Change #12: Prepare Mothers and Fathers for Cesarean Birth

Dear Peeps,

One way to change the experience women have giving birth in our culture is to warmly, honestly prepare them for all kinds of birth in our culture. That includes cesarean birth.

Have you noticed how many times the mother who is in birth shock or shame after a cesarean is the mother who did not read or ask about it, because she truly believed it would not happen to her? (With the rising cesarean rate, even if it "shouldn't" happen to her, it might.)

If you were to ask her (or the father) what would have helped, she (or he) might say--"I wish I had known what to expect. It was such a shock."

We must not put the onus of holistic preparation on uniniated mothers or fathers, i.e., "if they don't ask, we won't talk about it." Mothers and fathers who are not prepared suffer terrible emotional shock, not from the surgery itself, but from their own innocence, cluelessness, self-judgment, and being so overwhelmed, that they disconnect to get through it.

Even when the tide of unnecessary cesareans turns back, some women will have cesareans. So, cesarean preparation must become part of holistic preparation. All mothers, fathers, other mothers and their birth partners need to be prepared to give birth-in-awareness by cesarean.

In the birth trauma work I do, story after story, is not about the cesarean itself, but the shock of not knowing what to expect, or what to do, or what it means about her as a mother. On the other hand, BFW mentors have often heard thanks from parents who, because of the sensitive role-play class on cesarean birth-in-awareness, were prepared and much less traumatized.

Parents who see midwives, doulas, and take classes--and hear not a word about what to do during cesarean birth--often feel betrayed. Oddly, not talking about cesarean preparation prenatally adds to their feeling of shame because the people they trusted (i.e., the people who 'trust birth') did not talk about it. Silence sends a meta-message something like, "cesareans are something that happens to unprepared, uncommitted women, or women who don't have protection from information and doulas."

When birth peeps (or even friends) talk, straighforwardly and warmly, about giving birth by cesarean in-awareness, we model acceptance and strength. If we have rapport with the parents, they embody our acceptance and strength. Think of this as an emotional homeopathic dose of Medicine against shame, withdrawal, the pervasive feeling of failure. And, if she does have a cesarean birth, she knows she has an ally in us: we dared to talk about it!

If you are one of the people she trusts (one of the people who 'trust birth') and you talked about giving birth by cesarean, even if you are not with her in the operating room, she knows you are "with her." She knows she can come talk to you later.

Not all birth peeps can talk about cesarean birth warmly and without bias. Some need to first go through a period of healing their own birth trauma or agreements against cesareans or cesarean parents. Then, it can be done.

There are many ways of teaching about cesarean. Some send tacit or overt messages of judgment, with reasons and ways to avoid cesarean at all costs. The positive intention is to scare or motivate a woman not to "choose" a cesarean, but in labor, we all know that "choice"and informed consent are nebulous,gray areas.

When I teach couples about cesarean birth, I feel it is a ceremony, an initiation into self-acceptance and envisioning themselves coping--even with an unwished-for cesarean. The teaching is about embracing oneself, not about avoiding and regretting.

Fathers and other mothers experience cesarean birth from an entirely different perspective. They too need support and preparation; they too, can be traumatized by lack of preparation. If we don't tell them, they will be so overwhelmed by the surgery environment. This week I worked with a lovely couple who was unprepared for cesarean birth, but had one. The baby was born healthy, taken to the baby table for the baby dry and wrap ritual... then given to the father and escorted out of the room to the nursery. The mother never saw her baby. ... not until hours later in the recovery room. This father had no idea he could take it to his wife, the mother.... and help her see him, hold him, on the operating table. He was utterly overwhelmed and shepherded out of the operating room without a clue of the options. Their experience would be so different if ...if only.... they had been prepared for cesarean birth-in-awareness.

Some of you may already be doing this. And for some, it is so counter-intuitive, you can't imagine how to talk about cesarean birth without sounding like you are "approving" it or hypnotizing them to give birth by cesarean. These are important considerations. It can be done though. If you want to learn one way to do this, take an introduction to mentoring workshop, or contact Birthing From Within for a phone class.

There are many ways to change birth in our culture. It's not only about changing the medical protocols and rituals, but in preparing parents to birth in the culture they are actually birthing in, and not the one we wish they were birthing in.

In-Love,

Pam