The myth of "too posh to push" - a raw experience of a C-section

As hinted at in the title, this post is not light-hearted and fluffy, nor for anyone wanting to avoid “too much information”. This piece is about a major surgical procedure and the experiences leading up to it, the actual procedure and recovery.

There is no doubt in my mind that the percentage of babies born via Caesarian section is higher than it should be, particularly in the South African private health sector where as many as 70% of women covered by medical aid schemes will give birth via this method. However, the idea held by many that surgery is the "easy" way to give birth is something that I take exception to. I cannot compare my birthing experience to another woman's, particularly someone who has given natural birth because even labour is something that I did not have to contend with, but I can relate the sensations and emotions so intimately linked with the memories from the day of my daughter's birth and the days following it.

To put this piece into perspective, I did not elect to have a C-section (and I do not meter out judgement for women who do opt for it as I feel that such a decision is one which a woman needs to choose for herself), I had to have one because my daughter was in breech position. I had hoped to have a natural birth, but had maintained an open mind regarding the options so as to avoid fixating on the idea of an "ideal birth". I did not give much thought to external cephalic version (turning the baby) because, at 28 weeks gestation, my doctor had mentioned that the position and size of the placenta in my womb may have made it difficult for Eliana to turn and, as such, the idea of manually turning her did not bode well with me – my mind continually thought of placental abruption and cord strangulation... Aside from the 50:50 success rate and risks of such a procedure. I also had not had any surgeries before and was quite apprehensive (Read: scared out of my mind!) regarding how I would react to the anaesthetics to be used. Even though I had prayed about it and was at peace with the decision, I was very nervous about the procedure. Nervous to the point I made strict instructions in my birth plan regarding my daughter's post-natal care in case something happened to prevent me from being able to ensure that she was cared for as I wanted her to be.

My arrival at the hospital was relaxed, despite running late in leaving home and being worried about a late admission. I was sent up to the labour ward and shown to a birthing room with instructions to remove my clothing, underwear and jewellery, put on a hospital gown and pee in a urine sample tub (Oh! The glamour!). After that I lay on the bed and had sensors put onto my swollen, 39 weeks pregnant belly to monitor Eliana's heart rate while my husband lounged in a recliner. It was a peaceful experience – exactly what I needed after a restless night's sleep and a mind in overdrive speculating about the surgery. 

I was scheduled to go into theatre at nine o’ clock, the nurses started prepping me at about eight o’ clock. One nurse asked me why I was having a C-section and I explained that El was breeched, she even asked if she "really is breech?" and I felt slight stirrings of irritation because I was not sure if the hints of doubt were an indication of C-section judgement. I did not want to have to justify myself to someone, especially when I was about to have my abdomen cut open – a procedure I had really not wanted. But thankfully there was no further discussion in this regard. The first attempt to insert a drip into my hand was unsuccessful. Despite having a rather large tattoo on my back, I’m not exactly partial to needles being inserted into my blood vessels, muscles or subdermal tissue. At least it was second time lucky and the needle was in and the exceptional thirst which accompanied being told one cannot drink anything from a certain time was quenched a short while thereafter. But there was more non-surgical pain yet to come. 

I had requested a micro-birthing to be done when, at 36 weeks, El was not showing any signs of moving off of her comfy “throne”. Micro-birthing is a practice to introduce a mother’s vaginal flora to her child when born via C-section and it is based on the hypothesis that the lack of this exposure may be the reason for higher instances of allergies and gut problems in C-section babies. As a C-section baby and allergy sufferer myself, it sounded like a good option even if the benefit is only theoretical at this stage. The procedure involves the vaginal insertion of a swab before the surgery, with it being removed and placed in a sterile container before the catheter is inserted. When the baby is born, it is then wiped down with this swab so as to mimic the exposure it would have had with a normal vaginal delivery. At the time the swab was to be inserted, my doctor had come upstairs to “check-in” and the nurses asked her to assist in this regard. I honestly did not think that inserting a swab would be so painful! Maybe I was disillusioned because of how easy it is to insert a tampon, but it came as a huge shock when I experienced that pain. I actually cried out and breathed heavily, feeling raw as the sensitive skin was pushed at with a rough swab, but thankfully it did not take too long.

When the time came for me to go into theatre, I was told to drink a vial of what I assume was an antacid to “neutralise my stomach contents”. And the fear set in. As they moved me from my bed to the gurney, I started shaking, shaking with fear. Fear of the anaesthesia, fear of the surgery… fear of the unknown. When I arrived in the surgical ward, the anaesthesiologist came to chat to me about what to expect from the anaesthetics, he was very friendly and helped to reassure me (although I was still more than a little bit nervous!). Later a midwife arrived and again did her part to reassure me, saying that I looked a lot braver than what she did before her C-section (she commented that she had been brought into theatre “kicking and screaming”). She took Nik to get him scrubbed up and ready for theatre. Eventually at about half past nine I was wheeled into the operating room. 

As promised, the anaesthetic was administered without any problems and felt exactly as described: a surge of warmth from the lower spine downwards, followed by pins and needles in the legs. It felt so strange afterwards, not being able to feel my body below my waist and yet still being aware of being moved back into position with people tugging at me. Thankfully it also numbed the pain of the catheter insertion which I had been warned might be uncomfortable at best and very painful at worst. I had a blood pressure cuff on over my right arm and was told that I would need to extend my arm outwards and hold it when the cuff sporadically inflated to monitor my blood pressure during the procedure. As my obstetrician prepared to make the incision through which my daughter would enter the world, I asked Nik to play some music on my cellphone to help relax me. I had Nik sitting next to me on my right and the anaesthesiologist at my head. He calmly explained to me what was happening as it happened, telling me to expect to feel pulling and tugging in my abdomen and that there would be a sudden reduction in the pressure on my torso as well as whoosh of liquid as the amniotic fluid was released, assuring me not to think that I was bleeding! I did not really feel the pressure or whoosh of liquid, but the pulling and tugging were definitely there! 

My daughter was born at 09:50, it was a truly emotional moment to see her being held up high above the screen by my obstetrician upon her arrival. I wrote a piece specifically about her birth, this one is about my experience of the surgery and its after effects so I will not be delving into the experience of seeing and holding my daughter. I cannot recall much from after she was born as I was focusing on her cries and waiting for her to be brought to me. There was some more tugging, but mostly I recall my daughter, the midwife checking my breasts to see if I had started lactating (which I had) and waiting to hold my baby. 

When I was stitched up, my doctor gave Nik instructions for how to remove the dressing in a week’s time, I could only vaguely recall what was said. I was then rolled off onto the gurney, I had no sensation from the waist down. I was then taken (along with my husband and daughter) to the recovery ward and waited for some feeling to return to my legs. After some time I started to experience pins and needles and the nurses encouraged me to try to move my legs. It was frustrating, waiting to feel like I could actually move my own limbs. It took about 45 minutes for sensation to return. I felt helpless. 

And the helplessness would continue. What followed was needing to lie on a bed without getting up properly for almost 24 hours. The numbness was such that I did not even realise that the nurses had appropriately dressed me with a maternity mattress (maternity pad for the bleeding) and when I eventually felt blood discharging I panicked and asked Nik to help me put a pad in place only to find one already there. 

I received intravenous paracetamol and pethidine injections every few hours for the pain. The pethidine made me drowsy and their administration was at first not too much to be concerned about, but when I needed to have the third and fourth shots, it was very difficult and uncomfortable because I needed to lift my backside up off of the bed for the nurses to inject me. That was very difficult because it was painful to move. And the experience was the same when the nurse needed to change the pad. Pain and helplessness – not a great combination, especially when you have just been inducted into the realm of almost never having full control of your life again… parenthood. I felt frustrated, especially when I could not get up to brush my teeth or wash my face and no one came to help me do so in bed even after I requested assistance in this regard. I eventually took it as preparation for those no-shower parenthood days I had heard so much about. 

It was also upsetting not being able to tend to Eliana properly. It was difficult to reach over to her when she needed comfort, I could not get up to change her nappy and needed to ask nurses to assist with this simple task, although some may recognise that as a blessing instead of a curse. And it wasn’t just my wound which made this difficult, it was the drip and the catheter which further inhibited my range of motion (and comfort). 

By morning I had a nasty stitch in my back and asked Nik to bring a hot water bottle for me when he visited. I was woken up by the sound of showering shortly after five o’ clock, I had hoped that I might have at least been dopey enough from all the pain medication to sleep for longer, but alas my days of early morning waking began immediately!

It was during Nik’s visit that the nurses came to remove the drip, the catheter and to get me up and out of bed. Unfortunately there was a delay between the first two actions and the third one, meaning that by the time I was being made to get up I actually needed to go to the loo quite badly. So in addition to the excruciating pain of putting weight down on my feet and trying to straighten out my torso while upright, I also really needed to pee! I recall gasping in pain and feeling light headed while two nurses supported me. I could barely shuffle a few steps forward. In the shower I could not reach my calves to wash them and when getting dressed, I needed to ask Nik to come to help me put on my panties (thank goodness there was not anyone else in the next shower). 

Thankfully, getting up and moving around did get easier and I was able to tend to my baby much more easily, unencumbered by the catheter and drip, but the pain was still quite intense and the painkillers were stepped down to paracetamol with codeine and soluble diclofenac. A friend had advised me to lift the head of the bed high enough to allow me to get up by simply swinging me legs over the side as opposed to needing to lift myself using abdominal muscles which were cut and damaged. My wound was especially painful if I needed to cough or sneeze – I needed to hold a pillow against it to help the pressure. 

During my second night in hospital, I ended up with horrendous diarrhoea. As awful as it was, it was preferable to have diarrhoea than to need to use the bisacodyl suppositories that would be prescribed the following evening. Unfortunately in the week to come, constipation would rear its ugly head! It was bad to the point of constricting my bladder and I struggled to pass urine. I drank lactulose syrup with very little success even after having stopped dosing of the codeine-enhanced paracetamol. I used glycerine suppositories and still struggled. Eventually, fearing that I would end up with a bladder dangerously close to bursting, I called my former gynaecologist’s emergency number and asked if I could take an enema… orally to ensure everything was washed out. It was disgusting, but it was necessary. Thankfully I got some relief by noon the following day. Some women refer to passing the first stool as “the second birth”, after my experience, I can believe it even though I did not go through natural child birth. It is horrible to desperately feel the need to evacuate, but to be too scared to push and experiencing enormous discomfort and pain against a very fresh surgical wound. 

In the time after discharge, I very much missed the rails on the side of the hospital bed, as well as the remote-controlled mattress. It was difficult to get out of bed, very difficult. I could suddenly understand why babies grab at their feet to lift themselves up due to their immature core muscles, I ended up using my knee as leverage! It took about two weeks before I felt comfortable with sitting up. It was about the same amount of time before I could cough or sneeze without fear of sharp pain in my pelvic region over my wound. And three weeks before I could have a nice, relaxing bath as opposed to a quick shower.

Relating it after the fact might not seem so horrible, I do not think that I have been able to truly describe the pain and helplessness that I experienced, all worth it, but by no means an easy means to bring new life into the world. Depending on the circumstances, one may well miss the long hours of labour and the associated pain, but the pain comes later with a Caesarian section and, in general, lasts for longer while the surgery also leaves you somewhat debilitated for a period. Is a C-section the easy way out? I do not believe so. Is there an easy way to give birth? Considering the strain that your body undergoes no matter what route you go, whether your labour is short-lived and delivery fast, I do not think there is one. However you brought life into this world, be proud of what you have overcome. Be proud to call yourself a mother.