Saturday, January 16, 2010

Great expectations

I’ve recounted here the story of how I became a mother, for both the first and second time, in all of its gory detail.

If my great grandmother was alive, the namesake of my firstborn, she’d have corrected me loud and clear (she was 102 when she died and only a smidgeon deaf) that my babies “weren’t born, they were hatched.”

I wouldn’t have been offended.

But I'm sure there's someone out there who would have been.

Seems as though there has always been consternation concerning the C.

Many will tell you hospitals are performing cesareans far too often; some will tell you it’s ethical for women to choose surgery first; a few will tell you the medical profession has ruined the miracle of birth for women and others will say that lawyers ruined it for everyone.

Now, it seems, a few folks are likening cesarean sections to rape, saying that they weren’t given a choice. Doctors forcibly, or through coercion or lies, entered their bodies to remove their children, robbing them of a natural birth and leaving them with more than just bikini-line scars but psychological damage akin to sufferers of post traumatic stress.

I might have written these vocal few off as crackpots looking for attention, but their stories are compelling and familiar.

I suppose I could have been one of them.

Long before my doctor came into the labor room to tell me she thought it was “time to go in and get that baby,” I had endured more than 24 hours of mishandling in some form or other.

There was 9 a.m. ultrasound that lasted until 3 p.m. … No food. No water. In between I was forgotten on an examination table for more than an hour. The doctor who forgot me, returned and abraded the amniotic membrane without explaining why, or what I could expect. Once at the hospital I received so much fluid by the time it was all over I was blind from corneal swelling. I didn’t recognize my own body. I weighed more than I had while pregnant, though a few days later I weighed less than I had in high school.

As I recovered in the hospital, I was angry and disappointed. This wasn’t how it was supposed to be. This wasn’t what I’d prepared for. I didn’t know how to prepare for this.

After I got home my belly scars healed quickly to a thin, silvery line.

We both smiled, my doctor and me, as she examined my progress six weeks later. My baby, happy and healthy, asleep in my arms.

The second time, though elective, wasn't as pretty. My skin didn't heal as well, in fact it was somewhat gory for weeks. Once the incision closed it grew over with "proud flesh" that had to be burned off with acid in a series of weekly office visits. Nerve pain kept me virtually incapacitated for nearly two months.

I accepted this pain as I accepted my son. With fear and gratitude.

Thing is … what I’ve come to accept is that what happened to me wasn’t medical malpractice. It was my inexperience coupled with a doctor's horrific communication skills. The events that took place in my case the first time – the abrading of the membrane, the induction of labor, the decision to surgically intervene – were protocol and warranted.

But as a patient relying on a doctor to make that diagnosis I am at a disadvantage. There's always something a doctor leaves out, something you don't know to ask or something they don't think to tell. There's a decison based on any number of factors they may not have time to tell you, and there are always the possibility of mistakes.

When you have a c-section, or any surgical intervention, there’s a part of you that always wonders if it was really necessary. I’ve chosen to believe mine was, and I’ve chosen to remember the details with some degree of awe.

Others may not have my ability to suspend disbelief, I realize.

For them the trauma is catastrophic and insurmountable.

But rape and birth trauma are not comparable. Doctors don't force their will on patients for perverse pleasure. Their decisions are not easy. Do they wait and risk a life? Two lives? How much time do they have to explain it? How much choice does a mother really have when time is finite?

There is little doubt some doctors are better than others in their bedside manner. Improving communication should be a part of their continuting education. Patients, likewise, have got to be their own best advocate. They have to learn what questions they need to ask and how to ask them.

All births are different. All experiences are different. None are easy.

I was not alone in my experience.

My husband was just as afraid and even more horrified by what he saw; the amount of blood that was spilt on the floor of the operating room. Yet he chooses to remember the moment my doctor lifted up our daughter, and he became a dad.

We know we were lucky.


Blogger jennyq said...

I agree with you on this subject. Comparing a c section to rape? I just do not agree with that. I'm glad you took on this touchy subject.

January 16, 2010 at 3:32 PM 
Blogger PaperHearts said...

A thought provoking subject. Even if the birth experience isn't what a woman expected or wanted, ideally she would still see it for the incredible moment it is.

January 16, 2010 at 5:51 PM 
Blogger Diana said...

Unfortunately for some doctors, the decision IS easy. For them, to cut is quicker, more predictable, a way to get home to their families in time for dinner instead of having to wait around for a laboring woman to do her thing according to her body's and baby's timetable. They use scare tactics, half truths, medical jargon that frightened, exhausted women believe because really, who is going to challenge anyone who says 'do this or your baby will die', especially when already under the stress of active labor. For some women a c section IS a violation of their bodies. They don't want this, they say no, they ask why, beg, plead and still, it's done. Or the baby will die. Or the doctor's dinner will get cold. For some women the stress, the trauma is real. Imagine you're a young mother with total faith in her doctor. Your pregnancy has been normal and unremarkable, you go into labor without any interventions and head to the hospital to give birth. You get there and the doctor immediately administers pitocin, even though you're already in labor. The pitocin makes the contractions stronger and faster and harder so you ask for an epidural. The epidural stalls the contractions and you stop progressing. The doctor starts getting impatient. Administers more pit. which makes the baby's heartrate increase. The doctor sees that and springs into action, quick, heartrate, distress, immediate c section, have to go now, there are hands on you, ivs being inserted, masks slapped on, the bed is wheeled into the or, the lights are bright, more hands, a sheet going up, medicine, hands pulling at your belly, cutting, tugging, spreading, pulling your baby from you when you're not ready, you haven't had time to prepare for his, the baby isn't ready but then suddenly your baby is there and yes, it's perfect and wonderful but looking back at the experience, your heart hurts. That's not what you thought it would be, not what it HAD to be but because some doctor had an agenda, it's what it was. Perhaps rape isn't the best word but I've not heard a better one in our society that points to the violation of a woman's body. Yes, the outcome of birth, whether by c section or vaginal delivery is incredible and we shouldn't trivialize that ever. But I really believe that the journey to that moment is important too. I know that c sections are absolutely necessary for some women and their children, don't get me wrong. But I do believe that our country is cut happy. And it makes me very sad.

January 16, 2010 at 6:25 PM 
Blogger kc said...

I had a c-section after inducing labor. Had I known more, I might have resisted induction and possibly not ended up with a c-section...but it's hard to second guess that way. It all ended well - with a healthy baby and a healthy (after the c-section healed) mom. But I still wonder if it could have been avoided.

I can see how some women would feel "forced" into the decision - it's such an emotional thing, especially when you have a fantasy of your ideal birth experience and you end up with surgery you hadn't planned on and complications you didn't expect. It's disappointing and scary and those feelings can last for a really, really long time.

January 16, 2010 at 6:29 PM 
Blogger wickefamily said...

After having two C-section- I still have unresolved feelings. I think I chose my second because my first birth was so awful- that I just wanted to know what to expect. I do know the C-sections did take the beauty and expectation out of the experience for me.

January 16, 2010 at 8:57 PM 
Blogger toyfoto said...

These are GREAT pieces of insight. Thank you all for sharing them.

I don't believe people who experience birth trauma aren't genuinely suffering. I just think what is described as birth rape is really medical malfeasance when its describing doctors who perform them for nefarious reasons, such as wanting to get home to dinner. Rape is a sexual crime. I don't think one word can describe what happens in the practice of obstetrics from med school to O.R. and then, even, into the courts. There are so many shades of gray.

Of course, the use of the term rape will get a lot of attention for an important subject, which is improving medical outcomes for women, children and families in the least invasive way. But if the discussion isn't nuanced, those who are using the term as a battering ram run the risk of having their cause marginalized.

January 17, 2010 at 10:18 AM 
Blogger the mama said...

glad to see this subject is getting some well thought discussion and not just blind attention (or none at all). well done again, siobhan.

January 18, 2010 at 8:53 AM 
Blogger Sarah said...

Traumatic yes. God yes. I wasn't given a choice - and in my case, that was the right decision, in my case we needed delivery to be as tightly controlled as possible to minimize delivery trauma. My hospital simply didn't deliver 25 weekers vaginally if they could help it.

But rape? While I agree with everything Diana has said, and goodness knows I agree (hell, I know first-hand) that a traumatic birth experience can lead to PTSD, I still don't agree with calling it rape. I don't know what would be a better term, though.

January 19, 2010 at 10:59 AM 

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