My c-section: At the corner of empowerment and letting go

“Nothing was taken from me.”

Those were the first words that came to me when I described my c-section aloud.

“I didn’t feel pressured into it, and nothing was taken from me.”

I’ve realized how important it was for me to exercise agency in my birth. After 21 hours of unmedicated labor, nine of which involved some kind of pushing, I consented to the c-section.

“To not consent to a c-section would be going against my medical advice,” my doctor told me when we reviewed our options for the third time. “It’s a matter of trusting me as your doctor.”

I didn’t ask, “Is this emergent?”–I knew the answer was no; baby and I were healthy.

I didn’t ask, “What are the risks in not having the c-section now?” We acted before there was any pressing medical indication for c-section.

My Bradley classes, which involved a 36-hour training in natural childbirth, told us we should ask those questions to prevent an unnecessary c-section. But I didn’t want to ask the questions for some reason. I felt like I already knew the answers and that hearing my doctor say the expected responses would only complicate the issue for me. 

We decided to trust my doctor, who had the instincts that something was preventing our baby from coming out vaginally and that it would only put more stress on him to keep trying.

“To not consent to a c-section would be going against my medical advice,” she said. “It’s a matter of trusting me as your doctor.”  

“Do you trust me?” She said, putting a spotlight on the elephant in the room. (Hint: the elephant was not my vagina. It was my trust.) I stared at the metal panel in the ceiling wondering if it could be an escape hatch.

“I guess I trust you…” I responded.

“You don’t sound too sure,” she said with a little laugh.

I chose trust.

I had interviewed several doctors and care providers and ultimately chose one I felt I could trust, who was evidence-based and took my wishes seriously. My doula and my childbirth instructor had recommended her, along with numerous moms I know who successfully had unmedicated births.

The trust in a doctor-patient relationship is important for everyone. I had heard women in the natural birth community talking about informed consent and informed refusal. They spoke of being empowered to say “no” to your doctor if you didn’t want a vaginal exam, an induction, or anything else that could be done to your body. They spoke of educating yourself as an advocate for yourself and your baby so you could know what your options were in pregnancy and birth. I did the research, and I declined some routine procedures, such as estimating the baby’s weight during an ultrasound in the final weeks of pregnancy. Saying “no” felt good. 

I knew that I could trust my doctor AND trust myself and my body at the same time, but it was difficult in that moment of decision about the c-section to sort through what that dual trust would look like. It felt more like dueling trust. As a survivor of repeat sexual abuse, I had a struggle giving in to trust of any kind–of myself and of my doctor. I felt a real leap of faith in choosing the c-section, in choosing trust for my doctor. My plans changed drastically from unmedicated natural birth to surgical birth. What would happen to my body changed dramatically, from pushing a baby out of myself to having a baby pulled out of me.

To later challenge that trust and question my doctor’s judgment and intentions would be to open my birth to trauma, to a host of regrets and self-scrutiny. It could shift from being an experience of mutual respect and trust to one of mistreatment, emotional injury, and bodily invasion. That is not the narrative I want or choose for my child’s birth or for my birth as a mother.

Maybe my baby would have come out naturally eventually. Who knows. The what-ifs and speculations do not help, so I try to not entertain them for long.

I needed to be able to make the choice of what happened to my body.  The idea of my birth becoming an emergency, of choices being made for me about my body and my baby in a moment of panic was terrifying. Not to mention the fear of knowing my baby or I was in danger. I did not want to be put under anesthesia and to wake up with my baby having been cut from me. I wanted to be awake and to remember what happened to my body. To not remember the details, to have not chosen the c-section but been forced into it in fear and panic would have felt like another rape.

No. I got to say, “I consent”. I had a choice. My husband and I discussed the choice alone for a few minutes. I had about an hour of being prepped before surgery when I could further process what was about to happen.

In surgery I got to be awake and to talk to my husband while the doctors cut through my layers. We laughed and joked. Upon my request, he narrated the whole operation, saying things like, “Now they’re digging out some pieces of corn and flinging ketchup around.” The room was jovial. There was a lot of laughter. Arms shaky and teeth chattering in anticipation, I got to feel the doctors pushing my baby down and out. I got to hear his first cry and to hold him on my chest and see his pink face. I could kiss his wet head. I was able to cry and shake and feel. I was overcome with all kinds of emotion.

 

Trust is complicated after deep betrayal.

In making the decision to have the c-section and in processing the birth, I have chosen trust. Over and over I have chosen trust. 

I try to center myself in this trust, to return my focus to it when the doubts fly monkeys around me. Letting the questions and doubts arise and reflecting on them is healthy and natural, but sometimes I spiral out of orbit. I don’t just question why and how I chose a cesarean birth; I spiral into the same kinds of negative thought patterns that came up when I questioned my responsibility in my abuse.

“Control, control. You wanted to have too much control over the situation. You didn’t trust yourself enough. If you were more comfortable letting go and not being in control, you could have continued laboring naturally, and your baby could have been born vaginally. A stronger person would have been able to let go of control and trust her body.“

Then the other voice says, “You didn’t stay in control. In birth you gave over control of your body to another person once again. You should have fought harder. You should have trusted yourself above all. You allowed yourself to be swayed too easily. You were weak. A stronger person wouldn’t have ended up in that situation.”

Stop. Breathe. Relax your jaw. Let your shoulders down. Breathe. Trust. I remind myself that I was strong. I didn’t give up or give in. I worked hard to grow a healthy baby and to stay low risk. I ate my eggs and greens and orange foods, as the Brewer’s diet recommended. I bought loose herbs and made nettle-alfalfa-red raspberry tea. I walked and did cat and cow and prenatal yoga and spinning babies and water aerobics. I lived on the birth ball. I had chiropractic care for months and acupuncture in the last week to avoid induction. I labored naturally for 21 hours, pushing for nine. I was not going to “try” natural birth. I was all in.

When the time came to assess my birth plans against the real-life unfolding of my birth reality, I made the choice that seemed right for us. And it wasn’t an easy one. It took courage to change plans.

Trust is complicated after deep betrayal. Trusting someone else with your body is complicated after partner rape. I trusted Sean. I told him the bruising stories of my childhood. I showed him the parts of me that made me nervous and worried. The parts I thought might make me unlovable. Later he hurt me with them. It was as if he took my own knife out of my hand and held it against my neck. He wielded that knife on me often. He used it the night he raped me.

So trusting my doctor is tough. I interviewed three doctors and one midwife, and I picked her. I trusted her. But it’s hard to give that trust over fully. I wonder, “What if she was just tired and having a bad day. What if she was not at her best and wanted to go home? She was pregnant, too. I remember how tiring that was.” Or “What if the c-section recommendation was mostly about covering her ass for her small practice because she didn’t want to put herself at risk of being sued in my non-textbook labor? She just had to say it, but she didn’t mean it.”

I look for small signs that maybe she wasn’t trustworthy after all. “Did she even really read my birth plan? She said it looked good, but then when the birth day came, she didn’t want to wait as long as I wanted for her to wait to cut the cord.” She told me, “I’m worried that if you continue laboring, your baby will be in distress.” My Bradley classes taught me to be skeptical of this kind of scare-tactic comment based in potential danger rather than current status. 

Did she really care about me and my baby?  Or was she more worried about herself?

I find each little piece of the puzzle and try to put it together into the most evidence-based narrative. When you have lived through long-term emotional abuse, you question your judgment and your view of reality. You know that someone was able to turn your reality into fiction right before your eyes. And you question your truth because you know for a long time you hid the truth from yourself in those moments when your gut told you, “This is not right”. You are forever on a fact-finding mission, looking for evidence you can hang onto and pull out of your pocket when you start to doubt what is real. And you are constantly checking your perception to see if your eyes are really open or if you are living in what Jean-Paul Sartre called “la mauvaise foi”, or “bad faith”, self-deception.

I didn’t know if I should trust my body, which was telling me, “We’re utterly exhausted here. We’ve had no sleep for 40 hours and are moving through the most intense physical endurance experience of our life. We can do this for an hour or two more but no longer.” I didn’t know if I should trust my mind and heart, which were telling me, “I just don’t think this baby is going to come out of my vagina. Something feels off.” Doesn’t everyone just want labor to end once you’ve been working at it for 20+ hours?

I don’t want to be a victim in my birth as a mother.

I don’t want my story to be one about someone taking advantage of my trust, abusing power to make me believe surgery was necessary. I don’t even want it to be about my doctor’s well-intended misjudgment.

That doesn’t mean that I want the story clean, sterile as that operating room. I don’t need my finger to pin down for all time the account of that one true story of what happened. I am comfortable with the layers and some mystery because the collection of narratives is the closest thing I can tie to the truth.

I’m tired of being the victim, and I’m tired of being the survivor or hero, too. I’m tired of sad stories in my life. This one–this entrance of my perfect new son–I want it to be pure and beautiful. I don’t want it to be tainted, to be so heavy. I just want to be. I want to live on the side of empowerment that acknowledges that there is very little that I actually control. I want to live somewhere between seeking the truth and knowing that I see the world as I am, not as it is.

I want my son’s birth story to be about the loving care of so many people who supported me through the journey of birth. My husband, my doulas, my doctor, my childbirth teacher, my chiropractor, my acupuncturist, all the women in my life who sent me words of strength and affirmation in my final weeks of pregnancy. So many hands touched me and held my heart. 

This is my story. I can decide how I choose to see it and tell it.

When I think of my c-section, I will no longer call myself weak, quitter, unnatural, faithless. My new name will be… Mother of Dragons……….Nah. My new name will be strong, loving, capable, faithful.

I don’t like the way “c-section” feels in my mouth and rests on my heart. I didn’t want to be “sectioned”; I wanted to give birth while whole. I wanted to give birth with ALL of myself.

I will take my cesarean birth and change its name. I gave birth with ALL my sections of being: powerful and vulnerable, painful and triumphant, empowered and surrendering. I gave birth with my courageous section. My consensual section. My conscious section. My complex section. My conflicted section. My caring section. My comfort-stretching section. 

I was a cesarean warrior. (And maybe a mother of dragons…gotta keep you guessing.)

Photo credits: Jess Bollaert Eddleman of Clementine Birth & Photo