As a birth doula, I've had the amazing privilege of supporting clients through cesarean birth. Yes, COVID has complicated the ways in which doulas have historically been able to support clients, but we still get to be there for our clients, empowering them through education, and helping them prepare, both mentally and physically for the big day. Pivoting birth plans can be difficult, a time of processing emotions, and grieving the loss of hopes and dreams of an 'ideal birth'.
Yet, when someone feels supported, and empowered to make decisions for their care, this shift becomes their birth story, a story of transformation and right of passage into parenthood.
Through the hard work of education & changes in medical practice, huge efforts are being made to reduce cesarean rates as a general practice or ‘routine medical care.’ There are several medically indicated reasons why a cesarean might be suggested for the health and safety of mom and baby, having your cesarean scheduled so hospital staff don't need to be at your birth on a holiday is not a medical reason.
Here are common reasons for a planned cesarean:
-Placenta previa, or a uterine tumor that blocks the cervix
-malformed or injured pelvis
-genital herpes, if infection occurs in late pregnancy
-In some cases, if the mother has HIV
-transverse lie (baby is lying horizontally in uterus)
-Sometimes for multiples (twins, triplets)
-certain birth defects, problems with baby or medical problems with mother
For those that have given birth via cesarean, we need to acknowledge the extraordinary work their bodies have done to nourish, support and bring life. The world of obstetrics has finally started to change language surrounding Cesarean, to acknowledge that as much as it is a surgical procedure, it IS birth. So instead of cesarean surgery, it is now often called 'abdominal birth'.
I love this excerpt from an article entitled ‘When Things Don’t Go As Expected’ at www.havingababy.co
“Giving birth via c-section is just as brave, inspiring and strong as a home-birth, requiring you to dig deep inside and find resilience and acceptance of a new plan. You grew a little human inside for months, which is in and of itself extraordinary! The manner they come into the world is equally as extraordinary."
How common is Abdominal birth?
In 1970, about 5% of birthing people in the US had a Cesarean. From 1985 to present, rates have skyrocketed to over 33%. Canada sits at a rate of around 28%. Many experts believe that too many babies are born by c-section….in fact, the American Congress of Obstetricians and Gynaecologists (ACOG) made a statement in 2014 that said; "The rapid increase in cesarean birth rates from 1996-2011 without clear evidence of [collateral] decreases in maternal or neonatal mobility or mortality raises significant concern that cesarean delivery is overused.” The WHO considers a c section rate of 10-15% to be ideal, stating that when the rate goes above 10%, there is no evidence that mortality rates improve.
Can I request a cesarean without medical reason?
You have the right to request anything as a birthing person, although understanding the risks of your decisions are important. In 2013 the ACOG stated that without a medical reason for cesarean delivery;
“vaginal delivery is safe and appropriate and should be recommended.”
There are so many ways you can improve your chances of having a safe and satisfying birth experience and then there are situations when cesarean is the safest option to keep mama and baby healthy and safe. Cesarean has saved lives, but it is not recommended without a clear medical indication.
Did you have an abdominal birth? What was the reason for your abdominal birth?