There’s been a lot of talk lately on Babble – as well in the office – about whether there’s anything such as ‘choice’ in the whole business of childbirth. And, if there is, would you choose a so-called ‘natural’ delivery (no drugs, no epidural, no ‘medical’ intervention whatsoever) or a caesarean? The C-section is traditionally thought of as the inferior method of delivery – or, worse, the lazy cheat’s easy way out. But this post – and the brilliant comments that follow it (originally published on Babble in April this year), gives us the other side of the story. So much so, in fact, we decided to re-publish it. Please feel free to add your comments – we love hearing from you, especially on these controversial topics.
When I was pregnant with my third child, I accidentally wandered into a conversation in which two mothers I’d recently met were extolling the virtues of homebirths and water births, midwives and doulas. When the well-meaning mums asked about my birth plan, I told them I was having a scheduled C-section. Their faces conveyed self-righteous disapproval and my mind was immediately awhirl in disclaimers: I was having the scheduled C not because I wanted the convenience, not because I was afraid of labour, not because I didn’t want to miss my manicure appointment.
“My oldest son would have died if I didn’t have a C-section!” I said instead.
It was unfair to pull the “my kid almost died” trump card, and if I hadn’t skulked off in annoyance and then embarrassment at having reacted so defensively, I could have told them about my first pregnancy and the months of bleeding, followed by the morning at thirty-two weeks in which there was no kicking; then the hours on the monitors where the heart rate was at first fine, then shockingly not fine, which provoked the careening stretcher; the epidural which didn’t have time to take effect, so instead the general anesthesia and the intubation. It was birth as highly medicalised and impersonal as critics of the C-section claim, one in which I had no voice and no control.
I also could have admitted that I’ve occasionally felt a twinge of loss that I’ll never give birth more naturally. Having never experienced labour, I sometimes feel like a little girl eavesdropping on the grown-ups’ tales of childbirth. I pore over pictures my husband took during one of my C-sections, to convince myself that this was my body, my baby. When I watched a friend’s video of her home birth — in water, no less — I felt as I do when watching Olympic figure skaters: as much as I would love to do that, it’s never going to happen.
But that loss is nowhere near what I would have felt had all those highly-interventionist, medical-establishment doctors not been exactly where I needed them. After a month in the NICU, when we were finally ready to take our son home, the resident who’d been on call the night of my C-section told us how blue our baby was. He held his fingers imperceptibly apart and told us we’d come “this close.”
Those words followed me for the four years in which I worked up the courage to get pregnant again. I went back to the same OB, who warned me I would be closely monitored. But this pregnancy was so uneventful that by my third trimester, my doctor raised the possibility of a VBAC. I was aware of the spate of newspaper articles decrying the increased rate of C-sections and moved by a relative’s joy at having a VBAC. Mostly I was tempted by the opportunity to prove to myself that I could do it. My mother used to tell me about her paternalistic male OB who, in the days of twilight medication and fathers in the waiting room, had instructed her to “lie back, sweetheart, you don’t have to do a thing,” to which I’d always rolled my eyes, confident of my physical capabilities and glad for all that had changed in the world.
If I’d tried, and all went well, perhaps this would be an essay in praise of VBAC. But that of course would only be evident in hindsight, when the result of the birth was cradled in my arms. Not yet having crossed over to that safe other side, what my prior experience taught me most starkly was that birth was not a process that I could control. The incision scar fades after a year or two, but the scars of near-tragedy are etched more permanently, making it hard to care about the experience, rather than the result, of birth.
My scars also make it hard not to hear a tone of triumphalism on the part of some who are lucky (because that, after all, is what it is) enough to have the birth of their dreams. Or to hear narcissism at the wishful fantasy that it is simply a matter of “trusting my body,” or to hear folly at the idea that what matters most in a birth is your own experience of it. Surely the current obsession with the process of birth comes in response to the many years in which women were told to lie back and do nothing, yet it reminds me of the bride fixated on the wedding, not the marriage, the bride bedecked with a breathtaking array of flowers, as if the abundant beauty can serve as a talisman against the harsher realities that lie ahead.
For me, the question of VBAC was easily decided when at thirty-seven weeks, my doctor saw a heart rate deceleration. While this wasn’t necessarily cause for alarm, she wanted to do a C-section that evening. Was this the much-maligned elective C, which I was choosing because I was distrustful of my body? Was this the voice of the medical establishment, belittling my capabilities, trampling my rights? Was this an example of a doctor rushing to surgery, for fear of malpractice? What I heard was the voice of my doctor, wise, capable and kind, who had saved the life of my first child. My desire for a certain experience, my image of who I thought I was or wanted to be, mattered least of all.
During my third pregnancy, with a different OB in a different city, there wasn’t a conversation about VBAC. November 26, 8 a.m., was penciled in on our calendars, though given a variety of complications, it seemed unlikely I’d go to term. But the weeks passed and the baby grew, until the date loomed before me, and I remembered more viscerally the physical pain of my previous C-sections. When I told my doctor how afraid I was, his nurse happened to repeat the same sentiment my mother once heard. “Lie back, he’ll take care of everything.”
Beautiful words, those were. Because a C-section is a scary thing in which I was glad to take no active role. Even when it’s planned, it doesn’t necessarily go according to plan. This time, I knew the date so far in advance that I made sure to complete a major project beforehand; the night before, I packed a few days’ worth of school lunches and laid out my kids’ clothes. Most of all, I concentrated on not letting my mind wander to the netherworld of all that could go wrong. Yet no matter how much I’d prepared myself, I still felt terror at being wheeled into that operating room. Despite the fact that I’d had every test and an inordinate number of sonograms, the moment my baby was lifted out was unexpectedly fraught with worry as the neontalogist present was concerned about a possible malformation. While my baby was examined across the room, I had to wait helpless and terrified until I was told she was going to be fine.
Was it the birth of my dreams? Hardly. Do I wish it could have been different? Sure. But compared with the result — my daughter, Liana, little sister to my sons Eitan and Daniel — I really don’t care. If I’ve learned anything in ten years of motherhood, it’s that the way our children are brought into the world means very little for how they live in the world. Nor do the intense hours in which we become mothers shape the months, years and decades of our actually being mothers. And if the experience of childbirth is in fact a crucial process, then let it be the process of teaching us that our children will emerge in ways varied and complicated, not necessarily in times or manners of our choosing, neither made in our image nor as proof of our prowess. Let birth remind us that, with children, so little goes according to even the most well-drawn plan.
Photo: Kelly Sue DeConnick via Creative Commons
I’d just like to say I wholeheartedly agree with you. My wife had our first in November last year, a couple of weeks early. After a day and a half of labour (on an epidural) the doctors explained that thinmgs just weren’t progressing, and they didn’t know why, and that while the baby wasn’t distressed yet, it might be worth considering a c-section.
As the doctor said the words I could see her visibly tense, as if she expected a barrage of abuse for suggesting such an unnatural thing.
We had decided months previously that whicle a natural birth would be nice, if it came to a point where doctors (who deal with this every day) think a c-section is a good idea then fine, we’ll do that. Our only idea of a ‘birth plan’ was that, at the end, both mum and bub are alive and well. And they were.
Thank you for this article – you have captured many of the emotions I felt having an emergency C-section.
I was lucky to be able to have a natural 2x midwife assisted water birth for my baby – and i realise that it is luck not choice that enable women to do this. I think the basic issue re the birth wars is purely access to more unbiased education. Yes c-sections are appropriate for some people – but some “emergency” c-sections can statistically be related to early medicalised interventions. Women need to know what they are agreeing to and the possible outcomes of those choices. “The business of being born” a documentery by Riki Lake should be seen by all pregnant women!
I chose to have a c-section over a vaginal birth for a variety of rational reasons, none of them convenience, fear or health. It was simply my chosen method for giving birth. It was a wonderful, serene, empowering experience, and my baby arrived huge, healthy, screaming and with an APGAR of 10. What more could a woman want? I totally dig those women who get something out of a vaginal birth. Good on them. However, it’s not for me. End. Of. Story. Funnily enough, we women are perfectly capable of making intelligent, rational and wel thought through decisions about their birth. End. Of. Story.
Miranda …it’s the end of story for you but actually considering the costs and risks involved in non elective section it actually isn’t a personal choice. Your choice has repercussions beyond your personal preferences. I believe we shouldn’t just think of ourselves in these suitations but much like environmental issues we need to think of the collective. So it’s not the end of the story just because you prefer not to have to justify your choices even when they impact on others. I’ve had three vaginal deliveries 1 epidural and agumentation and two very painful but I felt it was the right thing to do based on the statistics of outcomes for Australian births.
As for trusting your OB it’s shown that in NSW that all other factors discounted you are more likely to end up with a c-section if you have private care and an OB regardless of age, additional health concerns.
I couldn’t agree with you more Jen!
Thanks Tova for this. You sum up many of my thoughts on the matter.
I had an emergency c-section after an abruption at 30 weeks. I’m very lucky we both survived.
I didn’t have any romantic notions about natural childbirth so didn’t care about the birth part, I was more concerned with my baby’s survival. (That said, I’m glad to have had a c-section rather than vaginal birth, it was actually rather wonderful and easy despite the emergency circumstances). Now though I feel so often like I’m having to justify my c-section or am seen as having a second rate birth. People can get so ideological about birth.
Frankly I feel like telling those natural birth zealots that I had a c-section because I’m lazy and couldn’t be bothered with the pain.
It is so true, what you’ve written, Tova: Both that how the baby comes out is so irrelevant to Motherhood and raising a healthy and happy child; and that those who have ‘beautiful’ natural childbirths are merely lucky, and have not earned the right to be so self-righteous! I’d love to see how a homebirther would deal with being in an emergency where their child’s life is at risk without intervention… I dare say we don’t hear from women like them because they are the ones who have become more humble about letting women live with their own birth stories without judging them. We don’t all get the birth we want and it is insulting to suggest that those of us who have had c-sections are naive and uninformed and ‘manipulated’ by OBs.
Tova,thank you so very much for expressing your feelings.We had our 1st baby in Dec 08 and throughout the pregnancy I was prepared for a VB and then at 36 weeks she turned breech and I felt lost.My hubby was wonderful and supportive and so was my mum and all the praying and wishing didn’t turn her around and I was scheduled in for a c-section.All through my time during the op I was thinking” I’m not giving birth”.I absolutely love my baby girl Maya to bits but I still feel like a little kid when I listen to other mothers stories who’ve had a VB. I just think people should hold back on judgements because they do not know the full story and a c-section doesn’t make it and lesser than what the experience deserves. I’ll comfortably say that VB mums would cringe if they had to go through the recovery us c-section mums go through.
What a wonderful article, thank you so much for sharing. I am not a mother yet but when we decide to have children I will give birth by C section END.OF.STORY To spend hours in agony is not for me and im sorry to say this but I feel quite unecessary in this day and age. I do however feel it is every womans choice and she should not have to Hear about “repercussions” and such, good on mothers who Do it Vaginally, just not my thing.
Great article. Sometimes babies are born “naturally” others by c-section. Does it really matter where and how they come out as long as both mother and baby are well? I think far too much emphasis is given to this tiny part of the babies life. Guaranteed they won’t remember it. I had three wonderful c-sections (non-elective), my mother had four. In our family this is the “natural” way to give birth.
Just a heads up for childless people after a c- section to prevent hours of agony. C-sections hurt. Not at the time (thank you drugs!) but afterwards when getting in and out of bed, when trying to cuddle your older children, etc. I find that people seem to think C-sections = walk in the park, don’t be fooled! I don’t judge either choice (if indeed it is a choice) but getting a 3 + kilo baby out hurts no matter how you end up doing it.
To all the passive aggresives who like to think they know better than other just as informed women as to what is best for them: I am ‘lazy’ and I am proud of not having had to suffer and scream to deliver my children, SO SUFFER IN YOUR RIGHTEOUS JOCKS:))
Dear ladies, I loved LOVED LOOOOVED my two elective C-sections. And I have no regrets and I go on record as to recommend any sane, modern woman to do the same. Why do you constatly talk about ’surviving’ your c-sections, your fear of the operating theatre, how unlucky you were to have a caesar..
Let’s look at this from my point of view, to which I am entitled:
How about we start talking about the unlucky situation your natural birth brought you into, to HAVE to have a c-section? How about YOUR ‘lazyness’ and ‘ignorance’ of trusting a semi-educated nurse with the birth and life of you and your child?
Mother nature which you so hail, created us – human beings, (our natural birth also:), mother nature also invented diseases, festering wounds, pain and suffering, starvation, random deaths, violence and many other natural elements. The same mother nature, aided by human invention, supplied us with epidurals and c-sections, and painless and less risky child-births. You want to trust God with you bith, you go for it! I prefer to trust a doctor (an educated God’s creation:)).
Lets also address the risks, if it was up to the ‘caring’ mother nature, MANY babies would not survive the birth. MANY births would be breached, many women would die as a result of natural complications. If it was up to mother nature, I would’ve possibly died from a tooth absces long before I even reached child bearing age:)) This was my reasoning for going elective: If I had needed a tooth pulled, I would ask for a needle, if I needed a knee reconstruction I would go to an orthopaedic surgeon and not a nurse who was to massage my knee into shape, so why would I stop at childbirth?
After two c-sections I had just as much post-op pain as my friends with stitched up vaginas. I had no infections, I hugged my older child Jen, the same day and walked around the same day. I went home after 4 days and did everything myself, apart from pushing the shopping trolley.
Both of my children were perfectly healthy, I was in no pain, in fact enjoyed the speed and ease of my birth, I took 6 weeks to fully recover, but breast fed my children and did all the house work with no problems at all. I also know some women who were so scarred by their natural birth that they urged me not to risk it.
The summ of it is that there are risks involved with c-sections, there are risks involved with natural births. Such is life. I feel, like yourselves, that I chose the best and least risky option for my child. Who are you wag your fingers at me?
Jen, Ricky Lake documentary? AHAHHAA ok..
And Miranda, shut up about social responsibility, how about the social responsibility and repercussion of deaths in childbirth? I bet you have some very righteous views on other things women chose to do with their boddies? The more we chose c-sections, the more the goverment will see that this is what women need, and have a right to, instead of being treated like morons who can’t chose for themselves in some states, treated like heffers. I didn’t have my children for the collective, I had them for me and I am a part of your collective too, so Miranda, you do what you like doing the way you like to do it, and let me do as I see fit with my life without hurting anyone else.
Love & Power to all women. Get smart girls xx
Tiana,
You obviously are trying very hard to justify your decision. You sound like a weak person.
Three mighty cheers for this article. It is always a great thing to behold when women have the courage to share their stories of complicated child birth. It helps us do away with myths that exist around the subject.
I had an emergency c-section in February this year, after it was determined by a mid wife that my baby was in distress (38 weeks). I myself had felt something was amiss for the 24 hours prior. My OB was called, and fortunately as well, the head pediatrician was available to assist. I had to have a general, and my son was born via a very fast caesar. And, well, he would not have survived had it not been for the fast-acting medical professionals on hand. I will forever be indebted to them all.
To all the women who have not had the experience of a caesarian, you simply need to ask yourselves, what would you have done? Putting yourself in another’s shoes goes a long way toward better understanding.
Well, we can see now that the “torrent of abuse” doesn’t come just from the “zealots” (loaded term) in favour of natural birth, hmm? (Yes, previous commenter, I’m looking at you).
Having established that “emotive” language isn’t the sole preserve of the presumed dirty hippies who favour home birth and the use of midwives, who are slandered as “semi-educated” (see above, also.)
The fact remains that we in Australia have a high, very high caesarean rate. We need to tease out how many of these caesareans are really needed, as with the original poster, as opposed to those which are convenient for the hospital administration.
There’s a tendency for cascading interventions (again, not for cases like the OP, but for relatively normal labour) for which the outcome of a caesarian is made much more likely.
THANK YOU for this article. My last pregnancy was a VBAC attempt turned rupture experience. I have experienced much sadness and grief over the ability of birthing naturally, and I have experienced alienation from my community of natural/homebirthing mothers.
I’m pregnant again – which in itself is terrifying – and I obviously have no choice but a planned c-section. Google “Peaceful c-section” and see what comes up – there are no resources out there for mamas like me (and the author of this article and others) who have NO CHOICE but to give birth by c-section. I’m saddened and disheartened by the natural birth community’s continued judgment and exclusion of mamas like me – I am an attachment parent to the fullest and I advocate birthing in awareness, natural birth and VBAC – but I have not been shown any respect for my situation – just immediate judgment and disdain.
I’ll continue supporting the causes I support and I will hope for a change in the natural birth community attitude. Sorry to generalize, but in my opinion, I am constantly being generalized myself…..as a mom who made a poor choice by getting a c-section. If I didn’t, I’d be dead…and so would my baby.
Lets talk about a ‘normal, uncomplicated’ pregnancy and baby for a minute.
Facts:
Vaginal births have better health implications for bubs (higher rates of breastfeeding, lower rates of asthma etc)
Caesars cost our health system lots of $$$
When managed properly, a vaginal birth does not need to be traumatic or result in any damage downstairs, whereas caeasars will always be major abdominal surgery!
Yes, caesars are very very necessary in circumstances like those in the main post, but not evident or necessary in others.
I’m all for choice, so if you want a caesar for no other reason than wanting it, then thats fine. My qualms are with doctors whos interventionalist actions result in unnecessary ceasars.
When I had my bubba my (private) OB offered that I could be induced. I was ignorant of the risks involved, and he did not take the time to tell me. But, the induction was insanely painful and causes bubs to go into distress. We were inches away from a caesar. If OB had just let me go into labour naturally then the possibility of a caesar wouldn’t have been on the table. Just my two cents.
What a great article. All of our children were born via cesarean and I’d have it no other way. However, after the birth of my second son and while pregnant with my third, I was repeatedly harassed by a scaremongering home birther. It was ridiculous because I saw her births as irresponsible. Yet, I let her be with her opinions. However, something I’ve noticed is that many, not all, but many ‘natural birth’ heroes have their entire ego and self tied up in how they gave birth. What ultimately counts is the way you mother your children. Ironically, the very person who birthed her children in water, I discovered, was also quite abusive to them after the fact. So, remember. If someone is overly gung-ho over their births and badly judging you, let the red light go on and question what may really be going on behind that crazed facade.
Thank you for putting my mind at ease.