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Friday, February 3, 2012

In Praise of C-Sections

Cesarean sections get a lot of attitude. They get a lot of snark. They're looked down upon. Many women feel like they've failed their babies and themselves should they give in to the the doctor's suggestion of a section. Many more feel guilty their entire lives because they (shudder) opted for one.

Any quick google search will show you that "more women are dying in childbirth, and it's due to increased Cesarean sections."

And I'm not trying to sweep that under the rug. C-sections are a major surgery, and like any major surgery, they are dangerous. They're not a walk in the park.

But let's take that from the other side. C-sections are a major surgery. They're hard. So when I see headlines like "Too Posh to Push," I have to wonder what on Earth everyone is on about.

Women who have to undergo sections require serious recovery time. If someone is choosing to have one, there's probably a reason.

There's this feeling that, as women, we should be able to do what we're biologically intended to do. We think that C-sections are "cheating," in a way. Women have been having babies for millions of years, we say. Long before C-section was an option. And they were just fine. Why are we such babies ourselves, these days?

We conveniently forget that those women were not just fine. In third world countries, dozen of women die in childbirth every day . In the 1800s in Sweden, one in 14 women died in childbirth. Although our mortality rate is up slightly now (due to the surgery), it's not a blip on the map compared to those figures. Women are having healthy babies and living themselves, in large part because C-section is available.

Obstructed birth is no joke. Breech babies are no joke. Fetal distress is no joke. A cord around a neck is not a joke. These are serious conditions that Cesarean sections help to alleviate.

The fact of the matter is, our biology has yet to catch up to our lifestyle. We're having bigger babies. We're having multiples. We're having children later in life. We're getting smarter (one would hope), we have bigger brains.

Overlapping skull and all, some women's birth canal simply cannot handle a 10-pound baby with a 34-cm circumference head. C-sections help them have their children. Why make them feel bad about that?

I have two beautiful healthy girls because C-section was available to me.

At 34 weeks, Baby A (Dulce) broke my water. She was low, head to the cervix, ready to greet the world (or just tired of sharing such a small space with her sister). Baby B was happily hanging out right up near my rib cage, feet down, no plans to move. She was going to go ahead and hang out in the womb a while longer, if it was okay with everyone. But it wasn't. I had to have the kids. Dulce decided.

When my doctor told me Lilly was breech and she would prefer to do a section, I nodded and signed. I'm not saying everyone should do that. There are many women who are more secure and attached to their birth plan than I was. But I didn't know the risks, I didn't know the likely outcomes. I knew my doctor thought the girls would fare better with a section. I nodded and signed.

And she could have flipped. Maybe she would have flipped. But I wasn't willing to risk it.

So, while my C-section was technically an emergency surgery, it actually wasn't. They had time to prepare. They had time to assess. They could do the surgery calmly, with no one in any stress.

When you have bypass surgery before you have a heart attack, you're much more likely to survive it.

And maybe we should look at that. Why would more women be dying in childbirth from 2007 on? Shouldn't the technology be getting better? I would think these numbers reflect an increased number of emergency C-sections having to be performed after every avenue for natural birth has been exhausted. With limited time, limited resources, and a baby or mother already well on their way to injury or death, of course the surgery is more risky.

I'm not saying everyone should go out and have sections. I'm not saying this surgery is better than natural childbirth by any means. I'm simply saying that if a woman chooses to have a Cesarean, perhaps there's a good reason for it. After all, surgery is hard. But having healthy children, and being able to care for them as a healthy mother is important, at least to me. And if the surgery does what it's meant to do, that is its purpose.

So maybe we can lay off other mothers for how they have their children.


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  1. Thank you for saying this Darlena. I agree. My baby would not descend into the birth canal and I needed an emergency section when her heartrate plummeted. It turns out her hands and feet were wrapped in her cord. No amount of changing positions or sheer determination was going to get her out of my birth canal in that condition. A c-section saved her life.

  2. I'm entirely with your bottom line - if a woman has a c-section, she shouldn't have to feel guilty about it, because we should be trusting her with her own body and her own new baby. Full stop. Her life. Hands off. It amazes me that some of the same people who will defend abortion rights to the bitter end suddenly have Serious Opinions about what qualifies as a "legitimate" reason to have a c-section.

    That said, I don't know if the "this is major surgery" message has really gotten through to us as a culture. I'm a moderately intelligent person who usually picks up on things pretty quickly, and I was shocked by how long and hard my c-section recovery was. I'm not sure how to solve this, and maybe I'm the only one, but I do think the "c-section is the easy way out" mentality comes, in part, because people on the whole don't really internalize how difficult it is.

    Having been through both a c-section that ended in a perfectly healthy baby and a VBAC that ended in a barely-alive baby, obviously I can't hate on c-sections. And if I were to have a third child, I'm pretty sure it would be by c-section. By choice. Even though I've shown myself physically capable of performing natural birth. And I'm totally not ashamed of that, because be where I've been and I'd love to see you decide any differently, natural birth advocates. However, I will say, physical recovery from the VBAC was way way way easier.

    I'm thrilled to live in a time and place where women don't, generally, mentally prepare themselves and/or their babies for death before they give birth because it doesn't usually happen. How lucky we are. And the c-section has something to do with that.

  3. The best childbirth option is.......the one which results in a healthy mother and child(ren). It isn't the Marvelous Mommy competition, it's the real world, and in the real world you do what needs to be done and ptooie to naysayers.

  4. Ugh, s! You're totally right. (This post deleted on me and I had to rewrite it, but the Pro-choice angle was one of my huge points! I knew I was forgetting something!)

    My body, my choice. Period. Very well pointed out.

    And as far as the surgery goes, even after my recovery, I didn't think of it as major surgery until I was complaining about being scared of another minor procedure and everyone was like, but didn't you have a C-section? This is NOTHING compared to that. That's how minor I thought it was. It's a huge misconception that lingers.

  5. I am a mommy that chose to have a C-section. My son's birth was planned months before he was born. I've had a few people look askance at me when this came up. I had my reasons. My biggest is that my husband has mild cerebral palsy due to his mother being moved while he was in the birth canal. C-sections are harder on moms. Natural birth is harder on the child, that was my doctor's opinion when I asked the difference. I decided I could handle the hard stuff, he could just get here safe and sound.

  6. Brilliant post! I've had four C-Sections due to a small pelvis. I probably would have died during child birth if it wasn't for this wonderful surgery.
    It has always baffled me when people describe it as the easy way out...Easy...No way! C- sections are far from easy! I've never felt guilty about them...they saved my life and enabled me to have my four lovely kids x

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