Wednesday, December 4, 2013

More Than A Scar

       Crisis [krahy-sis]
1.       A stage in a sequence of events at which the trend of all future events, especially for better or for worse, is determined; turning point.
2.       A condition of instability or danger, as in social, economic, political, or international affairs, leading to a decisive change.
3.       A dramatic emotional or circumstantial upheaval in a person’s life.

I was 37 weeks pregnant, sitting on the white, crunchy paper of a doctor’s office table, when my obstetrician informed me that I was very tiny and the fetus I was carrying was measuring large; “we should just schedule a c-section” he said. Something in me knew that was not the appropriate response and I declined, requesting I be allowed to try and birth my child naturally. Reluctantly, this man I entrusted with my care agreed as long as I “progressed fast enough.”

I was 40 weeks pregnant, sitting on the white, crunchy paper of a doctor’s office table, when my obstetrician reminded me that I was very tiny and the fetus I was carrying was measuring large. At this point, I scheduled my induction. Little did I know, ACOG does not support induction or routine cesarean section for a suspected big baby.

I was 40+3 weeks pregnant in a hospital bed, receiving Cervadil. A few hours later it was apparent that either my child was ready for his birthday or the Cervadil was all I was going to need. It was around 2am, Feb 6, 2007 and my labor had begun. I slept through most of early labor and a nurse came in at 7am because “it was time” for the Pitocin drip to begin. I didn’t want it, I was beginning labor on my own but “I had to” have it. It was started and then quickly stopped due to decels in fetal heart tones. I labored naturally on my own, frequently interrupted by “required” vaginal exams to ensure I was “progressing fast enough.”

It was Feb 6, 2007 at 2 o’clock in the afternoon, I was 7 centimeters dilated, my water had spontaneously ruptured about an hour ago, fetal heart tones were reading great, maternal blood pressure was spot on but twelve hours was long enough according to the obstetrician I had entrusted with my care. A cesarean section was ordered for “failure to progress” and approximately 1.5 hours later, my child was cut out of my body. I gave my child a kiss and we were separated, the rest of the operation details don’t matter much. He was 7lbs, 2oz, 20 in long and his head was 14 ¾ in diameter.  At my late ultrasounds, the doctor had estimated my baby to be around ten pounds but “Wow, what a big head. He wouldn’t have fit anyway,” was the explanation without apology from my obstetrician.

A mother seeking a TOLAC, (trial of labor after cesarean), in a rural town is very limited. At the hhosptal in my town an RCS, or routine cesarean section, is scheduled for mothers with prior cesareans. For my second birth I sought care from a group of midwives in the city and planned my birth place to be a hospital; not my first choice but one of the few options I had because of my prior cesarean. I was 37 weeks pregnant, moderately dissatisfied with my choice of care providers, sitting on the white, crunchy paper of a doctor’s office table. My midwife informed me my fetus was breech, I would “have to” have a cesarean. I found a new care provider. My crisis taught me that this is my body, my baby and my birth.

My crisis taught me that I shouldn’t trust another with my care; I had to be responsible for the decisions made. My crisis taught me to follow my heart. My crisis taught me that what one person says is not always correct. Little did I know how profound that statement was to become.

I was 41+6 weeks pregnant, it was a little after midnight and fear overwhelmed me; fear that if I didn’t “push fast enough” this opportunity, this right, and this birth, would be taken away from me. Three pushes later, my son was born, measuring in at 8lbs, 6oz, 19 in long with a head that was 14 ¾ in diameter. My prenatal challenges shaped who I was becoming as a mother but these numbers impacted the realization of my crisis on a deeply emotional level; realizing how much I had been lied to during my first pregnancy. The cut of my first birth may have been the actual event of a crisis but it was at this moment that it became such.  It was at this moment my life changed.

As the weeks unfolded I bonded with my VBAC baby like I have never done with my first child. It was during these moments I began to feel the emotional impact and realize my first birth experience was a crisis. It had always angered me, it had been a frustration during my second pregnancy but now, it hurt me. The cut of my cesarean cut more than just my body, it cut my soul.
-- Anonymous  

The cesarean rate in America is 32%. The World Health Organization recommends less than 15% to be appropriate.  With these numbers in mind, it's no surprise that so many mothers have suffered from birth trauma from a cesarean. If this is you, I encourage you to process your past birth experience(s). Find a local ICAN Chapter, take a birth after cesarean workshop, attend a group counseling session where you can share your experience(s), hopes and fears, and be showered with love, compassion and support. Some mothers may benefit from seeking a therapist trained in EMDR, (eye movement desensitization and reprocessing). All mothers will likely benefit from a doula.
Not all mothers feel traumatized by their cesarean but most view it as a crisis that challenges them to this day. Use this challenge to support those around you; use it to improve birth. Because when you know better, you do better. Find evidence based information; know and understand your options and make informed decisions, encouraging those around you to do the same. 
If a mother feels empowered in her birth experience, no matter the type of birth it is, she is less likely to suffer emotionally. Birth shapes the type of mothers we become, the relationships we have with our partners, our children and those around us.  A cesarean affects a mother emotionally, physically and medically for the rest of her life.

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Jennifer Valencia | Labor & Postpartum Doula | 928.300.1337


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