Lately, I’ve found myself wondering why some women feel cesarean birth is better than vaginal birth. It’s been something I questioned before I was pregnant and was particularly confusing when I was confronted with my own cesarean.
For me, I always wanted a natural, med-free, intervention-free birth. It was devastating for me to be confronted with a cesarean. The recovery was particularly difficult, and the couple of times I “overdid it” really were painful and debilitating.
I’m looking at future pregnancies with fear, as complications during pregnancy are more common after cesarean – placental issues, tubal pregnancies, secondary infertility. The VBAC fight was never one I wanted to be faced with, but here I am.
So how could someone be not just satisfied, but even pleased, with this? I’m slowly beginning to understand.
Recently, I read an article about post traumatic stress disorder following birth; it’s on the rise. As a medical system, we need to acknowledge that in an age where 1 in 10 women suffer from postpartum depression, much less PTSD, that it is apparently not about “just a healthy baby.”
Women need to have the opportunity to mourn the births they have lost. The ideal birth, whatever it is for that particular woman, needs to be acknowledged, and if at all possible, pursued. For me – I lost my first birth to major abdominal surgery. For some, it’s losing the ideal of pain management when a planned epidural doesn’t work, or just being able to go into labor before the pressure of induction begins.
Many women see the cesarean as what saved them – whether it did or not. Maybe it saved them from another traumatic induction lasting 48 hours or more. Maybe it was a way of attempting to control the unknown. Maybe the recovery temporarily saved them from additional childcare and household responsibilities.
As a birth professional, I’ll be honest that I’m a little biased about the solution. But fortunately there are studies and guidelines to back me up. (I’ll list them at the end.)
Childbirth education should be expanded, encouraged, and absolutely available to all. It needs to involved couples working through both their fears and expectations. It must involve current research about normal labor processes and when interventions are medically necessary as opposed to simply routine. It should provide an opportunity for couples to build relationships with others in the childbearing year, expanding their network of support.
Doula care needs to be covered by Medicaid and private insurance. Having a labor doula can decrease the need for cesarean by up to 50%. Postpartum doulas can fill the role once done by the extended family – helping the new family adjust with each child added to the family.
Midwifery care should be more widely available, particularly in rural areas where OB presence is minimal. Low-risk women should be seen first by midwives and referred to OBs as necessary.
Women with negative birth experience should report these to their care providers with the intent that questions are answered and care is altered. It wasn’t too long ago that women and families decided it was unacceptable for fathers to be in the waiting room during the birth of their own children, or that women shouldn’t be forced to undergo “Twilight Sleep” and not be mentally and emotionally present at their own birthing.
It should be no different now that we refuse to accept the parts of the system that make us uncomfortable and that are not supported by rigorous research. What we’re comfortable with may be different woman to woman – med-free, highly managed, etc – but it’s time for individualized care again.
No woman should have to feel that major abdominal surgery was an easier and more acceptable solution that the birth route her body was made and designed for.
Studies and Resources:
Expecting Trouble
– written by an obstetrician who feels 80-90% of women should have midwifery prenatal care and at least 70-80% should deliver with a midwife.
The Doula Book
– numerous studies about the benefits of a doula – from childbirth satisfaction to birth outcomes.
Healthy People 2020 Guidelines - reduce cesareans, among many others
For me, I always wanted a natural, med-free, intervention-free birth. It was devastating for me to be confronted with a cesarean. The recovery was particularly difficult, and the couple of times I “overdid it” really were painful and debilitating.
I’m looking at future pregnancies with fear, as complications during pregnancy are more common after cesarean – placental issues, tubal pregnancies, secondary infertility. The VBAC fight was never one I wanted to be faced with, but here I am.
So how could someone be not just satisfied, but even pleased, with this? I’m slowly beginning to understand.
Recently, I read an article about post traumatic stress disorder following birth; it’s on the rise. As a medical system, we need to acknowledge that in an age where 1 in 10 women suffer from postpartum depression, much less PTSD, that it is apparently not about “just a healthy baby.”
Women need to have the opportunity to mourn the births they have lost. The ideal birth, whatever it is for that particular woman, needs to be acknowledged, and if at all possible, pursued. For me – I lost my first birth to major abdominal surgery. For some, it’s losing the ideal of pain management when a planned epidural doesn’t work, or just being able to go into labor before the pressure of induction begins.
Many women see the cesarean as what saved them – whether it did or not. Maybe it saved them from another traumatic induction lasting 48 hours or more. Maybe it was a way of attempting to control the unknown. Maybe the recovery temporarily saved them from additional childcare and household responsibilities.
As a birth professional, I’ll be honest that I’m a little biased about the solution. But fortunately there are studies and guidelines to back me up. (I’ll list them at the end.)
Childbirth education should be expanded, encouraged, and absolutely available to all. It needs to involved couples working through both their fears and expectations. It must involve current research about normal labor processes and when interventions are medically necessary as opposed to simply routine. It should provide an opportunity for couples to build relationships with others in the childbearing year, expanding their network of support.
Doula care needs to be covered by Medicaid and private insurance. Having a labor doula can decrease the need for cesarean by up to 50%. Postpartum doulas can fill the role once done by the extended family – helping the new family adjust with each child added to the family.
Midwifery care should be more widely available, particularly in rural areas where OB presence is minimal. Low-risk women should be seen first by midwives and referred to OBs as necessary.
Women with negative birth experience should report these to their care providers with the intent that questions are answered and care is altered. It wasn’t too long ago that women and families decided it was unacceptable for fathers to be in the waiting room during the birth of their own children, or that women shouldn’t be forced to undergo “Twilight Sleep” and not be mentally and emotionally present at their own birthing.
It should be no different now that we refuse to accept the parts of the system that make us uncomfortable and that are not supported by rigorous research. What we’re comfortable with may be different woman to woman – med-free, highly managed, etc – but it’s time for individualized care again.
No woman should have to feel that major abdominal surgery was an easier and more acceptable solution that the birth route her body was made and designed for.
Studies and Resources:
Expecting Trouble
– written by an obstetrician who feels 80-90% of women should have midwifery prenatal care and at least 70-80% should deliver with a midwife.The Doula Book
– numerous studies about the benefits of a doula – from childbirth satisfaction to birth outcomes.Healthy People 2020 Guidelines - reduce cesareans, among many others
Post Traumatic Stress Disorder After Childbirth - particularly look at Ten Questions to Ask
Wonderful blog post, thank you for sharing. I too can relate to those feelings that surround a Cesearen Section. I have been there.. 1st birth induction led to heart d-cells then C/S. 2nd birth I wanted to VBAC but was given scare tactics and coerced to have a repeat C/S. I didn't educate myself enough and didn't have support. I remember feeling so robbed of the birth that wanted. It took several years before I even started to allow the healing needed with that experience. 3rd pregnancy I was planning a VBA2C, but lost baby by miscarriage. 4th Pregancay I was determined things would be different. I had to fight many fears that had been ingrained in my head. Along with the mental fight was the fight for my rights to birth vaginally. And finding the support I needed. In the end I had a challenging but successful hospital VBA2C. My doula was an amazing labor/birth support. I was thankful my birth, but that experience also taught me much. So, with my last birth I decided for a homebirth with a Midwife. It by far was my best birth experience. So many women are made to feel powerless and their true feelings are buried due to fear and acceptance. As you have said so well..No woman should have to feel that major abdominal surgery is easier or better than the bodies ability to birth.
ReplyDeleteThanks for your feedback :) It's always amazing to me how similar the stories are.
ReplyDeleteI think that healing part is really crucial - I'm finally coming to that point myself with both the C-section and early loss we had before.
When we get pregnant again, I'll certainly be picking your brain about your hospital VBAC. (All while hoping that we could actually have a homebirth!)
Thanks :)