Tuesday, February 28, 2012

Learning to celebrate a cesarean birth

This is one in a series of guest posts by other bloggers. Read to the end for a longer biographical note on today's guest blogger, Melissa from White Noise and Mothers of Change. Melissa shares how she navigated through sadness at her cesarean through to healing and birth advocacy.

Guest post by Melissa from White Noise

I had my first baby when I was 24. It took me awhile to get used to being unexpectedly pregnant, and many of the pregnancy milestones or discomforts felt like unasked for, alien body invasions. By my third trimester I finally felt emotionally settled in to the fact that I was going to have a baby, and was mentally preparing for a natural birth. When I was 36 weeks pregnant, I felt my fairly active baby make one herculean, earthquake-like somersault and wedge himself into my uterus head up, bottom down: breech. My doctor referred me to an obstetrician, who tried to turn him with an external cephalic version two weeks later. My baby was bigger than average, and I am small and compact, so turning him was unsuccessful. A week later I checked into the hospital for a scheduled cesarean, because that is what the recommendation was for breech babies at that time. The Society of Obstetricians and Gynecologists of Canada has since reversed that recommendation based on more extensive and up-to-date research, but we did what we thought was best at the time.

Now, I've always been a believer that nature is pretty smart. Handcrafted, homemade, baked, sewn or knit with love is pretty cool. My parents were hippies and my mom works in obstetrics and had her babies in the heat of the natural birth movement of the late seventies, so I always figured I would have natural births. I just didn't factor in the possibility of a cesarean. Surgical birth was something that happened to other women, ones with dangerous health situations or enormous babies~surely I wouldn't have a birth like that? I was planning on a drug-free natural birth with my husband there to help me out and lots of self-gratification for being strong and weathering pain like a champion.

Instead, I lay on a narrow operating table numb and cold, got my guts hauled out and my baby handed to me in a sort of awkward moment in which I felt no emotion whatsoever. I didn't feel bad, I just didn't feel anything at all until I had been in the recovery room for about half an hour. Like when you get a cut and don't really realize it until you look down and there's blood on your leg, and then it starts hurting a few minutes after your realize it really should.

My doctors were nice, the operating room nurse was very kind, the pediatrician was fine; nobody was mean to me or bullied me into a cesarean or anything: in fact, my obstetrician told me there was absolutely no reason I couldn't have a vaginal birth next time around. In my head I thought, damn straight. But I appreciate that she didn't try to instil fear in me, or question my body's ability to give birth naturally in the future. However, this birth was nowhere near what I had anticipated, hoped, or dreamed about for as long as I can remember, and it took some time to process that fact.

Cesarean birth happened to me. It was like this train that scooped me up at a railway crossing and just took me along for the ride. There are many ways to give birth vaginally; in hospital, at home, in a birthing center, unassiseted, husband-coached, epidural for pain relief or exhaustion, augmented, induced, by candlelight, in water, or with the help of acupuncture. There is pretty much only one way to have a cesarean, and as the birthing woman in the room I knew the least about the necessary process and had the least say in how things went down. There are ways to be empowered and make choices regarding cesarean delivery, but I didn't know about any of them and as such was swept away by the medical way of doing things and left feeling kind of like this:

From Woman to Woman and the Unnecessarean

Some women feel their cesareans were unnecessary and experience varying levels of emotional trauma from the experience. I don't feel that way. I feel that although breech vaginal birth is safe, I am not a good candidate for it because my babies are large and my pelvis is small. It took me three hours to push out my next biological son, five years later, and one hour to push out my daughter, two years after that. Breech babies can run into trouble during extended pushing stages because the head compresses the cord as it passes through the pelvis. Given the opportunity I would love to have at least tried, but I think that likely I would have wound up with a cesarean for fetal distress anyways. So I generally felt that my cesarean was a positive choice, and I didn't feel traumatized or emotionally scarred from it.

But I was very sad. The loss of that natural birth I planned for was very deep and real. And it started me off kind of limping, rather than euphoric and proud. As though I had signed up for a marathon, trained for it, started it, and then, not too far into the race, slipped and fell. The race had this miraculous prize: a baby! And everyone got a prize regardless of whether they ran across the finish line or were wheeled there by an obstetrician. But still, I had really hoped and trained for running the actual marathon…

One-day-old peanut; all I can think of when I look at this photo is 'cover that poor baby UP!' Newbies. Sheesh.

Every birth is beautiful, and miraculous, and every birth day is cause for celebration, no matter how that baby made its entrance earthside. And humans are remarkably adaptable creatures, so we can thrive and love and grow under a great variety of circumstances, natural or otherwise. I think sometimes this fact can get lost in discussions surrounding cesarean birth. Babies and birth are to be celebrated! I love my son and I'm so glad he is here! I am grateful that my obstetrician was skilled and helped me to give birth well and heal wholly. I'm grateful we are both healthy.

It is also important to acknowledge that when we circumnavigate nature, there will be inherent some measure of loss. Emotional loss like I experienced, in grieving the natural birth I did not have a chance to have that first time around. Loss of immunological optimization for my son, since the biochemical process of labour gives babies an immunological boost, and prepares their lungs for the outside world. Physical loss, since I was at greater risk for severe bleeding or hysterectomy during surgical birth. Loss of dignity and bodily autonomy. And loss of expectation of health for future pregnancies and births, since subsequent pregnancies and VBAC pose more risk for me and future babies than if I had never had a surgical birth.

Skipping the marathon may have started me off limping, but I adapted. Successfully breastfeeding my son helped me find my stride and made me feel strong and powerful, much as I imagined giving birth might. It was the first thing I did, as opposed to had happen. And five years later I had my chance to try again. Eight hours of labour, three hours of pushing, and out slid my 10 lb, 2 oz, VBAC baby, into my midwife's waiting hands. That experience was so positive and amazing that I immediately wanted to do it again, and two years later I did. Six hours of labour, one hour of pushing, and I gave birth to my little girl. It was beautiful. Her birth was so peaceful and calm and full of joy.

My second VBAC, March 1st, 2011

I gave birth three times, and all three times I welcomed the same beautiful prize into my arms. I'm so grateful. My cesarean gave me a profound, experiential empathy for all women who give birth this way, and our joy and our loss mixed together. It also made me a passionate advocate of VBAC, changes in maternity care, and access for all women to empowering choices in all modes of birth. Empowering choices may be natural, and they may not be. We all deserve to have the best, healthiest birth possible. Marathon or not.

bio pic photo for guest post — White NoiseMelissa Vose is an artist, writer, women's advocate, doula, and kid-wrangler. She lives in Western Canada with her wonderful husband and their four noisy, crazy kids. She blogs at White Noise, and is the Editor of Mothers of Change, a birth advocacy organization working to improve maternity care services in Canada. She is passionate about breastfeeding, attachment parenting, ecological living, advocacy work, art, social justice, traveling, and raising awareness regarding mental illness. She and her husband adopted their second son in late 2005.

19 comments:

Sarah @ Parenting God's Children said...

Thank you so much for sharing your story, Melissa. I truly believe it will touch so many mamas who've felt like like they have to 'deal' with a cesarean. I especially loved this part:
"Every birth is beautiful, and miraculous, and every birth day is cause for celebration, no matter how that baby made its entrance earthside. And humans are remarkably adaptable creatures, so we can thrive and love and grow under a great variety of circumstances, natural or otherwise."
Thank you, again, for sharing!

Becky said...

Congratulations on two VBACs! My husband's birthday is also March 1st. Coming up quickly! I had a c-section with my first. I only have one child, so thinking of having another c-section doesn't please me, yet thinking about a VBAC makes me nervous.

I remember having a feeling (about a month before she was born) that I would need a c-section. I'm glad that you don't think negatively about it. I didn't think negatively about it at first. But as time goes by, I get upset with how the nurses treated me (ignorance is bliss) and I have a feeling that the next time around, I will not be such a docile patient. Of course the baby was healthy and I'm grateful for that. Honestly, I'm not planning for a natural home birth, but I would like to get a doula for the second time around for extra help in having a VBAC. At least, I've decided that is my goal and found an OB that is more determined in that regard than most are. Thanks for sharing your experiences!

Lacey Jane said...

This story made me all weepy because I am 35.5 weeks along with my first, planning a homebirth, and my baby has been stubbornly breech since 28 weeks. No amount of upside down laying or Websters Techniques are turning her yet. I am terrified of a cesarean but 1- I still have time. I still. Have. Time. and 2- How wonderful it will be to hold my baby. No matter how she comes out of me.

melissa v. said...

@Sarah @ Parenting God's Children Thank you Sarah! It was quite an experience, and I'm glad writing about it will help others to process their own cesareans, or deepen their empathy for women in their lives who have had them. =)

melissa v. said...

@Becky Thank you Becky! Those VBACs were pretty cool. I was very nervous going into my first VBAC, and I honestly didn't care if it was natural or not, hospital or not, drug free or not, standing upside down on my head or leaning sideways. I just wanted a fair chance to have a vaginal birth. You know? I'm grateful for my birth team and their supportive cheerleading and care! Without them I don't know what I would have done. Good luck with your next birth, and know that no matter how it ends, you are a super momma. =)

melissa v. said...

@Lacey Jane My post is very timely for you, then! Have you heard of Spinning Babies dot com? Likely you have but just in case you haven't they are a good resource for breech babies. Also acupuncture works for some (including my cousin). Yes, you still have time! And yes, cesarean birth can be positive and empowering, too. <3 Good luck!

mjb said...

Great post Melissa. There is something lost at a cesarean birth, yet there is something gained too. You found it in empathy and advocacy, as did I. I bet every woman receives some gift from the experience-I mean besides the baby of course! This might be a great thing to help women find. Hmmm
Thanks again for sharing and making me think.

kelly @kellynaturally said...

This was a touching story. I had a cesarean after 31 hours of labor with my first. It was so hard to consent to that... realizing that it wasn't even in our birth plan because... it just wasn't ever part of the plan. It WAS like running a marathon... but for me, maybe like getting to mile 26, with .2 still to go when I stumbled (I had been fully dilated for hours, DD just wouldn't descend in her position).

My second birth was also a cesarean...

Yet, somehow, because we'd planned for the most natural VBAC - I mean really *planned* for it - ALL the scenarios, including the healing that was necessary to trust my body after that 1st c - when my baby needed to be born at 36 weeks, and a c-section was determined as the necessary course of action for his safety, I was far more ready to travel that course. I knew what to ask for, I knew what I needed and just wasn't nearly as scared or helpless, or defeated. Of course it wasn't the birth I'd planned, but being informed, empowered, and prepared makes such a difference.

I am so very happy that you acheived your VBACs. I am hoping that I'm able to pass on to my children that birth is ALWAYS a wonderful experience, to be celebrated and cherished, and that women are MADE to give birth - normally, without intervention (but at the same time honor their own births, which required medical assistance) - even if intervention has been required before. VBACs are such beautiful symbols of hope & triumph.

Thank you for sharing your story.

kelly @kellynaturally said...

@Lacey Jane

hi Lacey.

Both of mine were breech. Lauren, I hope you don't mind me sharing a post I wrote about helping breech babies to turn...

http://www.kellynaturally.com/post/Techniques-for-Turning-a-Breech-Baby.aspx

Rachel @ Lautaret Bohemiet said...

I'm so glad you had Melissa do a guest post. She is one of my very favorite bloggers, because she really GETS IT. Raw, honest, real, full of beautiful ideals and yet not judgy or preachy. One of the most encouraging birth bloggers out there because she's pretty much experienced it all and now has this incredible sense of empathy, compassion and empowerment for all women. I could read her writing all day long (and often do).

Great post!

Kirsten said...

Thank you so much for this, Melissa. This could very well have been written by me (up until the 2 VBACs). My daughter is only 3 months old so I am still coming to terms with having her ripped from me, which is how I felt (emotionally, physically I had surprisingly little pain). I cried multiple times a day for a long time, and still do once in a while. It also took longer for me to feel connected to her and we had a long, rough road to breastfeeding (I worked insanely hard to make it work). I find it very encouraging to read such a similar story to my own and see that you had two successful VBACs. I only hope we can share that similar experience as well.

melissa v. said...

@mjb Thanks Mieke! It is true that we gain something with nearly every difficult experience, and empathy cannot be overrated. My voice as an advocate for empowered cesareans, natural birth, and VBAC, carries more weight because of my experiences, also. And for that I am grateful.

melissa v. said...

@kelly @kellynaturally Thank you for sharing, Kelly. I am glad you had access to an attempt at VBAC, and I think you raise two important points that are rarely discussed; the second cesarean is easier than the first, and the planning and empowerment are what makes for a positive birth, no matter the mode of birth. VBACs are symbols of hope and triumph, but so are CBACs, if chosen by the women with solid information and good emotional support. I admire your commitment to teach your children to honour their own birth stories while also celebrating natural birth. This has been a goal of mine also, particularly for my son delivered by cesarean. I never want him to feel negatively about how he was born.
<3

melissa v. said...

@KirstenKirsten, I got a bit teary reading your comment. It really is heartbreaking to travel this path when you wanted and planned for something very different. But your journey is beautiful. It hurts, but it spurns us onward to do beautiful things, if we allow it to.

I feel for you as you heal! It is a tough road. Traveling mercies, and know you're not alone. xo

I also recently wrote about bonding and mode of birth, if you are interested in reading more about that topic! http://www.mothersofchange.com/2012/02/on-bonding.html

Good for you for achieving your goal to breastfeed, despite that ALSO being a difficult road... I found that to be my greatest factor in the healing process. <3

Mama B said...

Thank you, thank you, thank you for sharing. Thank you, thank you, thank you.

melissa v. said...

@Moon Key Mama; you are MOST welcome. It is healing for me to write it out, too. =)

Amber Strocel said...

I have not had a cesarean birth, but I did have an unexpected preterm birth. Instead of what I planned for, I experienced a high risk birth, and immediately afterwards my baby was whisked away to the NICU. I can relate to a lot of what you're writing here, and I think you did a beautiful job of explaining those mixed feelings of joy and loss.

Unknown said...

Hi,

Every once in a while I google "At Least You Have a Healthy Baby" to see where the photograph I took 1 years ago might pop up next. I took the photo 7 months after my first c-section (my second child). I did try to VBAC with my daughter but did not succeed in delivering her vaginally - but the second time was MUCH different as I was in a very supportive environment and although I was tired after 24 hours of trying to birth her, I was part of the process and knew I was "safe" with my birth team around me.

Thank you for using the photo and for keeping it alive, so to speak. I am immensely gratified that it spoke to you. Congratulations on your VBACs and healing. :)

Meghan

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