Last month was National Cesarean Awareness Month. If you follow parenting groups on social media, perhaps you’ve seen the memes with quotes like “1 in 3 just can’t be!” or infographics discussing the huge rise in c-sections in our nation, often with negative connotations.
In this society where mommy shame and judgment is rampant, where even some of my doula colleagues proudly wave the cesarean reduction flag, are we perhaps glossing over the experiences of those whose cesarean sections were perhaps empowering, healing and enjoyable experiences? Where do we draw the line between bringing attention to a legitimate health issue in our community and belittling those whose experiences truly matter?
I won’t sit here and say I have all the answers. In fact, I can barely even scratch the surface without delving way too deep into public health and feminist literature, which could take way more than just this article to get through.
I’m a birth and postpartum doula. My job is to provide unbiased, nonjudgmental support to families through the birthing period all the way to those first few months at home with a new baby. I still get some shocked looks when I tell prospective clients and moms that no, I don’t just support natural childbirth, that I am overjoyed to work with clients who have planned cesareans or drugs. I mean, I’d even be on board for a childbirth in the middle of the woods with a deer for a midwife! But I have to wonder, does some of this automatic defensiveness come from the fact that the “crunchy” community can sometimes be judgmental of those who choose surgical births, even if we mean well?
Want to know a secret? Which, well, won’t be a secret now if you’re reading this, but I digress. My son, my firstborn, was birthed via an elective c-section. I can’t sit back and say it was easy, I can’t even tell you that it was a decision that didn’t carry more risk than a natural vaginal birth, but you know what? I don’t regret it, not at all. It was the most empowering decision I could have made for my own body and for the health of my amazing little boy. I did go on to give birth via a Vaginal Birth After Cesarean to my daughter, but only after careful consideration of my own personal circumstances.
Says Sarah, of Schaghticoke: “My cesarean for a breech baby was not traumatic, and I was very happy with our decision. I asked every question I could. Our midwife gave us a list of OB’s that would great to work with. … She stayed in the room with us during the procedure, which comforted me to know that I had a woman with me for support. A week before, the OB sat with us for an hour and went over every step to expect. I would like to try for a VBAC with my next pregnancy, but will be fine with a repeat c-section if necessary.”
All this said, I don’t feel it would be right of me to avoid the elephant in the room: cesarean sections are indeed a source of public health crisis in the United States at this time. According to the World Health Organization, the rate of cesarean sections should not exceed 15 percent in first world countries (and likewise, should not fall below 5 percent in developing nations where surgery is often completely lifesaving). The current U.S. statistic hovers around 30 percent, with some hospitals in the South clocking in at 80-90 percent.
According to an evidence review conducted by non-profit organization Childbirth Connection, babies born by c-section are more likely to need breathing assistance and are more statistically likely to contract disease, while the mothers who receive c-sections are more likely to develop organ adhesions, pelvic pain and infertility. Long term effects that can increase with each subsequent pregnancy often take the form of placenta issues: placenta previa, which is when the placenta covers the cervix and prevents a natural childbirth, and placenta accreta, when the placenta adheres into cesarean or surgery scars instead of directly to the uterine wall. It should be noted that not all cesareans are smooth experiences.
Lyse of Ballston Spa said that her cesarean, which she describes as doctor chosen rather than her own decision, was “traumatic, impersonal and filled with medical issues.” She sadly recalls not being in a mindset during the surgery to fully recall the birth of her second baby and says that she required medication, therapy and the support of her loved ones to overcome the anxiety the birth experience caused her and her partner.
“If I could tell women anything, is that it’s never too late to say no. That if you’re not comfortable with something, don’t do it,” she said.
So, the takeaway, I believe, is that the entire topic of c-sections just cannot be placed in a box of “good” or “bad” because any and all childbirth experiences are valid and worthy of your support and praise.
Really, whether you’ve given birth from your genitals or your abdomen, you made the choice you needed to with the information you had available to you and that is worthy of at least two or three high fives.
Perhaps, the next time you feel a wave of judgment coming on (because we all do it), put yourself in the newly postpartum person’s shoes. Instead of saying, “I’m sorry” or assuming you know the story, try stepping out of your comfort zone. Sometimes, the most amazing thing you can do for someone is simply asking, “How are you feeling right now?”
Cara Del Favero is a Capital District mother of two, placenta encapsulation specialist and a birth and postpartum doula providing holistic, nonjudgmental support for all childbirth options. To contact her, visit thealbanydoula.net or call 337-6272.