[Trigger warning: childbirth trauma, medical details. Disclaimer: I have no medical training. This post comes from my records, what I remember, conversations I had later with my doctor, surgeon, and anesthesiologist, and Google searches.]
Four years ago today, I was two days past Ramona’s due date and three days away from “giving birth” to her. I put that in quotes because I felt, right or wrong, that I actually had no part in her birth.
I’ve never shared her birth story in its entirety here on the blog. It was a horrific thing, and I know I am not alone in experiencing a traumatic birth. One of the things about trauma, though, is that it’s easy to feel like there’s no way anyone else could understand what you went through. Really, I think the only one who can understand is Zach because he was there and went through his own personal hell watching what I was going through.
I’m glad I live in a day in age that women rarely die in childbirth. I try to be thankful for medical intervention because it’s possible that Ramona and/or I would not have made it through otherwise. But I can’t help feeling that I failed. I still feel it four years later, even after reminding myself thousands of times that the way Ramona was born does not invalidate my motherhood and does not make me a failure.
The way in which I feel I failed was in not giving voice at any point to my objection. Once Zach and I checked into St. Mary’s Hospital in Madison, I felt my power and autonomy were completely stripped from me.
We were first put in an exam room to wait for them to ready a birthing room for us. I told them I wanted to have as natural of a birth as possible and that I wanted a room with a tub. No problem, the nurse said, all our rooms have tubs. Except they don’t all have tubs. And there was only one room available for us, the one room that only had a shower. I wish at this point I would have said, “No! I’m staying here until you find me a tub.” Irrational, perhaps, but I labored for eight hours in the hospital before I asked for an epidural and waited another two hours before I received one. If I had spent–been allowed to spend–those ten hours in the exam room, perhaps by then a room with a tub would have been available, and perhaps that could have held me off from the epidural at least for a while. Instead, we took the room without the tub, didn’t raise any fuss even if I was very disappointed. It’s the first what if in the birth story.
I was dilated to six centimeters when we arrived at the hospital on the night of the 19th. I asked to not have frequent checks, and through the night this was respected. Early in the morning of the 20th, they checked my dilation, and I had barely dilated any further. I think this is the moment I gave up. It is the biggest what if moment that I go back to over and over again. I was so tired, in so much pain. But what if I could have endured? What if I could have been patient? If I had given her more time, would Ramona have found her own way?
I asked for drugs and then for an epidural, which I received some time after 8 a.m. The doctor told me to rest, but I was still in a lot of pain and I couldn’t sleep. When he checked in on me a few hours later, my labor was still not progressing. I was exhausted, worn thin with no resistance left in me, so when he said he was going to break my water (yes, it still hadn’t broken), all I said was, “Okay.” Again, what if?
Still there was little progress throughout most of the day on the 20th. I don’t know when exactly, but some time in the afternoon, the doctor decided it was time to speed things along. He said he was going to give me oxytocin to hopefully move me from active labor into the transition stage. Again, all I could find was a placid, weak “Okay.” What if?
At this point, Ramona had no choice, no time, and because of the oxytocin, increasingly no room. She became wedged in an early stage of shoulder dystocia. The doctor tried numerous times to manually turn Ramona by literally inserting his hand and rotating her head, but every time I contracted, she only got more wedged in that position. So he called the surgeon.
All throughout this, I continued to have a lot of pain. Not as much as I would have had without an epidural but much more than the virtual no pain some women experience with an epidural.
The surgeon assessed the situation and told us there was nothing we could do but a c-section. Ramona was too far up to be safely removed with forceps or vacuum (one of the things in her birth that I thank God for because I know how horrific that often is!), and she continued on using scare tactics to get us to agree: “Your baby is tired. She will be in distress soon. And if you continue to labor, you could become incontinent.” I mean, really? Really? I think back to this, and I am so angry at her lack of compassion.
I so did not want a c-section. Earlier in my pregnancy, Ramona had been breech and I cried many times when I thought I might not be able to have a vaginal delivery. If you’ve never given birth, I think it might be hard to understand how I felt about this. And many women have c-sections and are happy about it, and I am happy for them, without reservation. That just wasn’t me. I thought I was stronger than this. I had more faith in my body than this. My mother had fairly easy, by-the-books vaginal births, and that’s what I’d expected for myself.
So I cried, and I talked with Zach, but what could we do? At this point, we were out of options. I had to have a c-section.
Next comes one of the most insensitive parts of the whole birthing process. While I lay devastated and helpless in the hospital bed. the aides who were prepping me for surgery were having a race to see how fast they could get me ready and down to the operating room. I really can’t say anything else about this. To say I am angry, still angry, at their lack of compassion, their inability to even see me as human doesn’t begin to describe it.
If this was the end of the story, I think I could have healed better. If I had gone into the c-section, had a normal, lucid surgery, and been presented with Ramona when she was born, I think I could have gotten over all the what ifs, I could have forgiven myself and the medical profession for the way Ramona’s birth happened. But all of what happened before the c-section is nothing compared to what the surgery was.
If you’ve been given an epidural and are then taken down for a c-section, the practice is that they ramp up the dosage of analgesic and do surgery without a spinal block. They warn you that you’ll feel some tugging. The epidural had been dulling my pain to a point, but I was still having quite a lot of pain during contractions (frequent from the oxytocin). When they upped the dosage, I no longer felt the contractions. Before the surgeon begins to cut, they will test to see if the analgesic is working well by pinching you, once low on your belly and once higher. In the best case scenario, you won’t feel either of these pinches. I felt the higher one.
If a woman feels only the higher of the two pinches, the surgery begins, under the assumption that by the time they are cutting at the higher position (about ten minutes in), the analgesic will have kicked in up there, too. This is only an assumption, though. Not a guarantee. For me, the analgesic did not cover the higher portion of my belly, not right away and not ten minutes later when they were cutting. I won’t go into the details here. You can imagine enough on your own. I will say that after 24 hours of labor, my membranes were very thin, and when one of them tore, the surgery had to continue whether I was in any small semblance of comfort or in complete agony. If they didn’t continue, I would lose too much blood.
They did dose me up with enough other drugs so that at some point, my memory of what continues is washed away, forgotten in what feels like a hallucinogenic fog. Zach says that they very briefly presented Ramona to us before intubating and suctioning her airways (I had meconium-stained amniotic fluid–another reason for the c-section). I don’t remember it. I don’t remember the moment my daughter was born. The moment that’s supposed to be so amazing, that’s supposed to erase the memory of all the pain, and barring that, at least make it all worth it? I didn’t have that moment. I didn’t have any moment. I can’t even remember what time she was born. I always have to look it up in our records or ask Zach. It was some time between 7 p.m. and 9 p.m. on the 20th.
The moment I did have was an hour or so later when I woke up and saw Ramona clean, dressed, alien, somehow mine though there was no way for me to know this other than that I was told this was the child I gave birth to. I held her and said, probably more to myself than to her, “It’s okay, it’s all over now. We’re going to be okay.”
And we are okay. Ultimately, we are okay. I just still wish it all could have gone differently, and I want all the mothers out there who’ve gone through any similar or different form of trauma during childbirth to know: you are not alone, and even if no one else can truly understand, I hope we all as mothers can stand together, because this mothering thing is not easy. It’s not easy on day one or day one thousand or day ten thousand (okay, I’m guessing on the last one, but my mom could attest to this, I’m sure). I woke quickly to this truth, maybe others wake to it more slowly. I only know my own experience.
I keep reminding myself that in the end, the most important things came out okay–that Ramona and I recovered and are healthy, that we are together, and that no matter what happened on September 20, 2012, every September 20 since can be a happy one because it’s another year that God has blessed me to spend with my energetic, smart, empathetic little girl.