Dealing with Birth Trauma in the Face of a Second Delivery

The following is a personal account of what occurred and how I felt during my previous labor and delivery experience. In an effort to sort through my feelings as I head into a second birth scenario, I am posting the following blog. I realize that, for some, this may be triggering. It certainly is for me.

​ The idea of childbirth is a real mystery for anyone who is expecting, but it is certainly something that creeps up on you as you progress towards your due date. What will it really be like? I have only experienced birth once, but I am just as mystified this time as the date approaches as I was when I was pregnant with my first son and, at that time, completely naïve of the realities.

Part of you is super excited, happy, and anxious to meet your little one, and then - if you are anything like me - a bit apprehensive of what exactly the birth experience will be like. As a culture, we are exposed to so many similar (and terrifying) scenarios in the media: screaming sweaty women sitting with their legs behind their heads cursing out their husbands or partners. Crying at the pain. And just then - when you think this woman is really going to lose it - a crying, purple potato is placed delicately in her arms. The mother smiles, the baby coos, dad comes in for a hug and a photo. Suddenly, the pain is completely forgotten.

Or is it?

I thought I was over it. I thought I had forgotten it, but in recent days I have been facing the naked reality that - no, I am not in fact, over it. No, I am not ok with how my first birth occurred and, no, the familiar "all's well that ends well" that people try to shove down your throat whenever you bring it up is not ok.

Some of the details of that day are a bit hazy now, but in light of recent events (I'll get to those), some very strong feelings have been coming to the surface for me. I'm trying to name them and address them as they come, and the number one feeling that brings me to my knees was the ultimate and pervasive feeling of not being in control. Losing my autonomy. It was the exact opposite of empowering.

Before giving birth to my son, I had these grand ideas of what birth would be like for me. It was going to be different for me. I worked out every single day of my pregnancy, did thousands of squats (literally, because I read somewhere that if I did, my baby was all but guaranteed to just fall out when the time came), read all of the books, and compiled the perfect songs for my birth playlist. I wasn't going to take it "laying down" like that woman on TV. I wasn't going to be the woman screaming and crying on her back, looking completely helpless. I was going to squat and hover on all fours and naturally push this baby out of me with the aid of essential oils and soft music - certainly not with an epidural. I was going to be the birth champion! Oh, and it started so gloriously.

My son was brought earth-side by the miracle of surgical intervention on July 15th 2018 after suffering for about 30 hours of labor. What went wrong? How did that happen? How did I get to that point? I frequently find myself asking these questions randomly throughout the day or at night, when I can't sleep. Why was it so hard for me? Why is it so easy for others? What is wrong with me? It can make you crazy.

About two weeks passed his due date, and two non-stress tests later (the second of which I had failed), I was admitted to the hospital early on Saturday morning, confident that I was already in labor and that the transition from expectant to just mother would be a quick and smooth one.

I felt good. I felt ready. I felt like the contractions I had been experiencing since the night before were totally within my capability. I was excited. Then, that all changed.

I remember my contractions being about 6 minutes apart when I went in to be admitted. Granted, I was scheduled to be induced, but I had the dumb luck of going into labor the night before. The only problem standing in my way was that I was not dilated. At all. Zero.

As my contractions quickened, but I failed to dilate, it became clear that I was going to require my first intervention in the form of Cervidil - a medication used to soften and dilate the cervix. Within minutes, I went from watching the Happy Potter marathon on tv, carefully perched on top of a yoga ball to laying on the ground with contractions one minute apart.

Peep the side effects: The most common side effects associated with the administration of CERVIDIL are contractions occurring at a rate faster than normal (tachysystole) and signs that the baby is exhausted or in distress (uterine hyperstimulation). In clinical trials, these effects occurred alone or together in less than 1 in 20 women who were given CERVIDIL. In clinical trials, fever, nausea, vomiting, diarrhea and abdominal pain were noted in less than 1 in 100 women who were given CERVIDIL.)

I had all of the above.

Several hours passed - it could have been two, it could have been four - but the pain became so unbearable that morphine had no effect - besides aiding the Cervadil in making me vomit profusely. I mentally left my body. I remember surfing vividly on an exotic island. I was no longer present. The pain consumed every ounce of me and I vaguely remember asking to be euthanized. The worst part - the cervadil had only advanced me to 1cm in that time. But 1cm was enough to get me an epidural. Cue medical intervention number two.

I had not originally planned to have an epidural, but I don’t think I would have survived without it. The Cervadil had already wrecked any plans I had for a natural birth. I must say, I didn’t hesitate for a second when it was offered. It was something that, prior to the experience or labor and delivery, scared me a lot: a long, thick needle right to the spine? Something that could potentially cause paralysis or permanent spinal damage if I did so much as flinch? But when I tell you, I would have stayed statute-still and taken that sucker right in the eye, I am not lying to you. It was that bad.

Once the epidural was in, the pain dissipated and I was almost a new woman. The only reminder of the previously unbearable labor pains was the rhythmic contracting of my abdomen. I could feel it harden, but it didn’t hurt. I even picked up interest in the Harry Potter marathon again. With a renewed sense of hope the nurses and midwife assured me that I was progressing quickly and it would only be a matter of hours before I would be holding my son in my arms. That sounded promising and the epidural made me believe I really could push this baby out. Intervention number three: my water was manually broken by a midwife with zero bedside manner. I had actually asked for someone else at one point, but there wasn't anyone. I just didn't like how rough she was with me and the way she spoke to me bordered on condescending. Birth is an extremely emotional journey, it's not the time to have unhelpful people around. I was glad for the epidural at this point because water-breaking looks terrifying and I was grateful I couldn't feel it.

My labor began progressing quickly - and at some point the nurses/midwives became extremely busy with other births occurring in the hospital and I was given a drug to slow/stop my labor altogether. I lost my nurses for several hours. My fluids ran out. My epidural ran out. I spiked a fever. There was literally no one around - except for a young tech who sort of flitted in after my husband went out into the hallway to try and flag someone down and she stood there apologizing profusely that there was nothing she was legally allowed to do and we would have to wait.

I was eventually put on oxygen and given Pitocin in a vain attempt to restart my purposely-stalled labor. It didn't work. They gave me more. By the next morning, I had dilated to 8cm. However, my water had been broken for over 12 hours, my son was showing signs of distress, my fever wasn't going down, and neither of us were particularly tolerant of the increased dosage of Pitocin. Here comes the heavy with the news that a cesarean section may be our best option, as both baby and I were at an increased risk.

I went into the hospital with a plan. I went into the hospital stating that under NO circumstances was I to have cesarean section unless it involved imminent death for myself or my son. I had come into this hospital in labor, I was progressing quickly, they told me it was a matter of hours - NOT DAYS - before I would be holding my son. They stalled my labor. They left me alone. And I continued to fight and labor and will my body to bring my son into the world. And now they were just going to pull the plug on me? Just wheel me into surgery after a full day and then some of the most excruciating pains of my life? I felt defeated. Utterly gutted and I refused to accept it. Stubbornly, I swore I would get this baby out on my own. My most pathetic moment was asking my husband to put on some ganster rap while I got on all fours trying to move him down the birth canal. This is quite the feat for someone with an active epidural who cannot feel their legs.

Eventually, I was backed into a corner and told that there was no other option. Terrified and furious, I signed the surgery papers. My literal worst nightmare was coming true, and I was helpless. The feeling of helplessness - the loss of any control - the sheer necessity of just giving in - haunts me the most. Literally tied to a table while they tell you you might feel some pressure while they remove your insides and lay them on a table next to you. While your husband stands there, fascinated, watching the whole thing and you are just...lost. The worst thing he said to me and still says to this day was, "You said you were fine."

No, I said I thought was going to die. You weren't listening. You were looking right through me. You didn't see me. It hurts me to type that, but he and I have very different perspectives on how things transpired from that point on and it led to many arguments after. He didn't like when I would question how things got so complicated. I know he felt useless. I know it wasn't his fault. We didn't know any better at the time.

When it is all said and done, and it feels like forever, and they pull the baby out, there is no thought of your wish to have the placenta remain attached. They just cut the cord. They don't honor your desire to have skin to skin contact. They just cart him away, measure him and all that, quickly pose him next to your head, and then send him out of the room in the arms of your baby's father. You just sit there, empty and exposed, waiting for someone to put you back together. It's the opposite of empowering - it's defeating. Then, as they are cauterizing you - you can smell it. You know it's "you" burning. It's not my best memory. I don't know that I can or will ever forget it. The grand finale came when the two nurses jointly jumped on (maybe not jumped, per say, but it certainly felt that way) my stomach sending painful patches of trapped air up and down throughout my body. I didn't know that was possible. "Look at how flat your stomach is," they commented. I, in some desperate attempt at trying to feel good about something, latched onto the idea that at least I had that. Maybe I'd be like the women who leave the hospital in their pre-pregnancy pants. It was something.

In the minutes after, I was wheeled into recovery where my husband was sitting with our son. They finally handed him to me and he latched right away. No hesitation. I took this as my only win at the time and I held onto it for dear life.

The shakes lasted a bit and I was so hungry, yet I couldn't eat. I finally attempted to eat some cheese fries and promptly threw up all over myself in front of every member of my husband's family. It was par for the course.

I didn't realize that at the hospital where I gave birth, they don't take the baby from you and carry them off to some nursery. No, they keep the baby with you the whole time. I guess I was expected to miraculously care for both myself and an infant after the whole traumatic birth experience and I had no choice but to oblige. Don't get me wrong, I was grateful for and amazed by the presence of my nearly 10lb baby boy. And so in love. Yet, I just wasn't prepared enough. Or well enough. Or okay enough to just jump right into it.

Sleeping was difficult. Every half hour, they were either checking the baby or me - but never both at the same time. Of course not. That would be too kind. I fell asleep holding/nursing him more than once and was promptly scolded for it.

I asked to walk after 12 hours - as recommended by my surgeon and anesthesiologist - and the night nurse denied me, citing that I didn't urinate enough and that no one told her I was allowed to walk. She moved my catheter and it emptied. I asked to see a doctor. Instead, she chose to help me out of bed and begrudgingly assist me in taking my first extremely unsteady steps. She handed me my urine bag - or as she called it, my "Gucci bag," and roughly dragged me to the side of the room and sat me in a chair. She told me to ring the nurse's station when I wanted to go back and left. It was only myself and my husband (and the baby) in the room, but it was humiliating.

Thank God for my husband in this instance, because he gathered me up and walked me around the room a few times. It was the first time I had felt like I had regained some of my power since starting the labor and delivery journey.

I ended up staying in the hospital for a total of five days - which is quite a bit longer than the average postpartum stay; however, we had complications: a lactation specialist told me that we were doing just great, but a neonatologist came in five minutes later and said that my son was losing too much weight (he was nearly 10lbs at birth and lost almost a full pound in the following days - which I now know is completely normal - and he wasn't wasting away). I cried a lot over that. I felt like the breastfeeding was the one thing I had succeeded at. It was the one thing I felt like we had going for us and now I had all this additional pressure to pump and provide. Thankfully, that would eventually pass - as would all concern about his weight - as time went on.

I left the hospital on a Wednesday. I couldn't bend my feet at the ankles and I looked even more pregnant than when I had been admitted. Showering brought tears to my eyes. Everything brought tears to my eyes.

It would be weeks before I felt some semblance of normal. The swelling dissipated after about two weeks. The combination of fluids and drugs really did a number on me and the night sweats (which no one tells you about) where horrible. I also had extreme difficulty using the bathroom due to the number of postpartum medications I was taking. I quit them all pretty quickly. The side effects were worse than the surgical pain, and the surgial pain was no joke. I also inexplicably lost all feeling in my right forearm. It eventually came back almost a year later. No one knew why.

So, what is the take away here? I guess I was ok with facing a second cesarean until I started really thinking about it. I know that my experience this time is likely to be different if it is a planned surgery; however, I can't help wondering how necessary the surgery really is for me and how much I may just be being pushed in that direction because it's the easier thing that makes everyone money. I hate that I have thoughts like that.

This country has an exremely and alarmingly high maternal/fetal death rate, especially among women of color. If I had to go back anc change something, perhaps I would have hired a birth doula. I thought about it doing it this time, but due to COVID 19 restrictions, my fully-vaccinated husband is barely allowed to accompany me to the birth and has been shut out of all of my appointments. I am not sure that a doula would be allowed for a regular birth, let alone a cesarean. It is something I plan to investigate further at the time of this publication.
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