We live in a society where birth, as in natural, physiological, vaginal birth, is feared. From an early age we are told all about the pain and how undignified it is. As we get older we hear stories of “emergency” caesareans, epidurals, episiotomies and forceps. We watch TV shows such as One Born Every Minute where women are disempowered, belittled, manipulated and bullied. We are told to just “do what the nice doctor says”. We’re assured that it will all be worth it.
Pregnant women seem to be a magnet for horror birth stories. Image courtesy of Wikimedia Commons.
Is it really any wonder that women believe that a caesarean is the easy way out? Especially when horror stories of caesareans are not shared. Because, while it’s okay to share vaginal birth horrors, if you share caesarean horrors you are accused of judging women who had caesareans or fear mongering. So most women are entering their journeys from a place where vaginal birth is seen as dangerous, scary, undignified and downright gross and caesareans are seen as calm, safe, dignified and clean.
But is that really the reality? Before anyone gets upset it’s disclaimer time: I firmly believe that caesareans are an amazing intervention when used to save the lives of mums and bubs. I also support the right of every woman to make an informed decision to choose a caesarean for no reason at all if they wish. Caesareans most certainly can be calm, beautiful and amazing and some women recover quickly. And sometimes vaginal births really are scary and traumatic and involve a long recovery. As long as your decision is yours, informed and supported I’m totally okay with how you choose to birth your baby – not my birth, not my choice, not my responsibility!
Let’s start with the myths about vaginal births. Many women I know use words like “scary, undignified, dangerous, painful and traumatic” to describe their vaginal births or just vaginal birth in general. But when you delve deeper into their stories you often find that they were unsupported, uninformed and disempowered. They did little preparation for birth believing that they would just go in and do what the doctor / midwife says. They had no knowledge of all the natural pain relieving techniques available as they had been told to “just get the drugs”…without being told that sometimes the drugs don’t work or you might have to wait or that there could be dangerous side effects. They are often left wondering “what happened” as they had many things done to them rather than being an active participant in their birth. Or they experienced complications that they did not know were possible – because they just trusted that the doctor wouldn’t do something that may have risks. I’m by no means suggesting that this is their fault – after all, it’s how we are trained to behave in terms of pregnancy and birth. The decision making is someone else’s responsibility and we should just be good girls and do as we’re told. Any wonder women are thinking that a caesarean might be a much easier path to tread.
A lot of standard procedures, such as CTG monitors, can make a normal birth more traumatic for the woman. Image courtesy of Wikimedia commons.
And these women tend to drown out the voices of those who had positive experiences. Because sharing positive stories is seen as “bragging” or women who have positive experiences don’t want to feel like they are invalidating the feelings of those who did not have positive experiences. But there are many women out there who describe their vaginal births as beautiful, inspiring, powerful, intense, transformative and ecstatic. These women are generally well informed about ALL birthing options available to them and have chosen a care provider who will best help them achieve their goals. They feel supported, knowledgeable, prepared and informed. They will tell you that birthing a baby is hard work (sorry – for the most part it really is painful and it is hard). They understand that they hold ALL decision making responsibility and they take their responsibility seriously. These are the rebels who are bucking the trend and not doing as they are told. They are reclaiming their birth right and birth power. But because they are seen as “natural birthing hippies” their stories don’t reach as many women. If you have fear about birth I highly recommend seeking out these women and their stories – join natural birthing groups and homebirthing groups and ask for positivity. Many of these women have experienced both vaginal and surgical birth and can also give you their perspective on which option is “easier”.
This woman looks empowered, peaceful and positive - just how a woman should look and feel after a birth! Image courtesy of Wikimedia Commons.
Which brings us to the myths surrounding surgical births. How did we get to a point where major abdominal surgery is seen as “easier” than a normal biological function? The biggest myth and the one that most other myths come from is this: caesareans are no big deal, risk free and completely safe. Because, after all, obstetricians wouldn’t be subjecting one third of birthing women to a procedure that had increased risks over a vaginal birth? And would so many women be “choosing” caesareans if they had increased risks to themselves and their babies? Of course not! So let’s look at the stark and very confronting reality.
Maternal mortality is around 3 – 4 times greater with a caesarean. 3.6/100 000 for a vaginal birth and 13.3/100 000 for a caesarean birth. People are often VERY shocked when I mention this stat because, despite having had a caesarean, they were not aware of this significant increase in risk of death.
The chances of ending up with an emergency hysterectomy, blood clots, pulmonary embolism and infection are also significantly higher in women undergoing a caesarean.
Babies also tend to require more assistance with breathing, are more likely to be admitted to special care or intensive care and have higher incidences of persistent pulmonary hypertension when born via caesarean.
And the risks don’t stop once the caesarean is done and mum and bub recovered. Having a caesarean increases risks to both mother and baby in any future pregnancy with increased risks of placenta praevia and placenta accreta. The chances of these occurring go up with each subsequent caesarean and both increase the risks of death for both the mother and baby. Placenta accreta also brings with it an almost 100% chance of hysterectomy.
Caesareans are major surgery, like heart surgery they can be life saving but also come with a list of big risks. Make sure your decision is informed! Image courtesy of Wikimedia Commons.
So caesareans can certainly be life saving for mothers and babies – especially in cases such as placenta praevia, transverse presentation, prolapsed cord and true CPD. And there are many other circumstances where a mother may decide that she is more comfortable with the risks of a caesarean (which are relatively higher than vaginal birth but still very low on an absolute level) for either planned or unplanned reasons. But to say that a caesarean is the “easy way out” is ignorant and dismissive. And if you truly believe that, in the absence of medical complications, a caesarean is easier than a vaginal birth I would ask why? What happened in your previous birth or the births of those around you to make you believe that? Were the issues that presented due to medical complications or were they due to a lack of appropriate support? What stories are you listening to? What is your care provider telling you?
Caesareans: sometime life saving, sometimes the better choice, rarely the easy way out.