Monday, March 24, 2008

Yeah, That's What It's Like

Time ran an article on the rising c-section rates in Asia. While they listed a few of the risks of c-section, and some of the following sequelae, such as reduced fertility and limited choices for following births, they didn't include anything like this description of natural vaginal birth:

Utter the phrase "natural childbirth" and the mind envisages a stoic and earnest woman, surrounded by murmuring midwives in a softly lit room, where ambient music plays and tea lights flicker. Upon the elapse of some decent, manageable labor, she pushes out her baby with honest grunts. While that may be true for some, for most women natural childbirth is one of the most violent physical traumas they will ever experience, bar a serious accident or grievous assault. The average length of labor for a first-time mother is anything from seven to 12 hours, but it can easily be 20 hours or more. During that time, she is wracked by contractions — a euphemism that doesn't even come close to conveying the violent spasms that take hold when the body reflexively tries to squeeze a baby through a narrow vaginal opening. The forces involved are such that when the baby's head emerges, it can do so with sufficient pressure to rip the mother's perineum and leave grind marks on pubic bone. In many ways, the act of giving birth resembles a medical emergency — in fact, if no medical intervention of any kind were made, up to 1 in 67 women would die in labor. Fear of birth pain is thus legitimate and it is no wonder that many women elect to have C-sections — especially when the procedure is over in about 40 minutes and feels no more uncomfortable, in the words of an anesthetist in one of Hong Kong's top maternity hospitals, "than someone rummaging around in your tummy." When cost is not an issue, women express even greater interest in cesareans. In Hong Kong, just over 45% of private-hospital births are surgical, compared to a territory-wide rate of 27%.



Good night, nurse! If you talk about it that way, well, I'd choose a cesarean too. But they don't talk about the c-section. They don't say how they take the woman into a hard, bright, cold room and remove her clothes. Depending on the surgeon, the woman's arms may be strapped out to the side. She will have been paralyzed from the waist down, although a good portion of women won't be adequately anesthetized and will feel everything that is to come. They don't talk about how the surgeon uses an extremely sharp scalpel to cut through your skin and fat. That he pokes his fingers between your abdominal wall muscles and tears them apart, holding them out of the way with cold, hard, metal retractors. A "blade" that resembles a garden hoe is shoved in between the uterus and the bladder to prevent accidental cuts to that organ. Then a forceps is jammed into the uterine muscle, a suction machine vacuums out all the water and the surgeon forces two fingers into the wound and rips it open side to side. He crams his whole hand in to grab the babies head and yank it free, pulling back and forth to release the shoulders and extrude the baby. He then scrapes the placenta off with his hand and pulls the uterus out of the mother's body. It's sewn up and then all the mother's internal parts are stuffed back in, the uterus forced back into it's place, the next layer sewn and then the mother's skin stapled back together. The forces used from this violence are sometimes enough to cause vomiting on the table for the poor woman who's hands may be strapped down in the crucifixion position.

After her baby is ripped from her womb, the woman will be able to hear but not see what is going on. Once the baby has been wrapped up in a bundle, with goo in it's eyes that prevents it from seeing mom, the mother will be given a few seconds to rub cheeks with her baby who will then leave the room with the mother's support person. This leaves the woman all alone on the table with doctors discussing their vacation plans and remarking what skilled surgeons they are for being able to complete this surgery so quickly. The mother may be given an amnesiac drug so she forgets everything, including her baby's first cry. She will wake up later in a room, alone, with a nurse sitting in the corner charting and her partner/support person and the baby in an totally different area of the hospital.

The woman may be unable to walk upright for better than a week, and is often on strong narcotic pain medication that can cause constipation, reduced milk supply, and drowsiness in her and her baby. Moms with cesareans often have difficulty breastfeeding their babies, have delayed milk production, experience postpartum depression, and have higher numbers of having to return to the hospital because of infection.

That's what it's like.

11 comments:

~Miranda~ said...

Amen! How ridiculous that article was. Natural birth is beautiful and life affirming.

Housefairy said...

I loved your true account of c-section. But you forgot the months of debilitating pain afterwards...and then weird lump/flap on my tummy, and the numbness and the itching and the crumbling future for VBAC and and and....

what a freaky weirdo whoever wrote that first one. they probably meant someone on Pit in a hospital bed or something. My homebirth was nothing like that thing said...and i had an 11 pound 41 weeker. No tears.

sigh

Sheridan said...

Wow, that article was crazy. Apparantly written by someone who had a traumatic birth. Yes some births are like that, but usually caused by the craziness going on around them, the interventions, lack of support, etc.

I am glad you showed what a cesarean can be like in contrast. They never talk about that. "Rummaging around in your tummy" - That is ridiculous.

CNH said...

Uh, yeah, thanks! Good grief! I had a THIRTY-THREE HOUR labor for my fourth child and yet here I am still planning a home birth for my twins. It can't be all that bad, or I wouldn't keep doing it. Sheesh.

Jen said...

Both of the descriptions of the natural childbirth AND the C-section are at markedly sensationlist ends of the spectrum...talk about fear tactics on both parts.

WarriorMoM said...

Wow. I know I'm posting a moth late, but did you send that in as a letter to the editor of Time magazine? You capture the trauma so plainly and truthfully that the truth is undeniable.

Courtney said...

For the record, here's what happened at my c-section:

I agree being alone in the bright room was scary and probably the worst part of it for me. I wasn't naked, but they pulled my gown up to my ribs after putting a blanket over my legs to wash my tummy and drape me. My husband came in and held my hand (which was not strapped down) and once my son was born my husband held him by my head, gook and all, for the rest of the surgery. He was never taken out of the room or held by a nurse. Once the surgery was finished (about 30 minutes later), my son was put in my arms and the three of us went to recovery together where I successfully breastfed him immediately. The only time we were seperated was when my husband held him behind a curtain while I was given a spongebath by the nurse (about two hours after the birth). I was up and walking that night and felt only minor discomfort in the days following. Baby and I did great breastfeeding and he never even went to the nursery during the hospital stay.

Again, this was not my ideal experience, but I was able to make the best of it. Posts like yours are setting up moms who need c-sections to feel scared and unsure of themsevles. It's like your message is more important than the emotional well-being of pregnant women and that is sad for someone in your position.

jemima said...

This is the most unuseful thing I have read. My csection was nothing like that, my baby never left the room until I did and I was made comfortable and I was spoken to by everyone in there. I was getting scared about my 2nd csection coming in feb, but after reading your BS I am really looking forward to it. This will be my 2nd csection for my 3rd child. I hope no one reads this and thinks its really that horrible

One Hot Mama said...

Wow, Jemima, I'm glad you had a good experience and are looking forward to your major abdominal surgery, however, you can not tell me that my post is not what it's like, because it is EXACTLY what it was like for me with my fifth child. I wasn't writing fiction here, it was my experience.

Housefairy said...

Jemima and Courtney--what the FUCK is your point? Literally. What.

My sections were everything messed up and more--- my abuses on the carving table only to be eclipsed by abuses in the postpartum ward, then to come home to "friends" and "family" who poo-poo'ed me like so many Courtneys and Jemimas.

slwbm said...

housefairy. i feel the same way about courtney and jemima. i am so glad that they had a great experience, but my c-section was the most traumatic experience of my life! mine was a very extreme emergency and i had not been given anesthesia yet during the whole prep. so i saw and felt everything, including being stripped naked in front of what must have been 20 people and having sponges with goop being scrubbed all over my abdomen and even in between my legs very roughly. talk about humiliating! and i was not blessed with being able to get an epidural. i was put under completely so i was never able to see or hear my precious daughter when she was born. and because of recovery time, i didn't see her for hours. my baby was hours old and had met dozens of people before she got to meet her own mother. breaks my heart to this day. and now lets add on all the months of pain. my baby is 7.5 months old and just today, my incision area was throbbing. it has gotten a lot better, but still hurts sometimes. only in the last month has it stopped hurting every time i go for a walk. i am thankful for my c-section because without it both me and my baby would be dead. but i don't know why ANYONE would choose it!