Response to a quote from Jennifer Block's book "Pushed"

I started this letter on July 27, 2007 – Evan is 17 months old.

I finished it on September 4, 2007 - Evan is 18 1/2 months old.

** Please read my next blog post after this one... and you'll see how complex the road of C-section recovery is. A month ago, when I started this letter after reading "Pushed" I was still very much in angry/sad mode... but you'll see at the end of this letter that I was starting to pull out silver linings from my birth experience. The post that follows ("Did I Need a Cesarean?") will show you how my thoughts and views changed in a month's time. At that point, I was starting to see how the negative parts of my C-section were actually strengthening me and impacting my life in a positive way. For moms who feel like it will never get better... know that a lot can change in just a month. This post and the next one proves it. **

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I just finished reading Jennifer Block’s book “Pushed.” It’s a magnificent book, and I loved everything in it. Much of it made me mad, but I’m glad it’s out there for the public to view.

There was one quote in this book that I feel compelled to respond to. On p. 64, a certain Dr. Crane (an OB who is quoted in the book) says,

“There’s no doubt in my mind that there’s more maternal morbidity with a cesarean. But a hole in the bladder, a post-operative infection – that’s not going to ruin their lives. A bad baby is going to ruin our lives.”

I don’t even know where to begin. This statement makes me so furious. And it very clearly demonstrates why women who enter a hospital for a positive birth are fighting an uphill battle.

If you look at Dr. Crane’s statement, you’ll see a very interesting fact emerge: the life of a doctor is really the doctor’s main concern during labor and delivery. And the life of the baby becomes important to him mainly because if the baby dies, he believes that will ruin his (the doctor’s) life.

My question is: Where does this leave the mom?

And, if Dr. Crane doesn’t think that a hold in the bladder or a post-operative infection ruins a mom’s life, then what WILL it take to ruin a mom’s life, in his mind? Does the mom have to die? What does a ruined mom’s life look like, anyway?

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I’d like to address that question from my own personal experience. Since Dr. Crane is a medical doctor, and will assumedly perform many C-sections in the future, I feel compelled to set the record straight. Also, since he’s a man, and will never have to endure the repercussions of a C-section, I feel compelled to tell him the truth about what he’s doing to many of the women that he operates on. He probably won’t choose to accept the truth, but I am compelled to tell him anyway.

The truth is that it doesn’t take a hole in the bladder or a post-op infection for a C-section to ruin the life of woman, her child, and her family. A C-section has far-reaching effects, and these effects go way beyond the physical ramifications of surgery. Many doctors only think about the physical experiences of their patients, and they ignore the fact that there’s a PERSON on that operating table… a human being whose very energy, soul, cell memories, and sense of self-worth are being traumatized as the knife cuts the skin… as the hands reach in to tug and pull the baby out… as the uterus is plopped out of the belly unceremoniously and exposed while it’s sewn up… and as the stitches zig-zag back and forth on once-virgin pubic skin.

THE DOCTOR’S VIEW

From a medical perspective, here are the details of my C-section.

Patient: Christi Collins. 2/15/06 “planned” Cesarean Section for baby’s footling breech presentation. Bicornuate uterus/septum. Picture-perfect operation and recovery. No post-op infection, no hole in the bladder, no spinal headache, no incision splitting, no hysterectomy. Baby and husband were with mother during uterine repair. Mom breastfed in hospital. Baby roomed in the entire hospital stay.

From the medical view of things, one would think that Christi Collins was ecstatic and delighted with the experience. No life ruined here, right? Healthy baby, healthy mom. Picture perfect C-section. In fact, you’d probably suggest that Christi Collins would be an excellent candidate for a repeat C-section, right?

THE REAL VIEW, FROM THE PATIENT’S PERSPECTIVE

Repeat C-section, my ass. Let me, Christi Collins, share with you, Dr. Crane, the real story. You see, you as a doctor only see one side of it. You see us moms drugged up and tied down and so you think (because we are too terrified, numbed, or full of hatred to tell you otherwise) that we are fine. That we are grateful to you for slicing us open and medicalizing an inherently natural process. That we don’t care about what’s happening to our bodies, because it’s all in the name of a healthy baby, after all.

You have the gall to say that a hole in the bladder or an infection wouldn’t ruin our lives? Well, let me tell you that it doesn’t take a hole in the bladder or an infection to ruin a new mother’s life.

All it took to ruin my life was a “picture perfect” C-section.

Let me count the ways…

How EMOTIONAL TRAUMA/PTSD/PPD ruined my life

I went to a postpartum support group six weeks after my C-section. I sat in a roomful of women and talked angrily and sadly about my experiences as a mom. All of the other women were on medication for Postpartum Depression (PPD). I felt bad for them, but I was glad I didn’t have PPD… I was just really, really pissed off and angry about my C-section. That’s all.

I signed up for a Money and Business course (by phone) when my son was 5 months old. Interestingly enough, several people in that group were depressed. I felt bad for them, but was glad I wasn’t depressed. I was just having flashbacks and crying spells from my C-section. That’s all.

It took until I was 7 months postpartum for me to realize that something very serious was wrong with me and my reactions to new motherhood. I remember that day very well. I was on the phone with another holistic health counselor, and we were planning a support group for new moms (ironically enough). This other new mom had an empowering natural vaginal birth with her 3-month old son. As we spoke about our first few months of motherhood, I could hear – quite clearly and distinctly – the difference between the ways I was talking about motherhood… and the ways she was talking about motherhood.

We were both talking about sleep deprivation and a loss of freedom and the trials and tribulations of breastfeeding and getting our babies down for naps. The topics were the same. But the underlying tones in our voices were very different. There was an anger, bitterness, frustration, resentment, sadness, grief, and depression present in my voice that simply wasn’t present in her voice. I was shocked to realize that not all new moms felt the way I did… not all of them were depressed and still in shock from the experience. The way that she remembered her birth was almost the exact opposite of my memories of my birth. Her birth had empowered her and made her feel confident in herself. Mine had made me feel disempowered and violated.

That was the moment in time when I knew something was wrong with me. I’d gone online when my son was a few weeks old, to see if I had PPD, and at that point in time I fit almost all of the criteria. But I’d forgotten about it (or the sleep deprivation took over, I’m not sure what happened, to be honest!). Seven months later, I found myself taking the same PPD tests and scoring just as high. I also found a few sites that talked about Post Traumatic Stress Disorder. Apparently, you don’t have to be a prisoner of war to get PTSD – I got it from my “picture perfect” C-section.

How can PTSD wreck a mother’s life? Well, imagine that you can’t stop thinking about your surgery at all… You see, people ask me how much I thought about my C-section when I was in the depths of my PPD… and the truth is, I can’t remember when I DIDN’T think about it. It wasn’t in the front of my brain all the time, but it was always present in this persistent, underlying, dull, lingering, aching sadness or anger. These feelings never fully went away. At times, I felt like a zombie. I would play with my son, and the second he’d turn his back to pick up a block, I would feel my face go limp. Trying to pretend that you’re OK… when you’re not… is exhausting. Especially when you’re trying to pretend in front of a baby all day long.

There were sharper PTSD memories, too. These were flashbacks to the surgery itself, and the weeks leading up to the surgery, when I knew that my homebirth dream had come crashing down. These sharp memories were accompanied by insomnia, floods of body-wracking tears, angry yelling fits, extreme aloofness and despair. The memories were triggered by specific experiences: breastfeeding my son, going for a run, seeing a pregnant woman or a new mom, seeing any birth shows on TV, hearing my son cry, seeing my son, seeing my scar, attempting to have sex with my husband. All day long, I got constant reminders of my C-section, and they would plunge me back into despair.

The worst part is… most people don’t even know I’ve had trouble since Evan’s birth. See, that’s the thing, Dr. Crane… moms who are depressed usually don’t say anything to anyone. Because they’re not allowed to be unhappy. They have to be happy because they’ve got a baby. And a baby is supposed to make you happy. At least, that’s what everyone else says.

I’m not like most people, though. I’m pretty honest about what’s going on with me. I also knew that I needed help. So I tried telling people. When I finally got in for a medical physical and PPD support, and I told the nurse at the new doctor’s office that I was suffering from the traumatic effects of my C-section, she told me, “Well, at least you have a happy, healthy baby.” No help there… that only made me feel worse.

I called my OB-Gyn and told them that I had PPD and needed help (because that’s the thing all the books and literature tell you to do… tell your OB-Gyn – she’s the first line of defense). She never even called me back… her office manager simply left the name of an acupuncturist on my voice mail. She never checked up with me again. I could have committed suicide and she’d never know.

I tried telling my parents, but they didn’t really want to hear about my pain – they just wanted me to enjoy the time with their grandson because “it all goes by so fast.” I called my doula. I called the Catholic Church (I haven’t been to Mass in years, but I was desperate). I called Jewish Family Services (I’m not Jewish but I heard that they could help – they actually denied my request for a visiting mom volunteer when Evan was younger, but I tried again nevertheless). I told my mother-in-law, but she never asked me about it again. I told my friends, and some of them were really supportive, but many of them never checked in on me again either. Most of them don’t have kids… and the ones with kids didn’t have PPD, so very few people understood. I told my husband, and he tried to help me brainstorm places to get help… and he took care of my son a bit more… but he doesn’t know how to help me… it’s not covered anywhere in those “What to Expect” books. He just wants me to get better, to fix myself. And my husband doesn’t have time to be my therapist – he’s too busy trying to hold the rest of our lives together while I recover from my picture-perfect C-section. Remember, the one that hasn’t ruined my life?

You see, I did all the “right things.” I told the people in my innermost circles. But there was little help for me there. People didn’t understand how bad it was for me. They didn’t know what to do. So, I retreated, and I’ve been with my own pain for a long time. Many people still don’t know how much pain there is for me on a daily basis. So, has that pain ruined my life? You be the judge.

How a LACK OF BOND WITH BABY and – MISTRUST IN MY OWN MOTHERING CAPABILITIES ruined my life

I didn’t like my son for a long time. Like, 7-10 months, that’s how long it took. I didn’t feel a bond with him. To this day, I still have a twinge of regret when I see him sometimes, or when he cries for me. You took away our ability to breastfeed well for the first few weeks, because he was so tired from the drugs. We persisted, but I know many moms whose ability to breastfeed has been taken away because of C-section after-effects. Now, if breastfeeding is one of the best ways to positively impact the health of a baby and child, then couldn’t you say that a C-section ruins the lives of the babies whose moms can’t breastfeed them any longer? Again, you be the judge.

Now, 17 months later, I still don’t feel like a real mother. The C-section took away an important ritual and right of passage whereby my body was supposed to become a mother. What happened was surgery, it was not a birth. My cells and my psyche never got to transition into motherhood. So I find myself not quite knowing what to do with my son, or able to understand how I ended up with this little creature who depends on me.

For the first 3 months of my son’s life, I wouldn’t bathe him. I wouldn’t pull shirts over his head. I didn’t take him to the grocery store, or out to the stores. I wouldn’t put him in his carseat. Those things made him cry, and because the C-section made me doubt my abilities as a mom, I simply didn’t have the courage to do those typical mom things. When other people came over, I assumed that they knew how to take better care of my baby than I did. So I passed him off. The C-section ruined my chance to be a mother to my son for the first year of his life. I couldn’t even plan a birthday party for him, because the thought of February 15 was so painful I couldn’t even face it. I had to go to a therapy session that day and try to re-brand the day into a less painful memory for myself.

How FEAR OF ANOTHER PREGNANCY ruined my life

I am terrified to get pregnant again, because of the fear of another C-section. You have increased my risk of another surgery, simply because you forced me into the first one. If I get pregnant again, my options are extremely limited. You have essentially forced me into a high-risk category that I shouldn’t be in. I will have to fight, claw, and basically hibernate in order to get a natural birth next time around. You have taken away the bliss and happiness of trying to conceive another child. I am terrified of going through Postpartum Depression again.

How SERIOUS MISTRUST OF MEDICAL COMMUNITY ruined my life

I hope to never have to see another doctor again. If I got cancer, I would rather die than have chemo or see a traditional doctor. I am afraid to have my first dental filling, because I don’t want another doctor touching my body. I don’t want any doctors to come near me.

My son apparently needs surgery right now, and I’m procrastinating because frankly, I can’t trust that the doctor is telling me the truth. I can’t understand how a community that is supposed to serve women is taking away their options, one-by-one. Women with breech babies must have C-sections. Women with twins and multiples must have C-sections. Women who are induced, who “fail to progress,” who have “big babies,” who go past their “due dates”… they’re all forced into C-sections. These are not maternal request C-sections. These are C-sections that earn more money, keep you from getting sued, and increase the convenience of a nicely-balanced work-life schedule. If doctors were truly looking out for their patients’ well-being, they would provide them with options. They would consider the moms’ needs and desires over the insurance/malpractice companies’ mandates. So, you have basically told me that for my next birth, I must remain at home, and if I cannot find a homebirth midwife to attend my birth, then I will birth alone.

Ah, but perhaps you think that THIS concept (meaning, an unattended homebirth) will ruin my life by putting myself and my baby in danger… maybe I’ve got you at last!

How a 15-month pause in my SEX LIFE ruined my life

My husband and I were not able to have sex for 15 months after our son was born. 15 months. Tell me this, Dr. Crane… would 15 months of no sex ruin your life? It can sure ruin a marriage. Luckily, I have a loyal and understanding and very patient husband… but I can tell you that there were times in the last year and a half that I thought our marriage was ruined. Not because of anything my husband said or did – he was amazingly patient and kind and gentle. But because you lose intimacy when you can’t have sex. We lost intimacy. We became roommates. I almost took off and left a few times. I’m sure he wanted to, as well. Not only do I feel like my body is “broken” because of the C-section, but now I’ve got a ruined sex life to add to my brokenness.

Why would a C-section ruin a sex life? Well, I’m sure you’d have no problem understanding why a rape victim might have problems having sex after a rape. So, now you know why I’m having problems having sex after a C-section. That C-section that you said wouldn’t ruin my life… well, it felt like a rape. It was brutal and it was traumatic. I was powerless, out of control, and forced into something that I DID NOT WANT TO DO. In case you’ve forgotten what you’re doing there at the end of the operating table… you are CUTTING into my skin. While I’m awake. While I can hear you… smell the burning flesh (my own flesh)… and know that my virgin belly was being ripped open. You are a man, so you’ve never had a C-section. Why don’t you try staying awake for your next major surgery, and tell me how that feels? Oh, and don’t try to tell me that I can’t feel anything during surgery. That’s bull. Let me jump on your stomach, over and over, and you can tell me if you don’t feel anything.

The C-section happened at night. So, pretty much, my nighttimes feel like I’m reliving a rape over and over. Makes night sex pretty much impossible. Daytime sex? Well, then it’s light out, so I can see my scar, which makes me cry and reminds me of my rape… I mean C-section… so daytime sex is out, too.

I’m also terrified of getting pregnant again. It’s hard to enjoy sex (or even want to have sex) when you’re terrified of getting pregnant.

But again, the C-section hasn’t ruined my life or anything.

How THOUSANDS OF DOLLARS/HOURS SPENT ON COUNSELING AND SUPPORT ruined my life

Lest you think I’m simply wallowing in my despair, and trying to hold on to this event… let me tell you that my goal is to let it go and get over it. I have seen/talked with/met with TEN different counselors, trying to climb out of the depths of my despair from Evan’s birth. I’ve seen three people who specialize in traumatic birth counseling. I’ve seen a traditional psychologist. I’ve worked with three holistic health counselors and a spiritual counselor. I’ve had sessions with a shiatsu practitioner and a clinical nutritionist. I’ve waited months to see a traditional MD to get blood tests run to rule out physical causes of my depression.

I called more than 9 different doctors, trying to get in to see someone. The average wait time? THREE MONTHS. My life was ruined in an instant, and they want me to wait THREE MONTHS before I can start to get help? Three months feels like a lifetime when you’re depressed, and you’ve got a little baby to take care of and new motherhood to adjust to.

So, as you can see, I’m not sitting here wallowing in my despair. I am trying, desperately, to get help. I’ve spent thousands of dollars on this counseling, trying to get over an event that earned you thousands of dollars. If/when I ever get pregnant again, I will need to continue this counseling because of the intense fear I feel about perhaps having to deal with you and a C-section again next time around. But as you said, “It’s not going to ruin her life.” But it sure as heck has ruined my bank account. On that note…

How LOSS OF INCOME/BUSINESS SLOWDOWN ruined my life

As you might imagine, all of this counseling and depression jazz sure takes a toll on my mental and emotional capacity to run my business. You see, I’m a holistic health counselor… it’s my job to support other people and help them get healthier. When a holistic health counselor is so depressed she can’t even feed herself… when she’s so tired and in so much pain from a surgery she never wanted… when she’s focusing on just making it through another day… then she is in no place to support her clients, do lectures, facilitate teleclasses, write books, write magazine articles. I put my book on hold because of my C-section. I put my business on hold because I need to get better first. I’ve lost tens of thousands of dollars of business income because of this one “picture perfect” surgery… but of course, it hasn’t ruined my life or anything.

How DECREASED SOCIAL OPPORTUNITIES ruined my life

When a woman is depressed from her birth, they tell her: “Just go out and hang out with other moms!” Well, that doesn’t work. Let me tell you why. When you’re depressed, the last thing you want to do is go out and put on a happy face and try to pretend like everything is OK. The last thing you want to do when you’re a traumatized C-section mom is hear stories of vaginal births… or hear moms tell of C-sections that they liked (because most of them are lying, but they’re too much in denial to tell the truth). Contrary to what you hear (or what ACOG tells you), most moms don’t want C-sections. It’s just that most of them are too tired or scared to tell you how they really feel. That’s why I’m writing this to you.

I felt like a failure for having a C-section. Seeing pregnant women, moms with new babies, strollers, hospitals, doctors, etc. all made me relive that horrible memory. So, I literally couldn’t go out in public. It was too painful. And I was terrified that someone would ask me about my birth story. Who wants to hear someone tell them the story of how they were raped during their child’s birth? No one wants to hear that.

Here’s the other reason why I lost out on a lot of the “Mommy & Me” social events after my son was born. I was in too much pain to go. My other mom friends were out and about… but I could still barely even move around my own apartment. And remember, I had a “picture perfect” recovery. But I sure as heck missed out on the first few weeks. Remember, I wasn’t allowed to drive, I couldn’t lift my son’s carseat, I couldn’t carry groceries, and I sure as heck couldn’t get his stroller down from our 3^rd floor apartment. You sent me home with a newborn, and yet you told me I couldn’t lift his carseat. How in the world does that work, exactly? Lucky you, you’ll never have to find out.

HOW SURGICAL PHYSICAL RAMIFICATIONS ruined my life

You may notice that I haven’t mentioned many physical side effects of the surgery. Aside from the intense digestive problems that surfaced for 15 months after my C-section antibiotics were given… I haven’t had many physical problems. Thank goodness. Many moms have post-op problems that are debilitating to their bodies and crushing to their psyches. I was lucky enough to avoid that fate. But I have no idea what will happen the next time I want to get pregnant. Will I be able to get pregnant? Will my scar cause problems? Will I rupture? Will I be able to find a care provider who will attend the kind of birth I want to have… or will I be forced to labor alone or travel to a different country or go underground to find a care provider who doesn’t consider me to be a ticking time bomb? You see, my C-section has forever labeled me high-risk. The physical ramifications remain to be seen, but you have forever complicated things for me. You’ve taken away birthing options and you’ve lowered my confidence levels just enough to make the self-doubt creep a bit. You have ruined the innocence of my next pregnancy.

THE GOOD NEWS

When I think about the good that has come from my C-section, there is one silver lining. It has made me mad. It has made me mad enough that I will never, ever accept what you say as truth. I will fight to help other mothers avoid my fate.

You see, I was a well-educated woman. I was healthy. I’d planned hard for a natural birth. I’d prepared physically and emotionally. I’d read a ton about birth, and I thought I’d almost all but eliminated my chances of having a C-section by planning a homebirth. Well, now I know that even smart, well-meaning, strong women have C-sections. And now I hold no judgment for women who have C-sections. I know that most of them have these operations because they have no other choice, they’re not given accurate information, because they’ve been beaten down by their doctors, the media, their families, the TV shows and books that make them feel like they are broken. I never realized how strong the pressure was on women to succumb to C-sections until I was in the situation myself.

If you tell women how strong they were, instead of telling them they’re defective, they wouldn’t submit to C-sections. If you tell a woman you’ll be there to support her during labor, instead of telling her you’re going on vacation so you need to induce her, she wouldn’t submit to a C-section. If you tell her that her pelvis and body are designed to know exactly what to do to birth a baby, instead of telling her she’s too small, too large, too bony, too fat, too late, etc., she wouldn’t submit to a C-section. If you told moms that their bodies, their intuition, and their babies know exactly the right timing to start the labor process, instead of telling them they need to push the kid out by 40 weeks and under a 12-hour time table, then they wouldn’t submit to C-sections. And less lives would be ruined.

If I’d had my homebirth, I would probably judge C-section moms. I would think that they simply weren’t strong enough, didn’t read enough, didn’t have the right care provider, etc. But I know that simply isn’t true. Sometimes you need to go through the trauma and brutality of your first C-section to gain the power, strength, and self-confidence and TRUST in your own body to refuse a C-section the second time. And to help other women have the confidence to do the same. It’s my mission to help moms develop this power, strength, self-confidence and trust BEFORE they get sliced open by your scalpel.

And lest you think I’m the only crazy one who feels this way, know that I’m not. It’s just that most women won’t tell you. Most women don’t have the energy left to fight. They don’t want to speak their truth because when they spoke their truth during their pregnancies (or their labors) you told them they didn’t know what was true. Or you told them that they were putting their baby at risk. So, they remain silent.

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So let me be their voice and tell you that you HAVE ruined lives. Because, regardless of what you think, it takes less than a bladder infection and post-op infection to ruin a new mom’s life. Sometimes all it takes is a picture-perfect C-section.