Caesarean Awareness Month is in April every year. There’s a lot of talk about what it all means, and there’s a lot of silence as well. Most people will pass through April 2016 without ever knowing that it was Caesarean Awareness Month. Others will spend the month defending their caesareans as necessary and life-saving. The latter seem to miss the point of it entirely, and the former need a wake up call.
Why do we need caesarean awareness month? Here’s six reasons why.
There’s an awful lot of babies born via caesarean: In many industrialised countries, it is incredibly common for a whopping one in three babies to be born in an operating theatre. For some perspective you can picture it like this:
In 1970, there was a <5% caesarean rate. So if you’d stood in the playground of the average primary school with 350 kids, there would have been 17 or 18 kids that had been born via caesarean. Now, that same playground has more than three whole classes (assuming a class is 30 kids) of children born via caesarean, or 116 kids.
A caesarean is the most common surgery performed today, and given that only 50% of the population can have one, that’s pretty stark. When you look at how many countries have the capacity to offer caesareans, and the ones who have no such facilities, it becomes even more glaring that there’s something important going on.
Women die from not having caesareans, and they die from having them: Because so many women have caesareans these days, we tend to view them as normal. People genuinely think it’s risk free, unlike vaginal birth which they view as inherently dangerous. Overall they are low risk. However there’s no denying that some women die during caesareans, and so do some babies. There’s also no denying that women in impoverished countries are dying from a lack of caesareans. We desperately need to balance out the caesarean rate across the world. We need to significantly increase it in some places, to save lives, and significantly decrease it in others.
No one is saying you didn’t need your caesarean: There are probably a good number of women and babies who are here today thanks only to the availability of a timely caesarean. That’s something we should celebrate! If you’re here due to a caesarean, we are glad! If your baby is here thanks to a caesarean WOOHOO! We’re very lucky to have you both. If you chose to have a caesarean, we’re glad you could make that choice! The point of caesarean awareness month is to raise awareness about caesareans, no matter why or how they happen. It isn’t to tell women not to have them or that we wish they’d died behind a bush instead. Anyone who interprets it that way has missed the point by about a hundred miles.
Nor is it to make women who have had them feel guilty: Whether you fall into the camp who had an unnecessary caesarean, a life saving one, or you elected one. The point of Caesarean Awareness month is not to make you feel guilty about it. Whichever category you fall in, April is the month to stand up and tell your story. Learn about other women’s stories. Tell your story to validate other women, or to give them hope! There’s no need to defend yourself or to feel guilty. If you feel the need to do those, now is the time to reach out. Don’t criticise Caesarean Awareness Month. Just reach out for support and understanding. With a one in three rate of surgical birth, there’s no reason for you to feel alone! We need to raise awareness of the myriad of emotions women experience after a caesarean.
There is birth after caesarean: It’s one of the most persistent obstetric myths of the 20th and now 21st centuries. Once A Caesarean Always A Caesarean is a saying from a 1916 obstetric paper on keeping caesarean numbers low. We didn’t manage to do that by any stretch of the imagination, but we managed the repeat caesarean clause. Marvellous how these things turn out isn’t it! What we now know, is that because of amazing improvements in surgical techniques, birth after a caesarean is not only possible, but safe! Most reliable sources claim that the risk of uterine rupture in a VBAC (Vaginal Birth After Caesarean) is between 0.2% and 0.5%. Reliable sources also show how the risks posed to women, babies, and future pregnancies, increase significantly the more caesareans you have. Going back to 1916 we knew we had to keep caesareans to a minimum for the health and wellbeing of infants and their mothers. What we didn’t know then is that birth after caesarean could be safe. Now we do know that, perhaps we can reduce the number of caesareans by increasing the rate of VBAC. It’s been a century since that edict was issued, so let’s get a wriggle on. Let’s talk about VBAC this Caesarean Awareness Month!
Caesareans are major surgery: One in three women give birth via caesarean. In the US only 8 in 100 of those gives birth vaginally after that. In the UK 24 in 100 women give birth vaginally after a caesarean. In Australia 16 in every 100 women VBAC, which means that 84 of them will welcome more than one baby in an operating theatre. With those figures it’s easy to see how caesareans have become part of the furniture. Many women swear that they had no trouble healing physically. This is a testament to the incredible surgical techniques that modern women can access in industrialised countries. However it does not mean that a caesarean is a walk in the park. Think about it like this: Someone with cancer may have absolutely no idea that they have cancer, because there are no physical symptoms. You can grow a giant tumour without any inkling that it’s there. What your body goes through when you have a caesarean is major, whether you are physically aware of it or not. That’s why they make you sign a legal consent form acknowledging the risks.
Sometimes people think that because you have an epidural and stay awake throughout your caesarean, it’s an easy straightforward procedure. Something akin to a hair cut. However you can be awake when you have brain surgery, and no one would try and tell you that was a garden party.
Women are given epidurals and kept conscious throughout their surgical birth, not because it is a fun thing to do, but because this type of anaesthesia poses fewer risks to both mother and baby than a general anaesthesia. It’s about balancing risks. A caesarean is not a family fun day, it’s major surgery.
So here we are again, it’s Caesarean Awareness month, and already we’re seeing the April Fools out in droves talking down the importance of it, misinterpreting the reasons for it, or completely unaware that it’s even happening. April Fool’s Day ended at midday on the 1st of April, you had twelve solid hours to kid around, and now you have the rest of the month to talk about the impact of caesareans! Women who need them but can’t access them, women who are being forced into them when they don’t need them, women who aren’t aware that they have choices, the list goes on. These are the reasons for Caesarean Awareness Month in 2016. The REAL reasons for it.
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