I took that picture above at Indiana University many years after I graduated and I was walking around campus with my family, and I saw the statue with new eyes–with my doula eyes. I had never seen the low-transverse incision mark on her abdomen before that day. It made me smile in admiration and wonder if it was intentional. I’ll probably never know for sure, but I like to think that it is.
April is Cesarean Awareness Month. This was started by
ICAN (International Cesarean Awareness Network) to direct attention to the fact that the cesarean rate in the United States is too high.
32% of American babies in 2017 were born via cesarean section according to the CDC. That number actually hides quite a bit though. That is the number for TOTAL cesarean births, as Jill Arnold explains on cesareanrates.org, and looking at the low risk first time cesarean data gives us a more accurate picture of what we should be targeting to change, especially given the lack of access to and support of VBAC in many places in the country. There are some amazing people working to try to reduce that first cesarean, including the American College of Obstetricians and Gynecologists with this statement originally published in 2014, and Neel Shah and his team at Ariadne Labs who are working to reduce medically unnecessary cesarean surgeries. Shah says that as many as HALF of all cesareans may actually medically unnecessary, and he is not the only one working to reduce that number!
Sometimes cesarean surgery IS necessary. Sometimes surgery saves lives. NOBODY is suggesting that there should be ZERO cesarean surgeries! I join the chorus of people saying that perhaps we should question the efficacy and long-term health consequences for individuals all the way up to the population level.
I’ve never had a cesarean section surgery personally, but I have been in the operating room as a doula for some. Cesarean surgery can be scary, especially if you don’t know what to expect and your support person doesn’t either. Many times you weren’t expecting to be in that operating room, or are questioning whether you should be there right then. Learning about what to expect before you go into the operating room is one of the things I talk about in my childbirth classes. In my first prenatal visit with my clients, we talk about birth preferences, and I always make sure to talk about cesarean birth preferences with every single client no matter what their plans are. Plans sometimes go awry, and knowing what your options are if everything else is going sideways is a great way to mitigate fear as well.
Cesarean birth IS birth, and great medical staff can make a world of difference. There are even some hospitals that will allow a doula into the operating room as a second support person, which can be extremely beneficial for parents who can often feel like strangers in a strange surgery land. I know I have learned so much each time I have been in the operating room, including how best to support a person undergoing surgery, what is normal and expected, what exactly happens in that surgery, which staff is in charge of what action, where to stand, what not to say, and soo much more.
I sincerely hope that more doulas will be allowed in the operating room as a second support person for people undergoing cesarean surgery! I hope that it becomes just one more way that doulas can support the rest of the 32% of births in this country!
Photo by Chris Ensey on Unsplash
Birth is amazing, no matter how it happens. I seriously believe that! The bravery of having your body literally sliced open to bring a child into this world is not lost on me at all. I honor and respect all cesarean parents, and know the sacrifice you have made for those tiny humans.