I think it depends on how the intervention is handled. My wife had an emergency c-section, and the staff never let us feel out of control.

I had a terrible birth experience. I wanted a “natural” birth, but I was totally uneducated about what that meant. I got all my prenatal care at the hospital where I had my son, so I only got the official hospital version about birth. When I went in to have him I was already in labor, but they put me on Pictocin anyway, for no real reason. To this day (three years later) I have no idea why I was put on Pictocin almost as soon as I was admitted to the labor and delivery ward. The Pictocin made everything hurt so much, I ended up having all sorts of interventions I didn’t want to have, culminating in a c-section.

They were so condescending to me and my husband, it was like getting patted on the head, “oh yes dear, of course you want a natural birth” it was totally demeaning.

I’ve also found out that the prenatal care clinic at this hospital has a c-section rate of around 60%; this clinic mostly serves lower income women in the inner city who don’t have any health insurance besides the state insurance for pregnant women and children. That was what I had. They use these women as practice c-section guinea pigs for the fresh out of medical school OBGYNs who have spent all their time in school learning about birth interventions, not natural birth.

If anyone reading this is EVER planning on having a baby, DO NOT TAKE PICTOCIN, it makes it hurt more and stresses out you and your baby and then they say “ops! Gotta cut you open now! The baby is stressed out!”

Also read/ find out about birth from a non-medical perspective.
If this sounds really angry, it is because I am still angry about it.

However, keep in mind that they are talking about labors that require extreme medical interventions. There's a huge difference between a life and death situation where the mother feels powerless to save her child, and a more normal birth where a C-section is advised because labor isn't progressing. A woman is not going to get PTSD from the second situation, but a quick read of the post may not give that impression, because Miriam goes on to talk about C-section rates soaring and medical interventions becoming the norm. The point is that these situations aren't the norm, these are situations where medical intervention is absolutely necessary.

In other words, a routine C-section is not going to give you PTSD, even if your doctors and nurses are rude to you. And, no, I'm not an OB or a nurse, I'm a woman in my 34th week of a high-risk pregnancy so I'm very interested in the subject. It's wonderful that this mental health issue is finally being recognized and treated. Especially when post-partum depression is still underdiagnosed and undertreated. We still have a long way to go., but this is a hopeful development.

My mom had natural births, at the hospital, for all 4 of her daughters (including me- the baby). She never experienced post-partum depression, but there is one birth that has really stuck with her (and not in a "oh-isn't-it-a-miracle" way), that she's told me about every single time we even remotely discuss childbirth, or my childhood, or my sister's childhood. The doctor, despite her REFUSAL, broke her water with my older sister Rachael, which made the birth way too fast, out of her control, and in her words "scary". When I was born 2 years later she practically brow-beat the doctor with this story to make sure she didn't have to go through the same thing again. Just thought it was relevant.

MiriamCT--

A close friend of mine was also put on Pictocin when she was in labor, and she has no idea why. It's ocycotin, basically, and one of its side effects is it contracts the uterus, so it hurries laboe along (even if, as in the case of you and my friend) the labor is progressing just fine. Something happened with my friend's contracts; they started happening too quickly and there was a chance that she could rupture her uterus, so she was forced have a c-section. She was angry, but so grateful that her son was born healthily and that the doctors were there for her c-section. I'm angry on her behalf. In fact, it sounds like the exact same thing happened to her.

I don't know if she suffered from PTSD, but she def. experienced severe post-partum depression, and often mentioned feeling like "a failure" since she wasn't able to actually give birth on her own--she had to have a drug to induce contractinos and then a C-section. She said it wasn't the c-section that bothered her, but the drugs she was given.

BluePencils, I wouldn't be so quick to reach the conclusion that a "routine C-section" is not going to cause PTSD. First off, what would a routine C-section be? If it's not being done to save life and limb, that sounds like an unwarranted surgery. Now, if the C-section is actually being done because something has gone wrong, counted routine or otherwise, I can see why a mother might be traumatized and feel out of control.

In other words, a routine C-section is not going to give you PTSD, even if your doctors and nurses are rude to you.

I find that really condescending. Do you know how fucking scary it is to be told that they're going to cut you open now? That you have no choice in the matter and that if you don't do it, the baby will die and it will be all your fault (which is bullshit in most "routine" cases).

The nurses were great. It was my midwife who can rot in eternal hell. She's the one that made me feel like a failure for allowing the doctor to do a c-section. She's the one who tried to make me tell them not to do it, despite the irregular fetal heartbeat and the stall in labour for 3 goddamn hours. She's the one who played up my biggest fears to get me to go against the c-section that they were telling me was medically necessary (and as it turned out, there was NO CHANCE IN HELL I could have delivered that baby vaginally).

My c-section was routine as far as the medical system goes, but it sure as hell wasn't routine for me!

Don't tell me what can traumatize me and what can't.

I'm surprised no one here has mentioned a recent documentary called The Business of Being Born. It's a fascinating look at how women, pregnancy, and birth are treated in our society. It mentions a lot of the problems other commenters brought up-- most prominently, unnecessary Pictocin. It discussed the vicious cycle of contraction, Pictocin, and epidural that often leads to c-sections that, according to the film, would not have been necessary had no intervention happened in the first place.

I can't describe how shocking and fascinating this movie was. Everyone here should see it.

I am troubled by BluePencils' comment because it shows the ways in which a woman's post-partum mental state can be completely disregarded (hysteria, anyone?), not to mention the old adage: everyone's an expert on pregnancy. Whether one is pregnant or just knows of someone who has been, everyone seems to mysteriously have all the answers! I wonder how that works?

As others have pointed out, "routine" is not only highly suspect (should any caesarean be "routine?" I hope for uncomplicated, but the mere fact that a caesarean can now be considered "routine" is deeply troubling), it is completely subjective. I am glad to hear that some people are lucky enough to be part of a medical system where every caesarean is a wanted caesarean, and where the worst that can happen is that the staff is rude, but there are many, many women who report terrible abuses by medical staff in both caesarean and vaginal deliveries. Not all hospital staff are terrible or insensitive, not all caesareans are traumatizing, and not all women with a birth that is traumatizing at the time will exhibit PTSD.

From what I understand from the coverage of the study, it is not whether the caesarean is life-saving or not that is the determinative factor; rather, it is the woman's sense of powerlessness that is related to rates of PTSD. A woman can feel powerless or terrified if she is tied down during a perfectly "routine" caesarean, or might fear for her own life or her baby's in the face of exaggerated claims of fetal distress. Or what about women who suffer iatrogenic complications, such as hemorrhage caused by a caesarean that was not necessary to save lives? The feeling of your life slipping away is pretty damned scary, but does it fall into the category of "routine" or "required?" Frankly, I think it's irrelevant.

Bottom line: it is about the mother's subjective experience of trauma that makes the caesarean traumatic, not the doctor's assessment of whether the caesarean is necessary or not. Whether that trauma leads to PTSD is another issue, depending on the mother's particular susceptibilities and mitigating factors.

It is understandable that postpartum depression can result from the way a labouring woman is treated by medical staff. The powerlessness of saying "no" to an intervention and being ignored and getting it anyway is something I've seen described as "birth rape". In so many aspects of our lives, we're told we don't know what we want when we say no and somebody forces it on us anyway. The hospital is just one place where this happens. The lack of respect for women is appalling. At my own little backwater hospital, during a "natural" birth, I refused the narcotic in vogue at that time and the nurse said, "Don't be stupid" as she injected me with it. I don't remember much after that... except for the routine episiotomy (the doctor lied to me during prenatal exams and said he only did it when necessary and, after delivery, he told me it was always necessary). That women should be routinely tricked and bullied into stuff is disgusting.

And then there's the home life: the husband who thinks any woman who doesn't deliver in a field and keep on harvesting the grain is a spoiled modern woman - thus he refuses to "spoil" his wife further or contribute to her "laziness" by helping in any way after the child is born.

Since when did we start considering c-sections 'routine'? That's a pretty sad commentary on the state of childbirth.

The comments from all bloggers reveal just how personal and varied the process of childbirth is for women. Every woman's comment is valid because it relates to her unique experience, and how it affected her physically and psychologically. It is questionable to call C-sections "routine", as one would have thought such major surgery would be reserved for those women who cannot give birth vaginally for their own health reasons or the health of the baby. The C-section rate varies enormously between western countries, with my country, Australia, having one of the highest rates at about 30%.

I have a friend who is an obstetrician/gynaecologist and have asked him about this, and his answer was that we live in a highly litigious society, with doctors in his field paying enormous insurance premiums, and some are just not prepared to take the risk. In fact many are choosing to practise gynaecology but not obstetrics, and there is a crucial shortage in country areas. I asked him about the risks involved with having a C-section and he acknowledged that, but explained that some doctors feel more in control than with a vaginal birth. He also said that there is a popular belief that more medical intervention is needed because of women "delaying" having children, and that older mothers are considered higher risk. He stressed that there are good and bad doctors, mid-wives and nurses and practices go on which are questionable. He told me that when he was working in a public hospital, a colleague allowed a labouring woman who was obviously going to require a C-section, to suffer for longer than she had to, because this doctor was about to end her shift, and wanted to hand the patient to the doctor coming on the next shift. He told me he was powerless to intervene because he was a junior doctor at the time, and a definite hierarchy existed in the hospital.

That said, the medical advances which have been made are critical to the current state of maternal and child health (in affluent countries at least), and the days of childbirth being one of the biggest killers of women are behind us. However the pendulum seems to have swung so far in the other direction, with medical intervention of some sort becoming the norm rather than the exception. In a non high-risk or non-emergency situation, the decision to accept such intervention or not is the woman's choice, but it is not always presented this way, hence the feelings of powerlessness.

It seems that since I had my two babies in the late 80s when the trend was to have a "natural labour", increasing medical knowledge has been paralleled by increasing medical intervention. We were encouraged to have a "birth plan" made in consultation with our doctor, outlining before the event, your stance on various interventions. Of course such a plan is only useful if the people attending you during labour take any notice of it!!!!

So does it all boil down to the luck of the draw in the medical staff who attend you during labour? A woman who has the financial means to have a private obstetrician would be perceived as having more control over the situation, but C-section statistics in Australia reveal that private patients have a higher rate than public patients!

Often, women's stories of trauma caused by medical intervention and difficult births are dismissed with the comment that if a healthy outcome is obtained for both mother and child, what is there to complain about? If studies are recognising that women are showing signs of PTSD as a result of traumatic birth experiences, often reinforced by insensitive treatment by medical staff, then part of routine post-natal care should be to look for signs of this, just as Post-natal Depression is more widely screened for now. Of course, the bottom line is that this all takes money...

One of my friends who has had two children gave me this advice: "Have an advocate (midwife or doula) at the hospital with you because if you yourself get into an argument about your treatment with the doctor, you'll lose." So, yeah, when you're body is wracked with pain and your fearful for your own safety as well as that of your baby, and your partner is just as terrified and feeling powerless, it's hard to put up much resistence to the doctor. And, as they point out in "The Business of Being Born", the doctor maybe thinks he/she is giving you a choice about interventions but given their authority and your weakened state it sounds more like a command. And, doctors aren't shy about telling your your baby will die if you don't obey them (whether or not the baby is actually in danger). When I questioned some of my doctor's PRENATAL care decisions she started throwing around the term "fetal death" (not even thinly veiled scare tactics).

So, as many of you have pointed out, there is (or shouldn't be) such thing as a routine c-section. A C-section is major surgery and requires 4-6 weeks of rest and careful recuperation to recover from. Of course, this is inconvenient to say the least as this 4-6 weeks is also one of the most gruelling periods in terms of the exhaustion and stress of taking care of the baby.

Anyway, getting back to the trauma of the operation itself, assuming a typical hypermedicalized birth experience (that is, getting on the downwards spiral started with pitocin), you're in horrible pain for a long time, the doctors aren't listening to you and you're having trouble talking anyway because you're in so much pain, you feel powerless and then they announce you're going to cut you open, you're partner faints/vomits/turns grey when he/she watches the bloody show. I don't know, I think that would be a difficult experience to forget.

I'm having my baby in a hospital and I've gotten my prenatal care at a clinic in that same hospital. If I had it to do over again, I'd have gone with a midwife practice but it's too late now (I'm ready to go!). I won't have a midwife or a doula, just my partner and, hopefully, my mother. Both have been trained to say "No pitocin!!!" My doctor claims to fully support the natural approach and the hospital has a pretty low c-section rate (15-17%) so I'm cautiously optistic.

Just a note, in case others were startled by the probable typo in Cedar's comment above. The drug used to stimulate labor is called pitocin, and it is a synthetic form of a naturally occuring hormone, oxytocin, which is NOT oxycontin, as might be inferred from the misspelling/typo in the comment.

IANAD, but I do have experience with pitocin in my own deliveries.

I like to say that Pitocin is the equivalent of waterboarding for babies. Contractions compress the cord, restricting the infant's oxygen. Normally, contractions are relatively short and there is time between them for both mother and baby to catch their breath. With Pitocin, contractions are longer, more intense, and closer together. It is no wonder that "fetal distress" results.

Pitocin is virtually never medically necessary. It's used to combat the slowing of labor that comes from hospital stressors and anesthetics. Also, it's used to make sure that laboring women move in and out of the wards in a "timely" fashion -- like turning over tables at a restaurant.

Maternity care in this country is really in crisis, because we live in a culture that is profit-driven and misogynistic. Combine the two, and you get worse outcomes for more money spent. I highly recommend the documentary "The Business of Being Born" (available from Blockbuster and Netflix) and the book "Pushed."

I second (or third) the recommendation for The Business of Being Born. It's a must see.

And it also seem like a no-brainer to me that completely losing control of what happens to your body during a potentially scary/stressful experience like childbirth can cause PTSD. Duh! Anytime the people around me are condescending and ignore me, talk about me as if I'm not there or unconscious, or treat me like an irrational child that must be "handled" I'm going to be pissed off. But when you combine that with an experience that is really life-changing and of central importance to me at the time, it's devastating. My birth plan was partially ignored, and my partner and I had to do serious battle with the hospital staff to avoid all the unnecessary interventions. My midwife was out of town and I went into labor early, so we were on our own. My partner practically had to have a physical confrontation with the doctor to prevent a completely unnecessary episiotomy, and I had only been pushing for 30 minutes! My daughter was born 15 minutes later with no episiotomy and only minimal surface tearing. And I stood firm on refusing the Pitocin and epidural, so I still consider it a success, even though they ignored so many of the other things in my birth plan.