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I have a baby, but I've never given birth....

Gina tells of the emergency caesarean birth of her breech presenting daughter in 1988, and the emotional difficulties she faced afterwards.

I knew a few weeks before my due date that my baby was a breech, consequently I was offered an elective caesarean section which I declined, preferring to at least have a go. I had desperately wanted to have as natural a labour as possible and had stated this wish to maternity services personnel at every opportunity. Following X-rays I was told that I had every chance of delivering 'normally'. 'Normally' meant on my back with my legs in stirrups, large episiotomy, forceps, and preferably under epidural anasthetic. I have always had two nightmares regarding childbirth and here I was being asked which of the two I wished to endure. Despite nine months of pregnancy I was not psychologically ready to give birth. I had no acceptable choices open to me.

My contractions began at 6:30am Monday morning but by lunch time had disappeared. They started again at 8:00pm. At around l0:3Opm my waters started to leak with each contraction. Due to vague worry of cord prolapse and bearing in mind various horror stories of breech births, I decided to do what my husband thought best and went to hospital. We arrived at hospital at 12.30am Tuesday morning. Admission was very relaxed as it was obvious my labour was not 'established', and had it not been my first baby and in a breech position I would have been sent home. I was monitored for two half-hour sessions. The first soon after admission, the second at around 6.OOam, when my labour was officially deemed to have begun. The monitor also confirmed that the baby was strong and coping well with the contractions. I found this news a great comfort as I was disappointed in the performance of my own body! In fact the baby was not in distress at any point during my labour.

I was extremely tired as I had been up all night and I was only 3cms dilated. Contractions were still inefficient - strong but short and 3 minutes apart. I was advised that if I was to have my baby that day labour would need to be accelerated and as I didn't relish the thought of a second night like the last one I readily agreed. I also asked to have an epidural as I felt I had tasted labour sufficiently to know I would not be able to cope with artificially accelerated contractions, and I knew from previous discussions that it was preferred I had an epidural. Also I had already declined the offer of an epidural twice since arriving at the hospital. All requests by medical staff were made in a very pleasant manner and being a good patient, concerned for my baby, I was hardly in the frame of mind or position to argue - I simply did as I was told. I relinquished all involvement in and responsibility for my labour without question, arguement or comment.

I was moved from the labour room to the delivery room, the epidural was fitted, the oxytocin drip set up, and I was put back on the monitor. A clip was attached to the baby's bottom and again it was good to know that although I was knackered the baby was still strong and coping well. With the epidural working it was such a relief to lie there quietly drowsing, it was so peaceful. My husband was able to go off for a cup of tea and something to eat while I dozed. By 3.OOpm I was fully dilated but there was still a rim. It would have been unwise to start pushing too early with a breech, but by 5.OOpm I was given the all clear and the hard work began. Pushing was difficult as my epidural was working very well, however I could still feel the contractions and was surprised at how much control over pushing I did have.

By 6:30pm, one and a half hours of pushing later, the contractions, which had been fading fast packed their bags and deserted. I had no more strength left and in any case could not have pushed my baby out without the help of contractions. It was obvious that my baby was not going to be born in the normal manner. A very emotional and tearful interlude followed as the inevitable was agreed - off I was wheeled to the theatre where a medical team was ready and waiting.

The caesarean section was carried out under epidural so I was awake throughout. My baby arrived in the world about 20 minutes after the end of pushing, as it took them no longer than about ten minutes to get her out. She was in perfect health. My husband was present, music was playing (Simon & Garfunkel's Greatest Hits will never sound the same again!), the theatre was full of people and pleasant conversation, several jokes were made, and one of the theatre technicians took some photo's of us with my camera. It took about an hour to sew me up, but the time passed quite quickly as our attention was on the baby who was laid across my shoulder for most of the time. The experience of the section was as good as the hospital staff were able to make of it. It is a pity that I was in no state of mind to make the most of their efforts to make it as pleasant as possible.

It was certainly an experience and although I could not say in honesty that it was 'pleasant' it was certainly 'interesting'. It was nowhere near as terrible as I had expected and I would not be frightened of repeating the experience (although there would have to be a cast iron reason!!)

It was not easy to decide whether to have the section under epidural or general anaesthetic when I was given the choice. My epidural was already sited and working well so I opted for that although I did wonder what I'd let myself in for. It was the right decision for me as I was able to see my baby as soon as she was delivered, which I believe was crucial to the positive way I have felt about her ever since.

There were unpleasant moments though - I started to retch at one point. Trying to be sick while you're lying on your back with your stomach cut open is not pleasant! It didn't last long however and was soon under control. The surgeon removed the afterbirth and I was very uncomfortable while he swabbed the top of the uterus as it was just above where the epidural was effective, but although it hurt it wasn't too bad. The only really painful bit was while he put in a 'zip fastener', a form of stitching used in the nerve layer of skin. I had to concentrate and breathe my way through that bit which took about five minutes I think - it certainly seemed a long time! It was even more painful some days later when it was taken out, but by then I was no longer on any kind of painkillers (my own choice).

Immediately after the operation we were left in peace in a quiet, dim, side room and I put my baby successfully to the breast. Gordon was under no pressure to leave, although he did so soon after making a couple of phone calls on a portable telephone which was brought into the room for us.

Recovery was fairly quick and I don't think I was any worse off than someone who'd had a large episiotomy or forceps. The stitches were just in a different place! The scar is very neat and well below my bikini line. I was on my feet and walking the following day and was allowed to go home after five days, during which I kept my baby with me at all times and was not made to feel uncomfortable because of my wish to stay with her.

I needed her with me because I needed to reassure myself at a glance that it had indeed all been worthwhile. I also received alot of help breastfeeding and found the staff to be very helpful and pleasant at all times. I was able to take things very easily for the first two weeks at home as my husband and my mother did all the housework and cooking.

The biggest relief of all was that I felt no animosity whatsoever towards my baby at any time. I had been very worried that I might 'blame' her if my labour was long or difficult, and was surprised by my attachment to her right from the beginning.

In the days immediately following the section the sense of relief that the worst was over was overwhelmingly enormous, I was in a state of euphoria because I had survived my worst nightmare. This feeling of euphoria lasted for three or four months, about the time it took for life to settle into the new version of 'normality'. One day, out of the blue, like a slap in the face, with absolutely no warning, the thought struck - 'I have a baby, but I've never given birth'. Words cannot describe how deeply sad I felt. The sense of loss, failure, why me, where did I go wrong? Over the months I have cried and cried and cried. I thought perhaps if I cried enough I would not be able to cry any more. But the tears just kept coming.

It has taken me a long time just to make sense of my feelings. What they are and why I feel them. Physically I am fit and healthy. I recovered well from the operation. My baby is perfect - you could not possibly find a better candidate for an advert for 'caesarean section for better babies'. I live in a reasonably modern house, equipped with TV, video, fridge, freezer, microwave, I have worked happily with computers, modern technology is not a problem for me, so why do I feel such a strong need to return to the stone age to have my babies? Why wasn't I satisfied? After all, many women have had much worse experiences. For a long time none of my feelings made logical sense. I have come to realize that feelings are not always logical, especially mine! Equally strong, genuine feelings can even seem contradictory. There is a great deal more to birth than merely extracting a healthy baby from a healthy woman.

Basically I feel as though I spent a long time baking a very special cake, then through no fault of anyone, someone else had to come along, take it out of the oven and ice it. Despite the fact that they did a beautiful job, I simply wanted to do it myself.

I have been over and over my labour so many times. The 'perhaps ifs' crop up all over the place. Perhaps if I had not gone into hospital so soon; Perhaps if I had prepared myself better to feeling so very tired; Perhaps if I had refused the drip and insisted my labour be allowed to take its natural course; Perhaps if I had not given into psychological pressure and agreed to have an epidural; Perhaps if; Perhaps if; Perhaps if .... Why were my contractions so inefficient? Why did my labour end without achieving the birth of my baby? Why didn't I know what to do? Why did I give in so easily and do exactly what I was told without question?

Generally I am an independent individual, I do not like to rely on others. I strongly dislike the hospital environment - it makes me uneasy, I don't know why. My husband and I are extensively renovating and extending our own house ourselves, I knit and sew, I take particular pride and pleasure in producing beautiful things myself. It is therefore particularly hard for me to have had the experience of giving birth to my baby taken away from me. The only truly active part I could have had in bringing my child into the world was denied me. People used to ask me if I was proud of my baby and I used to think what a strange question - of course I wasn't proud of her. Her arrival had nothing to do with any conscious thought or action on my part. I have always seen her as a lovable, beautiful individual, not much to do with me. She wasn't born, she was cut out. Strange that something so beautiful should exit the body in the same way as ugly tumours, malfunctioning appendices, etc. There is a difference between a woman giving birth and a doctor getting a baby out. I didn't give birth to her, I just happened to be there. She doesn't really feel mine. The surgeon cut the connection between my pregnancy and my baby when he cut into me. A regular nightmare was that she'd been stolen and I couldn't prove she was mine. Most mothers probably worry about their babies being stolen, but how many worry about proving their baby is theirs? It is almost as if my baby died and someone has said 'Never mind dear, have this one, it's better than the one you would have had anyway'. And yet I have no intellectual doubt that she is mine. I recognised her as soon as she was delivered, and anyway, she's so exactly like her father in looks there can be no possible doubt.

I was relieved at the time and still am that my extreme negative feelings about the arrival of my baby do not seem to have affected my feelings for her, except for the lack of pride in the early months. She was successfully breastfed until she gave up on her own initiative at around nine months, and I have never, even for a second, blamed her for the nightmare.

I appreciate that I am a little on the strange side, but I cannot believe that I am totally alone in the feelings and emotions I have had to cope with as a result of undergoing a caesarean section. I personally believe there are three important issues with childbirth; the first two being the health of baby and mother, and the third being the quality of the experience of childbirth. The quality of my caesarean section experience was good, the quality of my childbirth experience was nil. Nothing will ever convince me that my caesarean section could not have been avoided, although of course it was necessary under the prevailing circumstances. However, I know I could have given birth naturally without detriment to myself or my baby had I felt confident and had I been in the hands of a midwife with the relevent experience. Unfortunately I did not realise that at the time.

I have now completed my journey from the negative to a positive viewpoint. I now understand fully the reasons behind why I had to be delivered of my baby by caesarean section. I have succeeded in finding my own answers and consequently I have learnt a great deal about myself. The baby that arrived in such an unnatural manner has grown into MY daughter. At the time of writing she is a bright, intelligent, beautiful 15 month old.

I shall always be very sad and regretful that her arrival should have been such a traumatic experience, but at least I have been able to gain from it and can see it now as a positive base on which to build.

This birth report was published in the AIMS QUARTERLY JOURNAL Vol.2 No.2 1990

See also Gina's birth report of her VBAC - From one extreme ... To the other!!

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