PART 1 by Abigail Dixon: Emergency C-section
I found out I was pregnant in August of 2016, in our new home in a quiet Connecticut suburb. My husband was staying in the city since we were still going back and forth and had not fully moved in yet, so I was waiting to tell him until I saw him. We had been married six weeks, and were not expecting to be expecting so soon. We had not even been trying. We knew how lucky we were. Despite some hyperemesis gravidarum that lasted until thirty-two weeks, the pregnancy was uneventful. I met all of the pregnancy milestones, and my daughter measured in the fiftieth percentile the entire time. No gestational diabetes, no preeclampsia, no anatomical or genetic red flags. Everyone was perfectly healthy as we neared D Day.
In the two months between when I was stopped puking my guts up multiple times a day and the day I had my daughter, I dreamed about how labor and delivery would go. I dreamed of her being placed on my chest, all covered in gook and screaming. I dreamed of her latching right away and all three of us, our new little family, enjoying the golden hour together doing skin-to-skin and staring lovingly at each other. This dream included a vaginal delivery, with an epidural, and the thought of a C-section crossed my mind on occasion, only because I’d been born via C-section because I was breech and it was the late 80’s. But my daughter was head down so I didn’t think I would end up having a C-section. Why would I? C-sections are for breech babies, big babies, or complicated pregnancies. Not my case at all.
Then, at forty weeks and two days, at 7:45 pm, my water broke while I was peeing. It wasn’t a dramatic gush of water, just a pop followed by a small trickle of water that didn’t stop. So I did what every other mom anticipating labor does (not really, I was just feeling super calm): I called my OBGYN, hopped in the shower, shaved my legs, threw on some comfortable clothes (absorbent pad included due to fluid still trickling out), blow dried my hair (gotta look good for those photos, am I right?) and came down to make my husband a grilled cheese after his Tuesday night tennis match.
My contractions weren’t crippling or frequent so my doctor suggested I not come to the hospital until 4am or if the contractions got stronger and closer together. She suggested we get some sleep if possible. Hah, sleep. That was funny. Around 11pm my contractions started to become more painful and by 2am I decided we were going to the hospital. In the car on the way to the hospital contractions were every five minutes and pretty strong but not intolerable. When I got to the hospital, they slowed to every ten minutes or so and were not at all strong. This is where my delivery starts to turn.
The hospital OB consulted my doctor and decided to start me on Pitocin. Having been somewhat traumatized by how painful my sister said Pitocin contractions were, I requested an epidural before they gave it to me. This is also when I learned that you’re on a clock once your water breaks. You have 24 hours to deliver your baby due to risk of infection. Talk about stress! Who puts deadlines on a woman in labor?!
Four hours into the Pitocin, I hadn’t made much progress dilation-wise, so they decided to up my dosage. This is when the shit hit the fan. Within minutes of the increased dosage, my contractions definitely got stronger, but my daughter’s heart rate would drop at the peak of each contraction. Seeing this on their monitors, my OB and L&D nurse rushed in, changed my position, and waited a few contractions to see that her heart rate wouldn’t decelerate again. This worked for a little while. Then the decelerations started again. My OB figured out that it was because amniotic fluid was still leaking out and there was little left to cushion the umbilical cord against the strong Pitocin contractions.
My OB was desperate for me to have a vaginal birth, even commenting on how great a birthing pelvis I have, so as a last ditch effort, she inserted a catheter into my cervix and tried to replace the fluid being lost. This also worked for a while….then it stopped. With each contraction peaking, my daughter’s heart rate would tank. At this point, 19 hours into labor, my OB came in and told me that a baby can only tolerate so many decelerations and that for her and my safety (risk of infection due to ruptured membranes), we needed to get her out pronto.
My anxiety took over and I immediately started sobbing. I was so terrified I asked for Xanax, which you cannot have because it can sedate the baby. I was whisked away to the OR, hooked up to spinal anesthesia, and surgery began. I felt completely helpless, on top of extremely nauseated from the meds. You can hear people discussing what is happening, and cauterized flesh is not the most pleasant of aromas. I was beyond terrified, and really cold. The anesthesiologist was lovely and tried to calm me down. I was itchy from the anesthesia as well, a little talked about yet very common side effect. There was no relief from that. My husband did his best too, but you’re having surgery while awake: despite being numb, it’s not a walk in the park.
Then suddenly it felt like an elephant was sitting on my chest. I was warned this would happen as they were pulling the baby out. Then I heard her cry and I saw her little face over the curtain. The nurses took her and I sent my husband over to be with her. She needed him now, not me. This was one of the most confusing points of the entire experience. I was overjoyed that my daughter and I were both safe, and that she was absolutely perfect, but I felt so guilty about her abrupt entrance into the world. She would be an hour without her mother, the only familiar scent and sensation she had at that point. That golden hour I had so badly wanted to experience with her and my husband was gone.
In recovery, about an hour after she made her entrance into the world, I got to hold my sweet, perfect, and hungry baby girl. I put her on the boob to nurse, but I couldn’t feel anything. I was still so numb, and would remain so for another twelve hours. When she finally came off, my nipples were bleeding and badly abraded. I couldn’t feel her improper latch, which made learning to breastfeed even harder as I had to wear shields for the first few weeks to allow the tissue to heal. There was another dream dashed.
Those twelve hours following the C-Section were blurry but difficult. I couldn’t get up to pick my baby up from the bassinet. I could barely adjust myself in the bed to nurse her. I was in so much pain with the incision and my nipples that I begged the nurses for extra pain medicine. Once the anesthesia fully wore off, catheter was out, my pain was controlled, and I was allowed to walk around, the guilt and shame set in big time. Did I scar my child by not delivering her vaginally? Did I ruin our chance at bonding? Why did my body not do what it was “supposed” to do? Did I even give birth? Did I take the easy way out? Was her gut flora going to be healthy despite not passing through the birth canal? (Yes, I really thought this; I’m a science nerd!) Would I be able to nurse her and have those special moments with her? Was this my fault?
For many moms, me included, the shame, guilt, and anxiety following an unexpected C-section are very, very real and painful. Maybe even more so than the incision itself. A week after delivery, around 1am, I would wake up from a dead sleep shaking and nauseated. When it happened several nights in a row, I knew this was my body’s way of telling me I need to talk to someone about the anxiety, guilt, and shame and get it under control. Thankfully, my supportive husband, sisters, and amazing mom friends were there. But as a therapist myself, I knew I needed professional care. I sought it out and the validation and perspective shift that my therapist offered were priceless.
We are now on the other side of all of this, and I am so grateful today for the health and well being of both my daughter and myself. I’m grateful to my OB who tried to make the experience as positive as possible and for doing everything in her power to give me the delivery I had dreamed of. This was not an easy place to get to, and I resented my body for a long time for not doing its job. But mothers are strong and fierce, and with the courage to ask for help, and a shift in perspective (which is not easy and takes time!), we can take the sting of things not having gone the way they were “supposed” to go. We can learn that the experience that was taken away by unforeseen circumstances, though it can’t be replaced, can be soothed with love, care, and lots of grace given. You’re a mom, and nothing will take that away from you. Ever.
Clearly, this was an unexpected turn of events, and not the way any mom dreams of having her baby come into the world. However, I learned some tips and tricks to help me and other mamas cope and prepare in the case of a future C-Section:
- I’m going to put this in all caps because it’s that important. REMEMBER THAT YOU ARE A MOTHER NO MATTER HOW YOU DELIVERED. NO, YOU DIDN’T TAKE THE EASY WAY OUT. YES, YOU DID GIVE BIRTH AND HAVING A C-SECTION DOES NOT MAKE YOU LESS OF A MOM THAN SOMEONE WHO HAD A VAGINAL DELIVERY!
Fed is best! If you do plan on breastfeeding and end up needing an urgent or emergency C-section, have a nurse watch the latch since you may be numb and don’t want to end up with shorn nipples from an improper latch right from the get go. If you don’t get the hang of nursing right away due to numbness or pain, it’s ok to hand express into a cup or give some formula, whatever you are comfortable with. Don’t forget baby’s tummy is tiny in the beginning!
Give yourself grace. You won’t be able to do much for baby in the first few days. You just had MAJOR surgery. Let your partner, family member, nurse, or doula help you. Let someone take care of you so you can care for baby.
This one is easier said than done, but it made a world of difference for me. Try to reflect on the fact that most doctors have yours and your baby’s best interest at heart. They did whatever they could to get you both through labor and delivery safely.
Post C-Section, drink lots of water and, for Pete’s sake, take the Colace. That first post surgery poop is terrifying, and you can’t go home until you do it but you think your incision will bust wide open! Mine was a breeze thanks to water, Colace, and walking around the maternity ward while trying to calm my incessantly screaming newborn.
Go to physical therapy. Your abdominal muscles are severed during surgery, and feeling connected to your core will make you feel more human and allow you the physical ability to play with, and eventually chase after, your bundle of joy!
Talk. Talk to your friends. Talk to your partner. Talk to your sisters and brothers and moms and dads. Talk to someone you trust. Talk to a therapist. Talk to me, I’m here to listen. Allow yourself to mourn the experience you didn’t get to have, get real about what happened in great detail, but also look towards moving forward with gratitude and love for your body and your new baby. Your body did an incredible thing, growing and bringing safely into the world this amazing new tiny human. You deserve to acknowledge yourself, your courage, and your strength and to be validated in your feelings. Bring to light the lows and work through them, because there are so many highs to experience in parenthood.
PART 2 by Stacy Hutton: Emergency C-Section/Postpartum PTSD
After 21 hours of labor, a nurse quickly walks into my room and asks me to turn onto my side and shoves a peanut ball in between my legs. A few minutes go by and she hits the call button on my bed yelling “We have a d-cel!” (Deceleration: Dip in fetal heart rate) Within 60 seconds my room had 15 medical professionals – techs, nurses, my midwife and my OB. Two nurses and my midwife are helping get me onto all fours, which was not happening because of my epidural. As they are trying to help me back onto the bed, I suddenly have a young man in my face barking “Stacy, do you consent to an emergency C-Section?” I was so confused because no one was explaining to me what was happening. No one told me what a “D-Cel” meant. No one told me why they were changing my position. No one told me that my baby’s heart rate was dropping. All I knew was that everything was fine until it wasn’t.
You know how in a movie when someone is being rushed through the hospital and they always do a quick shot of the ceiling and lights blurring by above you? Well that’s exactly what I saw as I was being rushed into an OR.
When it came to my Birth Plan, I naively joked that Plan A was “all the drugs” and Plan B was a C-Section. I was told by my birthing coach that 30% of women require C-Sections, but that number dramatically drops to less than 10% for women who have done some form of birth education. This number drops because women are properly educated on different techniques and positions to help baby descend into the birth canal as opposed to laboring in bed slowing down the process. With this knowledge in mind, I never properly prepared and planned for the possibility of a C-Section. I did not know what I was in for.
I had a perfect vision of how my birth would happen – I saw my baby being placed onto my chest immediately, gazing down at him and soaking up that beautiful moment of skin-to-skin and instant bonding. In reality, my son was not placed into my arms until they were rolling me out of the operating room and I just remember crying. I wasn’t crying because I had this beautiful baby boy in my arms, I was crying because my arms were so numb from all the drugs and I was struggling to hold him. This was not the magical bonding experience I had read about.
My extended stay in the hospital was a blur of nurses, midwives, doctors, lactation consultants and visitors. There were so many other things to focus on and distract me from truly focusing on my experience and what had happened. Once I got home, however, it all changed. The revolving door of people had gone away and I was suddenly left with the feeling of “What just happened?” This question running over and over again through my mind coupled with sleepless nights, breastfeeding issues, and weeks of healing left me feeling bewildered and in a haze.
As you prepare for the birth of your baby you hear about “the baby blues” and Postpartum Depression/Anxiety, but no one discusses the emotional healing that can be necessary from a C-Section. I had no idea that Post-Traumatic Stress Disorder could be a thing when it came to birth, but Postpartum PTSD affects about 9% of women following childbirth. I found myself avoiding anything that triggered memories of my birth, I was irritable, jumpy and I was experiencing anxiety.
I was lucky enough to have a pair of post-partum doulas help me after my birth. The wonderful thing about a doula versus a baby nurse is that their job isn’t just to take care of the baby, but they also focus on the mother and her needs. They were able to help me understand what I was going through and to let me know that I was not alone, that everything I was feeling was normal and that it may be beneficial to speak to a medical professional about what I was feeling.
Have A Plan
I highly recommend sitting down with your partner, doing the research and going through the multitude of scenarios that could happen during labor and how you would confront each one. By doing so, knowing how you plan to handle different situations makes them less scary if/when they come up. For example, if you have to have a C-Section, emergency or not, do the research and know what you want. Hospitals do allow skin-to-skin in the OR.
Create a support system to help you. Doulas, baby nurses, and nannies are of course helpful, but if you cannot afford one of those services lean on your spouse/partner, family and/or friends. You have just had major abdominal surgery and you need to properly heal as much for you as for your baby.
Do Not Be Afraid To Ask For Help
I know it is cliché, and everyone says it, but it is SO TRUE! If you feel you need to speak with a professional, there is absolutely NO shame in that! When you’re on an airplane, they tell you to put your oxygen mask on before helping others around you. The same goes for being a mother, taking care of you is what’s best for your baby. Your OBGYN or your Primary Care Physician are helpful resources and can refer you to someone who will specialize in what you need and will be in-network if that is something you require.
It is Temporary and Treatable
Postpartum PTSD is temporary and treatable with professional help. If you feel you may be suffering from this illness, know that it is not your fault and you are not to blame. Reach out.