I Support Natural Childbirth... and I'm Planning a Cesarean
Tuesday, March 22, 2011 at 9:13AM
Guest post by K
I am not normal.
I don’t know if it’s something about my DNA, my destiny, or just a stubborn and persistent abhorrence of being called “typical”, but I can confidently say that my reproductive history has a delightful track record of bucking the norm. That film we saw in fourth grade, and the box of maxi-pads they sent home with us? It was another six years before I ever needed to draw on that complimentary supply of data and napkins.
The training bras I stashed in the back of my closet in grade school? Put to better use as cleaning rags for the same period of time.
I have never been normal.
Oh, don’t get me wrong. Early in my first pregnancy I was diagnosed with a heart-shaped uterus and told I might never carry to term (POINT! – awarded to the reproductive system!). But the miscarriage that sometimes happens with a first pregnancy? That didn’t pass me by.
Pregnant a second time, I had visions of my belly swelling out grotesquely to one side of my body (since the pregnancy was in the ‘right’ side, as they told me). Thankfully, that didn’t happen.
The other thing that didn’t happen was the early labor, long walk in the mountains with my beloved. Pausing to lean against his mighty embrace with each contraction. At least, that’s what I expected after the video we saw in childbirth preparation class. Instead, my body – overachiever it is – had to one-up me by starting contractions 6 minutes apart. [POINT! Reproductive system!]
After 22 hours of labor, and a baby who basically peeked her little head out, waved, winked and darted back inside, the unplanned c-section was a blessing and a relief. My daughter arrived wailing, healthy and happy. And all was right in the world.
My c-section recovery was a breeze and I never regretted that it happened.
By the time I was in my third pregnancy, I adopted the attitude of “Be ready for anything.” Yeah, right.
My second child came screaming into our lives and ran headfirst into a shut door. Well, kind of. The exact terms would be “precipitous birth” and “shoulder dystocia”. Other terms that accompanied her “firemen in my bathroom”, “ambulance-riding”, “our doula will never get here in time” birth included “retained placenta” and “manual removal”.
And when the quiet, purple baby girl was carried away from me and put on a table to be slowly pinked up…
I didn’t care.
Something in me was torn apart, and I’m not just talking about my crotch.
My VBAC was terrifying, and the recovery was incredibly long and agonizing. I looked back at the c-section with envy.
I’ve never looked at my baby girl with resentment because of our birth experience, but I’ve sometimes looked at her with sorrow because we had such a rough introduction. (Okay, peeing my pants when I laugh also reminds me of her birth, but you didn’t want to know that, did you?)
Just like my unpredictable reproductive cycle, motherhood has been equally surprising—and rewarding.
I am educated. I am informed. I believe in and support natural birth.
I am also planning a c-section.
When I tell you that yes, I am planning a natural, woman-centered caesarean section to welcome our third child this summer, I say it with hope. Hope for reclaiming a sense of peace, comfort, and trust with my body. Hope for something that heals the exhaustion and terror of the other two births
Hope that you will recognize me as a capable, intelligent, and informed woman
A woman with the right to choose how and where she gives birth, just like the woman who chooses a midwife and delivery at a birth center. Just like the woman who chooses a natural birth, with no medication. Or the one who gives birth in a tub, in her living room
I am just like them, because I have made this choice for myself and my baby. And even though this birth will most likely NOT include a walk on the mountain, I’m quite positive that the experience will be just as spectacular.
I will have my mountain.
More reading:
Planning a Family-Centered Cesarean (PDF)
Reader Comments (152)
Each time we use the word unnecessary to describe anything about how another person may feel I want to cringe. Are many many surgical births medically unnecessary? YES! However, are they necessary to the mother? That is a gray area. Emotionally, it may be what's best for her at the time and as much as I hate to say it, there are other seemingly superficial reasons too like scheduling (wanting a partner or support person to be there, etc), that weigh in on a mothers decision to have one - What is necessary to me, may not be to you and vice versa. We CAN NOT say definitely what is and isn't necessary to any one person, or what matters, or how a birth SHOULD be unless it's our own. We can weigh in on the debate about medically unnecessary births, how the medical establishment keeps people uninformed, etc, but that is not really the debate here. I'm not even sure if there is a debate here.
If a mother is truly informed regarding all possible pros and cons of her choice of birth then our jobs as doulas, advocates, and childbirth educators is done and while I agree that a decision based on fear isn't truly a decision, but honestly I didn't see only a fear based decision here. I don't see how the poster not wanting to experience the traumas of her vaginal delivery, while also weighing the pros and cons of an alternative method or any different than if she'd had a traumatic c-section, and subsequently choose to do everything in her power to have a vaginal birth. We talk about the risk to mother and baby during c-section, yes, but that risk isn't for any of us to access unless we are the ones on the table and it's our own baby being birthed. We talk about choice, but real choice only comes when a person is free to make one that perhaps we are selves would not.
I find the use of the term 'natural' to describe a cesarean problematic. I agree with Trish and KK - 'informed' is a red herring in a sense. Why is the above reasons for a cesarean any more valid or justified than one chosen to fit into scheduling or to avoid vaginal 'stretching' or any other reason that isn't deemed as worthy as trauma and fear due to previous experiences?
Okay, I will admit that I am disheartened reading through comments on here. Well-meaning women write in to tell this other woman who, I don't know, appears to have *been through the mill* (just a tad) and then take a moment to finger-point, judge and talk down to her. Why can't we as a community of women be more supportive to ourselves; save the angst for the OBs perhaps?
Anyway, to answer a few questions on her behalf, as a fellow mixed-birth mom (I have a lovely mix of stillbirth, VBAC and c/s with an almost-rupture, breech presentation, transverse vaginal delivery, manual placenta removal...y'know, the usual):
"have you really thought this through?" -- um, her child almost *died* so I'm going to go with yes!
"are you *truly* informed?" -- really...I mean *really*?! How patronizing. Yes, she has "thought this through"! I'm sure she is well aware that c-sections come with increased bleeding, possible increased risks to baby & herself, that 30% of births are now by c/s; why would she be writing this *at all* if she didn't know? Language and questions like this drive *me* crazy because, even after my last c/s following a successful VBAC, I questioned and questioned myself because voices like *yours* kept creeping back in. Was there *anything* I could have done differently? And even if that answer to me is "yes" (and that's a big if), let me be clear for her and I that we are NOT all coerced, uninformed ragamuffins who just laid down and took it. That notion, even if hinted at, is *insulting* and, frankly, really unfair. When a woman goes through multiple traumatic experiences, should she really have to tolerate these types of questions after already putting herself out there?
"did you change positions in the first birth?" -- does she have to give you a play-by-play to convince you that she's informed enough? Even if she didn't then, is it possible that her giving birth in a clear emergency and almost losing a baby was traumatic and the *real* source of her thinking this through now? Hmmm.
So, here's my thinking. Back off, just a bit. Thank you to those who have clearly indicated that choice is choice, particularly when it is *clearly* informed choice.
If we start using mental health reasons for stating a c-section is necessary, then "unnecessarian" becomes obsolete. Then we say that a woman who had a c-section at her doctor's request for whatever reason like baby is too big, I have to get home to supper but I don't want you to know that so we have to say heart decels or your pelvis is too small or whatever else and she consents because she was afraid or didn't want to upset her OB and it was bad for her mental health because she was stressed or scared.
And right freakin' on, KK!
This posting and the comments raise a very interesting issue for me. I get frustrated that many people view breastfeeding as a lifestyle choice, birthing process as a choice. All these things actually have a biological norm. Our bodies are programmed to give birth vaginally (without drugs or intervention). Likewise our bodies are programmed to breastfeed.
BUT the physiology aside, many people are so removed from their biology, that culturally it is now quite accetable to override biological norms. Rather than deal with the fear or emotional issues preventing a normal biological process, we create "natural c-sections"...this sits very uncomfortably with me. In a very small number of cases, a c-section may prove a life saving measure. It seems this is a dangerous line that threatens all the hard work of VBAC advocates. Sure this is a much less traumatic surgery for mother and baby, can't deny that. BUT the research shows that vaginal birth - the biological norm - is a very important process to the long term health of mother and baby.
Seems to me that if no physiological medical reason exisits to prevent a vaginal birth, than a mother needs all the support and assistance she can get to overcome her fear and emotional blocks to birth as nature intended. That said: pregnancy is probably not the time to do this. This issue, as with breastfeeding, goes back to how we portray these issues to your children. If we are raised among naturally minded people (that is that vaginal birth and breastfeeding are the cultural norm, as well as the biological norm), we are more likely to accept the biological process, and have success. If, however, we are raised in a biologically disconnected culture (where c-sections and bottle feeding are the cultural norm), we are more likely to fear the biological norm and continue with the cultural norm.
I hear many women say they want to 'try' for a VBAC or 'try' to breastfeed, They recognise the importance, but ultimately - unless they say in their mind "I can, I will", and are fully supported by their family and medical professionals, it can be very difficult to overcome the doubt and fear they have in themselves.
I think women feel alot of pressure to perform biologically, when they do not feel connected to it, whether it be birthing or breastfeeding. They have to 'try' to be respected, and then they can say "i tried'. It seems to me that in this case a woman has recognised that to 'try' would be a falsehood that is insulting to her and a waste of time for those who would be supporting her. It is empowering to embrace that fact that she recognises her own capabilities and to own her choices. Yes, she probably has some fear and emotional issues that she needs to unpack, but right now, she has to make a desision based on a dead line. Pregnancy might not be long enough to unpack those issues, and so having the option to control a c-section to minimise the damage, is probably quite smart.
Thank you for sharing this - it has challenged me personally and I welcome the debate it raises.
KK, I'm not picking on you but your questions are very well stated and got me thinking, so I'd like to answer them from my perspective.
"If it isn't an unnecesarean, then maybe using the same logic, there is no such thing as an unnecesarean as long as the mother is informed and OK with having a cesarean?" ~Yes, that sounds about right to me.
"Any reason for a cesarean is good enough?" ~As long as it is the woman's reason, made with all the information SHE feels she needs to decide for her baby and her body.
"No one should discourage a woman from having a cesarean?" ~ I don't know about that, but I know that no one should discourage a woman from basing a cesarean decision on her own needs and values.
"I thought we were empowering women to trust in their bodies and abilities and for minimizing cesareans unless medically needed." ~Seems arbitrary for 'medically needed' cesareans to be acceptable then. Assuming that by 'medically needed' you mean 'would result in death or physical disability of woman and/or baby if not performed.' Many women, apparently including this author, value things other than lack of death or disability as they become mothers. Patrice makes this point much better than I am. But I fail to see why women valuing the whole experience, including their mental and social well-being, is controversial.
Of course, members of this community are here for different reasons. I'm here because I believe in trusting women to make their own decisions, and in empowering patient autonomy in maternity care.
I can sympathise from the other side of the coin as I planned a HBAC got the same flak. Sending you positive vibes that they follow your birth plan.
BTW- Normal is just a myth.
I think this article is the epitome of what we natural birth advocates are talking about, educated decisions. I am sure this was not an easy choice and she is informed!
Quick note: Don't worry about disagreeing with me just because this is my blog. I have friends with whom I disagree on many things. Not a problem.
^ I think that's exactly why you're only mostly hearing from women who *do* agree with you because I've seen this link posted all around facebook and a lot more people are disagreeing with you and Kim out there than are doing it here directly on your site.