Previous post here.
When I was six months pregnant, I stepped out of the shower one day and caught a glimpse of myself in a full-length mirror. Looking at my bulbous belly, I realized then and there that the only way my daughter – I already knew the baby was female – could be born was by caesarean section. I went into labour naturally three months later. After 36 hours of futile pushing, however, I found myself strapped to an operating table as a team of doctors cut my little girl out of my abdomen. (I was conscious during the surgery.)
My caesarean was necessary. The baby was too big; I was too small; and without medical intervention, both she and I would likely have died. That knowledge didn’t necessarily make recovery any easier: I distinctly remember my bandaged belly aching whenever I laughed and my stitches moved. Three days afterwards when a nurse took off my bandages and stitches, an angry red mark greeted me where I’d literally been sliced and diced.
The next few weeks were a blur of breastfeeding, diaper changing, setting up my computer so that I could work at home, and touching base once again with friends and colleagues. I didn’t reflect in any great depth on how my daughter was born. But then one morning in July (about two months after the birth), it seemed to all come back to me, almost out of the blue. On one hand, I wasn’t particularly surprised at having had to give birth abdominally. I was almost 39 when my daughter was born, and older first-time mothers are at greater risk of delivery complications. My three sisters all had their children by caesarean for the same reason I did: baby too large, mother too small (in medical terms, cephalopelvic disproportion). Add the fact that I’m fairly narrow in the pelvis, and I knew even before seeing my bulging belly in the mirror that my chances of being sectioned were fairly high. Nonetheless, it was a bit disconcerting to contemplate the fact that without modern medical technology, I would most likely be dead now. In a sense, my body had failed me.
Since that July morning, I’ve read a great deal about other women’s reactions to having a caesarean section. At one end of the spectrum, some mothers feel cheated of a ‘real’ birth experience by not being able to deliver vaginally. Other women in contrast specifically request a caesarean even without medical indication because they do not want to go through what they view as the pain of a so-called normal birth (famous example: Britney Spears). I admit that during the last weeks of my pregnancy, I briefly toyed with the idea of asking my obstetrician to give me a c-section because I didn’t exactly relish the thought of suffering through labour. Then I had the fantasy of labouring without a hitch and triumphantly expelling the baby in one or two big pushes. I did indeed go through labour – and ended up with major surgery and a cut belly nonetheless.
This May 8, that will be six years ago. The angry red mark that awaited me when my bandages were removed is now a small white line along my abdomen. It’s fairly inconspicuous, but it is visible. As one of my nieces said, ‘Aunt Emilia had a crack on her tummy.’ It’s really the only tangible bodily sign that I actually gave birth: I don’t have stretch marks; my breasts haven’t changed at all despite nursing my daughter for over two years; and all my pregnancy weight was gone in two months.
As with the operation itself, women’s feelings about their caesarean scars vary from person to person. One woman interviewed in a 1980s book on pregnancy and childbirth felt inconvenienced by her scar because she, in her own words, had a thing for ‘bikinis and such.’ On the other hand, a second woman who had undergone a c-section said she looked on her scar as a badge. My own feelings about my scar are more like those of the latter woman. I remember a discussion with an ex-boyfriend (not my daughter’s father) where he told me that if I had a caesarean, I’d always have to wear a one-piece bathing suit because otherwise everyone would see the mark on my belly. ‘Oh, but you’d probably be proud of your scar,’ he added immediately afterwards.
I am proud of my scar. I don’t feel I have to hide it if I go to the beach, for example. And any sense of failure I might have at not being able to give birth ‘normally’ has long dissipated. I am also aware that if I ever get pregnant again (a very unlikely occurrence, for lack of both desire and – at 44 – ability), I will in all probability need another caesarean. A VBAC (vaginal birth after caesarean) would not likely be in the cards for me if I ever found myself ‘with child’ now.
Six years later, my caesarean section seems less of a ‘major surgery’ than simply the way that my daughter came into the world. So in that way, my scar and the operation that led to my daughter’s birth seem worth celebrating.
I agree well said. I had the same experience you did, for the same reasons, with the exception that I was a scheduled c-section because of your reasons. I was originally far more terrified of surgery than of natural childbirth, but once that was the way it was going to go, I accepted it and came to terms with it. Being that my very first pregnancy ended in a very bad (and natural) miscarriage, my end-game was to have a healthy baby and a healthy mama. If surgery was the way to get that, then so be it. My childbirth experience was literally one of the best experiences of my life. It went to well in fact, that when I went on to have another daughter 2 years later with another surgery, I was scared because I thought for sure that, being it had gone so perfectly the first time, that something was bound to go wrong the second time around – but no, it too was an excellent (even though my 2nd had to spend some time in the NICU) experience as well. I sometimes think that maybe I would have liked to have had the experience of giving birth naturally, so that I can say I am one of the great warriors who pushed their babies out through the pain, etc, but the pain I experienced after surgery – which lasted days and days – was enough for me to know I’d done my part. Whether the pain is in the pushing or in the being cut open, we all do what is best for our babies to be born healthy, and no one should have to be made to feel “less than” because of it. Thank you for sharing – I haven’t thought about this in a while before your story was posted…
Thank you so much, Heather, for responding to my article. Again, the chance of me having another baby is not very high – and even if I can still conceive, at 44 I wouldn’t want to be faced with the choice of either an abortion or a child with Down Syndrome or another chromosomal anomaly (I am pro-choice, but abortion is a choice I would rather not make myself). But if I did get pregnant again, I am fairly sure I would have another caesarean. This time, though, it would be planned rather than done by emergency.
I just wanted to thank you so much for your thoughtful post about your caesarean. I had a surgery similar to a caesarean several years ago to remove a benign but troublesome growth (a fibroid) and I was told that any births would have to be caesareans in the future. Sometimes when I look through the caesarean section of this website I become discouraged; many women seem embarrassed of their scars and some have expressed a sense of failure at not being able to give birth “naturally.” It never occurred to me to think of a caesarean as a sign of my failure. It is a relief to have your body-positive message posted for others to see. Our bodies are no less strong, feminine, beautiful, or capable simply because we give birth by caesarean. Nor is our identity as a mother, sister, wife, friend, etc., constituted by our body. Thank you again for taking the time to share your story!
Thank you for your comment. I too have fibroids – I ‘started’ with one about eight years before I conceived, and by the time the doctors opened my belly, I apparently had a ‘multifibrous’ uterus. I am not sure that having fibroids contributed to my cesarean – as far as I know, my three sisters don’t have fibroids, and they’ve all had to have cesareans.
You might wish to consult with doctors about needing to have a cesarean for any future children. There might be some who would be open to ‘monitoring’ you so that you could have a vaginal birth if you desire (I would only really stress that whatever you decide, you should give birth in hospital, not at home; I’m not against home birth per se, but if you’re at high risk, you might do better to choose a hospital).
Homebirth midwives do not take high-risk cases, but VBAC alone is not considered a rick factor. I know many mamas who have had wonderful VBAC’s at home. Other risk factors may risk a mama out of a homebirth, though. Midwives are very good at knowing what is and isn’t safe at home. :)
I’m not an expert, so don’t take my word as Gospel, but maybe if Lisa has had uterine surgery, she should monitored more closely than average during the birth process if she chooses to have a vaginal delivery. Also, it’s possible to have a midwife at a hospital. Here in Ontario, Canada where I live there are midwives who work in hospitals. Unfortunately, there are not enough of them (midwives, that is). But she should talk to an OB or gynecologist for a second opinion if she is seriously considering a vaginal birth.
My entire point is that home birth midwives don’t take high-risk mamas. So if she is high risk, she won’t have a home birth. But since I don’t know her medical history or personal inclinations, I’m leaving it up to her and her health care professional to decide.
I don’t know anything about how fibroids play into the picture. But I do know that VBAC alone isn’t a reason to not have a home birth. She can research the option if she feels drawn to giving birth at home.
And if she doesn’t, that’s fine, too. I am not trying to push anyone into a home birth, but I just want to clarify here for future readers who may come along and read these comments. :)
Also, to clarify, home birth midwives can and often do monitor the birth process and watch for many of the same signs hospitals watch for. They know how to transfer a mama before things become too dangerous. Home birth is also based in science and midwives do a very good job of making sure their mamas and babies are safe every step of the way.
To Bonnie, out of curiosity, are you American or Canadian? I hear the midwifery system is a bit different ‘down there’ in the US.
Thanks for your responses, Bonnie & Emilia! I had a couple of OBGYNs tell me that a vaginal birth should not be in the cards for me after my myomectomy — my fiance (also a doctor, though not an OBGYN) seemed to think a VBAC would be a bad idea although we had only just started dating at the time so he really didn’t know too many of the details of my uterine status ;). It wasn’t the proclivity for fibroids as much as the surgery…the physicians thought it might leave me prone to a uterine rupture if I attempted VBAC. That’s been a while, though, so you both bring up the good point that I should see if my options are still the same once we try to conceive. I am a MAJOR worrier, so I will be trying to minimize the risk as much as possible! If baby and I are healthy post-birth I will consider myself eternally blessed!
American. So, yes, I speak for my understanding of how it works here in the US.
In this sense, though, how is midwifery different in Canada? I would think that a midwife would be able to determine if home birth was a safe option for a woman under any medical system?
In Canada, our midwives are trained in a four-year university course. They are permitted to attend home birth, but under strict conditions. For example, I believe that women with multiple births are strongly advised to give birth in hospital, even if they most likely can have a midwife there. Therefore a woman with Lisa’s condition might be advised against having a home birth.
Lisa, you might ask a couple of ObGyns about your chances for a vaginal birth to get a second opinion. I suspect that he/she would advise you to give birth in hospital, however.
I’ve said this several times already. But I will say it again, I guess. Midwives do not take high-risk cases for home births. They don’t allow high-risk mamas to give birth at home. High-risk mamas are risked out of home births and referred to OB’s.
I’m not speaking directly about Lisa’s health because I am not a medical professional and I am not HER health care provider. Yet, you seem to be making medical decisions for her.
I’m not pushing home birth. I’m dispelling the myth that home birth midwives would care for a high-risk mama. Cause they wouldn’t. Not only do they want what’s best for the mama and baby, but they’d also ruin their own careers by making unsafe choices.
High risk women do not give birth at home because home birth midwives would not oversee such a birth.
By ‘home birth midwives,’ do you mean Certified Professional Midwives or Certified Nurse Midwives?
Does it matter? Neither will take a high-risk client. In the US only CNM’s can attend births in a hospital, but either can and sometimes do attend births at home. It really varies from area to area depending on local laws and attitude to home birth. When I say a home birth midwife, I mean one that attends births at home, not in a hospital or a birthing center.
But, I ask again, what does it matter? If they don’t take high-risk clients, they don’t take high-risk clients.
You are pushing the issue as though you are aware of certain cases of high-risk mothers delivering at home. I’m sure this happens from time to time. For one thing, your definition of high-risk may not be the same as another woman’s. And that is OK. Each woman has the right to do her own research and make the choice she feels is best for her family. Other people do not have to agree. In fact, I would argue that certain people would feel that to automatically plan a cesarean without first at least trying to labor is the more dangerous choice. I don’t feel that way, but I bring it up to make the point that it is not OK to take one person’s opinion and try to apply it to everyone.
And I am sure that there has been an occasional midwife to make a poor choice and take on a high-risk client for a home birth. But there have also been doctors who make poor choices. When I say home birth midwives don’t take on high-risk mothers, I am speaking for the vast majority of midwives, not for the occasional bad one.
So I ask again. Does it matter?
I am continuing this discussion, not to try to change your opinion about what is best for you, or even about what you think is best for other women. I am continuing this discussion because I don’t want anyone who happens across this page to leave with a misunderstanding about what home birth is and what home birth midwives do.
Very nicely written!
I had a C-section on my first pregnancy and have already scheduled my second one for November, for the delivery of my baby boy. Both of them selective and based mainly on my personal believes and the support of my husband and doctor. I have never felt less mom than another mother who delivered naturally, and never will. For me, maternity has nothing to do with the birth experience in itself and all different decisions should be respected by other people, despite their own values. After all, moms who adopted babies are as moms as we are. The scar is for me just a scar, and can hardly be seen. I hope every woman feel free to make their own decisions and even if something in the end goes differently than expected, that they accept and embrace it. Being a mother is a daily experience!
To Graziela,
Thank you. I also wrote a piece on breastfeeding my daughter.
To Bonnie and Lisa, all I’ll say is consult a medical professional.
Right. Which I’ve never disagreed with.