Birth By Surgery: Can the C-Section Be “Natural”?
Many of you read and supported me in my “Medicalization of my Natural Birth“. Thanks, yo.
I never had to face a Caesarean section. Not with these birthin’ hips. I know, and am even related to, women who have. It’s a tough recovery for many, both physically and emotionally.
Now there’s a movement to make the C-section more “natural”. Vaginal birthing has had a natural movement over the last 20 years, and one doctor wants the C-section to have the same.
British professor Nicholas M. Fisk wants to encourage the same bonding that is present in many natural vaginal births in his C-section patients. He thinks C-sections should be more “woman-centered.”
But with 1/3 of all American labors ending in surgery (in the UK the C-section rate is 24 percent), is this something we should encourage? Do we really want him to soothe us into the decision of a C-section?! “There, there. At least it’ll be natural.”
What’s next…is he going to “naturalize” the vasectomy?!
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Here’s what happens in this OB’s “natural” C-section.
- Just as in a sterile C-section, the curtain goes up so the parents don’t see the incision and so the environment is clean.
- OB slows “delivering” the baby so mama’s contractions can clear baby’s lungs, “just as happens at a vaginal delivery”.
- The baby’s shoulders are delivered, and then the proud parents are allowed to watch the rest of the delivery.
- Baby is placed on mamas chest for bonding.
Don’t get me wrong; I know that some C-sections are honestly medically necessary. But I also know women who have been bullied into it. They feel like if the doctor says it’s so, it must be.
But there are WAY too many C-sections up in here. 2007 marked the 11th straight year for an increase in the procedure. And this rate has climbed 50 percent in the last decade. The number of vaginal births after C-section (VBAC) are on the decline, further increasing the C-section rate. The World Health Organization wants a C-section rate of no higher than 15 percent anywhere in the world. Considering that half of all C-sections are elective, I’d say we could trim down a bit!
I get that medical professionals are scared. We’re in an era of litigation. But please, can more doctors stand up and say bravely,
I’m ready to stop practicing defensive medicine. I’m ready to let women experience natural labor without interventions unless absolutely necessary.
I know this is a tricky topic. Women are all across the spectrum of guilt and satisfaction and delight with their birth experiences overall, especially when they give birth by surgery.
If this “natural” C-section is going to empower women and families for whom the surgery is actually necessary, that is fantastic. I’m all for bonding from the first and making each birth experience the best it can be.
But if this is a ploy by the medical community to dress up a wolf in tie-dye and Kumbaya songs, no thanks. If we want to make the C-section more like a vaginal delivery, might we move toward the actual natural birth for the many strong mamas out there?
Image: Focus by Kelly Sue on Flickr under a CC License.
Beautifull story. I suggest also this blog
http://healthmedicine-today.blogspot.com/
OB’s should ONLY be assisting at high risk pregnancies and situations that must end in c/s in order to save lives. Then they would have the time to really spend with their patients, address concerns, and take their time with “natural-ish cesareans” Reducing the overall number of women in the hospital giving birth (by having a system that supports low risk, healthy moms birthing their babies at home with trained professionals like CPM’s and CNM’s) would allow moms who birthed through surgery to stay in the hospital longer and receive the one-on-one medical care that they so very much deserve. 3 days is not long enough to recover from a cesarean, learn breastfeeding, adjust to being a mom, catch up on some sleep etc… when you have perfectly healthy moms who may need to labor for 2 days, competing for bed space, nursing and hospital resources, right along with the moms who have had surgery, someone is NOT getting the care and support that they really need.
Interesting.
I think your concern is completely appropriate because I don’t think it will help a woman who is choosing an elective c-section (though she certainly has that right) to feel even better about it because there is an emphasis on how mother-friendly aspect of the procedure.
On the other hand, women need to start demanding more respect regardless of the procedure. The way we are allowing our bodies to be treated is atrocious and I think many, many doctors could stand to use compassion and respect when doing a procedure like a C-section. I think most of the behavior is horrible, but I don’t blame the doctors. It is the responsibility of the women to demand the best for ourselves and our babies and the responsibility is for us to find consensus among ourselves, not pass it off to the medical community. I don’t much care what kind of birth you choose to have, but own it and know you deserve respectful care.
You know, I had three c-sections, all medically necessary for several reasons. I did have guilt after the first one, but have gotten over it. Once I realized there was really no choice and I got a healthy baby because of it, I let it go. I have to say that I felt that all three of mine were as ‘natural’ as possible. None of my babies were separated from me, I got to hold them throughout the time I was being put back together, with my last one when I couldn’t hold him my husband never stayed with him constantly and held him the entire time. He even took his shirt off and took off the blankets from the baby and held him to his skin until I could put him to breast.
I think the problem is four fold. We have insurance companies determining how long a mother can stay in the hospital, doctors afraid of litigation if the smallest thing goes awry, parents who are only too eager to sue the doctors, and hospitals who don’t give enough education to mothers considering c-section or educating those mothers who do have c-sections on how to recover from them. In all, we have a complete society who refuses to take accountability for anything and who wants to blame and get paid for everything in the form of litigation. So, your not just talking about a change in how doctors view birth, but the entire society which is much harder to change. I know of a lot of women who beg for a c-section *as a first time birth* with no medically necessary reasons, they just don’t want to go through the pain of labor. How disturbing is that!?
I must politely disagree with the previous commenter on 3 days not being long enought to recover well enough to go home after a c-section. I begged to go home after one night in the hospital with my 2nd and 3rd c-sections because I knew I would get better rest at home than in the hospital. Once you know how to recover from a c-section it is not that hard. I wanted my baby out of the hospital environment so we could bond and breast feed in peace. This is where the education of recovery would help immensely.
I have to agree with Kitty. I had a medically necessary with my son. I also had a wonderful experience. I nursed my baby right away, he roomed in with me and was never out of our sight.
I was ready to go home within 24 hours. The first 24 hours were the toughest, but after that I was fine. Even though I had help at home, I was up and around and did everything for myself.
In fact, I did a car trip with my baby when he was only 7 days old. We did great and while I do not condone elective c-sections for scheduling or non-medical reasons, I also think they can be a beautiful and wonderful experience for the family.
It was for us. =)
I think women deserve and should demand the best care regardless of the type of delivery. I don’t think encouraging bonding during a c-section is the issue, or would necessarily drive increases in this area.
Rather, we need to examine the ‘picture’ much earlier on to investigate what societal factors/medical practices are herding women in this direction - outside of medical necessity - and try to alter the course before she arrives at that destination.
If she is already at the point of delivering via c-section, then I feel that anything that improves the experience for her and her child would obviously be beneficial for them both and should be promoted.
I absolutely hear your concern regarding the possiblity of Cesarean Birth being “naturalized” without addressing the root issues around modern maternity care and our high Cesarean rates.
However, I applaud and celebrate this new approach to Cesarean Birth. As a Birthing From Within mentor I strive to support parents in birthing in awareness whether they are at home or in the OR.
We recently began mentoring a “Birth by Cesarean” prenatal class for clients needing to have a planned cesarean for medical reasons. It has been remarkable witnessing the commitment of these families to be fully present and connected to their birth experience.
In preparation for the workshop we did a series of qualitative interviews with over 20 past clients who had birthed by Cesarean. They offered up courageous, insightful perspectives on their experiences and I am hopeful that this new approach to Cesarean Birth spreads beyond a few radical OBs to be an option for more families.
While there is no question that there are times that c-sections are necessary, the problem is that more and more that is not the reason they are done. I too think that the time and energy would be better spent educating woman on the benefits of natural, vaginal birth and the true risks of elective c-section rather than re-branding c-sections as “natural”. Obviously for woman who have no choice the procedure should be made as positive as possible, but unfortunately as it moves to become the “norm” in many ways to schedule an elective c-section for reasons that have nothing to do with the health of baby or mother, I think I tend to see this as a wolf in sheeps clothing too…
I have pointed out before (in my “Medicalization” blog mentioned in the first line of this) that no matter how strong or natural-birth educated you are, sometimes you just feel pressured to go along with it. Any intervention. They’re the “professionals”, so they know better. One bloggy friend was actually told she’d tear from top to bottom if she gave birth vaginally. After 2 C-sections, she did a home VBAC. You can read about how wonderfully it changed her family here:
http://millermemoir.blogspot.com/2009/04/guest-blogger-my-husband-on-birth.html
For example, I was blogging away on natural birth and natural induction methods, but my medical midwife was pushing me to induce by 41.5 weeks, even though by all their interventions and tests, he was measuring “small” and my placenta was certainly fine to wait. Luckily, my son is as stubborn as I am and we went into labor the morning I was set to be induced. Even then they tried to intervene, though I was at Transition when I arrived!
If this could happen to me, who has had 5.5 and 2.5 labors, respectively, I fear all the interventions that push women eventually down the road to a C-section.
My oldest sister had an emergency C-section with her older son. He was literally stuck in the birth canal, approaching for too long. (And now she works with a special needs girl who had the same thing, only they waited and gave birth vaginally, so my sister is thankful she made that choice.) But my sister was then slightly “pushed” to have a second C-section. And though her second was also large–but not quite as big–I wonder if this strong, marathon-running woman could have had a VBAC. If anyone could, it was her.
While the “natural” C-section is a blessing for those who need it, I don’t want women to choose it over the blessing that is a natural vaginal birth.
My grandmother was told in 1950 when her first child was breech that “we *MODERN* obstetricians have no trouble delivering a breech baby vaginally.” And he did it just fine.
My mom was advised in 1977 by her obstetrician to have a c-section when her first child was breech, but was willing to attempt a vaginal delivery when my mom said that’s what she wanted. And it was just fine.
In 2002, when my first baby was still breech at 34 weeks, my obstetrician flat-out refused to attempt a vaginal delivery as did every single other doctor at the military base where we lived (I was required to deliver at the base hospital or else pay for the entire cost out-of-pocket, which we could not afford). Fortunately, my baby did turn but had she not, I would’ve been stuck getting a c-section.
Why is it that the 1950’s era doctors could do vaginal breech deliveries but not the 21st century ones? Aren’t we supposed to be making progress?