An Unnatural Birth: In Praise of the Caesarean Section

I’m sitting, exhausted, in a tiny circle of new mommies, almost all of us first-timers, with our two-month-old babies in our laps. Some of the babies are sleeping, some are awake. For most of us, I assume, it was a struggle to even get here, to this meetup. It certainly was for me. The mommies are trading birthing stories, everything still fresh enough in our minds that we need to spill the details. Hours of labor, some easier than others, are logged and added up. Some women made it through without any pain medication, some ended up needing a bit of help. One woman gave birth in her apartment, a beautiful experience the way she tells it. All of the babies were born, all were well: healthy and fat and sitting in this circle, including mine.

Then it’s my turn—I haven’t offered, but people look over and I can see that I’m now expected to tell my story. I say—somewhat flippantly, for complicated emotional reasons—”Oh, my daughter was breech and I had a scheduled C-section.”

“I’m so sorry to hear that,” says one mother, who genuinely seems sad for me.

I nod in agreement. “Yeah, it was too bad it didn’t work out how we wanted. But it all turned out fine, I guess.”

I’m lying. We move on.

It took me months to come up with a better, more accurate, and more honest response to the, “I’m sorry to hear about your C-section” comment, but I’ve got it down now, and I need to, because I hear this fairly often. It is always, always, delivered with genuine caring and disappointment on behalf of my subpar birthing story. Like my well-worn “My face just looks like this” response to “You look like you’re having a bad day!” or “Why aren’t you smiling?” comments, my response to the C-section question can come off cutting, even rude—even though I don’t intend it that way, not really.

“Actually, it was fantastic,” I say now. “I slept well the night before, checked into the hospital, she was born healthy in about fifteen minutes, and I healed up in a few days.”

It’s all true: it was a wonderful experience. But it’s not what a lot of people expect (or maybe want) to hear about a C-section birth.

About 33 percent (nearly 1 in 3) of babies in the US are born via Caesarean section every year, a number which steadily increased from the 1970s to 2009 and has remained stable since. Many are born under the same conditions as mine: medical complications force the parents to decide, as near to the end of the pregnancy as possible, to schedule a surgery that cuts into your abdomen and uterus to remove the baby. You don’t labor, and neither does your baby. One moment she’s cozy in your womb, and the next, poof! Out in the world and unhappy about it.

Many, however, are born via C-section after the mother has labored for hours and hours, and maybe hasn’t slept in a day or more by that point. Referred to as an emergency C-section, it’s basically the worst of all possible healthy birthing scenarios when “planning” or envisioning your birth, because you labor (which is super hard, as I understand) and when that comes to nothing you need to have major abdominal surgery anyway. This sounds, indeed, like a horror show. But then again, the end is the beginning: you get a baby!

The point is, very few people choose to have a C-section (I suspect partly because they’re incredibly expensive if not medically necessary) but many do. And despite the huge amount of babies born this way, and with the best intentions possible, this “birthing experience” is seen as somehow unfortunate, a last resort, which you’ll have feel regret for in the months to come.

But it’s not. It is scary and weird to experience no pain in childbirth, but the fact that there is no pain doesn’t make it a lesser experience. It’s just a different one.

It’s taken these months to figure out how I feel about people unintentionally making me feel like I’ve missed out on something with my lame, over-medicalized birthing scene. But I’ve never had any confusion about the experience itself: it was great. It was an awesome day all around and I wouldn’t change a thing. The baby (who was both upside down and backwards in there) was calling the shots, so why wring my hands and wish it could have been another way?

In the past two decades or so there has been a growing backlash to the “over-medicalizing” of childbirth, resulting in a lot of positive reforms. This was for good reason. Children born in the ’50s and ’60s often had moms who, for no medical reason, welcomed them into the world zonked out on painkillers or cut open to make room for what nature could accommodate, and often both. Mostly, parents have a lot more options now, which is a good thing. Rather than a one-size fits all hospital birth, women are now routinely asked “what kind of birthing experience” they’d like to have. We are encouraged to form a “birthing plan.” You can have your baby with a doctor or a midwife, in a hospital or at home, in water or in a bed.

Always, the most important question you need to answer while formulating your “birthing plan” is whether or not you want a “natural” childbirth. This means: no drugs, no epidural, and out through the birth canal, with as little medical intervention as possible. Women who labor at home or in special birthing centers rather than in hospitals don’t have monitors for themselves or their baby. When I was pregnant, my doula (a “birthing coach” who I ended up not requiring) told me, “If you want a natural childbirth, you should not even think about the other options. You’re going to do it. Don’t say you’ll try. If you keep the epidural on the backburner in your mind, you’ll probably end up needing it.”

But months before I knew that I would have to have a C-section, I wasn’t really committed to the “100% natural at all cost” mentality. The “birthing experience” seemed like a means to an end: the end being a baby, who is awesome, and who I was very excited to meet. I had scenarios in my mind which were more ideal than others (and no, the one I ended up with wouldn’t have ranked very highly at the time), but it never occurred to me that I would feel like a failure or be disappointed if I changed my mind mid-labor and wanted an epidural, or if I needed to have a C-section, because that is preposterous. I can find no evidence that either I or my baby would have been better off for a little suffering between us. If that’s how you want to do it, go for it, I applaud you: awesome job. It’s a good thing that medicine has advanced far enough to know when to step back and let nature take over sometimes. But that doesn’t mean that one birth story is better than the next.

Speaking of nature. I’m all for nature. Totally on board with nature. I understand that babies have been being born the way they’re born for however long humans have been around for, and it’s all worked out fine. But a lot of the time it actually hasn’t worked out fine. Many mothers and babies have died along the way, for things which medicine routinely corrects for these days. Prematurity. High blood pressure. Babies in wrong positions. All of these could and often did spell death for both parties not so very long ago. The Caesarean section is a marvel. Medications which can help labor along and reduce pain without permanently damaging mother or child are wonders of modern medicine.

Sure: I love nature. But when nature wants you dead, fuck nature. Take medicine and science. Hell, if nature just wants you to be less comfortable than you’d like to be, fuck it. Take the epidural, and don’t feel bad about it.

I remember the moment my daughter was born. I don’t have any more “natural” scenarios to compare it to, but I can’t imagine anything could be better than those few minutes. My husband had just finished telling an anecdote about the song “Blue” by Eiffel 65, and there she was, spitting mad. It was perfect.

Every birthing experience where the end result is a healthy mother and healthy baby is equally awesome. You can argue that having an epidural should be considered under the umbrella of “natural” childbirth, but maybe we shouldn’t even bother. Maybe calling one birth natural and the others… “unnatural” (I guess?) is fucked up and childish, perpetuating the myth that there are definitively better routes to getting a baby out than others. Remember: this day isn’t about you. It’s about your baby, who will probably seem unhappy regardless of the delivery system.

The best way to have a baby is to have it the way that you want to, and hopefully that’s how you’ll have it. If, like me, you don’t get to decide, don’t feel bad. It really doesn’t matter, you will likely remember the day as one of the best of your life, and your baby will be amazing. There is no reason to get too attached to any one scenario of your child’s birth, because it probably won’t be anything like you imagined it. But it will still be yours, and as long as you are happy and healthy, with a healthy, beautiful son or daughter, at the end of it, it will be the best “birthing experience” ever. And don’t let anyone convince you otherwise.