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Do C-Sections Make Moms Less Sensitive?

Women who deliver their babies through Caesarean sections appear to be less sensitive to the sound of their baby's cry, according to provocative new research.

In the first study of its kind, James Swain of Yale University and his colleagues conducted brain scans on 12 new mothers women while they listened to recordings of their newborn babies crying.

Among the women who had Caesareans, crucial parts of their brains, including those that regulate emotions such as empathy, were significantly less responsive to their baby's cries, the researchers report in a paper being published in the October issue of The Journal of Child Psychology and Psychiatry. The more activity women had in those parts of their brains the more they thought and worried about their babies, the researchers also found.

When I spoke to Swain on the phone, he stressed that the study was small and needs to be confirmed by additional research. But the findings are potentially important because the Caesarean section rate has increased sharply in the United States. About a third of women are now giving birth that way. The increase is being fueled by a variety of factors, including more women having babies at older ages, more doctors jumping to a C-section at any sign of a problem, and more women opting for a C-section for convenience.

Swain says the findings suggest that women who have had a C-section may have a harder time bonding with their newborns, and could help explain why women who have had Caesareans appear more likely to suffer from post-partum depression.

You're probably wondering how having a C-section might affect maternal instincts. Well, vaginal birth has many effects on a woman's body, including boosting her levels of oxytocin -- a hormone that seems to play a key role in helping mothers bond with their children. So the brains of women who have Caesareans don't get primed by this bonding hormone.

Now, Swain says the findings shouldn't make anyone hesitate to get a C-section if they need one for medical reasons. And he has some unpublished data that indicate the negative effects of having a C-section disappear within three or four months.

But the findings might offer another reason to try to avoid unnecessary C-sections. It could also lead to ways to minimize or compensate for any effects C-sections may have on a woman's ability to bond with her baby.

Have you had a C-section? Any problems bonding with your baby afterwards?

By Rob Stein  |  September 4, 2008; 7:00 AM ET
Categories:  Motherhood  
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Comments

Did the study look at breastfeeding after the baby is born, which boosts oxytocin? I think it's pretty simplistic to say women who have C-sections have more trouble bonding.

Posted by: SSMD | September 4, 2008 8:00 AM | Report abuse

This would explain a lot about Britney....

Posted by: Anonymous | September 4, 2008 8:26 AM | Report abuse

I had two babies 19 and 21 years ago. One was C-Section, one was vaginal. I breastfed both of them past a year old. I do not think that was less sensitive to the one who was born by C-section. I think many things affect bonding and breast feeding is one of them. It also releases bonding hormones.

Posted by: ForZez | September 4, 2008 8:29 AM | Report abuse

So basically if I don't have a C-section, I won't become a psycho-obsessive about my new baby? And this is supposed to be a bad thing? As long as it's loved and well cared for, we're good right? And this part really bothers me, "the more they thought and worried about their babies." It seems to imply that if you have a C-section, you will not care enough about your baby, because you will not continuously think and worry about it. How much more thinking and worrying can a mother of a newborn do? Way to score one for the ‘natural-birth’ crazies.

Posted by: Other | September 4, 2008 8:34 AM | Report abuse

Oh, goody. Another tiny, untested study that will be used in an attempt to shame pregnant women into acting in a certain way on the remote chance that by doing so, they can eliminate some ill-defined and minuscule risk of harm to their kids.

Did the creators of the study even try looking to other factors besides the c-section that could cause this alleged distance in the dozen moms they studied?

FWIW, I did have a c-section with my daughter (after 28 hours of fruitless labor). She and I seem to have bonded just fine. And if it turns out that I need a c-section with the baby I'm currently expecting, then I'll do it again. As long as the baby and I both end up healthy, then I don't care how he or she is born.

Posted by: NewSAHM | September 4, 2008 8:57 AM | Report abuse

"Oh, goody. Another tiny, untested study that will be used in an attempt to shame pregnant women into acting in a certain way on the remote chance that by doing so, they can eliminate some ill-defined and minuscule risk of harm to their kids. "

No one can abuse you without your permission.

Posted by: It's a choice | September 4, 2008 9:47 AM | Report abuse

I gave birth in April to my first child via C-section (after 27 hours of labor). I actually did feel really disconnected from my baby for quite a bit of time after she was born (and I breastfeed). As time has passed it has faded, and I don't feel that way anymore.

But it never bothered me to hear her cry and I felt like it should, and it was noticable to me at the time how detached I felt from her. I don't know that I blame the c-section for how I felt, but this study does interest me.

Posted by: Carifly | September 4, 2008 9:49 AM | Report abuse

Puhleeze! I've had 3 babies by c-section as well as having several friends who've also had 3 babies by c-section and we all breastfed from the get-go and none of us felt there was any difficulty bonding. Perhaps some of the trouble women suffer after c-sections, like more depression, can be explained by a society that tells them they "failed" by not having a "normal" birth by vagina! Perhaps the women who are having trouble bonding after a c-section went through hours of debilitating labor before undergoing major surgery and just needed a few hours to catch their breath. Perhaps it was all that LABOR that was the problem and not the c-section!

These things shouldn't be published until further studies have been conducted that include large numbers of women and thorough research procedures. It's these stories that lead women to feel like a failure when they have a c-section when having a healthy baby and mother is the only thing that matters. Use this study to get more funding to study it, sure - but don't stick it in my face in the meantime!

Posted by: Carrie | September 4, 2008 10:14 AM | Report abuse

From the abstract:

"To test the hypothesis that CSD mothers would be less responsive to own baby-cry stimuli than VD mothers in the immediate postpartum period, we conducted functional magnetic resonance imaging, 2–4 weeks after delivery, of the brains of six mothers who delivered vaginally and six who had an elective CSD."

So, to summarize, those whose ax to grind is that women who have elective C-sections are selfish or unwise have a new club in the form of results of a study of TWELVE women (who knows whether this is even a random sample, or whether the twelve self-selected). Tell me why a study of twelve persons on any topic under the sun ever merits publication let alone discussion.

Posted by: Carola | September 4, 2008 11:54 AM | Report abuse

I had a scheduled c-section with my son because he was breech and there were other complications. I don't feel my bond with him was any less than my friends that delivered normally. It seems like just another way of convincing women that they must deliver vaginally otherwise suffer yet another consequence. I've met too many woman who feel terribly that they weren't able to deliver normal, without drugs or aren't able to breastfeed for one reason or another. It should matter more that Mom and baby make it through the birth safely and that the baby continues to be healthy.

Posted by: Betsy | September 4, 2008 12:00 PM | Report abuse

I've had 3 c-sections and did not breast feed at all and have had no bonding issues. Sounds like another poor study by men about an issue that really relates to women. Who thinks these things up? Also, who determines if a c-section is "unnecessary"? That should be between a woman and her doctor, not some research.

Posted by: Kim, Cleveland, OH | September 4, 2008 12:08 PM | Report abuse

I had a c/s with my first and I had a terrible time bonding with him. Things didn't really kick in until he was about 4 months old. I had two vaginal births after the c/s (very hard fought, btw, since docs HATE VBAC) and the post-partum and bonding was much smoother.

I think it's interesting to see c/s moms feel so defensive about this. The study is not saying that you're a bad mom. It's saying that there may be effects of the c/s that we have yet to fully understand.

I don't think any woman should be guilted into any type of birth. We should be given fair information and be trusted to make the decision that is best for us and our babies.

Research is showing over and over again that cesareans increase the risk of injury and death for both moms, babys, and future babies. In the meantime, other research keeps showing over and over again that VBAC is a safe and reasonable option for almost any mother.

So, why is it that the medical community is unnecessarily pushing c/s on moms when there is so much risk, and depriving moms of their VBAC choice when there is a very strong argument for it's safety?

Posted by: Bea | September 4, 2008 12:23 PM | Report abuse

A tiny fraction of women actually need C-Sections. The United States has a horrible rate of infant death, and its because women and our medical establishment treat pregnant women like they have cancer, rather than viewing pregnancy and birth like normal natural events. The slew of "interventions" from epidurals to vacuums to C-sections damage women and babies. Nearly all women can deliver vaginally and without drugs. Most have just been convinced that they can't. It's sad, really, that a great majority of our babies are born via intrusive surgery in a clinical setting. Check out the statistics for births attended by certified nurse midwives. It's not some crazy hippie thing -- its what most of the smart women in the developed world do. And it works. OBs are pathologists and spend most of their training practicing surgery, some rarely ever seeing a real natural birth. They are trained to look for and solve problems. Pregnancy isn't a problem, and most pregancy problems can be prevented by changes in diet, exercise, and attitude; certainly laying flat on your back with an epidural waiting for the baby to come doesn't help. That's right -- if women stopped thinking that they were sick or debilitated or helpless during pregnancy and birth -- and put that doctor right back into his or her place(as a service provider, rather than a supervisor), the surge of confidence would help them work with their bodies and get these babies out naturally -- the way every other mammal on earth does it. Except for the duck-billed platypus.

Posted by: Let's do better | September 4, 2008 12:24 PM | Report abuse

And to Kim, if you didn't breastfeed, you had bonding issues. Well bonded moms choose to do the best thing for their babies, which is breastfeeding.

Posted by: Let's do better | September 4, 2008 12:38 PM | Report abuse

Probably published by HMOs so they can encourage women to deliver vaginally so they can get them out of the hospital faster so the HMOs can save money.

Posted by: c-section mom | September 4, 2008 12:43 PM | Report abuse

I wanted to mention a study that was published in the fall of 2004 that compared thousands of women having repeat c-sections with thousands of women having VBACs. There were zero serious complications with the repeat c-sections and there were 9 infant DEATHS as well as additional numbers of brain damage with the VBACs. I do want to point out the numbers of problems were very small (on the order of 20) compared to the thousands of cases studied (on the order of 15,000). However, I took my chances with the ZERO complications per 15,000 to the smallest chance of trouble. I think the trouble is women are told they screwed up because they didn't push their doctor's to let them try harder - it's like being told you could have gotten a A in a class but you didn't study the right material. It's a personal criticism. If you have a good relationship with your doctor and you are comfortable discussing your options, go that way. If you want to go with a natural birth with a midwife - go ahead. Just STOP telling me I did something wrong because I had my c-sections. It is NONE of your business and I believe my life and that of my babies was saved by this "intervention". I hate it when people say there is a right way and a wrong way to do something. I don't go around telling people they should have c-sections to avoid the trouble of labor and I don't tell people who have horrible birthing stories that a c-section would have been better. I really feel like people should stop trying to tell me I made my decision and I'm happy with it.

Now, I know I'm being super defensive about this and some might think it means I am really not happy about my c-sections. Actually, I'm upset on behalf of those I know who felt terrible after giving birth by c-section and had trouble bonding because they felt they had failed the first test of motherhood. It makes me blow my top to think of how sad OTHER PEOPLE'S IDEAS made my friends. I'm also VERY annoyed when people assure me that most people have c-sections out of ignorance. I was anything but ignorant, I understood exactly what was going on and what choices I had and I ended up with a c-section that made perfect sense to me.

Posted by: Carrie | September 4, 2008 12:48 PM | Report abuse

I, like Bea, am also intrigued by the defensiveness of some moms about this issue. The study is definitely not citable (only 12 subjects? really?), but it raises important questions. It's certainly not a new idea that C-section (or any traumatic birth) can interfere with bonding. There's the hormonal thing (which is helped by breastfeeding, which as people pointed out also releases oxytocin--although early breastfeeding problems are common with c/s moms, possibly due to a hormonal glitch), as well as the emotional and physical trauma that a c/s poses to some women. In _general_, c/s births involve more recovery and physical trauma than vaginal births do. It's just a fact!

Before I sound like a "natural-birth crazy," let me say that I had a non-emergency C-section after planning for a vaginal birth and was very disappointed in the circumstances. I was NOT disappointed in my beautiful baby son, nor was I disappointed in the expertise of my surgeon. These are separate issues.

I breastfed my son just fine after some bumpiness at the start, and I also felt that I bonded with him. In fact, after I got home from the hospital I was very protective of him and never wanted him out of my sight for the first few weeks at home. My mom pointed out later, and I agreed, that these feelings could have been enhanced by the delayed bonding after my surgery. I didn't get to see him, hold him, or feed him until he was an hour old. I couldn't walk for a day, and couldn't pick him up for a week. I never even changed his diaper until we had been home for a few days.

In my case I felt that bonding was delayed, and I point to the c/s for that. My son and I have a wonderful relationship, and I consider my birth experience as part of who I am today; but I believe that bonding can be compromised by surgical birth, because I dealt with that in a small way.

One commenter remarked that this study "seems like just another way of convincing women that they must deliver vaginally otherwise suffer yet another consequence." I find that incredibly ironic. What are all these "other ways" that are convincing women that they "must" deliver vaginally? The c/s rate in the U.S. is skyrocketing. In the D.C. area it is higher than the national average (which itself is pushing 50%!) I have never met a medical professional, and have met very few people in general while discussing the topic, who have voluntarily listed the risks of C-sections or the benefits of vaginal birth, or told me I should deliver vaginally, although they probably know of the pros and cons of both. I suppose it's all a matter of perspective, but the tone of that statement (that there are multitudinous and powerful advocates for vaginal birth out there) just doesn't ring true to me!

Posted by: Eliza | September 4, 2008 12:49 PM | Report abuse

I've had 2 c-sections and have had trouble with bonding both times, even though I was breastfeeding.

C-sections are definitely a disruption of the natural process of hormones. Major surgery is always physically traumatic, and quite often emotionally traumatic also.

The first c-section was an iatrogenic emergency, and the second I was denied a vbac while in labor.

Posted by: texmama | September 4, 2008 12:49 PM | Report abuse

sometimes it seems like there's a crazy conspiracy to make mothers who deliver via c-section feel defeated and guilty

Posted by: not convinced | September 4, 2008 12:50 PM | Report abuse

I second Let's do better's comments. No one is saying that C-sections should be avoided in the rare instances where they are medically necessary, but we need to give women credit for what their bodies are capable of doing. Our current interventionist model encourages women to see themselves as victims of their pregnancies. Too many women are made to believe that they shouldn't have to "endure" a natural birth. I don't think it's suprising to hear that, sadly, something is lost when a woman undergoes surgery instead of allowing her body to act naturally. Sometimes this is a compromise that is necessary for the overall health of the baby or mom, but, under most circumstances, c-sections and other interventions (including drugs for pain) are more dangerous for both the baby and the mom. We need to see ourselves as capable of doing what women have been doing for the whole of humanity. We can do better and ought not to give ourselves a pass because formula and c-sections are more convenient than labor pain and breasfeeding.

Posted by: Brenda | September 4, 2008 12:52 PM | Report abuse

I definitely had trouble bonding with my cesarean-born child. It is not impossible, and no one is trying to say that it is.

I think it is telling that so many are taking such personal offense to this- if you had no trouble bonding, fine, but don't discount those of us who have.
This is an observation- not a personal attack on you.

Posted by: mom who had a c-section | September 4, 2008 12:54 PM | Report abuse

It's so strange to me that women who shun unpasteurized cheese, bologna, and Tylenol during pregnancy are so willing to submit themselves and their not-quite-born babies to spinal anesthesia and a host of narcotics -- not to mention the post-surgery painkillers that are absolutely necessary because they've just had major abdomincal surgery. We have the obligation to try and do the best for our children. That's why we need to evaluate every choice.

Posted by: Let's do better | September 4, 2008 1:02 PM | Report abuse

BTW, mine was not of choice - he was trying to come out butt-first :-)...
The only bonding issue we had was that I became incredibly ill (bad flu bug) during my second week after and had to have mom take care of me and my son for almost a week.

Posted by: c-section mom | September 4, 2008 1:03 PM | Report abuse

Oy vey. We elevate birth and child rearing to some sort of religious experience and damn to hell those who don't "do it right." I had two c-sections, medically necessary (huge babies, small body) and bonded just fine. Depression? Well, if any, it was due to the pain of a gut wound that was pretty severe, esp. with the first baby. So, that I get. Breastfeeding? Hated it and if I ever have a third, will not do it. First baby would not latch on (even with tons of nurses and doctors helping), but I felt so guilty. Breast fed the second for about 4 months and could not keep up with his needs. Next baby? Scheduled c-section, formula from day one and I will finally get to be a stay at home mom (the dream of this GS-14!). And I will finally be over the guilt imposed by all these experts and "perfect moms". I love both my children passionately AND would like 2-3 more! As long as you aren't irresponsible (either acting like Britney on one hand or a helicopter mom on the other), let's just view these studies as studies and move along.

Posted by: Regular mom | September 4, 2008 1:04 PM | Report abuse

Also, I'm sorry for the c/s moms who feel that advocacy for vaginal birth is a personal criticism. I don't think the majority of advocates consider it to be one at all. Certainly as a c/s mom and advocate for vaginal birth, I never intend to criticize anyone's birth choices.

Re: the 2004 study (found here)--some might be interested in a few rebuttals to those results. The study differentiates among VBAC moms who chose to induce or augment labor, two things that increase the risk of uterine rupture. In particular, inducing with prostaglandins increases that risk. The infant injury and infant mortality in that study help to illustrate that NOT all moms are candidates for VBAC--but that doesn't mean that no moms are, or that most moms aren't.

An interesting side note, a study done in Norway in 2006 (also 18,000 participants) showed that ERCS (elective repeat c/s) babies were twice as likely as VBAC babies to be transferred to NICU or to have pulmonary disorders. Found here.

More info about VBAC vs. ERC here.

Posted by: Eliza | September 4, 2008 1:07 PM | Report abuse

So "Let's do better" - I take it you never had to labor for 22 hours, had internal hemmorraging, pushed your insides out for 2 hours only to be told "this baby isn't coming out this way"? I guess it was my fault - right? I BEGGED FOR A C-SECTION; HAD PUDDLES OF BLOOD ON THE FLOOR AT ONE CENTIMETER AND THE NURSE TOLD ME IT MUST BE MY CERVEX AND WOULDN'T CALL THE DOCTOR WON'T BE COMING IN UNTIL 5 CM???? After an excrutiating 24 hours my OB finally came to the conclusion that I must have a c-section. Both me and my child would have died had that c-section not been performed and the reason that both me and my child had to suffer for 24 hours is because of crazy zealots like you who insist that "any mammal on earth can deliver naturally".

Did you bother to ever look at maternal deaths 50 years ago?? There's a reason why those rates are now down and it's because of C-sections! And for the previous poster who said that no once can abuse you without your permission - WAKE UP! I was at the utter mercy of the nurses and doctors at that hospital - I had no choice in the matter whatsoever! I was in agony and BEGGED for a c-section. We treat our pets better!! Did I bond with my child afterwards? I couldn't hold him I was shaking so badly and he had to be rushed to NICU.

Here's the flip side - Second child - scheduled C 10 days early - baby weighed 8 lbs. 11 oz; came out in 20 minutes; no complications; perfect APGAR; scar healed nicely; mom and baby could actually bond immediately after birth.

So for all of you who feel the need to preach and have never gone through that- just zip it. I for one, am GRATEFUL that OB's have surgical training - hooray! yippee!! Keep it up! Thank you.

Posted by: Let's do better -not | September 4, 2008 1:08 PM | Report abuse

Fascinating regular mom -- you're happy to ignore the several zillion studies that show that breastfeeding is healthier in countless ways for your baby? What do doctors know about breastfeeding -- did you talk with other nursing moms or call a breastfeeding support group? Did you ever consider that your first baby's apparent inability to latch may have had something to do with your c-section -- perhaps the residual anesthetic in her or his system? It's difficult for me to get over the notion that you're happy to be an average parent and to do a just-okay job. Why not try to do things perfectly, as best as possible. Seriously, what job is more important? Birth and breast-feeding aren't rocket science; in fact, they both natural processes that our bodies know how to do.

Posted by: Let's do better | September 4, 2008 1:12 PM | Report abuse

I'm wasn't being defensive.. I was just trying to imply that we should take all "studies" with a grain of salt. i.e. one day eggs are bad for and then next day, they're good for you, yadayadayada.

Posted by: c-section mom | September 4, 2008 1:14 PM | Report abuse

oops - bad grammar

Posted by: c-section mom | September 4, 2008 1:16 PM | Report abuse

Obviously, my friend with the capital letters had a traumatic birth experience. I'd argue that she wouldn't have had that experience if she'd stayed away from the doctor in the first place. The doctor is the one who put her into bed and kept her off of her feet. If she'd stood upright, walked, and shunned the epidural, it's likely she wouldn't have had such a traumatic experience for herself and baby. As soon as you let yourself become a patient, you are helpless and await the rescue of the doctor. I labored 17 hard hours with my first child and 14 with my second with no drugs. I certainly know what labor pain feels like, and I know what it feels like to push a 9 lb baby out.

Posted by: Let's do better | September 4, 2008 1:17 PM | Report abuse

Long ago, my long-awaited baby, weighing nearly 10#, was born with minimal anesthesia and I hated the dr. for years. Swore it was my one and only. Even began to campaign for planned parenthood, due to rising numbers of teen unwed mothers who seem so ignorant that they and their careless lovers put them- selves through the agony of labor for an unwanted or unplanned baby. My second delivery was a C-section due to the baby's heart stress during labor. Had trouble bonding for 2 weeks, most of which was a personal feeling of abnormality. Of course, breastfeeding again, having a huge surgical site to avoid while nursing her, made for problems. But the cries of a hungry baby always made milk leak instantly.

Posted by: kidkare1943 | September 4, 2008 1:24 PM | Report abuse

How, exactly, is "bonding" being defined here? The study cites brain scans that register activity, but doesn't in any clear way tie that to this elusive concept of bonding that everybody is commenting about. I'd be curious to know how some of these posters instinctively knew that they were or were not bonding with their infant. For what it is worth, I had a c-section and did not breastfeed, and I fell in love with my son the moment I saw him. Was that "bonding?"

Posted by: Arlington | September 4, 2008 1:27 PM | Report abuse

You are right about one thing - it was a traumatic birth experience but you are so very WRONG in your assumptions. My OB wouldn't come to the hospital before I was dilated 5 cm. I was bleeding and in pain at 1 cm and was complaining to the nurse (internal hemorrage, remember, my friend?) It is standard practice not to give an epidural before 5 cm for fear that it will slow the birth process so as much as I would have loved not to have felt the agony of my insides ripping, I had no choice in the matter). I tried to walk, squat like an Indian, do whatever crazy stunts anyone suggested but frankly I ended up in the shower in the fetal position (think the last scene of "Braveheart" if that gives you any sense of what I must have been feeling). I suspect your labor pains didn't come close. My doctor did not have my lie in bed and hook me up to epidurals thus making me a victim - I begged her to help me and she had your view "any mammal can deliver naturally". You certainly don't know what kind of pain I went through or that of other woman who went through life saving c-sections and I resent your preachy attitude to the contrary. Again, consider there's a whole other side to this that you just couldn't possibly understand and zip it! Thank God for surgery and competent OBs that can perform them!

Posted by: Let's do better - not | September 4, 2008 1:29 PM | Report abuse

Wow - never seen so many comments on this blog - HOT TOPIC!

I've done it all, unschedule c-s after a long labor (completely blame that on the medical community being forced to stay in bed, baby in bad position, full labor and pushing.) Next child was VBAC, w/ a certified nurse-midwife, wonderful experience. Last delivery was scheduled c-s -no choice there w/ breech twins.

Guess what? I bonded w/ ALL my children. The first was the hardest b/c of the long labor followed by an unplanned major surgery - went through both really - plus a hospital-acquired infection. But irregardless, unplanned c-s, vbac, planned c-s - I cared for and loved my kids.

I completely understand that some moms didn't feel bonded right away. Breastfeeding can be tough, other factors intervene, but one small study isn't going to prove to me that it's as simple as vaginal=bonding, c-s=less bonding.

Posted by: been there | September 4, 2008 1:32 PM | Report abuse

Why did you go to the hospital in the first place? Consider a birthing center? You weren't having a tumor removed. You were having a baby. Think differently for different results. Did you thank the doctor for the C-section, even after she had let you suffer and bleed for hours?

Posted by: Let's do better | September 4, 2008 1:35 PM | Report abuse

I must critcise this study due to it's incredibly small sample set, but the author mentioned that already. But like others, I find the heated responses of women fascinating. So many say they are "ok" with their c/s, yet the strong anger, the lashing out at people is amazing. If people are truly OK with their choices, why do you find yourself becoming angry and heated at a benign study that has no personal impact on them?
Because birth matters! Because even though we talk about how the only thing that matters is a healthy baby, even women who choose c/s know that the event has a profound effect on them, good or bad. Birth is a personal moment that only happens once.
My 2c on this one, yes, it is possible that major surgery, under the influence of narcotic medications may impare functions for a while. But with any situation, it is how the person reacts to it. My take home message, this may be one more "side effects" of major abdominal surgery called c/s. Take it for what it is worth, nothing more.

Posted by: MomtoM | September 4, 2008 1:44 PM | Report abuse

"Both me and my child would have died had that c-section not been performed and the reason that both me and my child had to suffer for 24 hours is because of crazy zealots "

The people I know who support birth choices for women, which include vaginal birth and VBAC, recognize there are times when a c-section is medically necessary. I don't consider us zealots for wanting women to have choices in how we birth our children. These choices are being taken away from so many women by the malpractice insurance companies who are looking not at risk to women and their babies but financial risk to doctors and insurance companies.

I think the above poster's birth experience sounds horrific and not unsimilar to my first birth. But I cannot understand how "zealots" are to be blamed for this at all; it sounds like gross negligence on the part of the nurse and quite possibly the doctor as well.

Posted by: Jennifer | September 4, 2008 1:48 PM | Report abuse

I think this is an important area of study to explore -- not to guilt moms who have c-sections, but both to make them more aware of potential bonding issues and inform their choices for future pregnancies. The key is to make *informed decisions* in birthing matters, and to understand and be prepared to deal with the potential consequences of various modes of delivery. Instead of viewing this as a conspiracy to belittle c-section moms, more c-section moms should welcome the additional information. The delivery of a child has serious emotional and physical ramifications for both the mother and the child, and all parents should balance the potential effects of their choices and make the best choice for their families.

Posted by: DPW | September 4, 2008 1:48 PM | Report abuse

MomtoM makes great points. Birth is a pivotal experience. It affects how we feel about our babies. Think of all of those women who tell the "horror" stories of their children's births to everyone they meet. Could underlying resentment and pain be impacting their bond and commitment to their new baby? Worth more study, for sure. It really is a great issue for feminists -- why let the medical establishment prescribe how we carry and birth our babies. Research, wake-up, and be proactive before you end up with an unwanted c-section and the physical and emotional scars that accompany it.

Posted by: Let's do better | September 4, 2008 1:49 PM | Report abuse

Oxytocin is released from breastfeeding too, so presumably if you have a c-section, but begin to nurse immediately, your oxytocin levels would be the same if not higher than someone who delivered vaginally and then only used formula. Where's that study? FWIW, I had a scheduled c-section for medical reasons, I began nursing immediately, nursed for 14 months, and never had any bonding issues.

Posted by: heather | September 4, 2008 1:56 PM | Report abuse

Wow! I'm so glad that someone finally mentioned that birth matters. The experience matters to both the mother and child. It's sad to hear that some women have endured such traumatic births that result in so much anger and resentment. True medical emergencies are one thing, but many women so quickly assume that they just can't do it. Women believe doctors who tell them they can't or shouldn't do it when, in truth, the doctors are speaking for their own convenience. Those women are missing out and their children are missing out.

Posted by: Brenda | September 4, 2008 2:01 PM | Report abuse

Emotions definitely running high here. We all want to be good parents and I know it's hard not to feel offended when you did X and someone else says they did Y. It feels like a personal attack.

But maybe we can agree on a few things?

*Thank goodness for cesarean sections when they are truly needed. They DO save lives. (especially when a mother is hemmoraghing for crying out loud!! I'm sorry you weren't treated better "let's-do-better-NOT")

*Cesareans come with documented risks to mothers and babies and those risks should be outweighed by the benefit of doing one.

*Women should be fully informed of the risks and benefits of cs vs. vaginal birth and the choice should be hers.

*And, in the vein of what this small study showed, cesarean may have effects that we may not fully appreciate and understand.

I just got done reading "In Defense of Food" by Michael Pollan and I see a lot of similarities between what he says about the subtle and not-so-subtle impact of a corrupted food supply and the impact I see in over-medicalizing birth. We have so completely lost touch with what birth is supposed to be and we have very little idea about the long-term consequences of making birth a medical event like an appendectomy rather than respecting it as a physiological process like menstruation.

In my first two pregnancies, I spent all my time thinking about how to make labor less horrible. I was well into my third pregnancy before it occurred to me that it could be something other than awful. My thinking shifted to "how do I make this a wonderful, safe, healthy and empowering experience." In my experience, there is nothing wonderful or empowering about being cut open with a scalpel, tied to a bed with a monitor, IV tube, etc, or having supernatural contractions being induced by artificial chemicals. I'd do any of that in a heartbeat if it was a matter of keeping me or my baby safe. But the awful truth is that most of us are subjected to these sub-standard practices because it's what doctors are used to doing...it keeps patients in line, quiet, on schedule. And at the end of the day, we don't have much to show for it in terms of how well mothers and babies do. The U.S. ranks 41st interationally on maternal mortality and we've got the 2nd worst newborn death rate in the industrialized world.

We have the technology. We're spending the money. And still crap for outcomes? I wanted better for myself and my babies and to do that, I decided to go "organic" on my last birth. Outcome? Safe mom. Safe baby. Happy mom. Happy baby.

But the "system" isn't geared to do "organic." It's geared to do McDonalds. So if you want something different, you have to research it and hunt it down.

Good reading: Pushed by Jennifer Block
Good watching: The Business of Being Born on both Netflix and Blockbuster.

Posted by: Bea | September 4, 2008 2:02 PM | Report abuse

To my "friend" - You clearly missed a few points - had I not had an emergency c-section my son would have died and I would have died. Three separate OBs were called in for the emergency as I discovered when I received their invoices. Had I been with a nurse midwife we would have died - all the breathing, chanting, walking, doing the Hopi Indian dance would not have saved either of us. No, I did not thank my OB - she failed to recognize the severity of the circumstances; she did not rush to surgery. I truly believe that she didn't want to stand on her feet in the middle of the night and perform the surgery. I did meet with the head of the practice and they did admit that the hemorrage was not caught. I chose not to pursue a lawsuit because I was ultimately happy to have a beautiful son and I don't believe lawsuits help the healthcare crisis. I am grateful that there were surgeons who were finally able to help deliver my son, sew up my uterus without a hysterectomy, and leave me able to carry and deliver via c-section a second child. Why can't you accept that a nurse midwife would have never been able to do that? Are you head of the nurse midwife association? Insurance companies favor natural deliveries. The Blue Cross reimbursement rate for a natural delivery is $4000; a c-section is $10,000. There is tremendous pressure on OB's not to perform c-sections by insurance providers for this reason. Doctors should have the choice to perform them when medically necessary without insurance companies and preachy natural birth advocates persecuting them or the mothers that undergo the procedure.

Posted by: Let's do better - not | September 4, 2008 2:02 PM | Report abuse

Birth really does matter. With all of the talk of family values today, what value are we placing on our babies and ourselves when we let big business make our decisions. Perhaps if we stopped rushing and "getting through" the experience, we'd realize that it is all pretty amazing -- that might set us up for getting somewhere in the country with a reasonable system of paid maternity/paternity leave, etc. The more we value this experience, our babies, and the tremendous responsibility of parenthood -- and the more we own that experience -- the more chance we have to really champion our children's rights and our rights in larger society. I may sound nuts, but I think they are all connected. Speed and convenience are not working for us.

Posted by: Let's do better | September 4, 2008 2:14 PM | Report abuse

I was startled to read that C-section moms are supposedly less responsive to their babies' cries. I had both my kids by C-section and would wake up at the sound of the first whimper to breastfeed them. Being a loving mom has nothing to do with the way you give birth to your child. You may have a dreafully painful natural delivery or a fraught-with-tension emergency C-section (as I did with my first child) but when you hold your baby for the first time, you bond for life. It amazes me that there are researchers who waste their time on such studies.

Posted by: Deepika | September 4, 2008 2:18 PM | Report abuse

To "Let's-do-better-NOT" You actually may have been in better hands with a nurse midwife because they tend to spend much more time with their patients in labor. They're not at home, getting occasional phone calls/update from a nurse. They are by your side, and can see how you are doing with their own two eyes. They have collaborative relationships with physicians, so had you been a patient of a nurse-midwife, she would have been able to get a doctor to tend to you more effectively than that very lame nurse did.

Having said that, I appreciate what you are saying. You had an emergency. You and your baby could have died. That is very scary. I just don't understand the die-hard allegiance to the system that nearly failed you.

Posted by: Bea | September 4, 2008 2:19 PM | Report abuse

Birth is a really emotional issue for me, as I had two very unwanted but ultimately necessary c-sections. Without participating in the debate going on here, I just want to thank you for covering this topic and look forward to reading more about it in the future.

Posted by: MSU | September 4, 2008 2:45 PM | Report abuse

To answer Bea's comment - I'm not sure it's a die-hard allegiance to the system -maybe there isn't enough information out there about what a nurse midwife can do in the event of an emergency or for high risk pregnancies or how insurance providers cover nurse midwives and then OBs when surgery is needed? I can tell you that they (the system) got it right with the second child who was delivered via-c without emotional distress in a very controlled environment with minimal discomfort for which I am eternally grateful. I never got the sense that any of the OBs in my practice advocated c-sections. All of them viewed it as medically necessary only. I'm not sure where all the docs are that hand out c-sections like tic tacs but that was not my experience.

Delivery should be an individual matter based on the medical needs of the mother and baby. I think what we all can agree on is that paid maternity/paternity leave in this country is abysmal regardless of delivery method. Equally deplorable is the lack of resources for early education and child care. All of us want happy, healthy, educated children. It would be nice to see all this energy being directed towards that end instead of arguing at cross purposes as to how these children came into the world.

Posted by: Let's do it better - Not | September 4, 2008 2:48 PM | Report abuse

Thank you for addressing this issue. Thank goodness c-sections exist for when they are truly needed, but when they are done for financial or convenience reasons, all sorts of unnecessary risks are introduced to the mother and baby.

In most cases, vaginal birth is safer for the mom and the baby. I don't think people who talk about that are trying to make anyone feel guilty. They are sharing facts that women can use to make truly informed birthing choices.

Posted by: Lisa H. | September 4, 2008 2:54 PM | Report abuse

I guess I'm just a little confused. When I was pregnant a c-section was not an option I could just choose. I was told a c-section would only be the case in an emergency. We hear about celebrities opting for c-sections but I always thought that was not an option for mere mortals. The posters on this site make it sound like every woman has the option to choose a c-section. Insurance providers don't permit. Is there really a surge in medically unnecessary c-sections? And if so, don't you think insurance companies and medicaid would bust these doctors?

Posted by: vhr | September 4, 2008 3:27 PM | Report abuse

Very interesting. I delivered my first baby by c-section after 29 hours of labor. After my surgery, I didn’t see her for 3 hours. When we were finally transferred to the post partum room, I actually asked my husband, “Are you sure this is our baby?” I have no recollection of actually saying that, though I remember thinking it. What a terrible way to start my relationship with my first child. I successfully breastfed her but I felt a terrible disconnect – like I was so excited for an event that didn’t happen. Instead I was randomly handed a baby that I had no part in birthing. I know others feel differently and I am grateful for that. I suffered terrible post partum depression afterwards and I hate to hear women going through what I did. No one told me I failed but I couldn’t shake the feeling of being broken.

I decided that there must be a better way to birth. I hired a wonderful midwife and my second child came into this world vaginally and completely unmedicated after 41 hours of labor. I have never felt such joy, elation or love in my entire life.

I still feel bad that my first child did not get that wonderful birth but both of my children are the lights of my life.

The cesarean rate in this country is much too high (31.1% in 2006; it was nearly 40% in NJ in 2007)). This is another reason we need to lower it. The author left out one very key reason the c-section rate is sky-rocketing: doctors telling women that VBAC (vaginal birth after cesarean) is unsafe or refusing to allow them to attempt one.

Posted by: NJ_VBAC_mom | September 4, 2008 4:40 PM | Report abuse

Carrie ~ Are you talking about the Landon study published in the New England Journal of Medicine in 2004? If so, you better reread it.

7 mothers (out of 15,800) undergoing repeat c-sections died; 3 mothers (out of nearly 17,800) attempting VBAC died.


There were 114 uterine ruptures among the nearly 17,800 women attempting VBAC (mostly in patients receiving pitocin or labor induction drugs). 12 babies suffered Hypoxic-ischemic encephalopathy following VBAC attempts but only 7 of those were following a uterine rupture. While no babies died during the repeat c-sections, only 2 babies died following VBAC attempts. Obviously very few uterine ruptures result in fetal death.

So there were 2 neonatal deaths in the VBAC group vs 7 maternal deaths in the repeat c-section group.

The choice between VBAC and repeat c-section is not that clear cut. I had another child to consider whom I did not want to leave motherless.

Posted by: NJ_VBAC_mom | September 4, 2008 4:45 PM | Report abuse

Yes, a small study, but I am thankful to see that it's being acknowledged that BIRTH MATTERS. It's not saying that a mom who births vaginally is better than a cesarean mom, it's just acknowledging the obvious- hormones are affected when the natural process is tampered with. Luckily we are conscious, intelligent beings and we can often work through this to still parent successfully, but that doesn't mean that it's the same physiological process when a baby is born vaginally or by cesarean. I look forward to reading more about this issue.

Posted by: LNC | September 4, 2008 5:19 PM | Report abuse

To VHR: If only the insurance companies could be part of the solution! But they choose not to be for fear of bad PR and the difficulties involved in telling the difference between a necessary and unnecessary c/s. Remember all that flack they got about "drive-thru" deliveries and mastectomies? If they made concerted efforts to reduce the c/s rate, they would be accused by doctors (and probably women too) of depriving dying women and babies of necessary c/s. So, they continue to pay for hundreds of thousands of unnecessary and very expensive surgeries. (about $6-7K for normal vaginal birth, about $13-16k for a normal c/s) And THEY are not the ones getting stuck with the bill. YOU are. How many times have your health insurance premiums gone up in the last decade? How much are you spending on your Rx co-pays compared to 5-10 years ago? It all trickles down to you. And it's pretty easy to find OBs who will do c/s on patient request. They're happy to do it. It's quick, they can schedule it during the day, and it makes them feel more protected from lawsuits. So, the insurance companies are subsidizing a major lifestyle improvement for OBs. But a very percentage of women who end up agreeing to unnecessary c/s (who are told it's no big deal) will suffer a consequence they didn't bank on...bleeding, infection, blood clots, a baby with respiratory distress, or born prematurely...or later on, infertility, miscarriage and dangerous complications with their placenta in the next pregnancy. The evidence on this is indisputable. It's not a question of *if* this stuff happens, it's a question of *who* it ends up happening to. Necessary or not, some c/s moms will draw the short stick and pay a price.

Posted by: Melgirl | September 4, 2008 5:25 PM | Report abuse

Sure birth matters. It's how we get babies. The problem is, a natural vaginal birth has been glorified as the be all and end all of how to have a baby. No wonder c/s moms get defensive. They are too often told (if not in so many words) that their experience was wrong or a failure. How is it a failure to have a healthy baby? I had a C-section, and I don't feel bad about it. Sure, I'm going to try a VBAC with my next kid due in a couple months, but that's because I know recovery from a vaginal birth is usually easier. If it ends up a c/s again, so be it. I had no trouble bonding and no ppd, and don't expect any trouble this time either.

Posted by: mar | September 4, 2008 7:21 PM | Report abuse

Hi Mar - Glad your c/s experience wasn't bad for you. If you're truly interested in a VBAC, you should hook up with the International Cesarean Awareness Network. There are ICAN chapters in the area. Check out this link http://icanofnova.org/articles/Cesarean_Rates You'll see your chances of VBAC are less than 1% at most area hospitals and it's because docs hate "letting" women have them. If you want it, you have to fight for it unless you dumb-luck into it. ICAN moms have been there, done that, and have a lot of good tips to share.

Good luck and best wishes for a safe and happy arrival for your little one.

Posted by: bea | September 4, 2008 7:48 PM | Report abuse

First baby was an emergency c-section -- they didn't discover until my water broke she was coming feet first. Had I waited for labor to start chances are too good we'd have lost her had her foot pushed the cord out first. Absolutely stunned they held fast to their claim she was head down, after baby two I knew for sure baby one never went head down. Felt like a failure because I didn't even get to try labor (too late to turn her, too much fluid lost). Delivery was way out of my control, didn't see her for hours. Recovery was fine, I didn't have hours of labor and pushing prior to surgery. And it did give us a great child birth story.
VBAC'd with DS, over four years later. No complications, no issues and yes, we got overloaded with info on the risks. A little more medical than I wanted, but I also wanted the best shot at a VBAC. Loved the experience!
As for bonding -- no difference. I loved them both beyond anything I've ever felt before. Was extremely sensitive to their cries (still am), I didn't see a difference and DH swears I could hear them from miles away.

Posted by: Anonymous | September 4, 2008 9:26 PM | Report abuse

First baby was an emergency c-section -- they didn't discover until my water broke she was coming feet first. Had I waited for labor to start chances are too good we'd have lost her had her foot pushed the cord out first. Absolutely stunned they held fast to their claim she was head down until we were in triage, after baby two I knew for sure baby one never went head down. Felt like a failure because I didn't even get to try labor (too late to turn her, too much fluid lost). Delivery was way out of my control, didn't see her for hours after. Recovery was fine, I didn't have hours of labor and pushing prior to surgery. And it did give us a great child birth story.
VBAC'd with DS, over four years later. No complications, no issues and yes, we got overloaded with info on the risks. A little more medical than I wanted, but I also wanted the best shot at a VBAC. Loved the experience!
As for bonding -- no difference. I loved them both beyond anything I've ever felt before. Was extremely sensitive to their cries (still am), I didn't see a difference and DH swears I could hear them from miles away.

Posted by: Stroller Momma | September 4, 2008 9:27 PM | Report abuse

"Just STOP telling me I did something wrong because I had my c-sections. It is NONE of your business and I believe my life and that of my babies was saved by this "intervention". I hate it when people say there is a right way and a wrong way to do something."

If you are in my PPO, anyone else's HMO, or on Medicaid- basically unless you paid every red cent out of pocket- then it is the business of others. Of course we all want all moms and babies to be happy and healthy, but the pie can only be sliced so many ways before we run out.

If we are paying for medically unnecessary c-sections, then there is less $$ left to pay for breast cancer treatments, care for kids with cystic fibrosis- I want the money in my PPO/HMO/ and from my taxes to be spent wisely, so that moms and thier babies can receive care no matter their ages.

Medically unnecessary procedures should be covered as such, I do not wish for my PPO to pay for any medically unnecessary surgeries. Believing that your c-section was medically necessary and life-saving does not make it so.

"Insurance companies favor natural deliveries. The Blue Cross reimbursement rate for a natural delivery is $4000; a c-section is $10,000. There is tremendous pressure on OB's not to perform c-sections by insurance providers for this reason. Doctors should have the choice to perform them when medically necessary without insurance companies and preachy natural birth advocates persecuting them or the mothers that undergo the procedure."

Doctors make more money on c-sections. Let's not feel sorry for the obs. I know there is big controvery in this field, about mal-practice rates and such, but seriously. I did a search on our county assessor's site looking up the purchase prices of the homes for all the obs I could find and the same for all the certified-nurse-midwives I could find. There was noooooooo comparision. I know that no one wants to think that her doctor added an addition with funds that she is still struggling to pay off, but the obs who live across from my friend just purchased an adjoining lot, and knocked down the house on it to expand thier lawn.

When fewer insurance funds are spent on unnecessary procedures, there are more funds to spend on necessary ones. I dislike the insurance game as much as anyone, and find the money raked in by those at the top of those gammets to be sick and twisted, but the reality is that the company is only going to pay out so much, and if it spend it here, it won't spend it later. As to just leaving the option of surgical birth up to doctors- just like every other profession, some doctors are great, some stink. It is funny how so many babies are born Tuesday through Friday during bankers hours compared to nights and weekends. We can't just say let's trust the doctors, because they are often faced with a conflict of interest, due to hospital policy, personal commitments, etc.

There are so many reasons to avoid medically unnecessary c-sections. C-sections run higher risks for moms than vaginal birth, can make subsequent conceptions more difficult, and gestations more complicated and dangerous. Like for example placenta acreatea. This occurs when the placenta grows into the uterus itself, rather than the lining. The incidence of this has increased 10x since c-sections became so common, from 1 in 25,000 to now 1 in 2,500. One in 11 babies dies and the condition usually requires a hysterectomy. And 1 in 14 moms with the condition dies as well. I'm not sure how that stacks up mathmatically to 9 in 25,000 infant deaths with attempted vaginal births (as was cited earlier as bad odds), but considering the effects of a c-section just in terms of that one baby is a bit of a narrow perspective. C-section increases the odds of ectopic pregnancy, one of the leading causes of maternal death in the US, also placenta previa, placental rupture, and uterine rupture are more likely. You can look up the stats if you care. And where do we get off thinking we are entitled to perfect outcomes 100% of the time? That is so arrogant when one considers that there is only so much health care to go around. Rail against it all you'd like- it's reality.

I was present during the labor of a friend whose uterus was rupturing. She had a "window" in her uterus (much like a hole in your ear for an earring). This window was the result of a c-section she'd had with her previous pregnancy done after an elective induction that went nowhere. The window and its rupture were fortunately not at the site of the placenta (placentas don't like to grow over scar tissue, look up why if you are interested), so she was fine, and baby was fine, although it was incredibly painful for her. She got an epidural, but it didn't touch that pain. The contractions were a distraction from the real pain of rupturing. Anyway, following the ordeal she was then told by her doc not to become pregnant again- it would be too risky for her and her baby. But she did, and baby was sectioned early (due to previous mess) and had to spend time in the ICU. Which cost thousands and thousands and thousands of dollars and was graciously covered by those in her HMO.

And although she is not someone whose parenting I admire, and I don't think of her as a critical thinker or a strong woman I would say that she is nicely bonded with her children, and they love her very much. She mostly breastfed them, although it was a struggle each time, especially following her first, due to the vomiting and fever caused by her uterine infection.

I'm just saying: let's think before we have that c-section. There are times for surgical birth. Just not even close to 35% of the time. Check out Ian Mae Gaskin's stats. And think about the reasons for the sections, many of which really are for convenience, or for conditions that can exist only due to poor diet and lack of exercise, or for iatrogenic reasons. Save the OR and the funds for those for whom the benefits are most likely to outweigh the risks.

Oh- and to the poster who commented that the increase in maternal death rates decreased due to c-sections: you should take a look at what happened when birth moved from home to the hospital, and then again when hand washing became routine.


Posted by: bigpictureisbest | September 4, 2008 10:29 PM | Report abuse

Thanks for this article. I think it was informative and unbiased.

Posted by: Eve | September 4, 2008 10:41 PM | Report abuse

I had two c-sections. No problems bonding. Breast fed for around a year for both.

I was always anti c-section, anti-medicalization of the natural childbirth experience until my first c-section saved my daughter's life. Now my perspective is that the easy availability of c-sections has fundamentally transformed childbirth into something we can expect to survive. There are far fewer dead mothers and babies thanks to this intervention. Because of that, I would rather have too many c-sections than too few. I bet every mother whose life was saved because of a c-section would agree with me. A serious study of the costs of c-sections would need to include the costs of caring for more seriously injured mothers, more babies who were disabled because of birth trauma, the societal costs of more children with no mothers, etc. There are costs on the other side of the balance sheet which balance the added costs of c-sections.

The study focuses on the oxytocin benefits of vaginal birth on bonding vs the lack thereof in c-sections. What the report doesn't control for (and needs to) is difficulty of recovery. A c-section is major surgery and recovery is no joke. I was in bed, catheterized, on the epidural for hours after the c-section. I could not get up and pick my baby up out of the crib. In spite of the epidural, I was in serious discomfort. As much as I wanted to bond with my babies 100%, part of my time and energy was spent recovering. That said, I didn't feel any lack of bonding at all, loved them enormously right from the start.

Posted by: Hard to recover from a c-section | September 5, 2008 11:50 AM | Report abuse

I do agree that the CS rate in this country is excessive and that honest assessment of the risks of vaginal birth vs. CS is not examined enough.

Don't be mislead, however, about the very real patronizing condemnation thrown about by natural childbirth enthusiasts. While touting "informed consent" and "informed choice" these women really DO look down on women who have a CS as being ignorant, pitiful, uninformed, selfish, naive. Real women give birth vaginally and truly venerated goddesses give birth at home. These "real" women extend no respect at all to those who have indeed made informed choices to use OB's and hospitals for their baby's birth.

I belonged to the ICAN email list for a while as well as a Christian natural childbirth email list and their "support" is veiled contempt and self-rightousness. If I "really investigated the facts" or worse if I "really trusted God" I would not choose an OB as a health care provider nor would I give birth in a hospital.

Each side will try to be even handed in this discussion but a reading between the lines can easily see otherwise.

Posted by: shema4t4 | September 6, 2008 12:15 AM | Report abuse

My baby was born via cesarean for failure to progress. I had hoped for a natural birth but always said, "I'm not going to be a martyr! I'm not above pain relief." I felt so sad and empty afterwards so I tried telling people that I was sad about my c-section.

I expected people to give me sympathy and tell me that vaginal birth was best.

But no one did.

Everyone told me that it didn't matter how the baby got here.... the only thing that matters is a healthy baby.... at least you didn't get messed up down there....

It shocks me that women think they are looked down upon for having c-sections. People treated me like I was lucky! And I shouldn't complain. So why did I feel so sad? And why did no one take me seriously? And what about my health? My healthy baby didn't have an emotionally healthy mother.

I joined the ICAN email group. I don't think the women are self righteous at all. They give you straight talk about birth but I think they genuinely care about the whole mother (physically and emotionally), as well as the baby, and want women to have wonderful memories of their births.

Posted by: MommaL | September 6, 2008 9:46 AM | Report abuse

My baby was born via cesarean for failure to progress. I had hoped for a natural birth but always said, "I'm not going to be a martyr! I'm not above pain relief." I felt so sad and empty afterwards so I tried telling people that I was sad about my c-section.

I expected people to give me sympathy and tell me that vaginal birth was best.

But no one did.

Everyone told me that it didn't matter how the baby got here.... the only thing that matters is a healthy baby.... at least you didn't get messed up down there....

It shocks me that women think they are looked down upon for having c-sections. People treated me like I was lucky! And I shouldn't complain. So why did I feel so sad? And why did no one take me seriously? And what about my health? My healthy baby didn't have an emotionally healthy mother.

I joined the ICAN email group. I don't think the women are self righteous at all. They give you straight talk about birth but I think they genuinely care about the whole mother (physically and emotionally), as well as the baby, and want women to have wonderful memories of their births.

Posted by: MommaL | September 6, 2008 10:31 AM | Report abuse

"There are far fewer dead mothers and babies thanks to this intervention. Because of that, I would rather have too many c-sections than too few."
An intervention that is wonderful when actually necessary, and expensive and dangerous when not. A couple extra, sure, but not 3 times as many as medically required. The pie can only be sliced so many ways.

"I bet every mother whose life was saved because of a c-section would agree with me." Most moms who have c-sections are told that the surgery was a life-saving operation. Who wants to believe that they have undergone such an event and assumed the associated risks and expense without good reason? I attended a birth where the mom was induced while baby was high in the pelvis- pit was generously given, mom layed in bed, and was eventually sectioned for failure to progress. Upon section it was discovered that baby's head was not presenting in a way too crooked to get through the pelvis. This mom is told that baby never would have come out that way. Good thing we operated when we did before baby became stressed... Well seriously, how did that happen? Gosh, what if we'd waited for labor to begin instead of inducing so dr. could go out of town? Maybe baby would've found a decent way through the pelvis of being jammed into a weird position. We have to look at how and why so many of these life-saving events become necessary and be responsible about avoiding them when possible. Save the OR and the funds for those for whom the benefits are most likely to outweigh the risks.

"A serious study of the costs of c-sections would need to include the costs of caring for more seriously injured mothers, more babies who were disabled because of birth trauma, the societal costs of more children with no mothers, etc. There are costs on the other side of the balance sheet which balance the added costs of c-sections." This is true. However, we need to include in that study a comprehensive review of the factors that contributed to the sections so that only those that were truely unavoidable are included. When baby is in a transverse lie, or when mom has serious placenta previa (with no prior history of C-section or other uterine damage), or cord entanglement occurs (although one study showed that moms who exercise have less of that), etc. then let's include those in this study. But for those who eat trash and sit on the couch and develop gestational diabetes or hypertention or pre-eclampsia- those are conditions that should have been addressed and managed long before the day of delivery.

I knew a woman long ago who, as part of a series of unfortunate interventions, ended up with an amnio-infusion and then sadly an amniotic fluid embolism from which she died. Maybe the result would've been the same with a more natural approach, but I doubt it, since amnio-infusion is a major factor leading to that usually fatal complication. Her doctor induced her as per his week past dates routine.

Iatrogenically caused surgical births are not something for which to feel grateful. Neither are surgical births due to poor life-style/health choices something about which to get excited. We need to consider the reasons women need these life-saving measures. Again, refer to Ina Mae Gaskins stats for an idea of how many women truely require surgical birth.

"If I "really investigated the facts" or worse if I "really trusted God" I would not choose an OB as a health care provider nor would I give birth in a hospital." I have had babies at home and in the hospital. You assume riskes either way- just pick your poison. I am a photographer, and can not help but look at life as a series of photo opportunities. OBs are surgeons, and can not help but look at birth as possible surgeries. Midwives are experts in normal. They know and love normal. Most midwives are not excited about sickness and that sort of thing- they love normal, and like everyone else they want to feel successful and helpful at the end of the day. They do not want to keep in their practices women who will likely present problems in labor. If you have reason to anticipate that you will be needing a c-section due to some pre-existng condition, then it would be silly to see a midwife. If you expect to birth vaginally, then a midwife is a great choice. She will be with you during your labor, whereas an OB will likely stop in a couple times to make sure you are fine, and then arrive for pushing. And by the way, babies who are not doing well during labor let you know- they don't have great heart tones, things don't progess, and having a midwife who is checking these things is a whole lot more reassuring to me than a continuous electronic fetal monitering belt that someone is reading from a remote location. Did you know a study showed that intermitent auscultation is at least as reliable as that belt? Oh, and third stage- don't get me started... Know what you want. You don't go to Taco Bell for chinese food.

Posted by: Anonymous | September 6, 2008 1:29 PM | Report abuse

I don't understand why the women here who have had c-sections are so defensive about them. C-sections are such a common choice in medicine, I've never heard anyone judged harshly for having one. I've heard doctors criticized for being quick to perform one, but no one blames the mother for agreeing to one.

As someone who gave birth twice in a birthing center that is now closed for no good reason, it seems like natural child birth needs defending. My birth experiences were beautiful; and it's unbelievable what blank stares I get when I talk about it to women who haven't been through something similar. It's sad that there aren't many people who understand the birthing center experience, or the irreplaceable experience of feeling a child born without intervention, and why it's important to keep choices like that open to women.

I understand it's not an option for all pregnancies; and I also gave birth to twins in a hospital. It was a high risk pregnancy and I received great medical care, but the experience was often just plain silly. I had to fight hard throughout the pregnancy to deliver the twins vaginally. It's a shame I had to get so insistent every step of the way to not be automatically scheduled for a c-section at 36 weeks. Anyone in my situation not willing to adamantly defend their desire for a vaginal birth would have automatically had a c-section. It's a much a business decision as a health decision these days, and that doesn't seem quite right.

Posted by: common sense | September 6, 2008 5:12 PM | Report abuse

I'm glad so many of you haven't had the judgmental finger pointed your way by natural childbirth advocates after you have had a c-section . It's a disapppointing experience and I don't wish it on anyone. I certainly didn't appreciate it. My unfortunate perspective regarding my time with the ICAN email group is obviously not shared by all and I respect that. My read-between-the-lines was that the women on frequenting the email list at that time cared a lot more about being right than they did about me. An unfortunate experience and I'm glad to see that it's just my own point of view.

Posted by: shema4t4 | September 6, 2008 7:30 PM | Report abuse

I'll admit it- I liked my c-section. I had my first child vaginally, with a nurse-midwife- and it was an awesome experience. But afterwards I was exhausted and had tons of pain for a long time (30 hr labor with a 9-lb baby, and I was barely 100 lbs when I got pregnant). My recovery was very slow and painful.

The second time around, I was having twins, and one was breech and the other was transverse. So I knew pretty early on that I needed a c/s. I was really nervous about it, but the recovery was (for me) much easier than from the vag. birth. I felt like I bonded with my twins more quickly than with my first child because I wasn't in as much pain as I had been the first time.


I think a study with a sample size of 12 is just garbage. I would also like to know if these women had planned vs emergency c-sections. I would imagine that an emergency c/s is much more traumatic, especially since those women may have had to go through a long labor AND surgery.


Posted by: va | September 6, 2008 7:50 PM | Report abuse

Press on this study (here and in the NYT) totally glosses over what the study means by a c section birth. Is it one with no labor only? Or is it one that ends in a c section, regardless of how much labor and/or pushing occurred before that? Hormone levels and maternal fatigue would be quite different for the two situations.

Here's a vote against long labor + surgery! My planned c section was a breeze compared to the unplanned one.

Posted by: Lynne | September 8, 2008 6:35 PM | Report abuse

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