Like greased lightning, two early posttraumatic insights came into me on the operating table that would sow the seeds for posttraumatic growth. Nearing the end of a long-drawn-out ordeal in labor, I felt the rumblings of shock and trauma. Hours later, being prepped for surgery unmistakably rattled the foundation of my birth-related belief system. And yet, once in the operating room, I found myself at the Gate of Gratitude and Relief:  I was at once grateful and guilty; grateful for the ending of three days of unrelenting pain and guilty for being thankful for the epidural. I felt defeated and, at the same time, unabashed relief that the battle was over and I would see my baby at last.  

As sterile drapes were placed, I turned my head and looked at a bright white wall, and watched the second-hand ticking on a clock. Just then, the first insight came through my mindless exhausted mind: “The trauma I’m going to experience won’t be from the cesarean. “I was already traumatized about cesarean before I went into labor.” In that instant, I understood that my absence of compassion for cesarean mothers and my judgments about the rising incidence of (unnecessary) cesarean sections were the true seeds emotional trauma. But from where did they come? (I’ll save the answer for another post.)

While busy figures in masks and gowns bustled about, the second series of flash insights came into me: “I am not alone. A million women are having cesareans this year; I am one of them now. What was it I needed to know as a mother that I didn’t know as a midwife? What is it all of us need to know? Why didn’t I know it?” And this is when the first glimmer of an elder-mentor eclipsed the childbirth teacher role. I was abruptly pulled out of this reverie, hearing Sky cry for the first time and seeing him for a fleeting moment. Some minutes later, Peter held our swaddled Sky; we started singing his birth song; he instantly stopped crying and looked down at me with his big eyes. I fell in love; my eyes teared up. So began the cesarean-recovery journey; within weeks, I plummeted into a deep depression.

I wept every day; I was falling apart and could not get it together. The labor, transfer from home birth, and cesarean shock and trauma was a prominent piece. Still, another grief (that I did not expect) surfaced and was darkening postpartum:  Falling in love with my baby and feeling so protective raised the questions again and again, “How could she have done all that to me? How could my father leave and never look back on me?” There it was, all the pain and shame I had tried to bury by excelling in school, being productive, positive, and good, and meditating it away. My mother was a scary borderline personality, an adult child of an alcoholic, a mess, but my only parent after my alcoholic dad just up and left us when I was six years old. I kept thinking I shouldn’t raise Sky; someone else could do it better; I couldn’t bear it if I hurt him. These doubts were unexpected because from the minute I knew I was pregnant, I was in love with the child I was carrying and with the idea of being a mother. By then, my family had all but deserted me, perhaps because of my path in life (I’ll never know why); my husband was in his world. It was a dark, confusing, lonely time. I wondered how long this would go on? What could I do to pull myself together again? I started grasping at straws. The posttraumatic growth events highlighted below overlapped when being lived; and many influential meetings and medicines cannot be mentioned in a brief blog like this.

One day, out of the blue, I recalled an abridged version of a myth about Inanna; I read it when I was pregnant but didn’t get it. Then, suddenly, I realized what was happening to me was like Inanna: Bidu, the Gatekeeper, had taken everything, and I was alone in the underworld. But Inanna found her way out of the underworld. “I will follow in her footsteps.” That was the first ray of light. And following in the footsteps of Inanna led me to study mythology, the heroic journey, and archetypal psychology, which has become the cornerstone of my work with birth as a heroic journey and Birth Story Medicine.

About then, I stumbled upon an ancient Greek Gate in the form of Plato’s “Myth of Er.” This myth was a spiritual balm for me.  I now had to consider the possibilities of fate and destiny, that everything was as it should be, and that maybe this experience would serve a purpose.

When I was pregnant and still a shiny new homebirth nurse-midwife, I met Lewis Mehl Madrona for the first time. In just a few days, his teachings on Holistic Prenatal Care changed the course of my life. He introduced the work of Milton Erickson and Ericksonian Hypnotherapy; the model and demonstrations blew my mind. It was a timely introduction; and unbeknownst to me, it would become a critical piece of my post-traumatic growth within the year. Looking for a way out or through, I flipped through a phonebook and found Brian, an Ericksonian hypnotherapist. He helped me reframe my beliefs and identity as a midwife. I worried my homebirth clients would not believe or trust me as their midwife when they knew I could not give birth? I scoffed at Brian’s suggestion that I now knew something women needed to know about: the experience of birthing by cesarean. As it happened, the following week a woman came to see me. Again, the timing was right. Knowing I had given birth by cesarean, she looked into my eyes and confided that she was worried about cesarean and asked me if I could prepare her in case it happened to her. Before my cesarean, I did not prepare women in what to expect during cesarean, partly because I believed it would undermine their confidence and partly, I didn’t have insight cesarean from a mother’s perspective. But having been initiated by fire, I could tell her what she needed to know with compassion; that session was calming for her and healing for me. 

For years the Questions that came to me during surgery were like a steady drum beat ever keeping me on my path to self-discovery.  At some point I began asking a new question: What do I know now—as a mother—that I didn’t know as a midwife? The answer was validating. The outcome of my birth did not define me; outcomes do not define any woman. Our entire childbearing year is an embodied learning experience. It’s just that what we learn and how we learn it is never what we expect! Books convey ideas, but there is another kind of alive and personally meaningful learning from within. For a while, I discounted a strata of learnings gained during pregnancy, the inner journey through a long, protracted labor, the hard work of pushing, the defeat and wisdom of transfer, hospital birth as a patient, cesarean birth, nursing and mothering an infant, and postpartum depression. The only thing I had not experienced was “the last push,” but having pushed for hours, I earned a grand education nonetheless. So, yes, I still could be a worthy midwife.

But most of my work with Brian was first aid reframing my self-image as a mother; we only scraped the surface of how being raised by a borderline mother and abandoned by my father shaped me. This healing was a beginning; it was gradual, a struggle, and continued for decades. Our work together got me to another Gate.

The Questions that surged through me on the operating table haunted me for years. I had to answer them for myself, but also because I knew millions of other women were also asking these questions, also lost in a postpartum underworld! I had lots of questions and needed lots of answers. So I enrolled in a Masters of Psychology/Counseling program. I was building a new framework of beliefs and understanding, but the biggest takeaway was the discoveries made during thesis research on the Drawings of Ancient and Modern Pregnant Women, still in development today. The Cesarean Birth Art processes came from my Posttraumatic drawings and making “lines of birth.”

At another Gate on my Return, Bidu took my cracked pitcher of Trust Birth flavored Kool-Aid (still a favorite beverage of half the birthing culture) and whatever hadn’t already spilled out of it. It was a blessing he took it because part of me wanted to salvage it, refill it, keep serving it to other newbies. 

My Return took years; I used to wonder why it took so long. Was it because the more idealistic one is, the more repair work there is to do on the way back? Or, does it take others a long time, but I never asked. Recently I read possible explanations for gradual or abrupt transformations offered by researchers cited in Posttraumatic Growth by Tedeshi, Park, and Calhoun:

“Positive psychological adaptation to trauma unfolds at a gradual pace and tempo as we work through the lengthy process of growing by bringing a moderate ‘dosing’ of traumatic material into awareness.”1 Likewise, rebuilding shattered assumptions and changing perceptions of ourselves and birth in our culture or the world is a gradual process. Perhaps incremental insights allow for integration and lasting change. 

Some people do experience abrupt, dramatic change soon after a crisis or trauma. But it’s unclear what prompts sudden, lasting change because studies would have to measure the state of mind, emotion, and locus of control in a group before and after a traumatic event–and that’s not possible. However, when sudden change did occur, it was related to finding new meaning in life, e.g., a shift from seeking achievement, adventure, and pleasure to seeking personal peace of mind and spirituality.2

If there were a ritual, a symbolic moment that captures completing a heroic journey and receiving the “tincture of transformation,” this memory would come to mind.  During a power journey to Teotihuacan in Mexico, a leader guided us in a personal ritual of letting go before the incredible pyramid or temple of the Feathered Serpent.  I was leaning over the railing facing rows of ornately carved Feathered-Serpent heads when the leader came behind me and said softly, “Keep going until there is not one Thread left hanging from your ribs.” 

This Thread was an ambiguous personal symbol; for me, it represented a ghost of a storyline. This Invitation took me to a spot along my rib cage. Yes. There it was—a rotting, gray, limp old thread—loosely attached from mind to rib. With the power of imagery and ceremony, I imagined it, plucked it, and tossed it to the Feathered Serpent to digest for me.

How I knew my search had come to an end? 

Eight years after my search for meaning began, I was pregnant for the second time. There would be no “do-over” plan because I already knew the first birth and initiation was as it should be. It was done. Now, in a new childbearing year, the child and me were on a new heroic journey. If there were one thing I would do in the “corrective” spirit, it was to begin preparation with the thing I still preferred not to have, a cesarean birth. But instead of attempts to avoid it, I embraced the possibility of it without. self-judgment. I imagined and planned a “spiritual cesarean.” And of course, nobody but me had to do anything differently for me to experience this. I did not give a thought to preparing for a VBAC. I reasoned: if the kid was to be born that way, he would just “fall out,” which is what he did!

Then, one day before my second labor, without any prompting, a surprising thought popped into my head: “All that effort, education, expense, and travel to heal my birth story, but all along it was my birth experience healing me.” I laughed at the irony of this paradox. Ananke, the goddess of necessity and inevitability, had struck again—none of it could have been any other way. And from this knowing tumbled another and another:  I didn’t miss birth’s rite of passage, I had a profound cesarean-birth rite of passage! (And suddenly I saw the countless ways women and men can be initiated and transformed, and natural birth is just one of them!)  I didn’t fail in giving birth. Now that I could see the courage and perseverance I brought to the Ordeal, the new question is: How did I not see and respect this sooner? Respecting myself through and through allowed me to see everyone’s path and self-doubt in the light of compassion! 

I felt different. A lightness of being. If I knew how to dance an Irish jig, I would have danced it. But I just stood there realizing that—then, wondering could it be the trauma story is—gone! At that moment, I checked for any Threads secreted away in my mind or hanging from ribs. None? I didn’t believe it. Over the following days and weeks, I checked again. Nada!  And again. I carefully tracked through my story and beliefs, Nada!  Where did it all go? (Which lends the question, from where did it come!?) To this day, not a trace of emotional birth trauma or negative beliefs! And this is how I came to know that even a story that haunts and taunts us for years, that seems to be a fixed loss, grief, or belief–might not always be.



1 M.A. Greenberg (1995). Cognitive processing of traumas. Journal of Applied Social Psychology. 25:1261-1296. and M.J. Horowitz (1986) Stress response syndromes. Northvale, NJ: Aronson.

2. Tedeshi, Park, and Calhoun (1998). Posttraumatic Growth: Positive Changes in the Aftermath of Crisis. pp. 86-88, York: Psychology Press.

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