I’m One Of Those Women

And by that, I mean my Caesarean section was a maternal request. There was no physical indication for a Caesarean, yet I asked for and was granted one for the birth of my second child.

It never ceases to amaze me that there is a general consensus on the positive nature of women being supported in whether or not they consent to sex; of women being supported in their choice and access to contraception; of women having choice as to whether or not they continue with a pregnancy; of women having access to support for either of those choices; of women having antenatal care; and of women then ceasing to have choice, rights and support when they give birth.

Here in the UK, women have the right to a home birth. There are now NICE (National Institute for Health and Care Excellence) recommendations that women also be allowed a Caesarean on maternal request. At last, a balance is coming: that regardless of birthing choice, women be supported in their choice.

As a result of the NICE recommendations and the midwives and obstetricians caring for me, I was supported in my choice to have a Caesarean. Perhaps there are those that would suggest a doula and counselling would have stopped my need for a Caesarean. There are a few flaws with the notion that women should be, by whatever means, stopped from having a Caesarean. The first, in my case, is that my midwives and the majority of my antenatal care came courtesy of our local midwife unit. A midwife unit that happens to an award winner. A midwife unit that has a 70% water birth rate and has access for all mothers to relaxation and hypnosis. They recognised that a positive birth is not about how a baby comes into the world, it’s about treating a mother like a human being, a person. About supporting a mother in making informed choice.

And it’s the choice that matters. The motivation for the choice matters, just as the motivation matters for however a woman chooses to give birth, but it is critical that the choice be, above all else, an informed one.

If women can be supported in the choice to give birth at home or at hospital, to give birth medicated or unmedicated, why can’t they be supported in making an informed choice from all the available options? With the help of midwives and obstetricians, women can be supported and informed about a range of options surrounding birth, but as soon as those option veer north of a woman’s vagina, all of a sudden, women aren’t deemed competent of knowing what’s right for them and their child.

When people are forced to follow the advice of doctors, they are sectioned in order to receive treatment. When Caesareans by maternal requests are denied, women are being forced to give birth in a way that they didn’t choose. These denials and the support of these denials seem to reinforce the idea that women are incompetent, and seem to reinforce the idea that it’s okay to treat competent women in a way that goes against their wishes.

There are plenty of arguments floating about that tell of the horrors of a Caesarean. The problem is that there’s often no balance brought about by also telling the risks of vaginal birth, too. And many of the risks associated with Caesareans are possible with a vaginal birth. Of the results achieved by continuing to talk about the horrors of Caesarean delivery, there is one that is incredibly damaging: the undermining of those women who have difficult vaginal deliveries. There will be women who have Caesareans who have very painful and difficult recoveries, but it mustn’t be forgotten that there are women who give birth vaginally who also have very painful and difficult recoveries. There are women who will have lasting damage from a Caesarean, but there will also be women who have lasting damage from a vaginal delivery. There are babies delivered by Caesarean who may have trouble breathing, but there are babies delivered vaginally who are going to have trouble breathing, too. The risk from a Caesarean may be higher, but there are very few risks which are exclusive to Caesareans.

I guess what I’m trying to say is that this is my body, please don’t try to take away my choice.

12 thoughts on “I’m One Of Those Women”

  1. Years ago, there might have been more risks with a C. But now a days? a lot better to have an elective one than an emergency one. Just as we have higher success rates with a number of other surgeries, we have a higher rate now than we did years ago of successful completion of this particular one.

    My siblings and I were all C-section babies. I was super late (as in, my initial due date was July 4th and my birthday is August 2), and I believe the doctors were scheduling a C-section because of it. I went into fetal distress before the scheduled date, though, and they had to do an emergency one.

    My brother was another emergency C-section, so by the time my sister happened, my mother elected to have a C-section rather than the risk of an emergency one. That was back in 1991, and I don’t know if they would have been as ok with it as they were if she hadn’t had two emergency ones already. I have to wonder what would have happened if it had been acceptable to get an elective one without the medical history when I was all fetal and stuff.

    At this point, if I’m able to have kids (and I want to, but medical issues…) I’d like to aim for a vaginal birth. But if the doctors think there’s indicators for a C, I don’t have any problems with the idea of it as precautionary for me. If others want it purely electively, I support that too.

    In the end emotional trauma is a great thing to prevent. And being able to chose how you give birth might be able to help reduce that trauma for some people.

  2. This is actually something that I find difficult to discuss well. Because on the individual level I absolutely agree with you: there’s no ‘easy’ way to get a baby out of you, and how you do so should be your choice, as it’ll be happening in and to and with your body. So, kudos to you and your care team who supported you so well!

    But on a public health advocacy level, more medically unnecessary c-sections is generally a bad thing, because all other things being equal, on a population level, c-sections result in worse outcomes for women and babies than vaginal births.

    I suppose it’s like the other b-word (*whispers* breastfeeding): it’s no skin off my nose how you choose to feed your baby (as long as you do feed it :) ). But on a population level, we’d be better off if we could figure out ways to help more women breastfeed. I wish I saw more people who balanced these two things well, you know?

  3. I love this so much! Thank you for writing it. The method of birth should be the mother’s choice, provided that the method is reasonably safe for both mother and baby. I plan to have a c-section if and when I get pregnant, and that choice is my own. I get so sick of seeing people judge and shame women who have chosen c-sections for whatever reason.

    Additionally, there has been research (I’ll look for it if anyone wants it) that shows that while vaginal births are slightly safer, planned c-sections are safer than unplanned emergency ones. I try to stay up on some of the research in preparation for feeling like I have to defend my choice to all of my friends, family, and acquaintances.

      1. He sees it more as a personal safety issue for me. And as much as he knows about women giving birth (ie. little to none) he does not want me to go through a surgical procedure that he sees as far more potentially bad than a vaginal birth. I explained the whole women in America overall still have something like a 12% mortality rate in childbirth either way, and many of the complications of cesaerians are also entirely possible during a vaginal birth. Didn’t care, though. He’s still super against the idea and can’t really seem to articulate more of his issues with elective cesaerian beyond that. Luckily, we are not crossing that bridge for a while.

        1. 12% mortality rate in the USA??!? No.

          Maternal Mortality Ratio (MMR) is measured as maternal deaths per 100,000 live births. While it’s higher in the US than in other Western countries, it’s nowhere near that figure: latest figures I can find (2010) are 21 per 100,000.

          Here is a good site summarising the risks and benefits of c-sections and vaginal birth: they have different sets of risks but overall (and as I said above, all other things being equal) vaginal births are generally safer with less risk of complications for the woman and the baby. http://www.childbirthconnection.org/article.asp?ck=10166

  4. Thanks for posting! As a currently pregnant person, I agree whole-heartedly with this: “…it’s about treating a mother like a human being, a person. About supporting a mother in making informed choice.” Amen!

    I really, really don’t want a C-section, but I completely support your right to choose (or in this case, to have chosen…) the birth that you felt was best for you and baby.

    1. I too am childless by choice and this topic gets my blood pressure up simply because its about choice. How its totally okay if we get pregnant, but totally not okay what we choose to do with that pregnancy: terminate it, give birth vaginally or through C-section. I’ll never understand the logic. If we aren’t competent enough to decide when and how we should give birth, maybe someone needs to invent artificial incubators so all the hard decisions can be made by the competent people who think so little of wimmenz.

Leave a Reply