Challenges in Supporting CBAC Mothers

Challenges in Supporting CBAC Mothers

Trying to find the best way to support a CBAC mother can be difficult for healthcare providers, birth workers, friends, family members, and ICAN Chapter Leaders. But why is it so hard to offer comfort in this situation?

The answer boils down to our societal discomfort with grieving. Anyone who has ever experienced the death of a loved one has also experienced how difficult it is for some people to offer them love and support afterwards. And that’s after the huge impact of a death.
Of course, grieving a cesarean is not the same as grieving the death of a loved one, yet the process of grief is similar, whatever the loss. But because because people don’t equate this with “real” grieving, they often don’t know how to handle it. Few people understand how to help others deal with their life disappointments. As a result, people often respond by denying the difficulty of these experiences or by cutting grieving people off from support entirely.

As women who have experienced cesareans know, “Just be grateful for a healthy baby” is a common refrain. Yes, we are grateful for a healthy baby, but the experience of the mother counts too.

Trauma has to be processed, not just passed over, even when the traumatic experience brings us a beloved baby. We can love our baby even if we don’t love the way the baby arrived, and we can mourn the necessity of a cesarean even if it was truly life-saving.

Society has such a difficult time with the concept that the arrival of a baby can be anything other than the most joyful of occasions that it views any ambivalence as a very betrayal of the ideals of motherhood. In society’s view, if you aren’t happy with the birth, you aren’t happy with the child.

Yet we in ICAN know that these are two different things. You can grieve the birth while still loving the baby and being grateful for its presence. Women who have difficult or disappointing birth experiences need to have support for processing those experiences too, completely separate from their feelings over having a new baby.

It’s even harder to get support for grieving a cesarean that occurs around a VBAC attempt. So much of cesarean group support is aimed towards the women who have VBACs that women who don’t have VBACs often don’t feel comfortable or welcome anymore. No one knows quite what to say to them, and the mother may feel there is judgment around her choices and what she “should” have done differently. The focus is on the “triumphant” VBAC moms, and the non-VBAC moms may feel like they just don’t belong. 

Our discomfort with grieving in general, our societal disapproval with birth disappointment, and our undiluted focus on successful VBACs means that the CBAC mother is often left with little emotional support during a difficult and trying time.

Here is a summary of why it is difficult for birth workers and family members/friends to provide support for women who have experienced CBACs:

  • Grief is difficult and society doesn’t teach us how to deal well with grief – It is difficult to be around grieving people and society has not given us many tools for helping grieving people. We don’t know how to do it, so we often don’t do it at all
  • It is natural to distance yourself from someone who experienced your worst fear – Bad things happen in the world and that can be difficult to acknowledge. Being around someone who experienced your worst nightmare can make you confront your own fears about failure or loss. It takes tremendous courage to unflinchingly stand by someone who experienced what you are most afraid of, whether that is the loss of a VBAC or the major illness of a child or the death of a loved one
  • We may have grief of our own about their outcome – It’s only natural to want a VBAC for your friends, and it’s hard to see someone you care for not get that. Recognize that you may have your own grief over the outcome to deal with
  • We are afraid of doing it wrong – Many of us fear hurting someone by saying something inadvertently insensitive. We’re hesitant to stick our necks out for fear of offending. Sometimes in fear of saying the wrong thing, we say nothing at all – yet  silence can be the most hurtful thing of all
  • There is no “one size fits all” correct response – Different mothers are offended by different things. When supporting the CBAC mother, we can feel “damned if we do, damned if we don’t” – a no-win scenario – so we often just “don’t”
  • We may just not realize why something is insensitive – At some point, most people have said insensitive things to another person without having any idea of the hurt they’ve caused or why what they said was insensitive. Knowing how to respond sensitively is a learning process, and sometimes we’ve not had the right instruction in being more empathetic. Even with the very best of intentions, we can inadvertently wound someone further. We must forgive ourselves our failures and yet still take the chance of reaching out and trying to help
  • People in grief can be touchy – Grieving people can have a shorter fuse than they might have when not grieving, or might become more sensitive to the phrasing of something that the rest of us don’t see as a big deal. Sometimes they displace their anger over the event onto someone nearby for seemingly insignificant reasons. It can be difficult to accept the anger or frustration without taking it personally and knowing it may simply be an offloading of grief or anger onto a “safe” target
  • CBAC realities can sometimes challenge cherished birth beliefs – Some activists have a hard time accepting that birth doesn’t always go well, and that sometimes babies can’t be born safely, even with plenty of time and support. It may be easier for some to blame the mother or second-guess her decisions rather than question their own birth beliefs
  • We may tend to want to manage other people’s grief  We may feel the need to impose our own agenda or timeline onto other people’s grief, to tell them it’s time to move on, to push them to process things before they are ready to process them, to impose our own agenda onto their grief because their grief makes us uncomfortable. We have to let go of the need to micromanage other people’s grief 
  • We feel the need to “fix” people’s grief for them  Most people avoid grieving people or push someone to move through grief quickly because it is very painful to watch someone in pain and we want to help. However, we have to recognize that we are powerless to “fix” another person’s grief for them. They must do it on their own terms and timeline, and often the best we can do is to become a silent and supportive witness to their pain

Dealing with CBAC Challenges: Summary 

Supporting a grieving person can be difficult work. Understand that going in, and be forgiving of yourself if you are less than perfect in your support sometimes. Don’t take things personally, because sometimes the support person can be a lightning rod for the grieving person’s pain. It’s not necessarily about you; it may be about their grief instead, or about their anger over the circumstances.

Accept that you may make mistakes but be willing to take the risk of reaching out. It’s better to offer less-than-perfect support than for the grieving person to have no support at all. 

At the same time, be willing to respect the needs of the grieving person. They may need space and time away from others more than anything else. Be led by the mother and follow her cues.

Approach support with humility, openness and the willingness to listen.

Never underestimate the power of simply standing witness to someone’s grief. Just listening and being there may be more powerful than we think.