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Monday, April 4, 2011

Another cesarean? This time, I'm doing it my way

It's been almost ten days since my youngest turned two. On his birthday, I thought back to where I was - and how much of my birth story I still find triumphant, some parts completely dissatisfying and frustrating. From the time he was probably less than twelve hours old, the seed was already planted in my mind: I wanted another baby.

But was it for a do-over? Was it for the right reasons?

I still think what I thunk before: I want another baby. And I must resign myself, if I ever get to that point, that I might have to have another cesarean.

The moments leading up to and following my son's birth still leave me frustrated with myself and completely hollow inside: I felt no joy when I first saw him. I only realized later that an adverse reaction to the anti-nausea meds they had given me prior were what made me feel like I was having a panic attack, a feeling of intense anxiety and a weight pushing down on my chest. The only thing I could do was thrash my head back and forth, since I was numb from the chest down. No one noticed; I asked my husband later if he remembers me doing that, and he said no.

I resigned myself to the idea that if I had another cesarean, I would want it done my way. More attention paid to me as the mother, rather than standing over me having a conversation that didn't even pertain to me. Somehow making me feel like more of a participant, instead of just lying there like a dead fish. Perhaps asking me if I wanted to see my baby being born, or at least be able to hold him immediately following the surgery. Keep him in the room with me as they're cleaning him up, where I can see him, instead of in another room where I can only hear and just imagine what is going on. And the ability to hold him skin-to-skin, and nurse as soon as possible, with no immediate separation for newborn testing.

It's sad that you even have to ask for such things to happen, rather instead putting up with things like having your baby immediately whisked away because it's a matter of course, rather than something really being wrong. I've heard many expressions of "You've waited this long to see your baby, you can wait another couple of hours." The immediate hours after my first cesarean were such a blur that I don't even remember where my son was most of the time, and their idea of separating us so "I could rest" is the biggest bunch of bullshit I've ever heard. A half-attentive nurse was popping in and out over the course of several hours to check my beeping IV, which she had inserted improperly, causing that very important post-surgery pain medication to actually leach into my tissues, instead of into my veins. Nurses didn't believe me or even take notice when I said it hurt just as badly to inject myself with pain meds, and actually told me I couldn't have any more because I'd already gone past my ten-dose-per-hour limit. Not, "Are you still in that much pain?" or "Let's see if there's something wrong."

Ironically my VBAC in the same hospital three years later was a totally different experience. I had no epidural, so was able to walk around and move freely, and felt great. My labor was pretty short upon arriving at the hospital, and I was in a post-partum room with a matter of hours. The nurse brought me my food (they told me after the first baby that I was responsible for getting my own, after just having had major abdominal surgery). I was puzzled, but am still curious why I got better treatment after a vaginal birth than I did a cesarean. I decided before my third was born that I would never give birth in that hospital again.

Not that long ago, a friend shared her link with me on "Gentle Cesareans." Curious, I realized it was basically a "Cesarean, My Way" plan, that involves the mother more in the birth process and makes it feel more like a normal birth. (I hesitate to call this "natural," because, after all, if surgical birth were truly natural we'd all be born with zippers on our abdomens in addition to a perfectly working vagina, in my opinion.)

Like this article, I ask many of the same questions: Why do our arms need to be strapped down? Why are we so shielded from ourselves, and why aren't we asked - which I never was - whether we wanted to watch our baby being born?

Taking my history into account, if I should become pregnant again I'll have to consider my options carefully: I've had two cesareans, a history of late-onset PIH, and two prior breech presentations. I know that decision might come sooner rather than later, if the baby is breech - either I find a care provider who will deliver me anyway, or I consent to another cesarean, this time on my own terms:

I want to see my child being born.

I want my child to be cleaned, weighed and measured where I can see. (My first wasn't even in the room with me while this was happening.)

I want the baby to be handed to me immediately, and as much skin-to-contact as soon as possible.

I want the baby to be with me, or nearby, if I can't hold him, at all times.

British obstetrician Nick Fisk "pioneered" this "groundbreaking approach to surgical delivery," in an age where many doctors are clinically-minded and all about speedy deliveries. In a case of distress, that is obviously of the utmost importance - but in a scheduled delivery? And why do you have to ask specifically for this type of delivery - why isn't it done, whenever possible, to give the mom the very best birth experience possible? (And perhaps by acknowledging the "gentle cesarean" are they essentially saying that there is more to the birth experience than just a healthy baby?)

As Fisk started to examine the conventions of surgical delivery, he was struck by how easily they could be challenged. Why, for example, did they need to be done so quickly, when slowing them down would give the parents more chance to participate in their child's delivery and might give the baby a gentler experience of coming into the world? Why, too, was it so important for the parents to be screened off from the mother's abdomen? And was it really essential for the baby to be whisked off for an immediate medical examination, rather than delivered into the arms of his mother?
What I want to know is, what took them so long?


L said...

Thank you. Your post just made me cry- it brought back many memories of my son's birth in 2008 (some I've tried to forget)-but I could have almost wrote this post. I had the same feelings of a bit of a panic attack. I also hated that as soon as my son disappeared from the room an even greater fear and panic set in- the fear that someone (perhaps my mother in law) would get to hold my baby before me! Silly I know. And that's the about the last thing I remember- it's so foggy holding my son for a minute when I got back to my room, then I passed out until morning. =( Even though I had an amazing experience with my vbac last May, nothing can take away that experience- which honestly I try to keep telling myself wasn't "that bad." But, perhaps I need to accept that it was and try to move through my feelings, instead of ignoring them. Thank you.

The Deranged Housewife said...

((hugs)) I'm so glad I was able to help you in some way - that is my greatest hope with this blog! :)

I too had a VBAC in 2006, and am so glad I did. While there were certain things about it that I wish I could change, it is still *my* birth and I am glad I did it that way. It also transformed me into the birth advocate that I am, by forcing me to reexamine my feelings about birth and challenge supposedly conventional "wisdom." I have met so many wonderful people along the way!