There’s a lot of misconception that the rising rates of c-sections in our country are because women are “too posh to push” but the truth behind that might be more due to the cultural perceptions of birth rather than truly “choosing” a cesarean in spite of overwhelming evidence that vaginal birth carries less risk to mothers and babies.
Why Women “Prefer” C-Sections By Carly Bonderud
Despite the fact that c-section rates are rising in every country and women are literally fighting to birth vaginally, the cultural consensus depicted in the media is that women “prefer c-sections” and doctors are performing elective caesareans which are affecting the rates.
I can attest to the fact that as a childless young woman, I once said “just cut me open and take the baby out”. A lot of women do, especially when we consider the “horror” of “doing it natural”.
But the thing about that “preference” is that it comes from our culture of fear and misinformation. I didn’t want a c-section because I liked the idea of surgery (I don’t). I didn’t want it because it was “safer” (It’s not). I wanted it to avoid the horrors that I was told by family and friends awaited me in “natural” childbirth.
You see, there’s this prevalent myth that serves doctors who like to do c-sections, and it’s that vaginal birth destroys vaginas. It’s not true. Birth in its physiological form does not destroy the vagina. When women are left to birth without interference quite often they do so without any tearing at all, or the tears are so minor that they aren’t even noticed. Vaginas don’t stay stretched out forever, they do snap back to their original size after the post-partum recovery. And labor itself isn’t this long, painful ordeal that the media and pop culture have led us to believe.
These are things I didn’t yet know when I expressed disdain for “natural” birth. I thought I would be in constant pain because “A Baby Story” showed mothers in constant pain. I thought I would have to have cervical exams repeatedly in labor because that’s what they did on the birth shows. I thought I would be stuck in bed because that’s also where all the women were in these shows. I thought I would be given an episiotomy because all the women in my family had episiotomies and said it was “better than tearing” and I believed them.
So given the cultural depictions of birth, I was understandably terrified of it. I thought that birth would require an IV either way, but at least if it was a c-section then I wouldn’t have “days of labor” and a “damaged vagina” afterward.
I put off getting pregnant because I was afraid of the episiotomy, the epidural, the IV, the fingers in my cervix, and all the other interventions in birth that I was led to believe were “inevitable” because the birth culture told me so. It wasn’t until I actually became pregnant and started googling “how to avoid tearing and avoid an episiotomy” that I learned a tiny bit about physiological birth. That tiny sliver of truth led me to research more about birth and the more I learned, the more I realized that I had it all wrong! I most definitely DIDN’T want a c-section, but I didn’t want what the hospitals had turned vaginal birth into either. I realized that there was a better way for me; one that would give me back my control—and my dignity in childbirth.
I fired the OB practice I had gone to, thinking that’s where I was “supposed” to go and having no family doctor in any case to guide me elsewhere (not that they would have). I only knew that some women had home births from the few stories I had heard (and once scoffed at prior to my education in birth) and that midwives existed. So, I decided that no matter how “nice” the hospital in my community might have been, no matter how “updated” the facilities were, I didn’t want to birth there. I chose home birth.
In choosing a midwife, I gave myself a gift that few first time mothers receive; true, informed consent. I was told HOW birth ACTUALLY works, which was something that the health centre’s birth classes (sponsored by the hospital) failed to teach in all their breathing exercises and positions, and the flowery words they used to describe how “wonderful” the hospital was to “allow” any birthing position (which I later found out was a lie)! I wasn’t told that I could refuse cervical exams though, and I wasn’t advised on how to write my birth plan to make sure that as little of their “policies” interfered with my birth. I was thankful that even though I was planning a home birth, I paid attention to those lessons. In the end I was tricked into birthing in the hospital, and while it might not have been the intention of the midwife, I suspect the OBs had a hand in guiding her “advice” to me.
Perhaps if I had known to google “informed consent and refusal” I might have learned my rights earlier. I might not have chosen the first midwife practice that came up in the search engine, instead knowing that I could (and should) shop around until I found the right fit for me.
Some women want a hands-on birth. That’s their choice and they deserve a care provider who is in line with their wishes. But some women want to be left completely alone to do as their bodies tell them to, and I was one of those women. I was a woman who ALWAYS wanted bodily autonomy even as a child. The thought of other people, even doctors, doing things to my body that were painful, humiliating, and unwanted, was what had caused me to roll my eyes in my early twenties and express a desire to just be put to sleep and cut open to birth my children. The terror I felt in watching any show on TV depicting birth was the fear of being in that same position, in pain, with my “dignity left at the door”.
I was told NOTHING of physiological birth before I got pregnant. Well-meaning women who had given birth told me that “all that matters is a healthy baby” and when I expressed my fears about being cut and about the pain, they laughed and said I wouldn’t care about the needles when I was in “so much pain” and would welcome that epidural that terrified me. I was dismayed when I learned that a c-section also had an epidural (hence my desire to be “knocked out” for it).
There were no women in my family or outside of it who told me what birth was really like, because truthfully there are few women in the culture who birth outside the system. Those of us who do are the outliers; the selfish, silly women who prioritize “experience” over a healthy baby. “If you want an experience,” they say “go to Disneyland”.
So is it any wonder that when the terrified women who have been told all their lives how painful and humiliating birth is come into the office of the OBs, that they are eager to simply agree with the doctor’s advice to “just schedule a c-section” for any variation of pregnancy, including twins, breech, and just a suspected “big baby”? Is it any wonder that they agree to the epidural and the hospital protocols that require women go into labor by a certain day, so they don’t have a “big baby”? Is it any wonder why the women who are induced and then have a c-section are so easy to convince to have another c-section so they “don’t have to suffer like that again”, with no knowledge forthcoming that the reason labor was so painful was because they were induced? Is it any wonder that women fear birth?
The problem with the rising c-section rates for “elective c-section” is that they include repeat c-sections that women choose out of fear, because they were induced or because their doctors convinced them that their babies are “too big”. Women who start out wanting a VBAC who don’t know that they need to shop carefully for their care providers end up going to the same OBs that cut them the first time. “Oh sure,” these doctors say, “we will ‘let’ you VBAC, but the risk of uterine rupture is higher” and they don’t give a number, nor do they outline the risks of repeat unnecessary surgery. Or they place all sorts of restrictions on “allowing” a vaginal birth after cesarean so that women are worn down and agree to surgery that was already scheduled in advance “just in case” they go past that arbitrary date for labor to start.
Then these same women, who vastly outnumber the outliers in the culture, go on to tell their “horror stories” and they insist that vaginal birth is dangerous, especially VBAC, and that only a fool would risk it. They insist that labor is always painful. While this might have been their experience, they miss out on (and sometimes ignore) crucial pieces of information that would paint a different picture. For those women who haven’t yet experienced birth, this also paints a false picture in their minds of what birth is like, and they go into their pregnancies believing that a c-section is an easy way out of the pain of birth. This isn’t to say that a c-section IS the “easy way out”, but the women who automatically choose a repeat c-section have said “I don’t feel like going through THAT again” in regards to trying for a vaginal birth. And who can blame them when “natural” is used to describe ANY unmedicated vaginal birth, regardless of whether it’s physiological or medicalized in a hospital setting that was never intended to support the physiological process in the first place.
It’s time we address the real issue with women “choosing” a c-section and start depicting birth in a more positive way; one in which women actually have control of their bodies, can manage the surges of labor with deep concentration and determination, and can birth without leaving their dignity at the door.