Expectations

I’m not sure how I feel about this story: http://offbeatmama.com/2010/06/caesarian-empowerment

Basically, a woman describes the days leading up to her c-section and her son’s birth, and concludes that it was an empowering experience.  I have no argument with that.  I do not argue with people’s descriptions of their own experiences; only they know how they felt/feel, and it’s not for me to question.

Indeed, when I read this bit, I could really identify with this mother’s words:

My entire self was not raging with ‘oh no! my mother-club-initiation might not be possible’…the only thing rattling and screaming in that entire infinite few minutes was, ‘Get him out. Get him out. He can not die. No way. Not now. Out,’ my oxygen masked face eyes blazing alternately into le bebe’s soon-to-be-father and the doula’s eyes, both extending their ferocious and magnificent support. Because this was no longer about my precious experience. It was about le bebe getting the hell out of my body now to survive.

I remember that moment so clearly from when I had Annika (second baby).  After months of planning a homebirth, and years of commitment to physiological birth, the moment came in my labour when what started as mild fetal distress the night before became serious, and I knew–from the feeling in my body, to the looks in my midwife’s eyes and the eyes of the OB on call–that she wasn’t going to be born according to plan. I remember telling the doctor to “fix it!  fix it!” and I was ready, at that moment, to let them kill me before allowing any harm to come to my child.  There are few times in life when I’ve felt as certain and full of purpose as I did at that moment.  (Interestingly, it has been difficult to remember that in the 3.75 years since…but more on that another time.)  So, I get the part about knowing for yourself what you and your baby need, and I am not in the slightest bit questioning that aspect of this story. 

The part that has me ruminating is the idea that a surgical birth is something that women should not grieve.   This mother writes,

But the point is the birth of the child and the child was birthed. I pride myself on appreciating and respecting other people’s perspectives and beliefs, but on this matter, I am unwavering. A caesarian is a powerful birth unto itself, without need for apology, and with only reason to celebrate. Those who do not agree are grappling with expectations and not reality.

A caesarian can be a powerful and legitimate way of bringing a baby into the world, and there are ways–particularly when a surgery is planned in advance–that one can make the most of the situation, personalize it, and so on (on that note, I wishI had read the chapter in Birthing from Within  on this before my c-section, but I was in the it will never happen to me  camp–live and learn…).  But I am not sure that is really possible in emergency situations where you have minutes before the first cut.  This woman seems to have had a full night to think about it and ready herself mentally for what was about to take place.  I had less than half and hour between the Moment of Terror and seeing my baby outside my body. I wish I had spent those minutes calmly connecting with my body and my baby, etc., but the reality was I spent them sobbing out of a) fear for my baby, and b) deep, deep sadness.  Maybe I needed a reality check, but I started grieving the loss of a physiological birth the moment I realized it was not going to happen.  

No woman needs to apologize for the way she gives birth.  Ever.  But I have trouble getting behind the idea that a caesarian is something for which there is only reason to celebrate.  A baby is a cause for celebration.  A healthy baby even moreso.  But in a context where interventions are overused, iatrogenic complications rampant, and c-section rates skyrocketing far above recommended levels, it is hard to isolate a surgicalbirth–however justified and legitimate it may have been–as a straightforwardly joyous event. 

 I do not mean for a moment that a woman cannot feel joy when she has a c-section.  I was thrilled to have my daughter born safely.  I was relieved that she was healthy and that any distress she endured during labour seemed to have had no lasting impact.  I remain grateful to the people who supported me that day, even though I still often question the decisions they guided me to make leading up to the Moment of Terror. Ibelieve that this woman felt empowered; I, too, felt very sure of myself on the day of my surgery, sure that it was the right thing to do, and not in the slightest bit victimized by any part of the process.  

And I also grieve my c-section–as necessary as I knew it was in the moment–because it was a loss for me as an individual.  My baby and I are separate entities; we always have been, even when we were linked by an umbilical cord.  My experience was tied to hers, but it was not about her alone.  Her health did not cancel out my trauma.  Perhaps the root of my grief was expectations–that is one way to look at it.  But I am not certain that there is anything inherently wrong with expecting to birth a baby without the use of a scalpel.  Obviously in some cases that expectation remains unfulfilled.  But I do not believe that the outcome–the necessity of the scalpel, the presence of the scalpel, the action of the scalpel–cancels out the legitimacy of the wish, the plan, the belief in the possibility that a body will work as a body is designed to work. If we lived in a world where we could be certain that medical intervention in birth only did good, I might be more easily persuaded. But when 40% of women are giving birth surgically, I have to question the situation.  I think the problem is less my unrealistic expectations of my own body, and more a system that makes intervention and surgery the new normal.

Every woman will experience birth–surgical or otherwise–in her own way, and each individual experience deserves respect.  I am struggling to figure out how to support women in a way that emphasizes empowerment (as the story in this link does) and yet also does not erase legitimate sadness or grief or a political context that is hostile to physiological birth.  I know I made the right decision when I locked eyes with the OB and did not even have to tell her to cut; we both made the decision at the same time.  Both of us knew.  And I still hate that it had to happen, wonder if there was anything we could have done differently that might have prevented it, and will go to my grave doing what I can to ensure that no woman ends up cut unless there is really no other way.

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3 Comments (+add yours?)

  1. Kimberley
    Jul 01, 2010 @ 21:08:52

    Thanks for this, Alisa. Having had two c-sections- the first an emerg after 40 hours of labor and that same moment with all those around me knowing that there was no other option, and a second planned c-section after being advised that VBAC was not possible but went into labor 2 1/2 weeks early- I agree that the experience can be BOTH celebrated and mourned. I have struggled with balancing what I should feel/do feel/want to feel. I have battled with “what did I do wrong” and “could this have been prevented”. So, what I do know at this point is that a c-section delivery adds a whole other layer to the experience. It isn’t “natural”. Or rather, surgery isn’t natural. Surgery is traumatic. On so many levels. I vividly remember my first emergency c-section- the narrow, metal table beneath me, the lights and faces hovering overhead, the sudden burst of tears with tremendous fear, the nurse telling me I would be holding my baby in less than 10 minutes (to which I replied, Take longer than that!) I was not prepared. And even the second time, while I had months to prepare, I wasn’t ready to be cut open. I have come to realize that there isn’t any “getting over it” but more a need to accept it, honor it as what the universe ultimately had in store for me on those 2 days, and gratitude that I am even able to have children. Part of me may always mourn. The scar, a reminder of my experience. And two beautiful children that keep me busy enough not to dwell on it too much and simply move forward. I hope to be stronger and wiser for it. But I agree with you, if ever this can be prevented, it should be.

    Reply

  2. thejugglingmatriarch
    Jul 02, 2010 @ 04:58:03

    Thanks for sharing that, Kim. I think you’re right on about not “getting over it”–it took me over a year to really figure out for myself that “getting over it” is not an option, but it is possible to integrate that experience into my life and use it in some way to build my future. I think that’s really the key, and maybe the thing I was thinking but couldn’t articulate when I was writing this post: it doesn’t have to be a choice between celebrating or mourning. It’s both, which can feel kind of maddening at times–it’s hard to be thrilled and traumatized at the same moment, all while caring for a brand new baby! I do recall being shocked at how little support there was in the immediate aftermath–there were lots of people excited about the baby, but there wasn’t really anyone who was able to connect with me and help me navigate such a totally unexpected and thoroughly terrifying experience. I guess this is part of why I felt compelled to write about this, because there is already no shortage of people ready to congratulate women who have had babies, who really don’t even give a second thought to what they might have been through in the course of getting those babies out of their bodies. The vast majority of people take the opinion that all that matters is a healthy baby. And yes, in the end, a healthy baby is absolutely what I (and every other mother I’ve ever known) wanted. But at some point I would like to see that standard shift to the idea that what matters is a healthy baby *and* a healthy mother. We don’t disappear when our babies are born, and it’s neither selfish nor unrealistic to care about our own emotional and physical wellbeing just because we have had children.

    Reply

  3. Trackback: Grace under pressure: the challenge of a long pregnancy « Thejugglingmatriarch's Blog

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