"I think I know what you want," my doctor said as I sat on the thin paper of the exam table, swollen, pregnant belly resting in my lap. "You don't want it to feel like a procedure. You want it to feel like birth."
Years before I got pregnant, my sister had an unmedicated birth. Afterward, I visited her in the hospital and saw how she glowed with power and awe from her body's accomplishment. When I decided to have children, I wanted that moment too.
In my first pregnancy with my son, I spent hours lolling about in lukewarm baths reading Ina May Gaskin's "Guide to Childbirth" and imagining how my own "natural" birth would unfold. I wanted that goddess moment. I wanted to channel my inner strength and the good vibes of my matriarchal ancestors, culminating in some glorious crescendo when I welcomed my child into the world.
Like most things in life, my fantasy did not become my reality. As it turned out, my water broke at 35 weeks. My son's birth involved an induction with Pitocin, an epidural, an episiotomy, a second-degree tear, and a birth injury that took nearly a year to heal. I felt about as far from my "natural" vision as possible.
Pregnant with my daughter, I hoped for something different. My husband and I planned to have two children, so this pregnancy felt like my last chance to experience what I wanted. My son's birth left me traumatized by the shock of his early arrival and feeling like a failure for having given in to the crushing, drug-induced pain. I felt like I wasn't tough enough, wasn't "woman enough" to birth my own baby. I was embarrassed and ashamed.
What bothered me most was the fear of never knowing if I could do it without drugs. Childbirth is not like running a marathon or training for an Iron Man. Most people get few opportunities to experience birth; it's not as if there's always another race.
Just as I entered the third trimester of my daughter's pregnancy, my doctor told me she recommended that I have a C-section. I separated my pubic bone during my son's birth, and my daughter was diagnosed with fetal macrosomia. In other words, she measured really, really big.
"The risk for pelvic trauma is just too great," my doctor told me.
I reluctantly agreed.
A scheduled, surgical, medicalized birth was not the redemptive experience I envisioned. Still, I trusted that my doctor and I were making the best decision for my health and my baby's health. Together we created a plan for my C-section to become the birth experience I wanted it to be.
Step 1: I hired a doula
A doula is essentially a birth companion. She's not a healthcare professional, but she's earned certification from DONA International to be able to assist and educate birthing people. I loved my OB, but the current state of the American healthcare system meant that she was busy with lots of other patients, procedures and appointments. As a scientific-minded individual, I wanted the best of western medicine treating me through my pregnancy and birth, but I wanted a little taste of the crunchier side too. Enter said doula.
The mix of an OB provider with a doula on the side made for a perfect combination. It was the best of both worlds. Anna met with me to discuss my goals for my birth, texted support, went on walks with me to check in on my thoughts and feelings as my pregnancy progressed, and educated me on the process of the C-section. My anesthesiologist generously granted Anna access to the operating room on the day of my daughter's delivery. My doula took photos and supported and comforted me while my husband was with our new baby. After birth, she made sure I had a care package waiting for me when I arrived home from the hospital, and she met with me, bringing homemade soup and helping me to process my experience. A doula isn't cheap. But I saw hiring Anna as an investment in my mental health.
Step 2: I requested a clear drape
This might sound strange, but yes, I requested a clear drape for the surgery. No one wants to be lying on an operating room table with a front-row seat to their abdomen being sliced open. But a clear drape is nothing like that. Being pregnant, women cannot see past the bulge of their bellies to witness any slicing, blood, or gore. Instead, a clear drape simply offers a view of the baby being born. During my C-section, a blue curtain shielded me during the beginning and end of the procedure. This blue sheet was dropped during the birth revealing the clear drape so that I could see my baby girl as soon as she made her way earthside.
Step 3: Skin-to-skin in the OR
An operating room is just that, an operating room. It's sterile, almost militarized in its efficiency, and there's a hierarchy at play. My doctor stood by her word and made sure my C-section felt like a birth and not a procedure by facilitating skin-to-skin contact with my daughter immediately after delivery. My anesthesiologist helped to pull my hospital gown down so that my husband could place my daughter on my chest. There's nothing like feeling the warmth of a new baby. We got to bond and snuggle while my doctor stitched me up.
On a crisp November morning, I woke up at 4:30 a.m. to a contraction that shook me out of a dream. Oh, that's what real ones feel like, I thought. I remember that. The contractions quickly became regular. By the time we headed to the hospital just a few hours later, they were two to three minutes apart. After laboring with a mask on, having a Covid swab up my nose mid-contraction, and finally making it to the OR, my doctor informed me that I was eight centimeters dilated and fully effaced. We'd arrived for the C-section just in the nick of time.
Aside from my husband, I found myself in a room of all women, as birthing women have for centuries.
Through the clear drape, I saw all nine-plus glorious pounds of my daughter emerge.
"It's a boy!" my husband shouted.
"Look again, dad," my doctor laughed.
She was, of course, a girl.
I watched my husband cut her umbilical cord. Anna, the doula, stayed with me and captured each sweet moment with our camera. I felt the weight of my new baby on my chest. It was a surgery; there was no getting around that. But it was also a birth.
Carrying a baby and bringing that new life into the world requires strength and power, no matter how that baby arrives. Every birthing person is a goddess and deserves some measure of awe.
Later, blessedly hooked up to a morphine drip and immobilized by a catheter, I cradled my daughter and felt triumphant. From the excitement of rushing into the operating room to the moment I first glimpsed my baby through the clear drape, I loved everything about that day. I was able to experience going into labor naturally, and I'd labored to transition. I felt like the unanswered question from my son's delivery was finally resolved. Yes, I possessed the strength for an unmedicated birth.
But in the end, why does this question even matter? Having an uncomplicated pregnancy and birth is a privilege. Having the health, youth and confidence for a home or birth center birth is also a privilege.
Sometimes, the conditions required to achieve a "natural" vaginal birth are impossible to meet. And that's OK. Because birthing women have nothing to prove. Having a C-section is hard and requires a certain level of fortitude. Carrying a baby and bringing that new life into the world requires strength and power, no matter how that baby arrives. Every birthing person is a goddess and deserves some measure of awe.
I hope to one day teach my daughter the lesson I learned from her birth.
That she is, and always will be, enough.