When we think about moms and their birth experiences, we think about the transformation they go through: their shifting identities, their bodies’ constant changes, the way their brains evolve to focus on their babies’ well-being, and so many other things.
But if you’re a birth worker, you know that supporting births transforms doulas in many other ways, too.
This blog is about that: the first birth I attended that ended in a C-section, and how it rocked my world.
The timeline:
Day 1: Sunday
I was contacted by social services, asking if I would be interested in supporting a single Latin American mom. I said yes.
Day 2: Monday
I spoke with the mom for the first time, and we agreed to meet on Wednesday for a long prenatal meeting where we could get to know each other, connect, and begin the learning process. But that never happened.
Day 3: Tuesday
She called me saying that her doctors wanted to induce labor because she was showing signs of preeclampsia (protein in her urine and an intense headache). She also told me she had gestational diabetes (GD) and thyroid issues.
Day 4: Wednesday
Baby was born at 11:18 pm (yes, I remember by heart)
My intuition
I knew right away that this wasn’t going to be the dreamy, no-epidural, no-GMO, all-vegan, no-interventions, crunchy kind of vaginal birth experience. This was going to be a highly medicalized case.
One thing about me is that my intuition rarely fails, so after reassuring my client over the phone as best I could, I called my mentor. I remember saying, “Elba, I don’t know why or how, but I think this is going to be very similar to the way I was born. I feel like this is going to be a C-section.”
My mentor, a very intuitive woman with lots of experience, agreed.
The Case
We met at the hospital after most of the interventions were already done. We hadn’t had the chance to talk about her dreams and fears, so I had no idea about her wishes.
Her case was extremely challenging.
She was stuck at 3 cm of dilation, with preeclampsia symptoms, GD, a failed mechanical induction, a failed epidural, magnesium, lots of fluids, and Pitocin (synthetic oxytocin), following prostaglandins.
Can you imagine how many cables and wires were connected to her body for monitoring?
It was extremely difficult to use the peanut ball or even change the position of the bed because of all the cables, and because the baby wasn’t tolerating any position other than mom lying almost flat on her back.
I felt like everything I had learned was useless.
All I could do was be there for her. Hold her hand during contractions, guide her breathing to help her move out of panic mode, and use peppermint oil to ease her headache and nausea.
You might think that was enough, but you weren’t there to see her pain.
I will never forget the pain on her face. I will never forget her hand squeezing mine during cervical checks. And I will never forget her short, high-pitched yell when the doctor pulled the Foley balloon out of her body. I will never forget the nurses entering the room, turning on the lights, and talking as if they were in a cafeteria every 30 minutes.
The Decision for a C-Section
Note: if you’re reading this and are pregnant, please take a big breath in and say out loud “this is not my story” because it is not. This is not typical; I haven’t seen a case like this again (knock on wood)
I knew she didn’t want a C-section, but, truth be told, if she had been my best friend (or any other of my clients), I would have suggested exploring the idea a couple of hours earlier. Not because she wasn’t capable of giving birth, but because she couldn’t move, use the peanut ball, or sleep. Her case was hard.
So, when she finally said out loud, “Why aren’t they offering me a C-section? I can’t do this anymore. I’m too tired. Can I have a C-section?” I immediately called the nurse.
I have to be honest: they didn’t seem thrilled about the idea of a C-section.
They tried to convince her to wait longer because the OR team wasn’t ready until morning; that meant waiting 4 more hours, which, looking back in time, is not a typical move from any other hospital I have been to, so I find this weird (to say the least). You could tell she was done. She was almost in tears. She could barely open her eyes because of the headache. She couldn’t change positions; she was vomiting, and she couldn’t sleep. She couldn’t wait 4 more hours.
She was done.
One has to question the medical system: Why do they insist that all women have to give birth vaginally? Even when their case makes it an increasingly difficult path to follow? Could this, too, be another expression of obstetric violence?
Food for thought.
The C-Section
I went into the operating room with her, and then the worst-case scenario happened.
Just like my mom’s experience when she was trying to give birth to me, my client’s spinal block wasn’t working. She was in excruciating pain when they made the first incision.
I turned to the anesthesiologist and advocated for her. He increased the dose. A couple of minutes later, the pain was still there, so he increased it a second time.
Then came the third time.
That was when I tapped into a very intense, protective, Durga-like energy within me. I didn’t say a word. I simply turned my head and looked him straight in the eye with the intensity of a thousand suns. He knew what I was implying, the mom was still in pain.
He took a deep breath and said out loud, “Stop the surgery.”
I guided her breathing through what felt like the longest two minutes ever.
They restarted the surgery, and this time, she wasn’t in pain anymore.
Baby girl was born with her eyes open, looking around attentively, without crying.
I could sense the panic building in her mom, so I went to check on the baby and took a short video for her to see. She calmed down once she saw her baby moving, still without crying.
Suddenly, the mom started saying she couldn’t breathe. I called the anesthesiologist, who checked her and said she was okay. At the same time, the doctors expressed concern about the baby’s lungs and started giving her oxygen.
A couple of minutes later, they took the baby to the NICU, where she spent the next 16 hours.
Mom and daughter didn’t meet until 4 p.m. the following day.
I will never forget the mom’s distress as she lay shaking in the recovery room, not knowing where her baby was.
I asked the nurses for so many favors; they graciously let me go find the baby, take more pictures, and go back to the recovery room to show them to her mom. I will never forget the relief on her face.
Needless to say, it was a difficult night.
My transformation
When I finally got home, I could think of nothing but my mom.
She was 26, alone, and unheard.
They told her, “Your baby has the umbilical cord around her neck. We need to start labor now.”
She hadn’t had any contractions that morning, so they induced her with “el suerito,” a.k.a. Pitocin.
When the induction was unsuccessful, they performed a C-section using an expired spinal block: an expired raquidea.
My mom fainted from the pain, but she remembers the OB-GYN saying, “Calm down, child. This doesn’t hurt. You’re just nervous,” followed by a nurse’s “Doctor! It’s expired!!” She remembers the fear in the doctor’s eyes. She remembers not being heard, and being alone.
It’s hard for me not to draw parallels between the two stories. I can’t help wondering how different my mom’s life story might have been if she had had a doula by her side.
Even though I still wish I could have done more for that mom during her labor, I know that night transformed me.
That night, I became more than a doula, a birth worker, or a birth guardian.
That night, I became the woman my mom needed when she was young.
The woman who advocates.
The woman who believes in your experience.
The woman who will challenge the doctor if necessary.
I became the woman who stays.
