Rachel Somerstein had been in labor for almost 24 hours when someone showed her a paper to sign.
It was after midnight, in a small hospital in upstate New York, and with her first delivery heading toward an unplanned C-section, she was in no position to read the fine print.
Her birth had already had a complicated start: the anesthesiologist had to redo the epidural three times.
Now, as her daughter’s heart rate slowed, she believed her worst fears were about to come true.
In his book, Invisible Labor: The Untold Story of Cesarean Sectionshe recalls, “I was sure that this left turn into unknown territory meant that… I would die, that my baby would die.”
Caesarean section is the most common surgery in the world. In the United States it represents one in every three births.
As Rachel Somerstein recovered, she discovered she wasn’t the only mother who had experienced birth trauma.
Her husband later told her that the general feeling in the operating room was that she was hysterical. After all, a cesarean section is the most common surgery in the world. In In the United States they represent one in every three births.
What did he have to worry about?
“I briefly remember being taken on a stretcher to the operating room,” he writes. ‘Almost naked and frozen, I hunched over on my belly and leaned against the doula.
‘While the anesthesiologist was trying to insert a new tube into my spine to administer the anesthesia, my body kept trying to expel the baby.
‘As with the epidural, the anesthesiologist had difficulty placing the needle correctly. Someone may have tied or restrained my arms. The doctor made the first cut.
‘”I felt that,” I told him.
“You will feel pressure,” he said.
But Rachel felt everything. Every cut.
The separation of your abdominal muscles. The scissors used to move your bladder. The scalpel with which the doctor ‘cut’ her uterus.
The obstetrician later noted: “The patient… was screaming in pain.”
‘My legs, as I remember, and as the doctor wrote, “were moving quite a bit.”
‘They kicked high enough that I could see them over the curtain, rigged so I couldn’t see what was happening.
‘The anesthesia had failed and everyone knew it. However, the operation continued. I was expected to endure the pain. I would later find scratches on my hips. From the nails of the nurses, perhaps, who hold me down.
Later, while she was recovering, her daughter was brought to her to be fed, but Rachel was still in shock and in excruciating pain.
‘”I don’t want to see her,” I shouted. ‘Take her away!’
Immediately afterwards, Rachel felt guilty for rejecting her son in that first moment of need, but then realized that it was one of her purest acts as a mother: “I didn’t want to associate her with my pain anymore. She was already very attached to that.
Two months later, at her last postpartum checkup, she was told that she looked great, but didn’t feel very well. She couldn’t feel his core muscles. Her vulva was numb but his sex hurt.
‘A midwife suggested a lubricant, which didn’t work: “It still hurts,” I said. “More lube,” she said.
Her own research revealed that pelvic floor physical therapy could have helped, but it was never suggested to her. The belief at the time was that a C-section “protects” the perineum, so pelvic floor PT is unnecessary.
However, it wasn’t until almost two years later that one of the most unexpected (and most difficult) parts of his recovery emerged.
They brought her daughter to her to feed her, but Rachel was still in shock and in excruciating pain. ‘”I don’t want to see her,” she shouted. ‘Take her away!’
“I was waiting for a colonoscopy, the first time I had been in a hospital since birth,” he writes.
“I lay down on a stretcher in a surgery room. I started shaking and crying, but I couldn’t explain to the nurse what was happening, because I didn’t understand it either. I was having a panic attack, something that had never happened to me before.
For the first time, Rachel told a stranger that she had palpated her C-section and recognized her own post-traumatic stress disorder (PTSD). as a result: “Something that is not routinely screened for postpartum, although nearly one in five mothers who are ‘high risk’ develop PTSD after birth,” she says.
‘High risk mothers are those who have had a traumatic birth, like me; a serious obstetric complication; “a history of sexual or physical violence or child abuse”; or who give birth to premature babies, with very low birth weight or with “fetal (abnormalities).”
Friends and family encouraged her to file a negligence lawsuit, but no local attorneys took the case. One even asked her why she was making such a fuss. ‘How long did she really take?’ she asked. ‘Five minutes?’
Another suggested that he must suddenly need the money, which is why he had waited so long to apply.
Rachel added: ‘The most empathetic explained that payments for pain and suffering have a limit. Since my daughter and I had not suffered permanent physical injuries, it did not make financial sense to represent me.’
As she tried to make sense of what had happened to her, she discovered she was not alone: ”I felt sick knowing how many people are hurt, harmed, or killed during or after pregnancy or childbirth—harm disproportionately caused by the mothers of their children.” “. color.’
While maternal mortality rates decreased slightly in 2022, they have doubled since 1999, according to a recent study published in JAMA.
Rachel cites another survey and writes: “Maternal mortality in 48 US states increased approximately 27 percent between 2000 and 2014, reaching 23.8 per 100,000 live births, one of the highest rates of any country.” rich.”
According to a 2007 study by the U.S. Department of Health and Human Services, the increasing number of C-sections is partly to blame for this troubling statistic.
The number of operations more than doubled between 1996 and 2007, when it reached 32 percent of all births, a level at which it has more or less remained since.
Birth has come up a lot in conversations with other parents: a secret club that suffers in silence.
Rachel writes: ‘And although I thought what I had experienced was very unusual, I discovered that breakthrough pain during caesarean sections is not that rare, although researchers have only just begun to investigate it.
‘My trauma was not unique either; A large proportion of mothers (up to 45 percent, according to one study) feel traumatized by birth.
And anecdotally, she learned that there is a “secret club” of mothers who suffer in silence, writing: “As I have raised my children over the past seven years, birth has come up a lot in conversations with other parents , often in fragments”. between serving snacks or pushing a swing in the park.
‘When they heard about my experience, many mothers confessed to me about their own cesarean sections: “Physically I was fine, but emotionally it was hard.” Or: “I had postpartum depression, but I was never diagnosed.”
Rachel even met women who worked in medicine who told her similar stories.
“Oh, honey,” a nurse told me over the phone, “I know how you feel. I had an emergency C-section, lost a lot of blood, and even lost my uterus.”
“There are so many of us,” Rachel writes, “at all levels of society, who seem like normal, well-adjusted people doing our thing, belying the traumatizing or unresolved C-section at the center.”
Invisible Labor: The Untold Story of Cesarean Section by Rachel Somerstein is published by Ecco Labor.