Tuesday, March 11, 2008

c-section reflection

I have always wondered in retrospect if there was anything we could have done to prevent the c-section I had when Daniel was born. At the time, we felt we'd done all we could, but time gives a thinking woman plenty of time to ... well ... think. I've spent many hours looking up what went wrong, querying other people about things like asynclitic head positions and stubborn cervical lips that refuse to dilate completely. At first, in the months after Daniel was born, I lay awake in bed tearfully regaling Steve with my feelings of anger and regret and doubts. I'm mostly over the anger and regret now, but the doubts are still there. Just this morning, the midwife asked me about the part of my cervix that wouldn't dilate to a full 10 centimeters: "Did they try smoothing it back while having you try to push?" "No," I said. "I was never aware that was an option." She quickly assured me that it doesn't always work, then changed the subject, but there it was — another piece of ammunition to make me think I might have had an unnecessary c-section. And with the national c-section rate at over 30 percent (compared to the 15 percent recommended by the World Health Organization), it's quite possible.

So now I'm preparing for what is commonly known as a VBAC (which stands for "vaginal birth after caesarian" and is pronounced VEE-back). And I'm understandably nervous. I want so much to be able to let go and put it all in God's hands and the hands of my caregivers, but I'm nervous about laboring with this bad hip, and I'm nervous that what happened last time might happen again. Any number of things: The cocked head and stubborn cervix. The added stress of a hospital environment and the things I'm required to do according to protocol. Today I asked the midwife if I could decline having an IV port put into my hand until it became absolutely necessary, and she said it's something they insist upon with all VBAC patients. "I can't decline it?" I asked. "You can decline it, but we can then decline to keep seeing you as a patient," she said. And this is from a midwife in the most VBAC-friendly clinic in the area, one I chose solely — despite the half-hour drive to get there — because I knew I had the best chance of successfully having this baby the way I want to.

Last night (which happened to be the day I hit 37 weeks — full-term, baby!), I went to a meeting of the local branch of the International Caesarean Awareness Network to see if I could find some support and more information about what's ahead. I felt like I didn't really fit in, though. I sat in a circle of about a dozen rather earthy mamas, all of whom were bound by nothing but a scar across their lower bellies and the accompanying story of anger and regret. In a way, it was comforting to hear other women talk so openly about their c-sections, and it was inspiring to hear stories of successful VBACS. But at one level, it felt really wierd — some of the women seemed so angry, like they had never managed let go of the bad energy surrounding their c-section births. (And I have to say, Daniel's birth itself was not a negative experience for me; it was actually joyful.) I mean, here's a group that meets monthly to dwell on this particular part of their identity as mothers. Maybe it feels empowering to them. Some of them certainly seem to have embraced the "joy of childbirth" rather fiercely, so good for them. But I wondered, don't any of them get sick of it and decide to move on? Regardless of my feelings about my c-section, it takes up relatively little space in my psyche compared to the energy I give to actually parenting Daniel these days. And I like it that way.

Some of them seemed really strident in their attitudes toward hospitals, and when I shared some of my feelings about my baby's upcoming birth, they were pushing me to places I didn't want to go. "Go in armed with your research," I was told. "Learn these words: I do not consent," said one woman. "Well," I said hesitantly, feeling like I was coming across as an idiot, "I don't want to be that difficult person. I don't want to be so adversarial that I put off the very people who are supposed to be helping me." Well, several of them rolled their eyes, and I could see them biting back the words they really wanted to say. But it's true. Even though I have strong desires for how I hope this birth will go, I'm not, at heart, an adversarial activist. And I especially don't want to be one on a day when I need to focus entirely on myself. I just want to know that I am in good hands (like Steve's and the doula's and the midwife's and God's) and to let go of my need to control things. Kind of like on my wedding day. I did a lot of planning and organizing ahead of time so that everything could fall into place on the day, allowing me to glide along in my altered state and not worry about anything. Not worry. And I don't want to worry on the day the Lemmondrop is born, either, even though I'm doing a lot of it now.

So I don't think I'll be going back to the ICAN meetings, even though I did find some comfort in some of the women's VBAC birth stories and appreciated the chance to ask some questions. I just don't think this is a place within myself where I want to dwell on such a regular basis. I do hope the Lemmondrop's birth goes smoothly, and if I end up with another c-section, I'm sure there will be some more tearful nights, and I'll have to deal with that. I keep reminding myself to let go, to put this in God's hands — something that doesn't always come easily to me. Ultimately, what's important to me is to be a good mother, and to be healthy. And whatever happens in three weeks (give or take), most of all, I just want to have a healthy baby.

10 comments:

LutherLiz said...

I certainly hope it goes well for you the second time around. And can I just say, I think it is refreshing to be able to get upset about something and still not be "millitant" about it. I don't know if you can ever know that the c-section was the right decision, but I do think it is important not to immediately dismiss the doctors as trying to do the right thing in the situation. Still, what do I know ahving no experience with it myself. Good luck!

Barbara said...

Wow, Emilie, I had no idea there were so many heavy emotions--so much anger and regret--surrounding the c-section experience for women, especially when the result is a healthy baby. It seems to me that some of those women at the group were a little rough on you, especially when you were just being honest about your feelings.

Obviously I have no advice to give since I know next to nothing about childbirth but it sounds to me as though you and Steve have a very balanced attitude about the whole VBAC experience--what to expect and how to handle it. And you know that you and the wee one will have a gazillion people holding you in prayer throughout!

Monkeymama said...

It has to be difficult to research your VBAC options without running into a lot of heated attitudes, which I would think would dredge up any frustration or anger left.

"The Business of Being Born" takes a very harsh, critical view of c-sections and hearing some of it made me cringe in thinking how it would come across to a woman who had to have one. It is a difficult subject when "medical necessity" is so vague.

I hope that this little one's birth goes smoothly, that you feel respected by your care providers, and that you can trust your midwife enough so that it is a peaceful experience.

Anonymous said...

Emilie, I'm sorry they dismissed your request not to have the IV put in "in advance." I suppose a person could be grateful for the straight-forward reply, but it would be nicer to have the request honored. Stick with your guns, and be gentle with yourself and with them. Your gentleness is a strength that people who can only get things aggressively can NEVER understand. Ask your midwife again-- maybe she was in a bad mood that day. Maybe she'd have a more satisfying answer the second time.(Laura S)

Marketing Mama said...

Em- I think it's great that you've been doing research and that you attended that meeting. I had no idea such a group existed. Best wishes to you...

Ahuva Batya said...

Em, it has been a real education for me, to read your thoughts and feelings about your c-secion. I did not know it had caused you so much regret; I knew it was not what you preferred, but I think you are so strong to address how you feel. I agree with Liz, it is so refreshing to hear someone who can contain their feelings within reasonable scope without becoming militant. Those women are not for you, and I think you should stay away from their negative energy. I am wishing all the best for your birth of baby Lemmondrop.

Ellen said...

Your words at that group must have been like sunlight hitting a murky pond. As frustrating as it must have been to see the women in that group respond to your feelings in such a negative way, it sounds like they needed to hear a different perspective whether they like it or not. Good for you!

Soupy said...

Wow. Emilie. I have to say thank you for writing this. Having gone thru pretty much the same experience as you w/Keifer, I am in awe that you attended the group and sat thru the meeting and I'm proud that you asked the questions you did. I'm looking forward to hearing every detail (so journel it, hee hee) when you go into labor again, as I am very anxious to hear about how things go.
I am praying for nothing but the best for you and the birth of Lemmondrop #2, I'm so excited for you and S. and D.!
Hugss and love from the southern Metro area..........

mo*reezy said...

Over and over again I'm discovering and coming out dismayed at just how dang militant women are about personal birth and parenting choices and how nasty and unsupportive they've become to other women. I'm not sure where on earth we learned that "our way" is synonymous with "the right way for everyone." Each parent has the right to make personal choices and do what works for their family. How about women just celebrate birth, and each other, and leave each other with kind wishes and support, even when others make choices (or find ourselves in a birth situation requiring a choice) we wouldn't necessarily have made?

info said...

Hey there! Just wanted to send you loads of positive energy! I had an incredible VBAC at home almost 4 months ago! If you like to read birth stories, mine is available at www.vbacfacts.com/hbacbirth. I do think it's a little harder to have a VBAC in the hospital due to all their protocals and 'requirements,' which interfers with the normal course of birth, BUT women do it. Best of luck!
Jen