Let’s just get one thing straight …. I am grateful for c-sections. I’m the woman they were made for. All four of my children came into this world via cesarean. They had perfectly round heads, cried right away and may not have lived if it weren’t for this medical intervention. And for that I’m beyond thankful. But c-sections still suck.
If you’d had a cesarean or have had a frank conversation with a friend who has, you’re probably familiar with the typical ways in which they’re pretty awful:
- The idea of actually walking the first 24 hours after brings visions of your insides falling out and onto the floor. Really.
- When the nurse commands you to take your first shower, you want to laugh in her face then lock her out of your room. There’s no way you can walk to the bathroom, more less stand upright for an extended period of time while water, which you’re sure will feel like acid, runs over your incision.
- And let’s not even talk about passing gas or going number two.
- The anesthesia (or whatever potion they run through your spinal) can make you so itchy you’re convinced invisible bugs are crawling all over your body.
- To prevent your incision from popping open, you can’t drive or lift your other children (or more specifically, anything heavier than your newborn) for 3-6 weeks. Yeah, right.
But this isn’t the really horrible list. It can be worse, much worse. As the veteran of three sections, I’m here to share what no one is willing to tell you about why c-sections really suck.
Once you have one, you’ll probably have more.
This is for a variety of reasons. A vertical incision in your uterus increases your risk of uterine rupture in future vaginal births. And even if your incision is horizontal (decreasing that risk), many, many OBs are reluctant to support VBACs (vaginal birth after cesarian section), and some hospitals downright prohibit them. While the risk of uterine rupture is less than 1 percent, VBACs are controversial, leading many doctors and nurses to become very nervous at the thought of VBAC deliveries. (And with our litigious society, who can blame them?)
I tried a VBAC for my second pregnancy. I was a perfect candidate: horizontal uterine incision, seven years since my last c-section, and perfect health with no history of surgical complications. My midwife, whom I believed would have been the epitome of patience and calm during my labor, was out of town when my water broke as was her supervising OB. I was warned that one doctor in the practice was 100% against VBACs, and, of course, she was the on-call doc for my labor. And my nurse was so nervous during my delivery, I felt responsible for calming her down. After several hours of unmedicated labor (I chose Hypnobirthing for pain control – which I highly recommend, by the way), I was wheeled into the OR for an emergency c-section. We’ll never know if my c-section was actually medically necessary (nuchal cord was identified during the surgery) or primarily the result of cautious medical decisions.
Swelling that will make you feel like a water balloon.
Especially if your section was scheduled, you may experience incredible swelling in your hands, feet and ankles days after your section (that seriously rival any pre-delivery swelling you had). I was on IV fluids for several hours before and an entire day after my surgery, which not only caused me to swell up like a blow fish, but made my already excruciating pregnancy-induced carpal tunnel worse.
Two words: Diastasis Recti.
Diastasis recti occurs when the right and left halves of the recus abdominis muscles separate from each other. So visualize the 6-pack abs you’ve always wanted, and now envision them separated down the middle. With this “muscle wall” literally ripped in half, you are left with a weak core and a chronically “pooched” stomach. Because your abs no longer hold your tummy in, it sticks out regardless of how thin you are. If you are anything like me, your pooch looks like a small half moon in the morning, and progresses to a 5-months-pregnant look at the end of the day. While a c-section doesn’t cause the separation (your growing baby does), many professionals admit that it can hinder/prevent the muscles’ ability to heal back together using traditional physical therapy approaches, especially at the bottom of the separation near your surgical scar.
Many doctors view diastasis recti solely as a cosmetic issue and believe that us moms are concerned about it only because we no longer look good in tummy skimming clothes. But, as a woman with a separation so large I can fit my full fist between my stomach muscles, it’s about so much more than aesthetics. It renders your core weak making your lower back hurt − especially when holding and caring for your children. While you won’t find many medical practitioners backing up this next claim, many women with the condition, including me, will tell you their digestive life isn’t the same. Perhaps it’s because the musculature that holds your intestines in isn’t as supportive. Whatever the reason, things just don’t move along like they used to, if you know what I mean.
Traditional core strengthening exercises make diastasis recti worse (think crunches and Pilates), and targeted physical therapy doesn’t always heal it, especially for large separations like mine. But insurance considers surgical repair a cosmetic procedure. My cynical side says this is because it’s primarily a woman’s issue, but I digress. So, unless you’re positioned to pour thousands of dollars into medical bills, you might be stuck with this chronic condition.
Two more words: Wound VAC.
The more c-sections you have, the greater your risk of wound complications, a.k.a. your incision not healing properly. One of the ways your body naturally copes with an incision is by increasing the amount of blood and fluid to the trauma site. But, multiple c-sections means that your body has re-routed this extra fluid to that same site over and over. Thus, by section two, three or four, your incision site may receive too much fluid when trying to heal and ultimately hinder or prevent the healing process all together.
Three days after I was released from the hospital after my third c-section, my incision burst resulting in blood and fluid everywhere. While the top layer of my skin was healing (where the stitches were), the deeper layers of tissue were not and were instead filling with fluid. My doctor trained my husband to “pack” my incision twice each day (basically shoving gauze-like material into the wound so it could soak up the fluid and promote healing). However, it wasn’t working.
Here enters the wound V.A.C. (vacuum assisted therapy). Fortunately, a close family friend, who is also a surgeon, recommended speeding up my healing process with a portable machine called a V.A.C. Without it, he predicted my healing would take 2 months, if it ever healed properly at all. A sponge is inserted into your wound and the machine essentially sucks out the fluid collected by the sponge. With it, my incision was almost closed within 10 days. After the 10 days, my husband was again packing the greatly minimized wound. It’s been 22 days since I’ve been off the V.A.C., and I’m almost all healed up.
Yes, the V.A.C. was a godsend. But it wasn’t fun. Hauling around a small machine 24/7 while nursing a newborn and caring for a toddler and 9-year old twins sucked. And changing the dressings every two days felt like someone was tearing off my top layer of skin. And let’s not even talk about the smell. Between my open wound smelling like a sewer and my clothes smelling like baby puke, my friend lovingly suggested I wear a Febreze air freshener under my skirt. Good times.
Trashing the Fantasy.
C-section was not how I envisioned my children entering this world. I would have vaginal births without pain medications and medical intervention. Immediately after, my baby would be placed on my belly and breast-feed. And I’d be up and about a day or so after birth.
But that’s not how any of mine happened, and I’ve had to let go of my ideas of how my birth was supposed to go. I’ve had to forgive myself for not trying harder, being tougher and accept the truth that trying and toughness had nothing to do with it. And I also know that vaginal births aren’t always a bed of roses either.
But in the event that folks create a pretty picture of a c-section birth, I’m here to put a face on that reality. Don’t say I didn’t warn you.
*I’m not a medical doctor and this post represents my personal opinions and experience. Your experience may differ. For your sake, I hope it’s much better.