April in C-Section Awareness Month. This is MY story, my experience, my truth. This is not intended to diminish your journey.
A lot of emotions come up when I think about the birth of my oldest daughter, Zelda. Mostly the emotions are negative: grief, utter sadness, disappointment. Why didn’t my OB have my best interest in mind when suggesting an elective induction instead of having me go home to stay in bed & rest? Why did my OB completely ignore my written “c-section” plan that I had “just incase”? Why were strange Dr. men I will never meet again putting their hands up my vagina when there was no medical indication to do so? Why were my only two options to use a vacuum or have a c-section, when I could have just taken a break to sort out my thoughts and options? Why didn’t anyone tell me I would experience extremely painful gas pains post-cesarean, postpartum depression, & trouble breastfeeding?
RELATED READING :: You Can Ask Why I’m Having A C-Section
I’ve never questioned my ability to give birth. But I have questioned the medical model as a whole, the lack of respect and care given to many women, the money making interventions, the non-peaceful hospital settings, the pockets of America that have little to no resources for women who need help with breastfeeding, overcoming birth trauma, and postpartum mental health support. I mostly blame myself for the outcome of what turned out to be an unnecessary c-section with my first born. I was extremely uneducated about birth, breastfeeding, and my birth options. When I first found out I was pregnant, I daydreamed about a birth center birth or even a home birth. However, after realizing the closest and only birth center in the area was an hour away and didn’t take my insurance, I quit seeking information (definitely wish I hadn’t closed that door). I didn’t even bother to find more information on home birth. Mostly, because I assumed I couldn’t afford it and no one in my “circle” would have been supportive of that. Not being educated in my birth options is ultimately what landed me in my final destination of a cesarean, extended hospital stay, postpartum depression, and a failed attempt to successfully breastfeed.
On the other hand, that experience sent me on a mission to do better- for myself, for my future children, and for other moms and their babies. A few years later in 2020, I set out to change my career to prenatal and postpartum fitness, which eventually bloomed into birth work. In 2021 I became pregnant with my second daughter Esther and I knew things must be different. I would not fail in the ways I did previously and I would come out victorious in my birth desires. I spent the entire pregnancy preparing myself mentally, physically, spiritually, and emotionally for a home birth. Aside from my education I was already going through to become a Birthfit Coach, I read every book I could get my hands on, listened to podcasts, read articles on the internet, got weekly chiropractic care, went to a free pregnancy and postpartum support group, surrounded myself with people that supported my birth desires, hired an amazing Midwife, meditated and prayed daily about the birth of my Esther. On November 18th at 12:57 AM, I brought my daughter into the world in the peace and comfort of our home. Something I had desired so badly for my first daughter I got to experience my second. What I deserved to have with my first daughter and didn’t get- I got to experience with my second daughter. What was just a look at my first daughter after she was removed from my womb & whisked away- was now hours of skin-to-skin with my second. She didn’t leave my sight.
After having an absolutely incredible birth experience with my second daughter came more grief and “stuff” to work through from my first birth experience. As parents we always joke “the first kid is the experiment”. In some ways it’s true. Sometimes we don’t learn from our experiences until they’ve already happened. Sometimes we can’t be prepared until after the fact. I’ve forgiven myself for the choices I made and the outcomes that happened. I made the best decision I could with the information I had at the time. That being said- just because I’ve forgiven myself doesn’t mean it’s still not painful to think about or that I won’t spend the rest of my life showering my first born with the physical love and affection that she didn’t receive as a newborn.
Unfortunately, my story isn’t much different from a lot of women in America. There are thousands–if not millions–of mothers who feel robbed of their first birth experience due to unexpected C-section. Believe it or not- there are thousands of women across America who choose to have a birth center or home birth after cesarean instead of having a VBAC in the hospital too.
I won’t give all the details of either of my birth story because I didn’t want to fill your head with another depressing C-section story. While yes, just like all mothers, my birth story is important too (good or bad)- but as a birth worker I also want to highlight some information that I think all pregnant mothers should know about cesarean sections (that I DID NOT know as a first time mother) and some information about out of hospital birth in America. Had I known this information, I would maybe have made completely different choices in my first birth.
- The national cesarean rate in America as a whole is 32.1%, this is a 60% increase since 1996. The national rate has steadily increased since hospital birth became the new normal. On the same hand, the maternal mortality rate has not decreased. ACOG & the WHO recommend a cesarean rate of 5%-10%. Anything over 10% has not been proven to increase maternal mortality rates.
- You can call the hospital you plan to deliver at and ask what their cesarean rate is for first time moms. You can even make your OB a little uncomfortable (probably) and ask them what their personal statistics have been the last 3-5 years. It may take some time for them to get this information to you, but they do have it. Why would you do this? Because it will give you an idea of the chance that you may have a cesarean with that particular OB. You may find that some have a 5%-15% rate while others have a 20%-35% rate. You may also consider asking what percentage of their clients who are considered “low risk” end up being induced.
- Just like hospitals, birth centers and home births midwives all have different stats based on their practice, but there is a national average. Birthing at a birth center or at home, transfers to the hospital are around 10%. And of that 10% less most are non-emergent. The main reason for out of hospital transfer is due to maternal exhaustion. Meaning the mother seeks more rest via pharmaceuticals (like an epidural), IV fluids, or maybe an elective cesarean if she has had one previously.
- Birth Centers and home birth midwives have cesarean rates of 0%-10%. If you’d like to know more details, you can call your local birth centers & midwives you’re considering for your delivery and ask them of their previous and current stats. They’re usually happy to share due to the excitingly low percentage of transfer and cesarean rates.
- Successful VBAC (vaginal birth after cesarean) rates in the hospital are as low as 13% on average. I personally consider this unacceptable! This low success rate is not just because “moms can’t do it”. Much of this has to do with the fact that some hospitals will not even allow women to try for a VBAC! This is completely unacceptable & takes away a woman’s right to birth how she desires! On the other side of this- birth center & homebirth VBAC rates range from 60%-90%! To get more clear on current stats in your area, call your local hospitals and midwives!
Always remember that you have a say in how your birth goes. You have a right to know the risks/benefits of every single medical procedure that is done to you and your baby in order to make an informed decision. Hire a doula to help advocate for you and your family! You deserve to feel respected and cared for.
Check out some of these links below to find out more about cesareans in America, VBACS, & your birth options:
- The 5 Most Common Reasons for C-section (and How to Avoid Them)
- Changes in primary and repeat cesarean delivery: United States 2016-2021
- Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician – PMC
- Homebirth Study One-page Fact Sheet | Midwives Alliance of North America
- WHO statement on caesarean section rates
- Transforming Maternity Care in the United States – PMC
- Evidence on: Doulas
- EBB 113 – The Evidence on VBAC
- International Cesarean Awareness Network