• Families recount pains and fears of modern childbirth

By MUSA JIBRIL

If all men truly were made of sterner stuff, why would some of them cringe or cry in the face of Caesarean section?  This question is at times unfathomable. For instance, Chukwudi Osondu, 46, a father of five is one of such men whose phobia for Caesarean section––the medical procedure of women giving birth to a baby by abdominal operation––borders on the absurd.

As we sit under the shade of his house in Aradagun, Badagry, a suburb of Lagos, he gives a snap account of the night his wife was delivered of their third child: “I was out of my mind, weeping like a child until the doctor ‘chased’ me out, accusing me of frightening the poor woman. Then I went outside, walking about aimlessly, until my brother-in-law came and consoled me.”

Five years on, two children later, and one more recurrence, Osondu still has not got over his fear for C-Section.

“I am not comfortable with any medical operation that involves opening up human beings and stitching them. It fills me with great fear,” he explains. “That night, my mind was filled with frightening thoughts. I just couldn’t get it out of my mind that my wife would not die. I kept asking myself, “What if the doctor made a mistake? What is she did not survive? The brief sleep I had, I was tormented by a nightmare I couldn’t tell anybody, so nobody understood why I was crying.”

Today, he remains the butt of joke, at the family hospital in Badagry and among his in-laws.  Even his wife, he says, occasionally digs at him.

The male fear at times oscillates between concerns of mortality and material cost of the surgery, as it was in the case of John Ukpong, who, found himself in a relationship that ended in pregnancy. As he claims, “from Day One, I prayed against Cesarean” which he describes as “a very expensive form of childbirth that dries up people’s finances.”

Ukpong’s fright was not unfounded: “I have seen a friend almost ruined by Cesarean operation. The financial implication overwhelmed her because her husband at the time was unemployed. I had to clean out my account to help the family offset a N250, 000 bill.”

His woman, due for delivery in February, was far overdue by May, the situation becoming more alarming with the absence of any sign of imminent birth, ended in the doctor’s pronouncement that the child could only be delivered via the abdominal surgery.

The bogey of fund popped up. “I was given a speculated amount of N150, 000. I told them honestly I did not have that amount. They asked if I could come up with N50, 000. I deposited all I had on me, which amounted to N75, 000.”

Eventually, the expense totaled N175, 000 in addition to a pint of blood at N15, 000. Given a lenient option of payment in instalment, it took him four months––from May to September––to pay up.

He says: “My modest journalist’s wage was not enough. I had to turn to other sources for money.”

In retrospect, Ukpong considers himself lucky. “I knew what my friends passed through. Of my two friends, one paid N250, 000, the other a little less, because she was prepared, having known from antenatal her cervix was too narrow.”

Only women can tell

No matter how emotional men are about CS, their concerns swiftly pale out of significance in comparison to the woman’s since they do not directly go under the surgeon’s knife. As the saying goes, “only the wearer knows where the shoe pinches.” Caesarean section is a woman thing. Only women can adequately capture the moment.

In this wise, one can take for gospel truth the view of Chikodi Ugo. At 35, and after two kids, both by operation, the HR consultant qualifies to be called a ‘Caesarean birth veteran’––if there is such a label.

On both occasions, having carried her pregnancies to term, her cervix failed to soften or dilate to allow the baby exit the birth canal.

Her story: “After about seven month gone with my first pregnancy, the doctor told me my pelvic wasn’t opening, that the foetus was hanging, above where it should be. At seven months, the foetus should be coming down with the head in the cervix and ready to push through. By the eighth month, it was the same despite the fact that I was doing the prescribed morning exercise. Then I was 36 weeks––nine months––gone! The doctor told me it had to be by Caesarean. Having anticipated a child for four years, I wanted my baby by any means, so I was not in the least bothered that my belly was going to be cut open.”

Overwhelmed by joy of becoming a mother, she was in a jolly good mood even as she was going into the theatre. Understandably. Her fecundity came after four years of marriage. Not until the moment the doctor started praying shortly before commencing the operation did the gravity of the situation weigh on her mind.

Ugo had no recall of the surgery.  She was ‘knocked out. She came out of a deep slumber to behold and carry her son, the only indication of surgery being a line of stitches below her abdomen.  Save for constipation and the awkwardness at using the toilet, she was fit as a fiddle, free of any post operation complications.

“After a week, I started sweeping my house. Though I feel some discomfort around my stomach, I was fine,” she recalls.

Panic only cropped up when it was time to remove the staples.

“My blood pressure increased, and I didn’t want to tell the doctor it was because of my fear for the stitches he was going to remove.  But I had to tell him when he asked what the problem was. I told him: “I heard people saying it was hurtful taking out ‘the wire’.”

A no-problem assurance from the doctor calmed her down, followed by what she thought was a cursory examination, and was surprised when a few minutes later, the physician pronounced it done.

“I felt ashamed, to think that I almost killed myself worrying over nothing,” she says.

By the seventh month of her second pregnancy, she was, again, confirmed for another cesarean birth.  The second procedure was different in one fundamental way in that she was fully awake, but with her lower body numbed due to regional anesthetics.

“This time, I experienced pain. They told me I wouldn’t feel pain, but I felt it and I told them. And they had to inject me again, and for the third time.”

Chinenye Ibekwe, a businesswoman in her late 30s, can objectively balance vaginal birth against the Caesarean version. After two normal childbirths, her third delivery was a complete departure because of a breech foetus.

“The doctor said it was risky for me to go through labour and my husband said he was for the surgery if that was the only way to save my life and the baby’s. So, I had to take it in good faith.”

On the night of October 14, 2014, when she had her third child by C-Section, she was conscious through the procedure: “I was given an injection on my lap. I didn’t feel any pain. While the operation was going on, the medical team conversed with me. They kept me talking, though they used a drape to screen my lower body so I couldn’t see what they were doing.  At last, they showed me the baby. I was dressed and taken into the ward. I slept off.”

The most gratifying part of the operation for Ibekwe was the escape from labour.  It was a big relief to be excused from the so-called Curse of Eve.

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The edict held sacrosanct by theologians––“with pain you will give birth to children”––does not apply to the Caesareans.   

Ugo and Ibekwe were lucky because their procedures were planned. Patients of emergency caesarean, on the other hand, are liable to suffer the grinds and rigours of labour as a prelude to the actual surgery. That was the travails of Omolola Adeniran in 2013 when she discovered that being a nurse hardly prepared her for the ordeal.

“As a nurse I thought I knew every thing about CS. Being accustomed to it, I had no fear,” she says, noting that what made her experience a travail was the element of last-minute decision that robbed her of psychological preparation.

With three previous natural births, she felt no cause for alarm on that fateful day she went to the hospital as an unbooked patient hoping to deliver and return home.

“I got to the hospital at 8 am, and nurses attended to me. Being a nurse, when my contractions were getting strong I expected the child would be born in the next five minutes.”

Alas, five minutes turned into 50 agonizing minutes during which the nurses started speaking in hushed tones.  As the ‘mule kicks’ from inside her became intense, the pain became unbearable, with the gripelasting an average of five minutes.

“The contraction was kicking the breath out of me. I could not even pray,” she recalls poignantly.

There is something wrong. That was as far as her experience as a nurse aided her. Soon after, the doctor confirmed her hunch. Natural birth is high risk.

Perplexed, she told the doctor: “This is my fourth child, not my first, why can’t I have a natural birth?” 

Though traumatised by labour pain, she remembered being wheeled into the theatre shortly before 10 am.  When she opened her eyes by 5 pm, she had a faint recall of the intervening hours––voices saying, ‘this woman is very strong’; her complaints about pain (Why don’t you give me xylocaine injection?) and the responses it generated (Is she a nurse? Yes, she is) and the vague feeling of her body being invaded, opened, cleaned and stitched. 

One hour after wakefulness, she was in serrated pain. “I was almost screaming until given an injection that sedated me and I went to sleep. It was on the third day, I was able to stand.”

Four years after, the ordeal is still harrowing to remember. “At the time I was told it has to be CS, my situation was critical, I knew I was hanging between life and death. Judging by the intensity of the contraction and the excruciating pain, I was certain a delay would lead to the loss of my life, or the baby.”

Much ado about bills

This is another gospel truth for men: When the final hour kicked in and a woman faces the prospect of a doctor’s scalpel, worries about bill is about the last thing on her mind. 

One way or another, this concern is always resolved satisfactorily.

Ibekwe recounts: “One hears stories of how someone paid N200, 000 or more, or how another was asked to first deposit N100, 000. I’d always prayed that I wouldn’t have to go through it, principally because of the financial aspect.”

Lo, the reality, for her, was far more ameliorative: “I never had to pay deposit. It all cost N47, 000 at the General Hospital, close to Akerele, Surulere.”

The Ugos were better prepared. “We were ready for it knowing well ahead it was going to be CS. The doctor too––being our family doctor––was lenient with us. After the first bulk payment, we cleared the rest in subsequent payments.  At the second birth, we were better prepared financially.”

In the case of Adeniran, whose preparation was for a normal birth, her case at Jomark Hospital in Alaba, Ajegunle, wasn’t so much a big deal about her ability to pay the bills as the urgency to rescue mother and child.

“I went to the hospital with N1100.  Without waiting for me to pay for even a pint of blood, they set me up for the operation, despite my being an unbooked patient. Eventually, my bill was N135, 000. I made the first tranche of payment on the third day and balanced subsequently.”

Once a Caesarean

After two CS births, Chikaodi Ugo now yearns for natural birth.

“I have not experienced labour at all. I only heard of it,” she begins. “I am told the pain is about 20 times as painful as menstrual cramps.  Some women told me, “You don’t even want to know what we go through” with regard to the pain of labour, and that arising from the stitched tears of their privates, as well as the traditional massage they are subjected to afterwards.”

She is not put off anyway, saying: “The good thing for them is the healing process won’t take more than a week, unlike those of us who went through CS that required weeks to mend during which we had to be extra careful.”

She especially abhors the post-caesarean demands. “Bending put a strain on the stitches as you are meant to lie supine most of the time. If that is so, who will bathe you and your child? Who will cook for you? I was lucky my mum did all that for me on both occasions. It was because I wasn’t doing any work the pain wasn’t so much.”

Chinenye Ibekwe differs. Preferring CS to vaginal birth, she says, “It saves the woman a lot of stress”––and she knows better, having gone through a three-hour labour for her first child.

“With CS, I was spared of all the pains that comes with natural birth, chest, back, shoulder, thighs, hips––I did not feel pain anywhere. I felt comfortable. With CS, you have your life in order, but not so with vaginal birth––when you are done with the push, you are drained of strength and essence, because you would have pushed a lot of goodness out of your body,” she articulates.

Her experience blew away all the myths surrounding birth. “Afterwards, I see CS as a normal course of action when a child doesn’t come out natural.” 

As for Adeniran, whether a woman eventually put to bed by surgery or naturally, she believes, it is important she be prepared for both. “That will save you any unnecessary emotional stress at the moment of birth,” she advises.

Of the two birth methods, she has no favourite. “Just as vaginal birth makes you feel roundly womanly, Caesarean section is also a fact of life for every woman.”