Dr Strangebirth – How I Learnt To Stop Worrying and Love the Caesarean

The second part of a trilogy of posts about Wriggly's arrival. The first part can be found back here.

Public holidays are wonderful things, especially around the year’s end. They give us time and excuse to catch up with friends and family, and even when it rains it’s really rather nice to know that you’re often being paid to eat trifle and try to find batteries for new toys.

Unless of course you are heavily pregnant, the fetus is lying all funny, and your midwife won’t really talk to you about it other than to stoke your simmering fear. Then the public holidays that dot the end of December and beginning of January seem to be specifically sent to torment you, by making sure that hospitals are running on a skeleton staffing rota and thus no one is available to talk to anyone not actually in labour.

Into the dark cavern I was inhabiting stepped Jenny, an ex-midwife from my partner’s church. She furnished him with a number of leaflets, produced by National Women’s, which clearly explained the process of undergoing a C section. They were a much needed antidote for the almost anti-medical attitude of my own midwifery clinic.

Once we actually got into the hospital system it was a revelation. The day after Boxing Day we headed to Waitakere for an attempt at ECV, with the aim of putting the fetus in the right position for a natural birth. In the car boot was a bag packed in case the attempt at rotation instead prodded the baby into coming early. I was nervous.

Luckily the midwives and obstetrician were not. Tom and his team were relaxed, friendly, informative, and I felt like there was nothing we couldn’t achieve together. Of course I was wrong – despite three attempts at moving the fetus around, it wouldn’t flip. The ECV process was like a very very firm massage of my distended abdomen, much more violent than I had expected. It was mostly uncomfortable rather than painful, but the care of the hospital staff, and the presence of my partner, enabled me to relax and even laugh. Tom was obviously gutted that he hadn’t succeeded with the turning, and booked me in for an “elective” caesarean a week before the due date.

“Elective” is a word that seems to have a bizarre meaning in our health system. It indicates that the patient has had some choice in the matter. Yes, I had to actively decide to have a caesarean, and the midwife did seem surprisingly eager to give natural birth a go despite the intractable breech position. My worst case scenario, my Plan Z if you will, had long been hours of painful pushing followed by an emergency caesarean under general anaesthetic. I knew that I would not cope well in that situation, would not be in a position to make good decisions, and that I would be terrified of not coming out of the anaesthetic. I also knew, from past experience, that I get very ill after a general, and I could not imagine that would be a good start to breastfeeding or motherhood, staggering about the place and unable to keep food down.

So my election of a caesarean was one of many of those decisions women seem to have – no choice at all really. We tried everything to turn him before C Day, including a stupid diet based on principles of categorizing food into yin and yang and eliminating one of these entirely (I forget which was which, but meat was good and sugar was bad). You try eating nothing with any form of sweetener, including fruit, for a week after Xmas and at the business end of pregnancy.

As it turned out, while the surgeon was twisting Wriggly out of my body she commented that there was no way he was coming out naturally and I would have ended up on the operating table regardless. By going the elective route I’d effectively put myself in the best position to be undergoing an operation – well-rested, well-fed, well-supported, and in a good mental state – that was in fact necessary. A hundred years ago I guess that there’s a possibility that we both could have died.

It annoys me that many people portray those who give birth by caesarean as “too posh to push.” Around a third of NZ’s babies are delivered through the sunroof these days, and by talking up the evils of the surgical option in ante-natal classes many facilitators are effectively adding to the guilt and self-doubt of one in three of the mothers in their classes.

Very very few women would choose a caesarean if they knew they could have an uncomplicated and safe natural birth. The recovery time from a caesarean is enough to put you off – it’ll still be another six months or so before I am fully restored. Having your life suddenly and severely curtailed by the arrival of your firstborn is shock enough without also dealing with the aftermath of an operation that is the equivalent of a serious car accident. And speaking of cars, not being able to drive for six weeks afterwards does rather tend to exacerbate the loss of independence.

If a woman knows all this and still chooses a caesarean when natural childbirth is a viable option for her then I think we should respect her choice. It’s her body, her birth process, and frankly what she says go. Tales of doctors who want to remove women from any decision-making about the end of their pregnancy infuriate me no end. The focus should be on helping the mother to deliver her baby with the least difficulty, in a manner that pleases her as much as possible and keeps both her and child safe.

Part Three sometime soonish.