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.