I see you, friend. You prepared for your first baby, and their birth, with all the passion and dedication you know how to muster. You planned for a natural birth, making all the “right” choices to give yourself the best chance. But through a series of events that you’re now agonizing as completely within your control (though they weren’t), you “ended up in a c-section”. You feel like a failure, because that’s how you’ve gone through life — if you don’t reach your goal, you’re a failure. I see you walking the path that I did — googling for resources, looking for every book on the subject, just like I did. Just like you prepared for your birth.
Sacred Sister, as you approach your second birth, I know you don’t see your first birth, a c-birth, as a failure — because it was necessary and needed to save your little one’s life. You are hoping for a VBAC, a chance to prove that you’re strong, powerful, and that you’re able to do the most primal of things that a woman can do. You’re already thrilled that this pregnancy has gone differently than the previous one, and I’m thrilled for you, proud of you. And I mean what I posted on your Facebook wall: You’re a strong mama. Your first baby was born the way he was because you’re a strong mama, and your second baby will be born the way they are born because you are strong. You will make the decision that is right for you in the moment. Because how you birth does not determine if you’re strong, powerful, and primal. How you birth is a complicated equation, but the meaning of birth is what we assign to it — we need to stop assigning failure and triumph to birth.
April is Cesarean Awareness Month, as declared by International Cesarean Awareness Network (ICAN). They’re an amazing organization, which has been doing the work of peer counseling women through traumatic birth for longer than I’ve been alive, as well as bringing light to stigmas and the need for change in the maternity care system around the world.
However, C-section is not the core problem, it’s a symptom of the problem.
The real problem is how much control society exerts over the female body, and as a result, how much judgement women feel for their every decision.
We Created the association between C-Section & Failure
For Cesarean Awareness Month, there are tons of memes out there advising us how to relate to women who have had a c-section. There are lots of blog posts out there how to talk to women who have had c-sections, because c-section is seen as a failure. The reason c-section is seen as failure is because we’ve created that meaning in our culture. The following memes are invaluable in showing us what to do, and what to avoid when we talk to our friends, families, sisters, daughters and (especially) ourselves about c-sections.
Mommas who have just given birth don’t need to hear how they could have approached their birth differently. They don’t need to know what you think. If they’re statisfied with their birth experience, this is going to put the idea that something was ‘wrong’ in their head. If they aren’t satisfied this is going to add to their sense that something is “wrong” with the way they birthed. Moms who have experienced birthing trauma don’t need any more fuel for their internal anxiety.
But if mother and baby are physically and emotionally healthy as they can expect to be, but the birth was a c-section, why are we questioning that the birth was anything but a success? Mommas have a primal urge for their babies to be born healthy, and whole, and to have the emotional and physical forbearance to heal ourselves and care for our children. That’s what we should be promoting as good and natural.
C-Section began to get a bad reputation when statisticians and public health professionals realized that the rate of surgical birth (aka c-section) was rising, back in the 1970s. Now, there is an international standard that states that no more than probably 10-15% of births should be surgical, because only 10-15% of births probably have a medical necessity to be surgical. The latest statistics show us that the rate in the US is roughly double what “medically necessary” might be. What natural birth advocates want is for doctors to stop performing medically and emotionally unnecessary surgical birth. This makes sense as a goal, because there is evidence based practices that show that labor and vaginal birth can have long-term beneficial health impacts for baby. But what has resulted is women teaching women that if they have a c-section, they’ve capitulated to medical pressure, they’ve done the “easy” thing, they’ve failed to utilize their body’s natural functions. What has resulted is the idea that c-section is a failure. C-section is surgical birth — the meaning of “failure” has to do with the idea that women have failed to protect themselves against medical care providers’ unnecessary interventions.
Whose Job Is It To Protect Women in Childbirth From Unnecessary Interventions?
And important part of the real problem to address is how much we make women being treated well through their pregnancy and birth experience the responsibility of the woman and her family. Another way to say this: Who treats pregnant women poorly? Medical care providers. Whose job is it to make sure women are treated well? If you say “women,” then you are blaming the victim — it’s the job of medical care providers. This goes down the line: Whose job is it to make sure that evidenced based care exists? Whose job is it to make sure that medical autonomy is respected and that the final decision maker in every instance is the patient, as is considered ethical by all medical organisations? Whose job is it?
My dear friends, it is not your job.
I know that I can just leave the Facebook groups, stop reading the blogs, but I cannot look away while women are in pain. I’m tired of reading about women who are desperate to VBAC, who have to list their un-receptive doctor and an inability to find another doctor because of funds or geography, a VBAC ban at their hospital and the inability to get to another hospital because of funds or geography, about women who know that the margin of error for ultrasounds for size is huge — they can even provide citations, thanks to projects like Evidence Based Birth & VBACFacts — but doctors ignore them anyway because “They Know Best.” The comments on these posts are always helpful, telling the desperate mama important strategies to get what she wants, but it’s always, always putting the onus on women to wrestle their autonomy back from those who took it. And a VBAC that takes place under the circumstances of so much stress is not necessarily any better than a repeat c-section.
Not only have we created a culture in which having a surgical birth is assigned a meaning of “failure,” we have created a culture in which the failure is the mother’s, instead of the doctor’s. And then, we often forget that c-birth has a myriad of completely necessary and appropriate in the situation applications which save lives, and can create emotional safety — we are lucky to have such a technique capable of saving lives.
We can actually have all three things: a low rate of non-medical surgical births, women who have good experiences in labor and birthing, and life saving surgery. It’s just not going to be easy to change the culture.
We can change the meaning of c-section.
One of the biggest things I’m seeking to do with my work, including the DIY Course (and soon, the group journey!) of Transforming Birth Trauma, is to change the meaning of birth stories for mommas who have had a traumatic experience. The voice of society tells us mommas that there is a “good” and “bad” and a “right” and “wrong” to the way we birthed out children. There are facts — ways that birth occurred, how we felt in the moment, and how we are affected long-term by those facts — and there are the meaning we assign to those facts, and the meaning we assign becomes the story we tell about them.
It is up to us to tell a story about “failure” — is it our own failure, or the failure of our care providers? But we can also tell a story about success, about triumph, even when things are terrible — where we resisted in little ways, when everything was against us; where we learned something even though the suffering was great. Or we can choose to make no meaning at all — neither negative or positive.
If you’d like to begin this journey of changing the meaning of your birthing experience with me, click below to join my mailing list and receive a free lesson from Transforming Birth Trauma. This lesson will give you the tools to speak clearly about your experience of birth trauma so that you can be easily understood and also receive the help you need.