How do cesarean births affect women and their babies?

I recently talked about my friend's elective cesarean for her breech baby. Recently, we had an open-hearted chat about how she had been feeling since the birth of her daughter. She admitted that she had gone through a difficult period of depressed mood, crying and feeling like she wasn't bonding with her baby girl. She felt like she was missing something. Although she acknowledges that no one pressured her to have a cesarean and that she took that decision fully informed, I think she has pangs of regret for not experiencing labour and vaginal birth.

She is only beginning to realise the implications of having that scarlet C on her uterus. Before giving birth, it was hard to grasp that cesareans do have a long-term impact on her reproductive health. Cesareans do lead to more miscarriages and placenta issues in ulterior pregnancies. They may also lead to a number of other complications, but reading about it is quite different than experiencing it in your own body.

I suddenly remembered Suzanne Arms urging us to protect our sisters from harm and from being cut open unnecessarily. I suddenly felt like I had somewhat failed my friend. In my decision not to advocate for natural birth in any aggressive way, did I let her down? It's a difficult call to make. Breech birth is something that holds so much unknown... I only very recently managed to get my hands on "A Breech in the System" and felt really compelled by Karin's fight to give birth naturally. I felt it was unfair that my friend, who was offered the possibility to birth her breech baby vaginally, chose an elective cesarean while other women who wish to birth vaginally their breech babies are not always offered the possibility by their local hospitals or care-system. 

Still, my concern today is to help my friend deal with the aftermath of this birth. I just celebrated the first anniversary of my son's birth and it reactivated a lot of pain and sorrow. It actually reactivated something in my son too. We had to deal with two very difficult weeks of sleepless nights. Our osteopath felt like his birth trauma was giving him quite a bit of grief. 

All this led me to think about the way cesareans are portrayed like benign interventions when they're not. They have long term consequences both for mothers and babies. Many of which are still unknown. I would be interested in finding out if some research has been done on behavioural and developmental differences between cesarean babies, operative vaginal delivered babies and natural vaginal birth babies. I know that cesareans have been linked to more risks of respiratory illnesses in children but the more I speak with mothers the more I get the feeling that there are many more consequences. One mother was actually convinced that her cesarean-born son's issues with substance abuse later in life were somehow linked to his birth trauma. She was adamant that there was a clear difference between her cesarean-born son and her other children, born vaginally and without operative interventions. This is something I'm hearing more and more. The question of bonding is an important one as well. Psychologists have known for a long time how important a strong attachment is for a baby's development. With more and more mothers having a hard time bonding with their children, are we setting the stage for a generation or more of emotionally scarred children as well?

The consequences on mothers are also to be considered. Long-term pain or numbness around the scar area, depression, PTSD, and a sense that your body has failed you does not make for happy women. Dealing with the physical and emotional aftermath of a cesarean birth can take up a lot of precious time and energy. Healing is sometimes a long process and not a linear one.

This is something that should be considered as cesarean rates are sky-rocketing in many countries. There are already so many things that negatively impact our children's development... Current birth models are obviously causing more harm than good. I am curious about a book that was recently published “Birth Models that Work”. I’m going to order it and see what it offers in terms of alternatives to our current model. 

In the meantime, we need to think about the best way we can support mothers and babies that have experiences difficult births. Nurse and midwife visits are obviously not enough. Support groups are not always available and some mothers are not even aware that they exist. What can we do to nurture those pairs back to health and support them throughout their healing journey? As I look at all the pregnancy books I’ve been reading as part of my childbirth educator degree, I see that chapters on caesareans usually focus on the actual surgery and offer only little advice about healing, with a few mentions about PPD and PTSD but not much in terms of scar care, emotional healing or tips on bonding with baby, fewer yet offer information about long-term issues and how to deal with them. I must say, more and more are mentioning VBAC. Yeah! We still really need to rethink the way caesareans are both portrayed to the public and practiced by medical staff. Education is only one aspect of the problem. There are many other aspects that need to be dealt with. Too many women and their babies are suffering the consequences of our lack of insight on these matters.

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