Why I Had an Elective C-Section
elective c-section

Why I Had an Elective C-Section

Early in my pregnancy, I realized that there are things you should say and things you should not say.

This is perhaps always true in polite society, regardless of whether you’re hosting a small human in what used to be your abdomen. But pregnancy, in my experience, tends to come along with an audience—and audiences expect a performance.

The following lines generally go over well:

  • “Oh my goodness, my feet are so swollen—not that I can see them!”
  • “Boy or girl, we just want a happy, healthy baby.”
  • “The nursery is coming along great—now if only dad would put together that crib already!”

These aren’t as well received:

  • “Excuse me, but I am afraid that I am peeing on my feet as we speak. What’s going on down there—can you see my feet?”
  • “The more girls I spawn, the more powerful my coven.”
  • “Our reality star President just withdrew from the Paris Climate Agreement. I have not picked out nursery colors yet.”

But if you really want to alienate your audience, drop this bomb on them when they (inevitably) ask about your delivery plans: “I’m having an elective C-section.”

An Unexpected Alternative

I didn’t necessarily set out to have a cesarean section. Going into pregnancy, I assumed it had a good possibility of ending in some good old-fashioned pushing and pulling.

Was I looking forward to it? Not exactly. My people don’t have a great track record at delivering babies—my grandmother, mother, and sister all had to have emergency C-sections—but there’s a first for everything, and I was prepared to try.

But during one of my first prenatal appointments, as we were discussing birth plans, I mentioned to my doctor that I was kind of, sort of, maybe hoping I would end up needing a C-section…

“You don’t have to need one,” she replied matter-of-factly as I tiptoed around the issue. “You can choose one.”

This was news to me. I thought a C-section was only offered after natural labor didn’t progress, or if there was a medical emergency. Whereas I assumed the Angelina Jolies of the world could skip the whole labor business, I didn’t realize that I could, too.

But yes, my doctor informed me. When appropriate for the individual mom and baby, she would schedule an elective C-section, as would many of her colleagues.

Now, to be clear, if my doctor had recommended I give birth in a yurt while doing a headstand underwater, I would have lit some incense and done my best to om that baby into existence—I trust doctors, especially my own.

But thankfully, she didn’t. She laid out the facts, told me to think it over, and sent me on my way as if having a voice in your pregnancy was a perfectly normal, everyday occurrence.

Weighing the Risks

To be clear, like all surgeries and like vaginal deliveries, C-sections come with risks, and my doctor made sure I understood them all.

Studies have shown that having a cesarean delivery increases the risk of major bleeding in future pregnancies, and can lead to respiratory distress in babies. There’s evidence that passing through the birth canal helps to expose a baby to important bacteria in the mother’s gut (although there’s also evidence that breastfeeding produces the same effect).

But there are also some benefits to the procedure. C-sections may reduce the risk of incontinence—which, although not life-threatening, can be life-altering for the mother. Fetal trauma and birth injuries can be reduced by cesarean deliveries, as can labor complications such as fetal heart rate fluctuations.

After I returned home from my appointment, I discussed things with my husband (who, although a bench player at best, was a valued member of Team Baby). Once we decided that a C-section was the right choice for us, I assumed I was done talking about it.

Which was, of course, a rookie mom mistake.

A Note on”Helpful” Advice

For whatever reason, just as people feel comfortable touching pregnant bellies, they’re comfortable giving medical advice to pregnant women. For 32 years, the only person who cared about my health was my own mother. But suddenly, near strangers were Very Concerned.

As a warning, if you ever accidentally say, “I’m having an elective C-section,” be prepared for your pregnancy audience to respond with the following:

  • “My [acquaintance who is not a doctor] told me [a semi-fact about C-sections].”
  • “You should really talk to my [medical-ish practitioner who did not go to medical school].”
  • “I was reading [a thing that’s not a medical journal] and it said [another semi-fact about C-sections].”
  • “It’s [not natural/the easy way out] and you’re being [a synonym for selfish].”

I’m not sure why people seem to have so many opinions about the “right” way to have a baby. Part of it, I think, is that when someone makes a choice that’s very different from your own, it has a way of making yours seem less legitimate. (I am guilty of this on a near-daily basis. Do not choose a side salad over fries while anywhere near me.)

But there also seems to be a pervasive feeling that childbirth should be hard, that it must involve some amount of suffering, that those who decline epidurals and pain medication are somehow more virtuous.

At the time, I was flustered and unsure of how to respond to seemingly well-meaning (if not entirely unsolicited) advice. I mumbled something about the baby being breech at the moment anyway and changed the subject.

But now, nearly two years later, I have finally worked out my response: “My doctor and I are comfortable with my choice.”

Enjoying the ‘Easy Way Out’

I feel guilty admitting this next part, because I feel guilty about everything. I’m a mother, and before I was a mother, I attended 15 years of Catholic school. The very fabric of my being is guilty.

But guilty or not, it’s true: For me—and to be clear, I’m only speaking for me here—a planned C-section was very much the “easy way out.”

I knew the time and date of my delivery for months, so I was able to enjoy a leisurely day before checking into the hospital. I spent one last quiet morning with my dogs, got my hair blown-out, and took my final stroller-free walk through the city.

Once we arrived at the hospital, my husband, my mom, and I watched Friends reruns until I was taken into the operating room. Within a few minutes, the epidural kicked in, and the surgeon went to work. Before I could ask how long it would take, my daughter Matilda announced her arrival with a scream that sent the medical student running for cover.

Was the recovery fun? Not exactly. I needed significant help getting out of bed for the first 48 hours, and it would be a few days before I was comfortable standing long enough take a proper shower. I did stay in the hospital for four nights, but this was by choice—my nurses were amazing, the lactation consultants were just down the hall, and I knew it would be years before I would enjoy another breakfast in bed.

If my surgery had been a tummy tuck or breast augmentation—two elective procedures that we readily, and rightly, offer to women—I would probably look back on those first few days of recovery and say the pain wasn’t worth it.

But considering the payoff (an amazing baby) and the alternative (attempting to push that amazing baby’s 100th percentile head through my vagina) I’m more than happy with my choice.

C is For Choice

Choice is a word I’ve always liked when it comes to my body. I was lucky to choose to have a baby, and I was lucky to choose the way I delivered her into this weird and wonderful world.

I didn’t realize it at the time, but it was the last choice I’d make for a while. Newborns, as it turns out, are quite the decision makers. For the first couple months, Matilda dictated every minute of my day, from when I slept (never) to when I ate (rarely) to when I used the bathroom (typically an hour after I would have liked to).

Would I recommend my choice to others? Absolutely not. That’s the thing about choices—they’re entirely personal. What’s right for one body and mind may not be right for another.

But I would, if I may, suggest that we give others the space to make their own choices about their own bodies, even when those choices don’t align with our own experience and values.

Because being a woman is hard in 2018—and as I’m finding, being a mother is even harder.  The more we support each other, the more we can make sure our daughters grow up in a world with choices.

Featured image by Melissa Johnson
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