No Revision for My Incision Decision

Why choosing to have a scheduled cesarean delivery was the best choice for me and my baby.

Oct 01, 2024

My goal for labor and delivery was simple: bring my baby from my womb to the Earth in the safest way possible based on my current circumstances.

My circumstances were a baby in Frank breech position and a nuchal cord. I felt confident in scheduling my c-section knowing it was the best decision to minimize the risks for my baby and my body.

How we bring our children into this world is nobody else’s business. I’m sharing my business because I’ve read and listened to too many stories about mothers feeling guilty for making their own best decisions for labor and delivery, whether those decisions were made in advance or made during an emergency.

Of course, we never really have a concrete choice, do we? My daughter flew into the world at supersonic speed two weeks early when my water broke unsuspectingly and sent me sliding into the hospital in mismatched shoes and a towel wrapped around my waist.

This is not a persuasive piece to advocate for c-section deliveries or to ignore those whose c-sections were unplanned (and/or unwanted). It is not a dissection of the concerning study that recently suggested that doctors give Black women more c-sections to fill operating rooms and it is not a policy analysis on why the rates of c-section deliveries are increasing.

This is a personal essay on my positive birth experience with a scheduled c-section, and I hope that anyone reading this who is anticipating their own cesarean delivery feels a little bit less anxious about their choice.

Planning for My Cesarean Delivery

Throughout my pregnancy, I was asked by a surprising number of people how I planned to deliver my daughter. I was even more surprised by the number of people who said having a “natural birth” without any medical interventions was “best,” and who scoffed dramatically at the words “epidural” or “c-section.”

I was quite actually flabbergasted by anyone at all who had any opinion about my choices for my body. It all felt quite trivial and overly competitive, like one type of birth deserved more kudos than the other. Like birth was a game or a contest and not the delivery of a live human being.

There were several birth interventions I was adamant about avoiding, but a cesarean wasn’t one of them. My list was short: no sweeping of my membranes (because unnecessary ouch), no cervical checks (also because unnecessary ouch), and no induction unless necessary to preserve the health of me or my baby based only on my doctor’s professional medical opinion.

I also understood that I didn’t really have much control over any of this. Nature would take its course and determine my outcome no matter what I envisioned, so I did my best to lower my expectations.

Leading up to birth, I heard a lot of quips like, “Your body will do what it needs to do.” I disagree.

For those of us who have ever been diagnosed with a debilitating illness or condition, we know all too well that our bodies don’t always do what they need to do. I understand the intention found between these lines, but it would be silly to think I have a say in the things my body does or doesn’t do. All I can do is prepare, however I can, and hope for the best.

When I was 17, I was diagnosed with a congenital heart condition called Atrial Septal Defect (ASD) after experiencing heart palpitations and unexplained shortness of breath. ASD is marked by a hole between the upper chambers of the heart because the atrial wall failed to fully close in utero or just after birth. ASD causes filtered blood to mix with unfiltered blood, resulting in the improper recycling of mixed blood throughout the heart’s chambers. I underwent catheter-based heart surgery to repair my ASD.

Alas, my body didn’t need to do what it needed to do, and it required medical intervention for an optimal health outcome.

(PSA: you can check for ASD in your babies if you ask for a routine echocardiogram, especially if they’re experiencing any peculiar symptoms — it can save your baby’s health for life. Chest x-rays and EKGs can also be done, but advocate for an echocardiogram for the most thorough check; it’s the best way to identify ASD).

Perhaps my prior experience with a major surgery helped me feel comfortable with the prospect of an operating room during delivery. Perhaps my amazing relationship with my OBGYN and her team of incredible nurses built unwavering trust between us, and I knew that any medical decisions she and her staff would help me make would be in my best interest. Perhaps I was lucky. Perhaps I was diligent.

Perhaps, perhaps, perhaps.

I don’t know what a “perfect birth” is supposed to look like. My body simply said, “No natural birth for you,” and I am not above fate, so I did not taunt it. To the extent I could control my circumstances, I decided to plan a cesarean delivery.

Around 32 weeks, my baby flipped — in the wrong direction. She danced on her head all throughout pregnancy until the very moment she needed to actually dance on her head. Booty down, sitting on my pelvic floor like I was a cozy, boucle loveseat, she perched and never budged. Legs straight up into my ribs, she kicked me all through the night while she bounced on my bladder. Such a sweet little thing!

I increased my prenatal yoga frequency. I incorporated modified inversions. I saw a physical therapist. I opened my pelvic floor and my hips and I stretched and I stretched and I stretched and…my baby didn’t care. If there was a “flip the baby” technique to be found on YouTube, I tried it. Nothing changed her position.

Around 36 weeks, my doctor discussed performing an ECV procedure (external cephalic version — designed to manually flip a baby by maneuvering the baby’s body from the outside). Researching the risks and pain often associated with an ECV, I declined. I had an instinctual drive that told me my baby was Frank breech for a reason. It turns out that reason was a nuchal cord (wrapped around her neck).

My doctor is wonderful. She has helped thousands of women deliver their babies. She knows how to deliver a breech baby. She knows how to account for nuchal cord risks. And we decided that for me, the risks were not ones I was willing to take simply for the experience of a vaginal delivery in my circumstances. So, we planned my cesarean delivery for Week 39.

At the start of Week 38, I went into spontaneous labor around 10AM with no contractions. Just a few hours later, my contractions were nearly on top of each other and I was being rushed into the operating room to what became an “emergency planned c-section.” By 1:31PM, my daughter was born. Whew — I’m already tired!

This was not the birth that I planned. It was chaotic and rushed and surreal and marked by adrenaline and wildness — but my baby ultimately came into a world of peace, one without fear of the outcome, and my own compassionate and caring doctor helped me deliver her. What more could I ask for?

I empathize with the mothers who planned to have vaginal births and ended up on an operating table, expectations nonetheless devastating. I empathize with the mothers who had traumatic birth experiences because nothing went as planned, and they labored and labored until they were forced to receive their own incisions. It’s hard and it’s heartbreaking.

I understand how jarring and bizarre birth is for everyone who experiences it. How it is difficult to advocate for yourself in the thick of it. But I also understand what it’s like to head into labor and delivery with some peace of mind knowing that there are medical interventions that can minimize risks and help bring a Frank breech baby with a nuchal cord safely into the world without fearing strangulation, an increased risk of hip dysplasia, or entrapment in a tiny uterine canal.

Birth is miraculous and hard. There is no “best” birth. There is just birth and how we are compelled to grapple with it.

Healing from My Cesarean Delivery

As someone who has been under general anesthesia multiple times, I can confirm that being numbed for a surgery while awake was far more difficult to manage, mentally, than any other surgery I’ve had and should not ever be passed off as the “easy way out” (or worse, that a c-section is “not a real birth”).

Albeit, recovery from my c-section was more manageable than I originally anticipated. Has recovery been challenging? Absolutely — but aren’t all birth recoveries challenging in their varying ways? My c-section was performed without complication and minimal blood loss. I am so grateful — and it was still hard.

My primary challenges during recovery:

Walking after surgery. It is, indeed, difficult to stand the first day in the hospital after a c-section. I was still able to hold my baby, though not directly on my lower abdomen where my incisions were made. I stood for the first time about 12 hours after surgery and took all movements very slowly. Walking the following day and night, whenever I could, helped my mobility greatly.
Breastfeeding. I have previously written about my challenges breastfeeding, and the c-section challenge here was isolated to limiting the number of positions I could try. Ultimately, no positions worked for me, so this challenge ended up being a wash.
Holding the baby/changing positions. For about a month, I felt a tugging, pressure, or minor pain when “crunching” up from anywhere with my baby in my arms — laying up in bed, scooting off the couch, or climbing out of a reclining chair. At about five weeks postpartum, I could walk farther distances (a little over 10 driveways) and sit up on my own without assistance. Some women feel better sooner, and some later, but my five week mark was my first “sweet spot.”
Daily living activities. Bowel movements were initially frightening (drink your MiraLax!!!), showering was an Olympic sport (I won a gold medal this summer in pulling on my sweatpants), and picking items off of the floor was a humbling workout (for my next pregnancy, I will be purchasing this lovely contraption).

I took my pain medication on schedule and never felt like I was really “hurting” unless I moved too suddenly. I’m almost four months postpartum today and have started doing modified exercises, taking things slowly, and letting my body heal.

Ultimately, I have no regrets in making my incision decision. I have an already-fading happy face scar where my baby was brought into this world — booty first and full of joy — and that perfect baby girl now in my arms with a head full of spiky hair and a belly full of milk.

They ask how she came into this world and I say at peace.

Xo,

Violet Carol

Thank you for reading! If this post resonated with you, please feel free to “like” it or leave a comment to connect.

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