Thursday 9 March 2006

oh, was it supposed to be fun?


Why mothers should be offered caesareans

Jo Revill thinks that traumatic or potentially dangerous births can be avoided if women opt for elective caesareans. She argues that it's an issue of choice, and that encouraging women to have a caesarian is "doing both mother and child a great service." Here are some excerpts from the article with my comments below.

"We are fast approaching the point where logically we should encourage women to have a caesarean whether or not they have a medical or psychological reason for wanting one."
No. We should inform women of their birth options and the consequences of each, and then let them decide what's best for them. One birth choice shouldn't be "encouraged" over another, particularly when it involves elective surgery.

"By having a planned surgical delivery, you simply avoid the biggest risk factor of all: the possibility of an emergency caesarean."
I might have a problem with my appendix and tonsils one day. I think I'll saunter over to my hospital and have them removed, just in case. Having a caesarean to avoid a caesarean seems like flawed logic to me, but maybe I'm missing something.

"...by taking away the unpredictability, pain and fear associated with normal birth you may be doing both mother and child a great service."
Because as we all know, major abdominal surgery is predictable, painless, and has no emotional consequences. Especially if you need to recover from said surgery on no sleep whilst taking care of a tiny human being. And being its sole source of food.

"Some 30 per cent of women [who have vaginal births] suffer urinary incontinence afterwards."
Which is from being pregnant, not from giving birth vaginally. C-section mothers suffer from this too, because the pelvic floor is weakened from carrying a baby.

"The guilt that a woman can be made to feel for exercising choice can be terrible. When Kate Winslet had to undergo an emergency caesarean for the birth of her first child, Mia, the actress admitted she 'felt a failure' in some way."
How is an emergency caesarean a choice? How can Winslet's situation be compared to someone who elects to have a caesarean?

My main concern with this article is that is omits some fundamental issues about caesareans. There is no mention of the increase in ectopic pregnancies, uterine rupture in future pregnancies, bladder and bowel complications, adhesions, and difficulties breastfeeding in c-section mothers. Like Revill's sister, my surgery itself was fairly calm and downright civil - it was the recovery that was unexpectedly difficult and traumatising. For her to infer that a surgical birth is always going to be calmer, less painful, and a better experience than a vaginal birth is simply irresponsible journalism. Of course women should be allowed to make birth choices, but it's hugely important that these are informed choices. Otherwise, we're perpetuating the misconception that c-section recovery takes 6 weeks and try to avoid the vacuum and car for a wee while, dear.

I will try for a vaginal birth next time, but there are specific situations in which I will opt for a c-section. If there is no choice but induction, I will choose a repeat section, for example. I am not opposed to caesareans; I am opposed to misinformation. Shame on you, Guardian.

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