When I was pregnant, Caesareans didn’t figure in my thinking, I neither considered nor planned for one: they were for celebrities or women on the verge of death. So, ending up with an emergency C-section after three days in labour was, to say the least, a shock. Suddenly all the studies about Caesareans were relevant to me: I was one of the statistics.
The simple fact is that, although Caesareans can be life-saving, it’s just not how a baby is meant to be born. The latest research, published this month in Birth: Issues in Perinatal Care, says that babies born to mothers who elected for a C-section were nearly three times more likely to die in the first few weeks of life than those born vaginally. The emphasis on the reporting (not the study) was that women who have C-sections are selfish, when most are simply grossly ill-informed.
The findings had a darker side that was not explored, which is that once you’ve had one C-section you often have to fight for a vaginal birth or VBAC (vaginal birth after Caesarean). In many cases, women find themselves beaten into having a “voluntary” C-section, despite research that suggests vaginal birth is better for mother and baby.
Even in theory it’s hard. At a talk I gave to a group of midwives and paediatricians I mentioned, informally, my own experiences to a paediatrician and said, half jokingly, that next time I’d like to try for a home birth. “That would be really irresponsible of you,” she said. “There’s a high likelihood of your scar rupturing.”
Ah, scar rupture. The threat that keeps C-section women in line: If you’re “selfish” enough to try for a vaginal birth next time, your womb will burst open. The chances of a scar rupture are real, but they stand at only 0.5 per cent. But the chances of suffering unstoppable bleeding during a Caesarean, which results in an emergency hysterectomy, are 0.7 per cent. Doctors and midwives rarely tell you that bit. Neither do many go into other Caesarean risks: potential damage to the mother’s bladder and bowel, less chance of succeeding at breastfeeding, compromising the baby’s immune system (because it doesn’t get vital bacteria from the mother’s vagina as it’s delivered), that the baby may be twice as likely to develop food allergies and more likely to develop asthma. They don’t tell you this because you might start making a fuss and say that, actually, you want to try for a vaginal birth. And that wouldn’t do because Caesareans are easier to manage: you’re booked in, you’re cut open, your baby is born. The risks are mainly yours.
My most chilling encounter was with a surgeon who, when I discussed the risks of repeated Caesareans, replied: “Yes, but do women really need to know?” I happen to think they do.
— The Guardian
Photograph: Antoine Barrillon