Why I Love the Necessary Cesarean

It was thirty three years ago.  A woman of thirty was going about her chores heavily pregnant with her fifth child.  The days were long and it was humid and hot, a typical late August evening in Buffalo.  She scrubbed dishes in the kitchen of her house in the city while trying to herd the older children in from the pool in the backyard.  It was then that she heard a sound.  An alarming pop and then felt the gush warm down her leg and heard it hitting the floor with a splash.  Looking down perhaps she expected to see the pure clear glisten of amniotic fluid.  Instead, she saw red.  Bright red and lots of it.  She knew this wasn't normal, after all this was her fifth time around and she'd worked for years caring for women in labor and delivery.  It wasn't good.

She sent her oldest daughter to grab the next door neighbor.  Grandma came to watch the kids.  Her husband arrived home from work in time to rush her to the hospital.  The doctor finally arrived and told her the baby needs to come out NOW.  It was a case of a placental abruption.  For some unknown reason the baby's source of food, nutrients, and most importantly, oxygen was pulling away from her uterus.  They could try to birth naturally but there wasn't time.  In the doctor's words at best the baby would be brain damaged, at worst the baby would be dead.  They had to go in immediately if the baby was to have any chance at life.   They did.  She was knocked out and with a vertical slash down her womb, they sliced her open and scooped out the infant, who thanks be to God and the doctors in the room took her first breath and cried.  Mom woke up later confused but begging for her baby.  She nursed and held and thanked God for the gift of her child.

That baby was me.

I think sometimes people think that because I am such a proponent of natural birth that I am somehow against surgical birth.  I'm not.  I likely wouldn't be here were it not for the skill of doctors who were trained in surgical birth.  I am grateful for a mother who allowed herself to be cut open so that I could live.  I am grateful for a hospital near enough to their home and doctors who were trained for this emergency.  So grateful.  What I am against is unnecessary cesarean.  Anyone who has been through a cesarean birth knows how difficult it is.  Not that a natural birth is any picnic either, but you get all the endorphins and the high and if you take care of yourself and don't have any major complications, you can feel mostly recovered in a few weeks or even days.  Not so with major surgery.  Currently the cesarean rate in this country is around 33%.  One third of American babies are being born surgically.  It is recommended by the World Health Organization that a nation's cesarean rate is safest at around 10% of births, when it is determined that a situation is such that the benefits of a cesarean outweigh the risks.  It means that half to two thirds of surgical births are medically unnecessary and since we know that cesarean has much more serious risks than natural birth it means that we are putting mothers and babies in unnecessary danger.  It's not cool.  It's anti a culture of life to put babies and moms at risk because of convenience or fear of litigation or even sincere concern but one that is premised on bad science.  Women and babies deserve better than to be put at risk by a system that is broken.

I could go on for pages about the ways that our country's unnecessary cesarean rate is dangerous for mothers and babies.  How our country has one of the highest maternal and neonatal death rates in the industrialized world.  I could tell you about the tears in the eyes of the women I have talked to when they describe their unnecessary surgery, some of them left with lifelong complications and the inability to carry future babies safely.  Or the other mom who wasn't able to get out of bed to answer her baby's cries and how that ripped her apart and triggered postpartum depression.  I could tell you of the others who were talked into a cesarean because of a breech baby, a previous cesarean, an unnecessary induction, "failure to progress," twins, an estimated big baby, post due dates, "small hips," or their doctor's golf plans and now know after the fact that they had other options.
But today, today I am just grateful.  I am grateful for my life, a life that is no less worthy and in fact wouldn't be here if it weren't for a surgical birth.  Grateful for a mother who had to endure two more surgical births after me as well as one heck of a battle scar because of her sacrifice for my life.  I'm grateful for God giving us doctors with a skill that when used prudently and correctly can save lives.

If you are a mom who has had a surgical birth, necessary or otherwise, I salute you.  I don't know what it's like to go through that and I'd love to hear your story.  Please know if you are a mom that may have a cesarean in the future that you have options and that you still deserve to be treated with dignity and respect before, during and after the birth and so does your baby.  There are simple ways to limit the trauma and risk of a cesarean and you have a right to know them.  While we work to make sure that the unnecessary cesarean rate drops, we can also make sure that when they are prudently performed they are done so well and that the mental, emotional, spiritual, and physical needs of both mom and baby are addressed.  Birth is important.  YOUR birth, whether in the past or future, is important.  You are allowed to believe that and you are allowed to mourn a birth that didn't happen as you hoped while still celebrating the beautiful child you brought into the world.  Your baby is blessed to have a mom that loves them so much and who has sacrificed so much for them.  And so am I.

(This is where you get to pretend this is a picture of me but it's really Luke.)


15 comments

  1. love this love this love this! And basically you stole the words right out o' my mouth. :) You are a good birth advocate! I think sometimes what's hard for us moms that have the pleasure of multiple cesarean births, is when our more natural friends assume ours were unnecessary or throw us in the category of the 'uninformed'. Or worse, when people imply (and I gotta tell you it has happened to me so many times before) that our births were not 'intended' by God. I thank God often for the wonderful people who helped me bring my child into the world. With tears in my eyes, I just had a conversation with my ob where I profusely thanked her for every single thing she is currently doing to ensure our third c, in three years is as drama free as possible. Thanks for sharing this, because I think it is especially heard from birth advocates such as yourself! :)

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    1. I'm so glad you liked it. I think when people when it comes to it being intended or not by God (and I may have used that phrasing before, I don't know), they're only referring to how God ultimately designed childbirth to work and that a surgical birth is to be used when something is outside the norm. Just like any major surgery, you know? Surgery means something isn't normal. Thank God we have it for when we need it. He doesn't actively will us to undergo surgery but He does allow it in His passive will for a greater good because original sin, redemptive suffering, a live baby or mother, yada, yada, yada. He also didn't primarily will ANY pain in childbirth but that can be turned around and used for a greater good as well. But yeah, I can see how that phrase might be hurtful. I hope that makes sense...

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  2. Beautiful! So glad you are here to tell us about it! What a smart and unselfish mother you have. I've felt judged many times over all of my c-sections. Let's hope that section number five, coming soon, is not dramatic. Happy birthday!!!!

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  3. Wonderful post...I have never had a c-section but have had to recover from surgery, so I know it's no picnic. I'm sure recovering from surgery and childbirth at the same time is a tough road too. Well thought out post.

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  4. This is a sensitive subject no doubt, so I apologize if this sounds a little heated - I am glad to hear of cesarean support no matter what.

    I had a c-section for my first delivery for a number of the reasons you list as reasons given to "uninformed mothers" - over my due date, induction (after my multiple attempts at various more natural and unnatural methods failed), failure to progress with a sunny side up baby (who turned out to have a head almost 15 inches in circumference and wouldn't flip after many hours of different positions), blood pressure issues for both me and the baby etc. and the thing is I was informed and that was the route that I chose.

    In fact, my doctor gave me the first option of going for vaginal. She was highly supportive of that method, really wanted me to give it a try, but I made a different call.

    Turns out big heads run in the family - my husband had to extracted with vacuums and forceps from his mother who is more traditional/stereotypically suited to childbirth in her frame than I am - not to mention he was facing the right way to come out. Seeing the pictures of his poor bruised head when he was only hours old makes me wonder which way was more traumatic for the child and makes me a little more confident in my decision.

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  5. Thanks for this article. Well said!

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  6. Very good post! So thankful you're alive. When I first started reading it sounded like a novel. If you wrote a book I would definitely read it! Happy Birthday, you share a birthday with my son and Mother Teresa. Great day to be born.

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  7. Thank you, Mary and HAPPY BIRTHDAY!!!!! I sometimes feel like a failure for having 2 c-sections. I don't know if my first was necessary, but after 30 hours of labor and what seemed a complete failure to progress, I was happy to be cut open and get my baby in my arms. And my second...well it was a case of placental abruption - just like you were.

    Neither of my pregnancies were great and the deliveries don't have me singing the praises of childbirth. But I'm so, so thankful for the medical care I received and the two healthy babies God gave Kevin and I.

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  8. I love this post, Mary! I feel the same way about c-sections! I have had 7, and my husband consoles me with the fact that I most likely would have died in child birth without it. I tried a v-bac, but it didn't work. My doctor said that my pubic bone is flat on one side (instead of curved) and having sunny side up babies to boot, there was no way (the nurses also assured me that if there was a way, the doctor would have made it happen, that made me feel much better!).

    Although, I have found that c-sections can be wonderful and peaceful! Like any other repeat surgery, it gets easier the more you do it. My hospital is awesome and at the front of really positive changes, with my last baby, as soon as the surgery was over, they allowed us to do skin to skin and nursing! (They actually said I might be able to do skin to skin during the surgery, but I wanted to wait as I'm usually a bit anxious and tired during.) I was in love with that last birth, and recovered very quickly. I'm so happy that there are efforts to make c-sections wonderful for the mother and baby.

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    1. Seven, wow! I'm so glad they've gotten better and that is so awesome they gave you your baby right away! I'm hoping more and more hospitals start to do this because I can't imagine how hard it would be to not be able to be separated like that. Thank you for sharing!

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  9. I've had three c-sections. The first was an emergency one, and if I hadn't had it, my son would have died. He was already dying when they cut him out and passed him through the window to the NICU. His birth and subsequent recovery are an absolute miracle.

    Having said that, I wish I'd switched doctors. My second c-sec wasn't necessary, but my doctor almost lost his wife in a v-bac, so he was determined against it. He delivered my son two weeks early, and then left for his vacation. (Your mention of the convenience for doctors regarding c-secs rang with me). I finally switched to a MFM specialist who let me at least go to term, and was supportive of at least allowing me to try v-ba2c. It was the first (and probably only) pregnancy where I was able to feel (braxton-hicks) contractions. I loved those contractions. :) I didn't go into labor on my own, though, so I had my third son via c-sec, again. As it turns out, if I understood correctly, my uterus had folded under his head, blocking my cervix, was pretty thin, and he was nine pounds, so I'm at peace with that one. :)

    I would also like to mention how different doctors have different perspectives: My first doctor wouldn't even consider a vbac, but assured me with the fact that he had delivered six repeat c-sections, and his colleagues had delivered eight, so as long as I didn't want ten kids (I always wanted 12, but that's beside the point...) we probably wouldn't have problems. My second doctor was willing to go for a vbac, but sent in a colleague to tell me that, if I did end up doing the third caesarean, I should consider not having any more children.

    Brilliant, right?

    Honestly, though, it has helped me realize that my plans are not always what the Lord has in mind, and that's okay. :)

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    1. Thank you so much for your comment, Katrina. It is interesting how doctors all have different recommendations, isn't it? That's why I'm such a huge advocate for women doing their own research and asking questions and yes, DEFINITELY switching doctors if their advice doesn't make sense or is not based on evidence. So many women are afraid to switch because they don't want to offend their doctor or they think they're doctor is competent or a good doctor simply because they're nice, you know? I know some women are told they should never consider more than two or three cesareans but know several moms who have had at least five. Much of it depends on the type of incision and suturing but a huge part of it is just what the doctor is comfortable with. But if you're pregnant the baby's got to come out some way, right?

      I really appreciate what you said about loving the contractions. Something I've tried to remember while in labor is to think of and pray for the many many women who cannot have children and would give anything to be able to go through labor. I've never really extended that to c-section moms but it is so true and a great reminder.

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    2. I totally know what you're saying about reasons why women don't switch doctors, because all of them pertained to me! Sometimes it's so hard to see past what is potentially directly in front of us (confrontation, in this case), to what the end result will be. I will absolutely recommend to any woman to switch doctors if she doesn't feel comfortable, for whatever reason!!

      And I am TOTALLY going to have at least one more. In fact, I'm praying for twins on the next one, and then I'm going to FIGHT for one more pregnancy after that. :D I figure, if it works out, then that means I at least get six. ;)

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  10. Such a well written post. Thanks for sharing (and happy birthday!). My first was frank breech and wouldn't turn. I'm thankful for the skilled doctor/surgeon who delivered her safely eight years ago, and I'm also thankful that that same doctor supported my decision to have a v-bac with my second, even though I went a week overdue. Having done both, I know the recovery is leaps and bounds easier with a vaginal delivery, but I am, like you, so glad for the science and skill that brought my daughter and I safely through her delivery in 2005.

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  11. I appreciate this post- I think it really does need to be said that c-sections save lives, at least in terms of . Also the neonatal death rate in the US (4/1000) is on par with that of Canada and many Eastern European countries, and only a hair higher than the lowest worldwide rates in Western Europe (2/1000). That difference may not be strictly related to our c-section rate but the heterogeneity of our populations and differences in access to health care and resources. Either way, although the absolute risks are low, birth is inherently risky and we have to recognize that hospital intervention may not be perfect but it's better than the alternative.

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