Houston, we have a problem! The rate of cesarean birth in this country is out of control. Currently, the national average is 32.2% ! This is a major public health issue and one that is being looked at by many different organizations. You can check out this great information through Every Mother Counts and Dr. Neel Shah about this situation. My purpose in writing this piece is not to break down this multi-factorial issue, as this is being done by others. I have a different purpose in mind. If you are familiar with my recent writings, you will know that I am in the midst of attempting a language revolution in maternity care. In earlier pieces, I addressed Community Birthing and the concept of Physiologic Cord Clamping.
As a midwife, I have a statement that often shocks people; “I love a good cesarean birth!” This statement is important for two distinct reasons. First, like most available interventions, cesareans have a time and a place when they are exactly the correct thing to do. As a provider, I always want to have access to a safe cesarean for the few families who will truly need one. Unfortunately, like many available interventions in our current system, cesarean’s are being over used at epidemic levels. Cesarean Birth is a life-saving surgery, however, it is not risk free and has the potential for serious complications for both the pregnant person and the newborn. You can read about these here. So, like any intervention, we must always weigh the risks versus the benefits and use them with caution.
But, the second reason that my statement is important brings me to the whole purpose of this piece. It is in using the term Cesarean Birth versus the term Cesarean Section. I started to develop a serious disliking of the term cesarean section as a nurse. I worked on the L&D unit at a major university teaching hospital, it is a fantastic hospital and I was blessed to be able to work and get experience there. However, it is an institution and like any institution has its own culture. This culture is what I had most of my problems with. Analyzing the culture of hospitals and what it does to providers, staff and patients is worthy of its own study. I will break out this one little piece; often patients are reduced to a nuts and bolts description of their condition. For example, “the bypass in room 12”, the “knee replacement in room 10” or “the section in room 4”. Now, the vast majority of the time, the staff does not mean any harm with this lingo, it is a type of shorthand in the busy atmosphere of a hospital floor. The problem occurs when using the lingo becomes so wrote and automatic, used in all references to the patient so that it over shadows the humanity of the person. A person who just gave birth via major abdominal surgery is a parent who has just welcomed a child to the world, a parent who needs extra care and support to navigate that process. Continuously distilling these patients down to “the section” erodes their innate person hood and reduces them to a stark, clinical fact. Therein lies the problem, losing the humanity of the woman in the technological culture of the hospital.
Next, there is the complete erasing of the fact that this person, did in fact, give birth. The process of becoming a parent is complicated and long. For many, it starts with the first knowledge of pregnancy and goes through many stages as that pregnancy progresses. An integral part of this process is the birth itself and how that birth is managed and treated can have a huge impact on the entire family dynamic and the parents it creates. For many women (I am speaking specifically about unplanned surgeries, some women may choose a planned cesarean for a variety of reasons and are confident and comfortable with that choice), giving birth via cesarean is a traumatic outcome; one that was not planned and often occurs in response to a complication. This can leave them feeling overwhelmed, guilty, sad, angry or confused. They can also feel grateful and relieved that the intervention was available and safe. They can also feel elated and full of joy about their newborn. And they can feel all these emotions at the same time. When we reduce this experience down to “a section” or “being cut” we are undermining their experience of birth and potentially their healing process. So, let’s replace cesarean section with cesarean birth to acknowledge the beauty, strength and accomplishment of bringing forth life in which ever way possible or necessary.
What are your experiences with this topic? I would love to discuss your thoughts and reactions here….
Image credits Monet Nicole