This talk was given by one of my amazing clients, Shannon McLaughlin at the Cape Town Midwifery and Birth conference in October 2015. Her experience has been an eye opener in how we as birth workers (and women in general) treat mothers having cesarean births.

The Homebirth Cesarean Aftermath

While I was pregnant I felt like I was part of something bigger. Part of a special group of woman who knew a little secret. A secret about what birth was really all about. I loved it. I had found my tribe.

For months after the birth of my son I was filled with an immense amount of anger. Anger towards my midwife, anger towards my gynae, towards my boyfriend, towards my best friends, especially those who had had natural births, and worst of all, towards myself. But as the months went by I realised that my anger was actually towards none of those people, but rather towards the group of people that I had once considered to be my tribe, the natural birth society.

There is an unspoken message amongst the natural birth community and it says: • Birth is easy • If you believe you can, you will, no matter what • Shame on you if you elect to have a c-section • Breastfeeding is the only way. If you do not or cannot breastfeed there is something deeply wrong with you. • When you become a mother, your inner goddess will arise and you will feel more powerful than you ever have before • You’re supposed to be capable of handling this all with ease, because becoming a mother is natural

I’m here today to share my story of my home birth turned cesarean and the trauma I went through following my birth experience. My son Leo was born on the 16th of August 2014. We had planned a home birth and we planned well. Both my boyfriend and I attended birthing classes and I was really excited to have the home birth that I had been dreaming about for years. I come from a family of natural births, my Mom had 3 naturals and my Gran had 9 naturals, so caesareans were never really discussed amongst us. I never for a second considered that a c-section would be my fate. I had 2 close friends who had recently tried for home births but both landed up having to transfer to hospital for a c-section and even after that I still felt confident that I could do it. They both had a different midwife to me and I thought to myself, “maybe it’s the midwife she chose, or maybe she was holding onto some unresolved fear, it’s because she didn’t have a doula, or she didn’t hold a clear enough vision of her perfect birth.” My gynae had been supportive of my midwife from the start but at our 36 week appointment he changed his tone slightly. We were warned about this in our birthing class, that gynae’s prefer to schedule c-sections because you know, “they need to go and play golf on a friday afternoon and they don’t really care how your baby is born”. Well at least that’s what we were told. He told me that my baby was really big and already weighed 3,3kgs and that if we waited for my due date of the 1st of August, I’d be pushing out a 4 kilo baby. He then went on to describe what my labour would be like. He said that first my water would break and then my contractions would start and he asked me to imagine the worst pain I had ever experienced and then times that by a thousand. He said that is what my labour would feel like, considering the size of my baby. He then asked me if I was still planning on having a home birth. I politely smiled and answered yes. I remember driving home after that appointment and my hands were shaking. What kind of a man says that to a first time mom? Perhaps if he had approached my situation with more compassion I would’ve been open to discussing my options but because of the way it happened, I decided then and there that he would not be delivering my baby. I told my midwife that if we needed to transfer, we could go to the public hospital, and I only said this because I was 100% positive that we would not need to go to a hospital. Little did I know how true his words would ring. So we waited and we waited and we waited….and eventually my first contraction arrived at the beginning of my 43rd week.

36 hours after my first contraction, we were still at home. After about 24 hours I had asked my midwife to do a vaginal exam because I really needed to know how dilated I was. She said she didn’t really want to as she didn’t me to be disappointed if I was only at 2cms, and I told her that if I was at 2cms I wanted a c-section because I just couldn’t take the bone breaking pain any longer. So she agreed to check me and to her surprise and mine, I was at 8cms. It was at this point I remember glancing over into the bathroom mirror in front of me and getting a glimpse of what I looked like. My hair was all sweaty and stuck to my puffy red face and my eyes were all bloodshot and I thought to myself, shit I’m glad I didn’t hire that birth photographer. I remember a few other moments from the homebirth portion of my labour, but I really don't recall much, I lost touch with reality very quickly as the labour went on. I was never scared as the intense pain had taken me to another dimension of existence, I think I was more in shock from realizing how much pain my body could physically go through without my bones actually breaking.

A constant memory I have is the space that my doula held for me, she was so strong and she pressed down on my back with almost every contraction I had. She slept with me in my bed that night and as the contractions woke me and I screamed with each one, she pressed down hard and powerful, reminding me that she was there. She was the calm in my storm. Between contractions I would think of all my friends who had had natural drug free labours and I felt guilty for not honouring their immense strength and realizing what they had been through. I think that the joy and rush of actually birthing ones baby naturally must cause a woman to in a way forget the intensity of the labour, as most woman I know tend not to focus so much on that part of their birth story once their baby has arrived. But for me, that beautiful moment that I had envisioned so many many times, was not to be.

I had a really good experience when it came to finally getting my cesarean. They allowed my midwife into the theatre with me, and it was amazing to have her there, protecting our space. Both surgeons were female, as well as the anesthetist and from what I can remember I just feel like there was a lot of female energy in the room, which made me feel at ease. My boyfriend was dressed in his little blue theatre suit and he looked cute, nervous and happy at the same time. He sat next to me and held my hand. We never said anything to each other, I think we were both in such disbelief that the moment was finally here and that the struggle was almost over. We were about to have a baby! We didn’t know if we were having a boy or a girl and now that my pain was gone and the drugs had kicked in I was starting to enjoy the experience. I had asked them to do delayed cord clamping and they said they couldn’t as the risk of infection with a c-section was too high, but they said they’d give us a few extra seconds before they cut the chord which I happily accepted, I’d take what I could get at this point. I also didn’t want any Vitamin K or vaccines done and being a public hospital they thought this was totally ludicrous, so I’m very happy that my midwife was there to make sure that none of that was done. In what felt like just a few minutes, they lifted him up for us to see. He was all red and squishy but was just so cute, and I couldn’t wait to hold him.

While they stitched me up, my doula was outside in the corridor with my boyfriend and little Leo and she helped them do skin-to-skin while they waited for me to get sorted out. They then brought him back to me and we breastfed and slept. He didn’t leave my chest during the entire hospital stay. It was magical.

About 2 weeks after I had Leo, I logged onto Facebook and starting scrolling through my news feed. I noticed an image that was posted by one of the natural birth pages that I followed. It was a photo collage of a mom giving birth at home. She had her husband and her midwife with her and there were a few photos leading up to the moment that she birthed her baby. The words written over the photo were “she believed she could, so she did”. I was quite taken aback by this photo. I think I stared at it for about 10 minutes. I felt numb. I started to question my decision to have the c-section. “Why did I give up? Why did I not try hard enough? Now look what I’ve done to my baby - this is why he is crying so much, this is why he can’t feed properly, he can’t latch properly because he was born via c-section, he was drugged, how cruel - you went your whole pregnancy without drugs and now this?”

Over the next few weeks I started to notice this trend of what I now call “c-section bashing” in the natural birth community. Every single time I logged onto Facebook I would see some sort of negative article surrounding c-sections. I started to feel an immense amount of guilt over my birth, and it was because I had started paying quite a bit of attention to social media. The reason I was seeing all of this is because I was so excited for my natural birth that I had liked as many pages about this subject as possible, so that is what was showing up in my news feed, When I was pregnant it came across as positive stuff, but now after my experience, this positive stuff suddenly turned into major triggers for me, making me feel so guilty and sending me into a very deep depression. I started to believe that if I had died during labour, my baby would be better off. A c-section is so unnatural and we shouldn’t have intervened with nature’s course. If my time was up, then we should have let it be so. Being in this space, made me understand how people can commit suicide. I never considered committing suicide, because luckily I have been through therapy in my life and I know when help is needed. I then started feeling guilty for having previously judged people that had commited suicide… the guilt just comes from all angles when you’re in this space! And it was in that moment that I knew I had to call my therapist because something was seriously wrong with me.

So why did I want to come up here and talk today? We are advertising those mothers who are blessed with beautiful calm births, but we are excluding those mothers whose births are at the other end of the spectrum. We need to stop ignoring the moms who have difficult natural births and c-sections because it’s creating a false reality of what birth really is - and that’s the only reality we know while we are pregnant. We subscribe to the Facebook pages and blogs of our service providers, we see congratulations and photos posted publicly of their clients who have natural births, but when there is a c-section, there is no mention at all. No congratulations for that Mom or that baby. It’s as if they don’t exist. It’s false advertising. I know all the girls who had c-sections from our birthing classes - and all the girls who had naturals. Only the girls who had natural births were mentioned and congratulated. As birth workers and service providers you have a responsibility to make your Moms aware of the support that is available and if there isn’t support available then we need to work together to help create that support, that’s why we have conferences like this one. We need to tell these Moms that yes it’s going to be tough, but that’s okay, you are not alone in this. The first time I realised that I wasn’t alone was 6 or 7 months after I had my son. I went onto Facebook and saw that my midwife had shared an article called ‘the homebirth cesarean’. I read the article and I couldn’t believe that someone had taken the time to write about this. It was a thing! At the end of the article it linked to a closed private group on Facebook. I clicked the link and asked to join the group. They accepted me and I joined a support group of over 3000 members who had all had a homebirth cesarean. I couldn’t believe the words I was reading. Moms from all over the world had shared their stories on the wall of this group and it was like there words were my words. Everything was the same, the feelings of guilt, the depression, everything. Instead of feeling happy to have discovered this group, I was so angry. I thought “why the fuck am I only finding out about this now?” I needed this immediately after Leo was born.

Those months following his birth would have been so different if I knew about this then. Nobody told me there was a different reality and that I didn’t have to go into this dark place. And then I realized the main problem of it all: My birth type – the c-section - was not honoured by the natural birth community that I so desperately wanted to be a part of. It doesn’t matter what type of c-section it is. The tribe had spoken and it was time for me to go. I started to realise that I was doing okay, and that I was not such a terrible mother after all. These stories of other women healed me. A lot of them were way more traumatic than mine were and I found myself commenting and offering words of compassion and love to these new moms. I wanted to give them what I never had. I also had another drastic realisation from being in that group. I realised how traumatic that type of birth is for a midwife or doula, for them to take on that emotional burden. It’s so very heavy. And they don’t just have 1 woman to take care of. I didn’t want to be angry with them anymore. I wanted to hug them and say thank you. I setup a debrief session between the 3 of us.

The sun was shining over Table Mountain in the distance and I felt like the darkness was finally lifting. During my session I asked my midwife how much longer she thought it would have taken if we had carried on trying. I was still haunted by the thought that I should’ve just given it a few more hours. She told me that it was so difficult to say, and that they all do come out eventually, they have to, but… they don’t always come out alive. It was in that moment that I realised that our decision to transfer was a necessary one. It was not me giving up. It was me saving my babies life. I had never thought of my baby dying during labour, I just wanted the pain to end. I realised that without knowing it, I had made my first responsible decision as a mother. I took back a lot of my power that day. I have also come to realize that this was all meant to happen to me in the exact way that it did, because if it didn't, I would more than likely be sitting on my very high natural birth horse, probably writing blog posts about how empowering my natural birth was, with total disregard for any woman who weren't strong enough to come to the natural birth party. I have been deeply humbled by my experience and for that I am very grateful. In my opinion, the natural birth movement should celebrate c-section babies as much as it celebrates natural birth babies. This is how we bridge the gap and invite Moms from the other team over onto ours and start to make a positive change in the industry. If you want the gynae’s on your team, you need to get all the Moms on your team first. Like Nicole Daniels said last night - we can’t be both the perpetrators and the solution. We need to just be the solution. The idea I had in my head of what a c-section would be like and the actual experience that I had were so different.

Thinking back to when I saw Leo for the first time, it’s really a beautiful moment for me and one that changed my life forever. So that’s my story. Leo is now 14 months old and an amazing little guy. He’s happy and healthy and he’s fine. I wish I could have looked into the future and seen what a beautiful child I have and that he is okay, and that he hasn’t been poisoned by morphine, and that he hasn’t got less of a bond with me, because he didn’t pass through my vagina. I now see that from a holistic point of view, your birth itself is such a small part of the whole puzzle as to whether a baby will be healthy or not. The pregnancy, the birth, the way you feed your child, the way you live your life, those are contributing factors too, among many others. I want to end off by saying that I think that everyone in this room is amazing for the work that you do. This conference is beautiful and I am so grateful that I got to share my story with everyone here.

If there is one thought I leave you with, it’s that birth intervention does not need to be birth disappointment.

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