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My First Cesarean Client
by: Claudia E. Villeneuve
On the phone, Catalina (not her real name) had the sweetest
voice. I thought she was a teenager. When I finally met her,
she still looked like a teenager to me but she was in her
late twenties. She was excited about having her first child
and just wanted company for her birth, and I was overjoyed
to get my only second ever doula client.
We met twice before
she called me to say she was in labour. She was only starting
to have contractions but did not want to be alone with them.
I tried to get her to stay at home as long as possible but
after a few hours she felt she needed to go in. As soon as
she crossed the doors of the maternity ward her contractions
disappeared (nothing like showing up at the hospital to stave
off labour progress!). The assessment nurse monitored baby
for an hour but the contractions had gone away. We wandered
the maternity ward to get contractions going but it was so
impersonal that we tried to get her a room so that she could
have some privacy. We did and now with a room to work with,
I put my doula knowledge to work and tried to create a suitable
birthing atmosphere. I turned lights off, turned soft radio
music on, gave mom a swivel chair to sit on and lots of pillows
to lean over the bed. I chose to be very quiet while holding
her hand to get her through contractions. Nurse number 1
came in and was very silent, like we were. I figured we had
an enlightened nurse in the ways of natural birth. I was
wrong. Turning all the lights back on, she convinced mom
to get an oxytocin drip. The downward spiral had begun. Nurse
number 2 was not enlightened either, suggesting breaking
the waters as soon as she came in. She even called the resident
without the mom's permission and when mom refused the amniotomy,
the nurse made a bit of a scene saying we had wasted the
resident's time. She convinced mom to get an epidural (not
very hard to do after an augmentation) but mom still refused
the amniotomy.
Mom's waters broke on their own which
to my infinite surprise made her extremely proud of herself.
For the rest of the labour, and even after when she was told
she would need a caesarean if she wasn't dilating faster,
Catalina would remind me about how proud she was that she
had waited for the waters to break normally. She said it
was the one thing she had done in the hospital so far without
any help. The threat of a caesarean hung in the air for the
next half a day, and when she reached full dilation she was
told to start pushing. Pushing her first baby in the semi-sitting
position (the one that looks suspiciously like a lithotomy
but with your head up), with an epidural in, and strapped
to an EFM and IV was a challenge to say the least. We finally
saw the black hair of her baby's head but I think the doctor
had already decided that this was going to be a caesarean.
He did not think baby would slide under the pelvic bone and
I stood there in disbelief. I wanted Scotty to beam me up
a midwife. Any midwife would have allowed this baby to be
born vaginally by turning the mom on her side with her leg
up, or on a supported squat. Suddenly the forceps option
was offered, but inside the operating room, and I was asked
to suit up with a surgical gown.
I stepped into the freezing
cold OR with trepidation. Did I forget to mention that
I was a caesarean mom myself, who had experienced an induction,
epidural and a long threat of caesarean just like my client
did? A mom that felt the obstetrician remove her baby from
her abdomen only to be left waiting in continuous silence
for the celebratory “it's a boy, mom!” that never came?
The painful recovery from the caesarean was a piece of
cake compared to the pain of my OB and the whole surgical
team, not celebrating my baby's birth. You must imagine
then what I had been going through for the previous 27
hours as a doula for Catalina. I turned to see iodine being
applied to my client's pregnant abdomen. My client, the
one that looked like a teenager. The one that couldn't
wait to see her baby's face. The one that was so proud
that her body broke its own bag of waters. The one with
the surprised look in her face when the forceps were not
even tried. I was shushed and asked to leave after I blurted
out that forceps where supposed to be tried first. I switched
places with the baby's father and the OR door was closed
on my face. I knew what Catalina was going through, and
what her recovery would be like, what her future pregnancies
would be like, and I did not think it was fair to her at
all. I realized right there and there that I needed to
be at this birth, as emotionally crushing as it was, as
potentially career-derailing as it was, to confirm why
I became a birthing doula in the first place: To learn
from my caesarean experience by helping others prepare
to avoid one. Thinking of my home water VBAC, vaginal birth
after caesarean, I remember cuddling in my own bed a couple
of hours after the birth with both my children, and no
stomach staples at all. Guess who celebrated the emergence
of the baby this time around? Was it the awesome midwife?
No. I did.
Story published in Fall 2004 DAE Newsletter ,
published by Doula Association of Edmonton.
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