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When I was pregnant with my first IVF baby, I wanted a non-medicated “natural birth”. The kind you see in beautiful pictures, with a strong woman in an almost trance-like state as she delivers her baby into her own hands. In this picture, she is surrounded by a team of supportive women, a village, who are there to help, yet not interfere. After all, this is natural and she is built for this. Her significant other is there, lovingly rubbing her back, in awe of the miracle unfolding. Yes, there would be pain, but nothing that she can’t handle. She is built for this.

I did everything within my power to set myself up for the “natural” birth I pictured. I read all the books, watched all the documentaries, hired a doula and midwife, spent hours training myself in self-hypnosis for birth. While I did decide to deliver in the hospital, I was surrounded by a team of nurses, midwives, and doula, who were there to be my village, as well as my husband. I was not induced. There was not a “cascade of interventions” causing any stalls or other mishaps. Everything was set up for the birth that I wanted. There was even mood lighting and aromatherapy.

And yet, I still ended up with a c-section. As it turned out, my body just wasn’t built for this.

imagesI’ve written previously about my birth experience here and some of my reactions to it. Ultimately, I’m okay with the fact that the birth didn’t go as planned. I learned some hard lessons that day, including how to advocate for myself when I though I might have lost my voice. I did end up finding strength that day, it just wasn’t where I had expected it to be.

I am truly grateful to have access to medical treatments to help me get pregnant, and medical interventions for helping me birth by child safely. I can never think of this without remembering that my Grandmother’s sister died in childbirth; this was around 75 years ago, give or take. There’s a good chance her outcome would have been different had she lived in a different time like me.

So when I became pregnant with my second IVF baby, I was faced with some choices regarding this birth. The OB that did my c-section was retired, but he had said that my bone structure was about 1.5 inches too small in diameter to ever give birth to a full-term baby. I went back to the midwife that was there during my delivery and spent over an hour discussing this with her. We spent a lot of time talking about the pros and cons of trying for a VBAC (vaginal birth after cesarean). Ultimately, there seems to be some higher risks with trying a VBAC and failing, thus ending up needing a c-section anyway, versus forgoing the attempt and simply planning a c-section. One of the scariest risks during a VBAC is a uterine rupture. However, when we discussed those risks, the actual prevalence rates of something like a uterine rupture happening were just so small, and the success rates of VBACs were rather high. Still we had to consider my unique circumstances that led to my c-section in the first place. It wasn’t due to anything that happened in the hospital, such as medications used, induction, rushed schedules, nor was it anything to do with the baby, such as position or size. It was simply me. My body.

At one point, she said to me, “I know I’m not supposed to say this being a midwife, but sometimes too much importance is put on having a vaginal birth. It’s your experience that matters most. It’s okay to choose a c-section.” She also admitted that she learned a lot from witnessing my birth. You hear so many stories about unnecessary medical interventions being pushed on laboring women, but my story was just the opposite. My team was so focused on a medication-free, vaginal birth, that they didn’t truly hear me when I knew something was wrong.

This time, I’m planning a c-section. My new OB agreed that that was the safest course given my particular history. And so, I shamelessly scheduled a c-section.

I won’t lie, sometimes I have to remind myself that this is a valid choice and should not come with any shame or guilt. Yet, I still find myself “explaining” or excusing my choice to have a planned c-section when I’m asked about my due date or planned birth. I annoy myself when I do that. After all, birth is an incredibly individual experience and no one has the right to tell another woman how to go about it. This is not a time for shaming. But I’m not immune to the stigma. In my culture, c-sections are often seen as somehow a “failure,” or at least “less than” a vaginal birth. Just the fact that we say “natural birth” to refer to vaginal deliveries is telling, isn’t it? It’s the connotation that comes with the word natural and assumes that anything else is unnatural and thus, not right. Yes, I know that a c-section is a surgery and so it’s not actually the “natural” way for a baby to exit the body, and yes, I do believe that often c-sections are unnecessary. But they can also be life saving. And they are still a method of birthing a baby. Women who have c-sections are not less than. I keep expecting to encounter someone who is going to try to “talk me out of it” and I’m well prepared to argue my point.

Yet, to my surprise, I have received nothing but the opposite reaction. Every person who knows I’m having a scheduled c-section has responded with some variant of, “well after everything you’ve been through, you deserve a less stressful birth.” They are talking about my infertility.  They know the year leading up to this pregnancy was markedly stressful due to multiple rounds of IVF. And so they are basically suggesting that I’ve “earned” an experience that is somehow predictable and safe. This reaction always sits oddly with me. On the one hand, I’ll admit that going into this birth “knowing” when and what is going to happen, having a plan that is scheduled and predictable, is somehow comforting and really is less stressful. Probably less stressful because I will be able to avoid the birth trauma that I experienced last time. (Granted, I know even a scheduled c-section can go rogue, especially if this little babe has a different agenda, but shhhhh, let’s not talk about that.) However, on the other hand, this reaction irks me. As if you have to “earn” a stress-free birth experience. As if a major abdominal surgery is even stress-free.

But what I do know for sure, is that a c-section delivery is a birth just as much as a vaginal delivery is a birth. I am not less than because I have had (and am having) a c-section. I’m still trying to wrap my mind around my emotions with this upcoming birth. It does seem like it may be a bit surreal to go into the hospital before labor begins, and then undergo this procedure and be handed my baby. I suppose I keep comparing it to my last birth where I didn’t have the c-section until after 32 hours of hard labor. So there will be more posts to come about my emotions leading up to this birth, as well as the choices I’m making to support a “family friendly c-section” (yes, that’s a thing) and my emotional well-being pre- and post-partum. Stay tuned…