There are a lot of articles circulating these days about cesarean sections, going in gory detail about how they’re no walk in the park; defending the recovery, the pain, and the complications. These articles are basically arguing that cesarean’s are equally worthy of praise by those touting vaginal deliveries as heroic acts. Those implying that the mom who gave birth vaginally somehow loves her baby more than the woman who had a cesarean. And of course, defending cesareans against those who feel it’s the “easy way out”. Having had a cesarean, I appreciate these articles. I do. But I have a little problem with them. Every article I’ve read has been written by a woman who had a cesarean due to complications, and therefore HAD to have a cesarean. Either she labored for a gazillion hours before her baby began to deteriorate, she hemorrhaged, or previous birth complications required her to go the cesarean route the second time around. Even in these authors’ attempts to shed light on the misery of a c-section, they still, for some insane reason, feel the need to JUSTIFY & RATIONALIZE to the general public why they had a cesarean. It sort of implies that almost dying is the only justifiable reason to go cesarean. It still, silently categorizes the elective cesarean mama’s as the women who took the easy way out. Well I’m here to tell you, as a mother and as a nurse, that almost dying isn’t the only good reason to have a cesarean.
The day I found out I was pregnant; I knew I wanted an elective cesarean. The very first questions I asked my OB was, “are you comfortable with elective cesareans?” That was going to make or break our relationship. I shopped for a highly proficient surgeon for a reason. Thankfully, my OB was 100% on board with it. But I spent the following 9 months defending my decision to my husband, my sister, my mom, my co-workers and people I hardly knew. It wasn’t even like I asked for their opinions. People would just randomly ask me how I was going to deliver as casually as asking, “When are you going to lunch”? Think on that for a second; acquaintances at work asking about your vagina, and then lecturing you, because they don’t agree with what you want to do (or not do) with your vagina. That’s just fucking weird. Anyway…
I don’t believe there has ever been a decision in my life that instilled as much doubt and fear in me as this one. I’d actually like to take a brief moment to say FU to every person who undermined my confidence during that time. EXHALE. Thanks, I needed to get that off my chest. Moving on….I actually began hoping for some minor complication that would indicate a cesarean, like breech or transverse positioning, so that the people in my life would be more supportive. But no, I had the most textbook, normal, uncomplicated pregnancy ever. But I still wanted a c-section. I even used my unfavorable cervix at 39 weeks as an excuse to go to the OR for baby removal, rather than the LD unit for induction. Up until the very second when they placed my fat 8lb, 24 inch long baby on my chest, I doubted myself. It wasn’t until my uterus was placed back in my body, until my OB assured me that my bladder was intact, until my abdominal cavity was closed, and the nurses assured me that baby girl had an Apgar Score of 10, that I felt 100% confident in my decision.
You see, I love my vagina. Maybe I love my vagina more than the vaginal birth mom’s love their vaginas. Who knows? But I’ve worked with OB’s. I’ve seen and heard of awful, traumatic things that happen to women’s vaginas during deliveries. I was also well versed on birth trauma to babies that often go along with tearing their poor mothers in half on their way out. I’d like to mention here, that your vagina isn’t the only area at risk of trauma during a vaginal delivery. That’s right; no one likes to talk about your asshole. Many a woman suffers a torn asshole when pushing out a baby too (Especially now that episiotomies have become a less desirable procedure. But in all honesty, you can tear your asshole with an episiotomy too. That’s a different topic for a different day). Or mama tears INSIDE her vagina, and then she has a hole that communicates with her rectum. That little injury there is called a vaginal-rectal fistula, and it basically equates to poop or farts or both, in your vagina. Yes, that can happen. You’re welcome. Sure, these kinds of traumas are rare, but they do happen frequently enough for me to know I didn’t want to suffer one. Then there are the very common issues that follow vaginal deliveries, i.e. pelvic floor dysfunction. “Pelvic floor dysfunction” is a blanket term that covers numerous complications. Pelvic floor dysfunction is precisely why our own mom’s cross their legs when they laugh, squeeze their knees together when they run, or refused to jump rope with us when we were 9. Frankly, they pee their pants, and they pee their pants often. I knew for damn sure that I didn’t want to become a lifetime customer of Poise Pads. Pelvic floor dysfunction can cause fecal incontinence, prolapsed uterus and prolapsed bladder. Pelvic organ prolapse essentially means your pelvic organs try to fall out your vagina hole. In addition to just being plain old scared of severely damaging my honey pot, I did an immense amount of research. I knew all the stats for emergency cesareans, birth trauma, failed inductions etc.
At this point in my rant, I’m sure all the ladies out there who are still on the band wagon of believing electives are the “easy way out”, are sitting here right now calling me selfish. Obviously, since you broke your vagina for your baby, you’re a better mom than I am. But please, just give me a few more minutes of your time. Yes, as previously mentioned, I love my vagina. After 462 months of being pregnant and having absolutely no control over my body, I just wanted my vagina to be the same when I was done gestating my human. My baby alone was the only lifetime reminder I wanted of pregnancy and delivery. As you can deduce from my ramblings, I really cared about the integrity of my vagina. And I do! But I really just shared all those lovely details about vaginas because it’s funny to say vagina 11 times in one paragraph. I also thought it was important to shed light on those kinds of complications, because a lot of women don’t talk about the traumatic tidbits their tidbits suffered from the birthing process. Women should know these things going in! So although perineal preservation was an important part for why I chose an elective, it wasn’t the primary reason.
Do you know what I love more than my vagina? My baby. Ultimately, the driving force behind my decision was the well being of my baby. I mentioned earlier that I did a lot of research. When I mean a lot of research, I mean like 10+ hours a week for approximately 30 weeks. That’s 300 hours of research, utilizing peer reviewed material. All the legitimate medical literature out there will tell you that morbidity and mortality rates for cesarean are higher for mother, but lower for infant versus vaginal delivery. Just a little insight; one study concluded out of 300 vaginal deliveries 4 infants died. Out of the 300 cesarean deliveries, no infant died. I know that equates to approximately a 1% risk of having your baby die. But I doubt those mothers feel the loss of their babies to be statistically insignificant. So, in my selfish pursuit of having an easy delivery, I chose to put myself at a higher risk of dying in effort to put my baby at a lower risk; I chose to have major abdominal surgery, while being wide awake; I chose the 90 day recovery…..because it was the absolute safest, most controlled, lowest risk method of removing the baby from my uterus. I know from professional experience as an RN that vaginal deliveries almost never go as expected. I knew the statistics surrounding my own situation. I knew, that whatever I could do to minimize risk of injury or death of my baby, that I would do it….no questions asked.
So that’s it. The next time someone wants to pull the superiority card on an elective cesarean mama, just remember…she actually took the path that was more dangerous for herself, but safer for her baby. This rant isn’t about touting one mom as braver. It’s not about one mom sacrificing more for her baby. It’s about the fact that we ALL put our lives on the line to bring our babies into the world. And how we chose to do that doesn’t make one of us better than the other. More than anything, it’s about the fact that we shouldn’t even need to be talking about vaginal vs. cesarean, unless it’s with our doctor! Let’s just all shut up about it.
So, if you’re in the position where you’re trying to make the cesarean vs. vaginal delivery decision for yourself….just repeat after me: My body. My baby. My decision.