12 Comments
Sep 17Liked by Melinda Wenner Moyer

“You grew a baby in your body and brought it to this side of the veil. Another set of fingers and toes, a heart, a brain. How remarkable you are.” I will cherish this and use it to remind myself in difficult moments my strength as a mother. Thank you, Rachel ❤️ Great interview, Melinda!

Expand full comment
Sep 17Liked by Melinda Wenner Moyer

Really fascinating interview!!

Expand full comment
Sep 17·edited Sep 17Liked by Melinda Wenner Moyer

Such an interesting interview all around, thank you, but this was particularly fascinating to me: "the gap between the availability of midwives and the demand for them is greatest among Black women." Here's why: when I was born in New York City in the 1970s, my parents chose an in-hospital midwife birth, which gave them basically one choice, Roosevelt Hospital. They did a birthing class through the hospital (when the show Mad About You had a birthing class, my mom was like "whoever wrote the teacher of this class probably had a baby at Roosevelt in the 1970s"), at which they were basically the only middle-class white couple -- because apparently women on some kind of subsidized care (I'm not sure if we are talking Medicaid or what) were sent to those midwives. I think my parents had the impression that this was not something these women were allowed to choose so much as it was what was available to them, but I really don't know the details.

Anyway, reading this I am so grateful for the care I got, which included a nurse dedicated to me through labor and the support in avoiding intervention that, when things were complicated enough that the OB/GYN had to come in to check up on the midwife, the OB/GYN trusted the midwife's judgment that the situation was under control and didn't try to bigfoot the proceedings by demanding more intervention. In fact, my temperature rose enough that they were supposed to give the baby antibiotics at birth but they made the completely accurate judgment call that it wasn't necessary and the doctor signed off on that, too.

Expand full comment
Sep 17Liked by Melinda Wenner Moyer

This is a fascinating and important interview. I had my only child through an emergency C-section that I was relatively prepared for - it was introduced as 50% likely at the very start of my high risk pregnancy. Because of my medical circumstances, I worked with a Maternal-Fetal Medicine doctor and felt totally prepared and accepting of whatever could bring my son into the world healthy and safe. My entire pregnancy was very closely supervised and highly "medical" compared to most other women I know. I have excellent family support, great health insurance and was seeing 1-2 providers 2-3 times a week in my third trimester AND STILL... I was not prepared for the trauma and high levels of anxiety that followed the procedure, which ultimately happened under pretty urgent circumstances. Physically, I recovered quickly and had no complications. But mentally I was a wreck! It's astounding to me that with all the medical surveillance my pregnancy entailed (and the ensuing NICU stay and medically complicated first year for my son) not one provider talked to me about medication for anxiety. When my son was 2, I pursued my own treatment for what was diagnosed as PTSD, and with time, medication and therapy I am now, 8 years after his birth, able to say with confidence that we are both doing great. But it took longer than it should have!

Expand full comment
Sep 17Liked by Melinda Wenner Moyer

So good to read this! I was lucky to have an emergency c-section with a female surgeon who listened!! That’s was huge. Also, I think it’s absurd that women aren’t automatically sent to PT afterward. I would love to see a study on back issues related to c-sections. Major muscles and nerves are cut. It took me so long to find my core again and it was only through consistent work over a period of time, and I know what I’m doing. It’s crazy that so many also don’t get the physical support they need either.

Expand full comment

This is a fascinating interview. I remember Fleishman is in Trouble so vividly when Rachel went to the assault survivor support group. I had a c section with my second kid after attempting the version to turn him. I had just stopped being bruised when I reached my scheduled date. One SIL had a good experience with her c-section and my other SIL had an allergic reaction to anesthesia that made her unable to hold her baby so I was pretty nervous going into it. I ended up ok in the moment but I couldn’t stop thinking about how I willingly went in to have them cut my baby out of my body and the pain level after birth was very bad for a couple weeks. I hated being unable to pick up my oldest kid (though I know with a vaginal birth I likely would have still been restricted).

The first time I cried postpartum was when my then 2 yo tried to kiss my stomach and say “Boo boos all gone” because I always said that to him when he was hurt. He snuggled with me and held my hand a lot in those early weeks but I never got back the run and jump up hug at childcare pickup after he could only run to me and hug me with me crouching down.

I should have been on anxiety meds during both my births and postpartum, I had my babies about 2 years after several stillbirths and miscarriages in my extended family and friends and I had a lot of intrusive thoughts about my babies being born still. My first feeling upon both of them being born was just thank god they are alive. I knew I was anxious but somehow still never realized I had a diagnosable anxiety disorder. I’ve now been in therapy for a year and I wish I had pursued more mental health support after I had both my children.

Expand full comment

Just to balance out the anecdotal evidence: I had an unplanned (not emergency) C-section with my only birth 18 years ago, in Switzerland where nurse-midwives are the backbone of maternal-child care before, during, and after a birth. After 4 hours of labor in which dilation went from .5 cm to 2 cm and my son’s heart rate was regularly irregular, my ob-gyn was in favor of continuing to let nature take its course. The midwife wanted to get that baby out. My husband and I were presented with the facts and given time to consider a course of action. I had experienced a blissful and trouble-free pregnancy, and decided I didn’t need to risk anything at the finish line. The section was painless and undramatic. My husband got to hold our son first. I healed quickly and was treated with kid gloves by the army of midwives concerned for my physical and mental health. At 41 (!) I was simply ecstatic to have produced a healthy baby boy.

His irregular heart rate was monitored closely for the first three days, until it stopped skipping beats. On day 4 the pediatric cardiologist did an ultrasound and EKG for the tiny bean to rule out any structural damage.

Je ne regrette rien!

Expand full comment

Like Caroline Smrstik, I had a non-traumatic c-section (actually 2 of them). I find the discussion around c-sections to be very similar to the discussion around baby-feeding. “Of course fed (or healthy mom & baby) is best, but you should still try to do everything in your power to avoid formula (or a c-section).” Really, we should be empowering women & their healthcare providers to make informed, judgement free decisions. And we should be working to make all outcomes as trauma free as possible.

With each of my c-sections, there was a brief moment of distress for me: with the first kid, it was when I was first told I would need a c-section because my baby was in distress, but my medical providers were compassionate & that momentary distress did not become trauma. With the second kid, I went into labor 2 days before my elective c-section, and my distress happened when a medical resident told me I couldn’t I have a c-section because I wasn’t yet in labor (despite painful, frequent contractions, I wasn’t dilated enough to meet the medical definition), and I wasn’t yet quite at full term; that distress did not become trauma because the doctor on call intervened, and my own OB talked through the experience with me afterwards — and again provided empathy & compassion.

I don’t think it’s a coincidence that my OB has three kids, the youngest of whom is a few weeks younger than my older kid. She’s had one vaginal birth, one emergency c-section, and one elective c-section. So she truly understands what her patients are going through.

Expand full comment

Thank you for all this. I had an unplanned caesarean (“failure to progress”) and hearing about 36 hours of labor (I was around 24 hours) makes me wonder if I should have just held out, but there’s no knowing, and my daughter is healthy today. I’m often wondering if I’ll be able to do VBAC.

Expand full comment

Thank you for this interview. Somerstein’s book helped me understand my own experience of pregnancy and birth like no other has.

Expand full comment

By the time I was pregnant, in 2005-2006, almost everyone I knew who was having babies was having emergency Cesarean births. I chose to birth at home because I was afraid of unnecessary interventions in hospitals. ("Hospitals are for sick people", someone said to me. "Birth is not an ailment.") Both times I birthed, in 2006 and 2010, I had bags packed in case of a true emergency, in which case I would have been grateful for hospital care (including a Cesarean birth if needed). Both of my babies came two weeks after their estimated due date. Hospital doctors would have induced, which often leads to more interventions. I am thankful for births, in their own time, at home. Again: I am also thankful that the hospital was there if I needed it, which I could have. Grateful for the privelege of options, and for two "uneventful" (ha!) births.

Expand full comment