"Birth trauma is isolating. Devastating. Real." - birthtalk.org
By the end of pregnancy, any fears that I had about labour pains had subsided and I was completely overtaken with an urgent, pressing desire to get the baby out. From camping in the rain at 34 weeks, shuffling through the muck to the bathrooms two to three times a night, to lying all alone in the trailer whimpering, crying, feeling uncomfortable and useless; from the sweaty sleep and terrifying night terrors, to the swollen, aching feet and persistent, steady leaking between my thighs; from the suddenly dark, expanding areolas to the surprising, clumsy largeness that became my breasts – never mind the pus seeping out of my ingrown toenails, the persistent savage migraines, or the constant shortness of breath – I was done, just frickin’ done with pregnancy.
Between massive, painful hemorrhoids; deep, searing round ligament pain; and a sharp, agonizing pull in my groin with even the slightest movement, I was a week past my due date and praying for the thrill and pain of labour to just hurry up. Craig even recorded me stating that I would, never, ever do this again. Pregnancy was excruciating, terrifying, and completely outside my control. Already a migraine sufferer, I experience more than enough pain and discomfort at my body’s whim – with pregnancy, it was exponentially worse. While I relished the undulating flutters and kicks of Fitz moving in my womb, it was the only part of pregnancy that I enjoyed. I actually miss being curled on my side cuddling my full belly, just feeling him move or, as I reached full term, just watching my belly rise and rumble with his movements. Even with my relentless research and preparation, I was not equipped for the toll that growing another human takes on a mother and, despite reading countless pregnancy books, there was so much happening to my body, in my body, that I did not learn and that no one warned me about, and I hated it.
With both frequent migraines and post trauma daily headaches (I broke my neck in a car accident in 2004), I am no stranger to pain. In fact, I have a high tolerance for it. Most days, I get through my chronic pain with barely a complaint, trudging through it, knowing that I am lucky to be alive and not a quadriplegic; that this pain is simply the price I pay for that gift, for a relatively unencumbered life. I take a multitude of pills on a daily basis for pain management, including T3s. I take a maximum of two per day presently, but with my specialist OB/GYN’s leave, I only took one a day while pregnant, if that. Despite reassurances that it would not negatively impact my baby, I was nervous about it and only took one when I absolutely needed something to take the edge off: and that is all the T3s do – even now – just file off those sharp edges, dulling the pain just enough so that it is tolerable. They do not take the pain away, so I deal with a fair amount of pain every day of my life; an admission that is necessary to understanding my birth story, to understanding how much pain I am capable of enduring and, therefore, to understanding how much pain I was in during my extremely abnormal labour.
In my OB/GYN’s office, a week past my due date, my doctor did a cervical exam (which hurt like hell – I had joked that she needed to be gentle since nothing had been up there in months). As with every other exam, my cervix was shut up as tight as a bank vault holding the world’s most precious commodity. My doctor said I would have to be induced the following week. I was asked to sign a consent form, but she did not explain any risks to the induction and never told me about any other options, it seemed like the only next step.
Eager as I was to return to my old body, my old self (little did I know, I would never be my old self again), I signed off on an induction without hesitation. I trusted my doctor, trusted that the risks of waiting for my baby to come on his own outweighed the risks of an induction. She said that the induction would be gentle: that Cervidil is a gel inserted vaginally via a tiny tampon-like device, and is placed at the cervix’s opening (or where it is supposed to open, in my case). Cervidil (the generic name is dinoprostone – the dino part seems telling in retrospect because of the monstrous response my body had to it) stays in and is usually removed 12-24 hours later or if regular labour starts. I would be monitored for two hours following the insertion and then sent home to wait and see what happened. Typically, she said, nothing happens and it is re-inserted the next day. The Cervidil’s job is to soften the cervix, encouraging it to open and start labour. Considered a mild induction, it is often followed by inserting a balloon catheter that forcibly opens the cervix. At no point was I advised of the risks or the benefits of waiting for Fitz to come on his own; waiting for him to come on his own was not even given as an option. I was also not forewarned of any potential side effects or risks of a Cervidil induction. Looking back, I should have asked these questions, but I was beyond uncomfortable, beyond ready for my baby to get here, so I trusted my doctor and signed the induction release without another thought.
A week later, at nine days overdue, while Craig was at work, Mom took me to the hospital for my induction. My body was being so stubborn, and so I fully expected nothing to happen and figured I would be back home within a few hours. When I arrived, the nurse did a cervical exam and my cervix had not budged (and it was beginning to seem the women on my birth ‘team’ were even rougher with my vagina than the men). I was feeling fine, if a bit anxious for Fitz’s arrival. The on-call OB/GYN came in to check me himself and commented that I have a very narrow pelvis and would be a candidate for a caesarean section. I felt frustrated and confused by this statement. What did he mean I was a candidate for a C-section? Did he believe I needed one? Why was he proceeding with the Cervadil induction anyway? I wanted to give up and have the surgery right then, but because I trusted the medical community, I did not question him when he inserted the Cervidil.
The nurses strapped my belly with a fetal monitor to listen to Fitz’s heartbeat and to detect and track any contractions. After an hour, I started to feel menstrual-type cramping which registered as contractions on the monitor. A half hour later, Fitz’s heart rate dropped, bouncing back up quickly, but it was enough for them to admit me to keep an eye on him – to Mom’s relief (she had driven my labouring sister to the hospital and was not eager to repeat the harrowing, helpless, experience).
After about an hour, the cramps transformed into full-on, intense contractions that were coming quicker and quicker, lasting about 45 seconds in length with about 40 seconds to two minutes in between. I took a selfie when the cramping began to get really uncomfortable and, to monitor my own progress, I tracked each contraction with an app, which immediately advised me to go to the hospital (I found it funny that I was in the hospital and no one seemed to care that things had so swiftly progressed). Shortly after that, I texted Craig to come to the hospital because I was in too much agony to track contractions, take selfies, talk, or text updates to family and friends. The contractions were coming on hard and fast; I could barely catch my breath before another one started, signaling to us that I must be in active labour. Everything I read about childbirth and what I learned in the prenatal class said that when you get to the point where you say, “I cannot do this anymore!” you are about ready to push, and I definitely could not take any more pain. I could not remember ever being in this much agony, even when I broke my neck.
Following another painful cervical exam, the doctor announced that I was only a half centimeter dilated and that my contractions were not real because I was not dilating. From that moment on, my memory is foggy: I was trapped in the throes of labour, each contraction not at all like a wave, as Ina May Gaskin describes in Ina May’s Guide to Childbirth, but more like a tsunami. You can ride a wave, you can move with it, or let it wash over you, but a tsunami – a tsunami destroys you, leaves you broken, incoherent, gasping, and begging for rescue. As I fought my way through this labour, trying not to drown in it, my Mom and Craig stood by, helplessly watching me, attempting support, but ultimately being unable to soothe or calm me. To be fair, I was miserable, I was bitter, and I was angry so I was not the easiest person to empathize with, but the nurses met my suffering with unabashed criticism. When it all became too much and I was losing my resolve, I began to whimper and cry. One of the nurses turned to me and said stonily, “Get your crying out now because you are not helping yourself.”
Never had I felt so alone, so isolated, so judged, and so completely helpless. The nursing staff did little to hide their impatience or lack of empathy. They thought I was weak, that I should be able to take the pain. Eventually, when I was trying to alleviate my anguish in the shower, my mom convinced them to get me something for pain. First they tried laughing gas, which did nothing, it did not even make me buzzed let alone touch the pain. As I writhed around the bed, in utter torment, Craig turned to Mom, eyes full of heartache and whispered to her, “Is this normal?” “No,” she whispered back. Next, they tried a shot of Demerol. Again, no effect. A half hour later, they gave me another dose of Demerol and still nothing. I was told that my daily T3s had created a tolerance to the Demerol.
Amidst my furious efforts to grapple with the worst pain I have ever experienced, I was lost, and despite my cries for help, I was not heard. Powerless against what my OB/GYN later called, Tetanic contractions ("contractions coming so frequently that they merge into one sustained contraction”) and with zero control over my situation, I begged for them to, “Just cut the baby out, please, just cut him out of me!” The charge nurse’s response: “If you cannot handle this, what makes you think you can handle a post-operative incision?” Not only was I stripped of any agency whatsoever, but I was also deemed unfit and irrational – incapable of making decisions about my own healthcare. Since the reaction I was having to the Cervidil was uncommon, they treated me like the pain was not real. Experiencing this pain was beyond terrible, but to be told it was non-existent, to feel alone and irrational in the midst of it, was unbearable.
We said over and over again that my body was not reacting well to the Cervidil. We asked them to take it out, but the on-call OB/GYN wanted to wait it out. He wanted me to dilate to at least 2 cm before giving me an epidural. Finally, at 1.75 cm dilated, he called the anesthesiologist. Along with his arrival, came a nurse who understood how to help me. She assured me that my pain was real and told me not to listen to anyone who said otherwise. She validated me, supported me, truly empathized with me, and was able to calm me enough to get me through the epidural. One of the nurses commented to the anesthesiologist that I did not respond to the Demerol because of my T3 use and he laughed and said, “No. This woman is in serious pain and needs an epidural right now.” Between him and the new nurse, I was finally able to cope with my situation. Their empathy and validation alone made it easier.
Once the OB/GYN removed the Cervidil, I felt instant relief, although the contractions were still coming on strong and I was throwing up. The nurse talked me through the epidural, encouraging me, holding me (both physically and emotionally). My crazy onslaught of contractions made the anesthesiologist’s job difficult, but he was able to give me the epidural and once I had it, my temperament changed considerably and I said, “Wow, I think I can actually do this now…. I can really feel the Demerol now, I am pretty buzzed.” I was so good-natured and smiley. The anesthesiologist teased me and we discussed Milton’s Paradise Lost. I told him the contractions made me feel like Sin: the hounds of hell chained to her waist, running in and out of her vagina as though it were a kennel (I am an English major, by the way).
Minutes after the epidural was complete, the nurses were concerned about the fetal monitor1. Fitz’s heart rate had dropped again and was not rising. The atmosphere became charged with urgency as the OB/GYN did a lengthy internal examination, seemingly waiting for something, then declaring that I needed an emergency C-section. I had just received the epidural, and there was not enough time for it to set in for me to be conscious for the birth; they had to put me under to perform the surgery. I was transferred from the bed to a table and wheeled away to the OR. Craig was given scrubs to put on for the operation, but when he was ready, they turned him away saying there was no room for him. Meanwhile, in the OR, the familiar anesthesiologist stayed at my head, speaking calmly to me, reassuring me that he was taking care of me and all would be well. The nurses and surgical staff rapidly prepared both me and the room as I drifted off to sleep.
While I was operated on, Mom and Craig gathered my things and went to the waiting room. Both were shaken up, scared, worried. Craig reached out and took my mother’s hand, kissing it, grateful that she was there to share his concern. When the surgery was over, Craig was allowed into the OR to meet Fitz; there, he saw them putting me back together, stitching me up, and there he noticed a bloody, infant intubation tube. The doctor described my son as being like, “A limp dish rag,” when he was born, he was not taking his first breath and the amniotic sac was full of meconium2 (his first APGAR score was 1). In order to get him breathing, Fitz was intubated; however, he recovered quickly, his second APGAR score jumping to a 9. After Craig met him and held him skin to skin, Fitz was whisked away to the nursery for glucose and formula. I was still unconscious and did not wake until two hours after Fitz was born.
Craig was by my side when I awoke in recovery, and the first glimpse I received of my newborn son, was a photograph he had taken. Let me just say that again, I first saw my newborn baby in a picture on my husband’s phone. I cried. Craig proudly told me he had seen my uterus as they stitched me up, and then he brought Mom in to see me. Freezing from the anesthetic, they covered me in heated blankets. Still frozen from the epidural, my legs were shrouded in a machine that increased circulation. My throat was scratchy and tender, and I could barely talk. As they wheeled me to my shared room, they paused at the nursery. I met my son for the first time in a hallway. I held him for what was only a brief moment. I cried as I held him saying, “Hi Fitz, you were inside me, you are really real.” After a few minutes a nurse took him back and transported me to my room, where Craig and I waited for his arrival. I felt bereft, confused, still foggy from the anesthetic and my throat hurt badly. I wanted my child, but I assumed there was a good reason they were not bringing him to me yet. I knew he was receiving glucose for low blood sugar, but no one told me why I had to wait two more hours to have him. Finally I held him, skin-to-skin, nursing for the next six hours.
At the time, I was relieved that I was okay, that Fitz was okay, and thankful that the doctor had saved his life and that he was healthy. As the days progressed, I became more and more emotional thinking about Fitz’s birth. I was traumatized by the treatment I received prior to the epidural, the utter disregard for my pain and wellbeing. I felt angry and upset that I had no agency, that I had no voice when it came to my own body. I felt that if they had done a c-section when they determined I was a candidate, when the OB/GYN actually said out-loud that I was a candidate, instead of putting me through the atrocity that was the induction, I would have been the first person to meet Fitz: the first to hold him, to touch him, to gaze upon his perfection. I could have handled an unexpected course towards birth, but I was not prepared to lose those first moments with my son. While I am grateful that Craig held Fitz skin-to-skin in the nursery while I was unconscious, and instantly connected with our son, I mourn the loss of that monumental, once in a life time, moment of greeting my son immediately after he left my womb: of being first to welcome him into the world. After everything I went through to give him life, I was robbed of that satisfying, “It was all worth it,” hour after his birth. I cannot help but mourn the loss of that experience. I am a mother, and yet the most significant moment of becoming a mother was taken from me; I missed the beginning of my son’s life.
A week after his birth, once we were home from the hospital, I came emotionally undone: fearing that there was no picture of me and Fitz the day he was born. My husband showed me a shot he took in the hospital hallway, of me holding him, and while I was relieved to have the image it also broke my heart. I am in a bed, shrouded in blankets because I woke up shivering, puffy from the IV and anesthetic. I only held him for a few moments before they took him from me, so I cannot look at that picture without crying.
It has been two years since my son, Fitzgerald Morris Raypold, was born (September 8, 2015, at 7:27 p.m.) and I still have not resolved these feelings: the traumatic emotional pain of the birth; the isolation of not being believed; the powerlessness of not being heard or respected; the shock of being whisked off to surgery and placed under general anesthesia only to wake hours later to no baby, only a picture on a phone; the magnitude of losing those first moments of life; and an unceasing anger toward my course of care and why the Cervadil had been started, and continued, for so long.
I am still suffering and I do not know if the sadness will ever fade. Fitz and I have connected well – breastfeeding and skin-to-skin afforded us the opportunity to bond – and he is a happy, healthy toddler, but I doubt I will ever get over missing the beginning of his story. Most days I do not think about it; it is far from my mind, until it is not. Then I cry.
If you had a difficult birthing experience but don't meet the postpartum depression or anxiety criteria, you might be suffering from birth trauma and there is help! Learn more at Birth Talk and Birth Trauma Canada. You can also get one-on-one or group counselling here.