — but I had been leaking slowly for hours while I slept before I realized what was happening. When I checked into the hospital in the AM, they broke my water for real, and then waited for real labor to begin. It took forever for my cervix to dilate. The next morning I was still not at 10 cm. By hospital standards, my water had been broken for so long that from this stage on my baby would be at risk of being exposed to infection. My doctor strongly recommended a c-section, but made it clear it was my choice. I was so tired, and had felt like we had really tried everything, so I agreed.
A c-section never felt like a failure to me. Having a vaginal birth was a goal — an ideal — but it didn’t make the possibility of having a c-section the “losing choice.” So once I decided to have the surgery, I was nothing less than excited that in less than a half hour’s time, I would be meeting my first-born.
What I wasn’t prepared for: the little things they don’t tell you about. Like the shape of the table you lie on during the whole procedure. That’s important, I think. The operating table is shaped like a crucifix. Strange, right? Your arms are outstretched, so it feels like you’re flailing. It’s the opposite of what my body wanted to do in that moment, which was hug myself, or keep my arms tight at my sides. As excited as I was to meet my baby, I still was scared. I didn’t expect how heavy my legs would feel from the epidural — elephantine. And yet, I was able to be bothered by the way my right foot was awkwardly tilted towards the wall of the room. I couldn’t feel it, but I was aware of it, and I couldn’t get it out of my head as they prepped me for the surgery.
Another thing: After I got to lay eyes on this wonder of a human I’d been waiting forever for, he was sent down the hall with my husband, leaving me alone in the room with no one to hold my hand. I hadn’t ever thought beyond the joyous part where the baby comes out. What about after? The part where they put Humpty Dumpty back together again? For some reason, I could feel everything they were doing to my insides, and it was excruciating.
“Is there someone who can hold my hand please?” I cried. “Anybody! Please?” I was panicking. Crying hysterical tears that I couldn’t wipe from my bloated face because — well — my crucified arms.
A resident held my hand for a minute before he had to go do something else. It was the loneliest feeling in the world.
The next thing I remember is waking up in a strange curtained off room, with my father in law staring at me at the foot of my bed. It was all very dream-like.
I somehow weathered through what seemed like an endless stream of visitors (family, friends) who wanted to see the new baby, but all I wanted was to tell my story. It was urgent, and immediate, this need. “Do you know what they do during c-sections? Do you know about the table that’s shaped like a cross? Do you know that you FEEL THINGS? And that you go to sleep after?” And when I told people, they looked at me like I had missed the whole point. The looks on their faces said, “But what about the baby? Don’t you want to talk about the baby?”
I wanted little to do with the baby. It hadn’t taken that long for whatever joy I had felt upon meeting him to fade, because it was overshadowed by my intense fear about everything that was happening to me. I had a gaping wound on my belly that no one — not a single doctor, not my husband, not my friends — seemed to be worried about. My stomach was full of gas and fluids from surgery. I had a body I didn’t understand. Why did I still look pregnant? No one told me I would look pregnant after I was no longer pregnant? I was bleeding buckets of blood onto the same kind of square-shaped pad we used to potty train my dog when he was a puppy.
My husband left me alone every night to sleep at his aunt’s house. He came back in the mornings bearing croissants and good coffee, and refreshed and ready to do everything he could — but the aching loneliness of those nights was unbearable.
One night, friends of ours who are both doctors came to visit. One of them was a mother of one at the time (she has two now), and offered to walk with me in my nightly lap around the maternity ward. I knew that she had had a “difficult time” around her first baby’s birth, but didn’t know to call it Postpartum Depression back then.
As I shuffled down the cold hallways in my hospital-issued gown and husband’s oversized sweatshirt, I asked her, “Is this what it’s like? Did you know it would be like this? That you would be so sad? Why am I so sad?”
I felt like all this time, all those days and nights of anxious worry about what things to buy for the nursery, which breastfeeding accessories were the right ones, what carseat was the safest — I had been focusing on the wrong things. Those were nothing. NOTHING! This was the thing I should have been preparing for. The after. Why hadn’t anyone steered me towards the light? Why did they let me get distracted by amazon.com lists and other noise?
Did they not want me to know?
My friend, the doctor, told me that she had experienced this feeling too. The sadness, the disconnectedness, the feeling of being lost, underwater, blindsided. It was the first time in the days since I had given birth, that I felt seen by SOMEONE. A tiny weight lifted. I needed to know that I wasn’t the only one. She confirmed this. I didn’t know what I was going to do with this information, but at least I knew that I wasn’t “the crazy mom” in the maternity ward.
The trauma around my son’s birth is connected to the ways in which I was uninformed about c-sections, unsupported after my birth experience, and misunderstood by family and friends. I don’t blame any one thing or person for these failures. My beloved OBGYN worked hard to give me the birth that I had hoped for. And she ended up being the first person to ask me how I was doing emotionally — and was the first person to raise the alarm about my Postpartum Depression. Without her having taken the time to ask me questions about my mental state in our postpartum follow-up, I would have suffered for far longer than I did.
I also have a feeling that the culture of fighting so hard to avoid c-section births may encourage blinders against learning about what they entail. I basically put my fingers in my ears any time a c-section was brought up, because I thought that it was within my power to prevent one. In my experience, anything I’ve ever willed myself to do, I’ve done. Why would my birth be any different, I thought? What I didn’t realize in my first pregnancy was that the day of my labor would not be like my wedding day. It wasn’t something I could plan for, or produce, and then make the various participants in it do the things that I want according to some list.
Lately, my sons — now ages 5 and nearly 8 — ask about their birth stories. My second son was born by scheduled c-section, after carefully considering different options with my doctor. They’ve learned the difference between a vaginal birth and cesarean birth, and that most births are vaginal. From talking to relatives who have babies, they’ve learned the cultural desire and preference for vaginal births.
“Why was I born emergency?” My older son has been asking me lately. It’s complicated explaining the process of his birth, and the road that led to him being born via c-section. “It wasn’t an emergency,” I explain, again and again. “It was just seen as a safer option, but I guess we refer to it a lot as an emergency c-section — because it wasn’t something we planned.” At this, he usually squints his eyes a little, which he does when he’s thinking, and then stares off into the distance, which he does when he’s processing. “But it was the best day of your life, right?”
It’s hard to lie to him, so I just give him a big hug.