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Introduction "Your pain matters, it is your guide to healing. For some women, the experience is no big deal, and they quickly move on with their lives. Other women find a cesarean difficult to deal with emotionally. They are happy to have their children with them, but just can't see the method of their birth as 'no big deal'. For some, the lost dream of the way they had wanted to birth takes real grieving, and for others, the pain of the physical recovery from what is after all MAJOR surgery is difficult emotionally too. Still other women experience their birth and cesarean as a deeply traumatic event, even akin to rape. A woman's response to a cesarean depends on a great number of factors, including how she was treated by medical staff, the respect and dignity she was accorded, factors involved in the actual surgery, how labor went, the response of her loved ones, the fantasy birth she had dreamed of beforehand, the fears and emotions she brought to labor and birth, prior experiences with the medical establishment, and her own emotional background and personal history. Because of all of these variables, it is only logical that different women would experience and interpret a similar eventsurgical birthdifferently. This is completely normal. This particular FAQ is about the emotional recovery after a c-section. It discusses what women may experience emotionally, the wide range of responses that can happen, the validity of these responses, and ideas that other women have used to help themselves heal and grow after a cesarean. Because many women find that their future choices about birth and parenthood can be affected by their cesareans, this FAQ also briefly addresses the emotional aspects of choosing more children and birth choices in future pregnancies. Since women who 'love' their cesareans or have no problems recovering emotionally from them tend not to need a great deal of validation of that experience in our society, this FAQ does emphasize those women who found their cesarean emotionally disappointing or traumatic. However, this is not meant as a judgment of those who were not distressed by their cesarean. It is simply a validation to those who found the experience difficult and distressing, and a way to share steps that other women have found to be emotionally healing afterwards. It is important that women who read this FAQ not judge women whose experience of cesarean was different from theirs. No response is 'right' or 'wrong', and no one's experience is 'more valid' than anyone else's. They don't need to be justified, they just are. This is not the place for judgment of other people's choices or responses. Instead, this is the place to try and understand where someone else is coming from and why they feel that way, to empathize with those feelings, and to find validation for your own feelings, whether they are the same or different from others' feelings here. If you would like to share your own experience about emotional recovery from a cesarean, feel free to email Kmom about that experience. If you would like it shared here, please keep it reasonably brief, send it by email no attachments please , and give permission for your story to be published. See below for more information. Ideas for emotional healing and recovery in this FAQ are drawn from many resources. Further information on these books and where to find them can be found in the references section. Enormous thanks are due to the women who have dealt with these issues and shared what worked for them, and especially to those who have actively worked towards helping other women heal their birthing experiences. Bless you for breaking the silence and talking about an issue that few people took seriously. And bless you for lighting a candle for others to use as a guide towards healing. You will never know how many women you have helped. Since most women will not read this FAQ in its entirety at one time, a number of important points are repeated throughout the text to make the FAQ more user-friendly. Emotional Recovery After Cesarean: A Variety of Responses Women have a wide range of emotional responses after a cesarean. Some are devastated by it, some love it, some are disappointed but okay with it, some feel 'rescued' by it, and some seem fine at first only to experience delayed grieving later. There are many factors that can influence how a woman experiences and interprets a cesarean emotionally. Unplanned Cesarean Whether or not the cesarean was planned is often but not always a factor in how a woman experiences her cesarean. Women whose cesareans were planned ahead of time usually have the easiest time recovering emotionally, since they knew ahead of time that it would happen and more or less what to expect. They had time to grieve their lost ideal birth ahead of time, and were able to prepare themselves mentally for the rigors of surgery and recovery. They did not have to go through the pain of labor and the pain of surgery too. Because they did not want the cesarean but were forced to have one anyway, the emotional recovery in these cases can be difficult and painful. Women who do not plan to have a cesarean but who go through labor and still end up with a cesarean anyway generally have a hard time adjusting emotionally too. To go through the intensity of labor and then have to endure the pain of surgical recovery too is a double physical burden. To give up your fantasy of how you wanted your birth to go and face a totally unexpected outcome is a difficult emotional adjustment for many. Those who unconsciously believed that 'this won't happen to me' and conversely, those who were especially afraid of having a cesarean often face the most difficult emotional adjustments of all. Rigid expectations of birth, denial of the unpredictable nature of birth, or extreme avoidance fears of possible surgery make a cesarean that much harder to deal with if it does occur. Experience of Labor Another factor that strongly influences a woman's experience of cesarean birth is how her labor went. If a woman experienced a relatively easy labor but a situation suddenly occurred where a cesarean became necessary, some women feel bereft and robbed of the culmination of what they had been working towards. These women tend to adjust fairly quickly and are often able to navigate recovery easily enough. They usually do not face future pregnancies or births with much fear of labor, just the fear of the recurrence of the complication recurring. Once they get past the stage where the complication occurred, they generally do very well. Sometimes they do experience the complication recurring, but with a more favorable resolution, and then they are fine. On the other hand, sometimes women who have had a sudden cesarean due to an emergency during labor are traumatized by the suddenness of how things changed, the unpredictable nature of labor, and a sense of fear over this volatility. The quick action that sometimes must be taken because of complications often does not leave time for women to adjust emotionally; they may feel like their bodies and emotions have been hijacked. In subsequent labors, even if everything is going well, they may fear another sudden 'hijacking' by a complication, and often need a lot of reassurance that all is going well. Again, once they are past the point where the previous complication occurred, they can often relax a bit more. Women who experienced a very difficult and painful labor before their cesarean occurred often see the cesarean as a welcome release from the pain they experienced. These are often the women who 'loved' their cesareans, as to them it was a release or a rescue from a difficult situation. To go from an immense amount of pain with little or no progress to the numbness of cesarean anesthesia may feel like a real blessing, and to have the immediate gratification of having it all over and holding that precious little one in their arms sooner rather than later is an understandable joy. Many women in this position logically therefore see their anesthesiologist or OB as rescuer and hero. Ironically, many of these difficult labors were actually caused by the labor management policies of the doctors, who were then able to ride in on their white horse to 'rescue' the woman from the problem the doctors had created in the first place! Women in this situation usually divide into two campsthose who staunchly keep seeing their doctors as white knight rescuers, and those whose heroes get knocked from the pedestals when they find out that the actions of their doctors may have caused their cesareans in the first place. This is a particularly difficult emotional transition. A woman may be 'fine' with her cesarean at first because she saw it as a rescue from a difficult situation or a lifesaving measure for herself or her baby. If she finds out later that the doctor actually caused or greatly added to the problem that she had to be rescued from or even worse, put her baby's life in danger through his actions , that transition from loving the cesarean to feeling betrayed by it can be particularly bumpy. These women often start out 'fine' with their cesarean but have a very difficult time healing emotionally once they truly understand their prior labor and birth. Women who are induced, have a long and painful labor, and end in an unanticipated cesarean can also have a particularly hard emotional recovery. A cesarean after a long difficult induction can be particularly challenging physically, and induction drugs often have long-term physical effects too. Pitocin, for example, can cause significant swelling and edema in the mother, which may impact breastfeeding supply, make it difficult and painful to walk, and be very uncomfortable to deal with. Women who have been induced with Cytotec misoprostol often report that their labors were extremely painful and difficult to deal with. Babies who have experienced labors with lots of drugs and pain medications often are jaundiced, drowsy, and 'out of it' at first, then fussy later on. All of these physical factors tend to make emotional recovery much more difficult as well. Adding to the difficulty of physical and emotional recovery after a difficult induction is the fear factor. Some inductions are so difficult that women develop a tremendous fear about labor. They can feel traumatized by how hard it was and how much pain they went through. Many have great anxiety about going through labor again because their only experience of labor was such an unnaturally strong and painful one. As a result, many choose an elective cesarean for their next birth in order to avoid a recurrence of such a difficult labor, not knowing or not being able to trust that labor doesn't have to be that painful and hard. Experience of Surgery and Recovery What happens during surgery and recovery also influences a woman's perception about her cesarean. If the surgery was experienced as a blessed relief after a long and very difficult labor, many women feel 'rescued' by it, and may always want to have a cesarean in the future. If they have never experienced an uncomplicated vaginal birth and have no comparison of how much easier a vaginal birth is to recover from, then they have no standard by which to measure a surgical recovery. Therefore, if their surgical recovery was unremarkable, these women are inclined to think of a cesarean as 'no big deal'. On the other hand, if surgery was difficult or traumatic in any way, a woman's perception of her cesarean is understandably going to be more negative, and her emotional recovery afterwards more difficult. For example, some women have experienced a lack of complete anesthesia coverage during their cesareans, which can be absolutely devastating emotionally and physically. This type of experience has long-term effects on feelings and fears about birth and surgery, and is a very difficult issue to heal from. It also can involve Post-Traumatic Stress Disorder. True recovery often involves going back and revisiting and reprocessing the experience, and the difficulty of doing that can keep women from healing for a long time. However, emotional recovery is possible, and the experience can often be a potent healing influence. If a woman's physical recovery is difficult or involved after a cesarean, then her emotional recovery will also likely be affected. Since larger women are more at risk for infections and wound separations after a cesarean, this can be an issue for them although it should be noted that average-sized women can encounter problems too! If a woman's incision site will not close, develops an infection or pockets of fluid, then she may need long-term nursing care. Sometimes women even need to be re-admitted to the hospital for additional surgery on the site. Cesareans also increase the risk for postpartum health problems like gallstones, appendicitis, ectopic pregnancy, painful scar adhesions, and possibly infertility. If you experienced problems like this, it's understandable not appreciating the cesarean, or having difficulty recovering emotionally afterwards! Treatment by Staff How a woman was treated by the medical staff during her labor, during her cesarean, and during her recovery also influences her opinions about cesareans and her emotional recovery from them. If the staff were consistently helpful, nurturing, empathetic and considerate towards her feelings, this goes a long way towards helping a woman towards physical and emotional healing. She may still experience disappointment over her cesarean but probably won't be as deeply traumatized by it. On the other hand, if staff were uncaring, cold, distant, judgmental, or abusive during labor, the cesarean, or recovery, then a woman is highly likely to find her cesarean traumatic and have great difficulty recovering emotionally. Although we would like to think that all hospital staff is caring and considerate, some staff can be chillingly cruel or even sadistic. This may be particularly true if the staff is fat-phobic. If you read a few of the stories in the BBW Cesarean Birth Stories , you will understand better how some women can find their cesareans deeply traumatic, and carry long-term emotional wounds from them. Emotional healing is of course still possible; often these terrible experiences are a call to action and create great empowerment for these women if they are able to marshal their anger and channel it into action and reform.
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