The cesarean epidemic is close to out of control, and it seems that nobody wants to step in and make a change. Care providers seem to feel that they're powerless to stop cutting babies out…
Honestly this is a complex question that requires answers from many different places:
- Care providers
- Insurance providers / single-payer systems
- Communities and extended families
The biggest problem isn't the number of people / groups that need to help make this change. The problem is that practically nobody is working for the change. They're all pointing fingers – or expecting somebody else to do the work and know the best answer.
It's vital for families to stand up and ask questions about this issue – and it's vital to go into it with eyes wide open. There are many myths tossed around to make women think that the rising cesarean rate is inevitable. Let's look at each one:
Do women really want c-sections?
One of the most ludicrious claims tossed around is that women actually want cesarean sections. Sure, there are women here and there that ask for a cesarean for whatever reason. But the implication that many, many women would prefer major surgery is completely unfounded.
Why would a woman choose a cesarean (with no other indication)? Maybe she's scared of the pain of birth. Maybe she wants things on her schedule. But implying that most women can't bear the thought of labor pain or that they're so controlling that they need to control exactly when their babies will arrive is just ridiculous.
Women can handle labor. And care providers need to be honest with women – the pain of recovering from a c-section is much greater than the pain of recovering from a vaginal birth. You may not have a few hours of labor, but you do have days and weeks of recovery from a major surgery, while caring for a baby, ahead of you.
Care providers should also be honest that it's not controlling mothers scheduling most cesareans (or inductions) – it's controlling providers who want some predictability to their life and schedule. That's not a bad thing, but when you work with birthing women, being on call is part of life. There are other answers to having a sustainable practice and being mindful of provider self-care.
A few women really do want a scheduled cesarean – but women overwhelmingly do NOT (source).
Are women really broken?
Another common implication is that women are broken in some way. That our bodies just do not work.
Sadly sometimes even natural childbirth advocates give fuel to this argument – it's often said that since human women walk upright, we're somehow not as suited as ape mothers to giving birth. You'll hear this argument from skeptical doctors and from natural birth advocates alike (the advocates, of course, offer many ways to overcome this “deficiency”).
The truth of the matter is that women are well-suited to giving birth, and in fact, an upright position often greatly helps a baby come quickly and efficiently. Walking upright and naturally throughout pregnancy helps faciliate good baby positioning (check out my baby position guide for more).
It seems that being human leads towards smooth birthing of human babies. Women are not broken because they're not apes. (I've written more about why your pelvis completely adequate to birth your baby here).
A similar argument implies that modern women are somehow defective compared to our ancestors. Again, this is a silly argument. Women today are better-nourished and much more likely to have experienced optimal pelvic development than many women in the past.
Are women really too fat?
Blunt, but true – a variation on the “modern women are defective” argument is that modern women are, well, just too fat. Because women today are fat, they can't give birth naturally, or even vaginally.
There are cautions for larger women (check out What You Need to Know About Plus Sized Pregnancy for more), but most mothers can and do grow healthy babies – and have good births. In fact, many women make positive health changes during pregnancy because they're motivated to do so for their babies. These women may experience life-long health improvements because of this.
Sentencing women to prophylactic (preventative) cesareans just because they're above a certain weight is neither evidence-based nor fair to women…
…again, mothers want healthy babies and most will make positive changes for their babies!
Are women really too stupid?
That leads us to the next point – and one that's perhaps even more shameful than implying that women are making themselves candidates for majoy surgery just because they're not at an “ideal” weight…
…the implication that women are somehow just ignorant, and therefore need a cesarean section.
Maybe care providers who feel frustrated that women don't actually want to line up for (conviniently scheduled) cesareans use this kind of justfication. After all, how can a mere mother understand what's going on and know what's best for her and her baby?
How can an ignorant mother, simple enough to trust her instincts, really get through a process as fraught with danger as birth? I hope you can hear the hint (HINT) of sarcasm in my voice…
…women are not ignorant and can and do take excellent care of themselves and make good birthing choices when given all the information that they need. Of course there are many doctors who have great respect for the women they work with, but the frequency of condescending and patronizing attitudes toward pregnant women is really shocking.
A woman is not rendered to the status of a child just because she's carrying a child.
Do women really understand what's happening to them?
What mothers really need is information. In fact, this is what many of the groups I listed at the beginning of this need: communities, extended families…
They all need good information. Information on the pros and cons of cesarean section (get straight talk on c-sections here). They need to know that not only is natural birth a positive experience for mother and baby, it's a safer experience (listen to Dr. Sarah Buckley talk about hormones and safety in birth here).
Women need to know that healthy pregnancy and safe, vaginal births are not just about “luck” – there's so much a woman can do (especially with the support of her husband) to grow a healthy baby and have a great birth. Sometimes emergencies happen – sometimes cesareans are life-saving.
But most of the time, natural birth is the option that that makes the most sense for mother, baby, and family.
What's the solution?
Mamas and families need to understand the true implications of having a c-section. It has an impact not only on this birth and this baby, but on your future health, future fertility, and the safety of future babies.
Women need to know that they can do a lot to have a healthy baby.
Women need to know that care providers don't always make decisions because major surgery is the best option for mother and baby – they often make choices because they worry about lawsuits, they worry about insurance companies, and they worry about being home for dinner.
We need to stop implying that the cesarean epidemic is happening because women want it – or because women are somehow defective and need it.
When we're honest, we can make changes that will turn this epidemic around and lead to safer, happier birth experiences for mamas – and their babies.
(NOTE: Want a Perfect Birth Plan Template? Use this template and step-by-step videos to write a birth plan that gets your birth team on your side for a beautiful birth experience! Get the kit here.)
- My Guide to Preparing for a Natural Birth
- MamaBaby Birthing online natural childbirth classes
- What moms need to know about cesarean section