Birth Trauma: My Loss of Autonomy

c section experience autonomy loss
Sometimes nothing goes as planned.
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We had pulled over at the Molly Pitcher rest stop on the New Jersey Turnpike, and I maneuvered myself out of the car, nine months pregnant with my first child, but still ready to be an enormous maid of honor in my best friends wedding, which we were driving to when I realized I needed to eat a hot dog.  I waddled in and ordered, and we sat down to eat. I was sitting across from my partner, Andres, who is Colombian and who I mostly speak to in Spanish. We were tired and not talking much. On my third bite, I felt a warm wet oozing between my legs, and shocked, I looked up at Andres and said in a deathly serious tone, “Agua”. He was about to get up and buy me some water, when I said, “No no, I think my water broke”, and I immediately saw reflected in his face what must have been the look on mine. This was more than two weeks early. We had talked about what would happen if the baby came sooner, but for some reason we thought our daughter would be a bit late, and this definitely came as a surprise.

I got up slowly to reveal the puddle at my feet, and shuffled in my best attempt at inconspicuous towards the bathroom, trying not to catch the attention of the two cleaning ladies in my path, who I was creating more work for at best, but who I also worried might make a big deal. I wanted to be alone for a minute. I called my doula sitting on the toilet. “Well, it looks like its time for you to head back” she said, and told me that since my water had broken, I should expect contractions to begin soon. We set me up with towels and pillows in the car and started the long ride home to Boston. It was dark, and the music Andres put on and his worried and concentrating silence created a bubble in which I was able to breath deeply through the contractions that built in strength over the next five hours. I felt calm, though we were speeding towards our birth center at ninety miles an hour, and when we got pulled over, I was able to explain to the cop that I was in labor, and he let us go, flying through the night and breathing and preparing in our minds for the baby that was soon to change our lives forever.

When we arrived at the birth center, I was expecting to go straight to our birthing room and hang out in a tub where I would safely deliver my child into the warm water and hold her at my breast while we were still connected by the tube my body had used to feed her for these past months. But I had to be checked for anemia, and the process took forever, so I was trundling around with no comfortable way to sit down, perching on furniture awkwardly and dripping fluids for a while until I grabbed a sheet and shoved it between my legs, pulling up the ends like a diaper toga while assuring my midwife I had been eating lots of meat to avoid anemia, hence the earlier hotdog. But they had to be sure, because if I was anemic, I would not be able to continue with my natural birth plan then and there, I would be transferred to the hospital across the street to have a conventional birth. The worry and the discomfort and the bright lights pulled me right out of my breathing bubble and meditative state, and I waited anxiously. Just as my doula arrived, we got the test results and I was thankfully led up the stairs to where I would spend the next twenty-four hours. I had chosen this birth center because I wanted to be surrounded my women while I was birthing my daughter, and I wanted to be able to move my body, and I didn’t want to be given any pharmaceutical drugs. This is the way I live my life, and I wanted my birth to be the same way.

We started in the tub. I am short and kept slipping around, nowhere to brace my legs against. My midwife was mostly silent at my side, my doula was above me, checking in with me, telling me I was doing an excellent job at breathing. I had no words, I was in another realm, and the room was quiet. Almost too quiet, and I felt the scared and waiting eyes in the room focused on me in the back of my consciousness.  Andres had called my parents and I began to feel the presence of them downstairs in my mind as the contractions became stronger and I began to moan and wail. I had learned that I should keep my voice deep, to moo rather than screech, and I tried to remember that, though nobody in the room said anything along those lines. I just kept breathing, but I never got back to that serenity and concentration of the first few hours of labor in the car. I never felt comfortable again, and I watched silently as the whole thing slipped away from me.

I came out of the tub and was offered a birthing ball, but sitting didn’t feel good. I threw my upper body onto the bed and stayed that way for a while, with my doula massaging my low back, until at some point it was day. The sun streamed in through the windows and I knew hours had passed, yet it seemed everything in that vacuum of a room had stayed the same. I had been at  three centimeters when I arrived at the birthing center, and had only gotten to five in those lost hours. At some point my midwife left, and a new one took her place. At some point my parents left too. Andres and I were instructed to lie down on the bed, that I should try to get some rest in between contractions. I felt like I went into the deepest sleep in the short minutes of respite between waves of intense sensation. More hours passed.

Someone came to check my dilation and it hadn’t changed. It had been twenty hours since I arrived at the birth center and they have a time limit. In and out is preferable, and my body was not following the rules. I was told I would soon have to be transferred over to the hospital to receive Pitocin. I did not want this. The only other option was for Andres to stimulate my nipples, which would increase the natural oxytocin in my body and make my contractions stronger. It worked, and I was feeling much more pain now, instead of those tolerable waves of sensation like I had trained for in my birthing prep. But it didn’t bring my baby further down, and next thing I know, I am crossing the street in a wheelchair as the sun goes down again.

I knew that I would have to be constrained in a bed if I was given Pitocin, and the idea of not being able to move at all through the pain of even stronger, chemically induced contractions scared me, so I agreed that it would be best to get the epidural.  I found myself sitting upright on a hospital bed, being told to keep my head down so as to open the space between my vertebrae, but I kept peeking up at Andres- whose face again echoed alarm, or perhaps terror- as the anesthesiologist pulled out the ten inch needle that he was about to insert into my spinal column. The direct pain of the injection was almost more intense than the contractions had been, and they soon faded deep within me as my lower body went numb and detached from my trunk like a tissue paper doll handled too roughly. Again I was instructed to rest while the Pitocin was to do its job, and I fell asleep for three hours.

The nurses were cheery when I woke, ready to take a look at my cervix. We were all crestfallen to discover that I was only dilated to eight centimeters. A new midwife came in and told me that since more than twenty-four hours had passed since my water broke, the likelihood of infection was too high, and I would have to have a cesarean section. I had known that once any one medical intervention is taken, that the likelihood of having another nearly doubles. I had known that if I went into that building, my chances of having a c- section were increased a thousand-fold. Yet hearing her words still brought those crude realities crashing down upon me and I became so scared, I couldn’t speak for my tears. I had never had even the most minor of surgeries, I had been so confident in my body and its ability to push out my baby; none of this had been part of the plan.

They gave me some time to sit with the news.  My mind couldn’t wrap itself around it, and I could hardly make words, I could hardly speak Spanish and express my fears to Andres. I was alone. I sobbed and asked some questions but mostly just fell into a deep stupor. The midwife came back with the surgeon. She told me that years ago she had had a cesarean performed by the same surgeon, and that later she had been able to give birth vaginally in a VBAC, and she put her warm hand on my arm and reassured me. She wanted to get my consent; they wanted to cut me open as soon as possible, because I had also started to run a low fever. There was no way out.  As soon as I had agreed and they all left the room to get the next steps in motion, my doula stepped forward. She was pregnant as well, only five months, and she had been with me for so long. She said she had to leave. It was ten pm and she had to work in the morning. She wouldn’t be able to be with me in the operating room, they only allowed one person and of course it would be Andres. But at the time Andres spoke only very broken English, I needed someone else there.

My best friend Rose is loud and often brash. I love her but I had told her that I didn’t want her to come to the birth, though she had offered. I knew I would want to concentrate, though I didn’t foresee the somber silence that I now look back on as having settled upon my room in the birth center. In retrospect, some of her characteristic humor would have been welcome. And since my mother doesn’t have a car and Rose is always there for me, she was my saving grace. I asked my doula not to leave before they arrived, and I asked the doctors not to take me into the operating room until I could see them. These were the only things that I insisted on, and my wishes were respected.

When they arrived, I was so grateful for their presence and to see my friend trying her best to be as quiet as a mouse, or perhaps simply humbled by the whole situation. My mother too was watchful and consoling me with her eyes. As they shaved my pubic area I was able to make some small talk with the nurse about her southern accent while my doula gave Rose the instructions for how to receive my placenta, which we planned to have encapsulated. Then I was wheeled down the hall like in the movies, the face of my love hovering over me, new lines in his forehead that still remain to this day.

The operating room was cold and sterile and bright, just as you might imagine it to be. They picked me up by the sheet and put me on the operating table, my arms restrained at my sides like Jesus on the cross. The anesthesiologist was at my head, pumping me with way more drugs so I wouldn’t feel the cut, though I felt the pressure. Andres was holding my hand, which felt colder and colder, and I began to shiver. At first it felt like just a jangling in my chest, but I soon began to shake uncontrollably, my teeth chattering so hard I could barely speak through them to ask what was happening to me.  I thought I might be having a seizure; my arms were shaking, elbows akimbo as if I were dancing overconfidently under a limbo pole. I had now lost all control of my body.

Nobody tells you what a c-section will be like when you are planning a natural birth. They don’t want to scare you. But the anesthesia has the effect of causing the body to shake violently; I imagine that part must be hard to master when doctors are doing their training in the procedure. I couldn’t even worry about a possible slipped knife, because I finally heard the tiny whimpering of a baby squirrel and I knew my daughter was born; warm tears slipped down my face. Andres was gone, he had her, he was cutting the cord, I wish I could have seen him do that. It was almost over, but then I began to feel them inside me, scouring my organs, scraping me clean.  The pressure of their arms sloughing down and out inside my womb is a feeling I will never forget. Andres came over to let me hold my baby, she was healthy, she was responding well, but I couldn’t even see her clearly, I had become so stiff from the spasms of my muscles, which were still happening, I think they released my arms, but I was afraid to hold her, my body wasn’t mine. I kept saying “I’m so cold, I’m so cold…”

They wheeled me back into my room and wrapped my head and upper body with scarves and put blankets on me, and I began to come back down to the ground. Andres again offered me the tiny bundle in his arms, and I reached out to receive it, that squiggling ball of brand new life, hands still unsteady. But once I held her in my weak grasp, she gave me strength. I stopped shaking and held her close, and I offered her my breast. Her first real connection in the cold air of the world. She stopped her little squeaking and scrunched up her red face as if in agreement that the whole ordeal had been deeply unpleasant, but now we had each other. She was mine and I was hers and she knew my body. She found the nipple and she latched immediately, her strong suck pulling a joyful laugh out of me. I looked up to see my mom and Andres and Rose all crying and looking at me with pain and relief and love bursting out of them. I took a deep breath and began to be a mother.

The joy and exhaustion, fear and worry, and all the grey hairs that come with bringing a person into the world are just part of the process of living our lives. They teach us something about who we are in how we make decisions, how we relate to our emotions, and who we can depend on in our desperate moments. These are the experiences we are made of, and yet they are also the moments that tear us down. It took me two years of inexplicable rage and extreme exhaustion and mounting anxiety to realize that I was dealing with a case of post partum PTSD. The fact that I couldn’t even talk about my birth experience without crying, the fact that I felt deeply alone even when I wasn’t alone, the fact that my nerves jangled at the slightest change of wind. I lost my sense of autonomy over my own body in the birth of my daughter, I lost my faith in my physical being, and in my personal power.  This may not seem like the end of the world, and though the medical interventions may have prevented a much more tragic ending, it still felt like a death to me.  But with every new life, something always dies, and through it all we learn and grow and become stronger.

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