medical side effects

Pressured to Push
March 12th, 2010

To my male readers (both of you):  This one may be a bit outside of your wheelhouse.  Please feel free to keep reading.  If you’ve been through this experience I would be keenly interested in your perspective from the other side of the fence.  But this post is more estrogen-packed than usual.  Consider yourselves warned.

One of my best friends is pregnant with her second child.  She’s due any day and we’re all eagerly awaiting her little girl’s arrival.  Her son was born just shy of two years ago via a C-section after attempts at a vaginal delivery proved unsuccessful.  This time around my friend is hoping for a vaginal delivery, and has taken a series of very targeted steps toward that end.  When her previous OB was unsupportive of her interest in a VBAC she jumped ship and found a new OB who is.  She has hired a doula to guide her throughout labor and serve as her advocate with other medical staff.  She has researched VBACs extensively, and discussed the matter at length with her husband to cultivate his endorsement and support.  She is prepared.

The other night during dinner (at the dining room table, like the good little Lenten observers that we are) GAP and I were discussing our friend’s upcoming delivery, and, in spite of all her planning, we can’t help but feel a little bit nervous about it.  Once a woman has had a C-section vaginal births pose certain risks.  And, given those risks GAP posed the question: Why is it that women want a vaginal birth in the first place?

He didn’t limit his questioning to VBACs, either.  It is my casual understanding that many obstetricians prefer to deliver via C-section because less is left up to chance and fewer things can go wrong.  And I suspect that at some level GAP believes (particularly given our experiences with IEP’s delivery) that all babies would more prudently be delivered surgically.  He doesn’t really understand many women’s strong desire for vaginal deliveries.

His belief is that society has trumped up vaginal birth into some sort of a spiritual experience and that we women feel, either consciously or unconsciously, that it is something we are supposed to want.

I swiftly responded by asserting that this belief cheapens a woman’s emotions surrounding a vaginal birth.  I took it to mean that if our feelings weren’t original and uninfluenced by society, then they didn’t have as much value.  He countered (quite eloquently, I might add – he drives me nuts this way…) with the following analogy:

If I were to read A Tale of Two Cities in a vacuum, knowing the plot only, and not being able to relate anything outside of the book back to it, I would think it was a good book, but that’s it.  But when I come back to that book with knowledge of Christian allegory, Greek mythology, and all of the other layers that human society has added to it over the years, its meaning and significance grows exponentially.  Just because the more meaningful reading was influenced by society doesn’t diminish the value I took from it.

I couldn’t argue with that.  (Dammit!)  So we moved on in our discussion.

He asked me why I had wanted a vaginal birth when IEP was born, and why I would want another one the next time around.  I talked primarly about recovery times and other practical matters.  But what I couldn’t adequately articulate is the strong sense (instinct?) of wanting to push; of, after carrying this baby inside of me for nearly 40 weeks, needing to exert myself to the brink of exhaustion to bring his new life into the world.  And I wanted to feel that sense of completion, of (quite literally) deliverance.  It felt right.  And I believe that a C-section would have robbed me of the right and climactic ending to this process. 

(Note: If we had known at the time what was happening to IEP during delivery we would have gone straight to the OR.  And if either the baby or I are in any amount of distress during my next delivery I will sign on the dotted line for surgery immediately.  I would never pursue a vaginal birth in the face of legitimate medical risk.)

The son of a friend of mine was full breach in the womb, and she delivered via a planned C-section a week before her due date.  In the weeks leading up to the delivery she lamented the loss of that moment when the baby is born after hours of labor; the moment I described above.  In the interest of full disclosure I feel that I should note here that when he was several weeks old she confessed that her concerns were rendered moot once her son was born.  On the back end she didn’t feel that her birth experience suffered for lack of the “moment” at all.

So what is it, then, that makes us want to push?  And for the women who have no interest (scheduled C-sections have been on the rise for years), what is it that makes you want to avoid it?  Has society inflated our emotions about vaginal deliveries?  Or is there really something there – powerful, yet intangible; poignant, yet inexpressible; instinctual, yet untenable – that pressures us to push?

30 Responses to “Pressured to Push”

  1. Bridget Says:

    Gale, I’m so flattered to have made it into the discussion! And no, I did not miss that “moment” as I was so worried about in the weeks leading up to delivery. I had the benefit of a very routine, planned c-section with laid back surgical staff that made the mood in our OR a fun atmosphere (with the exception of the 2 surgeons that were diligently slicing and sewing and not cracking jokes and laughing with the rest of us). It was technically T’s first birthday party and because I had no complications it was light-hearted and exciting, just as I wanted it to be. In the end, the mood in his delivery room was better than it probably would have been had husband and I been through hours of labor and contractions. I had the “Hollywood Delivery” and I can’t complain.

    That being said I still want to try to have a VBAC on #2 (someday)… I never thought of it as an overwhelming desire to push, but I’m sure that plays into it (a few too many episodes of the baby story, I’m sure)… it’s a miracle that I didn’t fully experience. Our bodies are built for this job and I took the shortcut (well, I had to take the shortcut). I don’t like shortcuts. Really though, my motivating factor is that I didn’t like the surgery. I didn’t like that my insides were on the outside for an hour. My now 4-5 in. scar was actually a 12-14 in. cut in my extended belly, it was major surgery, common, but major. Our bodies are designed with a path for the baby to get out and that path is the best path to take if possible (never at the expense of the babe’s health). Recovery was not fun. For months afterward I would get shooting pains to my scar if I twisted wrong. Those pains always make me wonder what is different in there now that I’ve been cut open?

    But your post has me re-thinking, is my desire for a VBAC so I can have admission into the “I’ve been through labor” club? I never thought so, but maybe it is? My recovery was painful, but really the pain is a few weeks in life. I remember taking note that I was running by 10 weeks after delivery, obviously the surgery was not that debilitating. I can tell you that husband’s vote is for c-section again all the way. I’m sure he’d be saying “Amens” to all of GAP’s points. Are men less subject to the pressure to deliver vaginally or are they not as informed on the health benefits of vaginal delivery? Something I will research and ponder before I’m in the situation to decide. My doctor is supportive of VBAC so I’m glad the decision is mine to make.

  2. Gale Says:

    Bridget – Thanks for this thoughtful response. If you do “push” next time, I will be very curious about your comparisons of the two experiences. The same is true of my friend who is due shortly. These questions are so deeply personal, but yet not. The decisions we make about labor don’t only affect us. They affect our babies, our partners, and even members of our family. The fact remains that carrying a healthy baby to term is nothing to sneeze at. And regardless of how the delivery transpires, birth is always miraculous.

  3. Lindsey Says:

    Well Hello There!!

    I too am honored to have made it into the blog, and therefore, while I haven’t replied to any of your posts to date, I felt it necessary to put my two cents in here. While I will attempt to be organized in my response, I make no promises. As you know, I am just slightly passionate about this subject and that sometimes leads to scattered thoughts and too much emotion!!

    Like Bridget, one of my main reasons for attempting VBAC is recovery time. It was painful on its own and I didn’t have a two year old in addition to the new baby to keep up with. You gain a new respect for your abdominal muscles when you can feel everything, and I mean EVERYTHING, they are responsible for doing!! The pain added to the feed your baby every 2-3 hours, change her diaper when necessary, hug and kiss on your older baby because his life has just been turned upside down, prepare meals for yourself and #1, etc. and I will do everything in my power to have this baby naturally!!

    I am not and never would say that c-sections are not necessary at times; however, I believe they are done far too often and wonder if society influences c-sections more than it does the desire for a woman to have a natural, vaginal birth. Were you aware that the United States has one of if not the highest c-section rate of all the developed countries? (I am pasting a website here for the dvd extra Birth By Numbers – Yes in case GAP reads this, it is an extra on the video Orgasmic Birth which, in my opinion, should have been given a different name. It is an excellent, eye-opening video that I think will have people drawn away from it for its name alone. It is a long clip, but worth watching if you’re at all interested.) A woman is told extreme measures need to be taken in order to get labor going, or her labor has stalled for too long in her OBs opinion, or if her water has been broken too long, must I go on?

    Another great video I watched recently, The Business of Giving Birth, credits the c-section rate in part to the steps taken in the hospital to deliver a woman. A woman entering the hospital to be induced has an IV started for fluids and pitocin. Because pitocin is a synthetic hormone, it makes contractions stronger and more painful (and less productive at times) and so the woman asks for an epidural. The epidural in turn slows contractions down leaving the doctor upping the pitocin and possibly breaking the woman’s water. More pain, more medicine, back and forth until the baby ends up in distress. When the woman is rushed to the OR for an emergency c-section, everyone is left thinking, “Thank goodness we have the equipment necessary to save this child’s life.” When in reality, would the situation have escalated to the point that c-section was necessary if the medical staff had backed off and let the woman’s body do what it was made to do?! I will give the above situation partial credit for my c-section. I was given the pitocin and had my water broken and then was pressured to start magnesium for blood pressure by residents (even though their attending had said it was only necessary to start if my blood pressure reached a certain point which it hadn’t) and an epidural which would also help with my blood pressure. Medicine to start contractions then two that would slow them down. Had I only know what they were doing to me, I would have asked more questions or put up more of a fight. How was I supposed to know. I trusted their medical opinion. No one ever mentioned that all these measures increased my chances of a c-section by 70%!!

    While people do make the decision to have a c-section for one reason or the other, the idea that they are “safer” is kind of crazy in my opinion, and I would highly recommend they do their research before deciding that they are truly “safer.” Here are some of the risks with c-section (please inform GAP for me :) ): blood loss on average is about twice as much with c-section, risks of complications such as the woman’s bowel or bladder being nicked which would lead to another surgery to repair the damage if it is caught (if not caught the woman can become septic and die), the fetus can also be nicked while the surgeon is making the uterine incision, with each additional c-section, the woman has an increased risk of placenta accreta which is a condition where the placenta attaches too deeply into the wall of the uterus which can lead to hemorrhage and most likely hysterectomy, and again – etc.

    As earlier stated, I would never say that c-sections aren’t at times necessary. At the same time, the idea that c-section can be considered such an easy alternative is in my opinion naive. Ultimately, the end result of a healthy baby and healthy mom is the most important; however, give me a healthy mom without the recovery of a c-section to face those sleepless night anyday!!

  4. Celeste Says:

    This is a topic I am so so so passionate about. We discovered during labor with my first that she was breech and ended up having a c-section. No regrets, no laments. Everything was perfectly fine- mother and baby happy and healthy. Although I knew I wanted my next to be a VBAC, I wasn’t faced with the issue until seven years later. While pregnant with daughter #2 I read some books had many a conversation with my midwife and wrote a birth plan. I wanted everything as natural as possible. In particular, no induction.

    Five days after my due date, I went into labor. I labored for 28 hours total, but I was prepared for pain. For me, pain management came in the form of relaxation exercises, massage , and my wonderful friend the fit ball. I can truly say that, considering the fact that I did it drug-free, it was a really pleasant experience. That is, up until the final horrific 30-45 minutes of pushing. Nothing can prepare you for that feeling. Pure hell, really. But, having that said, I wouldn’t have done it any other way.

    This is a great question, Gale. What is up with this urge to push? I still don’t truly understand why I was so set on doing this as naturally as possible. Maybe because I realize this is a natural thing after all? Because there is nothing more natural on this earth than birthing? Because our bodies are impossibly strong and we yearn to witness that strength first-hand? Because there is no other time in our lives where we are so present and in the moment than during intense experiences like this?

  5. Jane Says:

    This is such an interesting topic and I look forward to reading other comments. For me, a vaginal delivery was the only thing I considered. First – because of the “natural” aspect of it. But mostly? Because I had a 10 mo. old baby at home and I couldn’t imagine what the recovery time would be like with a newborn and a 10 mo. old to look after. I WILLED myself to have a vaginal delivery – even when I was almost 2 weeks late and having to be induced to deliver my almost 10lb. baby.

  6. D Says:

    I have never understood why people care so much about having a vaginal birth. I feel almost callous in writing that because I had two vaginal births with my children. For me, as a sibling of a profoundly autistic brother, I was so freaked out that my babies would be healthy that I would have delivered them out of my nose if need be. I hope I don’t sound dismissive, it’s just that I never focused on the mode of birth. In fact, when my water was broken when I was at 10 cm with my first, there was meconium and my daughter ended up spending her first days in the NICU. (and I scarcely got to hold her because of the medical exigency). In fact, I actually second-guessed in the aftermath whether the meconium issue would have been avoided had I delivered sooner via c-section (doubtful and impossible to know in hindsight and thank goodness she is a happy and healthy almost 9 yo now). I do realize it easy for me to say no big deal, because btdt. Still, a part of me feels like we women are always putting pressure on ourselves to do everything even stuff that we can’t really control and that isn’t always the healthiest thing to do. So I hope your friend gets her vbac but if she doesn’t, I hope she believes me that she isn’t missing anything much. The good part of holding your new baby immediately afterwards is universal.

  7. Jana@Attitude Adjustment Says:

    What a great post. This issue is very fresh for me, because my daughter was born through VBAC (oh, how I loathe the acronym) four months ago. I really feel that the C-section I had with my son would not have been necessary if the doctor hadn’t told me to get the epidural too early. I feel like I was so naive at the time. I figured I’d have an epidural when the pain became unbearable, but I quickly listened to doctor’s orders, only to feel sickness immediately after in the pit of my pregnant stomach. He stopped moving downward, I stopped progressing, and I ended up with a C-section. The second time around, I felt pressured toward a C-section again by my OBs, even after I expressed my wish for a VBAC. So I switched to a midwife, the best thing I could have done. (Here is my blog post on it if you’re interested.

    Here’s what you can tell your husband. Having a baby cut out of you (and I hope not to step on other women’s toes here) takes away your ownership from the experience. It makes you feel powerless rather than powerful. (And I do think it’s different if you are in a high-risk situation, because in that case, you just want your healthy baby). My body was made to be able to carry and birth a baby. When I wasn’t able to do that, I felt defeated, like I couldn’t perform a primary function. (Feminists might have a field day with this description, but I’m trying to explain it the best way I can. I, too, am a feminist.) My husband didn’t quite understand my desire for a VBAC either. What I explained to him is that it’s like a man being impotent. He’s supposed to be able to, well, get an erection. If he can’t, he doesn’t feel like a man. Not being able to push out my son’s very tiny head made me feel the same way.

    I did push out my daughter’s very large head after three hours of pushing. I surely got what I wished for. Right after, I couldn’t believe I had gone through an experience that crazy, for lack of a better word. But I am so proud of myself for it, and I now feel like I can accomplish anything. (Well, I felt that way for a few days, at least.)

  8. Jana@Attitude Adjustment Says:

    Okay, so not to beat a dead horse, or anything, but here’s a recent article from NPR about the danger of repeat C-sections.

    Again, while it sometimes is medically necessary, there is more danger for the woman if she undergoes repeat C-sections: scar tissue that builds and could cause trauma, risk of infection, and cutting other organs by accident, not to mention that the number of children she wants to have could be limited because of the risk of repeat surgery. Many consider this a women’s rights issue, that doctors shouldn’t be able to force or pressure women into repeat Cesareans (or first Cesareans) for their convenience, for the increased income they acquire, or because they fear litigation.

    Okay, I’ll shut up now. I just want you to assure you friend she’s making a great decision. Husbands, take heed!

  9. Anna Says:

    I’ve been pondering this question all day, and I only find that I can comment because someone has already stated how I feel more succinctly than I can.
    While I agree with D that in the grand scheme of things, a healthy baby and mom is the most important, I REALLY didn’t want a c-section.
    Jana summed up my feelings in that I wanted to be an active participant in the process (I think I earned it). Being powerful rather than powerless. That really appealed to me and makes me proud to this day.

  10. Aidan Donnelley Rowley @ Ivy League Insecurities Says:

    This is a phenomenal and powerful post. Unfortunately, I am wrangling two tiny (and, yes, vaginally-delivered) girls toward bed. My hope is to pop back here later or this weekend to write more, but I couldn’t run away without telling you that I think this piece is super interesting and thought-provoking :)

  11. Becky Says:

    Hi Gale! – I enjoy reading your blog and today I feel compelled to comment since this topic was hugely on my mind for my entire pregnancy. I knew from the start that I absolutely did not want a c-section. I wanted to try to let my body do what I hoped and believed it could do by having our baby as naturally as possible. Also, I don’t think that it is highlighted enough these days that it is major abdominal surgery and should really be done only in necessary situations. I think part of my aversion to c-sections is the casual attitude that I’ve heard a lot of women talk about it in – like having the baby is this huge inconvenience and that they just can’t imagine actually waiting for the baby to come on its own time and instead feel the need to schedule it on a day that works for them. That just drives me crazy. I’m actually glad that the movement is so strongly towards giving birth vaginally since I feel like that is just such a better attitude in general to have. If the birth process is an inconvenience, how will the next 18 years be for a mom with that attitude??

    My other hang-up with c-sections is that a lot of time they are unnecessarily caused by a chain-reaction of medical interventions that many soon-to-be laboring mothers are not aware may lead to a c-section. I had a hard time getting my mind around opting for an epidural since despite the nice language a lot of the books couch it in, epidurals contain narcotics that cross the placenta and will get to your yet unborn-infant. How is that something that is okay to do – and actually heavily encouraged- when you spend the entire nine months of your pregnancy not only avoiding all drugs and alcohol, but also cheeses and deli meats and all sorts of other seemingly innocuous food items that MAY have a negative impact on your developing child. So a flood of heavy narcotics that knock all feeling out of a full grown woman’s lower half must have an effect on a 6-8 pound baby. So I had it in my mind that I wanted to avoid pain medication in general and also the chain-reaction that pain medication and medication to artificially induce labor can cause. Couple that with the knowledge that an epidural may stall labor to the point where a c-section then becomes necessary and I was completely out on that. It just wasn’t worth it for me.

    Having delivered vaginally and without any pain medication, I can look back on the experience and know that it was very, very HARD work to get to that point, but for me, it wasn’t undoable. It took a lot of determination and focus to make it through the contractions, but immediately after I had our son, I felt GREAT. I think that’s part of the beauty of not messing with the natural progression of having a baby. I doubt I would have felt anywhere near as good had I opted for a c-section. (Had it been necessary, I would have been over the moon that we had a healthy boy and I don’t think I would have cared how he arrived, just that he was out and healthy and doing well.)

    All of that makes me want to push again the next time. It was an experience I will never forget and was hugely positive for me.

  12. Gale Says:

    Wow! What fertile discussion! (Sorry, I couldn’t help myself…) Thanks to each of you for offering your unique and personal perspective on this highly intimate question. We all come into the delivery room having traveled different paths. And while we must be flexible and open to the changes that can come quickly during a birth, I really respect the choices that so many of you have made to really take control of your deliveries. I am inspired for sure.

    Thank you for sharing your stories. I look forward to the twists and turns this discussion continues to take.

  13. Lindsey Says:

    I think this is a complicated and fraught topic. I have many, many friends who have had very positive experiences of birth across the entire range: planned c-section to home (vaginal) birth. I can say that personally I was really interested in having an unmedicated delivery for reasons that felt sort of instinctive and primal. I kept this to myself while I was pregnant the first time and still don’t talk about it that often, because I find I get a lot of questions and frank challenges. I can’t describe why I had this desire particularly articulately; I can only say it was a deep and instinctive wish to experience birth as primally and fundamentally as women have for centuries. It was a painful experience, both times, for sure, but one I’d never trade.
    That said, as you say, Gale, I’d never pursue this in the face of a doctor telling me my baby was at risk. I am aware of my good fortune in things going smoothly enough that this is how it went. I cherish the memories of my deliveries and hold them among my very favorite life experiences.

  14. Lindsey Says:

    The main problem with always listening to what the doctor thinks is best is that they don’t always give you accurate statistics and some use scare tactics to get you to do what they want. Women have been told that attempting a VBAC increases their chance of uterine rupture up to 8-10%. This is an outright lie if you have a low transverse scar which is the way most c-sections are performed today. The chance of uterine rupture in a woman who has had one previous c-section is less than 1% and it only increases slightly in women with two previous c-sections. This is a doctor’s attempt to scare a patient into going under the knife.

    If you or a loved one was told they needed to undergo major surgery, would you not seek a second opinion? My experience taught me that I should have educated myself more the first time around. I could kick myself for not being my own advocate and having to learn the hard way. Don’t always believe what you are told. Do your research so you can ask necessary questions and if necessary find a new doctor!!

  15. Ashley Says:

    GREAT topic! I have to side with both Becky and Lindsey on this one. The original purpose of the Csection was not for convenience, but for emergency medical situations. And I strongly beleive that is what it should still be used for. I am shocked when not just patients, but doctors suggest or prefer a major abdominal surgery for their patients to better accomodate schedules. Craziness! I’ve had friends that wished their medical complications did not inhibit vaginal birth, as they couldn’t drive, walk up their porch stairs, and at times pick up their newborn because of the healing time from their C-sections. Is it crazy and unnerving waiting for your body (and baby) to begin the birth process, yes. But is it worth it? Absolutely. Our bodies were blessed with the amazing ability to give life, and thereby birth, to beautiful babies, and i feel that God knew what he was doing when he designed us this way! so we should just go with what is natural. It’s (in most cases) best for all. I was lucky enough to have two healthy vaginal deliveries, and I can’t imagine not doing it that way again. Gale, you really hit it on the head. The experience and desire of giving birth vaginally can’t be easily described, especially to a man. It feels as instinctual a need and desire as the need to hold your baby once born. It’s just there.

  16. Laura Says:

    Obviously from the numerous posts about wanting a vaginal and “natural” delivery, this is truly something that some women care very deeply about. I see that I am in the minority here, but I am a mother of a baby girl who was delivered vaginally less than a year ago, and I can truly say that the means of my daughter’s birth was not something that I felt strongly about. I don’t mean to sound ambivalent about something that some people consider to be monumental, but I agree with D in that I would have delivered the baby out my nose if it meant she arrived safe and sound. And if I’m being truly honest, I would have to admit that there were times during my pregnancy where I secretly wished for a c-section. I’m sure that this is making many of the pro-vag women gasp, but it was out of sheer fear of the vaginal delivery process (seriously, reading about the “ring of fire” isn’t supposed to turn a girl off of a vaginal delivery?? C’mon). In my opinion, both options are really scary.

    I was the girl that arrived at the hospital asking when I could get the epidural (turns out, I labored at home long enough to get it right then), and I don’t feel any less proud of my birthing experience. Actually, that isn’t really accurate. I can’t say that pride in myself is the emotion that I felt (or hoped to feel) on my daughter’s birth day. It was joy and love for her and my husband, which is exactly what I remember from that day. I can appreciate that not all women would feel this way, and if I could trade my experience with someone who desperately wanted a vaginal birth, I probably would. For me it was just a means to a very wonderful end, and my daughter would still be my daughter, no matter how she arrived in this world. Suffice it to say that I never considered an intervention-free birth, and after reading these comments, it seems as if even some women who feel this way can’t exactly describe why. However, I can appreciate that we are all different and have different perspectives and plans.

    And while I wouldn’t go so far as to say that I considered the birth process to be an inconvenience, maybe I subconsciously did, as I spent a big chunk of my pregnancy wishing that I could skip the labor part and fast-forward and get to the good stuff – like actually being able to hold her in my arms. I did get an epidural really early in the labor process, and it did not slow my contractions down, as I delivered about 6 hours later (and would have been about 4 hours without certain complications due to her positioning). So, was it simply luck that it worked out for me and that my desire for pain medication didn’t land me in the operating room? I tend to think so, because I wasn’t any more deserving of a relatively easy labor than the next girl, but I also think that luck gave me non-stop ridiculous heartburn for my entire pregnancy (I swear, it was more painful then the hours of contractions I experienced before the epidural). And obviously I know nothing about the recovery from a c-section, and I can only imagine how horrible it is, but my recovery experience was not a cake walk either (as I’m sure it isn’t for anyone). To this day, I still experience pain quite frequently, actually. But maybe I’m just a wimp (see above section about demanding an epidural when i walked though the hospital doors).

    I can’t really say how I’d feel about a VBAC unless I was actually facing one. And I realize that a 1% chance of uterine rupture doesn’t sound like a very high chance, and even more, I recognize that simply carrying and giving birth to a baby carry risks. One of my coworkers recently gave birth to a baby boy that only lived 28 minutes. He suffered from Trisomy 18, which is a chromosonal condition caused simply by chance and happens in only 1 out of every 3,000 births. That is a lot less than a 1% chance. But it happened to her, someone I know, someone who so desperately wanted a child. Her story breaks my heart. Ultimately we all do what we think is right for our family. And knowing what a vaginal birth is like, a VBAC wouldn’t be worth the additional risk for me, even if it is only 1%. I understand the lure of the vaginal birth in theory, but it does not hold the same power over every woman. And I am one of those women.

  17. Gale Says:

    Laura, thank you for this comment. It is brave and articulate and much needed in this “pro-vag” discussion. I really appreciate your coming to the table with an alternate view and I think you make some very relevant points about birth. Last night after reading all of the comments GAP mentioned that he couldn’t begin to understand how, after carrying a baby and giving birth (via any means) a woman could feel powerless in any way. (I think his exact words were something like, “only a woman could have a baby and find a way not to feel good about it.”) I am confident your perspective will really resonate with him. Again, thank you for sharing your experience and your views. You represent a big portion of women (who are apparently under-represented in the blogosphere) and I value it a great deal. Thank you.

  18. Nicki Says:

    My babies were all delivered many years ago and there will not, if I can help it and I can, be more. Six is enough. I had my babies every way imaginable but will say this. Last week the National Institute of Health had a conference on the topic of VBAC. There is a summary of the days at

    Now, my first birth was vaginal. I think I might have been in labor for eight hours total. My mother always told me I looked like I was born to birth babies and turns out she was right. I waited too long to have drugs once I got to the hospital. I distinctly, to this day, remember the nurse asking why I waited so long. I didn’t know any better.

    Then, I had twins. The goal, ultimately, was to deliver the twins vaginally also. I went into labor and again evidently waited to long to go the hospital. I was in a birthing room. The nurse was in the hallway on the phone with my OB. An ultrasound two weeks earlier showed one of the twins was breech. My OB, knowing my desire, asked them to get me to radiology for another ultrasound to see if Baby B had turned. The nurse was screaming at him that I would deliver babies in radiology if I got down there. No ultrasound as back then they were not in every room. This was 1987 so eons ago in medical technology. They quickly rolled a portable x-ray machine in and realized Baby B was still breech. I had an emergency C-Section under general anesthesia. I remember waking up in recovery and asking how big the babies were and being groggy enough to fight with the nurse when she said Baby A was 7 pounds, 15 ounces. I just kept saying, No I had twins.

    Then, came my VBAC. Another birth story about waiting too long to go to the hospital. This time my mother was in town to watch the other kids. She had flown in the night before and was at my grandparent’s. I went up to the farm with the other three kids and called my ex to tell him we were staying for dinner. Two hours later, I told my mother to help me get the kids in the car as I was in labor. We argued about who was driving home and I won. Never underestimate the determination of a laboring woman! We got to my house and couldn’t locate my ex. I had told him I was not going to be home til later. My mother put me in a cab and told the driver not to stop anywhere else. I let him pick up another fare down the hill. I got through admissions and up to the birthing center. Still no then-hubby. The nurses were drawing straws as to who was going to play hubby when he walked in at 8 pm. My OB was on vacation. The nurses prepared me for the fill-in to not want to do the VBAC. I convinced him it would be fine. This was just 16 months after my C-section. I delivered in 15 minutes. She was born at 8:14 pm. She was 9 pounds, 2 ounces.

    The next birth was determined to be over the weight limit that the hospital would allow for a VBAC. Number 5 was over nine pounds, like #4, but he was big early on. We planned a C-section for after my mother got to the area so she could watch the other four. This C-section was with an epidural so I was able to nurse immediately which was important to me. It was in a delivery room, not a birthing room, but in the birthing center.

    Number 6 was an emergency C-section for my health. I had horrible pregnancy-induced hypertension. The doctor – through a million different methods – could not get my blood pressure under control. Getting the baby out did. My BP went right back to normal – 122/70. This C-section was with spinal instead of an epidural. There were issues with the spinal as I had fallen down some stairs – someone left a ball on the stairs – when I was just barely pregnant. I had sublocated my tailbone and that caused some vertebrae to move closer together so they almost couldn’t do the spinal as they had to move up the spine to find a space.

    I guess my stories are not all that unique other than I have had three C-sections with three different anesthesias. I have also delivered vaginally and by VBAC. I would not say that any one way is right. I do encourage every expectant mother to discuss birth scenarios – yes, plural – with her OB. As with our children once they are out of the womb, we are their advocate. We need to be informed and make our informed decisions count.

  19. Jana@Attitude Adjustment Says:

    I felt very similar to Laura during my first delivery. I expected to get an epidural because I really didn’t see any reason not to. If I could deliver a healthy baby without the intense fear of pain and pain itself, why not? I knew a lot of women who said they didn’t want an epidural only to “give in” and get one, and I didn’t want to have a certain plan and be disappointed in myself.

    But then I got to the hospital, and I became part of the system. My labor was progressing very well. For no reason, the doctor broke my water. I trusted the doctor, because I thought she knew best. In retrospect, I think she just wanted to speed things along for herself. She told me that I’d be in “excruciating pain” soon, so I should just get the epidural. It didn’t feel right, but I did it anyway. Surprisingly, the contractions actually slowed. Then, as soon as the epidural took hold, I stopped progressing all together. If everything had gone well, I doubt I would have thought much about vaginal deliveries vs. C-sections. I would have joined the ranks of many of my friends who talked about when they got the epidural, etc. But that’s not the way it went for me, and dealing with the trauma of surgery made me feel for 10 months after like I had PTSD. I felt the knife cutting into me. When I told the doctors, they looked at me in disbelief. I felt the baby being jostled, my organs being taken out and put atop by open abdomen. At one point, due to the anesthesia or something, I felt like I was going to die. Then I didn’t get to hold my baby. I was so exhausted I needed morphine and didn’t see him for a couple of hours. The first pictures of him are with tubes stuck to him. No, this did not make me feel powerful.

    In 10 hours of labor, dealing with intense pain, I often thought I couldn’t “do it,” but I never thought I was going to die. I’d take that over a C-section any day.

    Our bodies are all different. My body would not work with an epidural. I tried many positions to get my daughter out, and finally realized I needed to do a kind of “crunch” to get her out. If I had an epidural and couldn’t feel my pelvis, I wouldn’t have been able to do this.

    I think most women who have had a surprise C-section, rather than a scheduled one (and even some who’ve scheduled them), would not want to go through it again.

    Too much of our cultural ethos about labor is that it is incredible pain and we should avoid that pain at all costs. But so many of those representations are false. (Just watch a recent episode of The Office–funny, but not realistic.) Few people talk about the adrenaline rush after, when you feel like you are the most amazing creature on earth. You don’t feel that way after a C-section. You just don’t.

  20. Aidan Donnelley Rowley @ Ivy League Insecurities Says:

    Back for round two to my comment. Reading through the abundance of thoughtful words above, I don’t feel that I have much to add. I do think that this “pressure to push” – like so many of the pressures we feel in life – is largely self-inflicted. I think that we are success hounds and that many of us view C-sections as some sort of “failure.” Which I think is RIDICULOUS. To the extent that there is any medical exigency, we should opt for surgery. A healthy baby and healthy mom is really all that matters, right?

    Gale – thank you for this phenomenal conversation. I might need to carry it on over at ILI next week!

  21. Elaine Says:

    Obviously a healthy baby and healthy mom are the most important goals; however, I’m sure that the “healthier” mom is not one recovering from major surgery – particularly if the surgery wasn’t necessary if the labor had been handled correctly. I’ve watched the pain of a young mother who can’t move as quickly to her crying newborn because of her post surgery pain. Having delivered multiple babies vaginally and knowing that pain, I promise you that my pain was nothing compared to the physical and emotional pain of that young mother. Pursuing a VBAC for the following birth cannot be viewed as anything but a selfless desire to do what is best for her and her baby.

  22. Alice Says:

    I have to say Thank You to Laura who replied with far more articulation and eloquence that I ever could. But I’ll offer my own opinion and experience as well.
    I, like Laura and D, was overwhelmingly concerned with delivering a healthy baby. We had watched two sets of close friends and one family member lose their babies during and shortly after birth in the year prior to our own son being born, so how my baby was born was not nearly as high on my list of concerns as just being able to take him home with me. And, like Laura – I have to admit the realities of a vaginal birth (medicated or not) were just as scary to me as major surgery.
    I delivered my first son 16 months ago via emergency c-section after 52 hours of induced labor due to complications. (And yes, after 3 days without sleep, food, or so much as a sip of water – when my doctor finally said the phrase “C-Section” my only response was “Where do I sign?”) I’m currently scheduled for a repeat c-section for the birth of my 2nd child in just over 4 weeks. I had one conversation with my doctor about attempting a vaginal birth – she actually brought it up. After she explained her concerns regarding my medical history and the reasons my induction and labor failed during my first delivery – my husband & I decided the risk to our child is simply too much for us to handle.
    My recovery experience was apparently not nearly as traumatic as many from what I’m reading – I was up and walking around within 24 hours, going up and down our stairs my first day home. I have no lingering pain or other side effects. I know many women with vaginal deliveries who had a much more difficult recovery than I did from my C-Section.
    While pregnant with my first, I did worry how I would feel if I ended up having a C-Section. My sister often laments her feelings of “failure” of having delivered both of children through C-Sections after an emergency delivery and then an unsuccessful VBAC attempt. I have to say that I have never for a moment felt like I was “cheated” out of my childbirth experience. I feel no less a woman or mother, no less powerful, no less an active participant in my child’s birth and in no way do I feel like I “failed”. When my husband looked at me and said “We have a son” – that is my moment. The fact that my son was there, in my arms, and healthy was the greatest miracle we could have ever asked for. And I can only pray that we’ll be so blessed to have the same result this time around.

  23. Lori Says:

    First I have to say that I have been enthralled in reading all the comments on this subject. Each night after I put my perfect 14 month old son to bed, I check into this blog entry, waiting for the night that I have enough energy and clarity to respond… I apologize in advance for the length of this reply!

    I had a complication free, easy, very enjoyable pregnancy and labor/delivery. No morning sickness, lots of healthy food (ok, a fair amount of ice cream, but come on!) and exercise, I felt great. I had never given c-sections a moment of thought, not for any reason, just that God had blessed me with this baby and He would do with me in this process as He intended. I didn’t overthink or obsess about anything, really, and that’s not usually a trait for which I’m known :) The thought that my water could break at any time of the day or I could go into labor at work crossed my mind, but it was never scary to me. Well, one Friday night at 2 am, it all started…and ended at 4:30 Saturday afternoon, one hour after checking into the hospital.

    I had thought, sure, I’ll get an epidural because why not? Turns out, I labored at home so long that I was dialated to 8 cm when I arrived at the hosiptal and the speed at which I was progressing, there was hardly time for the doctor to get there, let alone get an epidural. So he was born all natural, was perfect, and I can’t say that I’d do my next one differently. For me, I just didn’t want to get to the hospital too soon because I wanted to be as in control as I could. I didn’t want people to interrupt what my body was telling me to do just so they could check my progress, my blood pressure, give me ice chips when all I wanted was a big glass of cold water, etc. I realize (and did the moment they placed that perfect boy on my tummy) was that I had been blessed with a wonderful experience. Was it painful? I would say mostly uncomfortable and really only for the last 2 hours, then yes, it was painful for the 8 or 9 pushes it took to get him out. (Side note, pain tolerance is another trait for which I’m not usually known :) But once he was out, I felt great. Endorphins and adrenaline kicked in and I wasn’t even tired…yet!

    “They” are so quick to say that every woman is different, every pregnancy is different, and I am sure that the “healthy baby healthy mom” statement goes without saying to any parent or parent-to-be, translating that every delivery is viewed differently. The choice or need for a c-section is not one that should be judged by anyone. You do what works for you!!!! Personally, though, I wonder two things (without judgement):
    1) Because every one is different, are there doctors, and an increasing number, who prefer c-sections due to the fact that the procedure is the same no matter who is on the table (true emergency c-sections excluded)?
    2) Is the fear of the unknown what drives a woman to decide one route or the other? Never had a vaginal delivery…scary. Never had a c-section (or any major surgery)…scary. Don’t know when or where the baby will come…scary.

    For as long as we’ve been around, women have never had “control” of when the baby came. And anyone who knows me understands that I am quite often seen as a “control freak.” BUT we see movies, Baby Story, etc. that show women screaming and sweating for hours, but in reality, is that truly how it is, or has to be? Sure, that scared me, but when it was my time, there was no fear. Just focus, breathing, and the calming support of my wonderful husband. I guess what my ending thought is – the unknown is scary and let’s face it, none of us know what we’re getting into especially the first time around. I don’t believe that I would view a c-section as failure, but the recovery of my vaginal birth was only a few days. I wouldn’t change a thing and can only pray that the next time I get the blessing of another child, I have a similar experience. Was I lucky? I don’t think so because everything I did up to the minute he was born was a decision – what I ate, how much I slept, exercising regardless of desire, even when in labor. For me, God made us to do this and grants us the opportunity to not only give birth, but create a life. Who could ask for more.

  24. Kristen @ Motherese Says:

    I have a bicornuate uterus. As a result, I had complications with both of my pregnancies and both of my sons were fully breech. Because of my uterine condition (both of my sons grew only in one half of my uterus and suffered intrauterine growth restriction), I had no choice but to have c-sections with both of my deliveries. (VBAC will not be an option for me with any future pregnancies given the nature of the incision necessary to get my older son out of my womb.)

    Because the form of my deliveries was not a choice, I haven’t thought much about the urge to push. It wasn’t an option and I don’t feel as though I missed something. After two high-risk pregnancies and, with my first, months of vaginal bleeding, threatened miscarriage, and bedrest, I didn’t spend a moment – literally – feeling as though I was missing out on something.

    Like many of the women above, I support a woman’s right to deliver her baby in whatever way she chooses. I understand the arguments against c-sections that aren’t deemed medically necessary, but, frankly, I don’t think we have the right to judge the decisions another woman is making. I’m sure it’s not intentional, but there is a subtle current in some of the comments above that a c-section delivery is somehow “less than.” And I think that attitude is more pervasive than I realized before I had my c-section (maybe if I knew about it I would have felt badly about having a c-section?). And I think it is gravely to the detriment of women who seek a vaginal delivery but end up with a c-section.

    Yes, women have been delivering babies naturally for centuries. But, as a woman who would have bled to death during a natural delivery before safe c-sections were available, I don’t feel it’s my right to judge what other women are thinking when they choose or don’t choose to have a c-section.

    Thanks, Gale, for providing such “fertile” (yup, I had to do it too) ground for discussion. And thanks to your readers for such meaty commentary.

  25. Lindsey Says:

    I get the feeling some readers might misunderstand the feelings relayed in the “pro vag” postings. I would like to state that I never have and never will judge anyone for the way they choose to deliver. (I take that back, women who have c-sections simply so they can have a tummy tuck at the same time, I might slightly judge. “Designer births,” as I have heard them referred to, leave me wondering – why? Why a lot of things – too many to write.)

    My c-section, while there may be doctors who consider it an emergency simply because it was not planned, was not an emergency. I was fine, my son was fine, he simply had stopped descending. My doctor even gave me the option of pushing for another hour; however, after 24 hours of labor, 2 hours of pushing, 4 bags of fluid/medicine dripping into my arm, 1 epidural in my back, 1 catheter, 1 internal contraction monitor, and 1 internal fetal monitor, I had had enough!!! As I have stated in my previous posts, how many of those interventions were truly necessary?

    While I have chosen a VBAC, I would never say that it was the right decision for others. If it would put my child’s or my life at risk, I wouldn’t do it. As it is though, there are MANY other things that can go wrong in a pregnancy and the chances of those things happening are greater than some of the risks associated with VBAC – uterine rupture being the one most often mentioned. Does that mean we should choose to not get pregnant?

    I do not see myself as a failure because I delivered by c-section. I simply see it as an experience I would rather not have to go through again. One week after delivering my son, my husband asked if I was suffering from postpartum depression. I was no where near depression, I was just sad. Sad that this experience I had so looked forward to all my life had not turned out at all the way I had expected it to. I was in pain. Sometimes so much that I tried to will my son back to sleep because the process of swinging my legs off the side of my bed, bracing myself with one arm on the bed and one of the wall to assist me in sitting up using my abdominal muscles as little as possible was too much to think about. Add to that sheer exhaustion because I had newborn who ate non-stop and breast feeding was failing miserably with a lactation consultant finally telling me that the extent of the damage done to my nipples could qualify as a new “worst” picture in her book. Not only was I suffering from physical pain, I was also suffering from emotional pain.

    I choose to attempt a VBAC and frankly if others choose to judge me because they think I am putting my life or my child’s life at risk, have at it. I have done my research. I have the support of my midwife, my physician, my husband, and the rest of my family members, and that is all I need to know I am doing the right thing.

  26. Ten Dollar Thoughts » Blog Archive » Shame and Prejudice Says:

    [...] commencing with today’s topic, I want to thank all of you for making the discussion around Friday’s post so sincere, honest, and voluminous!  I had some suspicions that that post would touch a nerve, but [...]

  27. Laura Says:

    Just one more comment….I learned very quickly (even before I got pregnant) that just because another mother/parent takes a different course of action it doesn’t mean that anyone is doing something “wrong” as a parent. Every mother makes her own choices, because everyone is influenced by the different things. For example, I think that going back to work after my daughter was born was the best thing I could do for her, but I realize that there are many mothers that make the choice to stay home, for different reasons than those that matter most to me. It is a very personal choice, so it is natural to feel protective of that choice or circumstance. And birth experiences are a very personal thing as well. I know many people have mentioned this, but just want to say that I have no judgment over anyone’s birth paths or choices. I will even go so far as to say that if you want to get that tummy tuck, go ahead….And to Lindsey, specifically, your last comment left me feeling a little sad, as it seemed possible that you felt attacked, and that is the last thing that I’m sure any of us wanted (especially in the final emotional stretch of your pregnancy). I do hope that your experience is all that you are dreaming of…..

  28. Lindsey Says:

    Laura (hopefully you read this) – I didn’t mean to make anyone feel sad. I guess you have to know me and my joking, for the most part, attitude. I’m the first to jokingly say “don’t judge me,” but then again – those who throw stones in glass houses . . .

    Everyone is entitled to their own opinions. You have to do what is right for you.

    I am now, depending on who you ask, midwife – over 40 weeks based off LMP and doctor – 38 weeks and 4 days. As the D-Day, as I am calling it, quickly approaches, I find myself more excited than ever. Whether this baby comes natural (which it will – positive thinking you know) or via c-section, I will feel unbelievably blessed.

    Sorry again. I wasn’t meaning to have an attitude of any kind. That is just the way I am :)

  29. becca Says:

    Wow! So many amazing comments here! I had an emergency C with my first. I definitely always assumed I’d be pushing but when I started gushing blood while at work at 38 weeks… I quickly was told I didn’t have a choice. I always joked that I didn’t really Give Birth. I had a “Removal”. I can’t compare my birth stories to my friends who were so proud and blessed with vaginal deliveries. Do I wish I had a vaginal delivery? I never really thought about it since it wasn’t a choice with Hannah but I guess I’d feel certain pride for having gone through it. I chose a second C with Luke to avoid similar complications. I wanted simple and safe. It was the Easy Way Out. In the end, it was the child I had in my mind, not the delivery. But I am surely proud and impressed of the moms who gave birth vaginally and I support each and every mother’s choice, whichever way they choose to go.

  30. Tom Taker Says:

    C-sections are just another part of the American medical phenomenon. We have to face facts. Natural births, on average, are time consuming and way more effort. They also pay a lot less than surgical procedures. Combine those facts and what do you get? Surprise! Doctors favor c-sections. Less work and more money = c-sections up the wazoo.

    Doctors can’t take all the blame, though. American women are more impatient and have less tolerance for natural child birth, too, so they are requesting c-sections at a record rate. Just like all of the rest of us in this gasoline-powered fast food nation.

    Here’s a somewhat dated graph that powerfully illustrates the c-section phenomenon. Relentless Rise in Cesarean Section Rate