The National Center for Health Statistics reports that the rate of Caesarean sections is at an all-time high in the U.S.
Almost 1.2 million C-sections were performed in 2004, up 27.5 percent from 2003.
The increase in C-sections has been attributed to a number of factors, including the “too posh to push” contingent of women who supposedly prefer the convenience of a scheduled operation over vaginal birth. (Is this really a trend? Who in the world would want surgery?)
Another reason behind the increase is apparently the fear of malpractice suits if something goes wrong in a vaginal delivery. Ugh. There are some hospitals that have even banned vaginal deliveries after a woman has had a C-section.
Tonya Jamois, president of the advocacy organization International Cesarean Awareness Network, says “Women are struggling to avoid unnecessary surgery, but the medical system has abandoned them. For many, they have to submit to major surgery in order to get medical care.”
Having never had a kid, I’m unfamiliar with a lot of this stuff–any parents want to share?
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My wife and I had our first child last May and she wanted to have a natural childbirth as much as possible. That did not happen.
The medical staff did give her excellent care, but they really regarded her resistance to painkillers/epidural as a pain in their ass. At the end, my wife had gone about 10 hours without pain meds, then was given stadol, then was given the epidural and she was completely out of it – she was not going to be making any decisions.
So the medical staff turns to me and wants me to okay a c-section. I felt very pressured and wound up saying yes. I felt powerless in the hands of the medical staff and my wife, an RN, was not coherent enough to make the decision herself. That’s the opposite of what we wanted.
My advice to women? Look into getting a doula – a person with experience at births who can advocate on your behalf. Don’t assume the you or your husband/boyfriend/SO can effectively advocate in a situation of so much stress and pressure. A doula will not have the emotional involvement and can help you make a decision.
Our daughter is so beautiful and perfect, but the birth itself was not.
I’m a midwife. The women who seek me out for home birth care are the opposite end of the spectrum from the “too posh to push” crowd, but in childbirth circles we do hear a lot about women who want to schedule their C-sections at a time that’s convenient to their work schedule and others who want to avoid natural birth in the interests of “vaginal preservation.”
I have met the occasional woman in other settings who had actual fear of vaginal birth. One mentioned a history of sexual assault (it was not associated with her pregnancy).
I think choosing a C-section is not in the best interests of their health, but it’s not so hugely dangerous that they should be denied the right to choose it, IF they have really been informed about the potential risks.
Of much more concern is the pressure on women who don’t want to get cut. Here’s what happened to a friend of mine. A lot of hospitals get very aggressive with inductions and C-sections if labor is “taking too long.” And the thing of refusing to “allow” women to have a vaginal birth after a previous C-section has gotten really bad. I’ll try to find some good links and post them here.
OK, birthstories.com is a collection of birth stories from women. There is a section on scheduled C-sections. Most of them are for medical reasons (breech, placental problems, herpes, etc.), but there are some women who just wanted them (sometimes based on misinformation), and some who had them because of impatient doctors but still thought that the C-section was a wonderful thing.
There is also a section of VBAC (vaginal birth after cesarean) stories. Several stories describe women having to shop around or overcome opposition from doctors in order to have a vaginal birth.
Interestingly, the two stories of uterine ruptures during VBACs both involved the use of contraction-strengthening drugs during the labors.
I wish I could find a source..anyway, I’ve heard that having a c-section damages the muscles that help you give birth vaginally. Perhaps this explains the ban?
True story: a friend of mine was doing her ob-gyn rotation as an intern and assisted in a c-section of a rather young woman with an unsophisticated husband. She was conscious during the procedure and the hubby narrated what was happening. He had apparently never heard of the placenta. After the child was delivered the doctors removed the placenta and the husband yelled hysterically “Oh my god they’re taking out your liver!”
I’ve never been quite clear on why the rise in elective C-sections is seen as so ominous by many feminists. “Too posh to push”…I realize that LAMom probably isn’t using this phrase as an attack on women who choose C-sections, but I have heard other people say similar things to vilify women who view their work schedules or the avoidance of pain and (reasonably feared or not) permanent damage to their bodies as more important than having “the natural experience of birth.”
I’ve never been quite clear on why the rise in elective C-sections is seen as so ominous by many feminists.
Feminism, of course, means different things to different people. Many women who identify themselves as ecofeminists see the childbirth process as an expression of female power. Coming from that viewpoint, external pressures (like companies with inflexible work arrangements) and a culture that fears all things feminine are seen as causing women to lose touch with their inner strength.
The enlightened response to that would be to simply express our beliefs about the beauty and empowering nature of natural birth, and hope that women catch the vision. The misguided response is to attack women who make other choices.
A hospital can refuse to consider a vaginal birth after c/section if they cannot guarantee that they can provide 24/7 the resources that might be needed for an emergency surgery in the case of a uterine rupture. In this case, it’s probably a very responsible decision. While induction medication can raise the risk of rupture in a uterus that has a surgical scar, the fact is that women scar differently. One woman’s great strong scar can be very different from another’s that is much more thin. Unfortunately this cannot be known until an emergency situation develops.
I went into a vaginal birth VERY convinced of the rightness of this means of delivery if at all possible. However, as a result of the birth I had horrible chronic pain on the left side that prevented me from sitting or resuming a normal sex life. It was finally (mostly) resolved two YEARS later in surgery–my left pudendal nerve became entrapped as a result of my baby’s position during the birth. I will probably always have a small amount of pain due to some level of permanent nerve damage. It is worth noting that doctors who can deal with pudendal nerve entrapment are very few and you can probably count on going out of state for surgery, as I did. The average ob-gyn does NOT know what to do for perineal pain. Their education just does not encompass this, period.
Next I had surgery to correct the second degree perineal laceration I received (torn skin and muscle). The skin had been sewn too high and kept tearing open when I would try to resume intercourse. This surgery (perineoplasty) was just awful to recover from.
I also have stress incontinence since the birth, and kegels have no effect on that; next year I will talk to a doctor about bladder surgery.
Finally, I never had hemorrhoids during the pregnancy, but developed bad ones as a result of an hour of pushing. I am not ruling out surgery to correct them but I can only tolerate so much at a time on top of working full time and caring for a home and small child.
When you consider that birth means you are immediately tasked with caring for at least one small child with a lot of immediate needs, it makes perfect sense that you would not want to take any unnecessary risks with your health. People are very quick to say that in birth, only the baby matters, that “it’s not about you anymore”. The fact is that babies wouldn’t get very far without their mothers, and we need to keep mothers healthy.
So no, I don’t begrudge anyone a c-section for any reason. It can make all the difference in their experience of motherhood for a long time to come. I wish I had not gone through all of the physical damage that I had in my birth; it has also meant that I won’t have another child. I used up the last of my fertile time trying to recover from physical birth trauma. I have also had emotional issues about this–you have no idea how many people have tried to tell me that anything I have gone through is surely “worth it” to have a child. I think that is something that only ***I*** should be allowed to say. Some of us do trade our health for a baby, and it is only for us to say if it was worth it. Sometimes one feels it wasn’t worth it, and the culture is very quick to point fingers and call us traitors to motherhood if we dare admit it.
Most women will have a vaginal birth and be just fine. All I ask is some compassion for those who have already had a bad experience or who just don’t want to take the chance of a bad one. There’s a little more to the story than just saying that vaginal birth is the gold standard simply because of our anatomy.
As the last poster showed, this issue is not exactly black and white. I have no problem with women choosing to have a c-section if they’re fully informed. I think it’s important that they have this choice. As we can see, a vaginal delivery is not risk-free either. I really sympathize with what midwestie went through – I can’t imagine what it must be like for her. What does bother me are people who say that unmedicated vaginal birth is somehow empowering or a “right of passage” for a woman. I personally don’t find anything empowering about it, and I don’t think that the fact that I had a vaginal birth makes me more of a woman that somebody who never had kids or had a c-section.
Something that is worth mentioning are the malpractice situation in this country and the overall health of pregnant women. Pregnant women today are older and heavier than ever before, and that does not exactly make for an easy pregnancy and delivery. As far as a malpractice situation is concerned, that is what truly prevents doctors from doing vbacs. The chance of a uterine rupture with vbac is small, but when it happens, the consequences can be catastrophic for both mother and baby. If a doctor has enough patients doing vbacs, it’s just a matter of time before something like that happens, and then a doctor is almost always guaranteed to be sued, even if he/she did everything they were supposed to. It also effects a doctor on a personal level – who wants to see their patients go throw something so bad when it could have been prevented with a c-section (sort of like why so many doctors who perform abortions nowadays are older ones who saw the consequences of illigal abortions). So, it’s no wonder doctors don’t want to offer vbacs anymore. If women truly want to have vbacs as an option, they should lobby for medical liability reform that makes more sense than the one we have now.