Thursday, October 16, 2014

Why I Care about C-Sections (Even Though I Never Had One)

First, a story about back problems. Around four years ago, I had terrible sciatica. I could barely walk and I was in excruciating pain. My general practitioner referred me to an orthopedic surgeon, who recommended an epidural shot. I tried this procedure twice with no luck. Then the doctor suggested spinal surgery to correct the bulging disc that was causing me so much pain.

I thought about it, and I was scared. Surgery on the spine is serious, and I wanted to make sure I explored all other options first. So, I went to a highly-revered chiropractor. After about a month of treatment, I was free of pain.

That's my story. But then I have a friend who's also had chronic back pain. She's tried the chiropractic route and the PT route, but she hasn't had the luck I've had. She opted for the surgery - a few of them actually - and she's finally living a relatively pain-free life.

I was terrified of surgery and wanted to do everything I could to avoid it; it was a godsend for her and exactly what she needed.

What's wonderful about this story was that there was never a point where either one of us was pressured to have surgery. We were given options, treated like rational, intelligent adults, and given time to figure out what was the right move. And, because our situations were different, the "right move" was different for each of us.

So, you probably get the analogy. C-sections: for some women, they are literally life saving - for either themselves or their babies. They are the only option that makes sense. For others, and this is the part that people find so controversial, they are unnecessary and can even be harmful.

According to the World Health Organization, mothers and babies fare best in places where the c-section rate is between 5-10%, with anything higher than 15% doing more harm than good. (Althabe and Belizan 2006) According to the CDC, America's c-section rate is currently 32.8%, more three times the recommended rate. That means we have a problem.

5 - 10% of women need a c-section due to any number of circumstances. Assuming those women are treated with dignity and respect, that c-section probably feels like the greatest invention since sliced bread.

As for the other 22.8%, their feelings toward c-sections vary. Enough of them feel upset by their experiences that there are support groups across the country to help them process their emotions. Many feel like they were unfairly coerced into having a c-section for reasons that are not evidence-based, such as having a big baby. Others are not sure whether their c-section was necessary or not, because they were never given clear explanations or any real autonomy over what was happening to them.

But some women, whether they feel good about their c-sections or not, want to attack women who support lower interventions in birth and fight against the c-section rate. They think women like me are nosy, judgmental, bossy. They are, quite frankly, missing the damn point.

I'm an advocate for women. And when 1/3 of women who labor in America have their babies via c-section, that's upsetting. That means that when a healthy woman with a healthy pregnancy seeks traditional hospital care to birth her baby, she's facing steep odds that she could be given a procedure that she might not need and it will definitely make her life more complicated.

Yes, there are insufferable natural birth enthusiasts. I was at a mom's group once where a woman mouthed off against c-sections in a way that made it clear to the whole of us (including a wonderful mama friend who birthed her baby via c-section) that she thought those moms were less than. However, even though I surround myself with very crunchy-type moms and I also travel in a circle of doulas (whom many assume - wrongly - think the only valid birth is one without interventions), this has only happened once. What I hear much more frequently is concern that women are not treated fairly in their prenatal and birth care.

So, honestly, I'm getting frustrated that while I'm standing up for a woman's right to have a birth that is safe, respectful, and evidence-based, I'm viewed as anti-woman. If a woman has a c-section and feels great about it, that makes me happy. If a woman has a c-section and feels terrible about it, that makes me upset. If a woman has a c-section and then wants to make fun of "natural birth freaks," that pisses me off. When women, like the author of this article, suggest that those of us who are unhappy with the current c-section rate are so into being "natural" that we'd rather have a baby die than succumb to a c-section, then I get RIGHTEOUSLY angry.

Look, ladies, c-sections matter to all of us. If, like back-surgery, they are used sparingly and when necessary, then I think we'll all feel positively toward them. But right now they are far more common than they should be, and I'm going to keep fighting against that until America's c-section rate falls below 10%. Because I care about women, whether they return that sentiment or not.


Resource I couldn't link to:
Althabe F, Belizan JF. Caesarean section: The paradox. The Lancet 2006;368:1472-3.

Wednesday, October 1, 2014

Check Out My Spiritual Side

I'm going to start blogging for My New Name is Mommy, a blog for moms with a spiritual twist. My first entry is a piece about how the Jewish High Holy Days cause me to reflect on my parenting. I hope, no matter what your religious views, you'll take a moment to check out my piece! And L'Shanah Tovah to any Members of the Tribe out there!