April is Cesarean Awareness Month. It’s also the month when my daughter was born, via emergency c-section. I never expected for my body to be sliced open to bring my baby forth into the world. I did prenatal yoga, practiced Reiki, hired a doula and set out to have a natural birth. After 36 hours and a labor that failed to progress, I slowly walked into the operating room and handed myself over to a surgeon.
As I detail in my birth story on the International Cesarean Awareness site, although the surgery was indicated for failure to progress, it turned out I had placenta accreta, which is a true medical emergency. Placenta accreta occurs in about 1 of 2500 pregnancies and is a serious condition that can up the risk of maternal mortality. There has been more media attention focused on placenta accreta as of late because it is more common in women who have had c-sections or other uterine procedures that can cause scarring. It’s hard to say how I ended up with placenta accreta – I did not have a prior c-section, but I did have some exploratory procedures done many years ago that may have caused scarring on the uterus.
Within 12 hours of the surgery, I suffered a massive post-partum hemorrhage and nearly died. I had actually been bleeding out most of the night and lost about half the blood in my body by the time I went into shock as they sat me up for a routine examination first thing in the morning. The first thing I learned is that surgical procedures – even medically necessary ones – are not without inherent risks and should be taken very seriously. I fought very, very hard to stay alive and be with my brand-new baby. No one should have to spend the first day of their child’s life fighting for their own survival. Post-partum hemorrhage after c-section is not uncommon; I’ve spoken with many women who have experienced it to one degree or another. In my case, I was confined to bed in the hospital for nearly a week, because I was too physically weak to even get out of bed.
I was one of the worst-case scenarios, but I tell my story because I think far too many people still feel c-sections are like getting a quick nip and tuck. In fact, I can’t tell you how many “well-meaning” people told me things during my pregnancy, such as, “Oh, a c-section is so much easier than giving birth” (whether they knew this from personal experience or not) and “You won’t get all stretched out and sex will be the same as it was before you had your baby.” The first statement might be true in some limited situations, but the second one is pretty much a joke. Nerve damage and scarring in the pelvic cavity can lead to pelvic floor dysfunction, which can make sex – and even things like urination and bowel movements – a big problem. The next thing I learned is that the physical act of giving birth is natural – women are designed to do this! – but surgery should only be a corrective measure to literally save a life or if all other options have been fully exhausted.
Which leads me to the third thing I learned. Recently, on a local moms listserv, a mother made the comment that “most c-sections are performed to save a life and not to ease labor pain or give a tired mother an out.” This is factually incorrect. Most c-sections that are performed these days are not, strictly speaking, life-saving procedures. They are performed primarily for the doctor’s convenience – either to fit their schedule, limit their liability or to potentially improve the odds of an outcome (surgeons know the potential benefit and risk percentages of surgery; they are less comfortable with a “wait and see” approach associated with longer labors.) C-sections also often occur because of the widespread use of Pitocin to augment labor. Pitocin has been shown to increase the odds of fetal distress due to the sudden increase in and intensity of uterine contractions, which will immediately lead to the decision to perform a c-section.
Doctors also get reimbursed by insurance companies at a higher rate for surgical births versus vaginal births. Hospitals are cost centers and usually L&D units are not that profitable unless they are finding ways to perform chargable services. The second a laboring mother walks into a L&D unit, the clock is ticking. The longer she is there without producing a baby, the more it costs the hospital in terms of time, staffing and resources. Some women take longer to approach active, pushing labor than others, but if they walk into that hospital too soon, they can end up with a c-section simply because of the perspective that it’s “taking too long.” Don’t get me wrong – most OBs are not evil people trying to take advantage of laboring women. They are just faced with a set of medical and procedural protocols that go beyond just helping you deliver a baby.
The other thing I learned from my c-section is that healing goes deeper than the scar. In the first few months after my daughter was born, I was focused on the basics. I did perform scar massage and that helped the scar heal and flatten out but beyond that, I was so consumed with day-to-day life with an infant that I didn’t really deal with what was going on with me emotionally. It hit me right around the time of her first birthday, and it wasn’t until later that I realized I was suffering from PTSD brought on by birth trauma.
Healing the scar was relatively easy; healing my emotional self has been ongoing. I was able to feel present and really engaged this year at my daughter’s birthday, rather than wanting to crawl into a hole and feeling like I was stumbling through it as I did the last few years. Of course, it has nothing to do with my daughter – I want for her to have a wonderful birthday. Our bodies store memories of trauma and if those memories are triggered, it can cause depression, anxiety, anger, grief or just a sense of empty numbness.
Not every woman who has a c-section experiences all of this, or to the same degree. But I’ve come across many women – friends, clients and women I’ve met through ICAN or social media – who echo some or all of what I’m sharing here. It’s changed their lives in very profound ways. Some, like me, have become activists and educators as a result. I’m always thrilled when I hear that a mom who previously had a c-section was allowed and able to successfully give birth vaginally the next time around.
I was very touched by something my doula said to me after she gave birth to her son in November. She too had to have an emergency c-section because he had severe meconium aspiration (indeed, a life-saving operation if there is one.) My doula told me her c-section was terrifying, but that she took comfort and strength from remembering how calm I was in the operating room during my c-section. Never in my life would I have imagined that my experience could help another person in such a direct way. The final thing I learned is that I’m stronger than I think, and that this is a gift I can use to help others.
My intention in writing this is to educate on the issues, not say that c-sections are an inherently “bad” thing. Sometimes surgical births are necessary, but there are too many of them being performed for less than truly medically necessary reasons. 32.9% of all births now are c-sections. That statistic is simply too high. Women need to be educated on the issues, the risks and given more freedom to choose the path that is best for them and their baby. And we need to do a better job of helping women who have had them heal and integrate that experience in a healthy, transformational way.
(The photo is of my daughter being held over the drape after her birth. Copyright Dana Lisa Young and may not be used without express permission.)