Belly Up

* bellies * birth * babies * breastfeeding *

Monday, April 16, 2012

Beyond Healthy Babies and Healthy Moms

Yes, there is really is a ribbon
for everything, including cesarean awareness.
April is National Cesarean Awareness Month, so it seems as good a time as any to wade into a topic I have wanted to write about for a long time but that I have feared writing because the topic is more personal for many women than my typical posts.  I want to talk about why birth matters and I admit  I also want to respond to any person who has ever made a comment such as, "If baby and mom are healthy then that is all that matters...who cares how the baby got here?"  I am here to say that many people *do* care and that more should. 

Having a vaginal birth is not just about the warm fuzzy feelings a woman gets by pushing a baby out, though these do often come as part of childbirth (but not always).  However the experience is secondary to the life long health benefits that a vaginal birth can provide for both the mother and child.  As I do know many women, either by choice or through circumstance, have had c-sections it is important to say that I am not discussing these benefits in order to say that one group of women are better moms or that another group has children that are  ________ (fill in the blank with stuff like smarter, healthier etc) than others.  It isn't about that...really!  However in society's efforts to not hurt people's feelings, we miss the point that women need and deserve to know the truth.  We should be hearing this truth from our health care providers but all too often we are not.  Birth does matter!

Just a few stats:
Physical risks to mom during or caused by a c-section:*
-  double the blood loss as compared to vaginal birth,
-  1 in 25 women will need a blood transfusion
-  1 in 3 women will develop an infection on their incision or internally
-  1 in 154 will need a hysterectomy
-  1 in 2500 women die during a c-section vs 1 in 10,000 in vaginal birth.
-  increased risk for placenta increta, accreta and percreta which are life threatening 
-  increased risk for anesthesia complications and rehospitalization
-  abdominal scar tissue can create lifelong pelvic pain, bladder/bowel issues and pain during sex

Physical risks to baby:
-  respiratory distress syndrome
-  iatrogenic premature
-  persistent pulmonary hypertension
-  lacerations on the baby
-  babies born via c-section have higher rates of asthma and allergies
-  duration of breastfeeding is markedly lower for babies that were delivered via c-section.  (the risks of not receiving breast milk is longer than I can begin to address in this post.)

Physical risk to subsequent babies:
- increased risk of infertility and ectopic pregnancy
- increased risk of still birth, low birth weight and prematurity
- increased risk of having malformations or central nervous system injury

Not a short or fun list!. 

Women have feelings...
and they are not all the same.
Now, lets top that by getting emotional.  Some women will choose to have c-sections for little to no reason at all; others will want to avoid one if at all possible.  Others will be fine with the idea of their labor ending in a c-section if they feel it was needed but still find themselves disappointed or perhaps struggle with the difficulties of recovery and/or nursing issues caused by that recovery. Often when a woman has a c-section she feels like her body failed, that she failed her body...or that she failed her baby. She may grieve the experience and she may second guess herself or her careprovider. She may be happy, she may be sad, she may be angry, or she may be a confusing mix of all of the above.  However, what she is NOT is any less in love with her child or any less grateful to be holding him than the mom who doesn't express any grief over her experience.

Some people reading this will have had a c-section and think it totally rocked, and if that is you I am truly thankful that you had an good experience.  However, if you are someone who has ever made a comment to another woman about a healthy baby/healthy mom being all that matters, then please continue reading.  I truly believe that this type of comment is made in the spirit of encouragement, but it does the opposite as it expresses an underlying tone that mom's emotions are not acceptable and that as long as her baby is healthy that she does not deserve to feel emotional pain or to struggle with her physical recovery.  It also discounts the very real advantages of a normal vaginal birth and that a new mom has every right to at least feel a little sad that her baby missed no matter the reason her baby was not born vaginally.  

Yes, a healthy baby and healthy mom are the most important thing, but not the only thing.  A soldier coming home safely from the battleground is happy to be home, but his current state of health does not discount what he went through while he was there.  So if you have a friend or relative that has an unexpected c-section, ask her how she feels about it when you visit the new baby.  Affirm her feelings whatever they may be, even if they are different than how you think you would feel in her shoes.