Denise and her blog
Caesarean Birth Is Not A Lifestyle Choice!
The alarming rate of Caesareans, not just in the UK but in other countries too, is of grave concern. There is, of course, a multitude of reasons, not least the incidence of greater pathology in many women, lack of midwives to help maintain physiological birth, obstetric and managerial fear of litigation from failure to act when labour deviates from physiological progress and changing social trends in relation to childbirth and parenting. In the UK we are fast approaching a 50% Caesarean rate; in private care in South Africa, it can be as high as 90%. I cannot believe that almost 100% of the birthing population has so many issues that operative delivery is the only answer. However, with induction of labour rates at 60% or more in some UK units, it is hardly surprising that the “cascade of intervention” leads to increasing indications to manage and control birth.
Sadly, as I’ve mentioned before, Caesarean has become so normalised that young couples accept it as something that is, without challenge, part of their childbearing journey. My almost-daughter-in-law said she hadn’t made her mind up yet about the possibility of having a Caesarean, as if it is a lifestyle choice (no criticism intended, Ninka – and having twins in South Africa definitely increases the possibility of needing one). But Caesarean is not something on which you can make a decision until the time comes, usually shortly before or during labour, that indicates its necessity. It’s not like choosing whether to buy a new car or become vegetarian or change jobs.
Many expectant parents seem to take it in their stride that Caesarean may be needed, but I doubt they fully understand its implications. Caesarean is a major operation, the risks of which have been belittled by its frequency. It carries risks for both mother and baby that are rarely discussed at length with parents, just that it is “necessary”, with little opportunity to opt out. It has long-term sequelae that are almost never mentioned, not least a longer postnatal recovery time and the possibility of poor parent-infant bonding. Having a Caesarean is like having your appendix out – and having a baby as well. It is difficult enough recovering from physiological vaginal birth and caring for a newborn baby which, for most, is a completely alien concept until it happens. There is no rule book for caring for newborns – you are just expected to get on with it, deal with the sleepless nights, the difficulties of learning to breastfeed, the change in relationships between partners and sometimes the loss of identity for those who may, even temporarily, be stay-at-home parents rather than the competent professionals they were before pregnancy.
Caesarean birth – and its little sidekick, induction – are at risk of changing the microbiome of the human race. Will women evolve with zips down their abdomens that can conveniently be opened to lift the baby out? Women’s bodies are intended to become pregnant and to give birth – billions of people for thousands of years have been doing just that. Yes, there are some who experience difficulties or even die in childbirth, but that is not usually dependent on operative delivery – of course, in some cases, surgery can be a lifesaver for either or both mother and baby. But whilst we continue to normalise such deplorable and increasing rates of what can only be termed operative assault on women’s bodies, the higher the rates will rise.
Expectant parents need the facts, applied to their individual situations rather than a blanket policy of reaching for the scalpel as if all other avenues have failed. They need to know the benefits and the risks of both having or not having a Caesarean. As a society we need to stop treating major surgery as a minor inconvenience. And professionally, we need to acknowledge that childbirth is a normal biopsychosocial life event that, in the main, progresses without complications and brings a baby into the world without drama or trauma. Caesarean is NOT a lifestyle choice!
Birth Of My Son
My son, Adam, was born at home in July 1989, after a 24 hour labour with a four hour transition, ending in a forceps birth (yes, at home – it’s not what you know but who you know!) The consultant obstetrician was a friend who agreed to care for me even if it meant coming out to the birth. Adam was 10lb four ounces (4.3 kg). I was looked after by two midwives who were friends; my husband spent the very hot day washing cars and ordering in pizza for the midwives, whilst I huffed and puffed my way through first stage. To think Adam has just celebrated his 37th birthday is amazing.
See his proud grandfather with a newborn Adam.
Previous articles
Caesarean Birth Is Not A Lifestyle Choice!
Birth Of My Son
Paternalism in Maternity Care: The “Just In Case Syndrome”
Transitioning Role From Midwife To Grandmother
Midwifery, Aromatherapy and Natural Birth Under Attack Again
About Midwifery
Quality Of Education In Midwifery Complementary Therapies
Safe Maternity Care
The Publication Of The Ockenden Report
More from Denise at the 34th ICM Congress in Lisbon
