Wednesday, November 26, 2014

Why I'm Thankful for C-Sections

James is not impressed.
I have to admit every time I see an article or online conversation talking about the evils of c-sections I find myself feeling increasingly annoyed.

I have a love-hate relationship with my c-sections.  I hate that I had to have them, but I love that I'm alive and that my kids are alive and healthy and if c-sections weren't around none of us would be.

Sadie was born after five hours of pushing (without an epidural).  When I was being wheeled in for my c-section the words "I'm going to die" had been on repeat in my head for the better part of an hour.  And apparently they weren't far wrong.  Doctor after doctor (including our very nature-friendly family doctor) who I saw in the hours and days and weeks after the c-section volunteered the information that neither of us would have survived without the c-section.

Patch was transverse.  He'd been turned twice and was head down when an ultrasound was done while I was laboring in the hospital but sometime before my water broke (naturally) he turned himself around again and went back to his favorite position.  Both of our boys just seemed to love that position while they were in the womb.  Transverse likely wouldn't have ended while for me (or Patch) without a c-section either (even the all natural hypno-babies program that I did for that thirty-something hour trial of labor admits that transverse babies need c-sections).

Gearing up for c-section #4.
So I guess you could say that I have a healthy appreciation of c-sections since I wouldn't be here without them.  Would I have opted for them if I had a choice?  Absolutely not.  But I'm incredibly thankful that the technology exists that make five of the six lives in our house possible because without it Paul would have been widowed after less than two years of marriage.

Right now there's a popular article floating around my Facebook feed about the "cruelty" of c-sections.  They make the claim that c-sections are a form of birth control to prevent women from having more babies.

I find myself... skeptical.  I think that there are plenty of reasons that c-sections are done.  Many are absolutely necessary and lifesaving for the mother or the baby (or both).  Some probably are the result of doctors who are being over cautious because of a fear of lawsuits in the event that something does go wrong that might have been prevented.  I will admit that the c-section rate is very high in our country.  I seriously doubt, however, that many doctors are suggesting that first c-section as a way to discourage women from having more kids.  Is it within the realm of possibility that someone out there has that motivation?  Yes. Does it seem likely that many doctors do?  I just don't buy it.

I know that the motivation behind these articles is to encourage women to avoid c-sections, but I sometimes feel they overestimate the number of women who say "Oh you know what sounds fun?  Having to recover from major abdominal surgery while caring for a newborn!"  And so they come out swinging about the evils of c-sections and I feel that they often do so at the expense of women who have to do have to have them.  

Sadie after that first c-section.
I've known so many women who feel shame about their c-sections, who have lost the joyful realization that bringing a child into the world is beautiful, even when it wasn't the picture perfect birth they might have imagined or written into their birth plan.

When a woman begins to look into birthing she's likely to find a vocal portion of those writing about the subject passionately talking about the benefits of natural birth.  That isn't a bad thing.  I think natural births are amazing.  I desperately wanted one.  They just aren't always possible.

However I have a huge problem with the mindset that says that only one "type" of birth is good is good, only one is beautiful.  Some women even struggle to call their c-sections "giving birth" and I think in large part that's because of the shaming that's done when c-sections come up.  Your choices are suddenly questioned and you may even be told "well you could have done this and this and this" and you "likely wouldn't have needed one then."

I've been told that repeatedly when I've spoken up about the benefits (mainly not dying) of the surgery.

So for those of you out there who've felt doubts about your c-section, who've been questioned and made to feel like less of a mother because of the way in which you're child came into the world, I'd like to say that those who've made you feel that way are so, so very wrong.  Perhaps they are well meaning, but they are also still wrong.  Your birth and whatever way you brought your little one into the world is a hard but beautiful thing.

We are blessed to live in an age when doctors can save mothers and babies far more often than they could in past generations.  I'm reminded of that fact after hearing these claims of the "cruelty of c-sections" every time I look at my little family, which wouldn't exist if it weren't for that technology which so many feel the need to speak out against.  I'm thankful for c-sections and for all those lives that have been saved by the surgery.  Without it my family wouldn't exist.

9 comments:

  1. Cam, I had one vaginal birth and one c-section (due to a placenta previa). My vaginal birth was a horrible, doctor controlled mess (vacuum extractor and forceps, induced, epidural at the doctor's insistence). I didn't feel like I'd given birth, but like I'd had the baby ripped out of me. My c-section, on the other hand was actually pretty nice, they treated me like a person not an object. It was truly necessary, the placenta was both previa and accreta and I would have almost certainly not survived without it. As it was they nearly had to do a hysterectomy because of the accreta. I felt so much better after my c-section because they gave me everything I asked for (including 24 hour rooming in at a time that that was unheard of after a c-section). I still am sorry I never had the nice natural birth I aspired to, but I've never for one minute regretted that c-section. My daughter has had two births thus far. Her first was an unmedicated vaginal birth during which she tore horribly (enough that they had to have a surgeon come in to stitch her up). Her second was a c-section due to the baby being a footling breech. She had a much better recovery after the c-section (as did I). She's still hoping to have a V-Bac when they have their next baby sometime in the next few years (she's still not cycling yet), but if she has to have another c-section it won't break her heart.

    Is the c-section rate in this country abnormally high. Yup, it is. Do some doctors discourage women who have c-sections from having large families. Yup, but then they discourage large families in general. Ethel Kennedy had, I believe, 11 c sections and she's not the only one. Certainly the risks go up as you get into multiple c sections beyond 3 or 4 and I sure would want to make sure that I had at least two years between births (preferably 3)if I'd already had previous surgical births, but I think it's something that you have to discuss with your doctor. If you have a doctor who's comfortable with it, then I'd follow his recommendations. C-sections are a whole lot safer now than a hundred years ago. When I was pregnant and had a placenta previa diagonsed I read the statistics on mortality rates on placenta previa around the turn of the twentieth century. About 6 percent of the mothers survived (no word on the babies). I'll take a c-section over that any day.

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  2. I'm typing this with tears in my eyes.

    Thank you. Thank you.

    DD was transverse, too, and because of her positioning was not able to be turned via an external version, so C-section it was.

    To top it all off, nursing never worked for me. I tried everything: talked to two different lactation consultants, drank some amazingly nasty tea, talked to a LLL leader, talked to two doctors who did their darnedest to help, talked to countless nurses, nursed and pumped and skin-to-skin nonstop...and nothing. worked. After two bouts of mastitis, cracked and bleeding nipples, and a breast abscess that I will always have a scar from, I threw in the towel.

    To hear from some Catholic moms, ESPECIALLY, ironically, the ones who are also faithful enough to use NFP, I am a bad, terrible mother.

    I could have nursed if I just tried hard enough. (What else could I have done?)

    I "gave up" both by stopping nursing and by having a C-section.

    I was "too posh to push." (Never mind that two hundred years ago, both DD and I would have died in screaming agony while I tried to do the impossible--ie, push a transverse baby out.)

    Don't even get me started on the amount of harm the Kippleys have done by actively encouraging the attitude that all mothers can breastfeed (which is scientifically incorrect) and that it borders on--and may actually be--sinful for a Catholic mother *not* to breastfeed, though the Church teaches no such thing. Just what a new mom needs to hear, right? And the attitude in postpartum NFP circles is "having problems with PP NFP? Don't breastfeed? Well, it's all your fault for being selfish!" Not. Freaking. Helpful.

    Sorry for the rant, but thank you for this. Thank you so much.

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  3. YES! Same here. I didn't go into labor with my first wanting a CS, but he was huge and his shoulders were stuck. After laboring for 22 hours, it was time, and the doctor said later that he simply wasn't coming out. Second child - V-back - but now I wish she had been a C-section. I was so intent on a "regular" birth experience that I ended up with significant tearing and damage, had to go back to surgery in the months to come to repair damage to various areas/organs. It wasn't pretty. She had problems with heart rate decels from the stress, and ended up in the NICU for a little while. I would gladly go back and have a CS to be able to prevent all that.

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  4. Well said! I have two little ones so far (4 and 2) and both were C-sections. There was a lot of shame involved, and I remember sobbing when I was told during the second labor that I would need another section. I think part of it is the "us vs. them" mentality with women and doctors. I was told before my first was born that doctors would try to push a C-section on me if things weren't progressing, and I felt like maybe I had caused it by caving and having an epidural. I hadn't been strong enough to stand up and say no. After an unsuccessful VBAC attempt, the doctors determined that my pelvis is too small and my babies and I would never have made it, no matter how much pushing I did! Neither I nor my little ones would be alive without the surgeries. So thank you for writing all this!

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  5. While both of my children were vaginal births, the other two members of our household (myself and my husband) were c-section babies. I'm not sure if I could have been born vaginally if the doctor had allowed my mom a trial of labor, but my husband was born looking at the doctor upright after a trial of labor. He and my mother in law could have died.

    Are c-sections over done? Well in my case and my brother's, yes. Are they necessary in some cases? Most definitely. Without the necessary c-section, three people in my house wouldn't exist. I certainly think it's fair to be vocal about reducing the number of unnecessary ones while uplifting just how life-saving they are for others.

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  6. Two other thoughts have since occurred to me. I'm the Anonymous above. ;)

    As long as C-sections are done, some will always be unnecessary...in retrospect. The problem is that in the context of the baby's heart rate is decelerating/mom's BP is skyrocketing/mom's been in active labor for 48 hours and is passed exhausted, says she can't push anymore/whatever, the decision has to be made with the best information the doctor has at that time. Maybe the baby's head is just a bit too large for mom's pelvis. Maybe his head is turned slightly to the side and he won't come that way. Maybe he'd be just fine if the doctor decides to ignore the decels and have him vaginally anyway...but maybe he won't. And that puts both the doctor and the mom into a quandary: do you risk continuing labor and possibly ending up with a dead or brain-damaged baby and/or mom...or do you do a C-section, with the accompanying risks to the mother of major abdominal surgery, but be quite sure the baby will be okay?

    In retrospect, once baby is out and labor is over, one might be able to see that the baby would have fit through mom's pelvis, or that mom, given an epidural and a nap, could keep pushing. Sometimes you'll never know. The problem is, a doctor isn't all-knowing, and has to make the best decision for both his patients with the information he has to work with.

    There's also an attitude out there that C-sections are somehow inferior to natural birth. I don't understand it. Motherhood isn't a who-suffers-the-most contest. Vaginal birth is safer for mom, but less so for baby; that's considered, especially in the context of a hospital where mom can be knocked out, cut open, and the baby can be being resuscitated in 3 minutes, acceptable risk.

    That it's natural for a baby to be born vaginally doesn't make it superior. It's also natural for our appendixes to sometimes get infected, for some of us to develop cancer, and for some moms--say, those with breech or transverse babies or placenta previa/accrete or weak uteri or eclampsia--to die along with their babies (who could die of all sorts of other things--knots in their cords, strangled during a breech birth, etc) during labor. That doesn't mean that any of those are good, either.

    The body is designed a certain way, but it's not perfect, and thank God we have reason and science to help us learn new and different ways to save the lives of those involved in such situations.

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  7. One last thing...for now. ;)

    "I've known so many women who feel shame about their c-sections, who have lost the joyful realization that bringing a child into the world is beautiful, even when it wasn't the picture perfect birth they might have imagined or written into their birth plan."

    This. Yes.

    When I tell people that DD was born via C-section, their inevitable reaction is "that's horrible!" or "I'm so sorry, you poor thing," or "How long did you fight before they made you?" (Couldn't make this stuff up if I tried.)

    When I reply, quite honestly, that it was a beautiful, beautiful birth, that we were both surrounded by the kindest and most caring people I've ever met, that she was on my chest and nursing within a couple of minutes of her birth, and that I loved every second of it, they universally look stunned.

    The fact is, OBs and those who work in OB wards, generally speaking, really care about moms and babies and love being a part of birth. They aren't "the enemy," as many natural-childbirth advocates would have us believe. They want to help. They are caregivers in every sense of the word. Are there some bad apples? Of course! But I think they're the exception, not the rule.

    My doctor treated me, both ante- and post-partum, with courtesy and respect. He answered my questions honestly and clearly, and always made time to have decently-long appointments. If he hadn't, I would have switched doctors.

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  8. I loved this post. I have not had a C-section but for a time when they were talking about it I felt at peace about it. I just want to know who the cut happy doctors are because my group of doctors wouldn't even induce until 41w2d and would never have agreed to a just for the heck of it surgery.

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  9. I sm the happy mother of two children born by all natural birth, and two, soon to be three, by c-section. I have no problem with either because in the first cases, I was the perfect age, in good athletic shape, and have a very wide pelvis. So it is no surprise that my natural births were great. But later years, miles, weight gains, metabolic changes in my health, and other issues, and the c-sections have been easy decisions. What works, works, and if the outcome is a family it is all good.

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