Wounded without the Pleasure of a Scar

by Kara Laughlin


what good is it
to be ...
left with no trace
as if not spoken to in the act of love
as if wounded without the pleasure of a scar.
--from "The Cinnamon Peeler" by Michael Ondaajte


The first thing you need to know is that I am indeed grateful. It could have turned out differently, and I'm very happy that it didn't. As one friend has reminded me several times, in another age, I might have died in childbirth. So, yes. I am grateful to have a healthy baby. I am, yes, glad to be alive. Get that into your head now, because it's the last you're going to hear about it from me.

My son was born eight months ago, on May 15th. If you can call it "born" when a stranger numbs your body, cuts a slit in your swollen belly, pulls out the baby, and vacuums your uterus. I, in the depths of my heart, do not.

I might call it surgery or heroic measures or theft or battery. In a way, it's a combination of all those things, but it's not birth. C-section does a good job of describing it: like a very anal orange eater, sectioning each piece with his knife. That's what I was, an overripe fruit that had to be cut into or rot.

***

May 13th: I am crying in Kathy Easter's office. My husband is at work, and my mother and my younger sister Laura, who had scheduled their visit hoping the baby would be well established in the world by now, are at our house checking out all the cute clothes I've bought.

Kathy Easter is my favorite of all the midwives on the hospital's staff: she lent me a very liberal book on creating your childbearing experience; she is a big promoter of doulas; she's very supportive of natural childbirth, but not militant about it.

Which is why I'm shocked to find myself saying, through tears, "I just feel like induction is the first step on the way to an inevitable C-section." But the placenta, she tells me, is degrading, and the amniotic fluid is getting low, and even though she's usually a wait-and-see kind of gal, she doesn't think she can convince the obstetrician to let me leave the hospital. She doesn't think she wants to convince him. And anyway, a C-section is not inevitable; she thinks I have an excellent chance to deliver the baby vaginally, without painkillers, if that's what I want.

She consults with the obstetrician, who does let me leave, if I will check in to the hospital this afternoon. She says to go home, get my husband, go out to lunch and pack, and she'll see me in the morning after they've started the pitocin drip.

***

I was not a girl who dreamed of marriage. I didn't pin pillowcases behind my head and walk down the aisle with my teddy bear when I was eight. What I have dreamed about, for as long as I can remember, is having a baby.

I'm not talking about being a mom, though years of babysitting Laura had convinced me I'd be capable enough. No. I imagined the birth itself: what would it feel like to be pregnant? Would I know when labor started? What would that moment of realization be like? And feeling the baby stretch his way out into the world, what would that be like? Yes, it would be painful, but would I be up for the challenge that billions of other women had faced? And how would it feel to see that baby come out, all writhing and bloody, and to hold him before anyone else, while he was still attached to me, to meet, for the first time, this squirmy little thing I'd been getting to know for nine months from the inside out?

I dreamed of having a baby-literally. A recurring dream, from a much earlier time in my life: When I enter the dream I'm in the hospital, but I don't know why. My mother or my best friend or a nurse is in the room, and I ask what I'm doing there. "Don't you remember?" they ask. "You're pregnant."

"That's not possible," I say. "I'm still a virgin."

"No, you're not. Don't you remember, that one time?"

It always happens the same way, I always wake up in the hospital, and there's always some guy that I've slept with whom I know nothing about. I'm either about to have the baby, or I've already had it, but the hospital staff won't produce the baby. They're disturbed that I don't remember. They think I'm unfit to be a mother.

The last time I had the dream, it started the same way. I wake up in the hospital; I've had a baby. I don't remember having a baby. I don't remember ever having had sex. But this time they bring me the baby, though they don't plan to let me keep it. I know it's all true, everything, because the love I feel for this child they've put in my arms is the most ferocious powerful painful love I have ever felt in my life. They want to take the baby away, but I refuse, and I promise to her that I will take care of her, and I'll never let anyone take her away.

My therapist made a lot of that at the time.

***

Jim and I arrive at the hospital that night. Twice during the night, I'm given a vaginal suppository of gel to "ripen the cervix." I have some light contractions, which strengthen enough to keep me from sleeping around 3 a.m., and I allow myself some Benadryl. At 6:30 in the morning, the nurses start a pitocin drip. When my mother and sister visit around 10, the contractions are starting to demand my attention. The nurse continues to ratchet up the pitocin.

Laura leaves to run an errand, but my mom is in the room when Kathy Easter comes in to examine me. "We're not having the kind of progress I'd like to see," she says (read "any"), "So I think we should break your water."

I've read the books, and I know that breaking the water is an irreversible decision. Once you've broken the water, you can't turn the baby, and the countdown starts: most doctors don't like you to labor more than 12 hours after your water has broken because there's an increased risk of infection. Kathy would probably let me go 24.

We compromise: one more hour of labor, and then we'll reassess. Laura comes in and starts chattering about Animal Planet as a contraction floods my brain. That may be one of the most surprising things: I didn't know the pain would overwhelm my mind. I can't talk or open my eyes because the pain is everything.

If you haven't experienced this, I want to make clear that it's not that the pain is so sudden and excruciating-like a stab wound. It's more that it becomes who you are. It demands all of your attention. And, for me, anyway, it wasn't torture. It was manageable; I didn't feel like I would die, it's just that it was all there was. Pain was me.

I ask Mom and Laura to leave, telling myself, this is a good sign, you're getting serious, it won't be long now. The contractions are coming very frequently, and they're lasting a good 60 to 90 seconds. I feel I'm well on my way.

After an hour of labor, there's some progress: I'm 90% effaced and 2 cm dilated. Kathy breaks my water. I continue to labor at about the same rate. We notice meconium in the amniotic fluid. This is bad: meconium is fecal matter that the baby has passed in utero, and it's not good for him to inhale it-more pressure to get this finished up.

The contractions are now difficult to bear. I don't think I can stand much more of this. (In my mind, I'm telling myself, this is a good. It's a sign of transition; you won't be long now.) I mention that I might be willing to consider drugs. My doula (another Kathy) jumps on this announcement, which I take to be a sign that things are difficult indeed, since I've written on my chart that I don't want to use drugs and the doulas are trained to support the patient's wishes.


***


At some point, I stop being able to pee. I don't really want to anyway-the chances are good that I'll have a contraction on the toilet, and they are less comfortable in that position. The midwives and doulas (I have two of each, because one of each is in training) are more concerned-they think the head might be in the way. Kathy recommends a catheter to help me pee and another to dilute the meconium from the amniotic fluid. These procedures will require an epidural. Oh, and by the way, there's been no change in my cervix.

Everyone leaves the room to allow Jim and me time to decide. There's no debate. What else can we do? As far as I'm concerned, I left my autonomy behind when they started the pitocin drip, telling my uterus how to have its contractions. Jim calls them back. I have the epidural. I sleep.

***

The epidural requires that I turn over every half-hour or else only half of my body will be numb. I can't feel my body enough to do this myself, so the nurses and midwives have to do this for me. I am now nobody. I can't feel myself; I can't move myself, and I'm peeing-actually, still not peeing-through a tube. Every time they turn me to my left side, the baby's heart rate drops dangerously and they flip me back to my right.

For over a week before this, I've been at home, consigned, for fear that I might have pre-eclampsia, to bed rest, lying on my left side, and now they tell me that this position seems to be bothering the baby.

***

Kathy comes in and very gently suggests that the time has come for a c-section. She may say "cesarean birth." She is very sympathetic and politically correct. I agree.

***

Just before the operation, the OB on duty tells me that my labs have come back (labs? what labs?) and I do have severe pre-eclampsia, which is why my kidney and liver haven't been functioning, so an IV of magnesium will be administered right after the surgery for 24 hours to prevent seizures. It won't, I'm told, affect my ability to breastfeed.

***

My main concern is that I won't be awake when Joshua finally enters the world of air. I've been in labor so long that my arms are shuddering violently, nonstop. I get wheeled into the operating room, and Jim stands at my head.

You can tell that the Kathies really feel for me and Jim because they go out of their way to get us a couple of pathetic concessions: we can play the CD I brought and they'll dim the lights in the operating room so that Joshua won't have to squint when they hoist him out of me.

There's a drape in front of me, of course, and we tell them we want them to remove it when the baby's "born." Kathy the doula rubs a pressure point on my hand to ease the shuddering. I drift in and out of a light sleep.

***

When Joshua comes out, I'm the last to see. Jim is above me, and able to peek over the drape. I catch a quick glimpse of him, and, thank God because I was afraid I wouldn't be, I am overcome with the most ferocious powerful painful love I have ever felt in my life for this squirming thing that I've been getting to know from the inside out for the past nine months.

Then he's taken away-he's swallowed some amniotic fluid, and they have to fix him up. Jim goes with him, and I'm alone except for Kathy the doula whom I've met twice, while they vacuum me out and sew me up. Someone tells me that one of the benefits of the C-section is that my muscles will be sewn in a way that will help them grow back into pre-pregnancy position much faster. They say the scar will be nearly invisible. Nobody will know it's there, even in a two-piece bathing suit.

***

That's the end of the story. From there, we become a happy family, mama, papa, baby, and we put this unpleasantness behind us and get on with our lives.

Except for the mama. The one who was going to feel the delight and excitement of realizing that, yep, this is finally it, the baby has decided to come today. The one who was going to cuddle her baby on her stomach while his cord still pulsed with her own blood. Where is she?

And why am I the only one who feels her absence? To this day, I look for her. Compared to the life that came into the world, her absence is secondary. But still, I miss her. I wonder about her. I wish she could have been born too. Like a kid on Christmas Eve who has his presents stolen at gunpoint, but his life spared, I feel a guilty but overwhelming sorrow for all I've lost, in spite of what was gained.

That mother, the mother-in-birth I dreamed of being, died that day, as surely as a baby was born. I'm the only one who noticed she was gone.

-----

Kara Laughlin is a freelance writer living in Illinois. She expects to receive much email from readers telling her to be grateful she didn't die in childbirth.

 

 

Copyright © 2003 Kara Laughlin. All rights reserved.

 

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