The Trying Game

On physical therapy and C-sections and the futility of planning

This essay deals with topics some readers may find uncomfortable, including pregnancy, birth trauma and surgery. Please put your own oxygen mask on first xo

photo by Matt Flores on Unsplash

I’m not the type of person who avoids revisiting the past. I like to mull over moments of conflict, instances of high emotion, flashes of anger that punctuate my days. What was it about that moment, that response, that look that really – for want of a better word – “triggered” me¹? Could I have reacted in a different, possibly better, way? How will that moment of conflict, whoever it was with, influence our relationship in the future? What can I do differently, next time around?

In a way, I think of it as my attempt to improve myself – to make future interactions better, more compassionate, and less reactive (I’m speaking about my own reactivity here, not anyone else’s) – but in another way I’m just a real dweller. (See also: holding grudges, a sport at which I am champion.)

I find it hard to let things go, or to move on, when I don’t feel as though there’s been a satisfactory conclusion – but I don’t avoid those feelings. I approach them head on. I unpick old scabs. I examine old wounds. In this way, at least, I am no coward.

This week, though, I found myself somewhere I really didn’t want to revisit. It was a realisation that didn’t quite hit me until I was walking through the front door of my physical therapy office, pushing against it to let myself into the waiting room, sitting down in the scratchy – why are they always so scratchy? – armchair, gazing around at a room that felt familiar, and also not.

The last time I walked through those doors, in the autumn of 2021, I was 39 weeks pregnant: heavy and bloated, with feet – as my friend K. would tell me – like loaves of milk bread, smooth and round, like fermented dough.

I’d been attending since the early months of my pregnancy, every fortnight at first, and then with increasing frequency, learning about birthing positions and spinning babies and hypnobirthing, all with the aim of facilitating the “natural” birth I had planned for. At that last appointment, I told my therapist I’d see her after the birth – we had more Bachelor gossip to discuss, quite aside from which, I wanted her to meet the baby, oh, and to help me navigate whatever impact his birth would have on my body.

But the birth didn’t quite go to “plan” (I know, god laughs, but I don’t believe in god, which makes me wonder, who’s laughing exactly?!), and among the many complicated feelings I had, after the C-section that brought my now-almost-three-year-old into the world, was shame. I was so very ashamed.

It’s not that I think there’s anything shameful about having a necessary surgery to deliver a baby who is reluctant to come into the world “the old-fashioned” way; I’m not a moron.

But still: I felt as though, in that moment where my obstetrician said to me, “at this stage” – meaning, 24 hours after the beginning of my induction, enduring hourly injections of penicillin, a healthy dose of pitocin, having my waters manually broken, a Cook’s catheter inserted, and seeing my cervix dilate to 4cm and then, over the course of 12 hours, a further 1cm to 5cm total (when 10cm is the goal) – “I would probably recommend a C-section”, and I said “okay”, I was not only letting my baby down, but also my husband, my physical therapist, and myself…

I had, after all, read about all of the benefits of vaginal birth, not just for the baby – whose passage through the birth canal would imbue him with all sorts of magical probiotics while also wringing him out like a wet towel, freeing his lungs from whatever phlegm and liquid were left in there from his long nine months in utero – but for myself, too.

I’d been told all about how much easier recovery would be after a natural birth – more specifically, an unmedicated natural birth, something that’s held up as the Holy Grail of giving birth, but actually is, according to statistics, not as common as we’re led to believe; a 2008 CDC study reveals that 61% of people opt for an epidural or spinal anesthesia when giving birth.

Furthermore, I wanted so much to feel that moment of elation, of achievement, when I had done something that is, granted, so ordinary and everyday as to happen 267 times per minute, globally, but also wonderful and amazing and awe-inspiring and miraculous (or so I’m told). We’ve all seen those photographs, the videos – like when Kourtney pulled out her own baby on a pivotal early episode of Keeping Up With the Kardashians – of the moment the baby is pushed through the vaginal canal and placed on the woman’s chest. She is elated, awe-struck, suddenly – albeit perhaps temporarily – assured of her own power.

They are not images we associate with C-section surgeries, although I will say that I have since heard dozens, if not hundreds, of stories of women who had “healing”, “beautiful”, “amazing” C-section deliveries.

Instead, in that moment I felt as if, in acceding to my obstetrician’s recommendations, I’d taken the easy way out by opting to lie still and have my baby removed from my body, rather than delivering him into the world through some combination of heretofore unknown Herculean strength, grit and determination.

There is something in this, I know, about women’s suffering and, too, about how women’s suffering is commodified, especially in media; I’m thinking about the stories that emerged throughout the campaign to repeal the 8th amendment in Ireland, and grant abortion access to Irish women (without forcing them to travel to the UK or further), and how hard it was to convince people of our humanity, our need for respect and bodily autonomy, without granting them the privilege of reading our very personal, intimate, heartbreaking, private stories. We had to sacrifice our pound of flesh before we were believed, before we were respected as human beings worthy of respect, who could be entrusted to make the best decisions for their own bodies.

I felt like I just hadn’t suffered enough.

This, of course, is a laughable feeling to have (although, rest assured, I have allowed myself to feel my feelings on the subject; I know that our emotions can often be so completely divorced from all logic as to seem entirely nonsensical, and yet, feel no less real to us); I was cut open, an incision across my abdomen right through to my uterus, my baby removed (reluctantly, they told me), and then I was stitched back up.

I still remember the shock of the pain upon waking the following morning; there was no time for that beautiful, liminal space between sleep and wakefulness in which one has usually forgotten one’s troubles. No: I was immediately assailed by the agonising evidence of what my body had endured. But it still didn’t feel like enough.

It truly didn’t even occur to me to go back to my physical therapist, after Atlas’ birth, even though I know – knew then, even – that physical therapy is not just for the “natural” birthers among us. It can work wonders on C-section scars, for example, speeding the healing process and helping to break down any stubborn tissue that may cause stiffness and pain in the area. It can assist in the healing of damage done to the pelvic floor by carrying a baby for almost 10 full months. You learn exercises to help strengthen your core, repair torn muscles, realign hips, re-stablise your pelvis.

But I was embarrassed. I could barely speak about Atlas’ birth to my friends and family; the idea of going in to speak to my physical therapist, having to explain to her how and why all of our plans had come to nothing… As I write this down, I’m aware that I wasn’t then – and am not now – obliged to explain anything to anyone. And, furthermore, that she was not going to judge me for how my child was brought into the world. The truly tragic fact of the matter is, the only one judging me for that was (is) me.

When I go through the doors this week, I am aware that I have a new therapist. My previous therapist has, I think, left the practice; I don’t ask, because I don’t want to have to decide whether I do or don’t want her to be my therapist again. Maybe it’s nice to have a clean slate. (Plus, I don’t watch The Bachelor any more, so what would we even talk about?!)

This time around, we talk about our children. My new therapist has two, one of whom, a girl, is a year older than Atlas. We compare notes on pregnancy-with-a-toddler, a unique form of torture I wouldn’t wish on anyone.

She asks about my previous birth, and I give a very top-line outline of how it all went. I’m glad to be lying face down on the massage table, my stomach encased in a very comfortable pregnancy cushion thing. I wonder if I could buy one of those for my bed, I think to myself, as I cry (I hope subtly) into the headrest.

She asks what my plan is, this time around, and I tell her I haven’t quite decided. Initially, I’d hoped for a VBAC, but as the weeks have ground on – slowly, oh so slowly – I’ve started to feel as though I won’t be able for it. I’m barely sleeping; energy levels are low; pain ebbs and flows but it’s never at less than a 4 out of 10. How can I go through a vaginal birth in this condition?! I can barely bend to put on my socks. I have to sit down for 30 minutes after I empty the dishwasher. Yesterday, I had to ask Brandin to come and bring a not-very-heavy box down the stairs for me, and I still have 16 weeks to go. How tired and feeble will I be by then?!

Then again, if I schedule a C-section, and pick a “convenient” day – maybe a Thursday, so Brandin has the entire weekend off right afterwards, without dipping into the five days’ leave he has allocated for after his son is born (those are his remaining vacation and sick days for the year; there is no statutory paternity leave), probably a week or two before Christmas, so that both the baby and I can be adequately recovered to enjoy the turkey – will I regret not even allowing myself the opportunity to experience a “natural” birth? Not to mention the fact that it feels gross to slot the birth of my child in around Brandin’s work schedule and my desire to eat – and enjoy – my festive feast.

“You don’t have to decide now,” she tells me calmly, in a tone that carries no judgment, at least not that I can discern (and trust me, I discern judgment in the tones of strangers a lot, although I make no guarantees as to the accuracy of said discernment).

I take a deep breath, resisting the urge to wipe the tear that has now trickled down my nose and is dangling precariously off the edge of my left nostril. I concentrate on my yogic breathing – in through the nose, out through the mouth – and try my hardest not to spiral down a rabbit-hole of what-iffery that I know never leads anywhere good.

“You know,” she says, then, “Even if you have a C-section, there’s a lot of work we can do in preparing you for that, and in helping you heal afterwards, like making sure your scar is healing, and even beforehand, that it’s moving well and not too tight.” It’s a weird image, as if my scar will somehow leave my body, do some yoga poses of its own and loosen itself up, so to speak, before coming back to join me again.

A lot of my feelings around Atlas’ birth are, I know, tied up in my self-esteem. It feels as if giving birth, like ballet, running, pottery, kickboxing, and myriad other things I’ve tried, might just be something I’m not very good at. Something I just… quit, when the going got tough. Something I failed at. (And again, the logical part of my brain knows that I didn’t. I gave birth. The evidence is currently sucking his thumb and singing to his dinos in the next room.)

A day or two after I had Atlas, one of the nurses in Dupont Hospital here in Fort Wayne, where he was delivered, said congratulations to me. I responded in typical me fashion, by deflecting, stuttering, refusing to say thank you.

“Oh,” I said, “I had a C-section. I barely did anything.”

I remember she stopped whatever she was doing – changing the bedsheets, or clearing up beside my bed, or bringing me medication and saltine crackers, a highlight of each day in hospital, honestly – and looked me in the eye before saying, “Don’t think that you didn’t do anything. You brought him into this world. You kept him alive for the last 10 months and he’s here and you have the scars to show for it. You still did something amazing, mama.”

And, despite the fact that I had written, explicitly, on my birth plan – the same plan that talked about a natural, unmedicated birth (lol); where I’d outlined my desire to be as active as possible up to the moment of pushing (I had an IV inserted the minute I arrived at the hospital and subsequently gave up on any ideas I had about walking around, the hassle of it all) – that I didn’t want anyone to call me “mama”, her words were profoundly moving.

I’m still not sure if I fully believe her – deep down, where the shame and the sense of failure and the fear that, in that moment, I just wasn’t enough for my son – but, right then and there, I decided that I’d try.

I guess I’m still trying: to forgive myself for something I know doesn’t need to be forgiven; to accept the past as something I can’t change; to go into the future without carrying with me that same sense of shame, and fear, and self-flagellation that has made any conversations about Atlas’ birth, or my hopes for this upcoming birth, feel so terrifying to me.

I’m still trying.

1. This reminds me: I have started to block, wantonly and without exception, anyone and everyone who uses the word “triggered” in response to me, my emotions, and my reactions. On social media, obviously, although if blocking people in real life was possible – and easy – I’d probably do that too. One notable example is someone who DMed me something truly quite caustic recently, and when I replied and told them that they were being rude, and unnecessarily so, they said, “oh, that wasn’t my intention – I’m sorry if my response triggered you”. I’ve never reached for the block button quite as quickly as I did on that day, and with such glee, too! It’s very freeing.