Many years ago I wrote this piece after attending my very first ICAN conference in San Diego in 2005. I read this and part of me weeps for her, for the me I was and for the women who are becoming part of this sisterhood willingly, wittingly or not.  My pain has been transformed into outstretched hands and heart. It has given me a sensitivity and awareness of the birth world I would probably have never achieved on my own had my births been perfect, idyllic and without this trauma.

I love you dear sisters and my life would be far less without each of you.

Seems a long distance the ivory tower to the ground.  The surprise in finding the thorny bushes with burrs that dig deep and puncture again at will? Well meaning onlookers say “Well a hundred years ago you both would have died?”  And the farce begins.  Stuff it down because it is crazy not to be grateful for the surgeon’s hand.  Smile and pretend all the twisted darkness inside doesn’t really exist.  The oft daily chore mixed with joy of caring for a baby whom we are unsure is truly our own.   The continuing assault during lovemaking when a cringe comes from the depths when a loving and hungry hand brushes the incision site.  “How can he think I am beautiful?  How can he possibly want this?”  Another thing of beauty and perfection quashed underneath the burden of the surgeon’s handprint.  Oh no say it hasn’t already been a year.  The birthday.  THE birthday sounds so exciting but terror strikes.  Preparation to be happy, preparation to feel joy.  Preparation not to shortchange our amazing gift of a child under the pain of the surgeon’s knife print.

The anticipated day meant to birth us into motherhood and my child into my waiting hands to my craving breasts, I was birthed into the Sisterhood of the Scar forever.

This is a  slight re-do from a popular blog post from early 2008. The information is vital and pertinent to the near 1.5 million women (based on previous CDC data) who will have a cesarean surgery this year.

Having a cesarean section will almost always  get you a baby.  Generally there is much more to it and anyone could bargain for or anticipate even in the best of recoveries.

Let me count the ways in no particular order:

• A scar that in no way makes a bikini look better. Sometimes described as a shelf or a pouch.
• The feeling of failure, guilt or less than deserving of motherhood.
• The struggle of living with the huge dichotomy of loving your baby and perhaps hating the birth.
• Higher probability of losing your ability to have more children either through physiologic secondary infertility, pregnancy complications, self-induced secondary infertility, hysterectomy or lack of sexual intimacy in relationship.
• Higher probability of difficulty in breastfeeding.
• Postpartum depression or PTSD, especially in an unwanted cesarean.
• The feeling of failure as a wife or partner.
• Having others discount your feelings and needs. After all you “just” had a baby. Really you just had MAJOR surgery, perhaps by coercion, a true medical indication, or completely from interventions and medications.
• Living with the idea that you failed to pass induction, you failed to push out your baby, you failed because _________ (fill in the blank).
• Obtaining your records to find what you were told and what was written are different. Could your trusted care provider have lied and cheated you?
• Simply finding out that no one told you and you didn’t think it would happen to you. That being induced, getting the epidural, allowing AROM, not getting out of bed, etc. is why you had the cesarean. Is maternal ignorance and fear enough to quell what you feel and make it okay?
• How can you trust yourself as a mother when you ignored your maternal intuition and kept saying yes, because the nurse, midwife or doctor told you to?
• The way your marriage or partnership takes a turn toward hell or in the least a divided place.
• Living with dread when a hungry hand sweeps over your scar. Being sexual can be extremely difficult physically and emotionally.
• Having great fear of becoming pregnant again.
• Having great fear of going for a VBAC and ending up in the OR at the end.
• Not being understood and having others say to your face how lucky you are that you got to take the easy way out.
• Pain.
• Difficulty moving, walking, getting up, rolling over, coughing, laughing, tending to personal cleaning…. You get the idea. It is surgery.

Though not every woman will experience what is on the list, many do.  For all of these – there a stories layered and interwoven for too many women.

Every thirty seconds a woman is surgically having her baby delivered. Light her a candle. Offer her a meal. Let her speak. Listen to her intently. Don’t judge her. Send her to ICAN. http://www.ican-online.org/.

Putting effort into the initial postpartum period is in my opinion equally as important as preparing for pregnancy and birth.  Sometimes it is even more important due to circumstance or birth outcome.  Too many focus solely on the labor, delivery and perhaps the “stuff” that goes with having a baby while completely forgetting to look at all incredible change that occurs with having a new baby 24 hours a day, 7 days per week.

Below is a listing of important information to think about, investigate, understand and/or plan for.  Make a note of people in your immediate life that can be a resource as you go through the list.

Look carefully at class descriptions you may take in your local area, some are very thorough and others do not go into information you need in detail.

Here’s to postpartum preparedness!

Common Physical Changes for the Mother

Uterine Change and Bleeding

Breast Expectations and Breastfeeding Norms

Hormones and Symptoms

Recovery Requiring Attention

Vaginal Tearing, Episiotomy, Cesarean, Extreme Soreness or Swelling, Hemorrhoids

Nutrition

Common Psychological Changes

Mother and Father/Partner Changes

Processing the Birth Experience

Processing Becoming a Family

Postpartum Mood Disorders

Peer and Professional Support Resources

Understanding Your New Baby

Babymoon

How Baby’s Feed

Attachment

Infant Development

New Family Dynamic

Coping with Sleep Deprivation and Exhaustion

Managing Stress

Grieving the Changes

Siblings and Pets

Knowing How to Get the Right Support

Postpartum Doulas and Practical Support

Making Your Best Decisions

Defining Parental Roles – Financial, Baby Care, Changing the Status Quo

Choosing a Health Care Provider for your Baby

Early Infant Health Care Decisions – Vaccinations, Circumcision, etc.

Parenting Philosophies

Developing Your Parenting Style

Where Baby Will Sleep

Boundaries with Family and Friends

When to Seek Professional Help

Relationship Care

Realistic Expectations

Sexual Intimacy

Practicalities of Life

“Dating”

Priorities

Single Parenting

Arranging Practical Support

Making a Community

Parenting Needs

Unexpected Outcomes

Processing a Difficult Birth

Babies with Medical Needs, Coping and Advocating

Dealing with Loss, Grief, and Trauma

I offer a Postpartum Strategies class privately in the Colorado Springs area that goes into more detail on many of these topics.  My Bookstore lists several helpful books as well.