Tuesday, December 12, 2006

The Birth Story

Well, it’s not quite a tag but Mad Momma suggested I do a post on my c-section experience. So here I go…

It was all set up to be a normal birth. To start with, I had the necessary pelvic structure (I come from a long line of big-boned people) and had an easy, textbook pregnancy. I had gone for pre-natal classes and religiously done the exercises, which included the duck walk (which, for the uninitiated, is exactly what it sounds like and is supposed to help the baby descend into position). The baby also seemed to be doing his part and was not only facing in the right direction but the head too had got engaged, though not yet fully fixed.

17th May (the due date) arrived and there were still no signs of labour. My gynaecologist did a rather painful procedure called ‘stripping the membranes’ which she said would get the labour kick-started. I went home that day and witnessed some spotting but still no sign of labour. On 18th, I started to get some minor contractions (they were more like cramps actually) and I spoke to the doctor, who said that we should wait till they get stronger. But by the next day, they hadn’t really got much stronger so my doc insisted that I go and check myself into the hospital. When I reached the hospital, the resident on duty rightly commented that labour was at a very early stage and that I should go home and wait. He spoke to my gynaecologist on the phone and she suggested that he administer the pitocin drip and hurry things along. This made me pretty uncomfortable – for starters, the resident seemed to see merit in waiting and I also spoke to my mom-in-law (a practising ob-gyn in Bangalore) and she too didn’t see any reason to be in such a hurry.

So I called back my doctor and told her I wanted to wait. She sounded pretty pissed off and tried to convince to stay but finally agreed and asked me to come to her clinic in the evening. There she gave me a long talk about how she was the doctor and knew what was best and that waiting any longer than the next day was a risk that she was not willing to take and that I would have to check into the hospital the next day, no matter what the circumstances.

All the while, the contractions continued to be disappointingly mild though they did get closer together (moving from 30 minutes apart to 15 minutes apart). I had a horrible, restless night because of nerves as well as the contractions. The next day, without much progress being made, we had to finally give in to the expert advice of our doctor and get me admitted into the hospital. We had some wild thoughts about changing the doctor at the last minute but everyone advised against it since I had been seeing this doctor throughout my pregnancy.

So on 20th morning, we drove back to the hospital. Again, the resident and my mom-in-law (in touch via the phone) felt that we could still afford to wait but at that point, it didn’t make sense to fight my own doctor anymore especially since she kept saying that waiting longer would put the baby at risk. So they finally administered the pitocin drip and the pains did start to increase but 3-4 hours later, I was still dilated barely a finger and a half. Then they decided to do a heartbeat check on the baby and there were some irregularities. The explanation for this was that since the contractions had increased but the baby had not moved forward, the baby was getting the brunt of the contractions. So they decided to do a c-section and before I knew what was happening, I was in the OT.

The actual surgery was a pretty surreal experience. I really did have my heart set on a normal delivery and since all indications till then had suggested that it would be so, I hadn’t prepared myself for the c-section and was severely disappointed. And the experience of the last couple of days had made me feel like I had been pushed into something that could have been avoided. I think I even cried a little while they prepped me. I was awake throughout but only felt a pulling sensation on my abdomen. It was pretty weird as the other doctors in the room were pretty matter-of-fact about the whole thing and were even discussing the traffic they had to brave to get the hospital – most inappropriate I thought!

After that, I kind of lost track of time and I don’t really know how long the whole procedure took but I remember hearing the baby’s first cry, the doctor telling me that it was a boy and them showing him to me very briefly after they had wiped him off. Then I didn’t see him again till I was all stitched up and back in my room when they brought him all bundled up and ready for his first feed.

I’d like to be able to say that I took one look at him and it all didn’t matter any more. But I would be lying if I did. For starters, I wasn’t one of those instant bonding kind of mommies. The first few days for me were all about the physical aspects of having become a mother – dealing with the after-effects of surgery, painful breastfeeding sessions and loads of sleep deprivation. It was only a few weeks into the experience that I really started to feel the first pangs of maternal love. So this didn’t exactly distract me from my discomfort with the way the last couple of days had panned out. I felt then, and still feel today that things didn’t go as they ought to have. I have since then read up on some of this stuff and there are quite a few things that seem fishy:
  • There seems to have been an astronomical growth in the number of c-sections. I couldn’t find the data for India but it in the U.S., the percentage of c-section births has increased from 5% to 28% in the last 30 years! From a doctor’s point of view, c-sections are preferable. They are easier to schedule – active labour can come on at inconvenient times like 3.00 a.m. on a weekend. My c-section happened on a Friday, well in time for the doctor to get a few hours in at her clinic and be home in time for dinner… Also, c-sections are a more efficient use of their time – they earn more (almost double) for a lot less time.
  • I also sensed an impatience in her to get the thing over with. My delivery happened on Friday evening – maybe she had weekend plans that I was getting in the way of. I’m just saying…
  • Her biggest stated reason for hurrying things along was that it would be a risk to wait. Since then, I have come across many cases of women who went into labour more than a week after their due dates so I am not too sure what the risk was. After all, we did a foetal heart rate check on the 19th and it was perfectly fine. Also, she should have done an ultrasound to check if the amniotic fluid was drying up but when I suggested a last pre-delivery ultrasound, she said there was need for it. So in hindsight, I am a little unclear on what her risk perception was based on.
  • I also did some very basic research on the stripping procedure that the doctor had done. It is not as simple as she made it sound. It seems that it is effective only if the body is ready for labour and the cervix is adequately ripened and dilated. (I was not even 1 cm dilated when she did it). Moreover, it is not entirely risk-free and can result in infections both for the mother and the baby.
  • Lastly, after the surgery, she told me the reason why the head had not fixed fully was because it was de-flexed. I looked this up as well. The ideal position for labour is when the baby is head down, facing the mother’s back, with its chin tucked on its chest. When the chin is not tucked, the position is known as ‘deflexed head’. Nowhere did I find anything to suggest that this necessitates a caesarean (as a breech position does). It is only an indication of a possibly long, slow and difficult progression of labour. If this was indeed the case, I should have been the one to choose since it was not about risk levels. And we would have known that all that was holding things up was the deflexed head if she had only done an ultrasound before pressing the button…

I know all this sounds a bit like crying over spilt milk but I feel cheated out of a potential normal delivery. And it might happen the next time around too, since doctors are usually even more risk-averse when it comes to a vaginal birth after c-section (VBAC). It also doesn’t help that everyone involved, including family members, was very disappointed that I didn’t have a ‘normal’ birth. I know better now, but in the less rational postpartum days, I just felt like a big, fat failure.

On a final note, I have nothing against c-sections or people who have them. I just feel, and I am sure that most of you would agree, that if a natural birth is possible and there are no real risks involved, then doctors and mothers should be patient and let nature take it course.

30 comments:

  1. Sympathies with your ordeal.I am glad everything went well in the end.I am happy for you.

    I know you feel cheated out of a great experience, but what's imp is that you and baby are healthy and had a happy ending.

    Take care and enjoy.

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  2. regular or C-sec - you have a healthy happy Ayaan now, dont you?
    And dont go to that gynec again - looks like she values her weekend more than she does her patients ...

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  3. Natural birth yes but please take the painkillers on offer, men can't stand their women being in so much pain.

    Looking back I guess you made the best decision with the info that you had... maybe next time will be different ;)?

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  4. that's a lot of great info right there for a first-time to-be-mom. i'm terrified of natural birth, the labor pains & all that, but i would definitely not appreciate being pushed into having a c-section and being cheated out of what others have told me can make you feel like you can take ont he world single-handed (if you've delivered naturally!).
    here too (in dubai), there's a lot more c-sections than natural vaginal births. i've got the whole third trimester ahead of me and let's see what happens.
    i'm at babystory.wordpress.com

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  5. [Asha] Absolutely. In the final analysis, all that really matters is that Ayaan was born healthy.

    [Somethingtosay] You bet! Not only am I never going back to her, she's not getting any business from any of my friends, colleagues and acquaintances either.

    [Mosilager] No doubt about it, I would not have done the natural birth without the epidural. And on the men not standing it, tell me about it - I was pretty sure that Jai would have had a really tough time staying with my side throughout a normal delivery.

    [Mona] All the best. The third trimester is the most physically uncomfortable but make the most of it - you won't know what hit you once the baby comes along...

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  6. Avoid your gynaec and if possible warn everyone else you know as well

    and why were u stitched up- did they not have that super glue like thing?

    It is not crying over spilt milk- but being better informed for the next time

    But i cannot understand why family memebers were not with you on this-why feel any guilt about it- would they have doen it any other way with teh gynaec constantly raising the alarm

    I did feel bad about not having had a natural delivery but my gynaec was really a good one- and the double knot was one to reckon with

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  7. I am so indignant for you Ro. This doc seems to be one of the money-hungry types that abound these days...those looking to make a quick buck and those who treat their patients like cattle. these docs forget that patients today are educated, informed and have the power of google :) there really wasn't a strong case for a c-sec in your case. next time you should do a thorough background check on yr gynac and check her csec to normal deliveries ratio.

    your story reminds me of that of my cousin. her water broke before labour started and her gynac rushed her for a c-section citing grave risks etc. so my cousin who had a normal healthy pregnancy, whose baby had already descended etc ending up on the operating table. all the pregnancy books will tell you that if your water breaks before labour starts, you just get an antibiotic shot and wait for labour or induce labour. an ethical doctor would have advised thus. so sad her gynac wasn't and thank GOD for my gynac who gave us the right advice. hmmm...maybe i should also do a birth story post instead of turning your comments sections into my blog :)

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  8. its true... a lot of people are making a big hue and cry about c-sections these days and they dont seem to have the patience for a normal delivery. im NOT getting one UNLESS theres something REALLY wrong.

    you couldnt help what happened... your not a failure in any way. you have a healthy little naughty boy and thats all that matters.
    *hugs*

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  9. wow! this makes me so angry! that doctor shud get a lesson in ehtics before she is allowed to touch any other patients.

    And i love how u were matter-of-fact about the bonding instantly with the baby part...many women make such a big deal out of the whole thing

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  10. Okay my two cents. I know a lot of people are with you on this one and no one's gonna really like what I have to say, but still thought I'd like to share this one.
    I come from a long line of Ob-Gyns and I agree that number of CS have drastically increased over the past few decades. One reason being the ease of C-sections, the decreasing risks associated with having surgery and the improved health of baby and mothers. It may appear that the motivation for the docs is money and time management, and may be sometimes for some docs it could also be true, but that is not what drives every single Ob-Gyn doc. I have a friend who carried her baby to term, had a healthy viable fetus even when she went post dated and her doc insisted that they keep waiting. They waited and waited until the baby started getting fetal distress and the doc still wanted to wait. So by the time they did a CS on her she delivered a dead baby. Now tell me something wouldn't you rather have a baby than go through something that traumatic?
    I don't mean to sound insensitive but it really bothers me when people assume that doctors are doing everything for money and to suit their schedule. Some doctors may. But not all. And it is really unfair to judge everyone based on a few isolated unfortunate incidents. Because trust me if anything had gone wrong with a pregnancy because the doctor waited too long for a normal delivery, we would all be here screaming bloody murder and thumping our fists for why he/ she had not done a CS. Medicine is not infallible and for the most part it is a judgement call and we can only hope and pray that the people we are entrusting our lives with are capable and fit to make the best one there is. And trust me every Ob-Gyn I know would rather have a healthy living baby than wait long enough to get sued for having waited too long.
    I apologize for such a long comment but had to get this off my chest.

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  11. Rohini, I definitely think you were pushed into having a C-section by your ob/gyn. I think she was motivated by the weekend saver/less effort more money thing even though I do think not all ob/gyns are like that. I admire your maturity for being able to let go of it - i am still bitter about how my delivery and post-natal care was handled - evn after 8 LONG years.

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  12. I'm posting about my own experience. It's a post that's been waiting a few months. actually.

    M -- please read this one post and tell me then whether I'm being too hard on my gynae.

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  13. [Artnavy] I think it was those self dissolving internal stitches. I was too zapped at that time to ask. And I think in your case a c-section was completely justified - any risk to the mother or child is just not worth the badge value of a natural birth.

    [Aqua] Actually, this one does seem to have a largish number of c-sections to her credit. Many of the people (3 out of 4) I have met since who went to her seem to have ended up with c-sections.

    [Grafx] What is even more shocking is that women are choosing c-sections even when there is no problem. They don't think the pain is worth it....

    [Sudha] I know what you mean about people making a deal about it. I feel like a freak because everyone else I know seems to have teared up and/ or had an out-of-body experience when they first saw their kid. Nothing wrong with that, but I think I too practical and boring for something like that - for example, I have never cried in a movie...

    [M] Agree. I think they are a lot of responsible, good ob-gyns out there who take the call that is right for the mother and the baby - I am just saying that I don't think this one was one of them - there were just too many things that didn't add up and she was jumping to induce two days after the due date, which certainly cannot be classified as waiting too long. And the suing thing doesn't really happen in India so that could not have been her fear...

    [Gettingtherenow] Believe me, I am still bitter about it. And I will be seriously pissed off if this gets in the way of a normal delivery the second time around.

    [Sue] Oh goody! I love reading birth stories.

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  14. lol! u r no freak! and trust me, (whispering in ear) most of "them" are faking it (/whispering in ear)

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  15. Thesis is going well, it's out to the critics so that they can look over it before I have to officially turn it in. Now I'm enjoying being back at the lab bench immensely.

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  16. Not to make the pain or the experience any less and i totally am with you on this one that your Ob-Gyn may have been one of the "other" kinds...but suing docs is for real. And it does happen a lot in India. And just like here in the US even in India these days unfortuantely a lot of decisions are taken based on prior speculations of what may come next in terms of being sued for negligence. But trust me I know what you are saying and you have my sympathies.

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  17. [Sudha] :)

    [Ranjit] Cool. So now you should have no excuse for not posting. :)

    [M] I always thought suing in India was rare - who's going to go through years of being thrown about our super slow judicial system to get justice?

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  18. all's well that end's well! u have a lovely son !

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  19. [Itchingtowrite] You bet!

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  20. hey rohini, been on holiday and so didnt get a chance to check... thanks for an excellent post... i can see how much effort went into it...
    don't look back and blame the gyn... i do it often and it gets me nowhere!! as someone mentioned, we would have a lot more to object to if anything had gone wrong with us or the boys.....
    as for bonding with the baby... lying there in pain and having ur stitches contract with each gulp of milk is no fun... i hated my son at sight!! cried for 3 hours and only got attached to him many weeks later when he stopped looking like a rat...

    and have also made my peace with the fact that the second delivery will be a c-sec too....

    thanks again !
    mm

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  21. i completely agree- i feel like doctors are less patient than they used to be - and throwing out words like 'increased risk' or 'the baby is in danger' only works the mom into an unneccesary frenzy. are they giving themselves TOO much power?

    i did do research on a c-section before the birth of my son because i wanted to 'be prepared' either way. i did get to have a vaginal birth - but i was threatened at the very 'end' of my labor that if i couldn't get the job done on the next push we were going down the hall for surgery.

    at any rate- a mother is a mother is a mother. you carried that boy inside of you for 9 months - and you 'gave birth' to him on that fateful day. there is NO way you or anyone around you should consider that a failure. you got the 'job' done & you did it well.

    thank you for blogging about this - i think there is much to be said about the increase of c-sections and the 'authority' our doctors really have.

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  22. Gosh! What a post! Have you read Women's Bodies, Women's Wisdom by Dr Christiane Northrup? If not please do before your next baby. Its one AMAZING book every woman must read.

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  23. Hi M,
    In this case, I think the doc is a fraud.
    I went to her too for something else, and the nutcase told me i had TB, and insisted that I had TB even when all the tests came negative. She even wanted me to start taking antibiotics for it, which are pretty strong and have side-effects.
    luckily, ro's sis-in-law is a doctor and told me to wait and get a second opinion. that doc took one look at me, glanced through the test results and told me that nothing at all was the matter with me.
    all's well that ends well etc etc.
    but my parents were very stressed about their darling daughter being unwell at the time. and i did unnecessarily spend money getting tests done.
    ro, now that i have done all my bitching, i realise i should just check with you that this was the same doctor. can i get sued by her if i mention her name directly on your blog ?
    Zen.

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  24. [Mad Momma] As I said in my e-mail, thank you for being honest about being less than ecstatic when your son was born - very few people do

    [Mamo] I would still be okay if the decision was only based on actual perceptions of risk. What is scary is soemtimes the doctor is driven by monetary and scheduling reasons - that really sucks.

    [Sapna] Will be sure to check out the book. Thanks.

    [Zen] Yup, same doc. And better safe than sorry on the name-mentioning bit...

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  25. sorry to read about ur not-so- good exerience when it suppose to be a good memory.. That doc sound really bitchy.. Make sure to go to a different one the next time:-)

    And don't feel like a faliure just because u had c-section.. I think when you expect things to go in certain way and they happen differently we all feel thay way but delivery is the exceptional case.. We should all care about the outcome "healthy baby & mom" nomatter whats the procedure..
    Just think it was best for the baby and you made the right choice for him..

    Only thing I feel angry about is the family members not being understanding. They are there to make u feel better not the other way..

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  26. Well it's not that they were mean or anything. It was just that it was pretty obvious that everyone was very disappointed that it tunred out to be a c-section.

    And yes, in the end what matters was that Ayaan was born safe and healthy. That is why I stopped fighting my doctor after a while because if (IF) something had gone wrong, it would have not been worth it at all!

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  27. Hello Rohini,

    I plead guilty of not having read your blog for quite a while. :(

    This is to wish you, Jai and Ayaan a Merry Christmas and Happy New Year.
    :)

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  28. [Visitor] Hello there. Best wishes for the new year for you as well.

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  29. Reading blogs after a long time...you've captured it quite well. I can imagine how you feel - you were so prepared for a normal vag delivery and you were sorted cornered into having a c-sec. It's so hard to fight a doc during such intense moments esp when they use the word risk in association with your child. I was also induced but I reacted very strongly to minor dose of pitocin - went to full dilation in half an hour or so - heart rate started falling and the docs told me I have 10 min to push hard and get the baby out - they had already called in the C-sec team to come in - suddenly the room was filled with blue uniforms - I pushed so much (with epidural) that the baby came out but I had fourth degree tearing...labor was a short 3 hrs but I went through so much pain for the next five days...the fifth day I felt like I would collapse...my gyn was very nice and made time for me in her overbooked schedule and took care of me right away. But delivery moments are so unpredictable really...

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  30. Hey Rohini...

    Just read your birth story... your C experience is so similar to mine.. A perfect pregnancy ending in a C for no good reason..
    When I was admitted there were 5-6 births and all were C for different risk factors stated by the gynes.. Guess normal deliveries are so much rarer than C's these days...
    And I am so glad to find company in you on the bonding factor.. It had taken me too quite a while to bond and I was feeling guilty/strange about it :)...

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