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The Most Important Thing

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by Courtroom Mama

 I generally try not to get all butthurt over trolls, but I couldn’t contain my gasps of impotent horror as the following conversation unfolded in the comments of Emjaybee’s last post.


Screencaps in part:






Jill and Emjaybee were on it with lightning speed, of course, while I was puttering along on my phone totally unable to do anything about it. So, I thought I’d take a short break from “wallow[ing] in [my] unnecesarean grief” and voila, unpublished-reply-turned-post.


First of all, it bears mention that a person exposes him or herself as a troll when they ask the question in the form “So how exactly does a c-section ruin your life?” (Well, for starters, when it kills you, like folks sometimes seem to forget can be the case.)  Nevertheless, I think that there is a kernel of truth under there that needs to be addressed. I’m posting this in the hopes that someday someone will google “Why would the method of birth ever overshadow the birth of a healthy baby?” and get my very earnest explanation.

Human emotion is nuanced and complicated.  The singular nature of pregnancy and the unique relationship between a woman and her unborn baby seems to play hell on our need to simplify, homogenize, and categorize. Regardless of the headway that we have made in terms of gender equality in civil and political rights, we have a pretty rigid schema for what a normal pregnancy looks like: woman is pregnant, woman delivers baby, woman is happy.

That is not a woman, that is a paper doll.

The truth is that each of those clauses and each of those commas contain nearly infinite possibilities. The experience can be punctuated with an exclamation point, a question mark, or the silence of an ellipsis. We can acknowledge that women may meet their pregnancies with a variety of emotional responses—joy, shock, anger, ambivalence—but the idea that women might meet their babies with the same variety of emotion seems to be beyond the realm of comprehension. Aren’t babies supposed to make women happy?

I know that the question of the method of birth “overshadowing” a healthy baby is not one asked in good faith, but my answer to that sort of question has always been that women with negative feelings about their cesarean sections are, as a preliminary matter, grateful for their healthy babies and are able to experience other feelings in addition to and outside of joy and gratitude. Like when your mom explained to you that when your little sister was born she could love her and still love you just as much as she ever had.

But Dana made me think a little bit: are babies a balm that should heal all wounds? Even if we function under the assumption that a healthy baby is the most important thing in a birth (which, some people may be surprised to hear, is not universally the case across cultures or to individual women), is having even a welcome and wanted baby a substitute for the autonomy lost by a woman who has had the experience of being tied down and operated on, or the horror of seeing herself in a pool of blood in the reflective surfaces in the operating theater?

Is having a baby a substitute for posttraumatic stress? For the flinch and recoil of damaged nerves when a lover brushes her scar? For the knowledge that she may have to fight to even attempt to avoid scheduled surgical delivery even in the face of evidence suggesting that she’d most likely be able to deliver vaginally without any problem?

This is something that may be difficult for a person who had a necessary surgery, or who is okay with having had an unnecessary surgery, to understand. I’ve tried to explain the fact that the outcome doesn’t erase the pain of the journey, but there really is no metaphor. The closest I have come is this:

Imagine you get in a car to drive and see the person you love most in life. You get into a car accident on the way there, are rushed to the hospital, and the doctors save your life. When you open your eyes, your loved one is there to greet you. Now imagine instead that you get into the car, and on your way there, you’re pulled over for driving too slowly, and then taken to the hospital, where your healthy appendix is removed. When you open your eyes, your loved on is there to greet you.*

Notwithstanding your happiness to eventually get to your goal, you might have some questions—or even anger, sadness, or grief—about what happened to you on the way there. Why were you interrupted just for getting where you were going too slowly? How did that justify unnecessary surgery? Even in the first circumstance, might you not still feel trauma from the terror of fear of dying or never seeing your loved one? Getting to see that loved one might be the most important thing, but it doesn’t diminish the importance of your own physical and mental health. This is something that mothers don’t often get to hear: you are important too!

In closing, to those visitors who are not in the “choir”: nowhere on this website, or in ICAN’s materials, or in any of the countless books about healthy birth does it say that women should grieve or feel a sense of loss over cesarean surgery. In fact, my greatest wish: every cesarean a wanted cesarean. I wish that every woman who had surgery could feel at peace with it and supported and cared for by her medical team.  To express negative emotion or question the overuse of such a major medical intervention is not to condemn the women who made it through healthy and happy. Please, don’t take it personally; it’s not about you.


*Again, metaphor is imperfect. I’m actually having fun thinking about all the ways to tweak the image: the baby is riding with you and they pull you over for an appendectomy because they think it’s crying? Because your car has had a flat tire in the past? Because the traffic cop wants to fill a quota and go home early?

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Reader Comments (81)

@ Jill LOL...thanks!!

I'm a big reader here but not a big commenter... but that one made me see red! :)

April 9, 2010 | Unregistered CommenterLee-Ann

Andrea wrote: "I think trolls are great! I think that lots of those people are interested in learning, and maybe don't feel that they have anything to add, until they understand more. Also, they provide the opportunity to teach and share more, and to get deeper into the subject ourselves."

I agree with this. What I learned from Dana was that I am equally irritated by the whole "can't you just be happy?!" shpiel as I am with what I mentioned in my first comment: "...the attitude or assumption that every woman who has had a cesarean, necessary or not, has some kind of deep regret or despair over what happened." I don't even know if irritated is the right word. Disappointed, maybe? Perplexed that it's hard to admit that there is a range of ways that people experience the world?

April 9, 2010 | Registered CommenterJill

OK, Jill, that made me LOL. SNERK.

(you can pull my response if you like since it no longer makes sense).

April 9, 2010 | Unregistered Commenteremjaybee

Actually, Dr. Tuteur, you’re wrong about birth trauma being restricted to white women. Take, for example, the case of the Nigerian woman expecting triplets and forced to undergo a cesarean section in 1984 (cited in Susan Wolf’s Feminism & Bioethics: Beyond Reproduction,” among others), or Chao Lee, a Hmong immigrant in Wisconsin who was going to be similarly forced into surgery but found a culturally-sensitive physician to deliver her baby vaginally (cited in Merrick & Blank’s “The Politics of Pregnancy: Policy Dilemmas in the Maternal-Fetal Relationship”).

Indeed, both of them wanted to avoid cesarean surgery because of their cultural beliefs, including that a vaginal birth is a great blessing (and a triplet birth the greatest blessing of all), whereas a surgical delivery would be a shame upon the family or would endanger the woman’s spirit and those of her family. To the extent that it is about culture, it is not about impressing anybody, but rather about how the woman’s culture affects her experience. It’s entirely likely that neither woman would ever have to disclose the circumstances of their births, but to them a cesarean birth was undesirable.

As recent immigrants, both of them existed entirely outside of the white natural birthing movement. One would assume, given the ferocity with which the women fought against medical personnel and the courts, that surgery would have been very traumatizing to them.

There may be nothing inherently traumatizing about birth, but that’s a bit of a red herring: there is nothing inherently traumatizing about anything. Trauma is about a person’s experience, and the confluence of emotion and memory. Something that got left on the cutting room floor in my post was that people who undergo other procedures, like chemotherapy, bypass surgery, or other surgeries performed while they’re awake also experience trauma. Whom do you suppose they are trying to impress?

April 9, 2010 | Unregistered CommenterCourtroom Mama

Courtroom Mama, you just opened up a can of academic pwnage. And THANK YOU for pulling the plug on the racist comments about how only white people feel sad. Women of color experience emotions as well.

April 9, 2010 | Unregistered CommenterTanya


(New assholish comment replaced by the mods at 2:13 p.m.)

April 9, 2010 | Unregistered CommenterAmy Tuteur, MD

"I mean really, I was laying naked in the crucifix position being sliced open for crying out loud!"

It's funny. I like to think I am really "over" my C-section, but then I see something like that and feel like crying because it is so true. There was a huge sense of powerlessness and unnaturalness to the whole thing.

While a healthy baby is the most important thing, it's certainly not the ONLY important thing. And, of course, a lot of the babies born by C-section these days would have been perfectly healthy born vaginally. It's shocking to me when someone marginalizes the way a woman feels about her own birth experience or claims it should not have been traumatic or heartbreaking. It almost always comes from other women, too, which makes it doubly insensitive.

April 9, 2010 | Unregistered CommenterKK


Grow up. If you can't think of a reasonable response to the claim that the disappointment is culturally determined, at least let someone else address it. And if you want to delete something, just delete it and can the immature comments.

April 9, 2010 | Unregistered CommenterAmy Tuteur, MD

Thanks, Jill, for addressing this! The metaphor I always imagine is that if my newborn baby and I were in a car accident and both required major surgery and eventually recovered 100%, I would be SO HAPPY to hold my healthy baby, but I would be devastated about what we had both endured, the danger, the pain, and the fear of it all.

Of course, this metaphor doesn't address the disappointment I would feel about having missed out on birthing--my favorite thing to do and an experience more wonderful than I can describe!

It does, however, encompass my feeling that a cesarean is surgery for the baby too, as the mother baby unit is still one when the surgery is performed.

April 9, 2010 | Unregistered CommenterDiana

Moderators: ROFL, I mean down on the dirt ROFL!!!! thats the best things I've heard come out of her mouth!!

Keep up the wonderful mods ;}

April 9, 2010 | Unregistered CommenterNicole
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