I walked into the brightly lit OR alone.
My husband had to stay outside (for whatever reason) until surgery was about to start.
So I approached the operating table and a doctor asked me if I could sit up on the edge. It was quite high, but I had a pretty easy time hoisting my 6'1" pregnant body up there. It was time to place my spinal block.
My anesthesiologist asked me to round my back like a cat and stay very still. I leaned forward and rounded by back so my spine would stick out, and my nurse stood in front of me and held my hands. A needle pinched going into my back, more intense than getting a typical shot but it wasn't terrible. I breathed into it and groaned a little. This was just the numbing stuff before the anesthesia that would numb me from the waist down but I don't even remember that second needle. As the anesthesiologist worked, I thought of my brother who is also an anesthesiologist, and how interesting it would be to talk to him about my experience.
I was actually pretty anxious about having a needle inserted into my spine but since the car accident that set me on this path to health and wellness 10 years ago, I'm kind of nerdy when it comes to medical procedures and the body. My first birth had been completely unmedicated and I never really saw myself getting an epidural or undergoing any sort of medical intervention in order to have my babies. A spinal block is different than an epidural because it's just anesthesia injected directly into the spine, without anything getting threaded in there to control the medication. This was a one shot deal. I took some deep belly breaths and just trusted the process.
As soon as the medication was in, the anesthesiologist said, "OK, I need you to lay down, RIGHT NOW."
It suddenly dawned on me that yes, I had to get myself down onto the table before it was no longer possible!
I laid down as quickly as I could.
Dr. Cap came into the OR then and greeted me, his voice relaxed but clearly focused on the task at hand.
The drape was quickly placed over me, and now the anesthesiologist asked me to put my arms out on either side of me like a "T". He started to test my sensation, asking me if different parts of my upper and lower body felt the same, or different. Things were starting to feel different. The block was taking effect. Soon I couldn't feel my lower body at all. It was strange, but not alarming. I felt pretty relaxed.
Then the anesthesiologist flopped a piece of fabric over my arms on the table.
I felt them tighten.
He had just strapped me down.
THIS was NOT OK. I now know (from my anesthesiologist brother via my mom) that when people are numb from the waist down, they sometimes like to "help", or their reflexes cause them to interfere with the surgeon. But in that moment, all I knew was that I was being restrained for seemingly no reason. He didn't tell me this was going to happen, or why, so I started to freak out.
"What are you doing?" I asked him. "Please let me go. Don't tie me down."
I am not claustrophobic or anything, but being strapped down made me feel like I was being perceived as a hysterical woman who couldn't be trusted with her own body.
"Let me go, please let me go. Don't tie me down. Just don't tie me down." I was starting to feel a little panicky. I was already robbed of the birth I wanted, and I was not about to let this experience become something traumatic.
I didn't care if it was "procedure" or "policy". I needed to feel in control of my own body, especially being numb from the waist down. I needed my arms free.
"Ok, but don't touch the doctor." Quickly the straps loosened and were removed. I immediately relaxed.
Dr. Cap joked, "just don't grab my butt, Maggie!"
"Have people done that?!" I asked.
He laughed and said something like, "oh, you'd be surprised."
"Don't worry, I won't." I couldn't imagine grabbing someone while they were either cutting me open, getting my baby out, or stitching me closed.
But I also realized how important it was to have a voice and ask for what I needed, because if I'd stayed silent, I'd be strapped to that table, miserable.
Suddenly someone new was next to me on my left, dressed in full surgical garb complete with a mask, protective glasses, gloves... they looked down at me and said, "Hi Maggie."
It was SUSAN! My midwife had made it. I knew she had full privileges at the hospital and worked there often, and that she often worked with Dr. Cap, too, but after she had told me to go to his office that morning, instead of the birth center, I had assumed it would be just him from there on out. I was so grateful to see her and know that she would be a part of my birth, too. It still wasn't the birth center, it wasn't anywhere close to an unmedicated birth, but somehow having Susan there in the O.R. beside me made me feel even more supported. She, too, knew how badly I'd wanted to avoid this kind of birth. She looked me in the eye and smiled, unable to physically touch me now that she was dressed for surgery.
Then my husband was ushered in and he took his spot just next to my left shoulder. 'Hey baby," he said. I smiled up at him. I couldn't see what was happening below my chest because my "clear" drape was lined with blue fabric. I kind of wished I could see, then felt glad that I couldn't, and so I just waited. I knew my husband planned to take photos of the birth with his phone so I hoped they turned out ok.
"Ok, Maggie, I'm going to start. You'll feel some tugging."
Dr. Cap began my caesarean birth.
I felt nothing at first, and then soon there was some significant side to side tugging, but the drape blocked me from seeing anything more than Dr. Cap's and Susan's heads looking down at my belly as they worked.I felt relaxed and curious, anxious to meet my baby.
It only took a few minutes and soon, I heard Dr. Cap say, "there's a foot!"
So he HAD been footling! If he'd been frank breech, I was pretty sure his bum would have come out first because it would have been the part of him that was sitting down low in my pelvis.
"Here comes your baby, Maggie!" Dr. Cap said.
"I can't see! I can't see! I want to see!" My voice rose in pitch and volume. That damn blue liner was still obstructing my view and I didn't want to miss this! Everyone was so focused on the c-section, the drape had been forgotten.
Dr. Cap paused. "Someone get the drape for Maggie?" A hand reached over my right shoulder and pulled the liner away from the clear plastic drape, and there was my baby in Dr. Cap's hands, hovering in midair right over my chest. I was disappointed I hadn't seen him emerge but that feeling quickly faded.
All I could see was this perfect little baby in front of my eyes.
It turned out my husband didn't get any photos of this because he was too busy watching. I can't blame him, but damn.
My baby was covered in white vernix and my blood, and he was perfect. I felt my heart explode with joy and love and I drank in this beautiful sight. I couldn't believe he was here! I wanted to hold him so badly, but I kept my hands down, instead finding my voice. "Hi baby, I'm your mama." I called him by name, tears streaming down my face. "I'm right here. I love you."
Then he was carried away, the blood mopped from his face, and brought back to me with his cheek placed against mine. My god, he was so warm and so soft. I cried and talked to him more, just waiting until I could hold him close.
After a few moments he was whisked away again and my husband went with him, to check his vitals, make sure he was stable, and to wait for the umbilical cord to empty its blood into the baby. My husband gave him a finger to hold to make sure he was getting some skin-to-skin contact (when he wasn't taking photos) while the nurse looked him over, and when another nurse wanted to wipe the white, cheesy vernix off him, my husband stopped her. He and I wanted it left on for all the good things it offered our new baby. Vernix soaks in by itself and moisturizes baby's skin, helps regulate their temperature, and has antimicrobial properties that protect the baby from infections! He wasn't dirty, there was no reason to wipe it off or bathe him right away. When my husband spoke up, another nurse agreed with him. "Yes, it's really good for their skin!" she said. So the nurse mopped off the blood and left the vernix alone.
My placenta was still in my uterus and Dr. Cap was massaging my belly, getting it to release, so while the baby didn't get full delayed cord clamping, he got to have the blood that remained in the cord after it was clamped near the placenta and cut there. I do wish he had gotten all of the blood from my placenta and not just the cord blood, but I figured it was unsafe to leave me cut wide open for too long.
As Dr. Cap received my placenta and put it safely aside (he knew I wanted to keep it for placenta encapsulation), he told me that I had a full septum. My uterus was literally divided in half, top to bottom. "Maggie, it's a good thing we did this," Dr. Cap said to me. "Your baby had NO room in there. Other moms I've seen who had a uterus like yours couldn't carry past 24 weeks, and you had two full term baby boys. That's amazing."
My heart swelled with gratitude for the choice I'd just made, for being 6'1" and having enough space to grow my babies, and for my doctor who took such good care of me. Then suddenly my husband was there holding our baby and he gently placed our little guy on my bare chest. I cried some more.
And before the nurse could get to him to help him start breastfeeding, he started wiggling across my chest, hunting for my breast. It didn't matter that he'd been born via c-section, my baby was doing the breast crawl! It was the most beautiful thing to watch and it felt so special, like a little private moment for just us, hidden from view. Soon the nurse's hands were there to help him but he'd already found what he was searching for. He was latching on all by himself. I was so proud of him!
Then suddenly Dr. Cap said, "do you want a photo of your uterus so you can see the septum? I know you like that kind of thing."
A PHOTO?! Really? "Yes please!" I knew photos were usually strictly forbidden in the O.R. so for my doctor to offer that was huge. I DEFINITELY wanted to see what the inside of my uterus looked like so he quickly directed a nurse to grab my husband's phone and snap some photos.
This is what it looks like: CLICK TO SEE - WARNING, this is an open surgical wound. VERY GRAPHIC. Don't click if you're squeamish at all. This is something you won't be able to un-see ;)
Then Dr. Cap told me he was going to stitch me up. "Do your best stitches, please!" I said.
"I always do my best stitches. I'm doing this just like a plastic surgeon.," he said.
And a few minutes after that, it was done!
I had my baby, all was well. I was transferred from the operating table to a bed, and wheeled back to my room to recover, breathing in that new baby smell on my chest as he happily nursed away.
At my incision check about a week later, Dr. Cap told me more about my uterus. My little guy had been really wedged in there and it really was like my body KNEW to not go into labor.
"He couldn't even get around the corner to get into the garage, let alone get down the driveway!" Dr. Cap said. His umbilical cord had been wrapped around his neck once too, which wasn't a big deal during the caesarean, but might have been in other situations.
It was a good thing we didn't try an External Cephalic Version, too, although my gut had already told me that I wouldn't go through with one - either baby would flip on his own, or he'd stay breech and I was at peace with that. But now I knew that even if he wanted to turn, he couldn't. I felt a little badly for all the times I'd massaged my belly, encouraging him to turn. "Sorry, little one," I thought.
He would have had to choose a head-down position way earlier in my pregnancy but at 18 weeks, he was already breech, as the ultrasound tech pointed out when I was at a speciality appointment to check for normal growth and size. Normally a baby's position that early doesn't matter, but that assumes they have lots of room to turn and roll. If I'd started my Spinning Babies inversions then, maybe I would have had a totally different birth. But then again, maybe not. I really believe that babies choose their births, and are our greatest teachers.
Waiting for labor and trying to go the natural route would have most likely been really bad for baby and I, and I won't share the "could have happened" scenarios but... yeah. Bad. So I felt even more at peace with my choice for my baby's birth. I'd still never choose an elective c-section but since this one was necessary, and it was a positive experience with some minor hiccups, I was happy. I wasn't traumatized at all, and I had gotten the chance to experience how a belly birth could truly be just as beautiful as my unmedicated vaginal birth. What a gift, and a lesson for my ego that had held some pretty strong opinions about c-sections before I needed one myself.