I survived a C-section with no anesthetic – it was agony and I felt the surgeon cut through layers of my muscle
Rachel Somerstein had been in labor for almost 24 hours when someone held up a piece of paper for her to sign.
It was after midnight, in a small hospital in upstate New York, and because her first delivery was headed for an unplanned C-section, she was unable to read the fine print.
Her labor had already started complicated: the anesthetist had to repeat her epidural three times.
With her daughter’s heart rate dropping, she believed her worst fears were about to come true.
In her book, Invisible labor: the untold story of the caesarean sectionshe recalls, “I was sure that this left turn into unknown territory meant that… I was going to die, that my baby was going to die.”
The caesarean section is the most common operation in the world. In the US this is one in three births
As Rachel Somerstein recovered, she found herself far from alone among mothers who had experienced trauma during childbirth
Her husband later told her that the general feeling in the operating room was that she was hysterical. After all, the C-section is the world’s most common surgery. In in the US they account for one in three births.
What did she have to worry about?
“I remember being rolled into the operating room on a stretcher,” she writes. ‘Almost naked and freezing, I bent over my stomach and braced myself against the doula.
‘While the anesthetist tried to insert a new tube into my spine to administer the anesthesia, my body kept trying to push the baby out.
‘Just like with the epidural, the anesthetist had difficulty placing the needle correctly. Maybe someone tied or held my arms. The doctor made the first cut.
“I felt that,” I told him.
‘You’ll feel pressure,’ he said.’
But Rachel felt everything. Every cut.
The separation of her abdominal muscles. The scissors moved her bladder. The scalpel the doctor used to ‘cut’ her uterus.
The midwife 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 so high I could see them above the curtain, so rigged I couldn’t see what was going on.
‘The anesthesia had failed and everyone knew it. Still, the operation went ahead. I was expected to endure the pain. Later I discovered scratches on my hips. From the nails of the nurses, perhaps, who held me down.’
Then, as she recovered, her daughter was brought to her to nurse, but Rachel was still in shock and in excruciating pain.
“I don’t want to see her,” I shouted. “Take her away!”
In the immediate aftermath, Rachel felt guilty for rejecting her child in that first moment of need, but later realized that this was one of her purest acts as a mother: “I didn’t want to associate her with my pain anymore.” She was already so into it.’
Two months later, at her last postpartum check-up, she was told she looked good, but wasn’t feeling very well. She couldn’t feel her core muscles. Her vulva was numb, but sex hurt.
‘A midwife suggested lubricant, but that didn’t work: ‘It still hurts,’ I told her. “More lube,” she said.
Her own research suggested that pelvic floor physical therapy might have helped, but it was never suggested to her. At the time, it was believed that a cesarean section ‘spares’ the perineum, so pelvic floor PT is not necessary.
Yet it wasn’t until almost two years later that one of the most unexpected – and most difficult – parts of her recovery emerged.
Her daughter was brought to her to nurse, but Rachel was still in shock and in excruciating pain. “I don’t want to see her,” I shouted. “Take her away!”
“I was awaiting a colonoscopy, the first time I had been in a hospital since birth,” she wrote.
‘I was on a stretcher in an operating room. I started shaking and crying, but couldn’t explain to the nurse what was happening because I didn’t understand either. I had a panic attack, something that had never happened to me before.’
For the first time, Rachel told a stranger that she had felt her C-section and recognized her own post-traumatic stress disorder (PTSD). as a result, “Something that isn’t routinely screened for postpartum, even though nearly one in five ‘high-risk’ mothers develop PTSD after birth,” she says.
‘High-risk mothers are those who had a traumatic birth, like me; a serious obstetric complication; “a history of sexual or physical violence or child abuse;” or who deliver babies who are born prematurely, have very low birth weight or have a ‘fetus’ [anomalies].”‘
She was encouraged by friends and family to file a malpractice suit, but no local attorneys would take the case. One even asked what she was so concerned about. “How long did it really take?” he asked. ‘Five minutes?’
Another suggested she suddenly needed the money, which is why she waited so long to apply.
Rachel added, “The most empathetic explained that the payouts for pain and suffering are limited. Because my daughter and I were not permanently physically injured, it made no financial sense to represent me.”
As she tried to understand what had happened to her, she found she was far from alone: “I felt sick to hear how many people have been injured, damaged or killed during or after pregnancy or birth – harm that is disproportionately caused by mothers of children. colour.’
While maternal mortality fell slightly in 2022, it has doubled since 1999, according to a recent study published in JAMA.
Quoting another study, Rachel writes, “Maternal mortality rose by an estimated 27 percent in 48 U.S. states between 2000 and 2014, reaching 23.8 for every 100,000 live births, one of the highest rates of any rich country.”
According to a 2007 study by the U.S. Department of Health and Human Services, the increasing rate of C-sections is partly to blame for this troubling statistic.
The number of surgeries more than doubled between 1996 and 2007, when it reached 32 percent of all births — where it has more or less remained since.
Birth comes up a lot in conversations with other parents – a secret club that suffers in silence
Rachel writes, “And while I thought what I had experienced was highly unusual, I discovered that breakthrough pain during C-sections is not that rare, although researchers have only just begun to investigate this.
‘My trauma was not unique either; a large proportion of mothers – as many as 45 percent, per survey – feel traumatized by the birth.”
And anecdotally, she has 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 often come up in conversations with other parents, often in shreds. between handing out snacks or pushing a swing in the park.
‘When they heard about my experience, many mothers confessed to me about their own caesarean section: ‘Physically it went well, but emotionally it was tough.’ Or, “I had postpartum depression, but was never diagnosed.”
Rachel even encountered women who worked in medicine who told her similar stories.
“Oh honey,” a nurse said on the phone, “I know how you feel. I had an emergency caesarean section, lost so much blood and even lost my uterus.”
“There are so many of us,” Rachel writes, “in all walks of life, who look like normal, well-adjusted people doing our thing and belying the traumatizing or otherwise unresolved c-section in the center.”
Invisible labor: the untold story of the caesarean section by Rachel Somerstein is published by Ecco Labor.
