c section — Motherhood — Vanessa Evelyn

April is c-section awareness month. I had a c-section nearly two years ago and as someone who has been passionate about natural birth since childhood, it has been challenging to navigate my complicated feelings surrounding our birth story. It is a day I replay over and over again in my mind almost daily. Something that I don’t think I’ve shared here before is that growing up, I wanted to be an OBGYN so that I could help people bring their babies into the world. I was obsessed with babies from a very young age, and my passion for natural birth remains now, and continues to grow each day. I honestly think that I may have been a midwife in a past life, and had I known about traditional midwifery sooner, that likely would have been my career preference- opposed to the hospital model. While I have not pursued either of those fields, I do believe there is still time to enter the birthing space professionally in my lifetime. My layered pregnancy and birth story make me want to even more, so that I can potentially help others advocate for their birth preferences and enter parenthood/postpartum more seamlessly.

Deep down, I always knew that I wanted a home birth, but for our first baby we settled on a birth center that was not connected to a hospital because it was more affordable. I thought to myself, “a midwife is a midwife” and didn’t realize the vast differences between a highly medicalized midwife and a traditional midwife. At the time, a home birth seemed so unattainable from a financial standpoint and looking back, it’s something that I wish I had researched more and fought harder for. I do feel things would have been handled a lot differently if I worked with an independent midwife. While the birth center was not connected to a hospital, and for the most part respected my personal choices, they still did a lot of things the way a hospital-based practice would. It was really important for the birth center to maintain a positive relationship with the hospitals and doctors they partnered with for co-care or transfers, which I realize now was a priority for how they handled their protocols. One thing I really resent being told by one of the midwives at the birth center in the weeks leading up to my son’s birth, was that if I didn’t do things a certain way, I was basically “choosing a c-section”. Looking back, I feel that I was being groomed to conform to the system rather than being respected as an individual who was capable of making informed choices.

It was recommended that I get a third trimester growth scan via ultrasound at the hospital due to having a Velamentous Cord Insertion which can sometimes cause a growth restriction. That is when it was discovered that my son was breech at 32 weeks and 5 days. In California, midwives are not legally allowed to catch a breech baby unless it is a “surprise”. Everyone I encountered said that I still had plenty of time and reassured me that there was a chance of getting him to turn head down. However, it didn’t happen despite doing all the things people recommend: spinning babies, acupuncture, moxibustion, Webster Certified chiropractor, failed ECV, fear release, inversions in a swimming pool, prenatal massage, etc. I went into a speedy labor at 38 weeks and 3 days while home alone. I was fully dilated within a few short hours and upon hospital arrival my son was eager to come out. Had he been head down, I would have been applauded and welcomed with open arms. However, he was still breech and I was met with fear, coercion, and isolation tactics. I was separated from my then fiancé (now husband) and they refused to let my doula in (even though during this time doulas were allowed in delivery rooms #pandemicbabies). I refused surgery repeatedly in between intense contractions. I didn’t feel that I needed it. My baby was coming FAST and typically when this is the case, all is well. All the doctors in the room were also trained in vaginal breech birth. I did my research, I knew the risks, I trusted my body and my baby. But the doctors were consumed with hospital protocols and policies. They chose to ignore their breech training and didn’t practice informed consent. Instead, they yelled in my face and beat me down mentally and emotionally until I gave into their preferred method for breech presentation- a c-section.

In the words of Flor Cruz from Bad Ass Mother Birther, “The overuse of cesareans has cheapened its value to just a ‘routine procedure’ rather than the life saving surgery that it’s intended to be.” In my opinion, my surgery was completely unnecessary. The doctors chose not to embrace their breech training and instead used fear and coercion to get their way. They did not honor physiological birth or my choices as an informed mother. As I mentioned earlier, I think about our birth story almost every day. As I replay it in my mind, I wonder: How could things have been different? Why didn’t I do THIS or say THAT? Why did this happen to me as a person who is not afraid of natural birth? Why didn’t I just tune them out and go within? The truth is, I don’t have the answers to these questions yet- and I’m not sure if I ever will. One thing I do know is that I didn’t fail, the system worked against me and took advantage of one of the most vulnerable moments of my life. I did EVERYTHING I could down to the last moments and all I can do now is thank myself for that. I fought hard for myself and my baby in one of the most intimate, personal, and challenging moments of my life.

What I want people to become aware of this month is that many c-sections are in fact unnecessary. Hospitals should not have c-section rates of 20-30% +. C-sections come with their own risks, can impact your personal health, as well as all future pregnancies and deliveries. Inductions and a variety of other interventions highly raise your chance of an unnecessary c-section. And your providers can make or break your birth. Don’t settle for just “anyone”. I thought to myself, “It doesn’t matter what provider I get. I know my rights, the facts, and I believe in my body and my baby.” But despite all of this, they still got to me in the end. Do your best to follow your intuition and not make choices out of other people’s fears- whether it’s your provider or your loved ones. Do your research, explore your options, and fight hard for what you deserve. Giving birth is one of the most delicate and fiercest moments of your life and it’s a day (or days) you’ll never forget. Remember that there are cases where a c-section is truly necessary (transverse positioning, cord prolapse, vasa previa, placental abruption, placenta accreta, etc.) but be weary of providers who pressure you into interventions you’re not interested in when there is no true medical need. This is your body, your baby, and they ultimately work for you. They are not authoritative figures over you despite how they make you feel. Your individual choices should be respected because every body, baby, and pregnancy is unique. The way we birth matters, your voice matters, your intuition matters, your informed choices matter, and those factors should ultimately be the deciding factor of any decision we make during pregnancy and labor.