The doctor that delivered Jack and Marlowe was on the phone talking to a patient. She tried not to show any judgement in her voice or any positivity or negativity. The woman was asking for a planned c-section. I could tell from the look on her face that she was not completely happy about it but from years of experience knew that the woman was not going to be convinced otherwise. The doctor assured the woman that the doctor on-call was excellent and that she would be in good care. But the woman insisted that she be fit in her schedule. Dr. Russell had a trip planned with her family to go to France for a long weekend. The weekend of this woman’s due date. When faced with the prospect of delivering outside of the doctor she had been seeing throughout her pregnancy, she opted for a c-section scheduled that morning. The doctor would have to run for her plane (and did ultimately, meeting her family at the airport arriving just as their plane was boarding). The doctor told me that the requests are not often, but have been more so in her experience than ever before.
At the apartment we lived in before this one, our landlords lived above us. They were from Switzerland and their personalities seemed to indicate that they liked things planned and neat (hense the leveling on the Japanese Maple and koi pond into a square of putting-green green sod). They had two kids and one on the way. When Jack and Marlowe were born they came by, dropping off some gifts. The woman cringed when I told her they were born naturally and she told me that she was planning on having a cesarean section. I asked her why and she said that she had experienced childbirth two times already and didn’t need to go through it again. This woman is the president of an international bank. Implying that she is not stupid. But she chose this route I am assuming fully informed of her choices and risks.
I have noticed that there has been increased media coverage supporting the idea that women are requesting non-emergency cesarean sections. NPR (national public radio) reported this rise as well as Salon.com and USA Today. Although some argue the rate of non-emergency cesarean section requests are rising slower than portrayed. I wonder why then the press? On one hand we have an increased rise in people using doulas and midwives, but also the highest rate of cesarean section (31.1% in 2006) and an increased number of women choosing to medicalize their births.
Now don’t get me wrong. I believe in a woman’s right to choose, even if it is to choose a cesarean section. It is their body, their baby …not mine. What bothers me about this is that I wonder how many of this women have made an informed choice. Was it presented as “Would you like a c-section or would you like to risk a tear and possible decreased sexual function? or “Would you like a c-section or do you really need to go through all that pain?” sounds extreme? I don’t think so. What is the difference between that and being offered drugs by the nurses in the first hours of labor not allowing you to grow with the pain and in effect committing you to the slippery slope of pain aid? Was the effects of narcotics on your ability to make decisions and be alert for your birth covered in childbirth class? I am worried that many women will be misinformed of the risks. Yes, we are adults and we ultimately have to take responsibility and educate ourselves. But we put ourself in the care of someone who we hope will tell you the risks and options if an emergency arises. Say your baby flips around while in labor. You can’t exactly say, wait a second, I need to research the statistics associated with birthing a breach baby vaginally… You have to rely on those educated professionals, hoping they have been educated fully and are not influenced by a timeline, antiquated professors, restrictive hospital policy, distorted view of what a woman’s body is capable of or are one malpractice suit away from losing their license. You don’t know. We put our trust in the system. A system that stopped prescribing amphetamines for post partum depression in 1969 mind you. But this can hold true for midwives and homebirth midwives as well. We put our trust that there is not so much personal hatred for the medical world that intervention is dismissed when may be necessary. I suppose with choice opens up the flood gates for informed and misinformed choices in there. You have to take the bad with the good. Many would argue that we should not get to have a choice when we are putting an unborn child at risk. But to that I say, there is risk in every childbirth. And at some point we have to be parents, and we make decisions for our children that affect their safety every day.
But I also think that even when some women are given the information about fetal distress, and risk of infection and hospital borne infection, and risks associated with anesthesia as well as not being able to hold your baby for hours afterwards, and the strain it puts on the hospital for increased staff and a prolonged hospital stay, as well as a bigger bill for your insurance company that effects premiums, and that there are no studies done on the mortality or morbidity of infants birthed with planned cesarians, and a coincidentally increased rate of deaths of the mother alongside the rise of this procedure, and the potential emotional price paid by the baby and the mother by not experiencing a vaginal birth as well as a longer recovery period take a look at that and say …ok, sign me up! Why is that? Perhaps it is because we as a society have portrayed birth as horrific and filled with fear? And that some women just need more control over a situation and this is the answer? (um, good luck in the controlled slide of parenting). Or has it been painted in the media as an efficient and responsible choice?
When I found out that I was pregnant, I wanted to have the baby at home. Once it was determined they were twins, I would have had to go to the Farm in TN to have them naturally, or find a midwife willing to take me, and the one option I found did not gain my confidence. So I had to be comfortable taking away some of my preferred choices for the benefit of the babies. And although my doctor was seemingly a midwife in disguise (she let me go full term, didn’t do a cesarian even though I had HELLP, and encouraged me to remain drug free) I also knew that she worked within a system and she had to follow certain rules or otherwise risk her ability to practice. (And she was one of very few who took on high risk pregnancies). I would have been acting disrespectfully had I asked her to do this. But it was agreed that she would do whatever she possibly could get away with (not doing). Why then can’t a woman say that the best thing for my child is that I am going to have to be out of control for awhile? That measuring the risks of a vaginal birth vs a cesarean..ill take the one with the less risks!? I am not saying there are no risks in a vaginal birth, there are many. I guess I mean to ask, why are we so quick to hand over our power and control in an attempt to gain it? Is it the uneducated making these choices, or the wealthy educated woman? And why do we insist on normalizing surgical birth in this country when other countries with a strong natural birth percentage have better outcome statistics than we do? Is this statistic rising in countries with socialized medicine too?
My daughter and I have talked a lot about plastic surgery. She sees it a lot in young Hollywood, something a teen would find difficult not to notice. She asks me what I think, and I always joke that the two words that should not go together are “elective” and “surgery”. Who knew it would carry over to childbirth so easily?
Some good comments and discussion here at the Our Bodies Ourselves site.

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