I suppose it was inevitable that watching a c-section today would be shocking on many levels given that my previous exposure to childbirth was one in which natural processes, continuity of care and a family centered approach were emphasized. There is not a whole lot in the O.R. that is natural and voicing any preferences or opinions seems radical and futile. I suppose that when childbirth meets surgery there will be an inevitable conflict of interests. Surgery is man-made. Thus, we have full control and losing control has unpredictable, dire consequences. Certain things are done certain ways for a reason. In surgery, keeping track of instruments is more important than consoling the tears that lie behind the drape.
I stood, shifting my weight from one leg standing in a removed corner of the room to the other, which rested just feet away from her head. Wanting to go to her and DO something, I felt glued to my spot – bound by my submissive student role – guilty for judging those more experienced than me. As her body shook (a “normal” response to the spinal anesthesia disconnecting the central nervous system from the peripheries and stimulating the brain to respond as if the body is very cold), tears streamed down her cheeks as iodine streamed down her voluptuous belly into the creases of her thighs, and I watched as seven pairs of eyes blinked through their masks, focusing intently on a patch of flesh bordered by sheets and marked by the convergence of the bright lights. To my relief, the anesthetist gently touched her arm and asked her what was wrong..."I'm scared" she replied. He lifted his arm. "Are you cold? Or in pain?". She nodded her head no. And then the only face she could see disappeared behind her and out of view. "Okay good" he responded. "Your husband will be in shortly". And he was. I was relieved to see him tenderly kiss her forehead and place his hand among the tangled tubes on hers. I absolved myself of my relational nursing practice responsibilities, walked straight to the foot of the bed and positioned myself in direct viewing of the big show. Bright lights, curtains and all.
As an isolated activity, the c-section surgery was fascinating to me. I love watching surgery. The learning channel taught me that. I’m always amazed at what a meticulous craft it is. They stretch the skin with a force comparable to stretching canvas, break and assemble bones with the calculated precision of a wood-worker and suture the layers of muscular, adipose and cutaneous tissue with the dexterity and efficiency of an experienced seamstress. A caesarean birth is no different (well, except for the breaking bones part). I witnessed a diligent, expert performance. It was easy for all of us to forget who lay behind the curtain. But just as the baby was drawn up from inside mum’s tum and into the pediatrician’s hands, and even dad left mum’s side to crowd around the newborn in awe, I remembered. I leaned down to her and asked how she was. She nodded, silently, and strained to tilt her eyes up at her baby. As I mustered congratulations I felt myself begin to cry. Luckily my mask concealed my recognizable expression. I quickly told her she would see her baby in a few minutes and I re-joined my colleagues where I felt protected from this human challenge. Safe from confronting this experience any further. One that she would likely remember for a very long time. Or, one that she would erase from her memory completely. Not sure which is better.
All in all, the surgery went as expected with “no complications” and mum and baby both came out of it “alive and well”. The art piece of the surgeons’ performance was hidden beneath a single strip of clear tape and a blue hospital gown. Dad and baby moved one floor up and mum went to recover for hours - to choose her memory’s path: re-call and solidify or delete, delete, delete. Ultimately, what matters most is that she had a healthy baby. A comfort and joy that she would appreciate more fully once they were reunited upstairs.
I am incredibly grateful for this observation. And because of it, I am committed to being a different kind of nurse. To address women’s birth experience, should they be wanting to speak about it. To support women outside AND inside the O.R. To keep them with their baby and their loved ones for as long as possible. To respect and facilitate natural processes in this unnatural circumstance. To challenge the status quo and honor my instincts.
