A brief and personal history of the C-section

Barnstaple Hospital, north Devon, November, 2017. I’m flat on my back, flipped like a fish and gasping. A knife is inserted under my skin, and I’m gutted, my organs lifted into a bowl to make way as my son is born.

My smug plans for a gentle, hypno-natural, vaginal birth disappear down the drain, along with the kidney bowl of vomit I hurl, curling away from my newborn son. I clutch the theatre lead’s scrubs, with a whites-of-the-eyes, animal fear.

For 30 hours, I’ve laboured.

I’ve had every drug available to me, I’ve employed yogic breathing techniques on gas and air, I’ve squatted, I’ve howled, I’ve paced up and down.

I’ve been in, and out, of the birthing pool. I’ve had an entire imagined conversation with the artist Ai Wei Wei – a brief, if completely weird respite during one of my higher moments. It’s been exhausting, disappointing and torturously painful. And my baby is very happy where he is, thank you very much. He’s going nowhere.

Limp, empty and shaking, I’d signed a form that slid and blurred in front of me. Suddenly, I was wheeled down a corridor, sobbing and terrified, into theatre.

Hannah holds her son, following his birth by C-section.

*

Maurya Empire (what is now south Asia), c. 320 BC. Durdhara, the pregnant wife of the Emperor Chandragupta Maurya, innocently eats her husband’s food, so goes the story. She doesn’t realise it contains low levels of poison to increase his immunity in the case of assassination. She falls ill, and dies, but Chanakya, her husband’s teacher and advisor, cuts open her belly to save her child, a son.

This child, Bindusara, is the first recorded survivor of a C-section delivery. 

Depiction of Bindusara, 2nd Mauryan Emperor of India & first known child born of a C-section.

*

“Your body won’t make a baby that it can’t birth.” These were the soothing words of my hypnobirthing teacher, delivered reassuringly, several months before my emergency C-section, in a beanbag-filled room, tubes of softly glowing lights strewn across the floor. We’d just watched a video of a woman humming intensely as her baby slipped from her body into a birthing pool like a tiny, adorable tadpole, pulling it up to her breast: a joyful magic trick.

Well, it turns out I was one of the millions of women throughout history whose body did make a baby it couldn’t birth. Despite my best efforts. But before those 30 hellish hours, I was too wrapped up in my ‘positive birth’ bubble to take the idea of anything but the humming mermaid birth seriously as an option. I smiled indulgently, hands gently rubbing my swollen dome of a belly, when friends told me of their less than joyful labours. The fools! They were so conditioned by society to expect a miserable time giving birth that they manifested it. Armed with my positive affirmations and my videos of water births, I had successfully re-programmed myself. My birth experience would be positive. Of this, I was certain.

*

12 or 13 July, 100 BC. Gaius Julius Caesar is born, not, as it turns out by C-section. The man who would become the famous Roman Emperor, Julius Caesar, is often thought to be the source of the name Caesarean Section. But his mother survived his birth, ruling this out. It’s thought that the procedure is named for one of his ancestors, cut from his mother’s womb. 

*

When you’ve swallowed the hypnobirthing mantra, that birth is ‘natural’ (conveniently ignoring the fact that death in childbirth is also, very natural, because: negative vibes), accepting that something different came your way can be tricky. I don’t doubt that hypnobirthing is enormously valuable to many women. Birth is personal and whatever brings you through, be it drugs or humming, I’m not knocking it.

*

Sometime around the 1st Century, AD, Ulster. In the Medieval Ulster Cycle, mythological Irish folk hero Furbaid Ferbend’s pregnant mother is murdered by her own sister, Medb. He is born by posthumous c-section, and named for the Old Irish ‘urbad’, meaning ‘cutting.’ 

*

Hypnobirthing does come with the codicil that if you need interventions, you can use your affirmations and techniques to empower you through them, whatever your birth journey. But frankly, that’s a bit of a mixed message when the heart of its belief lies in the idea that your primal body knows what it’s up to, and Mother Nature has this covered.

And when your birth doesn’t follow the ‘natural’ journey marked out for you on your prettily illustrated pack, the emotions that follow can be complex. Throw in a bucketful of post-birth hormones, leaking breasts, leaking eyes and a leaking vagina (yup, you still bleed after a c-section), and shit can get bleak.

*

Babylonia, 500 AD. The Babylonian Talmud, the ancient text at the heart of Jewish law and theology, details a process called yotzei dofen, a kind of C-section. There is evidence that suggests women and children occasionally survived this process. 

*

Hardest of all to shake, was the crushing, surprising, feeling of failure. My logical brain knew that far from unfortunate, I was insanely lucky. A fluke of circumstance meant I lived in a time and place where a C-section was a viable, safe option for me and my baby. And far from being a failure, I was a bloody champion. A C-section is gruelling, major abdominal surgery. It’s no picnic. Almost two years later I flinch violently if anyone comes too close to my scar. And it twinges occasionally, this scar that connects me to my boy. Birth, whatever form it takes, makes warriors of women.

*

Illustration of ‘The Shanameh”: Simurgh, carrying Zal as a child. The phoenix-like beast returns to help Zal deliver his own son by C-section.

Around 1000 AD, Iran. The Shanameh, an epic poem by the Persian poet Ferdowsi details the birth of its hero, Rostam. His mother, Rudaba, ‘From top to toe she is Paradise gilded; all radiance, harmony and delectation’, labours at length with an unfeasibly enormous child. Her husband, Zal is sure she will die. But raised by Simurgh, a benevolent Phoenix-like bird, Zal is in possession of three golden feathers, and burning one, he summons his former protector, who instructs him on how to perform C-section. In the legend, both mother and child survive. 

*

I used to sit in the bath and force myself to look at my wound. I’d steel myself to peel one steri-strip off, and chant to myself ‘this is where my baby was born,’ trying to build a positive connection with this traumatised area of my body. And yet…I couldn’t let go of the feeling that I’d failed in some profound female way. When I bumped into the husband of a friend who’d just given birth vaginally, pride flushing across his face like sunbeams, my insides shrank even as I offered my congratulations. And a small voice in my head told me that no one would ever feel that pride about me. I hadn’t done what my body was ‘made’ to do. I couldn’t even feel proud of myself.

*

Siegerhausen, Switzerland, 1580something. A woman has laboured for 3 days. And now her husband, Jakob Nufer, a pig gelder, is about to take a knife to her womb. More familiar with the reproductive system of a sow, he cuts out his child, and miraculously, both mother and child survive. Supposedly, this is one of the first recorded instances of maternal survival during c-section in Europe. 

*

Call it morbid curiosity perhaps, but I only really began to come to terms with the trauma of my son’s birth when, at some point, I started to delve into C-sections from a historical perspective. It started by wanting to know more about the medical side of the procedure. And it turned out that for me, the way to shake the shame wasn’t in positive visualisations, it was in fact, information and detail.

*

Virginia, USA, 1794. Elizabeth Bennett begs her husband, Dr Jesse Bennett, to carry out a C-section, and save her unborn child following a prolonged labour. She knows that she will likely not survive the operation. Unwillingly, and knowing he is risking her life, Dr Bennett gives her laudanum and performs the operation on a table hastily assembled from two boards resting on barrels. Elizabeth’s sister holds a tallow candle to light the work, and Dr Bennett stitches the wound with tough linen thread. Against the odds, Elizabeth survives, and so does their daughter Maria. Dr Bennett refuses to report the operation, thinking that no one will believe a woman could survive such a violent procedure. But in 1892, a neighbour collects eyewitness accounts, and it’s recognised as the first C-section in America where both mother and child survived. 

*

It was in these forays into understanding more about the so-called, ‘too posh to push’ procedure that I began to understand the full weight of my fortune, in having failed to give birth vaginally here, and now.

I began to understand that the success of my own C-section, and those of many other modern women, rests on the lives of many, many women before me. Women who died in unimaginable pain and trauma. Even if they survived the initial surgical procedure, lack of hygiene, or surgical stitching meant that they often died soon afterwards of bleeding or infection.

*

James Berry, revolutionary Irish surgeon.

Cape Town, South Africa, 1822. A surgeon known as James Miranda Steuart Barry is appointed Colonial Medical Officer. It’s a secret unknown to his colleagues, but Barry was born Margaret Ann Bulkley, taking on the identity of James Barry in order to enter medical school, impossible for a woman in 1809. Whether Barry was transgender, or maintained a male identity to pursue a career and opportunities unavailable to a woman is not known, but it wasn’t until their death that their birth sex became known. Vegetarian, teetotaller and known for their temper and bravado; they once got into a war of words with Florence Nightingale, Barry also performed one of the first known C-sections in which both mother and child survived in Africa. 

*

I write this gazing at the sleeping face of my perfect son, and I am freshly aware that the gift of knowing him is only mine because of the suffering endured by these other women. I feel oddly close to them, sisterly even. These women whom I do not know, who across the globe and throughout history had their children cut from their dead or dying bodies.

Hannah and her son: “the gift of knowing him is mine because of the suffering endured by  other women.”

I don’t feel shame any more. I feel a sombre sense of reverence for those who didn’t have my good fortune. And I feel proud that while they suffered, the way was eventually paved so that women like me, whose bodies made babies they couldn’t birth, could deliver them safely.

By Hannah Marsh                              Twitter @Hannah_Marsh

 

  • Natty

    This is the second reading for me and still bringing a little tear to my eye. Beautifully written and a very healing journey. Thanks for sharing x

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