Monday, October 1, 2012

It DOES Matter

How often have you heard this statement: "It doesn't really matter how your baby comes into this world, just as long as he's healthy"?

I hear it a lot. I hear it from people who reject the idea that the woman's experience is what matters, clearly recognizing that the baby's health ought to trump the woman's experience every time they go head-to-head. I hear it a lot from doctors who want to make women feel better about having a c-section. I hear it from doctors who hate natural childbirth and suspect that women who desire it are evil. I hear it from women who have had c-sections, and are fending off disappointment

In fact, it comes up almost every time I'm talking to someone about their pregnancy or birth. When I was pregnant, almost every time I brought up the fact that I didn't want to be induced, someone or another would wrap up the conversation by saying, "Oh, but at least at the end of it you'll have a healthy baby, and that's all that matters, right?"

And here's where I think it's right. A healthy baby is the greatest good of pregnancy and childbirth, no doubt about it. Mothers must make sacrifices, during pregnancy, labor, and beyond, to keep their vulnerable children safe. And sometimes, the sacrifice involves a c-section. Babies DO need to be cut out. Baby's heart rate drops. Baby has a disability that makes the stress of labor inadvisable. Baby is transverse (although I heard an Appalachian midwife once describe a transverse birth in which she gave the laboring woman some whiskey, sent her husband out of the room, and turned the baby with her hand...from the inside. OUCH!) Mom falls into a coma and is still unconscious when it's time for the baby to be born...wait a minute. Scratch that. Apparently you can deliver a baby vaginally while you're unconscious.

Anyway, the point is, I understand. I know that sometimes a woman will be called upon to give up one good - her much-hoped-for, healthy, vaginal birth - for a higher good - the life and health of her child. She will need to be brave, and make a sacrifice. It's where the childbirth rubber meets the baby road, and it's hard. At the end of the day, it's true, a healthy baby is what everyone wants. But let's choose our words carefully and understand what they mean. Because "all that matters" is a healthy baby? Not even close.

You know what a c-section is? It's a giant cut. Through your skin and muscle. On purpose. A hole created to pull a baby out when you already had a hole that you were born with to do the same work. Your body has a hole that was designed for the very purpose of getting a baby out and sure, it's tough. It's painful, even when nothing goes wrong. (You can thank Eve and that stupid snake for that). But the hole you were born with opens and closes on its own and I've never heard of it getting infected! On the other hand, a c-section creates a hole where there wasn't supposed to be one, and it's a hole that will make recovery that much more difficult. It's a hole that will put you at risk for problems in future childbearing. A hole that will make the prospect of future childbearing episodes even more terrifying. A hole created by someone else that makes you think, "is it possible that I'm not fit to do this work? To have babies? That I just can't do this?"

In order for a c-section to occur, a woman must consciously lay aside a very real and powerful inclination towards bodily integrity. And most women, very naturally, hesitate to do that.

As evidence of this, not many women want c-sections. Oh, sure. The c-section rate is way up. But elective c-sections, or "on-demand," just because a woman asked for it? A measly 2%. It's COMPLETELY NATURAL for a woman to hope that she doesn't have to have a hole cut in her abdomen to give birth to her child. Because a healthy baby is not all that matters - a healthy mom is supremely important, too. And having a hole cut in your abdomen is, generally speaking, contrary to good health.

In case you're not convinced of the value and importance of keeping the skin and muscle in your abdomen intact, try this thought experiment. What would you do if someone came at your abdomen with a scalpel when you weren't pregnant? Run the other way? Punch them in the face? Jump up on a car hood and begin making animal noises? All of the above are acceptable answers, as far as I'm concerned. You would not let someone to cut a hole in your abdomen if there weren't a really, really good reason to do so.

So if someone suggests that you undergo a c-section, they'd better have really good reason for it. A c-section versus a vaginal birth is not like the difference between vanilla and chocolate ice cream. It's like the difference between eating ice cream with your mouth and receiving it through a feeding tube.

So when I ask an OB whether a c-section will be necessary to deliver my child, here's the kind of answer I hope to hear: "I really hope not. I'm going to do my best to make sure that you have a vaginal delivery." That's all. I want to know that my doctor would find it as regrettable as I do that c-sections ever have to happen. Regrettable that a woman ever has to have someone slice through her abdomen to pull out the child she worked so hard to grow inside, nourish, and prepare for life in the world. Regrettable that a woman has to lay aside her own physical health for the health of her baby. Regrettable that motherhood isn't always sweet, comfortable, and peaceful - but is sometimes painful, sacrificial, and leaves you with scars forever.

I also think it's quite natural for women to be frustrated if, upon reflection following their c-section, they come to believe that their doctor did not explore all the options to help them have a vaginal birth. Maybe the doctor didn't know all the techniques available to help make it happen that way. Maybe the doctor wasn't willing to be patient with a woman laboring for the first time. Or maybe the doctor just didn't appreciate the fact that he was suggesting cutting a hole in your abdomen, not a different flavor of ice cream.

A healthy baby is not the only thing that matters in childbirth. A healthy mother is supremely important. If you want to avoid a c-section, don't let anyone make you feel bad about it. There's no reason to feel bad about wanting to keep your abdomen intact. There's no reason to feel bad about wanting to use the hole you were born with to do the work it was made to do. There's no reason to feel bad about hesitating at your doctor's recommendation and investigating alternatives before consenting. It's quite natural.

As for myself, I am beginning to appreciate on a deeper level the sacrifice that women make to have a c-section. I know these women, because it's every woman I've ever talked to that had a c-section. Assessing that her baby's life is so valuable as to give up the good health of her own body, the woman and her doctor know of no other way to get the baby out without surgery, and so the woman courageously makes the sacrifice to lay aside her own bodily integrity, permit a c-section, and welcome a healthy baby into the world.

Bravo! May your sacrifice be re-paid a thousand times with maternal joy.