Cesarean Awareness Month: my personal story

It’s International Cesarean Awareness Month… and this is promoted and encouraged by ICAN: the International Cesarean Awareness Network - which “is a non-profit organisation whose mission is to improve maternal-child health by reducing preventable cesareans through education, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC).

As a VBAC mum myself, I’ve been umming and ahhing if I should share my personal story with you. One of the main things I focus on as a Doula is ensuring I approach your birth from a non-biased perspective and support you unconditionally in your choices. With all choices, there are risks, and I just want to highlight from the get-go that your journey will not be the same as mine. The fact that you are reading this blog post and are aware of what a Doula is and does already shows you’re on the right path to be informed, educated and make great choices for you and your baby – all things that in hindsight I wasn’t or didn’t do.

Please note that I’m not for a second suggesting that women should not have cesareans. Sometimes they are necessary and amazing life saving procedures. However for the most part, I feel we are often too trigger happy, and at the end of the day, it is still major abdominal surgery that perhaps could have been prevented, and that woman then has to recover while taking care of a new baby. I believe that women are amazing, and no matter what birth we have, we still did it and are still mothers just as equally as anyone else. In my opinion, a c-section is not the easy way out.

My emergency c-section following the cascade of intervention with an induction. I was naive, uneducated and am sharing my story from this vulnerable place during international cesarean awareness month, as well as how it is part of my journey today to become a Sydney based birth and postpartum Doula.

When I fell pregnant with my first in 2011, my GP gave me three referrals to various private Obstetricians (OBs), though I wish now with knowledge behind me that I knew public midwifery care was an option too, or even a private Midwife for a homebirth. I chose the private OB that many of my friends and even my sister had chosen for their births. I didn’t even think about the kind of births they had (mostly c-sections), only that they had raved about him and so passionately trusted and believed that he saved them and their baby’s life.

I had some complications in my pregnancy. Sciatica for one – which gave me much pain in the back of my hips and shooting electric pain down the backs of my legs… I had a lot of trouble walking or even getting comfortable sitting or lying down, never mind in and out of a chair or bed in the first place. The other main complication was that I had tested positive for a virus called CMV (which is kind of like glandular fever and less common in our developed world than in developing nations). This is one of the few pathogens that the placenta cannot filter out and so your baby has a risk of contracting it during your pregnancy. If your baby does contract it, then there is small risk of them having an intellectual, learning or hearing disability, amongst some other health issues too.

And so we had a lot of fear during my pregnancy that there would be a major health issue with our baby that we wouldn’t find out about until after he was born, or potentially until he’s 2 years of age. So when at 38 weeks gestation my OB suggested that I be induced to a) stop being in pain, b) find out sooner if my baby caught CMV and c) allow my husband to conveniently know when to take time off work to be there for my labour… we thought this sounded great and agreed to an induction at 38 weeks and 4 days.

This is where I feel most frustrated with myself – that I was naïve and didn’t understand the implications of an induction. I think something all along told me in the back of my mind that this wasn’t the right choice, but I wholeheartedly trusted in this raved-about-expert that I paid a fortune of money for to ensure the best outcome for me and my baby. We had done the birth education classes at the hospital and to this day, all I can remember them telling me about was what drugs were available, being given a tour of the delivery and maternity wards, and being shown how to bath a baby. I didn’t understand that an induction could take a long time, or how much more likely it would be to turn into further intervention.

The cascade of intervention actually – and yes it happened to me. I went in late in the afternoon and they inserted the prostaglandin gel. Overnight, I felt mild period pain and some cramping in my lower back… they did another check and inserted a second half dose of gel as my cervix was acting and behaving favourably. By early morning the OB came in and said I was 3cm and it was time to break my waters. As they went to try and do this, I was in such excruciating pain from them reaching their hands inside my vagina, that I demanded an epidural first. The epidural went in and once it was working, they went to break my waters. By now I was almost 4cm, and the second my waters were broken my baby went immediately into distress. I was looking at the CTG and saw numbers yoyoing all over the place and in the flurry of an emergency button being pressed, about 10 people suddenly in the room and scrubs being chucked at my husband to quickly get changed, I was being spoken at, rather than to, and being told it’s an emergency and they have to get the baby out now. Within about 7 minutes we were in theatre and my baby was born by emergency c-section… And the OB mentioned something about the umbilical cord being up around his neck.

I had no idea who I was, who this baby was or how we ended up there. I don’t remember a discussion about why it was such an emergency. I do remember asking the anaesthetist what was going on with the trace and instead of telling me they were worried about the baby, he told me one heart rate was mine and the other was the baby’s (though I think with hindsight it was my baby’s heart rate not stabilising and jumping around with the distress of his amniotic sac being ruptured).

It was a long and tough recovery for me physically, with pain for months at my scar. Even four months post birth, I still had trouble getting in and out of bed, or the car, or a simple chair. Emotionally I was almost not present, finding no joy in life or my new baby, with complete disconnection from my husband, family and friends. Though this is another story I might write about in the future. From this journey it took me down the path you can read on my about page (on how I came to be a Doula today), and with my second child I had a beautiful hands-off vaginal water birth in the public system with a Midwife.

I feel it’s essential that we not only trust our care provider, but that we are informed ourselves. If we are educated around our birthing choices, and understand that if our birth doesn’t go to plan and our preferences are no longer possible, that we know what option b and c are so we can give consent. Understanding things in advance and agreeing to the change at the time of need will help to prevent trauma.

I’m hoping that this blog post, of a very vulnerable time in my life, where to this day I feel much self-regret and frustration in that I relinquished my responsibility to birth my baby… has helped you to understand some of the things that may help with the main purpose of Cesarean Awareness Month, being to share resources for cesarean prevention.

My top suggestions for you to take on are:
- Choose your maternity care provider carefully
- Get educated (like really educated)
- Make informed choices that are right for you
- Be OK with whatever the outcome of your birth is, knowing it came from a place of informed consent
And…
Consider hiring a Doula to support you through this physical and emotional journey to meet your baby.

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About Essential Me

Hi, I'm Amanda.  I support women and couples during their pregnancy, birth and postnatal journey as a Doula, Ka Huna massage therapist and Pilates instructor.  I'm Based in Sydney and would love to help you.  Please check out my Top 10 Tips for the best possible birth experience here.  I'd love to meet you for an obligation free interview to see if you feel we're the right fit.  Contact me here. Thanks, Amanda x