My Baby, My Belly, My Decision: Maternal Choice C-Section

In the last couple of years, elective C-section has become one of those topics that magazines and news organizations love to jump on—it’s easy to illustrate with candid pictures of pregnant celebrities (hello, Britney Spears!) and it’s instantly combustible. Just put it out there and watch as another battle in the Mommy Wars sparks into action. When Victoria “Posh Spice” Beckham gave birth to her son Brooklyn via C-section in 1999, the British tabloids couldn’t resist the perfect headline: Too posh To push. Plenty of other boldface moms who’ve elected to have C-sections, such as Madonna, Claudia Schiffer, Elizabeth Hurley, and Denise Richards, have helped keep the trend in the news. When a mother-to-be on one of those ubiquitous childbirth reality shows announced that she wanted a C-section because vaginal birth was “barbaric,” message boards all over the web lit up with women excoriating her “idiotic” beliefs.

Slowly but surely, the women who choose C-sections are starting to fight back. On blogs and online magazines, they are explaining, sometimes angrily, and always passionately, that the decision about whether to have a child vaginally or surgically is theirs to make. They are going into this choice fully informed and completely in control. They are doing what they think is best and safest for themselves and their baby. They want the critics you to send their guilt trips somewhere else.

The way the media has painted this picture, you would think that millions of women were lining up at hospitals, swiping their credit cards, and asking if they can be out in time for their manicure appointment at noon. But while elective C-section is a growing trend, it is still a relatively small slice of the childbearing pie: In 2002, an estimated 2.5 percent of all births were elective C-sections, up 25 percent from just two years earlier. It’s not a huge amount, but it’s still more than twice the combined number of women who give birth at home or in independent childbirth centers.

And though home-birth moms and elective-C-section moms would seem to have absolutely nothing in common— one side strives for the least medical, most mom-centric birth; the other chooses the least natural, most doctor-centric birth—I found an astounding number of similarities between these two seemingly diametrically opposed groups. First and foremost, both groups are criticized by mainstream moms as selfish and irrational. Other women hear about these types of births and make assumptions about the women’s motivations that are often completely off the mark. In fact, I found that some of the most outspoken critics of elective C-sections and home births alike had never even talked to anyone who had deliberately made either choice.

Are there women who choose to have a C-section simply because they can’t be bothered with the inconvenience of a vaginal birth? Possibly. Though if convenience is all you want, you can always pick a date to induce vaginally, and since you are required to both stay in the hospital longer and recuperate at home longer for a C-section than for a vaginal birth, it’s not as if you can be off to your tennis game the next day. Are there women who choose a C-section solely because they think it is unladylike to scream and grunt and then shoot a baby out of your vagina? There may be, but I didn’t meet them.

Again, just like the home-birth women I met, the women who chose C-sections did it because they felt, in their particular case, that it was the safest, healthiest, most empowering option. Most of these women were over thirty-five—some were over forty—when they had their first child, and they knew that the odds of ending up with a C-section even after putting forth their most valiant effort at a vaginal birth were uncomfortably high. So instead of passively waiting until they or the baby were in distress, they preferred to take charge of the situation and plan a nonemergency C-section, which has a lower risk of complications and an easier recovery than a C-section after attempted vaginal birth. “I was forty-four when I had my son, and I found out that women my age had a much higher risk of placenta previa and a more than 40 percent chance of having a C-section,” explained Marie, a former lawyer and mother of one in New York. “My doctor also had her first child after she was forty, and she had gone through a very difficult labor, so when I asked about a scheduled C-section, she thought it was a wise idea. I think instead of romanticizing the idea of childbirth, I just looked at it in a very logical way, and this made the most sense. My partner had seen her sister go through a very painful birth process, so she completely supported my plan.”

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