Preface
I started this paper with a completely
different angle, in which I would talk about the main issues of childbirth in
the US, and what I could do about it as an activist. I
struggled with the problem that I frequently have which is that there is just
too much to say. My mind starts to
explode a little as I have more opinions and new insights or remember something
I want to remember to add. In a way, I
feel lucky that there isn’t much of a limit to access of information. It seems that in the last ten years, many
studies have been conducted and many opinions have been formed about the state
of birth in the United States and the rest of the world. However, when writing a paper that is not an
actual book, I struggle with what to leave out.
I’ve tried my best to attend to other areas, but I ended up “picking on”
cesarean births a lot in this paper. Mainly, it’s because it’s the ultimate
intervention- also the one with the most studies and the most opinions. I find
it particularly interesting that cesarean section has remained the most common
surgery performed in the United States for the past twenty-six years and that
pregnancy and birth are not (typically) a medical condition (Block, vvi). Anyway, there’s a lot of this kind of
information and fury in this essay; I try to also touch on other issues in the
birth business (yes, I call it a business- what I think it is, but not what it should be), but you will find this the main in
my discussion topics.
Too Posh to
Push
In the beginning of the film The Business of Being Born,
mothers, when asked if they would consider using a midwife, give answers that I
find unsurprising, but incredibly heart breaking. The scene behind them feels sterile and main-stream
while kids and parents play at a Mommy-And-Me- esque
gym. The mothers tell us that they are more
comfortable with the doctor aspect of hospital births, that home birth is
unsafe, and, according to one mother talking about cesarean birth, “...it’s just that it’s done- it’s surgery-1,2,3, you know, so
(laugh).” But to me it’s not really a
laughing matter. I have a hard time
feeling groovy about these new “Too Posh to Push” or “designer birth”
attitudes; these schools of thoughts basically state a “feminist” view of a
women having control of her body, having her baby when it’s convenient for her,
and also avoiding stretching, tearing, or cutting of the vaginal area.
I’m not anti-choice I just want people to make informed decisions.
There are different ideas of what is the more
feminist viewpoint on cesarean sections.
In her book, Birth: The Surprising
History of How We Were Born, author and anthologist Tina Cassidy tells us
that there has been back-lash from some feminists
regarding attempts to limit cesareans in recent years. She quotes a feminist in a 1998 publication
of British Medical Journal who wrote about how limits on women’s rights to
choose how they give birth proves that “medical and social prejudices against
women sidestepping the Biblical sentence to painful childbirth are still with
us” (125). Let me tell you the ways in
which I disagree with this statement. I’m
not anti-choice; I just want people to make informed decisions, which is my
first issue with that Other Feminist’s
P.O.V. Far too often, women are not making
informed decisions- they are echoing what they see in the media or hear from
their doctors. I’m not even sure if
there has been a study to prove that statement but what I do know that I have
heard so much misinformation and generalized “facts” thrown out by proponents
of medical birth. We learn from Jennifer
Block in the introduction of her book, Pushed:
The Painful Truth About Childbirth and Modern Maternity Care,
that we live in a country where 99% of all births take place in hospitals, 30.2
% of these women give birth by cesarean, yet we are second to last among thirty-three
industrialized countries in the infant mortality rate, and third to
last in the maternal mortality rate. The best infant and maternal mortality
outcomes are from the Netherlands, Denmark, and Sweden where obstetricians only
attend high-risk pregnancies. W.H.O.
(the World Health Organization) states that women are four times more likely to
die from a cesarean than a vaginal birth.
I wonder if just knowing these statistics
would change the types of “choices” women are making about how they give
birth. If you don’t know your options
then you don’t have any. So, even though
I do believe that one should have reigning choices over what happens with their
bodies, I also think that they owe it to themselves to know all of the options
before making a decision- especially when there are lives on the line.
The other point in which I disagree with the
Other Feminist is that she assumes that cesarean is less invasive and painful
for a mother. However, recovery time for
a mother to return to her daily normal schedule will be, at
the very least, double that of a woman who had a vaginal birth. Additionally, she just had surgery. Major
Surgery. And like most major surgeries,
there is a painful recovery. The
mother’s abdomen has been cut open- through muscles and all, and a small human
being was pulled from that wound, and then her belly was stapled back together.
That’s kind of a big deal and also really painful… after the drugs
wear off. So, my point is… that- Yes, I
think we should have the option to choose how we give birth. But an even bigger feminist movement is to
inform ourselves about our options before we make those decisions. Otherwise we are going to base our choices on
opinions like that of this quack doctor interviewed for The Business is Being Born, who said about natural birth, “I call it feminist machoism... when you’re pushing a stroller three months
later, you know, to say I did it naturally, personally, I don’t think it’s
important.”
The Price
of a Short Cut
We can all agree that
sometimes medical interventions in birth are necessary and that we are lucky to
live in a country where such advanced technology is available to help for the
best outcomes. Just to pull my argument
against uninformed-elective cesareans further, I want to talk a little bit
about the due date. First, let’s think
about the truth that “due date” is an abstract estimation. Parents and doctors tend to fixate on the forty-week
mark as an absolute finish line, often past the finish line. Pregnancy even one day over the forty-week
mark is considered “late,” and often pregnancies are induced
and/ or ended in a cesarean section by thirty-eight weeks (often due to belief
that the baby is getting too big and that there won’t be enough amniotic fluid,
or that it won’t be able to fit through the pelvis). The first problem with this theory is that
because the due date is an estimation based on either the last menstrual period
or a sonogram, these estimations can be off by two weeks or more on either side
of the date. This means that a cesarean
scheduled for the mother’s thirty-eight-week mark could potentially deliver a thirty-six-week,
or even younger, baby. According to Nell Lake’s article, “Labor Interrupted:
Cesareans,
“cascading interventions,” and finding a sense of balance” in
Harvard Magazine
(December 2012),
“…they
may be cut, or asphyxiate if the medical team has difficulty pulling them out.
Those born by cesarean are more likely to experience respiratory distress and,
later, to have asthma; controlled studies have found increased rates of obesity
among American babies born this way. The fetus of a mother who’s already had
one cesarean also seems to be at increased risk because it faces greater danger
when growing in a uterus with a surgical scar.”
There are many other studies
out there that show that a cesarean birth, besides being risky for both the
mother and the baby, have additional emotional and psychological side effects. These studies show us that bonding between a
mother and baby is harder and takes more time and effort after a cesarean. Dr. Michael
Odent (an influential and well respected obstetrician and proponent of natural
birth) has been quoted in many birth books and videos talking about why this is true. Here he is quoted by an online British
magazine The Daily Mail. The quote comes from a talk he was given in Cambridge:
Oxytocin is the hormone of love,
and to give birth without releasing this complex cocktail of love chemicals
disturbs the first contact between the mother and the baby. The hormone is
produced during sex and breastfeeding, as well as birth, but in the moments
after birth, a woman's oxytocin level is the highest it will ever be in her
life, and this peak is vital. It is this hormone flood that enables a woman to
fall in love with her newborn and forget the pain of birth…What we can say for
sure is that when a woman gives birth with
a pre-labor Caesarean section she does not release this flow of love hormones,
so she is a different woman than if she had given birth naturally and the first
contact between mother and baby is different.
What is also disrupted from the block of oxytocin
and bonding time is breastfeeding.
Mothers who have a cesarean generally have a harder time breastfeeding
than mothers who give birth vaginally.
None of this is to say that women who have cesarean
births do not bond with their babies or breastfeed successfully; it is to say
that a cesarean makes every part about recovering, getting to know your baby,
and figuring out this “mom thing” a lot more difficult.
Like I said earlier- I am so glad that we have the
option; sometimes it is necessary and a true blessing. However, when used superfluously, cesareans,
though they probably won’t kill you, cause a longer and more painful recovery,
and a harder transition with your new baby.
The post-partum and new mom thing is hard enough- do we really need to
make it more difficult?
Works Cited:
The Business of Being Born. Dir. Abby Epstein.
New Line. 2008. Film
Block, J. (2007). Pushed: The painful truth
about childbirth and modern maternity care. Cambridge, MA: Da Capo
Lifelong.
Cassidy, T. (2006). Birth: The surprising
history of how we are born. New York: Atlantic Monthly Press.
Cook, Emily “Women Who Have Cesareans ‘Less Likely to
Bond”. The DailyMail. July 13, 2006. http://www.dailymail.co.uk/health/article-395218
Lake, Nell “ Labor Interrupted: Cesareans, “cascading interventions,” and finding
a sense of balance.” Harvard Magazine December 2012.
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