My slanted scar: a story of love and pain
Georgia Johnston @georgiajohnstonphotography
As the firstborn child from a large family, having children always appealed to Sarah. Only time could reveal when, how and with whom. Her story of becoming a mum starts with two suitcases and a one-way ticket, a sudden relocation and the whirlwind of a global pandemic. She shares how giving birth was simultaneously the most traumatic and joyful event of her life.
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I always liked the idea of having children. I just didn’t know when, or care whether I birthed my own, blended families or expanded my sense of family through adoption. I appreciated the larger than life energy that emerges from chaos, as was her upbringing in a family with five children close in age. Given my academic journey, which moved me across time zones over and over again, maintaining a romantic relationship that could move with me seemed like an impossible feat. With only two suitcases packed and a one-way ticket, caught up in the whirlwind of a global pandemic, I suddenly relocated from Hawai’i back to western Canada to seek refuge on the eve of the Canada-US border closure for an indeterminate period of time. At the time I didn’t know when I would return or how much my life was about to change. Shortly after sheltering in place with family, I was recruited for a job in Canada, met someone from the West Coast like me, fell in love, and became pregnant. While I had hoped to return to Hawai’i and finish up the semester and year there, with Covid cases on the rise, and access to the more socialised Canadian health care system, I remained in Canada. I soon began to meet with a midwife. At the time of writing, I have not yet returned to Hawai’i, over a year later. When I do, I will have a healthy baby in tow. It sounds dreamy now, but this was not always a smooth journey. The love I have for this baby was punctuated by intense moments of trauma and moving together through pain. Giving birth was simultaneously the most traumatic and joyful event of my life. With such intensity informing this lived experience, I keep meditating on Nuu-chah-nulth teachings about Yaayukmiss – the relational, entwined emotions of love and pain.
A foreign concept
During the early stages of pregnancy, I was debilitatingly nauseous, sometimes releasing the contents of my stomach, including fluids, at all hours of the day and night. I had to reschedule classes, cancel meetings, turn off the video of numerous virtual calls and take frequent naps. More than once, I hurled on the street, in the car, and in the background while my partner was simultaneously delivering a presentation in real time. That pregnancy “glow” was a foreign concept to me. I ended up on a steady dose of Diclectin, a pregnancy sickness drug, to combat the nausea while gestating another being. My body of expanding organs built a placenta as my uterus grew. The foetal-maternal exchange dance took over and I was no longer in control of how I felt, managed time or nourished myself. During the first few months of pregnancy, while located in Victoria, B.C., Coast Salish territory, as the wildfire haze from California blew North, I was alone and struggling for breath, separated from family and loved ones, trying to construct a new home and a new life emerging inside of me. My therapist reminded me that I was not alone, I was cellularly connected to this budding life inside of me. Around the time of the Canadian Thanksgiving holiday, my partner and I received our first sonogram reading, and heard the baby’s beating heart. For the remainder of the pregnancy, we would hear comments about the baby’s vital signs: strong, steady and healthy. Nothing to be worried about we were told over and over again.
“It was difficult to be away from family during moments of celebration”
Second trimester: on the move
With my obviously expanding belly, and increasingly limited mobility, my partner and I soon realised that our stylish loft in downtown Victoria was not going to be feasible for us much longer, let alone with a newborn. We resumed our housing search. Around the same time, we found out we were having a baby boy, and announced this joyful news to family via Zoom with a mixture of sparkling water and a splash of blue Gatorade to mark the occasion. It was so difficult to be away from them during these moments of celebration. Over the winter months, my partner and I looked for a more suitable home to welcome our child into the world. First thing in the new year, I closed a deal on my first ever home purchase and made plans to move a month later. It was exciting to think about building a nursery for our little boy. As someone who grew up on the ocean and conducts research about seascapes across Pacific archipelagos, I was particularly committed to an ocean-themed nursery, including jellyfish wallpaper as a backdrop to the baby’s cot. We moved in around Valentine’s Day and began a deep period of nesting, receiving many hand-me-downs, gathering gently used items including a stroller and bassinet, and organising a virtual baby shower. I was happy to move between trimesters, because once the third trimester came around, my movements became much more confined.
Third trimester: creating a birth plan
Some of the traits you pick up along the way as an academic include organisation and planning skills. Creating lesson plans, delivering lectures, evaluating students are all requirements of this profession. I brought the same attributes to preparing for birth. My partner and I joined a preparing for childbirth class. I went to frequent appointments with our midwife, read countless books and joined several pregnancy apps. It was common to discuss birth plan preferences. We decided on a hospital birth, though my dream scenario would be an outdoor water birth. During delivery, the best plans become thwarted. I know too many mothers whose home births ended in emergency transfers to the hospital. I didn’t want that experience. I wanted to arrive at the hospital early, set up my preferred atmosphere – with flameless candles, tranquil lighting and a crystal lamp, low-fi hip hop playing, my fruit and popsicles readily accessible and clothing that would hold up while spending hours immersed in a small hospital shower. I thought that I would have a natural birth, unmedicated and without surgical interventions. This was Plan A.
“I was preparing for vaginal birth”
Born for labour
During the later stages of the third trimester, my midwife and doula offered tips on how to ripen my cervix and prepare my pelvic floor. This involved tea, intercourse, walks and acupuncture. I was preparing for a vaginal birth. My partner often joked that I was born for labour; nobody in my family, neither my mother nor my sisters delivered their babies with medications or surgery. I played rugby for years, am covered in tattoos and generally have a high tolerance for pain. When my contractions were to start, I would be ready I thought. One of the blessings of working in Canada is access to paid maternity and parental leave. This is one of the reasons I was compelled to leave a tenure-track position at the University of Hawai’i, Mānoa and return home to Canada. Paid leave is not a reality in most American states and it was not supported by the university. Now back in Canada, with income assistance from the federal government and my employer, I arranged for maternity leave to begin a few days before my scheduled due date. Coincidentally, the baby’s due date coincided with my partner’s final assignments for his graduate degree. We held our breath and hoped the little one would arrive late. Earth Day would be perfect, we thought.
Due date: hurry up and wait
Our baby’s due date came and went. The only sign of labour was the popping of my cervix cork – the release of the mucus plug – minutes after my partner completed his final presentation. What a considerate baby to wait until that moment, we amusedly told ourselves. Then Earth Day came and went. We caught up on sleep, resting and nesting, hoping to bank this for the postnatal period of incessant sleepless nights. Victoria General Hospital scheduled a few ‘non-stress tests’ – the name of which inevitably stressed me out given the possibility of something going sideways – to check up on his foetal development. Everything looked good, we were told over and over again. On my mother’s birthday, a week after the initial due date, we did another ultrasound and learned that I had a uniquely shaped placenta: a bilobed placenta, formed in two parts, like mickey mouse ears. We also learned that this organ I’d been cultivating for 9 months was nearing its expiration date. A few days later, we returned to the hospital for an Ob/Gyn consult. We do not advise leaving this for more than a few days, she told us. We don’t usually let mothers go past 42 weeks. I was cutting it close. An induction date was scheduled for the following Monday, my birthday, nearly two weeks beyond the baby’s initial due date.
“I sat down on a wheelchair resembling a shopping cart”
Setting up camp on the bed
True to my nature, I created a plan. Let’s give my body one more day to go into labour naturally, and another to try the midwife’s castor oil brew before the scheduled induction. I have to admit, I wasn’t too keen on pooping out the baby, or to force him out. Luckily, contractions started just after the Ob/Gyn consult, and active labour began that evening. We slept with our eyes open. By 5am, I insisted that we would go to the hospital. We called the birth support team – a midwife, her student and my doula – to let them know. It was the most painful drive of my life as each bump and turn enhanced the pain of each contraction. We arrived before the doors were open and called in for support. I sat down on a wheelchair resembling a shopping cart, as my partner wheeled me to the third floor and the hospital staff carried our carefully prepared hospital bags. I was in too much pain to set up the atmosphere I wanted. I was 6cm dilated and set up camp on the bed instead, from which I didn’t leave for hours. My water broke. Time became fluid.
Like the turn of a switch
The best way I can describe my labour experience is a confluence, or perhaps a collision of extremes: from the ‘spa’ to the ‘shitshow’. Though my partner gently reminds me that the hospital spa atmosphere is not one he wishes to return to anytime soon. From 5am until 1pm, I only advanced to 7cm dilated, despite trying a variety of positions and eventually spending hours in the hospital shower while my partner sprayed my body with warm water to ease the pain of contractions and fed me strawberries as we listened to low-fi hip-hop music. The baby’s heart rate remained strong and my contractions consistent. I was in the zone, breathing and roaring with each contraction, ready for the baby to emerge. I was so focused and present with the experience of what was happening in my body that I remember my doula commenting on how I should make labour preparation videos. We laughed. I recalled watching the labour videos in my preparatory classes where the partner fed the labouring mother popsicles in the bath; that would be ideal I thought to myself. After 24 hours of labour, thanks to the support of my birth team and their hands on pain management techniques, I made it that far without any medical interventions. Then like the turn of a switch, suddenly everything changed.
“I was not mentally prepared for a C-section”
Menu of options
I returned from a lengthy shower session for another cervix check. No progress. Upon the request of my midwife, an Ob/Gyn came in to assess the situation. She presented me with a menu of options to progress the labour and requested to put an IUPC – Intrauterine Pressure Catheter – into my birth canal to get a reading on the force of my contractions. It didn’t work. She shot up another device into my birth canal. I withered in pain as she fumbled around in the most sensitive part of my body, between contractions. After her reading of the findings, she recommended oxytocin to boost the intensity of the contractions, while mentioning that this was one step to enhance the pathway to vaginal birth, otherwise we may be looking at a C-section, which I was not mentally prepared for. It also looked like the baby was stuck as my pelvis was not creating enough space for him to emerge on his own. I was terrified of enduring endless hours of intense labour, but agreed to the IV and oxytocin hit to move things along.
No time
Nurses came in to hook me up to the IV in my left arm. As they did so, suddenly the baby’s bpm dropped to 55, well below the normal range of 110-160 bpm, demonstrating significant foetal distress. My midwife pulled the emergency chord from the wall behind my bed, and soon health care professionals flooded the room. My body was flipped side to side like a sausage in an attempt to reactivate the baby’s heart rate. The Ob/Gyn came back in and showed me the reading print out – the baby’s heart rate wasn’t even registering on the data chart: it was so low, it was off the screen. She said we had to move fast and perform an emergency C-section and that I would be put under general anaesthesia. I would be unconscious for the remainder of the delivery. On our way out the door, shortly before one nurse banged my bed into the doorframe and after another had inserted the IV crookedly into my wrist, the Ob/Gyn stood beside me and recited the potential risks: organ damage, internal bleeding, haemorrhaging, infection… as my mind raced to process the unfolding events swirling around me and over my body, I lost track, lost control, and felt like an immobile corpse being wheeled into the operating room just across the hall. My partner was asked to wait in another room. There was no time for him to scrub in. No time for the staff to sanitize my body. No time to count the tools before commencing surgery.
“For a week, it hurt to swallow, sneeze or laugh”
Grateful, confused, hurting
I was put under for about 30 minutes but the surgery itself took 3 minutes. While I was under, my blood was taken, the reading noted extremely elevated white blood cell levels, an indication of shock, stress or fighting off infection. Before I came into consciousness, my body was X-ray’d to see if any tools were left behind. I missed many moments, viewing the birth, hearing the baby’s initial cry, holding him in my arms, the APGAR test results, what to do with the placenta. When I came around, I recall seeing my partner with his bare chest, holding the baby. I smiled, unable to speak. Grateful, confused, hurting, numb and healing. A caesarean was not in my birth plan; yet it should have been, statistics in Canada are that 1 in 3 births end up in a C-section. Normally there is time to prepare the body and the birthing parent remains conscious. Mine was a more exceptional undertaking, involving ventilation through a tube inserted in my mouth which caused pain for over a week. It hurt to swallow, sneeze or laugh. The catheter inserted into my bladder meant I was bedridden for the first 24 hours. I swelled up to 30 lbs over my pre-delivery weight. My incision was crooked, an indication of the speed of the surgical operation.
A much needed conversation
I keep thinking of Emily Dickinson’s poem: “Tell all the truth, but tell it slant”, reminding me of how birth experiences may be tiring and joyful, and they are also traumatic and life-altering. While debriefing with my father, a doctor who used to deliver babies, he mentioned that this delivery was “a matter of life and death”. He informed me that there are degrees of emergency C-sections performed. Any unplanned C-section is deemed an emergency. Given the expediency, lack of agency and loss of consciousness, mine was a ‘crash’ or ‘crisis’ emergency. The scar tissue from the incision will forever remind me of how my body became a portal, symbolising the entangled and related emotions of love and pain. Like the suture that heals the open wound, speaking with others – family, friends and professional therapists – and writing serves as a cathartic form of stitching together the pieces of this story. I’m telling it not to cast blame on my birth support team or to throw shade on the birthing experience, but to honour the beautiful emergence of this new life and to contribute to a much needed public conversation about the private affair of birth.
“Our first day as parents was a blurry whirlwind of pain management”
The hospital penthouse suite
There is not much time to process the trauma of birth while simultaneously being thrown into the role of a new parent. I was so fortunate that my partner was able to spend the next few nights by my side in the hospital room without other patients around. Lucky enough to have a single room, we called it the hospital penthouse suite. As I was being fed antibiotics and fluids through an IV on my very swollen left arm, and had my blood drawn periodically from my now incredibly bruised right arm, in addition to the recent surgery in my belly inhibiting the free flow of movement, I was bedridden at first. Once the catheter was removed, a nurse walked me to the bathroom as we wheeled the IV beside us. As day bled into night, we found ourselves alone, my partner figuring out how to change a nappy for the first time and me trying to coach him from my bed. At 4am, we called in the nurse requesting assistance to learn some tricks to soothe our son to sleep: “Try patting his bum” she suggested from the doorway before quickly moving on to the next patient. Sleep escaped us that night. Our first day as parents was a blurry whirlwind of pain management, trying to squeeze in broken rest, learning how to keep our son alive and soothe his distress and finally informing our families why we had been out of touch for over 24 hours.
Managing and muddling through
I finally took a shower after one of the nurses kindly moved me on to oral antibiotics. My colostrum came in, so I could begin feeding the baby from my bed. The loss of sensation from the general anaesthetic soon transformed into sensory overload as I began to feel and process the wounds from a complicated birth. To manage or muddle through, we learned various breastfeeding positions, cradling or the football hold. Feeding led to a rush of oxytocin in my uterus, which created cramp-like pains while my uterus began its process of involution and the release of lochia. The expulsion of fluids was another focusing event in the room. From changing the baby’s meconium-filled nappies to learning his rooting signs, the engorgement of my breasts and breathing through the sensations of diastasis recti as my body slowly began to return the organs and muscles into their pre-pregnancy place, I barely had a moment to process the twin emotions of love and pain enframing this entire experience. Thankfully, my body responded well to the pain medication. My white blood cell count dropped significantly enough so that we could be discharged 48 hours after delivery, on my birthday. I insisted on indulging in the bittersweet taste of my first glass of champagne after nine months of abstinence
“The scars on your skin both attach you to a past of loss and a future of survival”
Storytelling scars
Feminist scholar Sara Ahmed talks about the stories of scar tissue and the politics of body sensations in The Cultural Politics of Emotion. The surface of skin is a place where emotions collide. Her words could not be more resonant than in the birthing experience. As she says: “The scars on your skin both attach you to a past of loss and a future of survival” (2015, p. 38). Each time I look at the slanted scar below my bikini line, I will think about the story of this birth, and reflect on the beautiful emergence of my son. My body became a portal, an opening to give him life. Many questions linger. We don’t have all the answers. What caused the rapid heart rate deceleration? Was my uniquely shaped two-pronged placenta failing us and to blame? What matters more than answering these questions is creating space for conversations about complicated births, so that crash emergencies are not normalised yet silenced, and that women do not hide in the shadows, afraid to discuss the entangled emotions of love and pain that transpire through all stages of birth. Following Sara Ahmed, I am optimistic that the shared language of pain can connect one body with other bodies to cultivate conversations and senses of community around these sensitive situations. By giving flesh to feelings, sharing and caring together through such intimate, visceral and intense experiences, there exists space for healing. There is much we can learn from these good scars. Every scar tells a story. Scars simultaneously remind us of painful injuries alongside the imaginative possibilities for other possible worlds and forms of life to emerge.
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