Learning lessons through Birth and Motherhood
Becoming a mother is the biggest transformation a woman can go through, it’s a full metamorphosis of mind, body, and spirit. The precarious journey involves creating, carrying, birthing and parenting, with each of these stages having its own unique challenges, and the sum of all these parts resulting in how we feel in this new role as mothers. There is pressure from society to get this role ‘right’ and pressure from within ourselves as women for the process to feel right. It’s been a wild ride for me personally and by far the most testing experience of my life has been through this initiation of becoming a mum. I’ve given birth twice and I still wrestle with how my experiences make me feel, were they traumatic or triumphant? As much as we humans like to put things in boxes, it just isn’t that simple. As time passes, like with any traumatic or seismic event, if we do the work to heal, perspectives can shift and there is a maturing. We can take the learning from one experience into the next with a little more trust within ourselves to make the right decisions going forward.
I have a nine month old and a two and a half year old. It took my husband and I nearly three years to first fall pregnant, needing every intervention that comes before IVF. We were about to start IVF when Covid hit and elective procedures/surgeries were halted. I quit my job in the hope that less stress and travel would help conception and I had to fore-go the long awaited maternity leave. A year after leaving that role, conception happened without the IVF treatment, however the pressure had started to build within my marriage, financially and in my psyche.
Then came the first brutal pregnancy. A blow I just did not see coming. I thought I was healthy and fit, so why was I so sick from something women go through all the time? I’ve now had two extremely hard pregnancies in a three year period and by-George do they take their toll. There isn’t much that can help with Hyperemesis Gravidarum and vomiting multiple times per day, and for me the anti-nausea/vomiting medications gave me adverse side effects of headaches and migraines, which I was suffering from anyway, so it was a battle faced unsupported. I couldn’t work, rest or play and without my coping mechanisms of the ocean and exercise (as I was often bedridden) my mind went to some dark places as I longed to get my life back and to feel well. It wasn’t a good start.
In spite of this I tried to prepare myself for birth and I wanted one that was ‘natural’, with the least amount of medical intervention possible. In the end, the polar opposite happened. Twice. Two emergency caesarean sections after labouring for roughly 22 hours each time. There is something poignant about how a child enters the world during the birthing stage. It tends to set a mother up for the next chapter, arguably the toughest stage, as we are thrust into a new dimension with little knowledge or practice on how to be responsible for this tiny human. Birth trauma rates in Australia are climbing, with 45.5% of women feeling like they have suffered from some form of it (1). And 70% of women who have c-sections for their first births, report them as traumatic (2). Obviously there are scales of trauma, but I definitely felt some version of it after my first was born, and I subsequently carried it with me into the mothering phase with bouts of post-natal depression and physical challenges as I tried to recover. A friend once likened challenging births to being in a traumatic accident, then starting a new job the next day without being allowed to sleep for the foreseeable future. Again, not a flying start. I would oscillate between feeling like I had failed and I was the one to blame for not being able to deliver naturally, and then being angry at the medical system for letting me down and not supporting me. Knowing what I know now about what gives a woman the best chance of delivering ‘successfully’, I feel like I made some wrong decisions leading up to the birth and that put me in a situation where the odds were against me.
After the birth I experienced my first foray into motherhood during Covid, it was isloting and precarious like the ocean can be. At the best of times the fourth trimester can be fraught with obstacles and unpredictability. If you enter into this phase carrying trauma from birth or pregnancy, it can be extremely difficult to get back behind the helm and redirect the ship. See, you have precious cargo on board now. The stakes are high. They’ve actually never been higher. As your boat launched and your body birthed into the high seas for its maiden voyage it acquired unexpected and unwanted damage, there are now holes in the hull, water is leaking in weighing it down, the ship is sinking quicker than you can repair the damage. You need a team to help patch up the holes before the boat is entirely submerged. But where is your crew? Who is your crew? There were so many people with opinions and advice during your pregnancy, did they disembark during the storm? You are exhausted, beaten, overwhelmed, confused and there is more uncertainty ahead as the ocean decides at a whim if it is a friend or foe. You wish for calm waters, but what you want isn’t taken into consideration, it’s out of your hands.
After making it through that first year, I finally came up for air but then unexpectedly fell pregnant again when my daughter was 14 months old. Although I was grateful the conception happened with ease this time, I just wasn’t ready. I wasn’t ready physically for another intense pregnancy (I had Hyperemesis again coupled with endless post-covid viruses and infections) and I wasn’t ready for the unexpected emotional battle that lay ahead of us. See, for my second birth I now fell into the Planned VBAC category (vaginal birth after caesarean), a group I wish I wasn’t a part of and is why a woman's first birth steers the decision making for the second. My husband and I were incredibly challenged by our decision to try for a natural delivery. My body felt like an election where everyone had an opinion and could vote, with there being the far left-wing and far-right wing groups weighing in. The reluctance to let women plan for a VBAC comes from the 1 in 200 chance that during labour the previous c-section scar can rupture (3), which can be catastrophic. However there is criteria that is factored in when assessing a women’s potential success and many women who choose to give birth vaginally after having had a previous caesarean section are successful (4). We fought doctors, family, and friends who tried to coerce us into having a planned c-section. My doctor even told me that I had white privilege and that if I was in Africa I would jump at the chance to have a planned c-section if it was offered (of course being due at Christmas had nothing to do with it). When I was in labour, the midwife who greeted us on arrival at the hospital said that I shouldn’t eat or drink anything while labouring, because I was a VBAC attempt and will most likely end up in theatre under a general anaesthetic. Talk about setting me up to fail as I am about to embark on the hardest journey of my life. Planting a seed of doubt like that in an already uncertain mind gravely impacted me going into that labour.
Despite navigating this unforeseen challenge during the pregnancy, we stayed firm on our decision to try naturally if I went into spontaneous labour before 40 weeks. And that I did, early Christmas morning. Ironically, that was the day I myself was due to be born, however my mother was also pushed into having a planned c-section, as she too had a c-section for her first but no other health complications for her pregnancy with me as her second. This felt alarmingly close to home, as intergenerational trauma had very much come into my consciousness when I was researching births. Relations with my mum were tense when we spoke of our family’s birth history, was history repeating itself? Was there unresolved trauma I was holding onto back when I was born? Or even from when my mother was born and I was a mere egg in her ovaries? Excitingly, the growing field of epigenetics is unravelling this mystery and my hope is we learn more about this topic in the near future to help guide and prepare new mothers.
When the second birth didn’t go as planned, the familiar sense of failure reared its ugly head again. I felt like I’d let my family down, my baby down and myself down. I realised one of the surprising places that this feeling of inadequacy was bubbling up from, was from the language people used when describing births, particularly other mothers and peers. I started to notice that if women gave birth without intervention vaginally, they described themselves as feeling powerful and exalted, some even bragging about their experience (thanks social media). It appeared they were holding themselves solely responsible for the successful outcome of the delivery with no mention of other variables. Yet, alternatively when I gave birth and I was deeply disappointed, people in a bid to reassure me shifted the focus from me to all the other variables dictating the outcome; baby’s size, baby’s position, the environment, the intervention and delivery team. This inconsistency around what determines why a birth is successful or not can leave the ‘unsuccessful’ mother grappling for validation of her experience and leave the ‘successful’ birth mother on a high. Since I didn’t get to experience those feelings of elation and what I see as a rite of passage as a woman, does that mean I am less than? Is that the standard society is measuring me against, my ability to birth without intervention? Of course intellectually I know better, but there is a deep conditioning in me that struggles to feel otherwise. Something as subtle as language can have a huge impact on a woman’s psyche right after birth as hormones are going ballistic and we are on the precipice of stormy seas. I salute these women for birthing naturally, but feel compassion for those who couldn’t (for whatever reason) wouldn’t go astray. Ultimately some women will need intervention, just not at the rate we see in Australia where for example the 38% c-section rate (5), is the highest in the world. Where possible women should be given the resources and tools to explore birth options without a fear-based approach. Striking a balance here is paramount.
As I agonised with the feelings of disappointment in that postpartum phase, I realised there was a small sense of empowerment creeping in when compared to my first birth, because this time we had the support of a couple of amazing midwives who guided us the whole way through and who we could trust. We were making informed decisions, we had done our research (a lot of research) and the decision didn’t feel reckless. That allowed me to feel courageous when faced with adversity which seems to be a common theme for me during pregnancy and birth. And yes, it didn’t go as planned and there was sadness. There were more tears than I’d like to admit. But I had moments during that labour of greatness, awe and gratefulness. Still, what was the lesson here? Did my husband and I make the wrong choice because it didn’t go as planned and we consequently compounded more trauma onto ourselves? Admittedly I was confused, physically broken, and grappling with what had happened after such an arduous lead-up. The hard pregnancy, the mental battle against ‘the system’ and then the birth had depleted me beyond recognition. The experience didn’t feel like how bringing a child into the world ‘should’ feel, there was no joy yet, just struggle.
Alas, everything happens for a reason as they say and this became clearer three months later when a doctor feared that I might have bowel cancer. After a second failed attempt to remove a giant polyp in my bowel via colonoscopy, he instructed me to get major bowel surgery immediately (a bowel resection, where they cut out a section of your bowel). The prospect of this surgery, including the recovery and the ramifications of something going wrong, was deeply concerning. I felt utterly stunned, like a deer in headlights helplessly watching the on-coming crash about to happen. How could I be back here so soon in a position of making hard-core life decisions about my body and health again? I was desperately craving a break from the brutalities of life. I questioned and imagined everything from my own mortality, to life as a disabled mother (if I needed a Stoma bag), to the pressure that was looming on my family as I needed caring for again.
Once again, my family, doctors and friends strongly encouraged me to take the path of the surgery. Trust your doctor, they said again.
Again, I didn’t take that path.
After coming to my senses just days before the surgery I hunted down some second opinions. I went into research mode, networked and called private mobile phone numbers of other doctors to explore options. It turned out that there was another solution. There was a specialist group of Gastroenterologists who could remove the potentially fatal polyp via colonoscopy and also who could stem the bleeding if that were to happen (quite likely), without the need of bowel surgery. I flew interstate to Sydney to get the procedure and it was successful. All pathology and histology showed no signs of cancer. I have never in my life felt relief like it. By avoiding the unnecessary surgery, I dodged a major bullet. Finally my efforts had paid off and there was an immense satisfaction in knowing I could (and should) trust my instincts. However, trusting your instincts as a birthing mother is more difficult because another life is involved and there is pressure to do everything with literally zero risk, not low risk… zero risk. But this strips the mother of a human right. The right to have sovereignty over her own body.
The bowel complications shone a light on the lesson I was trying so hard to make sense of after the two c-section births. You must advocate for yourself, especially within a flawed system. No one else will take your life as seriously as you. You have everything to gain and nothing to lose when you investigate options around your health. Even the people with your best interests at heart, even the ones closest to you may get it wrong and lead you astray unbeknownst to them. Doctors too are only human and can often favour following procedure over what is best for you personally. One decision in the day of the life of a doctor can be a major sliding door moment for a patient, impacting their entire life. During that second pregnancy I had a lot of practice challenging the status quo, advocating for myself and asking uncomfortable questions. It was unnerving, hard, and required a truck load of perseverance and most importantly courage. You could say that it was in vain as the birth still didn’t go as planned and involved trauma, however for me, the alternative of getting pushed into doing something that didn’t feel right for me or my family and that wasn’t 100% necessary, was worse. I would have felt victimised and disempowered and this is a dangerous place to live in. I didn’t realise it at the time, but it turns out the second birth was both disappointing and empowering. Because even though the odds were against me as I learnt late in the game that only 12% of VBACS are successful in a hospital setting versus 70% in a home setting (6), at least the birth was on my terms. I faced challenges during labour that other women don’t and even though it ended with a c-section, I had to harness great strength to get through bringing my daughter into the world.
Australia has a long way to go to decrease birth trauma rates, and we should prioritise this as a nation, as this trauma doesn’t just affect mothers and babies, it affects partners, families, and communities as it ripples outward. A woman is never more vulnerable than when getting initiated into the role of mother, so every single person on her team needs to be in her corner, as just one bad egg can really spoil the broth. As shame researcher Brené Brown summarises in her novel Daring Greatly, “Our willingness to own and engage with our vulnerability determines the depth of our courage and the clarity of our purpose; the level to which we protect ourselves from being vulnerable is a measure of our fear and disconnection.” Many things are out of our hands during birth and motherhood, but how we show up for the decisions we do control is what counts, and I will continue to choose courage over fear anyday.
References:
K.L. Alcorn, A. O'Donovan, J.C. Patrick, D. Creedy, G.J. Devilly
Keedle, H., Peters, L., Schmied, V. et al. Women’s experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia. BMC Pregnancy Childbirth 20, 381 (2020). https://doi.org/10.1186/s12884-020-03075-8
Chauhan SP, Martin JN, Henrichs CE, Morrison JC and Magann EF (2003) ‘Maternal and perinatal complications with uterine rupture in 142,075 patients who attempted vaginal birth after cesarean delivery: a review of the literature’, American Journal of Obstetrics Gynecology, 189(2):408–417, doi:10.1067/s0002-9378(03)00675-6.
RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) (2019) Birth after previous caesarean section - external site opens in new window, RANZCOG, accessed 11 May 2022.
Keedle, H., Peters, L., Schmied, V. et al. Women’s experiences of planning a vaginal birth after caesarean in different models of maternity care in Australia. BMC Pregnancy Childbirth 20, 381 (2020). https://doi.org/10.1186/s12884-020-03075-8
1 - Pregnant and bedridden in between spews. 2 - Just after the birth of my second baby. 3 - Two months in an finally at the creek