Caveat: I hate everything about this. And that's going to color so much of my response.
- No birth is trauma-free. Not a single one. Not even the very "best" ones where everything goes according to "plan" and everyone professes to feel healthy and well at the end.
- Every person's birth experience is valid, but it's also just ONE birth experience. Writing a book about your experience with your specific lens on the birth landscape is an effort in confirmation bias.
- Cesarean delivery, as practiced in the 21st century, saves lives. (That does not mean there aren't still providers in the world trying to get to a tee time. But in any major healthcare system, there is perpetual quality work being done trying to lower CS rates. That means more hospitalists (shift work - so no one has a tee time/is motivated by efficiency in birth) and more midwives (everyone should have a midwife!!! obstetricians are for when you risk out of midwifery care!)
- This book should have a companion piece about all the things you don't know about vaginal delivery. Like how your body might tear into your bladder and bowel and you might never void or defecate like you once did for the rest of your life. Or you might leak urine or stool or gas for the rest of your life. Or you might have pain with sex for the rest of your life. NO BIRTH IS TRAUMA-FREE.
Things that are absolutely correct:
- Every person should be able to take a full class about all the ways pregnancy and birth are going to FUCK YOU UP and change your life forever. This does not exist and if it did, fewer children would exist, because to know all the risks is terrifying. In a world of perfect reproductive justice, it would still be the norm.
- Unplanned cesarean deliveries are extremely difficult, especially if you read some of the modern books or soaked up the mantras that YOUR BODY CAN DO IT and YOU WERE MEANT FOR THIS MAMA - of course you feel like a failure, even if your body was NEVER going to push a baby out vaginally. We should be counseling every single birthing person that there are two methods of delivery, both are critical and valid and there is no value judgment between them. And you might need one in one pregnancy and another in another pregnancy and that is ok! And if that possible outcome is not acceptable to you, you should not have to participate in pregnancy and that's ok too!!!
- The history of medicine, including birth medicine, is racist. The people who choose to work in birth medicine are incredibly aware of that history and work daily to correct course.
For full disclosure, I had an elective cesarean delivery set to ABBA because I am A. posh, B. afraid of pain, C. anxious, and D. a urogynecologist. Recovery hurt, because it's major abdominal surgery. But my pelvic floor musculature is intact and that was MY birth goal. That and survival (which I almost didn't do - because as stated multiple times above, NO BIRTH IS TRAUMA-FREE).
Re: confirmation bias, it’s interesting to me that so much of the public conversation about c-sections, including the books and articles meant to prepare women for them, is driven by people who had unplanned/emergency sections. You rarely hear the voices of people who had planned and uneventful cesareans, in contrast to how the stories of women who had relatively easy and unremarkable vaginal births are heard all the time.
I still remember the fellow new mom who, when we were sharing our birth stories, said “I’m so sorry,” when I told her I’d had a c-section (planned due to breech presentation). I’d been through infertility treatment, 6 months of bed rest because of preterm labor, and then a baby with severe jaundice, major breastfeeding struggles, and what in hindsight I can recognize as postpartum OCD. My c-section was the LEAST traumatic part of my birth story and I have no regrets or sadness about it (or my second c-section, either).
This is exactly it! Unplanned births of any form are TRAUMATIC! And yes, coupling that with unexpected abdominal surgery is bound to be even more traumatic. And so much of the experience of pain is psychosocial, so it's also unsurprising that people with unplanned/emergency surgeries experience more pain.
Again, the best thing we can do is provide more information about every type of birth to people who are going to go through it! That way people can make informed choices for themselves. For me, I KNOW that uneventful vaginal birth is the "best" outcome, but I also know all the terrible things that can happen unexpectedly during labor, resulting in traumatic vaginal deliveries or emergency cesareans. So I chose a scheduled cesarean, knowing that it took away my chance for the "best" outcome, but also took away the chance for the really hard outcomes. I was ok with that! And the biggest thing that I was educated to be able to make that choice for myself!! Everyone deserves that!
Another thing that is absolutely correct that I forgot to add:
- Every birthing person should have access to postpartum (and sometimes antepartum!) therapy! Whether that is talk therapy for your radically-shifting world or pelvic floor physical therapy for your vaginal delivery or PT/OT for your cesarean delivery or ALL OF THE ABOVE BECAUSE YOUR BIRTH EXPERIENCE NECESSITATED IT!
Absolutely wild to me to read this comment during accreta awareness month?
As a VBAC mom, survivor of obstetric assault, Puerto Rican (please educate yourself on the history of reproductive coercion on the island including a 50% cesarean rate today) and peer support person for cesarean moms... I absolutely can say some traumas are *unique* to cesarean. Do not elide the distinction.
The women who lost desired babies after the fetus implanted in the scar.
The women bleeding to death in the OR with accreta.
The women who had CPS called on them for declining a cesarean for a too-long labor.
Kira Johnson.
Rinat Dray.
Truth matters. Silence about violence helps no one.
Of course there are traumas unique to surgical delivery. Informed consent for a scheduled cesarean delivery cannot occur without discussion of placenta accreta spectrum! Specifically about the increasing level of risk with each subsequent cesarean delivery. Scheduled cesarean may not be the correct delivery method for someone who wants 3+ children. But like you implied - every person should get to make that decision for themselves, free from assault or physician coercion. And for many people, cesarean delivery is the safest choice in spite of the risks.
Bringing obstetric violence to light is critical and has helped provide more protections for birthing people everywhere. Thank you for sharing your experience.
What can we do but strive to create a more just world every day? Reproductive justice is so far from reality for most people in our world, but we can all work toward that goal.
I signed consent forms for both of my sections that disclosed these risks, and they were covered at length by my doctors. This is pretty standard these days, though it sadly was not so in the past.
THIS. I had two unplanned C-sections and have only ever viewed them as life-saving for me and my children. Like the author, my babies were sunny side-up and came with days of back labor (72 hours with the first, 22 hours with the second). I never dilated past a few centimeters and I had ALL the drugs. C-sections were a godsend and both girls arrived healthy with a living mother. To me, that's the only fact that matters. Birth plans to me have always seemed like a way to control something that is entirely out of our control as birthing mothers. It's critical to have your preferences and feelings heard and recognized but sometimes things get out of hand and being attached to a particular outcome and/or process contributes to the sense of having been disenfranchised. I feel visceral hate toward any narrative that sets up C-section moms as making invalid choices. How many people talk about mothers who suffer or die under the care of poorly trained midwives who avoid medical assistance? All births are inherently dangerous. Women should be allowed to get through it however they need to.
Yes! I was so glad after my c-section that a friend reminded me of the fellow 1970s kids we know who suffered serious, lifelong medical consequences because of dangerous, long vagjnal births. My fetus’s oxygen levels are too low? Yup, let’s get him out fast!
Ooof thank you for this comment. I’ll post this in a stand alone post but the book Matrescence by Lucy Jones gets at the trauma of birth in more depth. Regardless of delivery system. I complete agree about how pregnancy in all its dimensions should be discussed and just isn’t.
Yes to this! I have prolapse from what was deemed a healthy, uneventful vaginal birth; experienced months of fecal incontinence and have worked very hard to get back to baseline. I did not fully understand the risks to my pelvic floor from vaginal delivery and wish any of my providers had discussed this. I don’t know if I would have scheduled a c-section, but having more knowledge would have helped my recovery and birth trauma immensely.
I always try to find myself in people’s narratives about c-section births but so far I haven’t. I chose to have an elective c-section 9 months ago and it was the most affirming part of my journey to becoming a mother.
After three years of infertility, many uterine and fallopian tube procedures (sedated and not), hundreds of vaginal ultrasounds, uterine biopsies, egg retrievals, and many fertility healthcare staff saying, “it’ll be just a pinch,” the pain (physical and emotional) had compounded and I could not go through “natural” or assisted labor. I knew there was going to be nothing natural or magical about it because I had enough experience in women’s medical care to know “just a pinch” would be just that to a nurse but absolutely not to me. One of the OBs I saw during my pregnancy aptly called it, “a thousand little insults.”
So when I finally got pregnant and discussed my birth with my OB, the same person who diagnosed my infertility years before, I was so relieved at how open and affirming she was about an elective c-section. She said I was a good candidate and it could give me the peace of mind I craved after a long journey. I grappled with the decision because I worried what other people would think of me, most of all, what did I think of me???
Knowing I was going to get a c-section opened up such great conversations with my providers leading up to my birth, prepped my partner for those 5 weeks of his parental leave, helped my friends know what my birth would be like, and most of all, helped me manage my own expectations. My husband and searched for a post-partum doula to support us post c-section, too.
So all in all , what I’m saying is not necessarily that all c-sections are good ones, but that it is possible that a c-section is what’s good and nourishing to you!
I'm actively searching for "positive" C-section stories as well, and this was really helpful. The birth of my first son 5 years ago was traumatic (vaginal) - and eventually led to a diagnosis of PTSD, which I didn't even know was a thing that could happen as a result of giving birth. I felt like I'd been hit by a bus and the recovery was very painful & difficult, hard to walk, get out of bed, etc, things that I didn't know to expect.
I am now 8 months pregnant and having a planned C-section for this birth. Being able to cut out the labor and pushing part of the birth is an active choice to avoid triggering trauma responses - and though I know C-sections have their own risks, complications and pain, it feels like the best choice for me - though it's still hard to feel like I can own this decision without guilt and hear a voice that says I'm "taking the easy way out".
In the 5 years since my first birth I've done a lot of therapy and have come to realize that the traumatic birth wasn't the "origin" of my PTSD but actually a retriggering of previous trauma - medical trauma from chronic illness, as well as realizing that a "bad experience" when I was 20 was actually a sexual assault that was pretty painful. I really relate to you talking about pain compounding over years - it's validating to hear someone else's story about actively choosing a C-section because it's the best thing for them.
My medical providers have luckily been very supportive and validating of my choice, but it's been a long road to get to feeling confident in my choice for a planned C-section. Thanks for sharing your story!
It was absolutely the right choice for me too! My anxiety around the whole process was so much more manageable knowing that I was going to walk in at a scheduled time and have my baby in my arms one hour later. My birth team let me play my own playlist, which also helped a ton.
I really think the key is *choice* - even when I experienced the normal pain of surgical recovery, I was able to feel like I could anticipate/expect and therefore control it a little more easily - like this was the plan that I picked for myself instead of a disappointing outcome.
That is a great point about being able to anticipate pain and how the choice of surgery helped with a sense of control over that pain. Definitely trying to make as many choices as I can for s different outcome this time.
You’ve touched on something so important. Sometimes the trauma doesn’t start at birth, but is rather an extension of something else. And pregnancy/childbirth is such a monumental experience that of course many lying things awaken. I really don’t think many women go into birth with that lens at all so the transformation is a huge shock to the system.
And yes! I am here to say it is absolutely possible to have a positive c-section experience. Two of my friends had planned c-sections for separate reasons and both were pretty much like, it was manageable and good. They didn’t really dwell on the pain, which I thought was interesting until I had my own c-section. I was in pain those first couple of days in the hospital. My doctor had me on a pain management protocol which really helped and at least set me in the right direction to start trusting my body to move. I’d describe the pain in the subsequent days as a very sorr and weakened abdominal core. They sent me home with hydrocodone just in case, but gabapentin + Tylenol was enough to manage for the next couple of weeks. I’d say by week 4 I knew my incision was there, though the pain had passed.
Here’s what I think was one of the critical things to my uneventful recovery: sleep. My husband woke up with the baby at night for almost a whole month just so I could have 5 hours of uninterrupted sleep at least. I could feel sleep was good for my body.
Thank you for sharing more details of your recovery! I'm honestly feeling a bit nervous for a new unknown kind of pain so it's helpful to hear your (and other's) experience so I know the kinds of thing to expect and it's not a complete surprise. Sleep definitely is going to be a top priority for both physical and mental well being! I'm really glad you had an overall positive and uneventful experience after the challenges you experienced getting pregnant.
Also had very positive experiences with 2 C-sections! The first was scheduled bc I had gone through years of infertility, IVF, and a very painful & traumatic miscarriage that was the same date as my due date for the 2nd pregnancy. I was terrified of being triggered during labor and psychologically reverting back to my miscarriage. My baby was breech but I opted not to attempt a version and just schedule a section. Having a quick birth experience and being well rested was a wonderful way to start parenting and it was so different than my previous trauma that I avoided any triggers. My second child flipped to breech at 39 weeks so that was also a C-section and also non-traumatic.
As far as advice, those pregnancy belts are really handy in the first few weeks postpartum when you just want your belly pushed tight. And going to a pelvic floor PT was really helpful, even for minor postpartum issues.
I had 2 planned c-sections and would do it again. With my second I was eating a cheeseburger 6 hours later. I’m glad that you have providers who are supportive of the choice that’s best for you.
Two C-sections here and they were 100% the right way to go. It sounds like you've walked a very rough road here. Please try to give yourself some grace. Suffering doesn't make an experience more or less valid. With all you've gone through, choosing a path that feels less difficult and is the best choice for *you* is full of power. My first c-section was after 72 hours of back labor and honestly, the doctors could have delivered my kid with a can opener and I would have been fine with it. My second was supposed to be a planned c-section but I went into labor two weeks early, and the L&D nurses refused to listen to me. They insisted we needed to wait and see how things went before going to a c-section. I felt so trapped and ignored! 22 hours and only 2 centimeters later, the OB who delivered my first came on rotation. She took one look at me and sent me straight up to surgery. I will love her forever for that.
I have had two planned c's and good experiences with both! My first was due to a breech baby, and the second because I decided against attempting a vbac (the devil you know, etc). I think my experience was helped by the fact that I had zero expectations other than wanting to emerge from birth with a healthy baby and as few complications as possible. Personally, any delivery method sounds terrifying so I just wanted to follow my OB's recommendations. My priorities were to schedule with an OB recommended by doctor friends and be at a good L&D hospital with a good NICU in case anything serious went south.
I did react to the painkillers and was throwing up for like 6 hours afterward, but I kept asking about that at follow ups and in pre-op and the crna at my second c-section made sure to add zofran to my epidural, which helped. As for recovery, try to line up as much help as possible. My spouse did not get paternity leave, so I hired whatever childcare we could afford and accepted all offers of help.
On a practical level, you will want to stock colace, gas-x, tylenol/advil, and pads for home. I also bought high-wasted c-section underwear that helps and packed high-wasted leggings or dresses for the hospital. It is a major surgery, so try to be patient and try to rest when you can feel you overdid it. Both times, I was cleared for exercise and activity at 6 weeks, and I have no issues now almost 3 years after the second c other than a little bulge at the incision scar.
Obviously, many people don't have this experience, but wanted to share my positive ones since you were asking! I have other friends who have undergone schedule c-sections and I think it's wildly different from emergency ones.
My 2nd c-section was planned. The recovery was truly not bad. I was surprised to feel able to move with freedom relatively quickly. Practice standing up as straight as you can. The more you walk after the surgery, the better you will feel. Sending good thoughts!
My first was an emergency C-section. My water broke and they tried to induce labour - though I would say "try" very loosely because it involved Cervadil, the insertion of which was more painful than anything. Anyway, after 30 hours and not getting more than 4cm dilated the baby went into bradycardia and the dr said we needed to do a C-section. After 4 years of infertility I was like "I just need to go home with a baby."
Result: a beautiful 9lb1oz boy and a scar that has healed so nicely you can barely tell it's there. There was a bit of a challenge because he met the 10lb threshold for carrying pretty quickly. But overall recovery was fine.
Thank you for writing this. It's helping me understand my experience. 27 years ago, I became pregnant with IVF twins after years of infertility treatments (4th transfer, second cycle with egg retrieval). My OB was a high-risk specialist (I'd miscarried once) and at my first appointment I said I wanted a c-section. He chuckled and said that's not how it goes and a vaginal birth was the best option. At a class for people pregnant with multiples, I had my only panic attack ever when they got to the part about giving birth. I was so panicked about the whole thing I just didn't think about it. Ever. I ended up having an emergency c-section to save my life, and I was grateful because all 3 of us lived and I didn't have to endure a vaginal delivery. I am understanding now, though, how traumatic it all was, starting with infertility. I am feeling so shaken, to realize how much I was affected and how I never dealt with any of it because no one then ever suggested that I might be anything other than grateful. Years later, a therapist said it seemed like I had PTSD, but it was puzzling because why? Never occurred to either of us that it might stem from any of this. I am so glad that you were able to make the best choice for you and I absolutely affirm that there is no one right answer for everyone. As much as I was unaware of, some part of me knew that vaginal birth would be too much for me.
God I was and am so resentful about my C-section, not because it made me feel less of a mother but because it made me feel less of an athlete. So many of my friends waltzed out of the maternity ward and were back on their bikes or the trails so quickly, where I was still learning to walk to the kitchen without hunching over. People couldn’t believe how much pain I was in, literally, they found me hard to believe. I, in turn, could not believe them because why would I want that! Why would I *act* that!
I feel for you! Don't know if it helps to know this, but I chose to deliver my twins vaginally (and was lucky to have the support to do so) because I was actually more scared of a c-section. But extreme pregnancy and delivery have left me with pelvic/hip problems that have negatively impacted my life as a trail runner ever since, even 13 years later! Postpartum athletic activity presents so many challenges and I wish there was more discussion of it - and better access to medical experts who can actually look at the situation from a holistic perspective (male sports medics are not helping me right now...). I hope you are back on the bike/trails now and able to enjoy them.
One point that I haven't seen made explicitly (maybe I missed it) is that a large part of society doesn't want to talk about how traumatizing birth is because they believe that this is what women are designed to do, that their main purpose for existing is to birth babies. This is ingrained from such a young age that any birth experience that involves trauma - even though as was pointed out in another comment that it's ALL of them - is seen as a failure on the part of the woman. And to keep that myth intact, young people aren't being allowed to learn what is actually involved in growing and birthing a baby.
And the language and images we use is such a big part of that. Making sure the makeup and hair are perfectly coiffed for that first picture of the family in the hospital? I mean you do you, but that only serves to perpetuate the ideal, imo. (But then again after my middle was born - VBAC - I chose a picture for a book I sent to the grandparents that is focused on my husband and our girl without noticing that in the background I was getting stitched up. I have regrets about that lol.)
I was fortunate to have a Labour & Delivery nurse as a sister so I went in with no illusions. She quit because she was tired of women ignoring medical advice because of what they had read about c-sections or because they were so tied to their birth plans. Babies died and women suffered irreparable harm. So I appreciate how the author says we need to approach the idea of birth plans focused on all potential outcomes because otherwise how do women know what to advocate for? And it has to be done well before the baby is on its way.
I have had an emergency C-section and two VBACs. More poking and prodding around down there from years of infertility treatments than I
care to recall. Nothing about any aspect of growing and birthing any of my kids was trauma
free. We have to stop treating having babies like it's a ride at Disneyland.
Thank you, thank you, thank you. Ordering this book immediately. I had an emergency c-section and, three weeks later, was hospitalized for postpartum psychosis. The combination of a traumatic and “unnatural” birth, being separated from my baby for several days while I was in a mental ward, and having to supplement breast milk with formula left me feeling like a failure of a mother straight out the gate. There was so much shame.
This week, my daughter will turn four and while the shame sometimes creeps back, I know at my core that I’m a good mom. My daughter is thriving and I couldn't love her more. Reading this was validating and healing. Thank you.
I had a scheduled c-section and it rocked. 10 / 10 would do again. So if anyone is reading this and spiraling about needing a c-section, let me tell you it's possible to have a good one.
My first kid was breech and I had a planned C-section. It was a very good experience.
In the weeks before birth, I did have not one but TWO male coworkers tell me "You know, even with a breech baby you can have a vaginal delivery." Mansplaining at its finest!
I had 2 breech babies and 2 planned c-sections. The c-sections were absolutely the right option in both situations and I was grateful to be able to approach them in a planned way instead of in an emergency.
I had two planned c-sections for medical reasons and both went great. The recovery was difficult. My daughter was so high up they cracked a rib trying to push her through the incision…the combo made moving, getting out of bed, trying to feed her, etc. difficult.
All that said, I have no complaints.
The problems I did encounter were people’s reactions to the fact that I had C-sections…like it’s a somehow ‘less than’ birth experience. A couple examples are my mom saying she didn’t know how to help me post birth because I was ‘doing it different than her.’ She’d had a vaginal delivery and didn’t breast feed. Note to everyone: new mom’s would like an uninterrupted shower, a warm meal, full cup of water, help picking up around the house, changing a diaper, holding the baby…so many ways to help!! We don’t have to birth exactly the same to understand a shared experience.
I also had a friend insist that both my kids and I needed to simulate a vaginal delivery (like, reenact it) to make up for the trauma of the C-section. It didn’t matter that I told her there was no trauma…it was planned, I felt pretty prepared, we listened to ABBA with my first and Van Morrison with the second…but she insisted we had to recover from it. I felt like I was supposed to feel bad about my births and what was wrong with me that I didn’t?
Every new gynecologist that I get (we’ve moved a bit) I’m always asked why I had c-sections (of course), but sometimes I feel judgment. Like I’m defending the reasons for the c section (breech, ‘did that try to turn the baby?’ Or placenta previa, ‘was it directly over the cervix?’). I always dread this conversation a little…
While reading this I couldn’t stop thinking about how angry I am for all women that are ignored or dismissed for their pain/trauma, but the fact that it’s that much worse for black women makes me sick. We have to do better.
I think your friend is outlining thoughts related to our births and how it may affect us later in life. I don’t think it’s necessarily outlandish as a concept. I was six weeks premature and, because I was one ounce under what was considered best at the time, taken away from my mother for a day and placed in a cold, stark incubator alone and away from her. Do I think that impacted me? I do. It’s not a bad thing to think about the differences between being born one way vs. another and the impact that might have such as via a c-section or other instances.
I can totally appreciate that that must have been traumatic for you and your mom. And I’m sorry. 💗
My point was that I had two very non-eventful births, that happened to be delivered via planned c-sections. I was able to breastfeed and be with my babies immediately, while I was sewed back up in the operating room. I don’t believe there’s anything to work through, and neither do my kids. The most difficult part is people acting like there is some problem with the way it happened. If that makes sense. xx
Thank you, it definitely must have been hard for my mom. And me… She said that’s what they did then. I’m not saying anything ‘bad’ happened after your children’s births for them. I was thinking the premise your friend may have had is, that, with their birthing via C-section, they did not ‘leave’ on their ‘own’ time; someone came in and removed them. That had to be/possibly was an impactful event for them. I’m sure there are theories out there. That may sound odd but I can understand that. I’m glad everything went well. Take care.
One thing that still breaks my heart about my hospital stay is that my pain wasn’t taken seriously *by other women*. 100% of the nurses were women, 50% of the doctors were women. When I tried to explain that my pain felt otherworldly and like I was dying, they’d roll their eyes or scoff and say things like, “Hon, if I could deal with it, you can too.” Eventually I found one woman who believed me, and then I got rushed into surgery.
I guess I was unprepared for the degree of internalized misogyny among women.
I’m so sorry your pain was dismissed so easily in what sounded like an already stressful time and I’m glad you found someone who really listened to you
I just had a planned C-section for my twins three weeks ago and it removed so much of the fear and anxiety I had about pushing out two babies and what that might do to my body long term. I’m so grateful it was not only an option but something my OB fully supported, especially since they’re my firsts. I don’t hear a lot about my similar situation and now that I’m struggling to breastfeed and pump I’m being told by lactation consultants that it’s probably because I had a C-section, which then makes me feel like I made a mistake or that I’m being punished for my elective surgery. Women just can’t win in our society.
It is NOT true that your challenges with breastfeeding are because of your delivery and your lactation consultants are doing you a disservice by telling you so. Wishing you all the best with breastfeeding and pumping if that is something you desire to do! But also here to be just a quiet voice letting you know that how you feed your babies does not determine your worth as a mother and formula is ok too. You created two new humans - you are remarkable!
I had two C-sections and breastfed both of my kids. You’re not being punished, you did what was right for you and your family. Sometimes it comes easy and sometimes it doesn’t. Good luck and feel free to reach out if you have any breastfeeding questions. xx
Congratulations on the birth of your twins! Multiples are no joke (fellow twin-mom here) and breastfeeding them is hard no matter how you delivered them. I’d be happy to share my experience if it would help. Ultimately I ditched the pump, fed them mostly one at a time (bouncy chairs were an godsend) and supplemented with formula. There are so many different ways to do it and you should feel empowered to find the way that works best for you and your babes. Good luck!!!!
Your lactation consultant should’ve told you that at three weeks everyone is struggling, regardless of how the babies arrive. It’s a brand new skillset for both you and the babies - it takes a long time to get the hang of a new skill. (It took about 2.5 months before the baby and I were really in sync and breastfeeding felt like a pleasant bonding experience.) And don’t let your lactation consultant try to tell you that there’ll be “some discomfort”. It’s straight-up painful in those early weeks.
Reading through these comments makes me realize how much the narrative in the US about pregnancy and childbirth is f-ed up. No one talks about the risks of childbirth when they promote 10 year olds having babies because abortions are illegal in their state. It’s abhorrent. We need so much more information out there about women’s reproductive systems and health so that whoever is making these decisions (lawmakers, Supreme Court) has better and more accurate information to base their decisions on. Sheesh!
If a 10 year old is having a baby they are likely going to need a c section too. We only want to talk about the beauty of pregnancy and the maternal radiance that motherhood brings. It’s all surface level discussion because the people leading those discussions don’t care about women or babies.
I would absolutely be dead without my c-section. I developed terrible preeclampsia in the midst of my feeble efforts trying to turn my breech baby at 35 weeks. I actually remember being pleasantly surprised at how little pain I felt after the c-section and how quickly I healed, probably because I heard all the horror stories about healing post c-section. What didn’t heal quickly, and in some cases at all, was the trauma of preeclampsia, my ongoing struggles with blood pressure years later, and fear it would happen again if I had another baby.
Yes (and I’m so sorry you went through that). I had HELLP Syndrome with my first, so I was pretty out of it during her birth due to the magnesium sulfate. My platelet count was too low for an epidural and I was diagnosed in active labor, so I labored and delivered on pitocin without any pain relief. Then she came out with a triple nuchal cord around her neck *and* with her hand up (so lots of internal tearing for me at a time when my bleeding was hard to control). On Friday night I saw a video of a doctor or nurse resuscitating a newborn who was born gray (as my daughter was), and I asked my husband if she cried when she came out. He said no. I had never asked that, even though it seems like the most obvious question in the world, but because I was so out of it it didn’t occur to me.
My daughter is 17. This experience was so long ago and I had another child and a wonderful experience with him, but I cannot believe the amount of trauma I still carry from that first birth. I cried when my husband said no—not just because I thought about the fear he and my mom (who was with us) must have felt, but because I was so out of it that I didn’t even know my baby wasn’t breathing when she was born.
Two thoughts but i want to first preface that with my experience so folks know where I'm coming from: 3 kids/2 inductions/3 epidurals/no c-sections/1 D&C in a pregnancy where baby was discovered to have no heartbeat at 18 weeks between kid 2 and 3. I don't consider any of my birth experiences to be traumatic outside of my later miscarriage/D&C for obvious reasons.
Thought one: my experience is that women LOVE to talk about all the icky, gooey of birth experiences. However, it is usually reserved for after someone else has given birth. Not like it's a club you have to be in or that i wouldn't share if someone who hadn't given birth asked but it's a bonding experience. I also find it very tied to engaging with a new mom. I work with a lot of women and when someone comes back from pat leave, they always want to talk about their birth story and then we all want to retell ours and our experience in comparison as part of it. There's a lot of "I never would have told you this beforehand new mom but now you get it!" So maybe it is kind of a club/bonding thing.
Second thought about your friend having no memory: I feel this piece leans too far into the trauma of it all - only as it relates to women who didn't go through something truly horrific. I've come to believe some of this is a biological and evolutionary response. My husband has graphic memories of all our kids' births. I do not. I have hazy fuzzy feelings and some moments that come into clearer view. My sister and her husband with 4 kids is the same. A lot of women I've talked to have similar experiences with their birthing partner. I've joked with people many times that women's brains and bodies must have evolved to not hold on to those feelings and memories or why would you do it again? I guess you could call that trauma response. I feel it's nature's way of giving us a gift that allows us to keep doing something hard but beautiful through a lot of extra doses of natural hormones. Those endorphins post-birth are healing our minds and bodies.
re: evolutionary response, I think this is an overlooked part of why c-sections are often experienced as traumatic. You don't get the endorphins. You don't get the baby-on-chest moment for another 20 minutes. The chalkboard isn't erased.
I definitely think it's a 'part of the club' thing. I heard SO many birth stories for the first time at my shower (another reason I suggest everyone have a shower - it's basically a stealth birth/childrearing consciousness raising event).
There’s actually research into why, though it appears research isn’t sure of the definitive cause. I think the fact that oxytocin has an amnesia effect could be part of it. I also really like the idea of the peak of difficulty and end rule where only the worst part and the outcome standout because they are the outliers, and the peak diminishes when the outcome is good. Both of these theories would be interesting to study, but not all amnesia is trauma. Exhaustion and the overwhelm of being a new mom could also influence the feelings.
Yes to the secret club reserved for post birth events - I distinctly remember two coworkers who didn’t want to hear details so they wouldn’t get scared to become mothers. It’s part of leaning out of the pain of others because it seems so scary. After they had their first kids, we all very graphically and with great delight got to tell our birth stories. Man, I just ADORE birth stories! It’s a v special bonding time.
A few weeks after our son was born (by C-section) my husband mentions that his clearest memory was "the smell of your burning flesh" from when they cauterized the incision. I had no memory.
I wish I would have pushed harder for information. I know I asked about C-section info at least twice during my pregnancy and was brushed off because it probably wouldn’t be necessary. I knew next to nothing about the process.
As a direct result of that lack of information, during my induction, I resisted the idea of a C-section (invasive unknown surgery on top of my first-ever hospitalization when I’m already scared from prior family deaths, gee I wonder why I wasn’t receptive to that) until it became an emergency situation. My child and I are both fine now, but my husband couldn’t be in the delivery room. I was put under and couldn’t see my baby for a couple hours at least. My body sustained a level of injury that was frankly unnecessary and shouldn’t have happened. I asked for information in advance so I could make informed decisions, and I was refused, and while I’m not angry at the individual providers for following their standard of care instructions, I’m angry that the standard is to withhold information. It shouldn’t have had to be like that.
Yeah it's like how NO ONE will talk to you about formula feeding until the final hour when you are already a parent and hallucinating from lack of sleep.
Yes! I’m so thankful my sister had already talked to me about it, and honestly the hospital did a good job of it too. But it took my hormone-addled postpartum self a while to be okay with it…once I got past that hurdle, and leaned into combo feeding and the formula only, things were great. I will sing the praises of Costco / Kirkland formula forever.
This piece really made me feel less alone. I had a longer comment here, but I’ve deleted it. I’m deeply grateful that this interview offers a space for people to acknowledge that C-sections can be both an act of mercy and a distinct sort of trauma, and one that we generally aren’t permitted to talk about. But I worried about leaving my comment up when there are pregnant commenters expressly requesting positive stories.
Let me instead say this to everybody who’s survived any sort of medical trauma: I’m glad we’re here.
What gets me is that your experience was at least partly PREVENTABLE. My OB for my vbac did cesareans with immediate skin to skin and has even done maternal assisted ones where mom pulls the baby out. He delivers at a hospital where they've gotten the overall cesarean rate to 20% (was 33% a few years ago). To do this requires acknowledging women are not candy wrappers or trash cans but human beings. A tall order, it seems.
I skimmed this because its a bit too close to home for me for now and maybe one day I'll be able to watch Fleishman. This part really stuck out to me in this interview: "That is the consequence of ignoring real birth experiences, of narrowing the story to, ‘It was rough, baby’s fine, the end:’the inhumane system we’ve created, where we shove mothers back to the responsibilities of their pre-birth lives, sometimes only a few weeks after having a baby, without a shred of the care they need emotionally, physically, or spiritually."
It really matched my experience after traumatic medical experiences that involved unplanned csections. Got a lot of: sorry that happened. Its over now. Look how cute your baby is....How many ounces is he drinking.....You must pump overnight....Go make bone broth....its time to go back to work now....
I couldn't remember how many ounces he drunk or get up to pump at night because I still couldn't bend down or shift positions to get up off the couch or the bed for weeks.
Society has a long way to go in terms of caring for, let alone acknowledging, the needs of birthing parents, especially those who had traumatic delivery experiences or abdominal surgery. A trauma counselor in the hospital would have made a huge difference for me. Knowing that I might not be ready to physically go to work everyday via public transportation even though my leave was over would have gone a long way. Instead I thought I was weak and wasn't healing well. I started blankly at coworkers when they asked if I was "all healed" from my csection.
Not to mention the lack of adequate followup care for the lifelong consequences of csection. During an endometriosis excision surgery several years after both of my csections I was found to have an csection scar defect called an isthmocele. No one ever mentioned that to me (and I complained to a lot of women's health providers A LOT about a variety of sympmtoms, some of which I much later learned are consistent with isthmoceles.)
According to the Cleaveland Clinic: "Between 24% and 70% of people who've had at least one c-section develop an isthmocele." For a frequent complication of an often performed surgery, that's the best range that research can come up with!?
Yes, c-sections are often necessary lifesaving medical procedures. I'm grateful that they exist. But the lack of followup care and knowledge about their consequences is really damaging. It wasn't only "rough" for that one day, it reverberates.
Thank you (both) for this. I’m going to order this book immediately. I had 3 csections: The first planned because the baby was breech. The second an attempted VBAC that became an unplanned c-section when I was 8 cm dilated and a resident thought to check the baby’s position… breech. The third planned because I’d had two previous sections, even though that baby was not breech.
I have a genetic bone disorder and have had about 40 fractures and 20 orthopedic surgeries. For me, pregnancy, birth, breastfeeding, and keeping my children alive and well through physical care allowed me to feel for the first time that my body was worthy, useful, powerful. I desperately wanted vaginal births to reinforce that sense of power and agency. My disorder was not the reason for my 3 sections — many women with my disorder give birth vaginally. I hate when people assume my disorder was the reason I had c sections.
For my 3rd c section, which happened in the middle of the night when I went into labor a week before I had a c section scheduled, the epidural didn’t fully work. It was highly traumatic and awful. And I remember thinking afterward that at least now I had a birth story that would be worthy of telling, because there was drama and trauma. My other two c sections didn’t make for a good story and no one in my social sphere ever expressed interest in how those births went. Whereas when friends had vaginal births, we all were interested in the story.
My kids are all young adults now but all of this is still very much with me. Thank you for bringing c sections and women’s experiences with them into the light.
I had an epidural that didn’t work in the midst of an induction that led to an unplanned C-section. The way the nurses and anesthesiologist made it seem like it was me not working and just perplexed by it and kept making me wait another 30 minutes to see.... Would have been a lot less damaging if they had said sometimes they don’t work. We believe you and let’s try again. I agreed to the epidural not for pain management but because I was told that I need to sleep and maybe it would help lower my BP. Well needless to say a non functioning epidural, painful contractions with less ability to move and frequent frustrating and useless calls to the anesthesiologist meant that I did not sleep and my BP did not go down.
I had an epidural that didn’t work and the anesthesiologist was just sooooo perplexed and asked “are you sure you’re feeling the contractions?” He actually repositioned the epidural but didn’t work still - then when we went for c-section they were like “don’t worry, they’ll give you extra xyz, you won’t feel anything.” They never quite got to those contractions… I’m SURE it happens all the time and yet such SURPRISE! Such SHOCK!
Caveat: I hate everything about this. And that's going to color so much of my response.
- No birth is trauma-free. Not a single one. Not even the very "best" ones where everything goes according to "plan" and everyone professes to feel healthy and well at the end.
- Every person's birth experience is valid, but it's also just ONE birth experience. Writing a book about your experience with your specific lens on the birth landscape is an effort in confirmation bias.
- Cesarean delivery, as practiced in the 21st century, saves lives. (That does not mean there aren't still providers in the world trying to get to a tee time. But in any major healthcare system, there is perpetual quality work being done trying to lower CS rates. That means more hospitalists (shift work - so no one has a tee time/is motivated by efficiency in birth) and more midwives (everyone should have a midwife!!! obstetricians are for when you risk out of midwifery care!)
- This book should have a companion piece about all the things you don't know about vaginal delivery. Like how your body might tear into your bladder and bowel and you might never void or defecate like you once did for the rest of your life. Or you might leak urine or stool or gas for the rest of your life. Or you might have pain with sex for the rest of your life. NO BIRTH IS TRAUMA-FREE.
Things that are absolutely correct:
- Every person should be able to take a full class about all the ways pregnancy and birth are going to FUCK YOU UP and change your life forever. This does not exist and if it did, fewer children would exist, because to know all the risks is terrifying. In a world of perfect reproductive justice, it would still be the norm.
- Unplanned cesarean deliveries are extremely difficult, especially if you read some of the modern books or soaked up the mantras that YOUR BODY CAN DO IT and YOU WERE MEANT FOR THIS MAMA - of course you feel like a failure, even if your body was NEVER going to push a baby out vaginally. We should be counseling every single birthing person that there are two methods of delivery, both are critical and valid and there is no value judgment between them. And you might need one in one pregnancy and another in another pregnancy and that is ok! And if that possible outcome is not acceptable to you, you should not have to participate in pregnancy and that's ok too!!!
- The history of medicine, including birth medicine, is racist. The people who choose to work in birth medicine are incredibly aware of that history and work daily to correct course.
For full disclosure, I had an elective cesarean delivery set to ABBA because I am A. posh, B. afraid of pain, C. anxious, and D. a urogynecologist. Recovery hurt, because it's major abdominal surgery. But my pelvic floor musculature is intact and that was MY birth goal. That and survival (which I almost didn't do - because as stated multiple times above, NO BIRTH IS TRAUMA-FREE).
Re: confirmation bias, it’s interesting to me that so much of the public conversation about c-sections, including the books and articles meant to prepare women for them, is driven by people who had unplanned/emergency sections. You rarely hear the voices of people who had planned and uneventful cesareans, in contrast to how the stories of women who had relatively easy and unremarkable vaginal births are heard all the time.
I still remember the fellow new mom who, when we were sharing our birth stories, said “I’m so sorry,” when I told her I’d had a c-section (planned due to breech presentation). I’d been through infertility treatment, 6 months of bed rest because of preterm labor, and then a baby with severe jaundice, major breastfeeding struggles, and what in hindsight I can recognize as postpartum OCD. My c-section was the LEAST traumatic part of my birth story and I have no regrets or sadness about it (or my second c-section, either).
This is exactly it! Unplanned births of any form are TRAUMATIC! And yes, coupling that with unexpected abdominal surgery is bound to be even more traumatic. And so much of the experience of pain is psychosocial, so it's also unsurprising that people with unplanned/emergency surgeries experience more pain.
Again, the best thing we can do is provide more information about every type of birth to people who are going to go through it! That way people can make informed choices for themselves. For me, I KNOW that uneventful vaginal birth is the "best" outcome, but I also know all the terrible things that can happen unexpectedly during labor, resulting in traumatic vaginal deliveries or emergency cesareans. So I chose a scheduled cesarean, knowing that it took away my chance for the "best" outcome, but also took away the chance for the really hard outcomes. I was ok with that! And the biggest thing that I was educated to be able to make that choice for myself!! Everyone deserves that!
Another thing that is absolutely correct that I forgot to add:
- Every birthing person should have access to postpartum (and sometimes antepartum!) therapy! Whether that is talk therapy for your radically-shifting world or pelvic floor physical therapy for your vaginal delivery or PT/OT for your cesarean delivery or ALL OF THE ABOVE BECAUSE YOUR BIRTH EXPERIENCE NECESSITATED IT!
100%. My psychologist and physiotherapist made a world of difference.
Absolutely wild to me to read this comment during accreta awareness month?
As a VBAC mom, survivor of obstetric assault, Puerto Rican (please educate yourself on the history of reproductive coercion on the island including a 50% cesarean rate today) and peer support person for cesarean moms... I absolutely can say some traumas are *unique* to cesarean. Do not elide the distinction.
The women who lost desired babies after the fetus implanted in the scar.
The women bleeding to death in the OR with accreta.
The women who had CPS called on them for declining a cesarean for a too-long labor.
Kira Johnson.
Rinat Dray.
Truth matters. Silence about violence helps no one.
Of course there are traumas unique to surgical delivery. Informed consent for a scheduled cesarean delivery cannot occur without discussion of placenta accreta spectrum! Specifically about the increasing level of risk with each subsequent cesarean delivery. Scheduled cesarean may not be the correct delivery method for someone who wants 3+ children. But like you implied - every person should get to make that decision for themselves, free from assault or physician coercion. And for many people, cesarean delivery is the safest choice in spite of the risks.
Bringing obstetric violence to light is critical and has helped provide more protections for birthing people everywhere. Thank you for sharing your experience.
How many cesarean consent forms include a disclosure of the mortality risk?
How many discussions of cesarean include a disclosure of risks, benefits, and alternatives?
I have yet to see this. I have yet to observe this. It did not happen for me or my mother or the thousands (at this point) of women I've spoken with.
But sure. It's a nice idea. If only it were reality.
What can we do but strive to create a more just world every day? Reproductive justice is so far from reality for most people in our world, but we can all work toward that goal.
I signed consent forms for both of my sections that disclosed these risks, and they were covered at length by my doctors. This is pretty standard these days, though it sadly was not so in the past.
THIS. I had two unplanned C-sections and have only ever viewed them as life-saving for me and my children. Like the author, my babies were sunny side-up and came with days of back labor (72 hours with the first, 22 hours with the second). I never dilated past a few centimeters and I had ALL the drugs. C-sections were a godsend and both girls arrived healthy with a living mother. To me, that's the only fact that matters. Birth plans to me have always seemed like a way to control something that is entirely out of our control as birthing mothers. It's critical to have your preferences and feelings heard and recognized but sometimes things get out of hand and being attached to a particular outcome and/or process contributes to the sense of having been disenfranchised. I feel visceral hate toward any narrative that sets up C-section moms as making invalid choices. How many people talk about mothers who suffer or die under the care of poorly trained midwives who avoid medical assistance? All births are inherently dangerous. Women should be allowed to get through it however they need to.
Yes! I was so glad after my c-section that a friend reminded me of the fellow 1970s kids we know who suffered serious, lifelong medical consequences because of dangerous, long vagjnal births. My fetus’s oxygen levels are too low? Yup, let’s get him out fast!
Ooof thank you for this comment. I’ll post this in a stand alone post but the book Matrescence by Lucy Jones gets at the trauma of birth in more depth. Regardless of delivery system. I complete agree about how pregnancy in all its dimensions should be discussed and just isn’t.
Yes to this! I have prolapse from what was deemed a healthy, uneventful vaginal birth; experienced months of fecal incontinence and have worked very hard to get back to baseline. I did not fully understand the risks to my pelvic floor from vaginal delivery and wish any of my providers had discussed this. I don’t know if I would have scheduled a c-section, but having more knowledge would have helped my recovery and birth trauma immensely.
I always try to find myself in people’s narratives about c-section births but so far I haven’t. I chose to have an elective c-section 9 months ago and it was the most affirming part of my journey to becoming a mother.
After three years of infertility, many uterine and fallopian tube procedures (sedated and not), hundreds of vaginal ultrasounds, uterine biopsies, egg retrievals, and many fertility healthcare staff saying, “it’ll be just a pinch,” the pain (physical and emotional) had compounded and I could not go through “natural” or assisted labor. I knew there was going to be nothing natural or magical about it because I had enough experience in women’s medical care to know “just a pinch” would be just that to a nurse but absolutely not to me. One of the OBs I saw during my pregnancy aptly called it, “a thousand little insults.”
So when I finally got pregnant and discussed my birth with my OB, the same person who diagnosed my infertility years before, I was so relieved at how open and affirming she was about an elective c-section. She said I was a good candidate and it could give me the peace of mind I craved after a long journey. I grappled with the decision because I worried what other people would think of me, most of all, what did I think of me???
Knowing I was going to get a c-section opened up such great conversations with my providers leading up to my birth, prepped my partner for those 5 weeks of his parental leave, helped my friends know what my birth would be like, and most of all, helped me manage my own expectations. My husband and searched for a post-partum doula to support us post c-section, too.
So all in all , what I’m saying is not necessarily that all c-sections are good ones, but that it is possible that a c-section is what’s good and nourishing to you!
I'm actively searching for "positive" C-section stories as well, and this was really helpful. The birth of my first son 5 years ago was traumatic (vaginal) - and eventually led to a diagnosis of PTSD, which I didn't even know was a thing that could happen as a result of giving birth. I felt like I'd been hit by a bus and the recovery was very painful & difficult, hard to walk, get out of bed, etc, things that I didn't know to expect.
I am now 8 months pregnant and having a planned C-section for this birth. Being able to cut out the labor and pushing part of the birth is an active choice to avoid triggering trauma responses - and though I know C-sections have their own risks, complications and pain, it feels like the best choice for me - though it's still hard to feel like I can own this decision without guilt and hear a voice that says I'm "taking the easy way out".
In the 5 years since my first birth I've done a lot of therapy and have come to realize that the traumatic birth wasn't the "origin" of my PTSD but actually a retriggering of previous trauma - medical trauma from chronic illness, as well as realizing that a "bad experience" when I was 20 was actually a sexual assault that was pretty painful. I really relate to you talking about pain compounding over years - it's validating to hear someone else's story about actively choosing a C-section because it's the best thing for them.
My medical providers have luckily been very supportive and validating of my choice, but it's been a long road to get to feeling confident in my choice for a planned C-section. Thanks for sharing your story!
I had a planned c-section five days ago and it went great. I would be happy to share my experience in detail if you want to chat :)
Thank you :) if you have any top things come to mind that you wish you had known before you had a C-section I'm all ears.
It was absolutely the right choice for me too! My anxiety around the whole process was so much more manageable knowing that I was going to walk in at a scheduled time and have my baby in my arms one hour later. My birth team let me play my own playlist, which also helped a ton.
I really think the key is *choice* - even when I experienced the normal pain of surgical recovery, I was able to feel like I could anticipate/expect and therefore control it a little more easily - like this was the plan that I picked for myself instead of a disappointing outcome.
That is a great point about being able to anticipate pain and how the choice of surgery helped with a sense of control over that pain. Definitely trying to make as many choices as I can for s different outcome this time.
You’ve touched on something so important. Sometimes the trauma doesn’t start at birth, but is rather an extension of something else. And pregnancy/childbirth is such a monumental experience that of course many lying things awaken. I really don’t think many women go into birth with that lens at all so the transformation is a huge shock to the system.
And yes! I am here to say it is absolutely possible to have a positive c-section experience. Two of my friends had planned c-sections for separate reasons and both were pretty much like, it was manageable and good. They didn’t really dwell on the pain, which I thought was interesting until I had my own c-section. I was in pain those first couple of days in the hospital. My doctor had me on a pain management protocol which really helped and at least set me in the right direction to start trusting my body to move. I’d describe the pain in the subsequent days as a very sorr and weakened abdominal core. They sent me home with hydrocodone just in case, but gabapentin + Tylenol was enough to manage for the next couple of weeks. I’d say by week 4 I knew my incision was there, though the pain had passed.
Here’s what I think was one of the critical things to my uneventful recovery: sleep. My husband woke up with the baby at night for almost a whole month just so I could have 5 hours of uninterrupted sleep at least. I could feel sleep was good for my body.
Wish you all the best with your delivery!!!
Thank you for sharing more details of your recovery! I'm honestly feeling a bit nervous for a new unknown kind of pain so it's helpful to hear your (and other's) experience so I know the kinds of thing to expect and it's not a complete surprise. Sleep definitely is going to be a top priority for both physical and mental well being! I'm really glad you had an overall positive and uneventful experience after the challenges you experienced getting pregnant.
Also had very positive experiences with 2 C-sections! The first was scheduled bc I had gone through years of infertility, IVF, and a very painful & traumatic miscarriage that was the same date as my due date for the 2nd pregnancy. I was terrified of being triggered during labor and psychologically reverting back to my miscarriage. My baby was breech but I opted not to attempt a version and just schedule a section. Having a quick birth experience and being well rested was a wonderful way to start parenting and it was so different than my previous trauma that I avoided any triggers. My second child flipped to breech at 39 weeks so that was also a C-section and also non-traumatic.
As far as advice, those pregnancy belts are really handy in the first few weeks postpartum when you just want your belly pushed tight. And going to a pelvic floor PT was really helpful, even for minor postpartum issues.
Good luck!!
I had 2 planned c-sections and would do it again. With my second I was eating a cheeseburger 6 hours later. I’m glad that you have providers who are supportive of the choice that’s best for you.
Two C-sections here and they were 100% the right way to go. It sounds like you've walked a very rough road here. Please try to give yourself some grace. Suffering doesn't make an experience more or less valid. With all you've gone through, choosing a path that feels less difficult and is the best choice for *you* is full of power. My first c-section was after 72 hours of back labor and honestly, the doctors could have delivered my kid with a can opener and I would have been fine with it. My second was supposed to be a planned c-section but I went into labor two weeks early, and the L&D nurses refused to listen to me. They insisted we needed to wait and see how things went before going to a c-section. I felt so trapped and ignored! 22 hours and only 2 centimeters later, the OB who delivered my first came on rotation. She took one look at me and sent me straight up to surgery. I will love her forever for that.
So true about suffering not making something more validating- thank you for that reminder. Choice is definitely powerful.
I'm glad you finally had your OB listen to you/advocate for you! Thanks for your support
I have had two planned c's and good experiences with both! My first was due to a breech baby, and the second because I decided against attempting a vbac (the devil you know, etc). I think my experience was helped by the fact that I had zero expectations other than wanting to emerge from birth with a healthy baby and as few complications as possible. Personally, any delivery method sounds terrifying so I just wanted to follow my OB's recommendations. My priorities were to schedule with an OB recommended by doctor friends and be at a good L&D hospital with a good NICU in case anything serious went south.
I did react to the painkillers and was throwing up for like 6 hours afterward, but I kept asking about that at follow ups and in pre-op and the crna at my second c-section made sure to add zofran to my epidural, which helped. As for recovery, try to line up as much help as possible. My spouse did not get paternity leave, so I hired whatever childcare we could afford and accepted all offers of help.
On a practical level, you will want to stock colace, gas-x, tylenol/advil, and pads for home. I also bought high-wasted c-section underwear that helps and packed high-wasted leggings or dresses for the hospital. It is a major surgery, so try to be patient and try to rest when you can feel you overdid it. Both times, I was cleared for exercise and activity at 6 weeks, and I have no issues now almost 3 years after the second c other than a little bulge at the incision scar.
Obviously, many people don't have this experience, but wanted to share my positive ones since you were asking! I have other friends who have undergone schedule c-sections and I think it's wildly different from emergency ones.
Thank you for all these positive C-section stories! They really do mean a lot & I appreciate the support!💜
My 2nd c-section was planned. The recovery was truly not bad. I was surprised to feel able to move with freedom relatively quickly. Practice standing up as straight as you can. The more you walk after the surgery, the better you will feel. Sending good thoughts!
My first was an emergency C-section. My water broke and they tried to induce labour - though I would say "try" very loosely because it involved Cervadil, the insertion of which was more painful than anything. Anyway, after 30 hours and not getting more than 4cm dilated the baby went into bradycardia and the dr said we needed to do a C-section. After 4 years of infertility I was like "I just need to go home with a baby."
Result: a beautiful 9lb1oz boy and a scar that has healed so nicely you can barely tell it's there. There was a bit of a challenge because he met the 10lb threshold for carrying pretty quickly. But overall recovery was fine.
Thank you for writing this. It's helping me understand my experience. 27 years ago, I became pregnant with IVF twins after years of infertility treatments (4th transfer, second cycle with egg retrieval). My OB was a high-risk specialist (I'd miscarried once) and at my first appointment I said I wanted a c-section. He chuckled and said that's not how it goes and a vaginal birth was the best option. At a class for people pregnant with multiples, I had my only panic attack ever when they got to the part about giving birth. I was so panicked about the whole thing I just didn't think about it. Ever. I ended up having an emergency c-section to save my life, and I was grateful because all 3 of us lived and I didn't have to endure a vaginal delivery. I am understanding now, though, how traumatic it all was, starting with infertility. I am feeling so shaken, to realize how much I was affected and how I never dealt with any of it because no one then ever suggested that I might be anything other than grateful. Years later, a therapist said it seemed like I had PTSD, but it was puzzling because why? Never occurred to either of us that it might stem from any of this. I am so glad that you were able to make the best choice for you and I absolutely affirm that there is no one right answer for everyone. As much as I was unaware of, some part of me knew that vaginal birth would be too much for me.
God I was and am so resentful about my C-section, not because it made me feel less of a mother but because it made me feel less of an athlete. So many of my friends waltzed out of the maternity ward and were back on their bikes or the trails so quickly, where I was still learning to walk to the kitchen without hunching over. People couldn’t believe how much pain I was in, literally, they found me hard to believe. I, in turn, could not believe them because why would I want that! Why would I *act* that!
So grateful for this piece.
I feel for you! Don't know if it helps to know this, but I chose to deliver my twins vaginally (and was lucky to have the support to do so) because I was actually more scared of a c-section. But extreme pregnancy and delivery have left me with pelvic/hip problems that have negatively impacted my life as a trail runner ever since, even 13 years later! Postpartum athletic activity presents so many challenges and I wish there was more discussion of it - and better access to medical experts who can actually look at the situation from a holistic perspective (male sports medics are not helping me right now...). I hope you are back on the bike/trails now and able to enjoy them.
Oh god, I feel for *you*. It's a mess out there, and like you said, I wish there were more experts and better access to help us recover and thrive.
One point that I haven't seen made explicitly (maybe I missed it) is that a large part of society doesn't want to talk about how traumatizing birth is because they believe that this is what women are designed to do, that their main purpose for existing is to birth babies. This is ingrained from such a young age that any birth experience that involves trauma - even though as was pointed out in another comment that it's ALL of them - is seen as a failure on the part of the woman. And to keep that myth intact, young people aren't being allowed to learn what is actually involved in growing and birthing a baby.
And the language and images we use is such a big part of that. Making sure the makeup and hair are perfectly coiffed for that first picture of the family in the hospital? I mean you do you, but that only serves to perpetuate the ideal, imo. (But then again after my middle was born - VBAC - I chose a picture for a book I sent to the grandparents that is focused on my husband and our girl without noticing that in the background I was getting stitched up. I have regrets about that lol.)
I was fortunate to have a Labour & Delivery nurse as a sister so I went in with no illusions. She quit because she was tired of women ignoring medical advice because of what they had read about c-sections or because they were so tied to their birth plans. Babies died and women suffered irreparable harm. So I appreciate how the author says we need to approach the idea of birth plans focused on all potential outcomes because otherwise how do women know what to advocate for? And it has to be done well before the baby is on its way.
I have had an emergency C-section and two VBACs. More poking and prodding around down there from years of infertility treatments than I
care to recall. Nothing about any aspect of growing and birthing any of my kids was trauma
free. We have to stop treating having babies like it's a ride at Disneyland.
Thank you, thank you, thank you. Ordering this book immediately. I had an emergency c-section and, three weeks later, was hospitalized for postpartum psychosis. The combination of a traumatic and “unnatural” birth, being separated from my baby for several days while I was in a mental ward, and having to supplement breast milk with formula left me feeling like a failure of a mother straight out the gate. There was so much shame.
This week, my daughter will turn four and while the shame sometimes creeps back, I know at my core that I’m a good mom. My daughter is thriving and I couldn't love her more. Reading this was validating and healing. Thank you.
I had a scheduled c-section and it rocked. 10 / 10 would do again. So if anyone is reading this and spiraling about needing a c-section, let me tell you it's possible to have a good one.
Thank you! I just found out my baby is breech, and while I appreciate the book’s perspective, I needed to read a positive counterpart today.
My first kid was breech and I had a planned C-section. It was a very good experience.
In the weeks before birth, I did have not one but TWO male coworkers tell me "You know, even with a breech baby you can have a vaginal delivery." Mansplaining at its finest!
How is that mansplaining? I don't understand.
.....wow!
I had 2 breech babies and 2 planned c-sections. The c-sections were absolutely the right option in both situations and I was grateful to be able to approach them in a planned way instead of in an emergency.
Also 2 breech babies and 2 uneventful C-sections! ❤️
I'll add that c-section wasn't even my first choice, just what was medically recommended.
This is so helpful to hear!
I had two planned c-sections for medical reasons and both went great. The recovery was difficult. My daughter was so high up they cracked a rib trying to push her through the incision…the combo made moving, getting out of bed, trying to feed her, etc. difficult.
All that said, I have no complaints.
The problems I did encounter were people’s reactions to the fact that I had C-sections…like it’s a somehow ‘less than’ birth experience. A couple examples are my mom saying she didn’t know how to help me post birth because I was ‘doing it different than her.’ She’d had a vaginal delivery and didn’t breast feed. Note to everyone: new mom’s would like an uninterrupted shower, a warm meal, full cup of water, help picking up around the house, changing a diaper, holding the baby…so many ways to help!! We don’t have to birth exactly the same to understand a shared experience.
I also had a friend insist that both my kids and I needed to simulate a vaginal delivery (like, reenact it) to make up for the trauma of the C-section. It didn’t matter that I told her there was no trauma…it was planned, I felt pretty prepared, we listened to ABBA with my first and Van Morrison with the second…but she insisted we had to recover from it. I felt like I was supposed to feel bad about my births and what was wrong with me that I didn’t?
Every new gynecologist that I get (we’ve moved a bit) I’m always asked why I had c-sections (of course), but sometimes I feel judgment. Like I’m defending the reasons for the c section (breech, ‘did that try to turn the baby?’ Or placenta previa, ‘was it directly over the cervix?’). I always dread this conversation a little…
While reading this I couldn’t stop thinking about how angry I am for all women that are ignored or dismissed for their pain/trauma, but the fact that it’s that much worse for black women makes me sick. We have to do better.
One more note: physical/occupational therapy is an absolute must!!! As well as lactation consultants. This was a great interview.
I think your friend is outlining thoughts related to our births and how it may affect us later in life. I don’t think it’s necessarily outlandish as a concept. I was six weeks premature and, because I was one ounce under what was considered best at the time, taken away from my mother for a day and placed in a cold, stark incubator alone and away from her. Do I think that impacted me? I do. It’s not a bad thing to think about the differences between being born one way vs. another and the impact that might have such as via a c-section or other instances.
I can totally appreciate that that must have been traumatic for you and your mom. And I’m sorry. 💗
My point was that I had two very non-eventful births, that happened to be delivered via planned c-sections. I was able to breastfeed and be with my babies immediately, while I was sewed back up in the operating room. I don’t believe there’s anything to work through, and neither do my kids. The most difficult part is people acting like there is some problem with the way it happened. If that makes sense. xx
Thank you, it definitely must have been hard for my mom. And me… She said that’s what they did then. I’m not saying anything ‘bad’ happened after your children’s births for them. I was thinking the premise your friend may have had is, that, with their birthing via C-section, they did not ‘leave’ on their ‘own’ time; someone came in and removed them. That had to be/possibly was an impactful event for them. I’m sure there are theories out there. That may sound odd but I can understand that. I’m glad everything went well. Take care.
”…we live in a society that routinely diminishes, ignores, and underestimates women’s pain from the time that we are children”: WORD
One thing that still breaks my heart about my hospital stay is that my pain wasn’t taken seriously *by other women*. 100% of the nurses were women, 50% of the doctors were women. When I tried to explain that my pain felt otherworldly and like I was dying, they’d roll their eyes or scoff and say things like, “Hon, if I could deal with it, you can too.” Eventually I found one woman who believed me, and then I got rushed into surgery.
I guess I was unprepared for the degree of internalized misogyny among women.
I’m so sorry your pain was dismissed so easily in what sounded like an already stressful time and I’m glad you found someone who really listened to you
I just had a planned C-section for my twins three weeks ago and it removed so much of the fear and anxiety I had about pushing out two babies and what that might do to my body long term. I’m so grateful it was not only an option but something my OB fully supported, especially since they’re my firsts. I don’t hear a lot about my similar situation and now that I’m struggling to breastfeed and pump I’m being told by lactation consultants that it’s probably because I had a C-section, which then makes me feel like I made a mistake or that I’m being punished for my elective surgery. Women just can’t win in our society.
It is NOT true that your challenges with breastfeeding are because of your delivery and your lactation consultants are doing you a disservice by telling you so. Wishing you all the best with breastfeeding and pumping if that is something you desire to do! But also here to be just a quiet voice letting you know that how you feed your babies does not determine your worth as a mother and formula is ok too. You created two new humans - you are remarkable!
I had two C-sections and breastfed both of my kids. You’re not being punished, you did what was right for you and your family. Sometimes it comes easy and sometimes it doesn’t. Good luck and feel free to reach out if you have any breastfeeding questions. xx
Congratulations on the birth of your twins! Multiples are no joke (fellow twin-mom here) and breastfeeding them is hard no matter how you delivered them. I’d be happy to share my experience if it would help. Ultimately I ditched the pump, fed them mostly one at a time (bouncy chairs were an godsend) and supplemented with formula. There are so many different ways to do it and you should feel empowered to find the way that works best for you and your babes. Good luck!!!!
Your lactation consultant should’ve told you that at three weeks everyone is struggling, regardless of how the babies arrive. It’s a brand new skillset for both you and the babies - it takes a long time to get the hang of a new skill. (It took about 2.5 months before the baby and I were really in sync and breastfeeding felt like a pleasant bonding experience.) And don’t let your lactation consultant try to tell you that there’ll be “some discomfort”. It’s straight-up painful in those early weeks.
Reading through these comments makes me realize how much the narrative in the US about pregnancy and childbirth is f-ed up. No one talks about the risks of childbirth when they promote 10 year olds having babies because abortions are illegal in their state. It’s abhorrent. We need so much more information out there about women’s reproductive systems and health so that whoever is making these decisions (lawmakers, Supreme Court) has better and more accurate information to base their decisions on. Sheesh!
If a 10 year old is having a baby they are likely going to need a c section too. We only want to talk about the beauty of pregnancy and the maternal radiance that motherhood brings. It’s all surface level discussion because the people leading those discussions don’t care about women or babies.
I would absolutely be dead without my c-section. I developed terrible preeclampsia in the midst of my feeble efforts trying to turn my breech baby at 35 weeks. I actually remember being pleasantly surprised at how little pain I felt after the c-section and how quickly I healed, probably because I heard all the horror stories about healing post c-section. What didn’t heal quickly, and in some cases at all, was the trauma of preeclampsia, my ongoing struggles with blood pressure years later, and fear it would happen again if I had another baby.
Yes (and I’m so sorry you went through that). I had HELLP Syndrome with my first, so I was pretty out of it during her birth due to the magnesium sulfate. My platelet count was too low for an epidural and I was diagnosed in active labor, so I labored and delivered on pitocin without any pain relief. Then she came out with a triple nuchal cord around her neck *and* with her hand up (so lots of internal tearing for me at a time when my bleeding was hard to control). On Friday night I saw a video of a doctor or nurse resuscitating a newborn who was born gray (as my daughter was), and I asked my husband if she cried when she came out. He said no. I had never asked that, even though it seems like the most obvious question in the world, but because I was so out of it it didn’t occur to me.
My daughter is 17. This experience was so long ago and I had another child and a wonderful experience with him, but I cannot believe the amount of trauma I still carry from that first birth. I cried when my husband said no—not just because I thought about the fear he and my mom (who was with us) must have felt, but because I was so out of it that I didn’t even know my baby wasn’t breathing when she was born.
I had HELLP too and do not remember giving birth and that to me is almost more traumatic than my 6 day hospital stay after.
Loved this piece so much!
Two thoughts but i want to first preface that with my experience so folks know where I'm coming from: 3 kids/2 inductions/3 epidurals/no c-sections/1 D&C in a pregnancy where baby was discovered to have no heartbeat at 18 weeks between kid 2 and 3. I don't consider any of my birth experiences to be traumatic outside of my later miscarriage/D&C for obvious reasons.
Thought one: my experience is that women LOVE to talk about all the icky, gooey of birth experiences. However, it is usually reserved for after someone else has given birth. Not like it's a club you have to be in or that i wouldn't share if someone who hadn't given birth asked but it's a bonding experience. I also find it very tied to engaging with a new mom. I work with a lot of women and when someone comes back from pat leave, they always want to talk about their birth story and then we all want to retell ours and our experience in comparison as part of it. There's a lot of "I never would have told you this beforehand new mom but now you get it!" So maybe it is kind of a club/bonding thing.
Second thought about your friend having no memory: I feel this piece leans too far into the trauma of it all - only as it relates to women who didn't go through something truly horrific. I've come to believe some of this is a biological and evolutionary response. My husband has graphic memories of all our kids' births. I do not. I have hazy fuzzy feelings and some moments that come into clearer view. My sister and her husband with 4 kids is the same. A lot of women I've talked to have similar experiences with their birthing partner. I've joked with people many times that women's brains and bodies must have evolved to not hold on to those feelings and memories or why would you do it again? I guess you could call that trauma response. I feel it's nature's way of giving us a gift that allows us to keep doing something hard but beautiful through a lot of extra doses of natural hormones. Those endorphins post-birth are healing our minds and bodies.
I definitely felt like I was stoned and/or not sober for my births! You go to a different place, most likely bc it is hard work and so so physical.
re: evolutionary response, I think this is an overlooked part of why c-sections are often experienced as traumatic. You don't get the endorphins. You don't get the baby-on-chest moment for another 20 minutes. The chalkboard isn't erased.
I definitely think it's a 'part of the club' thing. I heard SO many birth stories for the first time at my shower (another reason I suggest everyone have a shower - it's basically a stealth birth/childrearing consciousness raising event).
There’s actually research into why, though it appears research isn’t sure of the definitive cause. I think the fact that oxytocin has an amnesia effect could be part of it. I also really like the idea of the peak of difficulty and end rule where only the worst part and the outcome standout because they are the outliers, and the peak diminishes when the outcome is good. Both of these theories would be interesting to study, but not all amnesia is trauma. Exhaustion and the overwhelm of being a new mom could also influence the feelings.
Yes to the secret club reserved for post birth events - I distinctly remember two coworkers who didn’t want to hear details so they wouldn’t get scared to become mothers. It’s part of leaning out of the pain of others because it seems so scary. After they had their first kids, we all very graphically and with great delight got to tell our birth stories. Man, I just ADORE birth stories! It’s a v special bonding time.
A few weeks after our son was born (by C-section) my husband mentions that his clearest memory was "the smell of your burning flesh" from when they cauterized the incision. I had no memory.
I wish I would have pushed harder for information. I know I asked about C-section info at least twice during my pregnancy and was brushed off because it probably wouldn’t be necessary. I knew next to nothing about the process.
As a direct result of that lack of information, during my induction, I resisted the idea of a C-section (invasive unknown surgery on top of my first-ever hospitalization when I’m already scared from prior family deaths, gee I wonder why I wasn’t receptive to that) until it became an emergency situation. My child and I are both fine now, but my husband couldn’t be in the delivery room. I was put under and couldn’t see my baby for a couple hours at least. My body sustained a level of injury that was frankly unnecessary and shouldn’t have happened. I asked for information in advance so I could make informed decisions, and I was refused, and while I’m not angry at the individual providers for following their standard of care instructions, I’m angry that the standard is to withhold information. It shouldn’t have had to be like that.
Yeah it's like how NO ONE will talk to you about formula feeding until the final hour when you are already a parent and hallucinating from lack of sleep.
Yes! I’m so thankful my sister had already talked to me about it, and honestly the hospital did a good job of it too. But it took my hormone-addled postpartum self a while to be okay with it…once I got past that hurdle, and leaned into combo feeding and the formula only, things were great. I will sing the praises of Costco / Kirkland formula forever.
This piece really made me feel less alone. I had a longer comment here, but I’ve deleted it. I’m deeply grateful that this interview offers a space for people to acknowledge that C-sections can be both an act of mercy and a distinct sort of trauma, and one that we generally aren’t permitted to talk about. But I worried about leaving my comment up when there are pregnant commenters expressly requesting positive stories.
Let me instead say this to everybody who’s survived any sort of medical trauma: I’m glad we’re here.
I am so angry on your behalf.
What gets me is that your experience was at least partly PREVENTABLE. My OB for my vbac did cesareans with immediate skin to skin and has even done maternal assisted ones where mom pulls the baby out. He delivers at a hospital where they've gotten the overall cesarean rate to 20% (was 33% a few years ago). To do this requires acknowledging women are not candy wrappers or trash cans but human beings. A tall order, it seems.
This sounds really traumatic. I’m so sorry it happened that way. You deserved better. xx
I skimmed this because its a bit too close to home for me for now and maybe one day I'll be able to watch Fleishman. This part really stuck out to me in this interview: "That is the consequence of ignoring real birth experiences, of narrowing the story to, ‘It was rough, baby’s fine, the end:’the inhumane system we’ve created, where we shove mothers back to the responsibilities of their pre-birth lives, sometimes only a few weeks after having a baby, without a shred of the care they need emotionally, physically, or spiritually."
It really matched my experience after traumatic medical experiences that involved unplanned csections. Got a lot of: sorry that happened. Its over now. Look how cute your baby is....How many ounces is he drinking.....You must pump overnight....Go make bone broth....its time to go back to work now....
I couldn't remember how many ounces he drunk or get up to pump at night because I still couldn't bend down or shift positions to get up off the couch or the bed for weeks.
Society has a long way to go in terms of caring for, let alone acknowledging, the needs of birthing parents, especially those who had traumatic delivery experiences or abdominal surgery. A trauma counselor in the hospital would have made a huge difference for me. Knowing that I might not be ready to physically go to work everyday via public transportation even though my leave was over would have gone a long way. Instead I thought I was weak and wasn't healing well. I started blankly at coworkers when they asked if I was "all healed" from my csection.
Not to mention the lack of adequate followup care for the lifelong consequences of csection. During an endometriosis excision surgery several years after both of my csections I was found to have an csection scar defect called an isthmocele. No one ever mentioned that to me (and I complained to a lot of women's health providers A LOT about a variety of sympmtoms, some of which I much later learned are consistent with isthmoceles.)
According to the Cleaveland Clinic: "Between 24% and 70% of people who've had at least one c-section develop an isthmocele." For a frequent complication of an often performed surgery, that's the best range that research can come up with!?
Yes, c-sections are often necessary lifesaving medical procedures. I'm grateful that they exist. But the lack of followup care and knowledge about their consequences is really damaging. It wasn't only "rough" for that one day, it reverberates.
Thank you (both) for this. I’m going to order this book immediately. I had 3 csections: The first planned because the baby was breech. The second an attempted VBAC that became an unplanned c-section when I was 8 cm dilated and a resident thought to check the baby’s position… breech. The third planned because I’d had two previous sections, even though that baby was not breech.
I have a genetic bone disorder and have had about 40 fractures and 20 orthopedic surgeries. For me, pregnancy, birth, breastfeeding, and keeping my children alive and well through physical care allowed me to feel for the first time that my body was worthy, useful, powerful. I desperately wanted vaginal births to reinforce that sense of power and agency. My disorder was not the reason for my 3 sections — many women with my disorder give birth vaginally. I hate when people assume my disorder was the reason I had c sections.
For my 3rd c section, which happened in the middle of the night when I went into labor a week before I had a c section scheduled, the epidural didn’t fully work. It was highly traumatic and awful. And I remember thinking afterward that at least now I had a birth story that would be worthy of telling, because there was drama and trauma. My other two c sections didn’t make for a good story and no one in my social sphere ever expressed interest in how those births went. Whereas when friends had vaginal births, we all were interested in the story.
My kids are all young adults now but all of this is still very much with me. Thank you for bringing c sections and women’s experiences with them into the light.
This is not talked about enough: epidurals that are not working correctly. A massive source of pain and trauma in labor/birth!
I had an epidural that didn’t work in the midst of an induction that led to an unplanned C-section. The way the nurses and anesthesiologist made it seem like it was me not working and just perplexed by it and kept making me wait another 30 minutes to see.... Would have been a lot less damaging if they had said sometimes they don’t work. We believe you and let’s try again. I agreed to the epidural not for pain management but because I was told that I need to sleep and maybe it would help lower my BP. Well needless to say a non functioning epidural, painful contractions with less ability to move and frequent frustrating and useless calls to the anesthesiologist meant that I did not sleep and my BP did not go down.
I had an epidural that didn’t work and the anesthesiologist was just sooooo perplexed and asked “are you sure you’re feeling the contractions?” He actually repositioned the epidural but didn’t work still - then when we went for c-section they were like “don’t worry, they’ll give you extra xyz, you won’t feel anything.” They never quite got to those contractions… I’m SURE it happens all the time and yet such SURPRISE! Such SHOCK!