According to a study published on The Lancet, birth by Cesarean section in Ireland has increased nearly five-fold since the 1980s. The increase is not due to medical complications, but to the free will of women who feel that a scheduled Cesarean section is a better option to natural birth.
According to Muiris Houston, all women should be given the chance to choose between a natural birth and a Cesarean section, irrespective of medical need (Caesarean sections: ‘Too posh to push’ or ‘too poor to choose’? The Irish Times 30.10.18). He puts it down to a matter of equality and choice.
Yet, unnecessary Cesarean sections unnecessarily deprive the baby of one of the most important equipment the mother can give: a germ shower. When a baby is born through the vagina, its body is showered with vaginal germs, which, alone, can protect the baby from future diabetes, obesity, mental health problems, and many more illnesses. Women who are lucky enough to have the option of a natural birth should be informed very clearly by their doctors, but they are not. Choice does not lead to freedom, when it is not informed. Think of the staggering choice we have in our supermarkets: the explosion of consumerism goes hand in hand with environmental destruction. Choice does not make us necessarily free or better-off, when it is poorly informed.
Cesarean sections make recovery longer but in modern societies, women and couples are left alone to bear the burden of a new born. The risks associated with unnecessary surgery are also non-negligible, so are the costs. Before you think it is too cynical to talk money, consider this: health insurance will double in the next decade (Irish Independent 21.06.2017), a third of adult use withdrawal as a contraceptive method because sex education is non-existent or very poor and biased (Irish Times, 17.08.2017) and burn out is at epidemic levels (Irish Times, 18.07.2017). Let’s spend the money where it is most needed, in prevention and education.
In my view, equality and choice should not be measured in the terms framed by Muiris Houston. To understand and appreciate the context where this increase in Cesarean sections has taken place, let us consider the following data.
- In a country where 93 per cent of women feel vulnerable because of their sex, 60 per cent do not feel safe taking the bus, and over 30 per cent has experienced sexual harassment in public, it is difficult for a woman to trust her body (figures by Plan International Ireland, published on The Irish Independent 11.10.2018). If our female bodies put us regularly in danger, they can hardly be respected and trusted. On top of that, the Catholic church has dug a deep wound into our souls, and this is reflected in the way we see and experience our female bodies: they cannot be trusted.
- The Gender Equality Global Report and Ranking by Dutch social venture Equileap
showed that Ireland “was alone in having no companies performing well enough to be included in the full data sample in 2018”. Translation: no companies in the top 200 Irish businesses have women holding board and executive roles (The Irish times 04.10.2018)
- Over 50 per cent of medical negligence occur in maternity care despite maternity services accounting for only 3 per cent of the Health Service Executive budget.
For the sake of brevity I will not go on, but just think of the cervical test scandal and how clearly it has revealed a revolting misogyny against women, perpetrated by men and women doctors alike.
Women are taught since a young age that birth is a dreadful, horrible moment; their bodies cannot be trusted; pain is always bad and must be avoided at all costs. This is the context where Cesarean sections are increasing. They scare the s* out of us from every corner: on the bus, in the boardroom, at the hospital, in school.
Should we indulge these trends, or start a deep revolution to restore dignity, support, trust and strength to pregnant women?
Birth is an intense journey. It is similar to death and rebirth, but our bodies are up to it! They are designed to do it, they know how to do it.
Doulas are essential to guarantee the emotional support a birthing women need, and they should be accessible to all. The presence of a doula can lower the need for a Cesarean section based on medical reasons by 60 per cent, and can lower by 80 per cent the request of a Cesarean section for non medical reasons.
Breathing experts and natural birth experts can equip women and couples with the right techniques to learn how to use the breath and pain to navigate the journey without panic and terror, but conscious love and participation.
With the right education, support and techniques, natural birth can become again what has been for millennia: a source of strength and healthy pride, a gift.