Natural caesareans are growing in popularity. This is something we need to examine very closely. Living in a place and time where accessing major surgery easily is a great privilege. One not afforded to many women around the world, or women from the not so distant past. When a woman knows in advance that she will require a surgical birth, she may request that it be done with dimmed lights, an oil infuser, and gentle music playing. This type of caesarean is sometimes called a NATURAL caesarean, but major surgery is never natural.
There is no question about it, maternity care needs a giant overhaul, and wherever it is feasible, a caesarean should be as respectful of mother and baby as is humanly possible. There is absolutely no question about it. But there is no comparison between nature, and major surgery.
Calling a caesarean family orientated, woman centred, or calling it gentle, is sufficient. Major surgery can not be natural any more than a pacemaker can be a natural heartbeat, or dentures real teeth. Calling a caesarean natural is an outright lie that serves purely to further normalise the replacement of vaginal birth with surgery. Natural caesareans don’t exist, it’s just a new buzz word, and it’s causing a whole lot of hype and glossing over some very real problems.
Advances in surgical techniques and patient management have undoubtedly improved the safety of caesareans. So much so, in fact, that in many situations surgeons advise women that surgery is safer than a vaginal birth. Sometimes this is true, other times science shows us that birth is safer. This is particularly true of situations like VBAC, multiple births and breech position. Sometimes a caesarean is the wisest option, but not always.
We have reached a point in time where the number of caesareans that are being performed are actually causing more harm than good. Many people actually have no idea how involved a caesarean is. They believe it’s simple straightforward surgery, nothing more than having your tonsils out, but caesareans are quite literally very serious, major surgery. Many people actually believe that they pose no risks, and that vaginal birth is the most dangerous way to welcome a baby. The term “Natural Caesareans” further advances the misguided belief that they are a risk free vaginal birth replacement.
Roughly one in three women will give birth via caesarean, that may be slightly lower or much higher depending on where you live, so the normalisation of major surgery in the place of normal vaginal birth is arguably complete. Large numbers of people urge loved ones to choose caesareans in favour of vaginal birth. This is not because they are callous and uncaring, it is because they have distorted views of safety in birth. Natural caesareans can seem appealing when viewed against the backdrop of the invasive, embarrassing, impersonal nature of standard vaginal birth.
The reality is that ALL BIRTH has risks, caesareans are not a risk free option or hospitals would not require women to sign informed consent forms before taking them into an operating theatre.
The so called Natural Caesareans require exactly the same consent forms that your average surgical birth requires. However women do not sign those forms for vaginal birth – with the exception of some hospitals who present clients with informed consent forms before a VBAC or breech birth.
By the time we take the word natural and casually place it in front of the word caesarean, we reach a dangerous precipice. The normalisation of caesareans is spiralling out of control, and very few people are even questioning it. After all, everyone knows a couple of women who have had a caesarean or four and lived to tell the tale. Science has proven time and time again that wherever possible, vaginal birth is better for babies and for women. For this reason, calling caesareans natural is dangerous. It’s profitable for hospitals and surgeons to lump the two words together, but in reality the normalisation of caesareans is a giant experiment performed on our most vulnerable citizens.
Many women who meet their babies in an operating theatre feel traumatised by the experience and grieve for birth, and yes, some of those had calm, “natural caesareans”.
There are very few instances where women with all the information necessary, still prefer surgery, and very few instances where a medically necessary caesarean can be scheduled. Most caesareans occur after labour has commenced.
Although on a superficial level we may be able to convince a woman that her caesarean was somewhat akin to a birth, at a deeper emotional level, women know full well that caesareans are not natural. They can be calm – and in fact they SHOULD be calm and family centred wherever possible – but they can never be natural. To suggest that major surgery is natural is an insult to women everywhere.
Replacing birth with major surgery should be reserved only for the most unavoidable situations, where it really is life or death, or where mental health may be compromised by vaginal birth. This is NOT to say that women shouldn’t be able to have an elective caesarean, women who are counselled fully on the risks of a caesarean, and for personal reasons would still prefer surgery should be able to opt for surgery. The point is that we must do everything within our power to make birth something that women choose, rather than something they endure, or something they believe is best in an operating theatre.
Perhaps nothing showcases how important it is for women to meet their babies on THEIR OWN TERMS, quite so eloquently as the fact that we have coined a new buzzword for major surgery in order to placate women. But let’s not beat about the bush with it, let’s be honest about it. Although a caesarean can be CALM, it can never be natural. Major surgery is no closer to natural than dentures are to real teeth, and in most situations, a vaginal birth is safest for both mother and baby. Not all, no one is saying that, but in the majority of situations, vaginal birth is not only safer than the alternative, it far surpasses it.
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