Forced Birth is Torture.

An American Traumedy

Seven months ago, I was awake on an operating table with two worried surgeons rushing to save my life over my opened body while my (healthy, perfect, objectively gorgeous) newborn son screamed just out of arm’s reach.

I had exactly two questions and was given the same maddening answer to each one.

“Can I hold the baby?”

“Not yet.”

“Are you going to sew me up?”

“Not yet.”

It would have been polite at this point for someone to chime in with more information. A rough ETA, perhaps. A sugar-coated explanation. A word of reassurance. A lemon Spindrift.

Several more nurses and doctors rushed in with several bags of blood and hooked them up to my IV. I had seen blood transfusions on the TV show House so I knew what this was.

“We’re giving you a blood transfusion.” somebody said.

“I’ve seen this on House.” I said.

“It’s perf’ed.” One of the surgeons said to someone else.

“Can I be unconscious?” I asked the anesthesiologist with an LA Dodgers surgical cap. No response. My arms started shaking and my teeth started chattering.

“A-am I hav-v-v-v-ing a seizure?” I asked as best I could.

“It’s the adrenaline,” Dodgers said.

And so I waited, shaking like a tent revival born again getting an exorcism, my husband on the other side of the room desperately trying to console our newborn baby, while doctors barked medical jargon over my body as I lay hopefully not dying. I wondered Is this a Sixth Sense thing? Am I dead? I’m dead and this is hell. If I am dead who will order the right size Crocs for my toddler.

“He’s an 8 in Crocs. He needs new ones.” I said to a nurse. She nodded, God bless her.

At this point my husband showed up in my peripheral vision.

“I can’t joke.” I said.

“I know.” He said.

“Tell my family I was cracking people up til the end, though.”

He laughed. Nice.

Then he crouched in a squat next to me holding our new baby.

“Look at him.” I did. He was gorgeous. He was screaming but I just heard his healthy strong lungs. Perfect loud hearty lungs of my alive boy.

“It’s going to be okay.” he said with utter confidence.

“Are you-u- s-sure?’” I chattered like a wind-up mouth toy.

“Yes." he lied.

“Bess?” My OBGYN said.

It is bad when you are having surgery and suddenly the surgeon starts asking you a question.

“Yes?”

“We’re going to have to remove your uterus.”

“And put it back?”

“No.”

I noticed her eyelashes. Her mascara looked incredible. Were they extensions? I wondered if I should have put on makeup before I got under this lighting. My intestines were visible to the entire room but so were my under eye circles.

She looked sad for me. She delivered my first baby. She knew I had talked about having three kids. Both my grandmothers had three kids and called it “a little team.” There was the faint glimmer of adding another one to the mix. A daughter or a third son - a runt of my litter of puppies. A house full of kids brambling all over each other and taking care of each other and moving as a pack. I wasn’t ready to give it up.

So I bargained.

“Do you have to remove it?” This made sense to me at the time. Perhaps this was her first offer and she could walk away with just an appendix instead. Gallbladder even. Or a lesser toe.

By way of explanation she gestured for my husband to look over the drape. Charlie, who is a very smart man but not a medically trained surgeon, looked over the drape (HIS GOOD FUCKING MANNERS PREVENTS HIM FROM DECLINING AN INVITATION) and nodded exactly once.

“It’s gotta go.” He said. The color was gone from his face.

What my husband saw as he peeked into my open abdomen was a uterus with a golf-ball-sized hole in it.

This is when I asked again if someone would put me to sleep. A surprise hysterectomy is not something one generally wants to hear and see and, unfortunately due to all the cauterizing, smell.

What happened next was several hours of careful cutting and suction and burning and stitching while I lay with my arms strapped down and the baby wailed.

More blood transfusions. More talk of preserving ovaries and removing cervical tissue. A litany of organs being inspected for collateral damage.

I whisper-sang to my son the whole time, consoling us both. I’m not religious, but I sang the Mi Shebeirah. I sang the Dire Straits song “Walk of Life.” And I sang “You Are My Sunshine.” I saw my grandparents looking at me with placid smiles in the surgical lights. I can still picture their faces, completely reassuring.

At 5:45 AM, when they closed me up my husband got the nod from my doctor.

He put our baby on my chest and he stopped crying instantly. We both dozed in stillness, breathing together, his warm, tiny back rising and falling under the palm of my hand. A nurse pulled down my wet face mask and I breathed in the honey bread heaven smell of his head.

We made it.

*

Minutes or hours later, in the recovery room, a doctor was going over my chart. “Placenta percreta,” he said. “The placenta perforated the wall of your uterus.”

“Wow,” I said half asleep.

“Lucky the baby was breech.”

“What do you mean?” my husband asked.

“If she didn’t have a c-section, a vaginal birth would have been catastrophic.”

He went on.

“When they tried to take the placenta out, it wouldn’t have detached from the uterus. It would have all” He put his fists together and twisted them apart.

“Ok! Ok! I got it.” I told his fists.

Then he said something that was meant to be reassuring, but is the second-worst sentence I have ever heard in my life: “Better to catch this on the operating table than the morgue table.”

The worst sentence, by an absolute landslide, remains “I assumed you knew we weren’t exclusive.”

*

I put all of this in detail because the reality of childbirth gets sanitized into a “miraculous” non-event in the conversation around reproduction in America.

Had I endured this at the will of the state, it would have been tantamount to corporal and psychological torture.

It was my choice to get pregnant and keep the pregnancy (“Oh no! Oh Jesus Christ! Here we fucking go again!” were my exact words after taking the test). It was my choice to stay on modified bedrest from 22 weeks along after an unexplained hemorrhage sent me to the nearest hospital by ambulance. It was my choice to keep going after two more painful bleeds brought me back to the hospital overnight. It was my choice to have this baby. To sacrifice my uterus and a bucket of blood and whatever else.

To remove any part of agency from this scenario is to mandate the unimaginable.

This was not a case of medical negligence or lack of adequate prenatal care. I had the best high risk maternal-fetal medicine specialist in Los Angeles. Without naming names, he was also the high risk doctor for a nice couple from Santa Barbara who recently moved from England. To have quite literally gotten the royal treatment and still been in peril during the “miracle of childbirth” would be unfathomable if it weren’t so commonplace.

Placenta percreta (and its less severe but also life-threatening sisters placenta accreta and placenta increta) is virtually undiagnosable on ultrasound. The only way to find it is on an MRI, which - here’s the rub - is not a screening method performed during pregnancy. I had no risk factors associated with a higher likelihood of percreta, so there was no reason to order an advanced scan. Up until weeks before the birth/surprise hysterectomy, the scans looked completely normal.

We can send a guided cruise missile across the Pacific Ocean to a precise target in North Korea with the push of a button, but we just don’t have the technology to find a hole in a uterus with an ultrasound.

As I have written before and would like to shout at various passerby, the United States has the highest maternal mortality rate of any industrialized country. It is also the only industrialized country where that death rate is currently rising. Adding a population of pregnant people who do not want to be pregnant to that statistical stew is a recipe for doom. There are life-threatening complications that go undetected because maternal medicine exists in a 1980s parallel universe of grainy black and white images taken at (if you’re lucky) 2-month intervals. And there are life-threatening complications that will happen because people in no financial or emotional position to be pregnant won’t have any prenatal care at all.

When Senator Lindsey Graham showed his hand and proposed a national abortion ban, he condemned an entire population to medical trauma. When he and his GOP cohort grandstand about “preserving the sanctity of life,” they do not seem to include the onslaught of death from placental abruption, placenta previa, uterine rupture, ectopic pregnancy, chorioamnionitis, stroke, preeclampsia, amniotic fluid embolism, cardiomyopathy, suicide from PTSD or postpartum depression, and various other freak shit shows that happen to those of us in stirrups.

The “culture of life” is a cult of maternal death. To claim otherwise is to turn away from medical fact, which, of course, has been the right wing’s entire modus ever since Trump decided face masks were itchy. To entrust reproductive healthcare legislation to the same politicians whose criminally negligent pandemic response killed over a million people is to sign the death warrants of untold Americans.

*

I was lucky. My baby was breech, a c-section was ordered, and they caught my complication on exactly the right kind of table. This is a story about a best-case scenario in a worst-case scenario. And it is a story that ends here, as I sit typing in my office, my waking-up baby stirring in his crib on the monitor, babbling and cooing to himself with the innate joy of someone wholly wanted and deeply loved by a mother who would endure it all again just for him.