Here’s the premier post to this column about birth stories.  It details the difficult C-section experience and recovery for a mom who is also a nurse.  What follows is the story and then my direct reply to the author.  All names of included people have been altered or omitted for privacy reasons.

The story:

When I responded to the c-section article you asked for my son’s story. It has taken me a while to get it together, but here it is.

My husband and I tried for 4 years and had 3 losses. When we found out [this pregnancy] was viable we were over the moon. I had always had an idea of how I wanted delivery to go. I wanted an unmedicated delivery and immediate skin to skin.

At 28 weeks I was diagnosed with gestational diabetes. I was very strict with my diet and exercise. I only gained 9 pounds during my pregnancy. At about 30 weeks both my primary OB and the MFM (maternal fetal medicine) doctors started telling me [my baby] was macrosomic. My primary OB started pushing me to do a lung maturity and deliver at 35 weeks. I was determined to keep him in until term.

At my 38 week appointment my primary OB told me my baby weighed 4200g. She sat down in front of me and told me an induction would be dangerous. She told me it wasn’t safe for me to stay pregnant. “It would be a real shame if after all you have been through he had a dystocia (baby’s shoulder getting stuck at the time of vaginal delivery) and suffered permanent damage.”

So at 39 weeks I had an elective c-section. It was a disaster from the time I entered the OR. My spinal went too high and I had to be strapped to the table and “stood up” for the medicine to drain down. I blacked out several times during delivery. I don’t remember seeing him for the first time. He weighed 3363g instead of 4200g. My OB left after delivery. The 2nd year resident was left to close me up. Thank goodness she knew when she was in over her head. I barely remember seeing more residents coming in to help close me. My husband and my friend (who was also the nursery nurse) told me they were dropping towels to keep from sliding in my blood.

My 5:45 c section lasted until 7:15. I couldn’t sit up to nurse my baby or stay awake to visit with my family. I kept passing out. I had no urine output for hours. Finally at 7 or 8 that night I received two units of blood. I had a hematoma in my mons, but everyone told me it was normal. I’m a mother baby nurse, I know it’s not.

My incision opened a week and a half after I got home. It continued to drain for 4 months. I came back to work with an open wound in my abdomen. I have a suspicion that I was forced into my C-section because I was due on Christmas Day. But of course I can’t prove that. I’ve since changed OBs. If I were told my only way of having another child would be by C-section I wouldn’t do it. I don’t remember the first weeks of my son’s life. I don’t know if I could handle going through that again.

I’m sorry this ended up being so long but it’s a complicated story.

My reply:

Oh, that sucks, honey! Wow. What a terrible experience. As you are a great example of, it’s so complicated and messy to make decisions based on an ultrasound’s estimate of weight. I probably sound like a broken record player when I tell my patients that I really don’t trust u/s. It’s good, but it’s not precise. It can be off by 1 pound in either direction. Maybe someday we’ll have better technology for fetal weight estimations, but for now, your story is a testament to how unreliable things actually can be. What a bummer that things unfolded for you as they did. I’m so sorry.

I know that’s totally unhelpful and can’t change your experience, but I am really sorry you went through it. The way you tell it, it seems like it haunts you a little bit. I know the last thing you need is someone telling you any well intentioned advice about a future delivery, but I’m going to risk it– knowing what you know now about your previous c/s, it seems to me like you have 3 choices:

-no more pregnancies

-try a VBAC

-or do a repeat CS

The thing that comes to my mind that I want you to know is that if you were to ever consider another CS– it really is NOT guaranteed that it will be anything like your first one. Knowing your spinal went high will help them plan your next one differently. Knowing you had a stressful delivery will make everyone make preparations to make the next one more predictable and peaceful. Knowing you had a wound dehiscence and hematoma helps inform your future surgeon how to close you up (perhaps with an extra subcutaneous layer to close any dead space- which we usually recommend for anyone with >2-3cm of space there).

It really has the potential to be so much easier a second time around. I hope that’s not annoying to hear. I only wanted to plant a seed of optimism and hope for any future pregnancy you might pursue. I feel like I it would be worthwhile to address some of the issues you shared (ultrasound not being reliable, spinals going high, hematomas, difficult deliveries) in a future article. Thank you so much for sharing!

Take care!

Kristi