Content Warning on this whole post - discussing cesarean triggers, birth and/or sexual violence.
It has been brought up to me a few times that people think I am very anti-cesarean section for birth.
This is not actually true. I don't hate or condemn them, I just believe they are overused and over justified as "medically necessary" which isn't the fault of the birthing person, but usually a doctor using scare tactics.
I am SO GLAD that it is an option. BUT - I think it is drastically overused and the WHO (World Health Organization actually agrees with me). Even the CDC generally agrees with me.
In the case of a someone who has been traumatized by either past sexual/violence events or previous births, I think having a surgical option is important. I would strongly urge this person to do research on risks, and see if there's anyway therapy might make a vaginal birth a possibility, but, to each their own.
In the case of someone with a TRUE birthing emergency - baby's heart rate SERIOUSLY drops and won't recover even if mom is given oxygen, changes positions, etc. DO IT! Now, a lot of doctors argue about heart rate, but there's a wide amount of variation associated with healthy babies, plenty of other sources tell us that. Also to note as a definite reason for surgical delivery: placenta issues - placenta is over the cervix or attached through a previous uterine scar - these are serious concerns, vaginal birth is unsafe. If placenta detaches before baby is born - surgery is likely the best option, if umbilical cord is born before baby, surgery is probably safest. If baby or babies have some particular congenital issues - surgical birth is safest - conjoined twins, hydrocephaly, some heart conditions, or extremely early preemies.
Generally hearing that baby is "stuck" or mom is "stuck" during labor...well that's harder to understand. While occasionally a baby will be too big for the pelvis - that's typically because of some sort of disease or injury that affected pelvis such as rickets, polio, or a bad pelvis break that doesn't heal correctly. The rate of true baby too big to be born from a healthy pelvis is some astronomically small number. It *can* happen, but it's rare. Generally labor or birth ends up "stuck" for one of several reasons.
1 - Mom is stuck on her back in bed. This causes pelvis to be tilted in a way that baby not only has to go "uphill" on the way out, but also to prevent it from flexing and opening fully.
2 - Doctor isn't patient and doesn't want to wait for baby and body to deliver naturally. Active labor might not even techincally be started yet, or the body may be taking a needed rest as it gears up hormones for the next phase of labor/delivery. If neither the birther or birthee is in danger, then waiting is usually safe.
3 - Mom is low on energy or scared - both of these can arrest a labor. Solution - EAT, DRINK, PEE, and be in a safe place - whatever that means to you. For some women being safe means being in a hospital on monitors with a nurse. For others, safe is at home with your partner, your kids, a midwife and/or doula. Everyone's different.
4 - Mom was induced and neither body nor baby are truly ready for birth. There are very few reasons (HELLP Syndrome, Choleostasis, Pre-or Full Eclampsia, uncontrolled Gestational Diabetes, or a few other fetal health issues) that truly need induction. Water being broken but mom has no fever or contractions, mom is at due date, fluids are low are all generally not emergencies that need immediate induction.
Other reasons a cesarean might be pushed on mom strongly, even if it's not yet truly necessary.
1 -Mom has a fever, therefore infection is suspected after waters have broken. Epidurals can cause fevers. Just an FYI. Cervical exams don't tell the future (it doesn't really matter how dilated you are before or during labor until it's time to push, and intimate exams can INTRODUCE bacteria into the birth canal. Just another FYI. Infection is serious, but having no cervical exams reduces risk, and not having an epidural lowers chance of a fever that is unrelated to infection.
2 - Someone's heart rate has gotten a little low - take note that epidural can and frequently does cause low blood pressure - which can lead to baby's heart rate being low or high. Obviously this can turn into an emergency, but it may not be. You may be able to shut off epidural, move around, get oxygen, and improve things.
3 - Either mom is overweight or baby is suspected to be. Well, your vagina doesn't care what you weigh - so honestly your weight is unlikely to matter. Also, baby being big is a very inexact science - meaning late term ultrasounds are often off on baby's weight by more than a pound in either direction....so, that seems silly. \
4 - Low amniotic fluids - well, those can be replenished, and ultrasounds aren't great at measuring those - as any fluid behind baby isn't seen on a scan. Also, one of the first things doctors like to do to speed up a labor is to break the water....so why would low waters mean a surgery, if you like them gone for delivery?
Here's some general cesarean FAQs, but know that it's major surgery, generally recovery is SO MUCH LONGER than for a vaginal birth, they can cause breathing issues for babies due to not having fluids adequately squeezed out of their lungs or having mom be overhydrated during surgery, and that they carry plenty of risks for mom for this birth and any subsequent birth.
VBAC Stats
A VBAC is a vaginal birth after a prior cesarean. They're generally (in lieu of other health concerns) safer than another c-section. For some reason in the US they have a bed rep as more dangerous, but that's just not true. I'm just posting stats below, because I'm tired of making the same arguments.
General VBAC FAQs
I feel that most women have doctors that push c-sections, and after an inital c-section, they overstate the risks of VBAC while understating the risks of additional c-sections.
Most women are told that labor stalled therefore they're a bad candidate for a VBAC, but most labor stalls aren't dangerous and can be worked through by changing things.
This all being said though, I agree, c-sections can save lives. So they're important. The weird thing to me though is that the maternal and neonatal death rate in developing or undeveloped countries still tends to be lower than the c-section rate in the US. So, are all of them truly saving lives? Nope. Are many of them life saving? Well absolutely.
I don't hate you or think you're a bad mom, or not a real mom or that you had an unnatural birth because it was a c section. Not at all.
If you chose a section though, I will say that I probably don't understand your choice, but I don't have to. We don't have to all agree. Just please, please, please stop telling me that YOU think my VBAC plan is unsafe. I promise not to tell you that your C-Section Plan is a bad idea - because I'm not you, maybe it IS a great idea, for you. But if you start arguing safety, I'll bring up my handy charts above, showing
