I learned it the hard way: these are the only birth affirmations you need
In this post – marking Caesarean Awareness Month – Sarah-Jane reflects on how she feels during this month. Often, she cannot relate to the images and words used by other people when they share about their experience with caesarean birth. Sarah-Jane: “It feels almost laughable to me that my experience exists in the same world as these stories.”
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Caesarean Awareness Month is weird for me. On the one hand, education on caesarean births is extremely poor, and absolutely more awareness is needed. On the other hand, it means that all month I see images and read stories of births that were nothing like mine. I see women, their bodies hidden by that blue drape, smiling with their babies and partners. I read words like ‘empowering’ and ‘positive’, when the words I use to describe my birth are ‘alone’, ‘terrifying’ and ‘unconscious’. It feels almost laughable to me that my experience exists in the same world as these stories.
Hypnobirthing mantra
I had a straightforward low-risk pregnancy. Conceived in April 2020, my baby was a lockdown baby through and through. It’s easy to forget how different things were then – no vaccine, no partners at appointments or scans, no in-person antenatal groups, the list goes on. I spent my pregnancy very anxious about the thought of my partner catching Covid and having to give birth alone, but apart from that I felt good. I threw myself into hypnobirthing and antenatal ‘education’, I practiced affirmations almost every day (‘My baby will come when my baby is ready’; ‘I trust my body, I trust the process, my body knows what to do’). I consumed positive birth story after positive birth story, believing all the Instagram accounts telling me that (always vaginal, always straightforward, often at home/in water) ‘this is what birth really looks like’, and fully embracing the ‘no-horror-stories’ hypnobirthing mantra.
Euphoric warrior
I knew a caesarean was a possible outcome of any birth. But deep down, I didn’t think I would have a caesarean. No one in my large family had ever had a caesarean. I distinctly remember my mum, a veteran of four unmedicated, intervention-free vaginal births (including two home births) telling me that ‘if there’s one thing that women in our family are good at, it’s giving birth’. I’d always wanted kids and I’d always imagined that moment when I would push my baby into the world and feel euphoric, a warrior. I’d hold my baby and fall in love, and my partner would look on, amazed by my strength and courage. And, of course, now I’m a horror story.
“It had been drummed into me that caesareans are just Big Bad Unnecessary Interventions”
‘Real birth’
It was January 2021 and I was overdue. My partner and I were isolating because I was so anxious about him catching Covid. But still, I was looking forward to my ‘empowering birth experience’ and meeting my baby. At 40+5 I felt some leaking, and went to get checked. On the way to the hospital, my contractions started. I was excited! At the hospital, they confirmed that my waters had broken. But there was something else. There was meconium in the waters, meaning that the baby had done a poo inside. This could mean that she was distressed, so they wanted to speed things along. They offered me the choice of Pitocin or caesarean. And I chose Pitocin because I wanted a vaginal birth, because it had been drummed into me that vaginal birth is ‘better’, is ‘real birth’, whereas caesareans are just Big Bad Unnecessary Interventions.
Panic in the room
I got an epidural and started on the Pitocin. It was quiet, relaxed. My partner and I did a crossword. We dozed. Then I heard the ECG monitor change. My baby’s heart rate had been roughly 140 the entire time we’d been in hospital. All of a sudden, it was 60. The room filled with people, they turned me on my side, the obstetrician, her hand inside me, tried touching the baby’s head as that can sometimes help, they tried everything – nothing changed, her heart did not recover. The panic in the room grew. There were raised voices now. People started shouting things like ‘Category 1! Category 1!’, ‘General!’, ‘No time!’, ‘We’ve got 7 minutes!’. It was clear that my baby’s life was in danger. Someone came up to me with a consent form, and said: “We might have to do a hysterectomy, sign here.” Then they rushed me away, leaving my partner alone in the room, with no explanation as to why he wasn’t coming with me.
“I remember thinking that I would die and my baby would die”
Alone and terrified
They ran me to theatre, pulled my robe off and I lay there naked as people swarmed around me. Someone put an oxygen mask on my face and I couldn’t breathe with it on. I tried to tell people I couldn’t breathe. I remember thinking that I would die. ‘I would die, my baby would die, I would die, my baby would die’. ‘Why am I alone? Where’s my partner? I need him. I’m facing the most terrifying moment of my life, and I’m alone. We didn’t even say goodbye’.
Disoriented
Then they put me to sleep and delivered my baby in one minute. My notes say ‘knife to skin 5:24 am, baby born 5:25 am’. Coming around from the general anaesthetic (GA) was really f*cking slow. Hours of being confused and disorientated. I didn’t understand if my baby was alive or dead, born or not. I lost my vision, apparently a relatively common side effect of a GA. I couldn't see my baby. Staff tried to calm me down, telling me to look at her. But I couldn’t see. I have a photo of me holding her for the first time, two hours after she was born. I’m completely out of it and still have an oxygen mask on. I don’t remember it. All I do remember is crying. Saying ‘I can’t see’ over and over and over. And finally, at some point, this pained look on my partner’s face as he struggled to see me in such a state. On his chest, a blob that, looking back, must have been our baby. Our baby who, miraculously, had immediately recovered once she was delivered and could breathe.
“I was in shock and couldn’t process what had happened”
Colossal failure
The pain of the caesarean shocked me. I’d spent my pregnancy learning about pain relief for vaginal birth, but not for caesareans. Hours later, they encouraged me to get up and walk, but every time I did, I shook uncontrollably. Shock. I couldn’t process what had happened. When I closed my eyes I was just back on that theatre table – naked, alone, petrified. I’d missed the birth of my baby. What a colossal failure – a mother who missed her own child’s birth. The failure sank into me. How could I be sure she was mine? And beneath that failure, the shameful feeling that I’d ‘failed’ at birth by not birthing vaginally.
Close to devastation
My biggest anxiety, giving birth alone, had come to pass. But also been replaced with an even bigger realisation; that my baby had come close to not surviving her birth. We never found out why her heart rate crashed like that. Maybe she reacted to the Pitocin, maybe she’d tangled her cord and cut off her oxygen. I don’t think I fully appreciated how close we’d come to devastation until I asked a midwife what would have happened if they hadn’t given me a caesarean when they did. Death or serious brain damage, she said. It took hearing those words for the panic, the raised voices, the chaos, to make sense. It was so scary, but I cannot fault the professionals whose speed gave us our baby.
“The obstetrician who saved my baby’s life is skilled beyond belief: she did something amazing in one minute”
Gratitude
I’m 15 months on from my ‘crash section’, as I learnt it's called. Every day, I relive those moments in theatre, not knowing if I would wake up to no baby, no womb, or if I'd wake up at all. People shouting ‘No time!’ echoes around my head. I bury my face into my sweet baby, countering that memory of not being able to breathe, by breathing her in and thanking my lucky stars that I have her here with me, safe. My gratitude runs even deeper than my trauma. Caesareans are amazing, lifesaving operations. The obstetrician that saved my baby’s life is skilled beyond belief. I’ve since watched videos of caesareans – not of smiling faces behind blue drapes – but of stomachs, skin, muscle, fat, being torn open. She did that in one minute. And because she did, I have my baby.
Unprepared
I was hopelessly ill-informed and unprepared for the birth that I had. The birth prep I did had no information about that scary consent form, about caesarean categories, about anaesthesia in an emergency, about how it is standard procedure in all hospitals to deny the birthing person a birth partner in the event of a GA birth, about pain relief post-op, about how caesareans can really mess with your bowels, how the incision can hurt for months or years, and how the surgery can impact your muscles throughout your body. I know now I’m not a failure. But I don’t think everyone else does. Every interaction I had with a midwife post-birth involved the phrase ‘don’t worry, you can have a VBAC next time’. The subtle, insidious message that a caesarean is something to be disappointed with.
“Sadly, many strong, brave women – who sacrifice so much to birth their baby via caesarean – feel like failures”
The only affirmations you need
I’ve learnt so much from my experience. I’ve learnt, with huge sadness, that many women start their mothering journey feeling like failures. Strong, brave women, who sacrifice so much to birth their baby via caesarean. It’s a hard way to learn what matters most – that there are two modes of giving birth, and (if you get good care) you have the mode that is best for you and your baby’s health (mental as well as physical health). You cannot control which mode you get, and one way is not better than the other. You cannot fail at birth. Those are the only affirmations you need.
Million more moments
Birth is a sacrifice. Part of my sacrifice was that my partner and I missed the moment of our baby’s birth. We’ll always be a bit sad about that. My heart will always hurt a little bit when I hear birth stories where people get to be awake and with their partners. But I know that because of that sacrifice, we get to live a million more moments with our baby. Thank you to the medical professionals who have given us those moments. They are infinitely more important than which part of my body our baby came out of.