Edited by Amanda Fields and Rachel Mortiz
The Experiment, 2019; 256 pp; $15.95 (paperback)Buy Book
Twelve years ago, I was eight days overdue when a routine ultrasound showed the best chance of my firstborn son’s survival depended upon an immediate caesarean surgery. During the weeks and months following, I craved birth stories similar to my own. Back then, there didn’t seem to be any caesarean literature that fit the bill. Thanks to the efforts of Amanda Fields and Rachel Moritz, that book exists now.
My Caesarean: Twenty-One Mothers on the C-Section Experience and After is a collection of evocative essays written by a diverse group of writer-mothers. These intimate accounts say this to the reader: I see you; you are not alone; your birth story matters—sentiments I wish had been gifted to me following my first and two subsequent caesarean surgeries. The editorial pair, both C-section mothers, state the idea for My Caesarean first formed from the reaction to a social media thread whose response solidified the critical demand and need for stories about the C-section experience. In their “Editors’ Note” they share, “In editing these essays, we became immersed in the power of many voices assembled together, and the way they hold this subject up to the light. This book is here to widen our conversation about birth.”
The essayists don’t hold back in writing about the most intimate parts: emergency circumstances, failed birth plans, laboring bodies on display and organs on the table, troubling scars, painful incontinence, mounting fears, relentless self-doubts, rising anger, debilitating guilt, intrepid choices, physical resilience, emotional mending, reconciled anguish, and the intense joy and absolute love for the children cut from their wombs. Because of the depth and scope of the stories, My Caesarean will resonate with most C-section mothers; it is important reading for their partners and anyone interested in the nuances of caesarean birth and should be required reading for all physicians and medical students, as well.
As typical pregnancies follow a sequence of three trimesters, the editors have ordered this impactful collection into three parts: “Birth Matters,” “At the Threshold,” and “Beyond Postpartum.” Although only twenty-one essays are featured, the thoughtful arrangement is replete with the C-section experience, in its full terms.
The first section, “Birth Matters,” invites readers inside a spectrum of caesarean births and the reasons they were performed, often as emergencies. The book begins with an account capturing the essence and form of caesareans and the varied experiences the same woman can have in subsequent surgical births. Alicia Jo Rabins laments in her piece, “My Unnatural Birth Stories,” about what was lost: “Here are the births I didn’t experience: The water birth. The home birth. The natural hospital birth. The triumphant release . . . .The birth which leaves me knowing for the rest of my life that I’m strong and capable, that I can trust my animal body.”
The first of Rabins’ two caesareans occurred because her pregnancy lingered for two weeks past her due date. The second C-section because, after a few days of laboring, she and her child were in distress, in danger. She’s pragmatic in the retelling of her caesareans: “Here are the births I experienced: The anesthetic, full-body shudder. The cold overhead lights. The freezing room. The strangers in blue masks. My strapped-down arms.”
Offering the insight of a physician and caesarean mother, Mary Pan articulates in her essay, “Upside Down,” how she wrestled with her deep medical knowledge while she was pregnant. At almost full-term, her daughter repositioned to a breech position, which eradicated the chance Pan could labor naturally. She speaks of the “cultural negativity toward women who have a caesarean. Even the language used: “Did you have a natural birth?” As if having a baby by C-section is unnatural. As if growing a human inside another human for nine months then caring for it the rest of its life isn’t enough.”
As an interlude to the second section of the book, “At the Threshold,” Fields and Mortiz shed light on the statistics. “In 1970, the US caesarean rate was only 5 percent; by 1988, it had risen to 24.7 percent. What explains the increase?” they dare ask. They go on to detail a host of reasons for C-section intervention, such as failed epidurals, fetal distress, preeclampsia, placenta previa, placental abruption, cord prolapse, and sometimes for convenience, an actual preference. “The most common reason: failure to progress in labor.”
Occasionally, the survival of either mother or child, or both, is at stake, as Elizabeth Noll details in her essay, “The Emperor’s Cut”:
The cord had been wrapped around his neck twice, and as a consequence, it was too short. He would not have made it out of the birth canal.
. . . I knew that a C-section saved my life and my baby’s life.
. . . I would not be sitting here, writing this, if we’d let Nature take care of things. My son would not be asleep in the bedroom. We would be just memories now. Memories and bones.
Readers will learn that sometimes a C-section is the best and, perhaps, the only choice for a mother. Jen Fitzgerald, a survivor of child abuse, shares in “A Thin Blue Wall” how her body’s learned disassociation was a protective shell to the physical torment she endured, and how this response to trauma influenced her rationale for choosing a caesarean after her physician expressed concern for the size of her body in ratio to the growing child inside her womb: “I was told that my pubic bone hangs over my birth canal. It was past my due date and the baby had not even dropped. “There is nowhere for her to go,” my ob-gyn said. I was convinced that I’d clenched my body for so long that she had no hope of escaping it. Then I heard, “It’s your legal right to choose a caesarean section . . .”
Author Tyrese Coleman writes eloquently of personal trauma in “I Didn’t Dream of Pregnancy,” and the reasons she would have opted for a C-section even if the choice hadn’t already been made for her when pregnant with twins. Boldly, she writes of her “unpopular opinions”:
The decision to have an elective C-section is an act of empowerment. It means you truly know yourself, what your body can handle, and you shirk the inevitable judgment from people who believe the only legitimate birth experience—whatever that means—involves a vagina.
. . . I have never wanted to give birth that way. And although I did not have the choice at the time, if I did, I would still have decided to have a C-section.
A pregnant woman may require a caesarean because of prior abdominal surgeries, or she is advised against natural birth due to other health concerns, such as a physical abnormality perceived detrimental to her and the child. Cameron Denzen Hammon recounts in the essay, “Seam,” her doctor’s discovery: she has a tilted birth canal and her “daughter would have never made it out without a C-section.” She writes:
Three years later, when I struggled to get pregnant again, my doctor explained that the tilted canal is a genetic abnormality. “It’s a trait that mostly died out,” she explained, “because usually mother and daughter carrying it died in childbirth.” The genetic blueprint of our twin affliction would have died out, too. But this trait reappeared, or we who carry it did, after the proliferation of C-sections.
The stories in the third section, “Beyond Postpartum,” give voice to the sacrifices associated with pregnancy, labor, and the postpartum period, raise the issue of racial disparities, and offer insight into the powerful reclamations and resiliency of the female form. Latoya Jordan writes in “The Zigzag Mother” why she was drawn to natural approaches to childbirth. Yet, due to the presence of “meconium in the amniotic sac” after her water broke, a caesarean was imminent. Four years later, she had a uterine fibroid removed. Struggling to determine if she could endure another pregnancy after two surgeries, Jordan began to research and was shocked by her findings:
It seemed like every time I thought I might be ready . . . a story would pop up in the news of a woman just like me: Black, in her thirties or forties, who died after childbirth, usually post C-section. I consumed article after article about Black women dying at higher rates in childbirth.
. . . It didn’t matter how many books I read or videos I watched, how much prenatal yoga I did, or that I had health insurance, college degrees, a steady job, and a husband—none of that had saved any of the Black women I was reading about.
Readers will become acquainted with the types of scars formed after surgical births, the monumental recovery efforts, the mix of complications a C-section mother is apt to experience, and the intense recovery methods often necessary to reach a place of peace about caesarean birth. In her poignant reflection, “When Expectations Go Up in Flames,” Sara Bates writes:
It took me just over a year to fully understand that my son’s birth was not a test I needed to pass. It was not something I needed to do a certain way in order to become a worthy mother, not something to be defended or explained away, not something I had to prove to anyone, or to myself. It took a long time, but as the depths of my heart stretched beyond comprehension, I was able to let go of my caesarean and accept the heartache that came with it as part of motherhood.
My Caesarean holds the robust body of surgical birth stories between its slim covers. After reading the profound and varied takes, I couldn’t help but feel vindicated, held, seen, and understood as never before, all because of the mark of motherhood found between my narrow hips. As Maggie Smith concurs in the “Foreword”:
Our children’s births are individual, but these essays have opened my eyes to the caesarean experience as a shared experience . . . . Spending time with these women’s words makes me feel part of a community. We have scars in common—ones we can see, yes, and perhaps others that are not visible . . . . This book opened my eyes to other facets of the experience . . . .I’ve found a sense of community and connection with these other writer-mothers. We have similar scars but also shared gratitude, shared joy. What a gift.
What Amanda Fields and Rachel Moritz have together formed in My Caesarean: Twenty-One Mothers on the C-Section Experience and After is a raw collection of intimate surgical birth stories that rectify misapprehensions with care and narrative precision, honest chronicles, and a visceral beauty found inside the belly of mothers’ personal accounts. By tearing apart the seams that divide us on our views of birth, these effectual essays begin to remove any lingering stigma around and ignorance about C-sections. The editors have, indeed, triumphed in their hope “to begin a conversation about caesarean birth.”