April is Cesarean Appreciation Month

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The natural childbirth industry is second to none in its mastery of marketing. Several years ago, ICAN (International Cesarean Awareness Network) designated April as Cesarean Awareness month (CAM). That sounds ever so much better than Cesarean Defamation Month, which would be far more accurate.

As a result, we will be treated with a month of posts from the natural childbirth industry bemoaning the C-section rate, bewailing a “crisis” in maternity care, and aggressively decrying the rare complications of C-section while ignoring the major benefits. The natural childbirth industry promotes awareness of the risks of C-sections, and utterly ignores the benefits that dramatically outweigh those risks.

The truth is that C-sections have saved literally millions of lives and continue to save tens of thousands of mothers and babies in the US alone each and every year. Therefore, I am designating April Cesarean Appreciation Month in honor of the incredible benefits of C-sections.

In 2006 Dr. Atul Gawande wrote a piece for The New Yorker, The Score, that uses the Apgar score as a focus for a review of the history of contemporary obstetric care.

Gawande starts by acknowledging that for most of human existence, childbirth was the leading cause of death of young women and the leading cause of death of babies. The risks are legion, from hemorrhage, to infection to obstructed labor, when a baby is too big to fit through the maternal pelvis.

The natural childbirth industry would have you believe that these complications are rare, but in fact, they are so common that midwives and doctors invented tools to cope with them.

The first reliably life-saving invention for mothers was called a crochet, or, in another variation, a cranioclast: a sharp-pointed instrument, often with clawlike hooks, which birth attendants used in desperate situations to perforate and crush a fetus’s skull, extract the fetus, and save the mother’s life.

If only the baby could be removed healthy and whole from the mother’s uterus:

But Cesarean section on a living mother was considered criminal for much of history, because it almost always killed the mother—through hemorrhage and infection—and her life took precedence over that of the child… Only after the development of anesthesia and antisepsis, in the nineteenth century, and, in the early twentieth century, of a double-layer suturing technique that could stop an opened uterus from hemorrhaging, did Cesarean section become a tenable option.

The C-section was part of the transformation of modern obstetrics:

In the United States today, a full-term baby dies in just one out of five hundred childbirths, and a mother dies in one in ten thousand. If the statistics of 1940 had persisted, fifteen thousand mothers would have died last year (instead of fewer than five hundred)—and a hundred and twenty thousand newborns (instead of one-sixth that number).

And the statistics from the 1940’s were far better than those that occur in nature. If the statistics of pre-history had persisted, 40,000 mothers and 280,000 babies would have died last year.

As Gawande notes:

… [A]lmost nothing else in medicine has saved lives on the scale that obstetrics has.

In large part, that’s a result of the liberal use of C-sections.

A measure of how safe Cesareans have become is that there is ferocious but genuine debate about whether a mother in the thirty-ninth week of pregnancy with no special risks should be offered a Cesarean delivery as an alternative to waiting for labor…

…Many argue that the results for mothers are safe, too. Scheduled C-sections are certainly far less risky than emergency C-sections-procedures done quickly, in dire circumstances, for mothers and babies already in distress. One recent American study has raised concerns about the safety of scheduled C-sections, but two studies, one in Britain and one in Israel, actually found scheduled C-sections to have lower maternal mortality than vaginal delivery. Mothers who undergo planned C-sections may also (though this remains largely speculation) have fewer problems later in life with incontinence and uterine prolapse.

Of course, C-sections, like any surgical procedure, have complications. These include infection, bleeding, need for future C-sections, and risk of rare complications in future pregnancies like placenta accreta, where the placenta grows into the wall of the uterus at the location of the scar. Accreta is dangerous and can lead to hysterectomy and even death of the mother.

On balance, though, the benefits of C-sections dramatically outweigh the risks. That’s why April should be Cesarean Appreciation Month, in acknowledgement of the many millions of lives save by this simple surgery. It has transformed childbirth from an opportunity for women to make their wills and prepare for possible death into an opportunity to complain about having a C-section.

  • Gabrielle

    Not here. As part of C-section awareness month (or appreciation month!) I’ll be writing on my blog about why I choose repeat c-sections (I’m having my fourth CS this year) and I’m also writing about being gracious towards c-section moms. No mom should have to defend her birth or feel that it is invalid. It’s not just a surgery, it’s the birth of a baby, and it’s a beautiful thing.

  • Amanda

    I was a CS delivery in ’82 at 28 wks. I’d be a statistic if my birth mother had been allowed to delivery naturally. Sometimes they just need to happen.

  • guest

    Thank you for this. When I was gathering used baby supplies I ran into someone who was way into ICAN who started pestering me about how I should join it and never let a doctor do a c-section for twin births blah blah blah. She kept emailing me and wouldn’t accept my standard response (“I’m going to try a natural birth, but we’ll see how it all turns out”). She made me feel pretty shitty for a while because she just wouldn’t stop emailing me about it.

    A couple months later I did end up with a c-section. Induction for pre-e, premature baby with heart decels…it’s stupid that I had even a shadow of a doubt as to what the answer should be when my midwife and mfm recommended the section. I consented readily, but wondered if it was the right thing. OF COURSE it was the right thing. I hate ICAN.

  • Margaret01

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    Margaret From USA

  • Allie P

    As a CS baby, I approve this message.

  • PenFox

    For me (and a lot of other people), pregnancy and the stress and pain of childbirth can distort thinking and make it hard to think clearly and decisively. For this (and many other) reason(s), I’m especially proud of my clear-headedness in consenting, without hesitation or delay, to my first emergency C-section and my ERCS. The first C-section was due to fetal distress, and in my memory it felt like something that developed slowly over the course of a few hours of labor. The doctors and nurses had me turn this way and that to alleviate the problem, they changed (and then turned off) my pitocin drip, and they didn’t seem very stressed out. It would have been easy to advocate for “waiting another x minutes” to see if things improve (without actually knowing how long the nonreassuring patterns were present). It would have been easy to push back, delay, or flatly refuse. Instead, when the OB decided a CS would be best, I trusted him and his team, and they delivered my healthy, 8/9 APGAR boy in the OR. I am so proud of myself that in a moment of pressure, I focused on what mattered most: a healthy baby.

    For my 2nd, my OB offered a VBAC, but told me candidly that she thought I was not likely to succeed in a vaginal birth due to my anatomy. Again, I am so proud of myself that at a time when it is easiest to succumb to the pressures of others or ideal notions of what things could or should be like, I was able to think clearly about what was most important.

    I am so grateful that my two C-sections allowed me to bring home 2 healthy children. It’s possible that I could have delivered them vaginally, but it’s also possible that they could have suffered dearly in the process. I’m glad I didn’t have to find out which lot I would draw.

  • Medwife

    Re: Discussing ERCS with patients. It took me a bit to gain this insight: SO many women had their first c/s after long, tortuous, sometimes terrifying labor experiences and think that a repeat section = similar experience and recovery time. Now I always make a point to go over the dramatic difference between an intrapartum c/s and a scheduled repeat. Most women, after having this conversation, get a lot friendlier with the idea of getting a repeat. Just in my experience.

    • Roadstergal

      If your only experience of a hospital is an emergency C-section when you’re exhausted, dehydrated, and in pain, it would be no surprise if you ended up with a negative view of hospitals. Which is another thing that makes NCB advocates so frustrating. All of these women with all of this drive – if they wanted to direct it positively, they could address these fears. Have groups where women can share their experiences, ask questions, and have procedures explained to them – either before birth, or after their experience. Arrange for tours of local hospitals, perhaps even with a medwife or OB giving a high-level talk afterwards about practices, risks and benefits of various procedures, preventive measures, etc. De-mystification to remove some of the fear and stress…

    • Trixie

      Many women who are very frightened of a repeat cesarean also had a bad anesthesia reaction and/or bad pain management afterwards.

      • Somewhereinthemiddle

        That was my experience. I had so much nausea and vomited for about 12 hours with an incision in my belly before they took me seriously and gave me some anti nausea meds. The physician I saw post birth told me that I was sick because of what I had eaten and was pretty insenstitive to my discomfort. And in hindsight, my pain control was absolutely not adequate and I didn’t know that I could advocate for myself and insist on better pain control. I had very little help with the baby from spouse/ family and was go grateful when they took him to the nursey so I could focus on getting pain and nausea under control. I would hope that if I ever have need for a CS again, that the post birth/ surgical would be better than what I experienced the first time.

        • Medwife

          Ugh. Sorry for your unnecessarily bad experience 🙁

      • Mac Sherbert

        I known someone who had an emergency C-section…a true emergency like right now C-section. Her epidural wasn’t working correctly and they kept promising they would put her under once the baby was out, which they did. For her next baby she wanted a planned C-section, so there would be no emergencies without adequate pain relief!

        • Trixie

          That sounds terrifying. I can understand that!

    • Sue

      Thanks for the insight, Medwife. It is also pertinent to the person who has a terrible experience in their first birth, choosing another setting and thinking the change in setting made things better, when it was just that first times are frequently the hardest – especially for older first-timers.

    • AmyP

      That is really smart.

      Good for you!

  • JJ

    So thankful for the moms and babies I love who are alive today because they had a C-section. I would be missing out on some great friends and family members without them.

  • MaineJen

    I’m so thankful for the c sections that saved my neice (obstructed labor, mom with a fever) and my friend and her second daughter (her doctor told her that her uterus was “thin as saran wrap”; if she had not opted for the repeat section, she likely would have ruptured).

  • iris

    After having no less that six female relatives on my mom’s side have drastic complications during vaginal birth, all that ended with a C-Section, I told my doctor I was having a C-Section. My mother needed an emergency C-Section to save both our lives when I was born, and I am an only child because she lost her uterus. Two cousins can no longer reproduce after their first births as it might now kill them. He said I was very intelligent to bring up family history and had no issues scheduling a C-Section and getting my insurance to cover it. Don’t feel like being infertile after one birth, or have to have reconstructive surgery down there like my mother did, or constant pain when using the restroom like my aunt.

  • Lindsay

    I’m in the camp where I’ve only had a vaginal unmediated birth that ended in a large episiotomy, uterine infection, and a baby in the NICU for two weeks due to being premature. I am pregnant again, and I’ve already told my doctor that if I cannot have an epidural (a debate due to heperin injections and prior early birth) that I would like to be put under and the baby delivered via c-section. I cannot go through the trauma of vaginal birth again. PPD and months of counseling to deal with the long-term pain that vaginal birth caused is making me hope for a c-section.

    • FormerPhysicist

      Wishing you an understanding doctor and hospital, and luck as well.

    • Cobalt

      I hope you have an easier birth this time around!

  • FortyMegabytes

    My wife has some condition, I don’t know the name, but basically her uterus takes a right-angle turn right at her cervix. In simplest terms, it is physically impossible for her to give birth vaginally. (A side effect is that she doesn’t show at all; at nine months she looked like she was in her first trimester.)

    If it weren’t for cesareans, she would have died giving birth to her first kid, we never would have met, and I wouldn’t have an almost-four-year-old daughter now.

    So thank god for cesareans.

    • And thank god for reasonable husbands and fathers.

  • StThomas

    If it weren’t for Caesarian section, I would be a childless widower

    • FormerPhysicist

      So would my husband.

  • anne

    I’ve been reading this blog for over a year now, but this is my first time posting. I had three planned c-sections; my babies were all breech due to a septate uterus. I am 100% confident in that decision. I don’t know how one even begins to deliver a transverse breech that will. not. turn. (and believe me, we tried. ouch!) I had other complications that did not allow us to safely wait and see if they would turn on their own. They were all born between 37-38 weeks, perfect and beautiful and healthy.

    It has been 7 years since my last baby was born, and I STILL am having to defend the method by which my babies were born. Many misinformed, well-intentioned people (and some with not-so-good intentions) have demanded to know all the circumstances surrounding my c-sections, and they offer suggestions as to what I should have done differently to avoid the surgeries. It infuriates me. To insinuate my experience is something to be mourned or viewed as a tragedy is insulting to me. I loved my birth experiences. I love that I had the technology and medical help available to have surgical births, because it likely saved the life of my babies and myself. Every April I see those awful facebook posts about c-section awareness, and each time I thank my lucky stars that I live in a day and age when I don’t have to ‘trust birth’ and simply hope for the best.

    Thank you! thank you! thank you! Dr. Amy, for being one of the few voices of sanity on this issue!

    • MaineJen

      “I don’t know how one even begins to deliver a transverse breech that will. not. turn.”

      There are ways…most of us do not want to know about them. *shiver*

    • CanDoc

      Beautifully put!

    • Jenny

      I experienced the same thing…I had a c-section for a complete placenta previa and some crazy natural birth advocate told me it was still possible to birth naturally, that she knew someone who did. I was also told I should have gone to a cranio sacral therapist to make the placenta move! Some of these people can not accept the fact that c-sections save lives.

      • anne

        It’s crazy, right?! I have been told chiropractic, acupuncture, herbs, liver cleanses, etc, would have turned my babies and allowed me to deliver vaginally. I always listen politely, but I am always thinking, ‘What makes you assume my goal is having a natural birth? Why is there an automatic assumption that there is something wrong that I need to fix?’ I could go on and on about this, but I’ve taken up enough space as… 🙂

        • The Bofa on the Sofa

          Yep. When our first was breech, the doctor offered to try to turn him. She said that her success rate was about 1/6, but she’d be willing to try. Since my wife never had any interest in a vaginal birth in the first place, we didn’t bother. Stay breech, do a c-section, and we’ll be fine.

      • Cobalt

        That’s insane. Complete placenta previa is a death sentence without a cesarean.

  • demodocus’ spouse

    Every time I read about that old extraction method, I get shivers. One or the other had to die, or both would. Thank heavens for modern medicine.

  • Mel

    I am very grateful for the CSs that allowed a fellow teacher to have two beautiful children while still being alive.

    I am also grateful for the CSs that allowed my pseudo-nephew to be extracted after his shoulder dystocia and the planned CS that allowed his little brother to enter the world far more peacefully for both the baby and my cousin. I am preemptively grateful for the CS my cousin will be having soon that will give me my first pseudo-niece!

  • Daleth

    Yes. And let’s not forget, June 7 should be Cesarean Appreciation Day, since it is Virginia Apgar’s birthday. 🙂

    • Daleth

      PS thank you, c-section, for my babies’ Apgar scores of 9 and 10!

    • Empliau

      It’s my birthday too, and I am proud to share it with Dr. Apgar (as well as Jim Nabors and Beau Brummel). We’re an eclectic bunch, we 7th of June arrivers! I shall think of her when I blow out my candle.

      • Daleth

        It’s also the birthday of Prince, as in the Artist Formerly Known As. Eclectic indeed!

        • Empliau

          Thanks for letting me know! I have a brother who has Sigmund Freud and Orson Welles on his birthday, so I always felt a little envious. Dr. Apgar and Prince really spiff the neighborhood up!

          • Mattie

            And also me 😀 and George Clooney. Although my due date was a lot later…7 weeks in fact, and would have had me sharing a birthday with Julia Kristeva and Solange Knowles (you win some you lose some lol)

    • namaste863

      Dr. Seuss, Dezi Arnez, and, of all people, Mighael Gorbachev are my birthday buddies. June 7 happens to be my parents’ wedding anniversary (Well, okay…..they divorced 25 years later, but still….)

      • The Bofa on the Sofa

        You have the same birthday as my niece. She didn’t know about Dezi Arnez nor Mikhael Gorbechev.

        My birthday is the same as Gabe Kaplan (Mr Kotter)

  • luckymama75

    After this article, I can calm down after the ridiculous shit-show on the facebook page, Our Muddy Boots. She posts that “all c/sec’s should be mourned” and everyone reflects her sentiment, “it traumatized both myself and my son/daughter”. I couldn’t believe she had so many people jumping all over it and no one disagreeing so I posted, “I’m one of those weird people that loves her kids too much to worry about how they made it here. Just happy they did.” Deleted and banned. Oooohhh, so that’s why everyone was so agreeable. If you weren’t, you’re out.

    • Alannah

      There has been sooo much deleting and banning going on on that thread, it’s ridiculous. She banhammered every single commenter who had anything positive to say about cesareans or OBs. Only the sob stories remain.

      On the bright side, that post is already up and being lampooned on “Sanctimommy said what”.

    • Sarah

      If that bitch dares mourn either the one that brought me into the world or the one that brought my daughter into the world, I’ll circumcise her face.

      • MegaMechaMeg

        Did you see the bat shit insane lady claiming that her C-Section birth traumetized her? Complete with a link claiming people actively are able to remember their birth? I went full white girl and just couldn’t even anymore.

        • Sarah

          Yes. I don’t remember my birth, but perhaps that’s because I wasn’t unschooled.

          Seriously, obviously it’s fine for her to speak her truth about the trauma she feels because of her sections. That’s valid. But the rest was deranged.

        • Mattie

          Wow, people can remember their births, I can’t even remember what day of the week it is most of the time. I was reading through my baby book the other day, looking at photos and when I said my first words etc… apparently when I was 2 I had a little pull along horse and cart that I took everywhere and proudly named “horsey horse” I do not remember this AT ALL, but wish I did cause it sounds so cute haha

    • moto_librarian

      Yup. Lots of us posted our profound disagreements with her, and every single comment was deleted and the posters banned.

      • luckymama75

        Yeah I really thought comparing the NCB movement to a cult was exaggerated at first. Now I’m 100% convinced that’s exactly what it is. No one is allowed independent thought or even to be exposed to someone else’s independent thought if it differs from the agenda. It’s a little scary.

  • Dr Kitty

    I appreciate CS- it’s how I was born safely!

    It also meant my daughter’s birth was quick, calm, peaceful and painless rather than uncertain hours of pain and pushing with goodness only knows what complications.

    I have many reasons for not choosing VBAC this time.

    Personally, I was off all analgesia by 1 week post CS, driving at 2 weeks and back to myself with no fatigue or pain within 3 weeks. Of the many surgeries I have had, it was one of the easier recoveries.

    • I agree with you. My son was born by C/S after two days of contractions without dilatation, and by day 8 post-op, I flew from Israel to the US so my dying mother could see her first grandchild. After the first 24 hours, I did not need any analgesics stronger than paracetamol.
      Both C/S #2 and #3 were scheduled, and the recovery from both was as easy as from #1.

      As a result, I fully expected my hip replacement to be just about as easy. It wasn’t. No complications, but it was months before I felt fully recovered.

  • yentavegan

    April is my c/sec awareness month. DD2 and DD5 were both April C/Sec. Happy Passover shout out!

    • FrequentFlyer

      I have neen celebrating cs in May because that’s when both of my children were born. I am happy to start the party early though.;)

    • KarenJJ

      We also celebrate the anniversary of two c-sections in our family in April. We’d also celebrate an Induction anniversary, but my relative decided that April Fool’s Day was a bad idea for a birthday and scheduled the induction for a couple of days prior.

  • Driving280

    The Score article says (as I have read from many places): “Even without any complication, the recovery is weeks longer and more painful than with vaginal delivery.” Has there actually been any research on this? I realize that I am an anecdote, but for me, the C-section was much, much easier to recover from than a vaginal birth. I was really wiped out for days after a pretty short (7 hour) vaginal delivery, when I was in great shape and in my mid-30s, and it took a good 12 weeks to regain bladder and bowel control completely (though my bladder has never been the same). After the c-section in my early 40s, not in that great shape going in, I walked out of the hospital, felt basically ready to do anything a week out (ok, the wound was a little sore but nothing compared to serious pain/unpleasantness going to the bathroom) and started exercising at 4 weeks. One of my friends also had both a vaginal and a c-sec delivery and also had an easier recovery from the c-sec.

    • yentavegan

      Me too. My 2 c/sec were vastly easier recoveries. My perineum was not involved so after the c/sec’s I could move around much better.

    • Alannah

      Depends on the vaginal delivery.

      If you can shoot a baby out in 2 pushes without a tear or episio then your recovery will be far better than a cesarean moms.

      If you end up with a long exhausting labor with, a tear from front to back and hemorrhoids the size of dinner plates it may take you weeks longer to recover than the lady next door who had an elective cesarean.

      Unfortunately we can’t predict which woman will end up with which scenario.

      • Driving280

        Fair enough, but are there any studies showing that, on average, a vaginal birth is easier to recover from? What portion of vaginal births fall under the difficult to recover from vs. push the baby out in two pushes? Also, I believe I did push the baby out in about 4 pushes, though with a tear, and it was painful to recover from.

        But then again, maybe they should not do these studies, because if there is research showing that C-sections are not harder to recover from, they will quickly reduce your medical disability eligibility to 6 weeks from 8 weeks for those as well. 😛

        • If anyone were to do a study — and I think a study ought to be done — the reasons for the C/S would have to be taken into consideration, whether it’s a primary or repeat C/S, whether there was a trial of labor prior to surgery or not. I would expect that a woman who has labored for a considerable period, and is exhausted, or an emergency C/S where there is a rush to get the baby out so that the full scrub, etc. isn’t done, would have a greater chance of post-op pain and infection than a woman having an elective C/S. But does anyone know for sure?
          In other words, any study of C/Ss would have to take a lot of variables into consideration.

          • FrequentFlyer

            Oops! I asked my queation right before I saw this.

          • Mattie

            I do think it could be done, for example midwives in the UK visit all women postnatally for 4-6 weeks, and note recovery and pain levels, wound condition, mental health etc… so it could either be done currently, or looking at past notes. However there’s also the idea that women who feel they have failed by having a section, or are facing emotional problems related to disappointment or a mismatch of reality v expectation may view the recovery as worse than someone recovering from a planned c-section, or who went in with little/no expectation. Also pain threshold varies wildly from person to person which is also hard to control for.

          • If midwives are following women for the length of time you indicate, that is an improvement on my time in the UK. We handed over to the Health Visitor after the 10th postpartum day when our legal responsibility for the patient ended.

            There are objective and subjective factors, of course, and a certain amount of overlap. However, such factors as the length of labor before C/S; the incision infection rate, etc. are measurable. And the rate of patient expectation/ease of recovery, while subjective, could be valuable. I agree that the woman who desperately wants a vaginal birth but who is suddenly informed that the baby is in distress and an emergency C/S is indicated is likelier to perceive her recovery as “difficult”, even if, medically speaking, there weren’t any post op complications.

            My feeling is that too much of the “information” bandied about regarding C/Ss is anecdotal.

          • Mattie

            I think 10 days is the earliest discharge date, usually for women who are healthy, whose babies are doing well and who do not wish to have further visits. I think I might have over-estimated with the up to 6 weeks, I think it’s up to 4 weeks with the 6 week check with the GP. For women with more complex needs, or babies that do not seem to be doing so well, or where postnatal depression is a concern the midwife can visit up to 28 days postnatal, usually in close correspondence with the health visiting team.

      • Cobalt

        I had all my babies vaginally, and have had generally easy labors and deliveries (no incisions, anesthetics, or marathon labors). I was up and walking quickly enough to meet my babies in the nursery before they were done being washed up, and was back to my typical bathroom habits within 24 hours. I’ve known other moms who didn’t get up until the nurses made them though, it really depends on luck.

        One of my friends who had a scheduled cesarean left the hospital 36 hours later, feeling great and wearing jeans, carrying the baby in the car seat. You just don’t know, but with a planned cesarean you have the most control over the variables.

        • Roadstergal

          “You just don’t know, but with a planned cesarean you have the most control over the variables.”

          There’s something to be said for that – with option V, you could have a really easy time of it or a really horrid time, we can’t be sure, you might be able to have pain relief or it might all go too quickly, you might have tears or not… where with planned option C, you know pretty well what’s going to happen, when, and what the recovery will be like, and can plan accordingly. I just don’t see why planned option C isn’t a fairly ’empowering’ choice.

      • LinKir

        This happened to me. Labour stated and he was born in just under 3 hours. Pushing was very quick, no tears, no episiotomy. Recovery was super easy. However, I think this is a rare occurrence and the 3 hour medication free labour was horrible, terrible, awful!!! I was asking for the epidural, but there wasn’t time. They had the cart out, the anesthesiologist was on route, but then all the sudden I was complete and away went that cart, in came more nurses and doctors, and then he was here. It helped that I wasn’t in labour for long too because I wasn’t exhausted after.

        • CharlotteB

          This is basically exactly what happened to me. I have never, ever cursed so much in my life! I had planned to try to go med-free, but figured there would be time to get an epi if I needed it–first time mom, so labor is usually longish, right? But nope! Got to the hospital an hour after contractions started, was at 7cm at first check in triage, then 10 when I got to my room, so basically did transition as I was wheeled through the hall. I did have a (barely) 1st degree tear, and got stitches, but yeah, recovery was very easy.

          However, my experience makes me give massive side-eye to a lot of the ncb stuff. Not being able to move? Monitors? Not being allowed to eat? Multiple cervix checks? It’s hard for me to imagine that you’d notice or care. I didn’t feel the cervix checks, didn’t know if I had a monitor, and crawling from the gurney to the bed seemed absolutely impossible. It was probably one of the least empowering experiences of my life, and I was so angry during labor that I couldn’t get meds.

          If I have another baby, I’m doctor-shopping until I can find somebody who will induce at 39 weeks (or sooner, if they’d let me), and I want the epi in place the minute I walk in the door.

    • FrequentFlyer

      Has anyone compared the recovery from nice, calm, planned csections to recovery from an emergengcy cs after labor has started and gone wrong? I had easy, quick recoveries after both of mine, but they were done to prevent life threatening emergencies, not in the middle of them.

      • FormerPhysicist

        Yes, this! I had 3 c/s. First after kid #1 got stuck and wasn’t progressing. Second, planned pre-labor. Third, planned but oops, went into labor from pre-E and c/s was hurriedly moved up to NOW.
        Second, recovery was a breeze. First, well, it was okay. Third. well, did I have trouble recovering from the c/s, or the pre-E? I’m sure it was the latter. Especially since I was back in the hospital 2 weeks post-partum for post-partum pre-E.

        • Montserrat Blanco

          I would agree it was the preeclampsia. Mine got progressively better postpartum and I felt great like one hour after my CS. I started exercising two weeks after my CS, because I felt great. During the preeclampsia I felt awful. I had only felt almost that bad once before and I had a pneumonia….

      • Idigia

        Yes. Much faster the first recovery from an intrapartum c/s than the second from an elective. I was told it would be easier, ahha, sure. One month unable to walk without pain and bending. Each case is different.

    • Somewhereinthemiddle

      I don’t know but I would be interested in the answer too. My CS had a much more difficult recovery. It was after labor started but it wasn’t a super long and grueling labor or anything. My next two were vaginal births and were easy in comparison recovery wise because I had no major tearing and I had bowel and urinary continence almost immediately. My SIL on the other hand had a terrible recovery from a vaginal birth including a 4th degree tear and bleeding and pain that lasted for months. Obviously she is far from the only one who has had that sort of damage from a vaginal birth. If only there was a way to know ahead of time who is predisposed to serious tissue damage ahead of time, it would prevent so many serious birth related injuries.

    • Trixie

      My experience was that my VBBAC recovery was much faster and easier. But it can absolutely go either way.

    • guest

      I have no experience with vaginal birth, but like you, I felt my c-section recovery was pretty easy. Was there pain? Yes, of course. For about the first three days it really sucked. And then…it didn’t so much. I also didn’t come anywhere close to using all the painkillers I was given, not even all the ones given to me in the four days in the hospital (mine gave a little card of meds you could self-administer as long as you wrote down the times you took them.) At my follow-up visits I was asking for permission to start doing more activities and people seemed surprised. I listened to their advice, and I know it’s not easy for everyone, especially if an infection sets in or an incision opens, but I also wonder about the research.

    • Sarah Labor RN

      I had an elective Cesarean section for my second baby. My first baby was a four hour labor where I begged for pain relief, an epidural at complete, vacuum delivery, for fetal distress, shoulder dystocia, and third degree tear. Apgar 5/9. My CHOICE to have a section was the best!!!! The pain was NOTHING compared to the third degree tear and hemmrhoids caused by my vaginal birth. When I told one of the midwives I work with what happened to me she blamed me for having an epidural. Oh boy!!! The best part…I was under the care of a midwife for that delivery! Thank goodness for my OB who listened to my fears and anxiety after my first birth and agreed to the elective section. It was glorious.

  • Puffin

    I will be electing for a c-section with my next birth. With my obstetric history (two births complicated by placenta issues, eight early pregnancy failures) and medical history I am not taking the risk of giving birth vaginally again. I want another baby, not another birth. I’ve given birth “naturally” and it ended up with an arm shoved up into my uterus to scrape out the placenta because my body wouldn’t expel it and I was starting to bleed heavily so there was no time for analgaesia. Damn if that wasn’t the most painful thing I have ever experienced. I am NOT risking that again.

    I’ll take the c-section next time, thankyouverymuch.

    • DaisyGrrl

      The possibility of an arm shoved up the uterus to search for a retained placenta should be part of the informed consent for every unmedicated birth. I can’t even imagine how painful and scary that must have been for you!

      • moto_librarian

        I always tell people to get a heplock, even if it’s not “required.” I would have given my right arm to have had one with my first.

        • Medwife

          Yup. A fentanyl IV inj wouldn’t numb the pain of a manual exploration but it is one hell of a lot better than nothing.

          • moto_librarian

            The great thing about Fentanyl is that I have no memories of anything within about 30 seconds of it being administered. I had it for removal of an impacted wisdom tooth, an upper GI, and for those post-birth complications. I vaguely remember looking at the lights as they pushed me to the OR, but have no memories of the surgery at all.

          • Medwife

            Sounds like there was a whiff of Versed in there, too! Good stuff. If there’s breakthrough pain I certainly would prefer not to remember it. (It’s a common drug used in conscious and pre-procedure sedation.)

      • Puffin

        It wasn’t scary at all since the OB was quite clear about what she was doing and why. I did have a heplock, but because I won’t take opiates, there wasn’t anything they could give me which acted fast enough, as I understand it, so I didn’t have anything for pain at all. Typically retained placentas are removed under anaesthesia (as I have been told) or at least with some pain management, but there just wasn’t time for it with me, which I now know is because I was at considerable risk of very serious bleeding.

        Good thing I didn’t have that unassisted homebirth I’d planned. It was actually this blog that convinced me not to, and I’d quite possibly be dead if I had gone ahead with that plan

    • moto_librarian

      Yup. Manual examination and removal of clots without anesthesia was more painful than giving birth, which shocked me. I was so grateful to finally get fentanyl right before they wheeled me back to the OR.

  • Inmara

    This should be something our Ministry of Health acknowledges… not like it is now, when they have taken WHO’s recommendation of 15% C-section rate to hearth (it was cited in booklet I received when started my prenatal care) and try to assign funds accordingly. As a result, breech is not a medical recommendation for C-section anymore, and mothers who wouldn’t want this risk are forced to pay for C-section, and it’s huge financial burden (medically recommended it would be for free; most insurances don’t cover obstetric care at all).
    Only cases where I see significant advantages of vaginal birth or VBAC is when woman knows that she would want more than 2-3 children – then risks from repeated C-sections (like placenta accreta) might overweight benefits from planned C-sections.

    I have to say big thanks to Dr. Amy for this site – otherwise I would have lived in quite wooish and naturally-oriented bubble and might have made some dangerous choices (like birth in water). Now I know much better what my options are and will act accordingly when labor comes closer (4 months to go…). This new mindset has made quite disservice, too – I look at prenatal classes and information resources available in my country, and clearly see when they use some NCB myths, cite debunked studies and praise “natural” left and right. It will be hard to attend (because I would like some practical preparation for labor and baby care and only books won’t give it) and not get into some heated arguments…

  • EmbraceYourInnerCrone

    I appreciate cesarean every day. My mom is 85 my brother is 49 they both would have died in 1966 (previa followed by uterine abruption).

  • kt

    Fantastic, couldn’t agree more. I chose a caesarean and couldn’t have been happier at the outcome. Others however, are aghast when they heard I actually elected for it (usually from women who gave birth vaginally, and some men who believed women’s bodies are perfectly designed for birth!!)