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Thursday, April 15, 2010

"Emotional Inpact of Cesareans"

Another brilliant article in Midwifery Today Magazine on the topic of the Risks of Cesarean sections- not just the physical, but the emotional trauma that haunts so many mothers after being under the knife.  I have had 3 C/Sections.  Each one was very different and at different points in my life.  Each one made me feel like a failure.  Each one left me feeling like my body was imperfect- unfeminine- that it couldn't do what it was suppose to do.  Each one left me with a stronger urge to fight for the rights of birthing women everywhere, to save as many women as possible from going through what I've gone through.

Sadly though, so many women do not listen.  So many women seem to think that the medical machine knows what's best for them and they allow themselves to sacrifice up every bit of their autonomy onto the alter of modern obstetrics.   I cringe every time I hear a pregnant woman say "my doctor knows what's best for me.  I'll do whatever s/he says".  And every time I hear a woman say "Well, I'm just going to book a C/Section...."  I want to scream at them  "You have NO IDEA what you're doing to yourself!!!"

It's frustrating.  Yet I still talk about the dangers of Medical interventions every chance I get, to every pregnant woman I meet- IRL and on-line. I might be snubbed by most, but I know that my soapboxing have saved many women from the knife and many babies from the cold medical machine.  So I'll keep on preaching.  Regardless of the ridicule and back stabbing.

Emotional Impact of Cesareans

by Pam Udy

[Editor's note: This article first appeared in Midwifery Today Issue 89, Spring 2009.]
Every 30 seconds in the US, a cesarean is performed.(1) This overuse of cesarean surgery puts moms and babies at risk—not just physically, but emotionally. My intent with this article is to show the emotional impact that cesareans can have on the family. A cesarean can reach far beneath the bogus smile on mom‘s face. It can scar her heart, as well as her uterus.
A baby girl is born. She grows and begins menstruating. She becomes sexually active and becomes pregnant. She births her baby. She breastfeeds her baby. This is life—normal and natural, yet exciting and important. In the continuum of life, pregnancy, birth and the postpartum period are milestone events. These experiences profoundly affect women, babies, fathers and families. They have important and long-lasting effects on society.
When a woman gives birth, she has to reach down inside herself and give more than she thought she had. The limits of her existence are stretched. There is a moment when every woman thinks, “I can‘t do this.” If she is lucky, she has a midwife, a doula or her mom to whisper in her ear, “You are doing it.” As she does it, she becomes someone new: a mother. If the birthing process is skipped or occurs in a hostile situation, or if the interventions become overwhelming, she becomes a different mother than she would have been if she had only had a supportive, midwifery model of care.
The Mother-Friendly Childbirth Initiative of the Coalition for Improving Maternity Services asserts that: A woman‘s confidence and ability to give birth and to care for her baby are enhanced or diminished by every person who gives her care and by the environment in which she gives birth.(2)
To control and actively manage a woman‘s labor and delivery, modern obstetrical practice relies on conformity. A woman is “subject” to rules, restrictions and protocols enforced by nameless strangers. Physicians and the hospital staff have authority—there is an unbalance of power. Doctors know this and some use their power to persuade women to “make” decisions in the interests of the physicians; and if they can‘t, there are the courts. I say: You can only consent to that which you are capable of refusing. If you can‘t refuse the test, the drug, the procedure or the surgery, then you did not consent to it. This is coercion and it leads to disempowerment of women. Disempowerment as it pertains to pregnancy and birth is the exclusion of pregnant women from the decision-making process, leaving them without means of self-protection, limiting their birth choices and leaving them few, if any, options. This is detrimental to the growth a woman should experience during labor and birth.
Many women who have cesareans suffer in silence because society expects them to “just be happy about their baby.” Well-meaning family members say, “Be grateful; a hundred years ago you both would have died.” The farce begins. We paint a smile on and pretend it doesn‘t hurt.
How do we convey the experience of traumatic birth? My heart has broken a hundred times while listening to the stories of my International Cesarean Awareness Network (ICAN) sisters. How do I tell you of the depth of the pain? We have lost the societal norm of decent and respectful care during pregnancy, labor and birth in our hospitals. Moms and babies are paying a high price for unnecessary and inferior “care.” The March of Dimes says that one in eight babies is born premature, costing $26.2 billion dollars annually.(3) Prematurity is linked to cesareans.(4) Compared to 16 other countries with at least 100,000 births, the US ranked last in maternal mortality and third to last in perinatal mortality.(5) The response to these poor infant outcomes is a 50% increase in cesareans since 1996. The belief that more medical intervention is better, regardless of cost, isn‘t supported by research.
Research has shown that when we stray from evidence-based maternity care, we have a high degree of obstetric intervention that is associated with acute trauma symptoms.(6) I caution readers to remember that how a woman perceives the event, not the event itself, plays a vitally important role in whether she has trauma symptoms.
Women report experiences that fall into the following categories:
  • A sense of loss: birth didn‘t turn out like expected, loss of the experience of participating in the birth experience, not being there when the baby enters the world
  • Interrupted relationship with baby: feelings of detachment from her baby
  • Altered identity: sense of failure, feminine identity altered; lowered confidence in her body
  • Intimations of mortality: surgery gives “rise to fears about mortality”
  • Feelings of violation: from surgery where the body boundaries are violated, feeling “mutilated” or “butchered”
  • Anger at caregivers: particularly regarding “what was perceived to be an unnecessary cesarean, lack of involvement in medical decisions, feeling unsupported by hospital staff before, during and after the cesarean”
  • Dissociation: feeling that the surgery was taking place on someone else or from a distance
  • Humiliation: being scolded
  • Helplessness: not being able to take care of herself or her baby
  • Posttraumatic Stress Disorder symptoms: anxiety, trouble sleeping, panic attacks(7)
Caroline said, “I felt like I was up for sacrifice…I think I was sacrificed for the sake of my own stupidity…I think I sacrificed my soul. This sounds rather extreme, but so is the pain right now…. This was supposed to be the most wonderful day of my life—better than my wedding day—and for this reason, it was a devastating loss. It‘s funny that most people seem totally accepting of weddings and marriages gone awry, and how traumatic that can be, but a birth gone wrong? To most people there is no such thing. We are just lucky we are ’healthy‘.”(8)...

HERE to Read the entire article