Saturday, May 7, 2011

Planned C-sections Bring Greater Satisfaction Than Vaginal Births

In spite of a recent trend to demonize C-section and prevent women from getting one if they want to, research demonstrates that those women who  still manage to get their planned C-sections are a lot happier and less likely to suffer from postpartum depression than women who undergo vaginal birth:
The doctors found that women who planned C-sections were much more satisfied with their experiences than those who planned vaginal births. . . The study polled 160 women planning vaginal delivery and 44 planning C-sections. The women were asked eight weeks afterdelivery about their fulfillment, distress and difficulty. They rated their satisfaction with the childbirth experience on a scale from one to 100 and how they felt right after birth using descriptors such as "disappointed," "enthusiastic" and "cheated." Those planning C-sections reported higher satisfaction, higher fulfillment and lower distress and difficulty, and a more favorable overall experience than those planning vaginal birth. The federal Centers for Disease Control and Prevention reported that about one-third of U.S. women giving birth had C-sections in 2008, the latest data available. The number crossed all races and ages.
The main reason for the anti-C-section propaganda that we have been inundated with in recent years is the firm belief many still possess that true femininity is only achieved through pain and suffering. Consequently, women who plan to avoid the so-called "natural" childbirth have been demonized as not womanly enough. As this study shows, however, ultimately such women come out winning because they don't sacrifice their emotional and physical well-being to some medieval prejudices about what is and isn't "natural."

You can see how terrified our culture still is that some women might escape the horrors associated with vaginal birth in the language of the very article that quoted this important piece of research. In order to make up for the article's brave defense of planned C-sections, its author immediately proceeds to quote some unintelligent quack who obviously despises women for a living:
"How much this figures into an individual's psyche is nothing we can measure, because we can't do randomized studies by making some women have C-sections and some vaginal births," she said. "Instead, we absolutely should have more counseling. Labor is OK, and they'll survive. Most births go very well; there's no good evidence now to circumvent Mother Nature."
There is no doubt in my mind that the jerk who said this atrocity doesn't rely on "Mother Nature" when she, say, gets a toothache. I also don't believe that a dentist who'd tell her that pain is OK and she'll survive would not be her dentist for long. It will be especially funny if Nada Stotland, the woman-hater who made this statement, has ever used birth control, painkillers, reading glasses or tampons. The same goes for refrigerators, washing machines, computers, and all the other things that mother nature didn't provide us with but which we still use to make our lives easier on a daily basis.

26 comments:

Anita said...

I suppose this subject has to have its time on the platform, too, like everything else in life.

Personally, I say, let women have their c-sections if they want them, however, I suppose hospitals, insurance companies, and doctors say otherwise.

I had 2 unplanned c-sections and my 3rd one, planned. Didn't have the hardships of recovery as most do. Also, no leaky bladder caused by vaginal birth.

Once in a while, I see a baby being born on one of those "baby" reality shows, and I sometimes wonder what a vaginal birth would have been like...but, it's mostly a fleeting thought.

The means by which a baby gets here hardly compares to 18+ years of raising her or him. "It ain't no walk in the park." LOL

Kinda like, planning the perfect wedding, then having to face the reality of marriage.

I'm in the midst of both (wife and mother) and would do it over again, though, if I was re-born back into this world.

If you have time, read my post on vaginal/c-section. I've strayed from your point, but it prompted memories for me.
http://btdas.blogspot.com/2009/09/vaginal-vs-c-section.html

Anonymous said...

I hope that one day in the future women will not even have to carry babies, if they do not wish to do so -- artificial wombs.


-Mike

Nora said...

This post puts me in mind of how almost every pregnant person in TV/movies/chick lit ends up giving birth without any kind of pain killers (usually because they got to the hospital too late for them to be administered). People really don't want to see women doing something that men can't without being immediately punished, it seems.

Xtra said...

The most important factor, is the woman having the choice. With full information of the options and possible consequences. I had all my children vaginal with no epidural. I had all the information plus saw friends go though child birth and made my decision accordingly. I do not regret it. What worked for me may not work for other women. My problem is how doctors force a certain choice on women for their personal belief or pocketbook. Also, there are women on lower income levels whose only choice is what the doctors chooses.

Natasha from Russia said...

My personal experience shows that Cesarean section much more painful and heavy, than vaginal birth. But it only my experience and I can't do on the basis of it conclusions about other women. I know one, the woman should have a choice and only she has the right to choose, as to it to give birth.

Tim said...

Did the study just distinguish between vaginal birth and ceasar section ?

Because I think it would be interesting to know if the other methods would make a difference in happiness or satisfaction. I mean thinks like being at home or giving birth in a bathtub and doing it with or without epidural anaesthesia.

Clarissa said...

"I hope that one day in the future women will not even have to carry babies, if they do not wish to do so -- artificial wombs."

-Hear, hear!!

Natasha from Russia said...

"I hope that one day in the future women will not even have to carry babies, if they do not wish to do so -- artificial wombs."


Wait, this way is and now and it is called substitute motherhood

Clarissa said...

Surrogate mothers are not artificial wombs. They are just poor women who will do anything in order to make some money.

Anastasia said...

I don't know. Femininity aside, a C-section is major abdominal surgery and it's associated with a much higher rate of complications including maternal death. The maternal death rate in the US is higher than any other industrialized country--none of which practice c-section at the rate we do. Correlation is not causation but given that maternal deaths are more common with c-section, I think we can infer a connection.

So I don't think the issue really has anything to do with femininity or a cultural terror that someone might escape the horrors of vaginal birth. It has to do with outcomes. C-section is a necessary intervention in some cases. As an elective procedure, it's irresponsible medicine.

Clarissa said...

I've seen my sister 15 minutes after this so-called "major surgery" and now nobody will convince me that it is in any way more risky than being in labor for 38 hours and having your vagina torn into shreds in a way that prevents you from sitting (let alone having sex) for 2 months afterwards.

Maternal deaths are ONLY more common with EMERGENCY c-section. Which is different from elective c-sections. The latter an extremely low percentage of complications. The whole procedure takes half an hour. So let's not buy into the anti-C-section mythology.

michael said...

Clarissa C-sections are not only more dangerous when they are emergencies, but that does heighten the risk. t

Furthermore not every vaginal birth with or without pain meds is extremely painful, though they can be.

I believe a woman has the right to chose a c-section if she wants, but I do not believe most women are given adequate warning of the risks that can go with it, same as the risks associated with laboring with paid meds.

I also think that if the study included natural births/home births the results would be different. I am speculating that the satisfaction in both planned c sections and natural births would be more even because in both situations their is a higher chance that the mothers wishes are being respected, unlike in many vaginal births.

I personally favor natural/home birth because it seems to me to be a lot safer and more intimate, but I respect every womans right to chose her birth. I just don't believe c-sections are being demonized primarily to punish women... there are many in the natural birth movement who encourage women to labor without pain meds not to make them suffer but instead to show them how joyous and empowering a natural birth can be.

Clarissa said...

I especially adore men who try to enlighten women on how to give birth. I wonder why these folks don't realize how ridiculous they look.

Maybe you should go and empower yourself with a joyful natural birth, Michael, instead of spreading insulting inanities on my blog.

J. said...

Well, Michael didn't footnote, and he is, after all, a Dude, but I actually think he makes some good points...(he should know better than to preach on this topic, though...)

Just as there's a lot of negative mythology around the C-section, there's I think even more around vaginal birth. Most of the stuff that could leave a vagina "torn into shreds" and prevent normal activity and stuff is from medical interventions that happen during medicalized hospital childbirth, epidural fever, interventions, Pitocin-induced contractions, and so forth--there's not enough awareness of what "normal" birth is like, because very few women get to have them, so vaginal birth is blown up into this horrible painful body-destroying event.

Of all my friends who've given birth, I'm the only one who didn't have epidural or C-section, and I'm the only one who was able to get up after birthing and walk on my own power to the nursery where the morons had insisted my baby had to go after I birthed him. Other "natural" birth moms I've talked to have said the same--you do it, and it's DONE, and life goes on. Yeah, sure, it hurts, but it's not THAT bad.

I don't say all this to come down on one side or the other of the elective C-section debate, I just kind of wanted to offer counterpoint to the "who are these crazies trying to prevent women from these painless easy elective C sections so they can have these horrible vagina-shredding births" perspective.

(though I admit I was utterly uninterested in sex for the full two months and then some...but that wasn't because of my shredded girlparts, it was because I was sleep-deprived to the point of insanity...)
--J

FD said...

This study isn't about health outcomes but about emotional reactions so I'm not going to get sucked into the rabbit hole of the 'wonders of natural birth'.
I have a piece of anecdata which is relevant. My sil has had a vaginal delivery both in the US and in the UK. Her opinion is that while the technical standard of care was higher in her US hospital, with internal uterine monitoring and the obstetician in near constant attendance, she felt powerless and miserable and stressed because decisions were made over her head, she wasn't able to walk, she had to have an epidural due to no other form of pain relief being available, and the OB insisted on an epistotomy after the pitocin she was given (against her wishes, and despite there being no fetal distress) 'jump started her labour'.

She contrasts this with the 'lower standard' care she had under the NHS where the delivery was largely midwife driven, and she saw the obstetrician three times over a 20hr labour - on admission, when they discussed what to do about labour stopping, and then again for 'catching' duties. He was available for emergencies, but not obtrusively present. She was allowed to walk when she wanted throughout the birth, was given entonox for pain to self administer as necessary and also some pethidine at one point. An epidural was also offered, but when she said she'd rather not there was no attempt to push one n her. When her labour slowed, they discussed it and decided that as there was no fetal distress intervention was not appropriate. She mentioned that she'd had pitocin before and the OB said that he'd rather they tried a nice warm soak in the birthing pool and a walk first before he used drugs.

Even though comparatively it was crowded and low tech and a little shabby, she far preferred the UK experience, and more importantly, came home feeling happier, less stressed and in her own words, empowered, because as she put it, 'they listened to what I had to say about my body and let me have input into what was happening, and allowed the birth to happen on its own schedule rather than intervening to keep it to a timetable.'

If that kind of intrusive intervention/powerlessness and consequent negative feelings is common to vaginal deliveries in the US, I would venture to suggest that it's not at all surprising that women who have planned caesareans feel better about the process - at least then they are calling the shots and aren't being made to feel like an object that isn't co-operating.
I suspect what this study really shows isn't that caesareans are mentally better for women - it's that there's room for considerable improvement in obstetrical care and the way women in labour are treated.

heyjudi said...

I agree with Anastasia. As a (once upon a time) licensed doula and birthing coach, as well as a mother of two, I have a vested opinion on this matter.

I think medicine and myth have hyped vaginal birth to monstrous proportions. These two culprits have made women AFRAID of their bodies and the consequences of vaginal birth. VB has been demonized and taken women away from the idea that they have control of their bodies and don't have to be afraid of them.

While I would never argue against women having their own choice in the manner of their delivery I do feel that vaginal birth deserves a more favorable platform.

A woman who goes into childbirth with full knowledge and understanding of the mechanisms of childbirth and with a working knowledge of how to MANAGE a vaginal birth can have a positive experience. Hearing horror stories and trigger words/statements such as, "38 hours of labor and a shredded vagina . . . " contribute to the fear. The average labor time for a first time mother is 14 hours. The first 12 hours are mild contractions. There is usually 45 minutes to 1 hr of hard contractions during transition, and then the actual birth. My vagina is none the worse for wear and I was up and running after each birth because I took care of myself before, during and after my pregnancies. In fact, 1 week after my second son's birth, I was facing my OB/GYN across a net at a volleyball court.

The healing time involved in a C-section is much longer than the 2 months you allotted for sex after a vaginal delivery.

Furthermore, the medical industry pushes for more C-sections these days because, let's face it, the doctor AND the hospital make a lot more money from a C-section than from a vaginal delivery. On top of that, you have to realize that many doctors don't want to invest 12-20 hours of waiting on a mother to vaginally deliver . . . they're missing tee time at the green because your slow ass can't push that baby out in a time frame that is more convenient to her/his needs.

I watch shows about mothers giving birth and every time I hear of the doctor inducing the birth because "mom is a week overdue" (even without sign of distress to baby or mother), or "mom's been in labor for 7 hours and I think it's time to start thinking about a C-section" I CRINGE. Induction and C-sections raise the risk of death to mother and child exponentially.

At the heart of this post though, please realize that my point is that vaginal birth is not the monster the media has made it out to be. Between older women liking to share their "horror stories" of child birth and the mind boggling array of misinformation out there regarding VB, it's no wonder women are afraid of it. I see it this way: the medical establishment (and the media) are taking the power of vaginal birth away from women; they are trying to take away from us an experience (and the control of the experience) that men cannot share.

I say OWN your vagina- don't fear it. Trust your vagina, it knows what it's doing.

Anonymous said...

I hate to crash in and post a comment on a blog as a complete unknown, but I was so struck by the stridency of your post that I felt compelled to tell my own story.

Clarissa, you seem to view c-section as some sort of easy peasy panacea to childbirth when it really isn't that simple. I know others were suspicious of what Michael had to say as a man, but as a woman I pretty much agreed with everything he had to say. I had a c-section with my first pregnancy that went horribly wrong. I hemmorhaged badly, necessitating a transfusion that required I have follow up HIV testing for a year afterwards. Worse yet, I developed a septic post-operative infection that required an additional week in the hospital post-partum and that literally almost killed me. I was unable to get up and walk around, let along carry my babies (twins) for almost a month after my hospital discharge, and now almost 6 years later I continue to have complete numbness in the area surrounding my incision site.

A year ago, I had a drug-free VBAC, and the experience was like night and day. Even though my baby was over 8 pounds, I had no tearing and only had to push for maybe 30 minutes or so (I was in labor for maybe 8 hours total.) I was up and moving within an hour after giving birth and got to go home a day later. Not having to worry about caring for a c-section incision freed me to care for my kids and go back to living my life so much faster than before.

I absolutely agree that women should be given the choice of how they want to birth their babies, but they need to be fully informed of all of the benefits and drawbacks. Pointing out that there is an increased risk of infection and other complications related to c-sections v. vaginal birth is not being unfairly critical of the subject, it's just stating the facts as they are. And stating with certainty that vaginal birth tears a women's vagina to shreds is scare mongering and untrue. My vagina is doing just great, thanks for asking. I was actually able to get back to sex much sooner after my v-birth as opposed to my section, mostly because I didn't have the lingering pain and numbness from another surgery. Please don't assume that all women experience birth exactly the same way regardless of their circumstances, it's simply inaccurate.

Clarissa said...

Doulas and "advocates" of vaginal childbirth, when I talk about 38 or 44-hour-long deliveries and torn vaginas, I don't tell "horror stories." I narrate experiences of people I know and care about. Please have some respect, OK?

"mom's been in labor for 7 hours and I think it's time to start thinking about a C-section" I CRINGE. Induction and C-sections raise the risk of death to mother and child exponentially."

-It's scary how dense people become whenever this conversation begins. We are talking ONLY about PLANNED C-sections here. Do I need to repeat this for the fourth time, or will people finally get a clue?

Anonymous said...

I certainly didn't intend to sound disrespectful in my earlier comment, were you specifically calling out my comment or were you speaking more in generalities?

I'm also unclear on whether or not you are denying flat out that c-section brings an increased risk of certain complications (such as hemmorhage, thrombophilia and infection) are if you are taking the position that it isn't statistically relevant to the discussion at hand. This article is a little old, but it clearly sets out the statistical increase of these and other c-section related complications:
http://www.medscape.com/viewarticle/739458_4

I honestly don't intend to pick a fight with a stranger on the internet, as I already stated earlier I think women should make the birthing choices that they believe will be best for them. But like all medical decisions, it needs to be fully informed and not done in fear of something that may very well not come to pass. There are pluses and minuses to both c-section and vaginal birth, not all sections are traumatic or complicated, but nor are all v-births. There is a more measured path that can be taken in this discussion, and I really do think that these sorts of discussions can feed back into some of the old, crazy cultural prejudices regarding women and our vaginas. Specifically, that they are always scary, poorly functioning organs that can't ever be relied on to do their intended purpose correctly and that we need men to step in and set it all to right for us.

Lolagirl/Anon @10:34

Clarissa said...

Tell me, do you make the same speeches at the blogs of people who advocate flossing? Do you also insist that the suggestion to brush one's teeth positions our mouths as 'scary, poorly functioning organs that can't ever be relied on to do their intended purpose correctly'? How about hair? Do you brush it, tie it, maybe even cut it? Or just let it do it thing as nature intended? How about your stomach? Do you fill it with raw meat and unwashed bits of grass? It isn't like nature intended for stoves, pots and pans,etc.

And what on earth does this have to do with men stepping in anywhere? Do you suggest that there are no female doctors?

Why is it that this vile anti-C-section propaganda is always so full of completely ridiculous inanities?

michael said...

For the record "Michael" -me, is actually a female. I was signed into his account by mistake. Does that make my comment any more deserving of an actual response vs being told to take a hike?

michael said...

For the record "Michael" me- is actually female. I was signed into my bfs account my mistake.

Does that make my comment more deserving of an actual response vs being told to take a hike?

Clarissa said...

And now there are two of you?

The so-called "home births" are extremely irresponsible and stupid. I think people who believe the load of BS that money-hungry doulas and natural whatever advocates sell them and agree to these "home births" are either extremely stupid or have serious mental issues.

I pity their children profoundly. If their parents are wishing to put them at risk the second they are born just to feed some irrational fear of doctors, I can only imagine what kind of monstrosity awaits these poor kids later on in life. No vaccination? Homeschooling? Forced church attendance?

Brrrr.

liese4 said...

I had a homebirth with my firstborn, not because I thought it was cool or safe or neat, but because at 35 weeks pregnant my doctor dropped me as a patient for non-payment. I guess I could have tried to be an indigent patient, but instead we went shopping for midwives and found one who took over my care. I had a healthy 6lb 10oz baby boy after 38 hours of labor (but really only 5 or 6 of that was hard labor) I went to a wedding two days after his birth and was fine.

I can not comment on planned c-sections since my other 3 children (all girls) were all emergency c-sections and I guess that has a different outcome than planned ones. All 3 were painful and I'm about to go in for hernia repair that is from the last one (and my 'baby' is now 6!) So I really can't comment on 'planned' c-sections, maybe if it were planned it is easier, I don't know. I'm just glad I had a chance to try two types of birth, I know what a vaginal birth is like and I know what an emergency c-section is like.

Of course you know we homeschool, and that goes for the homebirthed child and the c-section ones. It wouldn't have mattered if they came out planned, unplanned, emergency or otherwise, we'd have still homeschooled them. My son is graduating, age 16, and will continue his college classes in the fall (he made a 95 in his English class and was glad he went to the class.) We don't homeschool to separate from society, we don't homeschool to create geniuses, we school this way because each of our children are unique and this is the best way to let them pursue dreams and goals that aren't always 'core subject' related (ie, marine biologist, musician, pilot and I don't know what the 6 y/o wants to be....yesterday it was a purple puppy.)

By the way, you used to live in Canada right? I have an art co-op coming up and we're doing Emily Carr's trees. I wonder if you ever came across her art while living in Canada and if you know anything about her style. I'll have ages 4-16 in my class, but we're striving for Carr's artistic style in tree paintings and gathering some info about her life.

Clarissa said...

'because at 35 weeks pregnant my doctor dropped me as a patient for non-payment'

-Gosh, that's horrible. I had no idea doctors were even allowed to do that.

I don't think I know who Emily Carr is, sorry! If you end up blogging about this class, feel free to share a link.

liese4 said...

'because at 35 weeks pregnant my doctor dropped me as a patient for non-payment'

-Gosh, that's horrible. I had no idea doctors were even allowed to do that.

Ethically or morally? I think that either way he was wrong, but patients with no insurance are made to dwell in the 'beneath society' status. The last thing a first time mother-to-be needs is the added stress of where she is going to have her baby!

I will give you the link, the class isn't until the 25th, so I still have a week and a half. I got 3 gorgeous books from the library to show the kids, here's a link to some of her art.

http://bcheritage.ca/emilycarrhomework/main.htm

She brought the native tribes of Canada to the masses and in some cases preserved their art and stories for us. Besides I love trees, so I think her art is beautiful.