The Fear of a Caesarean Section

(I’m reproducing this post from elsewhere, with minor edits for context. I wrote it back when we were in the early stages of our journey towards having a baby, but it still applies now. If anything, now that I am actually pregnant, my fear of requiring a c-section has grown rather than diminished. This is the reason that I’m so undecided on early induction as per policy for type 1 diabetic women, as induction is associated with an increased risk of requiring a c-section.)

 

I spoke with a former midwife this week. We weren’t talking about pregnancy, birth or even children. We were, however, talking about my multi-faceted medical history. Out of the blue she announced to me “Don’t ever get pregnant will you?” The question mark was very barely there.

She must have seen the involuntary look of shock on my face. Because having a baby is very much what I do want to do. And there is no good reason why I can’t achieve a successful pregnancy with a happy, healthy outcome, even if that may be more difficult for me and my healthcare team than for the mythical “average” woman. So she back peddled a bit and said “It’s just the midwife part of me talking. A woman like you would be a nightmare in labour.”

This wasn’t really getting any better. Frankly, I was offended. I don’t wish to be made to feel as if I would be some massive burden to healthcare staff by choosing to have a family. And I’m sure that as in every other sphere of medicine, there are apparently routine and straightforward things that quickly turn in to nightmares that were not foreseen, and things that look to be a challenge beforehand, but turn out to be a walk in the park. If we were to prevent all potential difficulties of child birth, we’d have to bring an end to human kind.  So I felt myself shifting uncomfortably, trying to formulate a response that wouldn’t be equally rude, but would make clear the offence taken. Meanwhile she back peddled a bit more and said “Well, anyway, you’d definitely have to have an elective section, and the whole thing would be stage-managed.”

“Probably” I responded, appearing to concede because I realised that this conversation would never go anywhere.

“Definitely” she said.

It wasn’t her place. She won’t be involved in my care should I ever reach the point of discussing the labour and delivery of our child. A caesarean section may well be what happens, if that is what will be safest and healthiest for the both of us either due to my medical conditions or some other factor.

But it won”t be “elective”. Planned, yes. Elective, no. Because there is nothing elective about something that you really don’t want to happen, something that you would only do if there were no other safe choice. Accepted, not elected, for the latter implies some sort of choice.
 


Choice is not something there is much of if you’re pregnant, or considering pregnancy, with less than perfect health. I feel strongly about this. I’m annoyed with the way in which women with diabetes who become pregnant do not seem to be treated as individuals. The blanket policies on care and delivery that do not take in to account the very different needs and wishes of very different people are just plain wrong. As they would be if talking about women without diabetes. Every person, when they are a medical patient for any reason, deserves to be treated as an individual person first and foremost. But that is really a rant for another day.

I feel strongly about it for a much more personal reason. I’m terrified by the thought of a caesarean section. There is a word for the fear of child birth – tokophobia. What I feel about caesarean birth is identical but there isn’t, as far as I know, a word to encapsulate that.

Ironically it is the situation that contributed to a chunk of my potentially problematic medical history that also gave rise to this fear. Through multiple attempts at lumbar punctures (or spinal taps) during my bouts with meningitis and encephalitis, I learned that I have “unusual spinal anatomy” that I’ve since been told means that a spinal block or epidural will be very difficult, if not impossible, for me. And that means I might need a general anaesthetic to deliver our child. Missing the moment I become a mum is the thing that petrifies me the most. The alternative, attempting the spinal anaesthetic but having it leave me with the sort of nerve injury I suffered before – or worse – is not a much better proposition, and scares me almost equally.

I’m also afraid that the attitude I encountered this week will prove to be more than a one off. That I’ll always been seen as a medical problem first and everything else second. I’m reminded that there are people out there who think that I shouldn’t have children and believe that it’s selfish and wrong.
 


Sometimes everything about expanding our family beyond the two of us feels like such a monumental challenge. But I’m definitely not done yet.

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