Why is having a c-section a big deal?
This is an idea that makes me a little crazy – a largely accepted cultural perception that c-sections just aren’t that big of a deal. The myth is mostly propagated by OBs – those who make money off of csections and don’t have to deal with the negative aftermath in their own lives.
So, while some mothers are going through the hardest few months of their lives, they also have friends and family smirking at them like they’re over-reacting, over-dramatizing, complaining, and being ungrateful.
I didn’t get this clueless attitude from all my family and friends, but I got it enough that it made me very angry on top of being horribly traumatized and depressed. It made me feel isolated and unaccepted. I already felt like I was a woman cursed with “the other birth story”. The one where everything goes wrong and no pregnant woman or starry-eyed, wannabe-pregnant woman wants to hear. I have the birth story that a lot of people dismiss as “rare” and “bad”.
Unfortunately, because stories like mine are so often untold and silenced – by others and mothers themselves – a lot of people don’t realize how common a story like mine is. An “emergency c-section” or, more accurately, being bullied into a c-section by an implied emergency is not uncommon. In fact, US researchers estimate that about half of all csections in the US are unnecessary.
In the case of my csection, I was not given a choice. I was not asked, or spoken to in a way that meant to inform me, or get my consent. Then, I alone had to deal with the aftermath.
My baby had two non-reassuring and recovering heart tones – not exactly an emergency, and actually common, but could really be an emergency if the baby died and I decided to sue the OB, which is probably how the doctor and nurse saw it. Or, what I think was likely – my delivery really felt like a “sleep emergency” for my OB, who was going on day three of her on-call shift as the only OB in town, and might have to sit through up to three or so hours of first-time-mom pushing with the most unpopular and highly anxious nurse on the floor at the moment.
So for all the people in our lives who need a little reality check, you can send them this post to give them a little clue why C-sections are a big deal. You might even want to send a copy of this to your overzealous OB department if they perform a high rate of c-sections.
25 Reasons C-sections Are a Bigger Deal Than Your OB Makes Them Seem:
- They hurt. A LOT. I shouldn’t have to justify this point of view, but I’ll tell you that healing from my csection hurt ten times worse than 10 hours of unmedicated, swift back labor from 1 to 8cm. It hurt much worse than my umbilical hernia surgery at 10 years old. I didn’t even take pain meds after that surgery. I took one Percocet instead of my allotted two the night after my surgery, and I woke up nauseaus from the pain. I was going to throw up. You know what would hurt most after abdominal surgery besides someone dragging you behind a car on a rope? Throwing up.
- Your body does feel like it has been cut in half. And you use your core for everything. The recovery hurts so much, for so long (about 2 months), that it’s’ worth using two bullet points for this. There’s a reason that magic trick with the magician sawing a woman in half is terrifying. It’s probably in a lot of people’s top ten fears to be cut open and gutted while awake. Sadly, after the epidural or spinal wear off in a couple hours, that’s exactly what it feels like happened to you. You can’t move a muscle without disturbing your core, which has been sliced and stitched several layers through. An incision about 5 inches long has been stretched open and kept that way for about an hour. You can’t cough, laugh (you’ll have no reason to, anyway) or cry without extreme abdominal pain for a couple months. Months! I’m talking breaking into a sweat and feeling dizzy kind of pain. And bonus, if you labored at all before the surgery, your abs will hurt much worse.
- You’re awake as your organs are removed. Most people know that this surgery takes place while you’re awake, but let’s all just let that sink in for a bit. Awake…While some of your organs are being pulled out and laid on your chest. My husband watched as they laid my uterus on my chest. He had tears streaming down his face. Some people aren’t allowed to bring their partners into the room, so you get to be alone while you contemplate death.
- Contractions obviously hurt worse after abdominal surgery. Those postpartum uterine contractions from nursing and the Pitocin they gave you to stop you from bleeding to death post surgery and close up your uterus stat hurt SO much worse than labor, now that you’ve had your abdomen cut open several layers through. Imagine going through transition again, only this time you’ve just had your stomach cut through and stitched hours before. Yep, that bad.
- Nursing is going to be much harder. Not only were you probably in recovery without your baby for a couple hours while she spent the first few hours of her very life alone in a plastic bin, but once hospital staff give you your baby, you will have a hard time holding her and you won’t be able to lift her. Most babies nurse immediately out of the womb, and your baby was denied this. This can negatively impact bonding for both baby and mother. Then of course, logistically, once you are able to nurse, there’s about one position you can do that in, since you’ve had debilitating abdominal surgery. And it’s not side-lying, like your sadist nurse is suggesting. (The fact that they suggest this is just one more obvious red flag that they don’t understand csection recovery.) You won’t be able to lay on your side for many weeks. Since you can’t completely sit up for a few days, and have to semi-recline, it’s hard to nurse the traditional way that moms are always photographed nursing in. That position takes a semblance of ab muscle to support you in an upright position – and you don’t have that. No, the position you get is the one that possibly hurts the most. It’s you lying down, while they mash the baby on top of you. The baby sucks up. It hurts.
- You can’t get on and off the toilet to pee by yourself. Since your ab muscles were spread apart (and not gently), it hurts more than a little bit to lower yourself to the toilet and engage your ab muscles (you can’t) to get back off the toilet. Think the hot flashes, and armpit and forehead cold sweats kind of pain. At the hospital, the nurses (supposedly – but not in my case) help you get on and off the toilet by lifting and pulling you. At home, you’re on your own. In my case, I was lucky with my husband being home for a week to help out. After that, I admit I did some peeing while standing up in the shower to get through.
- You’re going to be peeing a lot. Since you were pumped full of IV liquids during your surgery and you probably resembled an unseemly puffer fish afterward, you will be peeing a LOT to get rid of all this fluid. Like every hour. It’s a great ab workout, though! Wait, we’re not cleared for that, yet?
- That first poop is hard, in so many ways. And speaking of relieving yourself, since you had major abdominal surgery, your brain sent a message to your bowels to stop working because they were traumatized and your brain probably thought this was the end of the road for you. I mean, you were cut open. Seriously, your digestive system stops working during and after surgery for a bit, and then tries to kick into gear again. Because of this, and because of constipating painkillers like Percocet are constantly in your system for weeks, you can become very, very backed up. THEN, one fateful day, you will need to push out this excrement. Hopefully within a week of your surgery. Guess which muscles you use when you poop? Yep, all the ones that are in screaming pain. So much that you can’t actually push. Like pretty much everything having to do with a csection, it hurts. Some people have to have it pulled out of them it gets so bad. Hope you have help at home!
- While healing from likely the most major surgery of your life, you will have to take care of a newborn, also arguably one of the most challenging points in your life. If you have other children, you will be taking care of them, too. Just imagine chasing a toddler around on little sleep and feeling as if your body has just been cut in half. You will get no compassion from your OB or any nursing staff surrounding this very fact. They will act like it’s normal and no big deal. But they don’t have to go through it, and most likely have never been through it.
- It’s difficult to heal from. When you have any other type of surgery or illness or something physical your body needs to recover from, medical professionals are quick to tell you the most important thing is rest and sleep. Guess what you’re not getting with a newborn? It takes so much longer to heal. Plus your immune system is compromised – little sleep plus extreme stress plus being exposed to a less than sanitary hospital environment? Yeah, so, try not to get sick.
- Csection surgery creates a lot of painful gas. In addition to not being able to poop, it turns out opening your body up and shuffling around and removing and putting back organs will also give you major bloat and gas post-surgery, because, again, your digestive system shut down and has to reboot. You know how bad gas bloat hurts? Imagine that bad gas bloat pushing up against layers of healing incisions in your abdomen. Pain for days. For some reason, a lot of nurses think this is funny and will ask you if you’re passing gas about every hour, in front of all your family and friends in your room. And your hospital room probably smells.
- Going anywhere you have to go within a month of surgery hurts. Have you ever tried to ride in the passenger seat with a full latte without a cap on it? That’s kind of what it’s like going home after your c-section, and anywhere else for two weeks. Much like the capless latte, you will feel as if your organs might spill out of your body at any minute. Every bump and turn in the road feels like all your ab muscles are stretching to the breaking point. I literally imagined my muscles thinning and snapping like so many violin strings as we drove home from the hospital, to the pediatrician’s and down to my aunt’s for Christmas. (And if your family expects you to travel a week post c-section for a holiday like my family, instead of going to see you, they’re probably clueless like my family.) That’s what it felt like. I had to hold my stomach to keep my guts from spilling out and my incision from opening up. Too bad you have to take your baby to the pediatrician in a couple days post-op and like every week for a month. Hope they’re nearby and you have someone to drive you because…
- You can’t drive post-c-section because you’re on painkillers. Turns out, that’s dangerous. You also don’t want to get into an accident or stop too fast post-c-section because it will really hurt. Hope you have help around the house and you have enough savings to not return to work for a bit!
- Back to work before you’ve completely healed. Speaking of working, since most of the US “offers” only 6 weeks unpaid time off without your workplace legally being able fire you (although they could get around that easily by just eliminating your position altogether) postpartum, just about the time that you’re returning to work, you will start to feel less like you’ve just been cut open – right around week eight. Hopefully your job doesn’t entail any lifting, twisting or turning or walking for a while. Hopefully your job is one of those butt-in-seat kind of gigs. Hopefully you have enough money to cover those 6 weeks unpaid time off. Hopefully. As for bonding with baby? If it was an emergency c-section, you might still be having nightmares, but you might be coming out of the dark slightly and ready to bond with your baby. Too bad your time’s already up.
- Speaking of nightmares, you might have PTSD. Especially if you had an emergency or c-section, those moments leading from labor to the OR might have been less than ten. That’s not a lot of time to wrap your head around a surgery that will change your life forever – and not in the miraculous way you’ve probably imagined. Your med staff probably did not speak to you during surgery. It’s kind of an out of body experience, probably the furthest one from orgasm. Worse than having the PTSD, your OB doesn’t care or doesn’t know how to refer you to someone who can help care for you. It’s a relatively newly recognized truth that PTSD accompanies poor maternity and delivery care, and your OB probably doesn’t believe your symptoms are that bad, anyway.
- You also probably have postpartum depression. Csection and especially emergency csections increase risk of postpartum depression. Why? My guess is see all of the above. Oh yeah, plus all the hormonal changes after birth and during nursing.
- Because of these mental barriers, bonding is going to be harder. It’s hard to feel safe and warmth and love when all you feel is jittery, looming fear.
- Virtually no follow up care or resources. Speaking of your OB not knowing how to help you with PTSD or PPD (seriously, shame on them for not being able to help with at least PPD – it’s been recognized publicly for years) your OB will also probably fail to give you any resources on taking care of your body post surgery. Did you know that postpartum you only get one follow-up visit with your doctor? That’s whether you delivered vaginally or via surgery. Honestly, either way it sounds like way too little care, but can you imagine having any other kind of huge surgery and your doctor seeing you only once, six weeks later, to check the outermost incision? That appointment will last about seven minutes, and includes your doctor pulling down your pants to press their hands up against your incision and say, looks good to me! They might tell you not to exercise for a while, and then only to start with light exercise, they might not. If pressed for specifics, that’s about all you’ll get. But when, and what exactly can you do? Again, they won’t offer specifics because they don’t really know and they don’t want to get sued if you hurt yourself, so you’re kind of on your own. They won’t refer you to physical therapy unless you ask about it, and they won’t really think it’s necessary. They won’t tell you that in order to deliver vaginally next time that they will want you to wait 18 months before you get pregnant again. They won’t ask if you plan on becoming pregnant again. They will tell you that you are cleared to have ravaging sex. They won’t tell you how long to expect lochia (vaginal bleeding postpartum). They probably won’t tell you anything to look out for in terms of potential infection or other life-threatening problems post-csection. They won’t check for any kind of prolapse because you didn’t deliver vaginally, even though many prolapse cases are because of pregnancy… and you did do that, remember?
- You might feel ashamed that you didn’t really give birth. Of course you did, but there’s something to be said about having a baby pulled from your womb by strangers instead of you pushing her out. The power really is in someone else’s hands. Something that could feel extremely thrilling, messy, alive, very intimate, miraculous and powerful, can instead feel instead completely not intimate, impersonal, and sterile… like a surgery. Not always, but that could be your experience. It’s a very different experience than a vaginal birth, and it brings up a lot of feelings that people don’t usually talk about other than ICAN meetings. Unfortunately, some people will use this as excuse to look at you smugly and say, but you didn’t have to give birth. Those people don’t know what they’re talking about, and you have my permission to give them the finger.
- Isolation. You might feel a lot of things that you feel unable to talk about. Afterall, your experience is only a third of the population’s. Seventy percent of mothers in your age group will have had a vaginal birth, and you are outside of this club. For older mothers, this percentage is much smaller, really reducing your shoulders to lean on. Your OB went probably went into her profession to do this surgery, so she probably doesn’t feel sympathy for you. She probably thought your surgery was interesting, thrilling, or fascinating, but not unfortunate.
- You’re even more financially strapped. Csections cost more for insurance companies and more out of pocket. My csection, for instance, was about $4000 out of pocket. For vaginal birth I was told I would owe nothing out of pocket. Doctors and especially hospitals, pharmaceutical companies, and medical device companies do make more money off of csections and your bodily sacrifice.
- You’re probably going to end up with another surgical birth if you go to the hospital and have to take care of a newborn and a toddler. VBACs (vaginal birth after cesarean) are becoming more common, thanks to wider access to research statistics on uterine rupture (it’s about .4% – that’s right, less than 1%. Of those, many moms and babies make it out alive and healthy. OBs are still very fond of making this risk seem astronomical and will even use the phrase “extremely dangerous” when talking about VBACs. That’s not actually at all accurate, given the statistics. They wouldn’t talk about any other one percent risk as extremely dangerous, would they? For instance, did you know during the first few weeks of pregnancy you have almost a 20% risk of miscarriage? Yes, almost one in four pregnancies will miscarry. Doesn’t that sound much more likely and “dangerous” for your baby? Do you know what OBs do to mitigate that risk? Nothing. Why? Because they probably won’t get sued for it. That’s why some practices won’t even see women until after the first trimester, when they can get out of that messy, high potential of miscarriage window. The thing is, even though VBACs are actually considered safer than a repeat csection by ACOG, hospitals have interpreted prior ACOG suggestions to warrant a full surgical staff ready, round the clock, in L&D departments ready to receive VBAC patients. That’s just a lot of money for hospitals to spend on some women wanting to birth vaginally – and from a hospital’s point of view, all they care about is first, that baby coming out alive, and second, you being discharged alive. They do not care how that baby comes out. Hospitals also care A LOT about making money. Even those non profit hospitals. I’ve worked in a hospital setting for years as has my family, and trust me, most of their meetings are about their bottom line. They’re a business first, after all. And you know what makes a ton more money than women birthing vaginally? Surgery. Csections.
- Your next pregnancy will be full of red tape. And the more csections you have, the more “high risk” you will seem to the hospital system. You basically now have a big black mark on your chart that screams “potential liability”. Expect your next doctor to find just about any reason to convince you to have another c-section so they can feel safer in reducing their liability.
- You actually do have a higher risk of having future pregnancy and delivery complications now, thanks to your csection. Your doctor probably didn’t explain this to you at all, because OBs like to make csections sound like a breeze, (so fun for them!) but in illegally foregoing informed consent, they’ve illegally failed to tell you the medical risks involved in having a primary csection – and there are a few… For instance, a higher risk of death undergoing a csection vs a vaginal birth. In addition, for your next pregnancies, a slightly higher risk of uterine rupture (yes, your uterus CAN rupture even if you’ve never had a csection… bet your OB has never mentioned that), and a much higher risk of placenta previa, which is a situation where the placenta covers the cervix. This is a situation that will get you another csection. Adhesions – painful fibrous bands that form between tissues and organs, connecting them to each other. Adhesions are caused by surgical injury and according to the National Institutes of Health, over 90% of patients who have abdominal surgery develop them, and abdominal pain is the most common symptom. Your OB won’t care to tell you this, but I will: physcial therapy will help with this, as they will massage your incision. Make an appointment and tell them you are having abdominal pain post csection. This was hardest for me personally to come to terms with. In one fell swoop, the careless locum on call doc not only dashed my hopes for my current delivery, but made my future ones much more difficult as well. It was truly a selfish decision that she made without my consent.
- You were 7 times more likely to die during your birth than your friends giving birth vaginally. Yep, your birth was much more dangerous, although easier for your doc to handle. Here, the rest of the risks you open yourself up to (get it?) with having a csection, first time, or any time, around: Infection, surgical injury to you or baby, hemorrage (much higher risk with surgery than vaginal birth), problems with anasthesia – such as it not working and you being able to feel the surgery or partially feel it, or adverse affects, including death. The risk of death from a csection is 3 to 7 times greater than from a vaginal birth. Seven times greater. And they make a risk of uterine rupture of about .4% seem extremely dangerous. To whom? We have to ask ourselves. Your baby is also at a higher risk of developing an upper respiratory infection and breathing problems post birth if delivered by csection. Yes, your baby is also at a higher risk of problems. Not to mention all the drugs that your baby will also be exposed to before, during and after your csection. A common drug to stick in your IV with your epidural cocktail (you get an epidural or spinal before your csection for numbing) is Fentanyl. Fentanyl is four times more potent than Heroin. Great way to welcome baby into world, no?
- Bonus bullet! This will probably be the very least of your concerns, but you will have a 5 inch or so, likely red or purple, raised scar across your abdomen forever, and you either won’t be able to feel parts of it, or will still have stabbing pain in parts of it. It’s higher than your pubic hair line, and your bathing suit might cover it. You will probably always think of it at some point every time you get undressed, dressed, bathe, and have sex. So, hope you don’t have PTSD, because it comes with an at least daily reminder of your traumatic delivery.