Gentle birth options: Recovering emotionally from a cesarean section

Some women have planned -- or elective -- cesarean sections. Others are unplanned and some are emergency c sections. Some women are perfectly happy with their c sections. They have healthy babies, and they themselves are healthy. The outcome is all that matters to them -- and that's great. But other mothers may have come out physically whole, and their babies may have been fine, but they grieve their lost birth experience. Unfortunately, we live in a highly medical society that pathologizes pregnancy and does not accept that grief as normal, and the women then suffer guilt for their grief.

"I underwent the surgical removal of my children from my body---a procedure that has nothing to do with birth, that completely circumvents what my woman's body is made to do." said Gretchen Humphries in her blog, Birth Matters.

Women dream of their child's birth from the time they see those dual pink lines on the pregnancy test. They might fear the pain or welcome it. They might imagine panting, questioning if they can birth naturally or not. They might wonder if their partner will be able to support them as fully as they will need them to. They think about water birth and squatting, breastfeeding and a million other aspects of birth. They rarely imagine being strapped down on a table and having their babies cut from their bodies. And yet, for nearly  one-third of the women in America today, that's how they are giving birth.

It's not as if these women are physically unable to give birth. If that were the case -- if 31% of women were physically unable to give birth, the human race would have been in trouble centuries ago. It's that obstetricians and science (the word obstetrician, incidentally, comes from the Latin word that means "to obstruct") have intervened so much and created so many obstacles that few women trust in their bodies any longer. There are so many interventions that birth no longer proceeds down a natural path, from point A, the onset of labor, to point B, the birth of a baby.

A study released just Monday, August 30, 2010, showed that many women are being induced and then sectioned after being in active labor a mere two to three hours, according to a story in the St. Louis Post Dispatch. It's no wonder women feel robbed of their birth experiences -- they are being robbed of them. Worse, cesarean sections are not risk-free. Any surgery puts the mother's health at risk, but cesarean sections can also put the baby's health at risk. It's been estimated by the WHO that our c section rates are 3 to 6 times higher than they should be for optimal outcomes.

Once the cesarean section is done, though, how can a mother begin to heal emotionally? It's important to note that there is a huge difference between grieving over the lost birth experience and being thankful for one's baby. While a woman may adore her new baby, she may not be thankful for the way her baby was brought into the world.

A woman must first allow herself to grieve. If there are people in her life who are telling her to "get over it" or that "a healthy baby is all that matters" or other trite sayings, she should give herself permission to remove herself from their company for a period of time. This is her loss, and she has the right to grieve it as any other loss. She should not be pressured into feeling guilt as well as grief.

She should join a support group of mothers who have also suffered the loss of their longed-for  birth experience. The International Cesarean Awareness Network of St. Louis is a great organization, dedicated to both education and support. Women can either attend face-to-face meetings or use ICAN's online forums. If she is a spiritual person, she can also turn to her faith in times of need.

Finally, women must educate themselves. They should know what happened. Know why it happened the way it did. Know why it was necessary. Know if any of it was preventable. Know how it can be different next time (if there will be a next time).

Grieving a negative birth experience can be overwhelming in the immediate aftermath, but like any other grief, it does ease with the passage of time. If a woman (or couple) finds that she (or they) cannot move on from the experience, it may be time to seek professional help. It does not mean that there is anything wrong with her: it simply means that she need to talk to someone who can help her work through her feelings more than a support group can. She can get a referral from ICAN in order to find someone who is knowledgeable in birth trauma.

Births don't always go the way women envision them. In fact, they rarely do. Births are human, messy, unexpected. But if a birth experience leaves a woman traumatized and grieving, they should know they are not alone and that they do not have to feel guilty for feeling that way. There are many other women who have been there.

To learn more about cesarean sections, read The Silent Knife and Pushed: The Painful Truth About Childbirth and Modern Maternity Care. (The Silent Knife is available through local LLL libraries as well).

To explore other women's healing processes, visit Birth Cut, Birth Trauma Truths, Expecting the Unexpected, and Healing the Trauma (Midwifery Today.

The American maternity system is broken. Women often feel coerced, pressured, misled, and bullied into cesarean sections by their doctors and health care providers. And that is never acceptable. Women need informed choice and options, and they should be encouraged to exercise them.

Because a difficult birth or cesarean section can disrupt both attachment and breastfeeding, parents need to ensure they seek help if they need it. Hospital lactation consultants, LLL leaders, and support groups are available to assist if you need them.