Rachel Somerstein | Longreads | October 2019 | 12 minutes (2,917 words)
Birth stories have that inexorable narrative drive, borne from the tension of knowing what’s going to happen, but not how you’ll get there. I thought I knew how my story would go.
I never could have predicted what happened: my OB performed a C-section on me without anesthesia. Go on, read it again. Because of the anesthesiologist’s mistake, and the OB’s desire to get it done, I had major abdominal surgery without anesthetic. In a hospital, in the United States, in 2016. It’s more common than you’d think.
The first red flag was that the anesthesiologist had to re-up my epidural three times. Ultimately, it worked; despite back labor and what a nurse described as “monster” contractions, I felt comfortable enough, as a friend had put it describing her epidural, “to serve a meal.”
Hours passed. I labored, confined to bed, wondering whether my daughter would ever come out. I did all the relaxation things I was supposed to do: I pictured a sea anemone opening. I did the lion breath. Despite the pain, my cervix was not dilating much. It would turn out the baby’s feet were tangled up in her umbilical cord, and that her head was cocked to the side. In the parlance of labor, I was not progressing.
Eventually the doula and midwife went to dinner and told me to rest, dimming the lights. When they returned, my water had broken. I was almost fully dilated. Then the room became very busy. Someone turned on the baby warmer. The midwife told me to push, and I did, though I couldn’t really feel my lower body. It was just after midnight, my due date. I felt excited that, as a chronically late person, I’d finally be on time for something. My husband and I had long joked that our family crest would show the White Rabbit mid-flight, worriedly consulting his pocket watch.
I pushed for what seemed like a short time — but what doesn’t seem short when you’ve been in labor for 24 hours? — when the midwife whispered into my ear, “I think it’s time to call it. To do a C-section.” She explained that, amid the pushing, the baby’s heart rate wasn’t returning to levels that seemed safe. Also, she said, I’d been in labor for so long. The baby and I were exhausted.
I must have known something was going to go wrong, because I asked if I was going to die, if my baby was going to die. Oh, no, the midwife said, you’re going to be fine. I signed papers, things I couldn’t read because it was too loud in my head, which released the medical team from indemnities that would actually happen, but that I had never dreamed possible.
Then I waited. It took 40 minutes to pull together the surgical team. Some emergency!
Later the midwife would tell my husband, “I wonder, if we had just waited, if the baby would have slid out on her own. I wonder” — and, he told me, she didn’t seem to wonder, but to be pretty certain — “if maybe we didn’t need to do the C-section at all.”
I hadn’t read the chapter in “What to Expect When You’re Expecting” about C-sections. Though they constitute more than 30% of births in the U.S., I figured I didn’t need to. I wasn’t going to have one. I walked three miles a day through my third trimester. I did prenatal yoga. I’d hired a doula to attend my birth. In all, I acted much like I did before I got pregnant, earning opprobrium from strangers, neighbors, and colleagues for such outré behaviors as raking leaves, walking uphill, and lifting a chair into my office.
I never could have predicted what happened: my OB performed a C-section on me without anesthesia. Go on, read it again.
Adding to my confidence was a friend who had birthed her son at home, just a few weeks earlier, in an inflatable pool in her living room. I’d visited when he was about a week old. My friend was beatific and relaxed. It was as if she’d returned from a soul-transforming vacation in which she’d done something unfathomably sublime, like swimming with pink dolphins in the Amazon River. Now she was back among the mortals to share her newly-discovered secret of life.
“Was it really not that bad?” I asked.
For sure it was painful, she said. But her 3-year-old daughter, who had watched Frozen throughout the labor, had hardly seemed to notice the action taking place a few feet away.
I convinced myself that the external similarities between us made her easy experience a crystal-ball-mirror of my own: we were both assistant professors, we were both short, we’d both fought our institution for paid “reassigned time” — duties other than teaching — rather than take the plunge of unpaid leave and crash off of a financial cliff. We’d also both chosen to get pregnant on the tenure track, which some peers and mentors thought was really crazy. And here she was with her son, eating pizza like a normal person. I, too, was going to be fine.
When I got to the operating room for the section, I was basically naked and had a baby most of the way down my birth canal. It was bright and cold and everyone else had on clothes. I was conscious enough to feel embarrassed of my enormous stomach, stretch marks, hairy body. I’d met the OB who would do the operation once before. He was cavalier, one of the doctors from the practice I liked least.
I perched on the edge of the bed, my back hunched, as the anesthesiologist sought to insert the spinal block. He struggled to get it in the right place. He asked me to shift positions, to hunch my back more. Contractions waved down. My body was still trying to push out the baby.
“Your stomach looks totally different,” the doula remarked, as if I hadn’t noticed hours of contractions and pushing.
She laid me back. I felt as if I would choke under my belly.
According to the American Society of Anesthesiologists, a spinal block is the preferred anesthetic for C-sections, because it exposes babies to a low level of medication while also alleviating the mother’s pain and allowing her to “participate” in the birth.
The procedure takes skill. If the anesthesiologist inserts it too high, the mother will be temporarily paralyzed, which can affect her breathing. Put it too low, I found out, and it doesn’t work. Anesthesiologists will say that it’s “failed.”
If the surgeon continues anyway — separating the rectus muscles, entering the peritoneum, exposing the bladder — you’ll feel the whole operation.
In case you are wondering, the OB noticed. He even wrote about my pain his surgical notes: “It was noted at this point that the patient was a having great deal of difficulty, tolerating pain, was indicating that she was having a great deal of difficulty coping with the pain and was screaming from the pain.”
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I had really wanted to see the placenta, which the doula had said would look like a tree. I imagined a tree of life with many branches, like the gold-colored one that decorated a synagogue I used to go to, with the leaves bearing the names of donors.
I hadn’t wanted to eat it, or encapsulate it, as the doula had suggested I might. But I had really wanted to know what it looked like.
“She was moving her legs quite a bit as well,” the OB wrote, “and general anesthesia was being discussed once the baby was delivered.”
I remember my legs kicking as if to run off of the gurney. My body — as autonomously as if it were struggling for breath — was trying to escape.
I don’t remember the baby coming out. The surgical notes tell me she was weighed, evaluated, smeared with vitamins.
My body remained on the table. The placenta was delivered, the uterus removed from my body and cleared of clots and debris. “I should also note that the patient after baby was delivered continued to have a great deal of pain,” wrote the OB in his passive-voiced clinical notes, “and was converted to general anesthesia at that point.”
When my body tried to kick its way out of the torture, my doula may have helped hold me down. For this privilege I would pay her $1300.
The doula brought me my daughter to nurse when I woke up in the recovery room. She held her to my breast. The baby latched immediately. “A good latch,” she said, which I took to mean, “a mercy.”
But I couldn’t look at her; I was in too much pain. “I don’t want to see her,” I said. “No, no, no, I don’t want to see her. I can’t see her. Take her away!”
And can you imagine if she reads this? If she learns that at her most vulnerable, her first hours on the planet, I sent her away?
My placenta was probably in the garbage. And I was certain that I did not want to see that fucking child.
The next few days were a blaze of pain and trying to learn to breastfeed. A hospital PR person came to my room and my husband chased her out, telling her to “Get the fuck out of here.” Another medical person told me, “Your body didn’t respond to the anesthesia the way people normally do.” A nurse? The OB? I can’t remember. Whomever it was wanted me to understand that the barbaric torture I’d endured — the medieval butchery, the way operations took place prior to the introduction of ether in the 1840s, when people were specially employed to hold down the patient’s arms and legs — was my fault.
The anesthesiologist did the one human thing: apologized. It was the worst mistake he’d ever made, he said, his face ashen.
I told him, “I won’t sue you.”
And I didn’t. Partly because I didn’t want to; I held responsible the OB who didn’t listen to me, who continued to cut me through my screams.
The other reason I didn’t sue is that I couldn’t find a lawyer to represent me. I hadn’t suffered enough: an actual lawyer’s real words. One mused, How long was it? Five minutes? You’re healthy, your daughter’s healthy. What are you so upset about? Another asked, Why did you wait so long to bring a lawsuit? Insinuating that I was suddenly hard up for money, as if the mob were after me. The gentle one said, I’m so sorry this happened to you. It’s terrible. But we can’t take on this case.
After two years, I was nearly out of time. In New York, where I live, the statute of limitations for obstetric-related malpractice cases is two-and-a-half years. Before it elapsed, I gave up looking.
I couldn’t name her. The nurses left the paperwork for us, and every day, asked if we’d filled it out. The doula started calling the baby Nonahmay, for “no name.” We’d had two names on our shortlist, which seemed irrelevant, a relic from another time.
Eventually her name came to me. We were nursing, I think, in the hospital bed. I wrote it on the paperwork. It hadn’t been on any list. It meant “free person.” Maybe I was giving her what I hoped I would have one day: freedom from the trauma of her birth. It also happened to be the same name as my best friend from college. Maybe I was calling to her, bringing her to me, during the time I felt more alone in my life.
Still, I couldn’t use the baby’s name to address her. For weeks she remained “the baby.”
I had trouble bonding with the baby. My skin felt as if it had electricity inside and I didn’t want to touch her, or anyone. I did not want to see anyone either. Friends arranged a home visit from an acupuncturist and Chinese medicine practitioner. She felt around my ribs and said, “It’s good that this happened in spring, when the emotion is anger. It would be worse if it had happened in winter.” She was talking about which emotions are in “high tide,” according to the seasons of Chinese medicine. I looked at her, waiting for her to continue. “The winter emotion is fear,” she explained. I pictured my dead body when she said this, and saw how another person, or me at another time in my life, would have been overcome and suicided.
I didn’t speak much about it for the first few months, but I did tell some people. Some couldn’t bear to hear what happened. Others, knowing the story, wanted me to repeat it, the voyeuristic part of them unable to resist. Some people insisted on coming to meet the baby right away. “Please don’t come. I’m not ready,” I said. “It was really awful.” Don’t worry, move on! You have a baby now! A healthy baby! This is what the OB said, too. Get up, keep going, don’t stop. All I wanted was to sit in a rocking chair and cry. Eventually I stopped speaking of it at all.
During those zombie weeks I began moving pretty well, making my way around the block, doing pelvic lifts in bed, even walking the half-mile to the pediatrician’s office. I weaned myself off the opioids, because I was afraid I’d ask for more if I used up the prescription and God knows where that would take me. But the rapidity of my physical recovery felt dangerous: the outside me looked almost normal, like a regular postpartum person, cabbagey with enormous Barbie boobs. On the inside I could still feel electricity in my body. I felt dangerous. I was scared to hold my daughter. I was afraid I might zap someone.
Those first few weeks I also found mysterious wounds on my body, which led me to wonder what else I’d missed — in addition to my daughter’s birth — while delirious from being cut open without anesthesia. One was a large green bruise in the middle of my abdomen, which hurt terribly. It looked as if I’d impaled myself on something. I called the doula, afraid of infection. Maybe the doctor had forgotten gauze or a plastic glove in there; the possibility seemed as plausible as an unmedicated C-section now did. I went to the doctor, who found nothing. It was from my diaphragm, which had seized so hard during the operation that the organ had bruised the upper levels of my skin, turning it a sickly green.
I had trouble bonding with the baby. My skin felt as if it had electricity inside and I didn’t want to touch her, or anyone.
It took a lot longer for me to figure out the source of the scratches on my hips and arms. Years later, when I was in relaxation pose at the end of a yoga class, not thinking about the C-section consciously, it hit me. The scratches were from the nurses’ and the doula’s nails, from when I’d bucked and kicked beneath their hands.
We would be billed $50,000 for the delivery. Insurance paid for it all. I sometimes walked around thinking about that, all the people who profited from my pain.
My daughter is now 3-and-a-half. I used to wonder if she remembers it — the pain of her birth, my rejection of her, our lonely early months. She might, in her limbic system. The possibility is more painful now that we know each other — now that my heart is larger, has opened to accommodate my love for her.
Once, in the bath, she asked what the “hole” of her vagina was for. I told her babies come out of it. She said, in hilarious 3-year-old fashion, “NO WAY.”
“But sometimes babies come out another way, I told her. “Through the belly. A doctor makes a cut and takes them out. That’s how you came out.”
She listened. “Why?”
I paused. I was scared, unsure of how much to say, but I couldn’t stop talking. “It’s safer that way, sometimes.”
She didn’t say anything more. I thought of my husband telling me about how to talk to her about the death of a relative, She’ll let you know what she’s ready to hear. Let her questions lead you. Don’t tell her anything more than what she asks. I smiled at her, to keep my mouth shut.
Nearly four years after, the feelings of grief are still alive for me. I sometimes still feel that my internal, psychic damage is visible, that if you see me walking down the street you’ll see a damaged person. Sometimes I catch glimpses of myself in store windows and I’m surprised that I look whole, normal. To look at me, you’d never know.
But it’s my job to shield my daughter from these feelings, to change the narrative from the way it began. I have this chance all the time; it’s part of the regular stuff of parenting. Like when she wakes up in the middle of the night, and uses words to say what she could only express through cries as an infant:
“Momma! Momma! I need you! Come get me!”
My heart cracks. She’s scared. She needs me.
The miracle is, she can tell me so. The other miracle: I can hear her.
So I go to her. And lift her up.
* * *
Rachel Somerstein is an assistant professor of journalism at SUNY New Paltz. Her essays and reporting have appeared in the Boston Globe, the Washington Post, n+1, and WIRED, among other publications.
Editor: Sari Botton