The Effects of Fear

I recently posted a link on Facebook to an article I found about the disturbing effects of cesareans on women's fertility.  The issues discussed in the article include secondary infertility as a result of a primary cesarean, as well as the emotional and psychological scarring that leads many women to refuse to have more children.  These women simply can't face the possibility of having another cesarean, even if they know that a VBAC is also an option.

One of the most concerning things to me about an article like this is that the vast majority of women do not go into birth knowing the true risks of cesarean.  They are not told about the risks to future fertility (something like 13% had issues, as described in the article), to their future children, and to themselves.  Most women who have cesareans believe it is in the best interest of their child and themselves, but statistically we know that most cesareans are not necessary.

As they say near the end of the article, necessary cesareans account for approximately 5% (WHO says up to 10% is acceptable) of all births. In the US, it's 36% nationwide! We are, without question, at a point when we are causing more harm than good. It's statistics, and the evidence is abounding. Rather than saving lives, we're taking them. Rather than preventing harm, we're causing it. We're past the point of diminishing returns, and the blasé attitude in this country about cesareans is only making it worse.

It is true that many people escape cesareans "relatively unharmed." And there are, certainly, those 5-10% of cesareans that truly save lives. But 26-31% of women in America are undergoing major surgery; being introduced to the risk of infections (which can be major), damage to internal organs, and fertility issues; and having their babies health and breastfeeding relationships jeopardized for no reason. They are completely avoidable, mostly iatrogenic (caused by a hospital/doctor), superfluous cesareans that do more harm than good.

Fear is a huge enemy to birth. Unfortunately, our society and our medical professionals create an atmosphere of fear around every.single.birth. This fear that "something could go wrong" (and I am very familiar with what can, truly, go wrong in pregnancy and birth) makes women dependent on doctors and medical technology. Instead of relying on their bodies and the Omniscient Creator of their bodies and this awesome thing called birth, they rely on the god of Technology.

Unfortunately, study after study and uncountable real life situations have proven that these technologies are NOT creating better outcomes. In fact, in the US, where we use a laundry list of technological interventions because of our inordinate fear of birth (such as ultrasound, pitocin, continuous fetal monitoring, epidural, vacuum, forceps, and cesarean), our neonatal and maternal morbidity and mortality rates are climbing. We are one of the worst countries in the world for mother/baby health.  And, yet, these Technologies are touted as saving lives and preventing problems. Do they? Sure, in some situations. But they're overused and are responsible for so many of these problems.

And it's all because of fear. 

Women need to be informed, and by being informed, empowered. I have studied birth extensively, and I am firmly convinced that it is, as one midwife said, "as safe as life gets." There are risks everywhere, and birth is no different, when it is allowed to progress as designed.

It is, ultimately, a God-designed and God-ordained process that has very specific goals for both mother and child. When allowed to follow these processes, it is an amazing, enlightening, empowering, and wholly transforming experience. For every interference, some of that is lost, and the risks are increased.

I do highly recommend Pushed: The Painful Truth About Childbirth and Modern Maternity Care, by Jennifer Block, as a very thorough look at our modern birth care system. I feel that every woman (and her spouse) should read it, specifically, the first few chapters. Those interested in cesarean, VBAC, and birth advocacy should read the entire book (and likely won't be able to put it down).

Comments

[Paula]

I agree with most of what you say here, and am especially troubled by the American medical community's unwillingness to acknowledge the effects of cesareans on a woman's later reproductive health. The assumption that "this" pregnancy and baby are the only thing that matters allows them to pretend that unnecessary cesareans are not doing any harm.

I do think this statement is not quite true: "We are one of the worst countries in the world for mother/baby health." We don't look good compared to other developed countries, which of course are the ones we are rightfully compared to, but I have lived in some of the poorer third-world countries and can testify that we're not among the worst for mother/baby health--and statistics bear that out.