Some c-sections save babies’ lives. Some c-sections save mothers’ sanity. Then there are c-sections, like mine, that did neither. This letter is ode to those.
I know I’m not the only one. In 1970, the national c-section rate was 5.5%. Now, it’s over 32%. Yet with all these surgeries meant to save lives, maternal mortality has actually increased. This 540% increase in c-sections is not better for women and babies, and it isn’t by and large saving lives. Instead, it’s raising morbidity and mortality risk for low risk mothers by exposing them to surgical complications and accreta, traumatizing healthy people who would likely never otherwise experience the trauma of emergent major surgery, and bearing weight on families’ decisions to have more children.
I see posts of mothers from all over the country revealing they found out that their physicians had lied to them to coerce them into unnecessary and unwanted c-sections for various reasons – to control timing and scheduling or because the physician lacked skill or confidence in catching a breech or VBAC baby. Of course these real reasons are rarely admitted. Instead a non-evidence based reason or flat out lie is presented as reasoning. (“We can’t deliver vaginal breech birth,” and, “Your baby won’t fit through your pelvis,” are two of my favorites). These lies from our trusted physicians then are passed on from woman to woman, until the truth is hard to locate.
But worse, another more insidious set of lies is being passed around the parenting community: that women want all these unnecessary c-sections. That if neither mom nor baby died, then no harm was done whether there was unnecessary major surgery or not. That moms should just be grateful they and their babies are alive, because some women and babies aren’t. These lies are first told by medical staff to mothers, and then mothers bring these lies home and into their communities.
These lies which are spread to keep peace between the medical community and families, to dismiss questioning mothers, are the most harmful of all. Because these lies are the ones that make mothers – mothers who go home with their newborns and sit awake, alone, in the still hours of the night – question themselves. They think, “Why am I not at peace?”
I’ve seen love letters to c-section scars, love letters making peace with an unwanted procedure that ended in a much-wanted baby. A bittersweet way of saying: The ends justified the means.
While some people might feel peace and acceptance reading these sentiments, I do not. Because my c-section was not my choice. Nor did the ends justify the means at all, since my c-section was not medically indicated, but mandated.
When I look at my scar, I don’t see a badge of honor. I don’t see a mark of my bravery or fondly remember my physician as my baby’s gallant savior.
I see assault and battery.
I see trauma.
I flashback to me, alone, violently shivering on a cold metal operating table while I watch my insides in the reflective operating lights. I see me crying and calling out for help. I see a team of at least five people pretend they don’t hear me and pretend I am not there at all, until I feel so insignificant in my own body and birth that I think, “This is death.”
Much like a hostage situation, I was drugged on opioids then completely numbed and paralyzed from the waist down, yelled at, and wheeled into an operating room. There, the on-call OB gave me a speech with a smile about how I “couldn’t control everything” and “needed to let go and let God.” The irony of someone about to cut into me to take personal control of my textbook labor, yet lecturing me, rendered paralyzed and powerless over my own body, was too much. I tearfully begged and pleaded that I was scared, and I was fully ignored. When my baby cried after they had cut me multiple layers deep and wrenched her out of my pelvis, I cried out for her several times, and was again met with silence. Multiple humans, bent over a new mother’s open body, heard her crying out for her newborn baby and said nothing.
Even more devastating was that it was all for nothing. The despicable care that I was given was not about saving my baby’s life or mine. It wasn’t even slightly justified as an emergency requiring swift, life-saving action. It was just more convenient for the staff, and my humanity, dignity, and health were a lower priority.
Months later, when I was finally able to negotiate getting my daughter’s heart rate strip and my birth records from the hospital, but only after an email citing my HIPPA rights, I saw the truth. My daughter’s life was never in danger.
When the nurse disconnected my bed and started rolling me back into the OR without explanation to me or anyone else, pushing my doula and husband out of the way, I assumed it was an emergency. Yet, everything seemed…off. The nurse seemed to oversell it. She was just a little too dramatic. My doula, on the other hand, looked calm. I was calm. And the records showed my baby was calm. Her heart rate, having decelerated between 8 and 9cm once after the epidural and after they broke my water against my consent, had stabilized completely. And that’s when the nurse decided to roll me into the OR.
She simply grabbed the edge of my laboring bed and rolled me into the hallway. She didn’t tell me what she was doing. She didn’t explain risks, benefits, or alternatives to a c-section as the operating OB fraudulently recorded in my chart. She didn’t even let me know she was rolling me into surgery for a c-section. She just pushed my bed and went with me in tow, like an inanimate object.
Then, she leaned over me in the hallway and yelled into my face. She was so close I could feel her breath on me. “This is about your baby now, Sara. Don’t you care about your baby?” She didn’t want an answer. She wanted to scare me. Then she pushed me the final few feet into the OR.
The operating room was ready, and the team was scrubbed, but no one was in a hurry. A young chipper nurse came to my side and told me she was going to shave my pubic hair. Drugged, terrified, and confused, and now without my husband or doula by my side, a sneaking terror crept into my mind. Was this really an emergency?
Having gone through 9 cm of unmedicated labor, they decided to extract my baby, for no medical reason, at 2 am a week before Christmas.
They billed the surgery and anesthesia to my insurance as an “emergency c-section” for about $60,000.
This hospital was also my employer.
This was my birth in the United States, in Northern California just a couple hours North of Sacramento, which is home to some of the best birth facilities in the country.
Yet here, in this rural mountain community, I was treated as if I was less than human and not deserving of basic human dignity.
When I undress to take a shower, get out of the shower, pull my pants up or down to use the restroom, I see this scar.
It’s jagged, as if the OB sloppily or purposefully undulated the scalpel. One side is nearly an inch higher than the other and is visible above my underwear line.
My c-section scar is a sign of ultimate disrespect of my body and myself as a mother.
My c-section scar represents what a power struggle over a woman’s body looks like in the birth room and how it ultimately ends.
My c-section scar is a source of physical pain, undue suffering, emotional trauma, and a testament to how greed and misogyny in obstetrics personally affected me and my entire life. My marriage – my husband and doula, who I originally saw as my protectors – my assumption that I could protect myself and my daughter. All were upended.
How, I thought, can I teach my daughter that her body is her own, if one day I know our culture could render her powerless over her bodily autonomy during one of her most potentially powerful rites of passage? And then feel justified in doing so?
This thought devastated me in the hours after she was pulled from my body.
I cannot protect my daughter, and I cannot protect myself.
This is what I see when I look at my c-section scar.
I see one experience, replicated by the thousands all across the United States, where women are regularly coerced and forced into unnecessary c-sections with fraudulent information, threats of the death of their baby, and then supported with refrains from friends and family admonishing women that “at least they have a healthy baby.”
I see a 540% increase in our nation’s c-section rate since the 1970s.
I saw reluctance on the part of accountability boards and hospitals to fairly or accurately investigate maternal health complaints.
I saw corruption.
I heard multiple attorneys tell me they wouldn’t take my case and could hear the laughter in their voice as I told them about my unnecessary forced c-section. It just didn’t sound that bad to them. One asked, “Is the baby okay?” and after affirming yes, she discounted my complaints of abuse and assault.
Because in the United States, in birth, the ends justify the means.
And when I look at my scar, I do not see selfless, pure of soul self-sacrifice. I see that I was sacrificed against my will.
When I see my scar, I see how I am not valued as a mother and a woman in our culture, and I feel betrayed and alone.
My scar and my assault are one. The birth of my daughter and my assault are one.
Dear c-section scar, you show me that I am not safe as a birthing person in this country, nor are the countless women taken advantage of during labor and birth every day. Dear c-section scar, you remind me of my most powerless moments when they should have been my most proud. Dear c-section scar, you remind me of my place as a mother in our culture. Dear c-section scar, you remind me of my assault.
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This blog post is part of the #IsMomOK initiative. The time is now to share our stories and appeal to the medical community to take pause and listen, really listen.
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Author: Sara Conrad
Sara Conrad is the author of Csectionmama.org. She has a BA in journalism and English from the University of Iowa and was a student of the Iowa Writers’ Workshop. The former journalist and feminist magazine editor has always advocated for women’s rights. A survivor of birth assault, Sara works to stop obstetric violence and improve maternity care by working with Birth Monopoly and on the Board of ImprovingBirth.