Processing a CBAC

For this first day of CBAC week, our topic is processing your CBAC.  This is such a hugely important, and personal, topic for CBAC moms, and I’m going to present you here with the thoughts of three women–myself, Amy Shireman, and Melissa Tyler-Belmonte–on the issue.  I encourage you to leave comments below or on our Facebook page with your thoughts on how you’ve processed, or are processing, your CBAC.

Melek Speros

When my CBAC birth story was first published on the ICAN blog a couple months after my baby’s birth, one comment on it really stuck out to me.  It was from another CBAC mom who told me that my feelings about my CBAC would “…ebb and flow, and will vary a lot over time, even when you have had a relatively positive experience.”  “WHAT?!?” I thought to myself upon reading that.  I was (and am) still riding the high of an empowered pregnancy and birthing experience–a totally different kind of experience than the birth of my first son.  I had unintentionally gone in to my birth expecting to be devastated if I wound up with another cesarean birth–I even cried during labor to my midwives that I would never have a baby again if I had another cesarean.  So I was more than pleasantly surprised to have only positive feelings about my son’s birth. When I woke up from the surgery, the first thing that popped in to my head was “Whoa!! That was awesome, I can’t wait to do that again!” (Of course, hoping that next time it would end in a vaginal birth :))

Around month 8 postpartum, what should have been a minor and easily resolved misunderstanding between friends revealed to me that I had left out a really big part of my healing process.  While I celebrated the joy and beauty in the birth of my son, I neglected to give myself space to mourn the loss of the vaginal birth I had worked so hard for.  Through copious and highly emotional email exchanges with a fellow CBAC mom friend who helped me to work through it, I finally gave myself the space to grieve.  And I cried and cried and cried.  I’m crying now even typing about it.  I wanted that vaginal birth so badly and, you know what?  It kind of sucks that I didn’t get it.

In my birth story, I wrote about giving myself permission to feel whatever came along with his birth.  I realized after my minor emotional breakdown that I hadn’t given space to the feelings of grief that came up, not right away, but later on down the road.  I think a big part of me felt like giving breath to those feelings might somehow take away from the amazing experience that was my CBAC.  But I learned the two aren’t mutually exclusive.  Being sad that the vaginal birth I wanted so desperately didn’t happen doesn’t mean that my birth was any less powerful or sacred.

And I think that’s the biggest lesson I’ve learned thus far on my journey.  Give yourself space, freedom and permission to feel whatever you need to feel about your CBAC whenever you need to feel it.  Your feelings on day 1 may not be the same as they are on day 5 or day 17 or day 397, but whatever your feelings are, they are yours and they are valid.

Amy Shireman

Coming to Terms with My CBAC

By Amy Shireman of Shirebacon.com

My older son, Jack was born just over three years ago via a “planned” c-section.  I use the quotes because it was planned for all of two days.  He turned breech at my 39 week OB appointment.  I had a c-section two days later.  From the second I found out that I would give birth to Jack via c-section, I knew that I wanted a VBAC.  When I was admitted for Jack’s birth, my nurse could tell that this was not what I wanted.  As she calmly reassured me, she mentioned a VBAC and that practice I was with had an excellent VBAC track record.  I was beyond thrilled.

Fast-forward two years and I am faced with a decision.  After WEEKS of very strong contractions, I am not dilating past “maybe 1 cm”.  A decision is needed.  Either a RCS or an induction.  I chose induction with a foley cath followed by Pitocin.  I knew that my decision to be induced increased my chance of another c-section but I was positive that it wouldn’t come to that.  I was wrong.  After 20 hours of labor, 8 hours stuck at 7 cm and an amnio-infusion, my little boy was having heart decels, my progress had stopped and no one (including myself) was comfortable continuing labor.  And thus began my unexpected CBAC.

I had done a few things while I was pregnant to cope with a possible CBAC.  First was to accept that it was a possibility.  The other thing I was to have a birth plan of sorts.  Not a true plan, but a wants/doesn’t want kinda list.  No it didn’t sting any less when my doctor sat on the side of my bed, took my hand and told me she recommended a c-section, but I didn’t feel blind-sided like I did last time.  And it allowed me to have some control over what was happening.

When I came home from the hospital after my CBAC, I felt good.  I had labored for 20 hours!  No, I didn’t push, or give birth vaginally, but I had done more than the 1st time around when I hadn’t felt a single contraction.  The medical staff had done everything that they could to avoid another c-section and I was happy about that.  I was disappointed, but I felt OK about my decisions.  And I was OK about not giving birth vaginally.  Or so I thought.

Over the next several months, a few things happened.  My husband and I decided that we were, in all likelihood done having children, people I knew had successful VBACs, I had to leave my OB for insurance reasons, and my sister announced her pregnancy.  And that’s when it happened.  I had a complete breakdown.  I was mad, I was angry and I was sad.  I realized that I would likely never have the vaginal birth that I so desperately wanted.

I had a long talk with my husband.  He tries very hard to understand and he pointed out one very important thing to me.  After Jack was born, I talked about my c-section all the time.  I talked about my disappointment and my desire for a VBAC.  I talked about the c-section itself, I talked about my recovery.  After Xander was born, I didn’t talk about at all.  Maybe it was being busy with a 2 year old and a newborn, maybe it was my easy recovery, but more likely it was denial.  I never allowed myself to process the CBAC like I had done with my first c-section.  On top of my disappointment, I needed to deal with the fact that I would likely not have any more children and never give birth vaginally.

So I started talking about my CBAC.  I started blogging about VBACs, my boys’ birth stories, my feelings.  I connected with some other moms who have had CBACs, I’ve listened to women who had similar feelings about their c-sections and I’ve shared my feelings.  I was starting to feel much better and then BAM! I was blindsided. Twice.

I saw a request on a blog for “unnecessary c-section stories.”  A blogger who was training to be a doula wanted to highlight unnecessary c-section stories and what could be learned from them.  Neither of my c-sections were unnecessary, but I emailed the blogger anyway.  I offered to tell my stories and she proceeded to essentially tell me that I was wrong for being induced, wrong for trusting my doctor and wrong for agreeing to either c-section.   This after I literally explained my experiences in 3 sentences.  I was FUMING.  I wrote a blog post, I engaged in an email exchange with her, I yelled at my husband about her.   She accused me of being defensive because in my heart I knew that I was wrong in my choices. I finally just had to stop. I wasn’t going to convince her otherwise and I didn’t need to convince her.  My feelings and opinions are the only ones that matter and I without a doubt know that I did the right thing for me and my boys.

Then in early August my niece was born.  After my sister told me she was in labor, I waited by the phone and was beyond thrilled when my sister called to say that she gave birth to a beautiful healthy little girl.  You guys, I’ve never admitted this to anyone before.  After I got off the phone with my sister, I cried.  Not tears of happiness.  Tears of jealousy.  I tried SO HARD to have a vaginal birth.  I did everything I could and it still didn’t happen.  I researched everything I could, prepared every way possible and nothing.  My sister? I love her to death, but she’s not a researcher like me.  She basically just showed up at the hospital and 8 hours later had a baby.  I felt like a horrible person for being so jealous.

Later that night I was on Twitter and saw someone tweet something that really put things into perspective.  It was someone who struggled with infertility.  Someone close to her got pregnant super quickly and she basically said that she was insanely happy and insanely jealous all at the same time and that she was glad that she was in a place where she knew that it was ok to be jealous.  That’s when it hit me.  I had to see the words to realize that it was ok.  I’m allowed to be jealous and happy at the same time.  I can feel both at the same time.  And that jealousy is part of my healing and acceptance process.

These two events have helped me immensely in coming to terms with my CBAC.  And I know it’s a process, one that continues even 13 months after my CBAC.  I still have my moments and I suspect that I will always carry with me some amount of disappointment over both my c-sections.  But the important thing is that I know that it’s ok to be disappointed.  I know that my feelings are my feelings and  that it’s not “wrong” to have them and that just because it’s been more than a year since my CBAC, I don’t have to be over my disappointment.  I have connected with a lot of people who I can turn to when I need someone to listen to me or encourage me.  I am forever grateful for that.

Melissa Tyler-Belmonte

Many women, myself included, have planned VBACs (vaginal birth after Cesarean) or HBACs (homebirth after Cesarean).  I, myself, had a planned HBAC turn into a CBAC in 2007. After my birth, as I began processing my experience and my feelings, I turned to the internet birth community for help – and found not much out there. There were many triumphant, happy VBAC/HBAC stories (and of course, I cheered internally for every mama out there who was blessed with the birth they wanted) but only a smattering of women talking about their experiences with unplanned CBACs or “failed” homebirths/VBACs. At the time, I was also not able to find a local ICAN chapter to share my experience with. Feeling unrepresented in the birth community was a sad thing for me, but I continued on my journey processing my birth and trying to find and talk to other mothers who had been through the same thing as myself. I am thrilled to be contributing to the ICAN Blog on this topic, and I hope that “CBAC Week” will be an invaluable resource to all the C-section/CBAC mamas to come!

To sum up my own experiences, I had my first C-section in 2004 for breech presentation, amongst other issues. I planned a VBAC for my next baby as soon as I knew it was a possibility. In 2006, I found out I was carrying twins. Still determined to VBAC but being turned down by OB/GYN providers as a VBAC candidate due to the twin pregnancy, I found a homebirth midwife who would accept me as a patient. Unfortunately, due to breech/transverse positioning and stalled labor causing failure to descend once I hit 10 centimeters, I underwent a subsequent C-section to deliver my babies after over 24 hours of labor. My extended birth stories can be found here.  My “failure” to HBAC hit me like a train – it was so unexpected, something I had hardly considered as a possiblity. I had been so pumped up by most birth literature that I was doing what my body was designed to do, I had done everything “right” for optimal fetal positioning, I had worked hard to stay pregnant as long as possible, including enduring a ridiculously high-protein diet and spending most of my time resting despite having a toddler. I refused to let negativity into my space – I didn’t even pack a hospital bag. I was in no way prepared to walk into a hospital and acquiesce to another Cesarean, but it happened.

My first step of processing happened before the C-section even occurred. I made it a point to say to hospital staff “I am here for a Cesarean.” I knew that my chances of being “allowed” to VBAC at the hospital were almost nonexistent, and I knew that if I asked for a C-section when I walked in rather than having it pressed on me by hospital staff, I’d feel better about it later. It was my way of taking control of the situation, and keeping it my birth, rather than the birth the hospital gave me. Obviously, that is not an option for women who have already gone through their unplanned CBAC – but this tip may be helpful for anyone making a contingency plan for a CBAC, should their VBAC/HBAC not happen as they planned. Indeed, asserting myself and calling the shots was also a major factor in planning a peaceful, empowered CBAC with my fourth child. I think that most birth trauma stems from a loss of control of your birthing experience – so planning ahead of time ways you can remain “in the driver’s seat” even if your birth plan goes awry is a great idea.

My second tip is to ask for help. So many of us who have planned VBACs or HBACs planned to be mobile shortly after birth, able to care for ourselves and our children with relative ease, and may not have planned ahead for the alternative of surgical recovery. Be vocal about your needs with family and friends. Don’t push your body too hard – allow yourself time to recover and allow those around you to pick up your slack while you recover and enjoy your baby. Don’t feel compelled to “make up” for your birth outcome by being Super Mom – this was my mindset early on, and I definitely extended my recovery days and possibly even weeks by doing too much. Be gentle to yourself, respect your body’s need to recover. This tip is especially important if you labored before your CBAC, and especially if you labored for a good long while – your body went through labor AND major surgery! And most importantly, asking for help allows you time to rest and focus on emotionally processing your experience.

Emotionally, coming home to find the birth paraphernalia – the birth pool (drained, but still inflated,) some gloves, part of the birth kit – still out and around was perhaps the most difficult part of the experience for me. I allowed myself to have a bit of an emotional breakdown while my husband removed the pool and the other items. Allow yourself to process through emotion – whether it’s crying over the loss of your desired birth, or laughing over memories of the process. Bottling it up to deal with later is tempting when you’re exhausted and have a new baby to care for and family coming in and out visiting, but this step is vital. And all kinds of emotions are to be expected. I experienced grief over the loss of my experience, shame that I wasn’t strong enough to push my babies out, pride and wonder at how well I had handled labor, anger at the family members who told me “I told you so,” and, due to the circumstances of my CBAC, relief that everything had turned out okay and that the complications I experienced hadn’t been worse. Allowing myself to feel my feelings and accept them as they were, without overanalyzing or being angry at myself for feeling them, was a tip given to me by a therapist many years before I started having children, but it helped me process this particular experience beyond measure. No matter what you are feeling about your unplanned CBAC, it is valid.

Talking about my CBAC experience helped so much, and still does. Over four years later, I still feel comforted telling people about my births; it’s almost as if I’m unloading a small piece of the burden onto the listener. My husband heard most of it, and I was blessed that he, too, felt the sadness and grief over the loss of our birth experience that I did – that commiseration was invaluable. I also found tons of commiseration online, in forums and on the blogs of people who had been through similar experiences. ICAN – both meetings and online groups – can be invaluable in connecting you with other mothers to share your experience. For those uncomfortable with the internet as a medium for processing their feelings about their birth, therapy with a psychiatrist or counselor is also a valuable tool. Talking about your emotions makes them tangible and can help you feel validated, and feedback from the listener is also a valuable tool in dealing with the emotions surrounding your birth experience.

My final tip is that if you felt mistreated or marginalized during your CBAC, speak up about it. Make a call, or write a letter to your care providers letting them know that your birth experience was unsatisfactory and what they did to contribute to that. I was able to verbally tell the doctor who performed by unplanned CBAC that her comments about the integrity of my uterus made me feel terrible and as if I was a womb, rather than a person, to her, and this led to a conversation that I believe helped her to realize that patients with unexpected birth outcomes required support and gentleness rather than flippant comments on the way out of the OR. You don’t have to send the letter if you don’t want to, but getting the feelings down on paper in a manner you can make more sense of them can be helpful in your healing process as a way to “unload” those feelings. If you choose to send the letter, you can do so with the knowledge that your experience may pave the way for better care for other mothers. And conversely, thanking a provider who was supportive and sympathetic through your unplanned CBAC can also be cathartic and open up another line of communication that allows you to share and process your experience.

I know that as time goes on, in my own experience, processing became easier and easier. It’s hard to look at my two four-year-olds, one feisty and one sweet, and not feel content with what was a rocky beginning. In my opinion, the most important thing to take away from any birth experience is that your feelings are completely valid no matter what they are. Even the best birth can leave some negative emotions, and even the scariest, most traumatic birth can have bright spots or fortunate outcomes. There is no “perfect birth,” and being able to share your experiences with others is the best way to move towards peace and healing. I am grateful to be given a spot to share my experiences here on the ICAN Blog, I am thrilled that ICAN is addressing the topic of CBACs this week, and I hope that my tips for processing your CBAC experience are helpful in your journey!