Posted by: emjb | January 15, 2006

War wounds

First of all, I should probably correct an earlier post about my c-section scar being a foot long. It’s not quite that big. But when I put my hand on it, it feels enormous. This is the first week where doing that doesn’t bring on a wave of grief (still plently of anger hanging around, though). I mean, my belly was nothing special before, just an average one, no abs of steel. And I still have stretch marks, so it wouldn’t be an object of beauty right now no matter what. But the scar is an angry dark pink color, and it looks alien there. I’ve never had a scar that big. And now I’ve got this one for the rest of my life. It’s hard to adjust to.

I imagine heart surgery patients feel the same. Apparently, from what I’ve read, it’s not that unusual for any major body-altering surgery to bring on grief. We get pretty attached to our bodies in their original forms, and it’s a shock to have them changed on us. And surgery, I suspect, always feels like a violation or a trespass. It’s more intimate than sex, in a way, but done to you by a stranger in a mask while you’re helpless and drugged. And it leaves pain behind, along with the scars, and even phantom pains or weird twinges that weren’t there before after recovery is officially over.

Do surgeons ever think about or talk about these things? (perhaps doctormama can answer that one). When they’re standing over an unconscious or semi-conscious patient, does the patient’s fear and confusion mean anything to them?

I ask because I keep thinking how much difference it might have made had the surgeon taken the time to talk to me, to show me some compassion, to connect with me as a fellow human being. Do surgeons know how terrifying they look, robed and masked and holding a scapel over you? Could it be possible to dissipate that fear a bit by taking a few minutes to look their patients in the eye, to let them know they understand the fear and pain and that they are going to do their best to make it easy on their patients? I think yes. Maybe with scheduled surgeries, it happens more. Judging by the stories I read on the c-section mailing list, though, an awful lot of surgeons don’t; to the point where several relate stories similar to mine, where the surgeon nearly started cutting before the patient was properly anesthetized.

Technically my surgery was an unscheduled one, so I suppose it was considered “emergency” but neither I nor the baby were yet in distress; there was no real reason to rush, except the hospital’s schedule. And I’m sure that’s what the problem was. It was about 5 in the evening, the surgeon wanted to go home maybe, or had some other surgeries on the schedule. The whole thing took less than 45 minutes…efficient and successful, on paper. In terms of how long I’m taking to get over the surgery because of the way I was treated…not so much.

So many of the women on the c-section email list are like me, walking wounded. Even though I feel better today than I have in a long time, I’m one of them. So many c-sections. How many of them were necessary? How many of us will ever know for sure one way or another whether what we went through was really about our safety, and not someone else’s convenience? That’s the hell of it really. The way we’ve all lost trust in the doctors and hospitals that say they’re here to help us and keep us safe. There are women on that list who won’t go to the hospital for anything, not even a miscarriage, because they’re so angry and hurt by their experiences there. Undoubtedly, as it gets harder and harder to find midwives to do homebirths (or insurers to back them up) more women will opt for unassisted homebirths, raising the risks for themselves. Because they would rather risk birthing alone than going back into a hospital that symbolizes violation and pain and injury to them.

Women want to give birth in a safe place, and in this country, we’ve been taught to believe that would be a hospital. And then we go there, and we find out, it’s not as safe as we thought. That the US c-section rate is higher than a lot of medical professionals think it should be, meaning every birthing woman is at risk for getting one she doesn’t need, because our doctors and our system aren’t willing to find effective ways to bring that rate down. Because to hospitals, c-section is neat and tidy, no matter the fallout to the scarred and stunned women who undergo it.

In my opinion, we know pathetically little about birth and pregnancy and labor, anyway. It’s evident that Pitocin and epidurals raise c-section rates, but we still don’t offer much in the way of alternatives. We can’t accurately predict a baby’s size because our sonograms aren’t sophisticated enough. Most OBs have no clue about natural laboring methods, positions, why labor stalls, or even how to deliver a breech baby without c-section (some of them can be delivered this way). My hospital’s “birthing suite” for example, had no comfortable place to labor that was not the bed…and the bed was way up off the hard cold linoleum, so you always felt a little scared that you might fall off and crack your head. The foot of the bed was actually too unsteady to lean against, and your socks slipped on the floor. Why couldn’t there have been a mattress on the floor, too, or a lower bed or comfortable chair to labor on? If I’d known I’d have brought one. But it’s evident no one at that hospital had given much thought to laboring outside of lying flat on your back in bed, no matter how large and pretty the room was.

(And yes, I should have asked for those things, I know now. I would, now. But like a lot of people, I was scared and intimidated by the system, and distracted by labor, and I didn’t have the guts or the energy. Knowing what I know now? I’d be a huge pain in the hospital’s ass, or just have refused to be induced, or insisted on having the Pitocin turned off, blah blah blah. Hindsight’s 20/20, etc. )

C-section is a necessary tool and I’m glad we have it; but it is also a crutch that keeps our system from improving our understanding of vaginal births and how to make them more effective. It’s efficient, on paper. It’s traumatic, in the flesh.

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Responses

  1. A few random notes:

    – My scheduled c-section was much less traumatic than the emergency one. But not because of how the doctor treated me (they are still all business). Mainly because I went into the hospital mentally prepared for surgery. I didn’t care about the logistics, I just wanted to hear that baby cry.

    – I am also baffled as to where the line is between “necessary medical intervention” and “convenient for the doctors”. The whole thing makes my head hurt. I admire you for thinking about it so much. For me, it is just too hard to take all of that on.

    – Regarding your previous post about antidepressants: I know millions benefit from them, as the commentors themselves prove. However, they didn’t work for me. My problems were not completely chemical; they were situational. I had to learn to deal with major life changes, the grief from my son’s birth, and my resulting anxiety about the future. I wanted to try talk therapy. But I found my doctors wanted to push the drugs; they were a quick fix for them. The one medication I tried made things MUCH worse for me for several weeks. They told me it was a normal response. I was miserable. I decided I wanted another baby, and I didn’t WANT to be on these drugs for the rest of my life. I weaned off, against my doctor’s recommendation. Talk therapy, and time, is what ultimately helped me. Bottom line: do what works for YOU. Every situation is different.

    – Regarding your c-section scar: that scar, that seems so monstrous now, will fade. It will take a long time, and they will never be completely gone, but ALL of these scars will fade. Although, I’m sure it’s hard to imagine that day right now.

  2. Thanks, Mete! It always helps to hear from someone else. And I think, if I had gone into the birth knowing I had to have a c-section for some reason, I would have at least been able to get ready for it mentally…I had a really strong desire not to have one, and so it felt like defeat when I did. Which is also something I’m learning to deal with. I’m still planning on joining a support group, and the ICAN emails are definitely helpful to read every day.

    The scar bugs me a little less now. It’s more about what it represents than the scar itself, you know?


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