Whenever people discuss c-sections and natural childbirth, one well-meaning sentiment always rises from the fray:
It doesn’t matter how you give birth, as long as baby comes out healthy.
I appreciate people wanting to remove the judgment that often surrounds women’s choices and experiences. However, it’s disingenuous to say that how a woman gives birth doesn’t matter. I don’t want anyone dismissing my birth experiences as “not mattering,” simply because I got three healthy babies in the end. As one of the most significant events in a woman’s life, childbirth matters a lot.
Granted, taken alone and out of context, the means by which a woman gives birth doesn’t matter much in the big scheme of things. Having a c-section, an epidural, an unmedicated birth, or a forest birth in a pool of unicorn tears doesn’t define who you are as a mother.
But how you give birth does matter. More specifically, how you experience giving birth matters.
It matters how your doctor, midwife, or other caregiver treats you before, during, and after your birth.
It matters how much you educate yourself about the birth process and how knowledgeable you are about what’s happening with your body.
It matters how much you understand about your choices, how much support you have for those choices, and how empowered you feel to make those choices.
It matters how you feel about your childbirth experience throughout.
A birthing woman should, first and foremost, feel empowered. Yes, even if everything goes wrong and circumstances beyond her control result in the exact opposite birth than she hoped for. Even then, a woman should feel empowered by her caregivers. She should feel listened to. She should be given as much choice as possible—and her choices should be respected even if it turns out that they won’t work for whatever reason.
If you grow a baby in your body for nine months, you should be in the driver’s seat when it’s time for that baby to come out. Yes, sometimes the conditions get hairy. Sometimes obstacles spring up unexpectedly. Sometimes your vehicle breaks down completely. But you’re still the driver. At no point should you feel like someone has forcibly taken the wheel and kicked you out of the car, unless the car is on fire and that’s the only way to save you.
My first two birth experiences were incredible. The first was at a birth center with a midwife, and the second was a home birth with a male MD. Both of those providers made it clear that I was in the driver’s seat. They trusted me and my body and helped me do the same. They were prepared in case of emergency, of course, but they let me labor and birth the way I wanted. I came out of those births feeling like a superhero.
My third baby was born in a hospital with a female OB—a choice we made for insurance reasons (and because the doc who delivered my second had retired). That birth experience wasn’t bad, but it was distinctly different than the first two.
In the hospital, I felt limited in ways that people might not even think of if they hadn’t experienced anything different. I couldn’t leave the maternity ward and was only able to walk up and down one hallway. (Staying active in various ways during my first two labors helped immensely.) Whenever I was in bed, they had me strapped to the continuous monitor machine parked beside my bed. (I had intermittent monitoring with my first two births, which has been proven to be just as effective.) I was only allowed to eat popsicles and jell-o for 14 hours. (No food restrictions with my first two labors.) There was a lot more poking and prodding and checking and monitoring in the hospital, which all felt extraneous and rather invasive.
This was all at a renowned hospital in the Chicago suburbs. It had lovely, rooming-in birthing suites, baby-friendly practices, a great reputation, etc. The OB group was recommended by my home birthing doctor. So it’s not like it was a bad hospital with backwards providers. For a hospital birth, it was good.
But that’s kind of like saying Olive Garden has good pasta. Compared to some fast food place, sure, it’s good. But if you’ve had real, home-cooked pasta made by a genuine Italian grandmother, Olive Garden is going to seem sub-par. It’s not that the hospital experience was horrible. It just didn’t compare to my midwife birth center birth or my home birth. And in the end, it came down to empowerment.
Here’s one illustrative example: After I delivered the placenta during my third birth, the doctor announced, “Okay, we’re going to give you a shot of Pitocin now to help contract your uterus.”
Now, that might not seem like a big deal, but I was taken aback. I don’t like putting medications into my body unless necessary. If this had been my first baby, or if I didn’t understand how breastfeeding helps contract the uterus, I probably wouldn’t have thought anything of it. But I had delivered two children previously and contracted my uterus successfully by breastfeeding. I wasn’t bleeding heavily or anything. There was no medical need for Pitocin.
But the thing that bothered me most is that she didn’t ask me if I wanted it—she told me it was going to be done.
“Is that really necessary?” I asked. “With my other two I just breastfed and that seemed to work well.” She seemed slightly annoyed, but said, “Oh. Sure. If that’s the way you want to go.”
I haven’t always been someone who would question a highly qualified doctor. This woman happened to be the one doctor in my OB group that I hadn’t met before the birth, so it’s not like we discussed any of this beforehand. In the large scheme of things, what she did wasn’t a big deal—except when you add up all of those little choices being taken away, it does become a big deal. It was only because I knew first hand what a truly empowering birth experience looks like that I even recognized how disempowering those little things can be.
This is my body, my baby, and my birth. There should be nothing unnecessary done with any of those things for anyone else’s profit or convenience. And there certainly shouldn’t be anything forced, either through assumed acquiescence or outright coercion. There’s a big difference between suggesting an alternate route and reaching over and taking the steering wheel. Barring true emergencies, birth belongs to the birthing woman.
Generally speaking, midwives have a leg up in this area. Midwives are trained to help a woman harness her body’s own power, physically and mentally, and they encourage ownership of the birth process. There are some amazing OBs who operate the same way, but you do have to vet them out. There are also some control-freak midwives, I’m sure, so it’s not an across-the-board guarantee. But whom you choose as a provider makes a big difference.
The problem with saying “It doesn’t matter how you give birth” is that if women take that to heart, they may not take the time to educate themselves on their choices or vet potential providers to find the right fit since the birth process doesn’t really matter anyway. Empowerment starts with women educating themselves on the childbirth process and understanding that they are the drivers of that process. Birth attendants are primarily experienced navigators who know what to do if inclement weather hits or if the car breaks down. They should not take the wheel unless there is truly no other choice.
Childbirth is the likely the hardest, most overwhelming thing a woman will ever do, so of course those experiences matter. If you walk away from your birth feeling powerless, that’s important. No matter how your baby ultimately enters the world, how you experience birth and how empowered you feel throughout the process does matter. Let’s stop telling women that it doesn’t.
(Note: I’m aware that empowerment doesn’t always look like what I wanted in my birth experiences. If a woman wants to hand over the wheel and let her provider drive her whole birth, more power to her. I may not understand that choice, but I respect her right to make it. If that’s what empowerment means to her, I’m glad she has that option. Truly.)