I want to defend unnecessary cesareans.
I have a personal stake in this. I had a c-section. I didn’t want it. My baby’s head was turned sideways, facing my right hip (occiput transverse). I had been through 4 weeks of prodromal labor, with painful, productive contractions, followed by 24 hours of active labor. I had an epidural and artificial membrane rupture after about 15 hours labor, but no pitocin. I pushed for 5 hours, before the OB gently explained that I was doing everything right, but she didn’t think vaginal delivery was a possibility.
I held back tears until my husband left my side, and then I sobbed. I sobbed while the anesthesiologist reassured me and I sobbed while the medicine in my IV burned and stung me and I sobbed when my husband came back.
I had been told that I could avoid a c-section if I educated myself:
- “MY List of Things You Can Do to Avoid a C-Section….Education for both husband and wife.”
- “Educate yourself and research!”
And if I believed in and trusted myself:
I was educated. I did trust myself. And somehow a c-section was still happening to me. I was terrified of what would happen to my relationship with my baby, and I was so scared of what I expected to be weeks or months of painful recovery:
- “Because you don’t have the normal flood of hormones that accompanies natural labor and delivery, your ability to bond with your new child will be greatly inhibited.”
- “it’s extremely painful to support a baby for breastfeeding after going through such major surgery in the abdomen”
- “The minimum recovery time for a cesarean is 6 weeks, and that’s without complications….It took at least 6 months for me to start feeling semi-normal
- “Depending on the events leading up to a cesarean and the care provider, c-sections can be emotionally traumatic.”
You know why my c-section was traumatic? Because I felt like it was my fault. Because everything I read about c-sections treated them as something that happens to women who are uneducated and don’t advocate for themselves. Because I had bought into the idea that, if you don’t give birth vaginally, you did something wrong.
I don’t know if my c-section was necessary and I never will. Maybe if I had been somewhere without access to modern medicine, I would have been in labor for a few days, vomiting, in mind-warping pain, increasingly weaker and more exhausted, and eventually her head would have turned and I would have given birth vaginally.
Would that have been better?
Would that have been the way an educated person gives birth?
But I will never know if my c-section was necessary, and that gets to the crux of why I want to defend unnecessary cesareans: because of the gray area. C-sections are a great example of a signal detection problem.
1. True positive: A c-section is necessary and performed
2. True negative: A c-section is not necessary and not performed
3. False positive: A c-section is not necessary, but performed
4. False negative: A c-section is necessary, but not performed
Now, think about the consequences of 3 and 4:
- A c-section is not necessary, but performed: Well-documented risks of complications increase.
- A c-section is necessary, but not performed: Death or permanent injury of mother, baby, or both.