PTSD and Me.

I've seen a few post around the 'net in the last little while about PSTD caused by childbirth. Two years ago if you had asked me what post traumatic stress disorder was I would have told you that it was what happened to people who were involved in combat or violent crime.

Now I know differently.

For me it started almost immediately. Within hours of my baby's birth if I would fall asleep for even a moment I would be shocked back awake by violent dreams, mostly about people killing my baby. I wont go into details, but they were so awful that I didn't sleep at all for over 30 hours. No sleep at all despite 12 hours of labour followed by surgical birth. Finally, I literally passed out and slept dream free for a few hours only to wake up in a panic as my baby wasn't beside me. And when I say "panic" I mean I had what I believe to be the first anxiety attack I've ever had. Heart racing, cold sweats, nausea, and terrible fear. I quickly discovered I had to be in physical contact with my baby to feel even the slightest bit grounded.

Part of this reaction was likely due to the large amounts of morphine I had been given. Looking at my records I see that I was given hydromorph twice when I thought I was getting tylanol and that was on top of the 48 hours worth of morphine put through the epi line at the end of my cesarean. Some people feel awesome on morphine, I'm not one of them. My sister who came to see me in the hospital, on day two, realized what was happening, as she too reacts badly to opiates, can't sleep, lots of nightmares. But the other reason I was having these feelings was a much more complex issue I would eventually learn was my very own p.t.s.d.

I thought things would be better if I could just get out of the hospital and go home. I remember being very aware of "looking the part". I got into my flower flannel pajamas, and walked circles in the ward to prove I was ready to go home. The doctor agreed and I was free to take my baby home.

Unfortunately, things didn't get better. While the drug induced nightmares lessened, I was still plagued nightly by disconcerting dreams of birthing in dirty, public places or being chased by blue clad people through halls that turned Esher-like into themselves. Toss in the odd full blown hunted by a serial killer dream, and I found that most mornings I awoke in tears.

I also had a desperate need to be near my baby. I couldn't bear him to be out of my sight, or panic would start to set in. Yet strangely I didn't feel bonded to him in the way I had with my first born. While I needed him near me I didn't have any of the blissful gazing moments I had had naturally with my first son. In fact I had to remind myself to smile at him and talk to him and love him in the way I knew he deserved. I feel eternally grateful that his traumatic birth was not my first baby as I was able to recognize early that I wasn't bonding normally and actively work on bonding techniques. (I'll devote a whole post to that some time soon!)

I tried to find a way through this confusing time. I had a huge need to talk about what had happened to me. I needed to try to piece together what had occurred. I tracked down my primary care provider who was able to answer some of my questions and helped me fill in some of the information I needed. It made me feel better to know the details and not have a hole in my understanding of the first few moments of my son's life, but some of it made me angry as I realized that my experience had been made much worse by needless protocols and a lack of compassionate bedside manners.

The months ticked by. The nightmares continued and other symptoms started to be apparent.
Before my second son's birth I had what I would consider normal protective fear for my children. I would watch at the window while my 9 year old crossed the road to play with the neighbour and I would feel slightly nervous, silently willing him to be careful and watch for cars. Now it is completely different. Now I watch at the window in complete fear with violent images of him being killed by a speeding car flashing through my mind.
Every day I was( and still am) faced with heightened fear. Violent images of my loved ones meeting horrible deaths are hard to keep in check.

I started to search for information on what was happening to me. Soon I was reading about symptoms that sounded just like mine. I found information through ICAN's Recovery pages. You can find their info about PTSD and PPD HERE
http://www.ican-online.org/recovery/postpartum-depression-and-post-traumatic-stress-disorder

I also found on online community called Solace for Mothers http://www.solaceformothers.org/
where many women gather to share their stories and support each other. Unfortunately, I am not alone. Many, many women have ptsd from childbirth, and this online forum is so helpful as it can be really hard when no one understands what you are going through.

Fast forward to 18 months post birth and many sessions with a good councilor. I still have nightmares, but not every night. I still have way more fear then is healthy. I still have anxiety and hyper-vigilance. I still have lost some of the joy in my life to this condition. But I have hope. Hope that I will learn ways to overcome. Hope that one day I will be able to feel normal again. This year my plan is to watch the elementary school concert and NOT jump up to grab my kids and run when the grade ones stand up to sing a holiday song.

Some times I wonder why did my cesarean birthing experience result in ptsd for me when so many other women don't suffer from this.
In the thinking I have done about this I have come up with the facts that I am a very sensitive human. I am often struck by how much more information I receive then others close to me. Often this has been a great gift but when in a traumatic situation perhaps having such highly open senses may not be a good thing. I also have a extremely precise memory for what people say and do. (I got by in university by going to class, if heard the prof say it chances were high I would remember it, -sure beat studying) These are the attributes that I think lead me to be more susceptible.

I have read that some people think that some women are more likely to get ptsd because of previous experiences. This bothers me because who has had the perfect life? By the time we are of child bearing age who hasn't had their share of heartache and pain? Maybe for some prior traumas may add to their risk, but my own experience is that even a normal life can lead to reacting to birth trauma in this way.

Well thats my little bit on that. I hope that it is helpful to some.

I would like to end with this;
PLEASE If you are suffering don't suffer alone. Reach out. It's hard, you may have to reach out more then once ( I did), but when you start to find a way to feel better it will be worth it.

Resolution

There are these moments in my life when I feel a little push from the devine. Sometimes it's a gentle nudge in the right direction, sometimes it's a unwelcome shove that sends me into a momentary free fall.

I was just reminded about one of these moments. In the fall of last year I had written a "Review of my Birthing Experience" and was contemplating what to do with it. While I felt that it should be read by the care providers at the hospital I had delivered at it was extremely difficult to face the idea that numerous people would examine me again. No, not physically, but psychologically-I knew my experience would be reviewed and dissected by many, many people. I would never meet these people or even learn their names. I knew I would be criticised.
And worse then anything else, I would never know the truth about what was said about me behind those closed doors. And so I did nothing. I left my "Review" in a file and tried to move on with my life.

And then I picked up the paper in a coffee shop one day in December and on the cover was a picture of a vibrant young mother and her baby. The mother was a doctor who had spent her career delivering babies and her baby was born the same month as my baby at the same hospital. The story in the paper told of their death in a plane crash. Tears jumped to my eyes.

The next day I sent the review to the complaint department of the hospital.

Life is short. Life is too short to wait for another day for anything.

I read that this young mother/doctor had great faith in the hospital I delivered at and I'm sure she would want it to be the best it possibly can be. Criticism is a great motivator for change.
So in saying prayers for her family, and sending my review I tried to honour her life.

Dealing with the complaint wasn't fun, it didn't make me feel better, in fact in many ways I felt worse, but it was a push towards more positive births. By providing my feedback to those who cared for me I can only hope that there were ripples of change.

I believe saying our truths can be one of the hardest things and also the most important.

I was sent this in an email;

"Finding strategies to heal and integrate the experience in your truth takes time, energy and resolution."

And so, by chance yesterday, I found myself reading about that mother and her baby again;
lives lost reminding me to take a breath and feel my resolution.

WOW

I feel almost out of touch with my blog, like a friend that I haven't had a chance to call.

I am desperate to review Breastfeeding with Comfort and Joy by Laura Keegan.

I'd explain all the things I have going on that are keeping me from writing , but that would only take time away from what I need to say which is that

I AM FEELING SO HOPEFUL!!! Change is a coming I can feel it in the wind.

Last night I was in a room with Suzanne Arms (of Immaculate Deception and so much more)
Gloria Lemay, Jennifer Block (of Pushed), Helene Vadeboncoeur (of Birthing Normally after a caesarean or two), along with other activists, doulas, midwives, lacivists, intactivists, mothers who home birthed, hospital birthed, elective cesarean birthed, and 4 babies.

I could feel the cogs shifting, the universal work being done. Women are so powerful, we just have to take hold of it and NEVER LET GO AGAIN!

I must go, I have a 200+ to do list but I had to stop in and share my joy.

After august I'll fill in all the details.

What About Dads?

So it's almost father's day and I have been thinking about Dad's role during cesarean births, or for that matter all births.
In general in the last 35 years fathers have had an increasing role in the birth of their children. Gone are the days when gentlemen waited at home or in hospital waiting rooms cigar in hand. Now fathers are most commonly in the birthing room being with their partner while their new family member arrives.

The one exception to this rule seems to be father's who's babies are delivered by cesarean section while the mother is under general anesthetic. I can't seem to find any documented medical reason why this is so. In fact, I have found numerous reference to the difficult time families have after these types of births, because father's are mourning the loss of witnessing their babies arrival and the mother's fighting the irrational feeling that the baby they are given is not really theirs. I would like to issue a plea to hospitals every where:
PLEASE LET THE DADS IN.
Not only will this solve the problem of them missing their child's birth, but studies have shown that having someone take pictures during these types of births and later telling the details of the birth of their child can really help the mother's emotional healing and promote proper bonding. Who better to do this then the father?

I sure needed my partner with me during my birthing experience. In fact, one of the worst parts of my second son's birth was when I had been moved to the OR with the understanding that baby needed out quick and that a instrument delivery was likely, or perhaps a cesarean. I was alone (except for the room full of blue clad people!) when the doctor made the call to operate. I so needed my partner, but he was still in the hall waiting to be given permission to enter. He was upset and I was upset. Why couldn't he have been with me when this life changing decision was made?

I remember now the child birth class we took together and while we were talking about cesarean births the instructor told the partners "Don't be afraid to sound like a broken record by saying "When can mom see the baby?" Ask often , ask everyone, keep asking until it happens. As you know if you have read my previous post, we were lucky enough to have this not be an issue for us, but I have heard so very many stories of women waiting hours to see their new babies. So dads: KEEP ASKING FOR BABY TO BE WITH THEIR MOM.

I came across this post: "Delivery Room Football" by Dr. Emmett Miller describing the scene when after his wife's unexpected cesarean delivery. The pediatric team was getting ready to take his baby daughter away to the nursery before mom had even seen her. “Nobody’s leaving this room with that child!” he declared .“You’ll have to sign papers saying that you’re taking this child against medical advice!” countered the doctor holding the baby.
He recalls: "I imagine that if I had not been an experienced physician, I might have faltered long enough for him to succeed in an end run after all. But I had delivered enough babies to know that this one was in no immediate danger. A moment later, Lauren was there on her mother’s arm nuzzling for the breast."

You can read his whole story here:
http://www.thewellspring.com/flex/birth/2688/delivery-room-football-by-emmett-miller-md.cfm

While not many of us have medical professionals for partners , we can still advocate for mother baby contact, and if that is not possible then skin to skin with father is the next best thing.

A study from Sweden called:Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior. concluded:
"The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby."

The role of father's, like all elements of birthing, I believe is in need of greater understanding soI strongly urge you to visit:
http://theothersideoftheglassthefilm.blogspot.com/
"THE OTHER SIDE OF THE GLASS"
This is the site of the first birth empowerment film for fathers. Just the trailer made me want to cry. This film highlights the problems with the way father's are pushed aside and babies and mothers are subjected to unnecessary and practically violent procedures. Please go to the site. There is a chance to get an advance copy and help get this film finished.

So that covers what I have found out, so far, about dad's and with the birthing process. I know there is so much more to learn. Before I finish this post I wanted to add that dad's are not just helpers or extra people at the birth of their children. Birth can have a profound impact of fathers both in a positive or negative way, especially if the birth is difficult, as many cesareans are. Here is a link to a post partum dad's site:
http://postpartumdadsproject.org/ If you are a dad and are having a difficult time since the birth of your child you are not alone. Reach out to others who understand what you are going through.

We all have the chance to reach for greater and better births for every member of the family
so let's spread the word. Educate yourself, educate each other. Share your stories and a very HAPPY FATHER'S DAY to all.

Skin to Skin in the OR

In honour of the end of Cesarean Awareness Month, I am posting this picture of my brand new baby, less then ten minutes after his emergency cesarean delivery. As you can see we are skin to skin in the OR. I had no idea how special this was until I started learning more about cesareans. Now I know that, although it should be, having baby placed naked on it's mamas chest is not common practice. I was very lucky to have care providers that made this happen. When I see cesareans on TV ( yes sometimes I am foolish enough to watch "those" birth shows) I am saddened to see babies being excessively handled. Silly things are done, such as having foot prints taken, diapering, and tight swaddling, all before baby gets to meet their mom.

So fellow mothers and fathers, ask for your babies. Don't be afraid to speak up. If your baby is stable there is no reason not to meet them in their birth day suits. One of the most empowering moments of my crazy birth was having the chance to answer "No Diaper".

EDITED 2014 *I have received numerous requests to use this photo for educational purposes.  To this note I give permission for this image to be used for educational purposes in regards to promoting skin to skin contact in the OR during cesarean births.  The photo must be credited to cesareanparents.blogspot.com also the use of this photo must be reported in the comment section of this post.  At any time I reserve the right to revoke this permission. THANK YOU for your interest in this subject.

Abbie Dorn

I am saying a prayer for Abbie Dorn.

I read the paper at the coffee shop the other day and there on page 11 a tiny blurb:

"Abbie Dorn's parents are fighting for her right to see her children. She was left unable to move or speak after a botched delivery of triplets in 2006."

"Botched delivery of triplets" I knew that could mean only one thing:cesarean.

A quick web search led me to:

LOS ANGELES -- A Myrtle Beach mother who is unable to move or speak - and possibly to understand - is the focus of an unusual, emotional court case to decide if she has visitation rights with her 3-year-old triplets. (http://www.thesunnews.com/2010/04/22/1435062/visitation-right-sought-for-disabled.html)

More in depth article called : "Severely disabled, is she still a mom"

Severely disabled, is she still a mom? Battle nears over visitation rights of a woman injured in childbirth April 11, 2010|By Maria L. La Ganga

Sure enough one of the articles refers to the doctor accidentally "nicking" her uterus causing massive bleeding and resulting in brain damage. I can't find any mention to "cesarean" but I can't imagine her uterus was nicked any other way.

There is mention that she won a 7.8 million dollar medical malpractice suit.

She can no longer move or talk. Her parents believe she communicates through long blinks and tears. Her ex-husband believes she is vegetative. Abbie's parents and her ex. are in court battling over whether or not she has the right to visitation with her children. So very sad.

There are so many facets to her story, but as this is a cesarean blog I'm going to comment on that.

I can't find anything about her birth story. Does anyone know what happened?

I like to hope that her cesarean was necessary. I'd like to believe that she had a trial of labour and the "difficult delivery of the third baby" refers to a emergency situation.

I hope the surgery wasn't done "just in case", or "to ensure nothing happens to the babies".

I'd like to believe that this medical mishap was come to honestly. That there was good reason to deliver her babies surgically. Mistakes do happen.

I'd like to believe that Abbie was given the chance to birth her babies naturally .

I'd like to believe these things, but I would probably be wrong.

Everyday women are told that the only way to safely deliver multiples is by cesarean.

States one article:

"While for triplets and higher-grade multiples caesarean section is the first-line mode of delivery" http://www.ncbi.nlm.nih.gov/pubmed/17440267

And another asks:

"Is vaginal delivery in twin pregnancy still an option?" http://www.ncbi.nlm.nih.gov/pubmed/19570620

The thing that I find, again and again, is that there are only a few small studies on any birth topic. Risks to the babies seem to be the primary concern. Risks to moms seems to be unexplored.

One thing I know I can believe is that we can birth babies naturally, even multiples. Just because we are being advised against it by the medical establishment does not mean that there is no other way.

Here is an inspiring video about twins and triplets birthed naturally:

http://www.youtube.com/watch?v=7E-wULAaD50


And so Abbie Dorn I say a prayer for you. I hope you have peace in your heart.
I pray that you see your children soon.

New York Hospital Changing Policies.

I just read this great article I got through the ICAN Blog.


http://www.nytimes.com/2010/04/20/nyregion/20bigcity.html?hp

It's a New York Times article about two hospitals on Staten Island, one with an increasing cesarean rate and the other with a declining rate.

The article talks about the fact that many hospitals pay lip service to the fact that the cesarean rate is dangerously high, but have not taken dramatic steps to reduce them.

The article gives credit to Dr. Mitchell A. Maiman, the chairman of the obstetrics and gynecology department the one of the two hospitals, Staten Island University Hospital, for building the goal of cesarean reduction into policy.

Some of the things that they are doing...

Dr. Maiman and his colleagues do not allow unnecessary inductions for first-time pregnancies at any point before the 41st week.

They also do not allow C-sections for no reason other than the mother wants one, stating:
“I find that most of the time, if you explain to a mother you’ll recover faster, it’s safer,” he said, “then most women will choose a vaginal delivery.”

I found that the following quote from the article to be important as it illuminates the fact that women rarely request cesareans if given good information.

"Mother-demanded C-sections are unusual enough that the policy is probably more useful to Dr. Maiman for the message it sends to doctors and patients..." (bold mine)

Dr. Maiman actively encourages VBACs. -YAY!

And I love this one:

Residents are trained not only to avoid unnecessary C-sections, but to let higher-ups know if they witness another doctor about to perform one. -Go Dr.Maiman!

Change only happens when we DO!

Woman to Woman Videos

So I've been watching some fabulous videos from Birth Matters Virginia's Video contest winners.

I particularly responded to this one called

Prevent Cesarean Surgery
http://www.youtube.com/watch?v=vxRmVciXy-g
It just says it so well. I love that these videos are made by women for women.

Here is the link to the Birth Matter's page containing all of the finalists:
http://www.birthmattersva.org/videocontest.html

So many passionate women. It make me feel hopeful to find these beautifully strong voices.
It strikes me that, like a choir, our voices are stronger and fuller together.
Each one of us adding to the harmony.

My Story, blogs and

Finally a moment to myself (hmm and the whole wide world I guess...)

I've been really wanting to write lately and have found that I just haven't been able to fit it in.
The reasons seem to be both physical and mental. My 11 month old slept a whole 17 minutes today- all in the car seat. Can't multi-task much from from there. I'm working on excepting that I'm on the "three year chase" part of having a child, especially a boy!

I surrender to reading the same alphabet book 9 times a day.

It's also spring which for me means garden time. A time when I need to plant and weed and ready the soil. I love growing food in my yard. It makes me feel free and whole to eat things I grow myself. Some day I will start a garden blog as I keep promising all my aspiring gardener friends.

But back to this blog. I feel like I'm turning over a new leaf. I've become more self conscious. When I started posting here I had no idea about the world of blogging. I was frantically researching, trying to get some understanding of this totally surreal thing that had happened to me: the surgical birth of my son.

As I was discovering facts and information I realized I felt a need to make the things I was finding available to others. The idea of blogging came from a woman I went to high school with who has a blog about mothering. She sent me a link to it on facebook. So that's how I got here, my technological foot print.

I thought that I would have to try to get people to read what I wrote, that I would have to send them the link. I'd never heard of"google alerts".

Now I know that there are people out there who are reading what I write and I am humbled.
Thank you for those of you who have stopped by and said hello. You have encouraged me to keep doing and lending my voice to this important issue. I have recently learned that my province has the highest cesarean rate in Canada (30.4% during latest reporting period 2005).
Yikes.

I've been feeling a bit overwhelmed by the enormity of the problem. I've become involved in ICAN by starting a local chapter. Meeting women who have faced these same challenges, who are scarred by their babes' birthing.

Wow(okay that is sarcastic hey it's better then a "bad word"), the more I learn about the state of birthing in the world the more dire the situation appears. Thankfully there are many pushing to keep birth holistic and empowering.

I've been putting a lot of pressure on myself to cause change, to get the info out there and the result is less productivity. It seems if I want to I could see almost everything as an analogy for birth -the more you surrender the to your own flow the better.

So I do have a couple of half finished posts that I will work, but without guilt in the speed of their arrival. I will not be cynical. I will believe in change.

Spring Hello

Well it's officially spring today. I'm amazed that the year has turned seasons already.
I haven't blogged in a few weeks, decided to take some time to explore the world of bloggers and I want to say that I am totally impressed by the wonderful, committed, and passionate women out there. I'm going to put together a blog list, but I'm still working on it.

I'd also like to thank Michelle at BirthCut for doing a fantastic job putting together a "Positive Cesarean" page. I now believe that even the most ardent home-birth activist should protect themselves by having a "last resort" cesarean birth plan. I've spent the last 11 months trying to sort out my head from an emergency cesarean and I'm sure had I spent a short time really considering how to best cope in that situation I'd be much better off.
You can find it at:
http://www.birthcut.com/thepositivecesarean.htm

I'm going to focus my next few posts on reviewing articles that offer scientific evidence of how best to create cesarean births that achieve healthy psychological outcomes. Again, this is going into academic literature so I'll do my best but please forgive my mildly dyslexic (yes really) writing.

I'm off to tend to my garden, one of the things that has helped my healing has been connecting with the earth in a literal way. Nothing like digging in the dirt to let my inner earth mama out!

500 Years of Cesarean History

I'm not sure what the message is in the history of cesareans, but I know there is something important there. Every time I delve deeper into studying the history of surgical birth I sleep better, feel clearer, and have brighter thoughts. So, now I have with a birth history book with two whole post-it packs marking pages in it. (beg's the question- if I put a sticky on every page what's the point of any stickies at all?)

As it's now overdue at the library so I thought I would take another turn at summarizing some of it's amazing depth before I have to give it back. Here is my second installment from:

Not of Woman Born, Representations of Caesarean Birth in Medieval and Renaissance Culture, by Renate Blumenfeld-Kosinski

I'd recommend this book to anyone curious about the politicizing of birth and it traces this origin. Blumenfeld-Kosinski has done a thorough investigation of many ancient documents including early European medical treatises, clerical writing, court proceedings and visual representations. All of which depict a time when birth changed from being seen as an everyday activity done by women, to a time when a birthing women was attended by male medical attendants.

I am going to offer the following notes on Blumenfeld-Kosinski's first chapter titled:

Cesarean Birth in Medical Thought

Early Medieval thought was thick with religious connotations. Sex and birth were linked through the idea of virgin birth, the rejection of sexual pleasure of the clergy, and the belief that procreation was the only way to sanctify the sexual act. Infant and early childhood mortality was high. Birthing took place at home, attended by midwives and was considered a non-medical procedure. Cesareans, in the popular mind, were legends of miracles or whispered tales of horrors and mutilations. Cesareans were thought to be preformed only in the case of maternal death in an attempt to baptize the unborn child. They rarely resulted in a live child.

1100Ad the church was intertwined with everyday medical procedures. Priests preformed surgeries and nuns were often midwives. This changed after the pope warned clerical members from interfering with the ways of the world and body. In 1200AD deacons and priest were formally forbade from practicing surgeries. Lay professionals were the only ones preforming the tasks of surgeons, physicians and midwifes.

In 1236AD The Council of Canterbury decreed that cesareans be preformed in order to baptize an infant if the mother dies. The church was both limiting birth attendants to lay midwifes, but then requiring them to preform the clerical job of baptisms. During the 1300's confusion ruled as to how to insure the child's salvation. Generally, if the child died before the mother, or if it was born live and baptized it was saved, but if it died in it's deceased mother it was dammed. Midwives were forced to be not only birth attendants but also caretakers of the child's immortal soul. If a birth proved deadly for the mother they were charged to cut the baby out at just the right moment, to late and the baby would be already dead and it's soul would be doomed. (Wow, now that's pressure!) Too early and they risked killing the mother needlessly.

1400's brought with it a Renaissance of dissection and medical writings including:

"Lilium" by Bernard of Gordon was the first western medical text that included a written account of a cesarean resulting in a live baby. Bernard gathered advice from "old wives" that the baby can survive for a short time after the death of the mother and can be out of mother live.

1423 Piero d'Argella of Bologna authored "Chirurgia" and writes the first male obstetrical first-person account of a post-mortum cesarean.

In Germany in the mid 1400s Midwifery came under official control for the first time. Many statues to govern their procedures were written.

In 1480 a southern German statute contains the following:
"Many mother's ask, when they feel that they are dying, to liberate the child by an incision. In that case, the skillful midwife has to open up one side and pull out the baby. If the woman is still alive, the wound is to be closed with three or four lignatures, and a plaster of eggs and strong hemp fabric. Give the woman a sip of the best wine, and a drink made of salsifry and mountain albanum. The woman will recover, with God's help."

1513 Eucharius Roesslin wrote
"Der Swangern Frawen und Hebammen Rosegarten" (The Pregnant Women's and Midwives Rose Garden) which contains many instructions for the female midwifes but tellingly directs the instructions for cesarean to male surgeons. Birth has entered the realm of male practitioners through cesarean procedures.

1581 Francois Rousset wrote
Traitte Nouveau de l'Hysterotomotokie. ou enfantement Caesarien
Subtitle:The extraction of the child through lateral incision of the abdomen and uterus of a pregnant woman who cannot otherwise give birth.
Rousset coined the term "enfantement Caesarien" ("cesarean birth"). He named it after the first of the Caesars, Scipio Africanus, who was supposedly born this way(often confused with Julius Caesar who was not born by Caesarean)
This writing was, for it's time, radical as he suggested cesarean birth to be preformed on live women in order to save both mother and child.
His reason for this is that he has gathered case histories from "trustworthy" people who reported witnessing cesareans. He also examined women who had abdominal scars they reported to be from Cesareans. One such case was Anne Godart who is reported to have had 6 cesareans before dying during an attempted 7th birth, because her surgeon had died and no one could do the cesarean.
Roussset witnessed the performance of an operation he himself advised for prolonged labour. a young surgeon made an "incision on the woman's right side just lower then the naval, little blood was shed, and a living child was pulled out and the afterbirth. The wound was closed with 5 stitches. After 40 days of bed rest the woman was well again"
Rousset was passionate about innovation and active intervention in childbirth. He professed that surgeons should be "quick to act" but he was disputed by many who believed that his methods would result in the death of women who would have given birth naturally if given enough time (hmm... the first debate about failure to progress?)

Jacques Marchant was probably Rousset's biggest opponent siting many cases of failed cesarean and coining the term "natural versus unnatural" childbirth. He wrote:

"How can a surgeon plunge his hands into the side of a pregnant woman when there is a natural exit? Better to wait for nature then rush into a desperate and doomed operation"

Despite the debate, abdominal surgeries for bladder stones were being done successfully and it is sure that some cesareans were being done with good outcomes for mother's and babies during this time.

It wasn't until the late 1500s that cesareans were accepted by a broader number of medical professionals and were done in attempt to save both the mother and child. It was during this time that women were formally forbade from handling surgical instruments. This meant that birth,in western culture, had moved totally from women's world into male medical realm.

Blumenfeld-Kosinski sums up this chapter by relating the significance of cesarean procedure in bringing birthing into the realm of male obstetrical practice and away from female birth attendants.

There you have it, my attempt to sum up this extremely complex chapter. I'd guess that I included only about 1/100th of the information contained with in the original work.

I find it particularly telling that cesarean procedures were immediately the subject of great debate as to how they affect the preservation of the body and the salvation of the soul.

I believe that many women who have had cesareans will agree that they are a profound experience that affects their heart, body, and soul.

Another thing that struck me was that successful cesareans were most likely first done by women midwives and only later were they attempted by male counterparts. I wonder how birth would look now if we had been able to have both the world wise women and the book wise men work together instead of becoming adversaries. Instead, this time in history led to the vast persecution of women healers and over 150 000 of them were killed during the witch hunts.
We humans are so counterintuitive on so many levels.

Now I best get this book back to the library, I'm sure there are others wanting to read it (maybe?) I'll try again another time to relate more about it's general themes as they are so profound they keep me thinking.

Placental Thoughts

I've been thinking about placentas. I realized I missed "viewing my placenta" from the list of things I wish I'd been able to do during my cesarean birth. It's been bothering me that I forgot that one. I have the most beautiful pictures of my first placenta, but sadly didn't see my cesarean placenta before it went to pathology

I think they are important links to our animal self. I've lived on a farm, watched new mama animals eating their placentas. They are these unique, one time use organs, that our bodies create.

I see that the placenta is the living tie between mother and babe. I also think it's interesting that the placenta loses it's life at every birth as it is shed from both bodies.

I thought about consuming my own placenta. My uninformed idea was that I would have had to eat two pounds of placenta stir-fry. I just could quite see myself doing that no matter how good it is for me!

Turns out I should have looked in to it more.

I've been learning about placental encapsulation and it sounds super cool. I t allows the placenta to be stored and consumed easily. The benefits are reported as preventing postpartum depression, helping with milk supply and even help with menopause hormone changes.

Here is a link to a youtube video of a reporter following a professional "placenta-lady"

http://www.youtube.com/watch?v=uuxeAbeDcU0

And here's a blog post, with pictures, of a mama doing it herself.

http://mamamojo.wordpress.com/2008/06/10/placenta-dehydrationencapsulation-phase-one-complete/

Before I had a cesarean I had never thought of not seeing my placenta. Giving birth vaginally it's just not something you would miss, 'cause you have to push it out. It wasn't until the day after my cesarean that I thought about it at all.

If I had it to do over I'd encapsulate mine, or at least think to ask to see it.

p.s. just found this great site with lots of info:

http://www.placentabenefits.info/

History of Cesareans

So, I've been facing a few fears lately...
One being that I went to search out this book who's title so haunted me the first time I saw it.

Not of Women Born
Representations of Cesarean Birth in Medieval and Renaissance Culture
by Renate Blumenfeld-Kosinski

Well I've read it through now, it's a true academic read, made me put to use my high school Latin and wade through 40 pages of footnotes! -It's also totally fascinating.
It documents the time in the history of western civilization when cesarean births entered medical texts. A time when women healers and midwives were forced from the birthing room and their male counter parts took over with scalpels and forceps at the ready.

There is so much information in this book I'm going to have to divide it up into a few post topics to do it any justice.

I thought I would start by summing up the ancient history of cesareans that Blumenfeld-Kosinski includes:

2000BC Mesopotamian Cuneiform tablet references a child "pulled from the womb" and then adopted.

715BC the "lex regia" proclaimed by Roman king Numa Pompilius decreeing it unlawful to bury a undelivered women. Anyone doing this would be guilty of causing the death of the child.

3rd Century BC -3rd Century AD Two Ancient Jewish Texts reference Cesarean births:
Mishna text includes reference that twins brought forth by cut in the abdomen must share right of succession.
Nidda appendix to Talmud refers to women who bring forth children by cut in their abdomen not needing to observe the traditional days of purification, This text is
particularly interesting as it suggests that the mother has survived.

5th Century BC- 2nd Century AD an Indian doctor named Susruta writes medical text
Nidanasthana includes urgings for doctors to preform an abdominal delivery quickly in
the event of the death of the mother.

23-79 AD Roman Scholar
Pliny the Elder discusses the auspiciousness of a cesarean birth. The idea that the person
cheated death at birth.

These ancient references brought the context of the modern cesarean to a new place for me. These seeds in history, these ancient mothers, most who did not survive the births of their children, I feel the need to honour their sacrifice. While the risk of death during cesarean birth is still much higher then vaginal birth, I am so grateful for these thousands of years of learning that helped keep me and my baby safe.