Strollerderby

I do think that how we plan to give birth does say something about the sort of person we are, and therefore about what kind of parent we will be. The birth experience does indeed matter. It won't prevent or ensure bonding, but to say that accomplishing the hardest task that most people will ever face is insignificant isn't accurate either.

But the judging has got to stop, right now. Ultimately, how someone opts to or winds up giving birth is her business. Good information and greater options should be available, but harassment isn't informative or empowering.

If someone wants an elective c-section, fine. But I think the whole informed consent process needs to be more thorough. If you want a c-section for the hell of it, maybe you should have to be in the operating room for one so that you can experience everything from smelling cauterized flesh to seeing the doctors rest the woman's uterus on the outside of her abdomen so that they can more easily sew it up. Cesareans are marvelous procedures that save lives every day but they should never be viewed as anything less than the major abdominal surgery that they are.

Heh, I certainly didn't "break down" and get an epidural. I gladly planned it ahead of time. Who would get an inferiority complex merely because they don't romanticize pain?

katlady500: having to watch one, live, would be a bit much. A written account of the procedure, with a rundown of risks, aftercare, etc. should be quite enough.

Yes, the judgement should stop.  But, most likely, it never will.  We are not all going to agree about everything.  I have had c-sections and if someone wants to get all up in arms with me about it, then whatever.  I have better things to do, like raise the children I gave birth to. Instead of defending the manner in which they arrived.  But people like to judge, it's in our nature.  We want to feel like we know more than the next person or can presume what would be best for them because then that would mean that we are "doing it right". The whole c-section debate is just an extension of this.  So, meh, let's just move on.

My concern, not judgment, lies in the systematic desensitization of women to the idea of the regular need for highly managed or surgical births. Women have to ask themselves and their doctors why, for example, New Jersey's 2007 C-section rate was 39% with 2008 rates expected to come in even higher, or why New York states c-section rate has risen 24% in the past six years. The national rate has increased by 50% in the past decade, reaching a new record level every year in this century. This despite the WHO calling for a maximum cesarean section rate of 15 percent.

The United States has one of the highest cesarean rates of any industrialized nation, yet that has not led to improved infant or maternal mortality rates. Quite the contrary. According to a 2008 report in the American Journal of Obstetrics and Gynecology, 2.2 women died for every 100,000 cesarean births - 10 times higher than for vaginal births.

Sara, declining to get an epidural is not "romanticizing pain". It is making a choice that differs from yours. Some women opt for other forms of pain relief for reasons that don't come close to "romanticizing pain", but may include wanting to avoid the risks and disadvantages of an epidural. You're quite comfortable with your choice of an epidural, and I wouldn't condemn your choice. But dismissing another woman's choice to retain freedom of movement and avoiding the aftereffects of an epidural is hypocritical.

The whole motherhood thing is a huge competition.  And I don't know why.  First there's getting pregnant, then what kind of food you ate while you were pregnant...then the birth, how many meds, how natural it was.  Next breastfeeding, did you or didn't you??  How about diapers and wipes--cloth or disposable??? Is your child's diet organic???  onto preschool...which one???  Are we lazy for not sending them...fast forward to school??  Reading at grade level, sports??  junior high brings more anxiety and don't even go on to the secretative competitive parenting in high school.  Which school(s) were they accepted into?? Will they (gasp) choose not to go to college??  Cliques, sports again....

When does it all end???  Why can't we all just understand that this parenting journey is tough, that we all just want what is best for children and our families???  

I'm willing to bet there are homeschooled, breastfed, adult children of mothers who didn't have an epidural and chose natural childbirth, in prisons too.  

I had c-sections because I like my children born alive thankyouverymuch. If you are going to look down on me for that, you are setting yourself up for a lifetime of holier than thouness that really isn't worth it.  Because can you really look at a group of teens and tell which ones wore cloth diapers and who had moms who wanted an epidural???

Oh, and just for the record, my c-section births so rocked that I'd opt for another one in a skinny minute over the natural no IV 8 hour labor and almost 3 hours of pushing birth of my first born.  So I have experience in both fields.

I didn't smell flesh, I did feel my uterus being placed on my belly.  And it wasn't that bad.  I felt great afterwards.

Versus the stitches where no one deserves stitches (I tore) and having to spend 20 minutes to take a pee and then the specific washing and wiping afterwards....and feeling like hell...No thanks.

I've heard people tie the use of epidurals to the rise in c-section use, but I'm more inclined (through my own experience and speaking to others) that it may be tied to the use of pitocin and scheduled inductions.  I've known of countless women who start labor naturally, have epidurals, and the baby arrives as planned.  I've also known several women (including myself) who had inductions with pitocin and ended up with c-sections.

A rise in c-sections is meaningless data unless you tie it to other data.  For instance, has there been a rise in c-sections because more women are waiting until later in life to have babies, and therefore at higher risk for complications or health problems like heart disease or diabetes which could make natural birth dangerous for mother and child?  Maybe, but all by itself with no correlating data, the number of c-sections has no meaning.  So unless someone shows me that nearly all of of these c-sections are in young healthy women with no complications and singleton births I don't think it's time to start freaking about "unnecessary" c-sections.

It's possible that the rise in C-sections is, like many issues, a multi-faceted trend. Between the desire for a convenient delivery, the expense and bother of keeping L&D floors adequately staffed, the limited availability of midwives in many places (and limited insurance coverage of same), and employment policies that are not family-friendly, one could point to a number of factors that are not health related that contribute to a climate where c-sections are preferred. And "advanced maternal age" plays more of a role in the likelihood of genetic abnormalities than problems with the pregnancy itself, provided the mother is healthy. Issues like obesity, drug or alcohol use, and existing medical conditions affect a woman's experience of pregnancy more than age alone. Younger women are just as susceptible to the first three, and are more likely to have limited options for prenatal care.

It's nice to finally see some positive coverage about c-sections.  I am a physician, and while I am not pregnant and do not have kids, I would choose an elective c-section in a second.  Actually, if I have kids, I plan to do just that.  I have seen both sides - women screaming in pain with no epidural, peaceful painless epidural births, crash c-sections after hours of pushing, and planned quick c-sections.  As a medical student, I sewed up women after their c-sections.  I'd personally rather have a quick, planned c-section with adequate pain management post-op than an unpredictable vaginal delivery with tears and possible damage to the sphincters and incontinence.  There are of course risks inherent in both c-sections and vaginal deliveries - it is up to the mother to determine which risks she is willing to take on.  Giving birth is an inherently risky activity however you choose to do it.  However, I don't judge how other women want to give birth - if you want it natural with no pain control, I might think you're a little crazy, but it's not my life.  There is entirely too much judgment going on about these issues.  People need to mind their own business.  

Apologies, I don't really believe that everyone who wants an elective c-section should be forced to watch one. I just become frustrated by the large number of women I encounter at work that just show up at the hospital because they're tired of being pregnant and try to demand medically unnecessary c-sections without considering the repercussions. My hospital predominately serves a population that doesn't seem to ever take advantage of the educational resources available to them. It is inappropriate for me to generalize my experience to all the other perfectly sane, well informed women out there that may desire elective c-sections. And I should probably lighten up on the whole major abdominal surgery slant because most childbearing women are young and healthy and are capable of quickly healing even when things go wrong like a nicked bowel or bladder.

I'm a physician too (not an OB though) and after participating in a bunch of vaginal deliveries and C-sections in med school, I have to say they both suck and if there were any way around it I wouldn't want either of them.

But C-sections suck worse.

I suspect a lot of the trauma from vaginal deliveries is avoidable if you don't rush the mom.  Not all of it, but lots of it.  It looks to me like tearing happens when a terrified mom with three people screaming "PUSH" in her face forces her body beyond the limits of what it is supposed to be doing at the time.

C-section trauma is unavoidable though.  You *will* have your abs severed, they *won't* ever be the same again, you *will* have a scarred uterus and you *will* be at higher risk for future placentas to solder themselves to the scar or for your uterus to rupture during future deliveries.

Hence why I plan to *try* the 'natural' route.  It's not about the baby (who should be fine either way), it's about protecting my own body thankyouverymuch.  Not that I won't gladly take the epi if it hurts that badly, thank you very much.  But from what I can see labor pain is a very individual thing that spans a spectrum from 'not that bad' to 'hellish' and you can't predict where you'll fall.

It is funny that you mention breech births. My son was breech, so I had a c-section. I had a couple of women say to me afterwards, in a very sympathetic way, "isn't it awful that doctors won't vaginally deliver breech babies anymore?" Huh? There was no way I was going to vaginally deliver a butt-first, breech baby. I can't imagine that being squeezed through a small opening while being folded over like a taco can be the best thing, for baby or for mom.

I think people do take the anti-c-section thing too far.

People only mention the possible rise in csections when talking about the risks of an epidural.  I loved my epidural, until the next day when I developed a spinal headache.  It's rare, but it does happen and it is excruciating.  I'm a little scared to risk it again this time.  A few hours of labor pain might be better than the week I spent flat on my back in misery.

Cesarean birth in the United States:  epidemiology, trends and outcomes. (MacDorman, et al., Clin Perinatol. 35(2):293-307, June 2008)

Study Design: Researchers analyzed data describing cesarean births.

Bottom Line:  Both primary and repeat cesareans have increased. Increases in non-medically indicated primary cesareans have been more rapid than in the overall population and seem the result of changes in obstetric practice rather than changes in the medical risk profile or increases in "maternal request."

Physician financial incentives and cesarean delivery:   New conclusions from the healthcare cost and utilization project. (Grant, J Heath Econ. Epub 2 October)

Study Design:   Researcher analyzed the relationship between physician fees and the number of cesareans performed.

Bottom Line:  Analysis indicates that an increase of $1000 in the reimbursement for a cesarean section increases the rate of cesarean delivery by about 1%.

One piece of the puzzle is certainly that there are non-medical, non-evidence based incentives to encourage women to have a cesarean.  A medically indicated cesarean is a good thing.  A non-medically indicated cesarean, especially if the woman is NOT fully informed about the short- and long-term risks to herself AND her baby (yes, there are risks to the baby as well)is hard to defend.  She is being encouraged to take on risks that she doesn't understand for reasons that do not benefit her, her baby or her family.  That's not ok.  I wouldn't condemn or judge a woman for being deceived -- we still look to the medical establishment to be the experts and to give us information that is in our best interest.  Unfortunately, that just isn't the case some of the time, and seems to occur with some frequency in obstetrics.  It does take some time but there is factual (as opposed to opinion) information about the risks and benefits of elective cesarean.  Now that so many are being done, the risks are becoming more evident, so it behooves any woman who plans on having children to take the time to educate herself, then she really can make an informed decision.  There are just too many medico-legal and financial forces at work within the Health Care System to blindly trust the information you get from that system.

"'If one went to the extreme of giving the patient the full details of mortality and morbidity related to cesarean section, most of them would get up and go out and have their baby under a tree,'" [Dr. McDonald] said." Neel J. Medicolegal pressure, MDs' lack of patience cited in Cesarean 'epidemic.' Ob.Gyn. News Vol 22 No 10

I've had both a scheduled non-labor cesarean (which was made as "friendly" as it could be) and drug-free vaginal births.  My experience was that there was no comparison between the two and I can't imagine signing up for another cesarean unless there was clear medical reason to do so.

People who need to judge the birth choices/experiences of others are certainly not fully satisfied with their own as they need everyone to conform to their standards in order to validate their decision.  Is there really a right way and a wrong way to do birth?. Either way it is done there could be funky outcomes. And, on a brighter note there could be and are many beautiful out comes. I do have to respond to the idea that a c-section is in some way convenient. In no way is a C- section convenient. Please. It is major surgery. And although “natural” vaginal birth in all it’s forms is a big deal as well. I  do think that perhaps c-sections like home births, vaginal hospital births, and birth center births are not for everyone. To each her own. SomeonesMom I have to say that I think you are dead wrong. The birth of a child is just a fraction of what it means to be a mother. To say that how  you give birth says something about who you are and therefor what kind of parent you will be is insane. It really does open some very interesting conversations but you are making a very  high contrast statement about a very complex subject matter that can not be simplified in such a way.

Thanks, Mom of 4, for the great info that isn't just rhetoric. I am pregnant with number 2 and had a CS with my first after 18 hours of labour - 2 of which were pushing. When my dr said I had to have a CS I was devistated. I wanted to experiance the slimey cheesey coneheaded baby - instead I didn't get to hold my baby for nearly 45 minutes and she was handled to me all swaddled up with a hat on. I was so sad because it wasn't the experiance I wanted. Only whent I got my IUD a year later did my OB mention my daughter was sunny side up. UM _ you could have mentioned that!!!!! This time around I am DESPERATE for a VBAC. I have hired a doula and will do everything in my power to avoid another CS. My recovery was terrible - it took me months to get back on my feet and I was even readmitted to the hospital with infections resulting from my CS that made me had to pump and dump for 12 days only one month into breastfeeding.

I hated everything about my CS - but I know not everyone experiances it like I did. It was heartbreaking emotionally for me and physically worse than anything I could have imagined. The worst part was that I look back and don't feel it was needed. It was late, my OB wanted to go home, he made no effort to educate ME as to what was going on with my baby and my body. I am taking every step I can to avoid a CS this time round.

But if someone else WANTS a CS that's there's choice. I think they usually aren't told a lot about the risks of such a surgery (read Thinking Womans Guide to a Better Birth) but it's their choice. who cares?

I had three intervention free home water births and have never had a single stitch placed in my body as a result of giving birth. And all three of mine were over eight pounds.

I think part of the reason women elect to do something as violent as a c-section is because they are scared witless of giving birth and have no idea how to do it so that the pain is minimal, there is no trauma to the body. And doctors are piss poor assistants in the process, with economic incentives to slice and dice rather than hold a hand and encourage a mom to relax.

But it IS possible to give birth with little pain. I've done it three times. C-sections should only be done to save a women's life, or the life of her baby.

Crunchy Mama wonderful that your home birthing experience was what you wanted and that the out comes were good. But referring to c-sections as violent is extreme and selfish. You are placing yourself on a holier than thou pedestal. Choosing to have a c-section in no way states that a woman is fearful of birth. It is a choice and just that. You would no more like someone telling you that home birth is archaic , dangerous,and flakey than a woman who chooses to have an elective c-section wants to here about how she is violent and fearful.

I do need to add more to this discussion. I feel saddened that we as women cannot  try harder to respect each others choices . As a first time mother this topic has been a tough one for me as I fight for the right to be able to voice my pride in regards to my birth experience.

The birth of my daughter was a joyous one and she came into the world via a cesarian. So how could the event be joyous ? one may wonder. Well my thoughts were  not overly invested in the birth process but rather the outcome. I was more concerned with the wholeness of becoming a mother. I am confident that I will and have tested myself and my strength  in ways other than labor and childbirth. I have and will continue to seek various levels of perfection in regards to myself but will never use my children or their births as platforms to do so.I had “planned” for a “natural” birth at a birth center and when that did not work out I was induced and when that did not work out I had a CS. What lingers on in my thoughts is not the labor, of which there were hours , nor the fact that I had a c-section but rather it is having my baby in my arms warm and content.

I have such a problem with the so called “Natural” parenting movement. As it seems to be anything but natural. Rather it seems like a cult of insecure people following a set of rigid truths in order to feel good about themselves as Mamas and Papas. Part of this dynamic is to find those who have not practiced the same “truths” and passive aggressively lash out at them. How these people can get off feeling good about devaluing another woman’s birth experience is unimaginable. Do you really think you know what is right for me? You can post all the statistics you want and you will still never ever know. Many of the “natural”  birth/parenting movements feel as though they are designed to make money by feeding into the insecurities of parents namely mothers. As benign as it all seems the whole deal is a naturalistic fallacy at it’s finest. My daughter came from my womb. And that is natural.

I really respect any decision a parent makes for their birth. However, some are talking about elective c-sections as if they were an epidemic. A very small percentage of women elect to have a c-section. Depending on where you get your info, anywhere from 0.5% to 2% of births are elective c-sections. Compare that with 31% of all births are c-sections. Obviously, the great majority of c-sections are non-elective.

Also, some of these elective c-sections are for other reasons than convenience. Sometimes a woman will have a previous stillbirth during vaginal delivery, and she will elect to have her next baby via c-section, because she is terrified of this happening again. There may be no reason to think it would happen again, but you surely cannot fault a mother in this situation.

Honestly, I would respect a woman however she decided to give birth, but I think we talk too much about elective c-section when it is relatively rare.

gpgirl, I'm more concerned about docs and hospitals refusing to let a woman do a VBAC, or pushing a woman into a C-section for being "too short" or taking "too long" when labor hasn't exceeded the average by more than an hour. And for those of us who might like to have more children, it is personally relevant.

And Tolani, if your choices and values have no bearing on your parenting, that's your approach. If birth was an insignificant event in your life, that's up to you to think so, as well. But for the folk I know, the choices and plans they make, including for labor and birth, do reflect who they are as people, and who they are as people does come through in parenting. And perhaps some births are forgettable for some women, but I know great-grandmothers who remember their pregnancies and births as vividly as if it were yesterday, and consider them highly significant events. Different strokes for different folks, I guess.

It is not at all that birth was insignificant for me, quite the contrary. But I understand that plans often change and therefor focusing on the process rather than the outcome seemed narrow sighted. I had a birth plan and it was very thought out. But I was able to let it fly when my babe had different plans. My choices and values do very so much have a bearing on my parenting. I just see parenting as a instinctual part of life rather than a social statement or movement. As for Birth defining who I am, we will have to disagree about that. If you can tell who someone is by the birth they  have chosen or have experienced please enlighten me to what kind of parent the women who has a c-section is!

It is not at all that birth was insignificant for me, quite the contrary. But I understand that plans often change and therefor focusing on the process rather than the outcome seemed narrow sighted. I had a birth plan and it was very thought out. But I was able to let it fly when my babe had different plans. My choices and values do very so much have a bearing on my parenting. I just see parenting as a instinctual part of life rather than a social statement or movement. As for Birth defining who I am, we will have to disagree about that. If you can tell who someone is by the birth they  have chosen or have experienced please enlighten me to what kind of parent the women who has a c-section is!

That is why I stated that our birth plans, not the eventual outcome, reflects who we are. What happens during birth is subject to things beyond our control, so one cannot state that an emergency C-section is the same as a planned C-section, even though the outcomes are the same. And I never said that birth defines a person, but it is a significant event, it can affect a woman deeply, and not merely due to her role as a parent. I also never said that one can define a person by the birth they plan, but that who we are goes into the births we plan. A woman who's highly suspicious of modern medicine and abhors surgery is hardly likely to blithely schedule a C-section for convenience. Likewise, a woman who fears pain greatly is likely to prioritize pain relief in her plans. Whether their plans come to fruition or not has no bearing on who they are; but it does affect the plans they make.

Perhaps parenthood is largely instinctual; indeed some parts must be. But there are parents who make conscious choices after researching various options. I don't think that's a less valid method of parenting than other methods.

@Someonesmom - those are valid concerns, but those are not elective c-sections. A lot of discussion on this board seems to be focused on elective procedures, which I think is misplaced.

Also, until we stop being such a sue-crazy culture, we won't see a rise in VBAC's. The fact is, people say they want to make a decision, but if something goes wrong they will often sue, so a doctor wants to do everything to lessen his/her chance of a lawsuit. OB's get more lawsuits than any other specialty. If they don't try and control this, they will be run out of business. I always say excessive lawsuits are a major problem in our society.

Mila, I had a similar experience: when pregnant with No. 1, my doc surprised me at 41 weeks with, "You have a huge baby and we recommend a c-section." I was devastated, but I wanted everyone to be healthy (and my daughter came out at 11 pounds!). I got a staph infection from the surgery and was in the hospital 8 days, with IV antibiotics for 10 days after coming home. My daughter was released before me, my husband thought, at times, that I might die (he told me later) and it made breastfeeding such a nightmare that by two weeks my daughter was on formula.  

However, with No. 2 things went a lot better. I planned VBAC and my docs let me go 10 days over my due date before they did the c-section (they felt it was too dangerous to induce me). This c-section was the difference between night and day from my first--I healed well and felt a million trillion times better than the first time around. Best of luck to you with your VBAC!  

But I feel like, unless someone had a bad c-section (which they clearly happen), they think it's cake compared to vaginal birth (it's not! even with a good one!). And the same can be said for those of us who never had hours and hours of labor, ripping, etc. We can't walk in others' shoes, so let's just be supportive to each other. We all love our babies desperately!

Barb, amen to that. I'm sorry you had such a difficult first birth experience. And what's considered cake can depend on your tolerance level for certain aspects of either form of birth. If surgery and medication give you the heebie-jeebies, but pain's not nearly as scary, then a C-section will be more of an ordeal. If you'd happily face IV's and scalpels to steer clear of the "ring of fire", then it's a very different matter.

Someones Mom, having a C-section , or the umpteenth time, is not a painless happening. The recovery is very painful. It is abdominal surgery .You simply do not have a realistic understanding of the procedure!

Tolani, for the umpteenth time, will you quit inferring things that I did not state or imply? Of course major abdominal surgery is no joke- but it's surgery, which is different from not having surgery. It's also not vaginal birth. Is that difficult to understand, for you?

Tolani, for the umpteenth time, will you quit inferring things that I did not state or imply? Of course major abdominal surgery is no joke- but it's surgery, which is different from not having surgery. It's also not vaginal birth. Is that difficult to understand?

Someones Mom, I guess my issue would be that we are talking about C-sections here and the if not women are still judged for them. The answer would be a big yes. Because even in an article in which the discussion is about c-sections you still need to compare them to vaginal birth. We are talking about C-sections. So "the ring of fire" really does not have a relevance unless you feel the need to compare. So you are very right in saying “it is not vaginal birth”  So stay on topic and stop comparing the two:) I think the comparison thing is what the problem is. Respect the differences. Later!

TolaniLucia, when one is discussing a choice that some women make (and is at times taken from them) discussing alternatives does make sense, as I don't know of many people who make a decision without even contemplating the possibility of other options. Indeed, you must live in a rather interesting world. If you're offended by the notion that there are alternatives to a C-section, and that some women do weigh options and even reflect on choices made afterward, I'm not sure what to say to you.