Last month, after 38 long, miserable weeks of pregnancy, I gave birth via elective c-section. It seemed like a tough choice at the time, but in retrospect, I’m wildly happy I did it—so happy, in fact, that if I ever have another kid, the only way you will catch me giving birth out my vag is if it’s in the back of a taxi on the way to the operating room.
Having a Caesarean was never a part of my birth plan. The reason for that is that I never had a birth plan. Terrified by all of my options for getting my baby from uterus to open air, I made the mature decision to bury my head in the sand and shout “whatever you think is best!” at my doctors during all of my third-trimester appointments.
All I cared about was the drugs. I wanted all of them. (I have what you would call a low pain threshold.)
Game day came sooner than expected. At the beginning of my 38th week, I developed preeclampsia, a condition that the Downton Abbey fans among you will recognize as life-threatening. In late pregnancy, the treatment is immediate delivery. I had to make a choice: induced vaginal labor, starting that night, or a c-section.
As I frantically got my things together to leave for the hospital, I re-read a Xeroxed article one of my doctors had given me at a previous appointment. It was the American Congress of Obstetricians and Gynecologists’ official position on elective c-sections, outlining the pros and cons of that procedure vs. vaginal labor.
According to that article and pretty much every other reputable one you’ll find online, vaginal labor is medically preferable. C-sections are serious procedures that come with longer recovery times and increased—if unlikely—risks. They reduce vaginal trauma, of course, and they lower your chances of short-term problems like incontinence. But they also increase your risk of REALLY serious complications, such as blood clots and death.
With this information in mind, I decided that I wanted to try induced vaginal labor. (Who wouldn’t?) But once I got to the hospital, that plan lasted for about six seconds.
Remember when I said I had a low pain threshold? Yeah, I screamed when the doctor on duty did a cervical exam to see if I was dilated yet. A cervical exam. It was about as painful as an enthusiastic Pap smear, but it was already more than I could handle.
I wasn’t really dilated yet, so they started me on a dilation drug called Cervidil. One of the side effects was mild cramping, and this too caused me to break down and cry. Many of you experience far worse every month during your period. Not me! I’m a wimp.
Hours later, I was supposed to start Pitocin, the real-deal drug that would induce contractions. Instead, I summoned the doctor back to my delivery room for a Serious Talk About my Options.
Reader, I pussed. Or rather, in literal terms, I did the opposite: I decided that no puss was going to be harmed in the birth of my child.
Of course, I kid. This was not a decision I made lightly. There were medically compelling reasons for me to go under the knife: a high chance the induction would fail; a big-headed baby and a narrow pelvic opening. But also—and in my opinion, just as important—there were my feelings.
My #1 priority was a healthy baby, but escaping pain was a close second. As was maintaining my sanity. A can-do attitude is important to natural childbirth, and I was just so batshit terrified that I didn’t think I’d have the presence of mind to push or breathe through contractions. By the time my doctor and I finished our conversation, the right answer was clear to both of us.
You know that moment in "Lord of the Rings: The Two Towers" when the sun rises, and Aragorn looks to the east like Gandalf told him too, and BOOM, there he is with the Rohirrim, charging to the rescue? My c-section was like that for me, for the following reasons:
1. It was completely—completely—painless. I’d thought that the epidural might hurt going in, but even that was no more painful than your average blood test, thanks to my anesthesiologist’s liberal use of local anesthetic.
2. With two veteran surgeons, a nurse, an assistant, two neonatologists, and an anesthesiologist in the room, I felt beyond reassured. I was so relaxed and confident in their abilities that I was able to joke around with my husband for the entire procedure.
3. I had heard recovery would be difficult, but honestly…no. At least not for me. With rest and Percocet, it was tiddlywinks. I felt a few twinges of pain around my incision site for about 2 weeks afterward, but those are long gone now.
4. I had also heard it was tougher to bond with your baby after the procedure because you couldn’t get immediate skin-to-skin time. (Babies delivered via c-section need to be put under a warmer and examined immediately.) That didn’t really bother me—we were skin-to-skin within the hour, and we’ve certainly bonded since.
5. I was freaked out about what the scar would look like, but that ended up being another pleasant surprise. Right now, it looks like I got drunk in Tijuana and decided to get a small vanilla bean tattooed across my lower abdomen. Eventually, it’ll fade to white.
Today, I’m the mother of a beautiful baby boy, yet I have no idea what labor feels like. That doesn’t make me feel unhappy, or like less of a woman: it makes me want to run around in circles, screaming with relief. I win! I win! I win!
Not all the c-section veterans I know feel the same way. Three of the four people closest to me who’ve recently given birth have had the procedure, and their feelings about it run the gamut from glee to grief.
“I had a traumatic birth experience,” my 28-year-old friend Mary* wrote to me over email. “I was full on ‘natural’ birth…ever since high school, when I got very passionate about women’s health. For me, I saw birthing with midwives and a doula as a feminist action—it was important to take back women’s health care from a male-dominated field.”
Mary’s plan went awry when her medically-necessary induction failed, requiring an unscheduled c-section after 8 hours of hideously painful labor and pushing. (Inductions fail about 40% of the time.)
“As soon as I was hooked up to an IV, something in me gave up, and I felt like a patient in a hospital rather than an active participant,” she wrote.
As Mary’s friend, I’m disappointed that her birth didn’t go the way she wanted—but I’m also intrigued, because our feelings are mirror opposites. I loved my thoroughly-medicated birth for the same reasons she wanted an unmedicated one.
For me, getting a Caesarean felt like a feminine victory—a glorious reclaiming of agency and control from the jaws of a terrifying ordeal that has killed millions and millions of women over the millennia and probably would have killed me in an earlier age. It made me feel the same way I did when I went on the Pill for the first time: like I was no longer a slave to my biology.
My Caesarean also struck me as a huge privilege. I feel so lucky to live at a time and in a place where excellent medical care is available. And as someone who had no maternity coverage whatsoever for the first 5 months of pregnancy, I am grateful to have nabbed last-minute insurance that allowed me to spend 4 days in the hospital, recovering in the presence of nurses and lactation consultants.
These days, a Caesarean delivery doesn’t preclude vaginal childbirth in subsequent pregnancies. Women who wish to do so are welcome to try VBAC—vaginal birth after Caesarean. But I won’t be one of them. My c-section liberated me from my fear of childbirth, and from some of my body’s most dangerous vicissitudes.
Thank heavens for modern medicine.