Cesarean Awareness Month

I didn't plan to write about my emergency c-section anymore than I planned on having one. But, April is Cesarean Awareness Month and birth plans can change suddenly. So, here's my story.

 

The first day of labor was a piece of cake. My parents arrived around 11. They took us to brunch. I ordered fresh orange juice and a scone. We languished for a bit at the table. Michael schooled us on something political or societal. It was all very ordinary. Contractions were manageable. I shuffled around eating calamari, visiting an exotic aquarium store, and nursing a gelato.

Nothing so far prepared me for the night I was about to experience. With each contraction, my body tightened. As each breath became more erratic, my shoulders arose; my face grimaced. I couldn't repress the anguished sounds in my voice. To appease myself, I sang Moby's "Natural Blues" in a low drone and lingered in the shower for an hour, two hours; I don't know how long. Each contraction rendered me reluctant to be alone. Michael slept. Sleep seemed impossible to me.

The next day at the birth center, we tried several different, natural ways to encourage labor to progress. I took each suggestion the midwife made - Benadryl, a Foley catheter, showering, riding around in a car with the driver instructed to look for bumps, walking, lunging, squatting, relaxing in the buoyancy of a tub, and then eventually breaking my water - with some degree of hesitation, but obeyed her like I would a drill sergeant. The final labor-inducing aid was castor oil. That one terrified me. Taking a laxative to intensify my contractions seemed crazy. Every time a contraction began, I would throw off my robe and run to the bathroom. It was night again, and everyone had faded, to me and to rest. I finally felt okay to be alone. That bathroom in my castor oiled haze became a vision tent. By the third pace around the room, I realized my baby wasn't coming this way. The next time a nurse came in to check on me, I had her fetch the napping midwife. I said, "I'm at my wit's end. I need hospital intervention."

Michael and I, with my intensified contractions, left with our Prius and my parents followed, for what seemed like forever and really fast driving. When I checked into the hospital around 1 AM, the passivity of being wheeled into a room calmed me. I was so over feeling contractions. An epidural seemed like the best idea. A flurry of nurses came in and out, attaching machines to me and the baby. Things seemed to progress soundly. I learned my baby had a full head of hair. The only signal of a contraction was a beeping machine. I relaxed, and stayed alert, waiting until stage 2 of labor - pushing. After an hour or two, the nurse administered pitocin to induce labor. But, as soon as the baby's heart rate began decelerating, the doctor ordered an emergency c-section.

I understood the whoosh of the baby being lifted out. She uttered out a cry, nothing distressed or anything, and then another cry at the two people handling her. A male voice exclaimed, "She's a chunker!" The nurses cleaned her. Michael snapped a few photos, and then brought her swaddled over to me, putting us face to face. I caressed her face and said something to her. When she heard my voice, I could see it in her eyes that she recognized me. I stopped shaking when she was close to me. But as soon as they took her again, so my incision could be sutured, the uncontrollable shaking returned. There was nothing I wanted more than to hold my baby. But, I waited. Patiently. The morphine was pacifying. The doctor assured me after her successful suturing work, there would be no reason I couldn't have a VBAC, vaginal birth after cesarean. Someone mentioned at some point that my pelvis may have been too small for the passage of my 8 lb, 6 oz baby. But one thing the doctor said reverberated with me. The umbilical cord wasn't attached directly to the placenta, but rather to a membrane. The fact that my cervix never dilated past halfway at a 5 - the left side dilated completely but the right side not at all - was a blessing in disguise. The baby might not have survived what would have been a difficult passage through the birth canal. Oxygen and other sustenance would've been cut off from her, and with her right temple resting on my cervix instead of the ideal crown of her head, pushing would be troublesome.

Knocking on the birth center's door so early in labor may have been a rookie mistake, but labor never progressed. In hindsight, I'm glad I labored actively for two and a half days. But, the labor - birth especially - was nothing like I imagined it.

 Our version of the Sacred Hour, in the recovery room. She was born with her hand in her mouth like that.

Our version of the Sacred Hour, in the recovery room. She was born with her hand in her mouth like that.

Here are the things I would have done differently:

Hired a doula. I originally thought choosing the person who would birth the baby to be the most important. But, I ended up with a birth team I'd never even met. A doula would have been the constant presence no one else could be. Well, she and my partner could have taken turns attending to the laboring woman. But, she could have coached me to breathe correctly. She would have known the right massage techniques. She's trained to endure the exhaustion like attending partners and moms can't. And I had no choice but to endure my own exhaustion and stay alert to whatever each moment physically demanded. An experienced labor expert on hand would've been heavenly.

Held my baby post birth. The doctor insisted I would not be fit to hold her due to the shock my nervous system incurred within a matter of moments: a saline drip that caused swelling not even pregnancy had bestowed me, the sudden loss of hormones the moment the placenta was removed, and a round of antibiotics for the surgery. An uncontrollable shaking seized whatever part of my body wasn't numb. I couldn't will myself to stop, but the baby close to me magically made the shaking stop. Our parasympathetic nervous systems desperately needed to be activated. Anyone who has felt wondrous after yoga or meditation knows the feeling. At the time of birth, however, mother and child need the affection only the other can give.

I had been looking forward to the sacred hour, when mom and baby snuggle until the baby latches onto the breast. Lactation hormones would surge through my body and the breastfeeding relationship could begin in its ideal circumstance. Instead, breastfeeding was delayed to five or six hours past birth. I'm not sure, but that may have been why my milk supply never fully came in. I had to stop breastfeeding after two months, latching issues aside. Everyone said the latch looked great, except for a La Leche League leader. She knew when she saw my face when the baby first latched on. It wasn't right. No doubt: it's been seven months since the last nursing and my breasts still look like a bulls-eye. As a side note, everyone sees your breasts when you're breastfeeding. There's nothing but total surrender to that.

Ignored "natural vs unnatural" birthing myths. Early in my pregnancy I read the popular book Birthing from Within. It suggested visualization to imagine a birth worth happening and active-imagination exercises such as doodling your fears. There's supposed to be an internal surrender to a positive power. I felt guilty when the birth I'd imagined - a midwife-caught baby, the Sacred Hour, and an aromatherapy post-birth bath - resulted instead in a surgically-removed baby. In my hormonal stupor, I felt I'd neglected to properly address my birth fears and that somehow the emergency c-section was my fault. And the drugs! The morphine, the NSAIDS, and narcotic pain killers absolved all that nary a drug taking during pregnancy when I quit coffee, ignored every urge for a Tylenol, and bulldozed through a tremendous cold in month 8 drug-free. But, there was no way labor would have progressed safely for either me or my child in the birth I imagined. Grant it, some doctors may abuse the c-section rate. On the contrary, a complicated labor benefits from a doctor confident in the timing of a truly necessary Cesarean. An uncomplicated labor absolutely should progress naturally. A lot of ob-gyns are privy to that, thanks to natural birth activists. Nonetheless, as often argued by natural birth advocates, there ended up being little compromise to my ability to bond with my baby, despite the c-section. Apart from our mutual exhaustion, we stayed alert to the other. Now that I think of it, the "internal surrender to a positive power" may have been my intuition to get thee to a hospital.

Scheduled post birth R&R. I needed a chiropractic adjustment and a massage, stat. A birth can be a traumatic event on the body. Instead I waited 4 months post birth to sit in a jacuzzi once and then was inspired to find a chiropractor who gave me adjustments and exercises to do twice a day. Once I started those simple kneeling side planks, I reinstated the self-massage of exercise back into my life and soothed my parasympathetic nervous system with yoga. Although I desperately needed a post-birth massage, and still really do, I asked for a cleaning service instead of a massage for Mother's Day. My preference to not clean trumps an hour of tension-releasing any day. Bear in mind, I'm just now considering myself to have recovered mostly from pregnancy, 9 months postpartum. The requisite to wait 18 months between pregnancies is a superb idea.

As I sit here to reflect on the birth I received versus the birth I imagined, it bears mentioning there is nothing that will prepare for a birth except a birth. Cesarean or natural, each birth is as mysterious as the baby that follows.

 Isidora's first portrait! With a blue lip from sucking on her hand.

Isidora's first portrait! With a blue lip from sucking on her hand.