The C-Section as Birth Control
Did you know that women who experience cesarean birth (c-section) are less likely to have another baby? Cesarean section impacts far more than the birth experience- it impacts fertility.
I talked to not one but two women this week who had one child but had wanted to have more. What happened?
The thing that made them change their minds was giving birth to their first child. And they gave birth via emergency cesarean section. They were both so disturbed by the experience that they decided that they would have no more children.
We often talk about the impact of the ever present c-section in our culture. People talk about how it can impact the breastfeeding relationship or recovery time or the difficulties in VBAC and even how lifesaving and wonderful it can be. These are all important factors. But there is something that is often overlooked.
The c-section is a cruel form of birth control.
I have talked to dozens of women who limit their family size because of c-sections. Sometimes it is because their c-section was unexpected, scary, and traumatizing. Sometimes it is because they were told that they "had" to have repeat sections and that they should limit their family size to three or fewer children for their own personal safety.
Whatever the reason, we must talk about this issue.
Roger W. Harms, M.D. of the Mayo Clinic, when asked how many c-sections a woman can safely have says this:" Most women can safely have up to three C-sections. Each repeat C-section is generally more complicated than the last, however."
He goes on to mention some of the risks of numerous abdominal surgeries. They include:
"Primary concerns with repeat C-sections include:
- Weakened uterine wall. Each uterine incision leaves a weak spot in the uterine wall. This may interfere with future attempts at vaginal birth.
- Problems with the placenta. The more C-sections you've had, the greater the risk of developing problems with the placenta — such as when the placenta implants too deeply and firmly to the uterine wall (placenta accreta) or when the placenta partially or completely covers the opening of the cervix (placenta previa).
- Heavy bleeding. The risk of needing a hysterectomy — removal of the uterus — to stop excessive bleeding after delivery increases with the number of repeat C-sections."
I have met so many women though who never move past that first traumatic birth experience. To me this is one of the unspoken tragedies and cruelties of modern birth. Whatever you think of family size and population control, it is exceptionally distasteful that the way we damage women at the time of birth is so traumatizing both physically and emotionally that they actually change their life and family plans because of it.
We can talk all day about the monetary cost of the c-section or about how it saves lives or about bacteria in the birth canal and trouble breathing, but you can not put a price on the damage we are doing to women.
This is cruel. This is abusive. This is wrong. And- this is how we are treating women at the time of their babies births. We are literally hurting women so deeply that they are scared to death to ever bear another child.
How often does a normal, natural, un-medicated birth do this?
I want to share some comments from a mom forum regarding this subject. These women say it far better than I ever could.
"My doctor has said that since I had so much scar tissue from my third c-section, that he doesn't recommend that I try it again. We've decided to take his advice. Our third child died because of malformed kidneys, and my heart is longing for him, but we are blessed with two others, and God has seen us through it all. I know that if He means for us to have another, thought it may not be ours biologically, it will be a gift from Him. My advice to those who really want another child, but the circumstances don't favor it--pray for guidance, listen to your doctor, and be content with the blessings that you do have."
"i had two c-sections so far i am pregnant now and having 3rd c section soon. my dr keeps pushing me to have my tubes ties but i am married and only 25 i dont want to get tubes tied dont know what i should do???i have 2 boys dont know what this is? should i risk a 4th? or get tubes tied??"
"I am absolutelty scared to give birth, my husband and i trying to get pregnant again, i had c-section in August with my first baby and the recovery was horrible thanks to a hospital error that resulted in sever staph infection and blood infection. I really want to go naturally next time but im scared to death, especially since DD's head was 15 inches when she was born,"
"i had two c-sections so far i am pregnant now and having 3rd c section soon. my dr keeps pushing me to have my tubes ties but i am married and only 25 i dont want to get tubes tied dont know what i should do???i have 2 boys dont know what this is? should i risk a 4th? or get tubes tied??"
"I am absolutelty scared to give birth, my husband and i trying to get pregnant again, i had c-section in August with my first baby and the recovery was horrible thanks to a hospital error that resulted in sever staph infection and blood infection. I really want to go naturally next time but im scared to death, especially since DD's head was 15 inches when she was born,"
I must not be the only person who finds these sentiments so incredibly tragic. Women are yearning for more children. Women are being pushed into not just unwanted c-sections, but unwanted tubal ligations. Can we even describe how cruel this is?
Lest it seem like I am just inventing this problem after talking to a few women (in fact I have talked to numerous women through the years who get their tubes tied after their 2nd or 3rd c-section or who are so upset by the ordeal of the first birth that they simply stop trying on their own) let's look at a huge documented study supporting this fact: women who have c-sections have fewer children.
In fact, the study found that, "women who underwent C-section to have their first baby were 12 percent less likely to have another child than women who gave birth vaginally."
You can read the study in full here, which concluded, "This suggests that the reduced fertility was to a large degree voluntary and not related to the indication, nor to any physical consequence, of the cesarean delivery."
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There are women who have half a dozen or more c-sections safely. There are women who love their surgical births. There are women who have traumatic births and go on to have wonderful empowering births later. But we can not ignore the fact that the impact of the prominent cesarean section is far deeper and damaging than anybody cares to admit.We are talking about a surgery that is done about 30% of the time in the USA. We are talking about surgery that is the most common surgery for women. This is also a surgery that not too many years ago was done only about four percent of the time. The fact that the c-section is limiting family size is no laughing matter.
We can not ignore the impact of modern birth on the modern woman. We must take back our choices, our bodies, our births and our families. I wish I could say that there are others out there that will help us do this, but I just don't believe it any more. We must own our choices, face our fears, and give birth under our own power.
Comments
That seems like a pretty drastic thing to say to some people (Especially women who love their surgeries) but I can't put my family through that again. I don't care as much about me, but I find that when I'm not 100% mentally and physically, as I wasn't after my son's birth, I am a dead weight for them.
You mention that the wounds that are done to these women are deep. That is true. But who is going to measure the impact this has on Husbands, children and subsequent children?! My son is great, but I think he bears emotional scars of having a mentally absent mother for the first 12 months of his life.
But as we've been finding in this HBAC fight... the people that make the rules don't care that even though I am 26 and married, that I won't have any more children. By the sounds of those comments you took from the forum about Tubes getting tied it sounds like they don't want us "Defective" mothers breeding anymore anyways!!!
It's not usually until after a woman has gone through a traumatic birth that she begins to investigate and realize just how common it is for women to feel traumatized after a c-section. It's a dirty little secret that gets pushed to the side because we don't feel like we're supposed to complain as long as the baby is healthy. We have a long way to go in acknowledging that the mother's experience absolutely does matter in childbirth. How could it not?
That first mother's comment really pulled at my heartstrings. I also lost my third child shortly after his birth. I could not imagine not being able to have another child. It felt like a biological imperative to me. I had to.
My husband and I would like a couple more children in addition to our three living. Still, the idea of a second cesarean looms large to me. A cesarean might have saved the life of my third, so I am much more accepting of the idea.
I had a friend who also had a cesarean with her first. I encouraged her, along with many others, to try for a VBAC with her second. The doctor insanely decided to induce her labor and, while she delivered vaginally, her uterus ruptured. She required several blood transfusions and had a drastic hysterectomy. Her cesarean plus the decision of the doctor to induce gave her permanent birth control. It was heartbreaking for them as they had both wanted large families.
C-sections have so many untold or hidden consequences. Thank you so much for writing about this.
My oldest definietly bears the scars of being a c/s. And not just emotional, they cut his back. (mildly but still happened)
I cannot put my husband, our marriage, my family or my BODY through more of this torture. It makes me sick to think about, but it is true. C/S may be my birth control too.
I feel bad for those that think they can't have more, because they had a c-section. I also know of two or three moms that have had multiple c-sections. I know it can be done.
The answer is all the time. Women died many times during childbirth or had close calls that scared them away from sex forever. Teh pain of childbirth left many women fearful of sex itself. Queen Victoria herself said that bearing children was her punishment for loving to be with her husband.
As for me, it is now believed that the hours I spent in all natural childbirth were tragic enough to cause a cronic pain condition. I'll never be the same and I have an illness that is going to be with me for the rest of my life.
Interestingly, Utah, Idaho, and New Mexico have the lowest c-section rates in the country. My four children have been born in two of these states.
I see another side of the coin here that concerns me, and this is women who say, "My mom had all six of us by c-section. It's totally safe." Women are not warned of the dangers of repeat c-sections, only the "danger" of VBACs. Fascinating.
Thanks again for starting this conversation. I see everyone and their grandma has re-posted. I'll end up being the last because of vacation. Oh well. Another Tim McGraw show (#14) under my belt. :)
And I could have said the exact same thing as the first commenter!
I think just as much as I am scared by this happening to women is women letting it happen and not fighting it.
http://rubyslippersx3.blogspot.com/2011/05/further-thoughts-on-that-topic.html
http://rubyslippersx3.blogspot.com/2011/05/off-my-chest-lds-birth-control.html
From another perspective, having not even HAD a c/s, the IDEA of having one scares the heck out of me, because I feel like once I do, my options are SO limited (stubborn OB's, strict midwife regulations, my comfort birthing unassisted after a cesarean, etc). The thought of how I'd continue to birth like I WANT to after a cesarean really freaks me out, unfortunately. Thankfully I fully understand all I can do to avoid an unnecessary c/s (which, first and foremost, means birthing outside of a hospital, Lord-willing), but if I ever did need one, I fear it would really impact the way I viewed my future births.
I never knew that a cesarean could cause so much damage, physically and emotionally, to me. I think my daughter suffered so very much the first year of her life because I had a very hard time loving her because of what happened.
The idea that I might not be able to have more children because of my cesarean rips my heart out. Every single day I regret what happened when pregnant with her.
Three years later I was pregnant...It was unplanned. I fought hard to be given a TOL. In the end my baby turned very very late in birth (38+ weeks) and the concern was that there was something wrong with her head & brain development. She was footling breech, and I didn't have a proven pelvis. My TOL was going to happen at home b/c of the laws regarding midwives delivering VBAC babies. I did not think it would be safe to attempt a VBAC at home with a footling breech on a newborn that may have problems surviving.
I made the decision to opt for a second c-section. Then I cried for 4 days straight. And I cried the night before. I was so worried everything would be exactly like the first time...That I would leave the hospital feeling injured & broken.
My baby was delivered healthy & okay (and no, I don't think this was one of those bait & switch sections...My midwives were doing everything possible to get the baby turned and even hid my files from their officer manager who would have told me immediately to transfer my care).
We're considering now planning a third child...I'm not really considering what would happen during labor & delivery.
I remember when I had to get approved for my VBAC/TOL I had to see a doctor a few hours away. He brought up the concerns mentioned in the article...and then said, "Once a year I volunteer in somewhere Texas...And almost every year I help deliver Mrs. Hernandez. She's had 13 c-sections. Her babies are all born healthy." We discussed it further and he was basically saying, "A c-section won't limit the number of children you want to have..." Which was the exact opposite of the 20 or so doctors I'd talk to before. They all wanted to cut me off at 2. Do I want 13 babies? Probably not...but I'd like the OPTION to have 13 babies...
obgyn gilbert
The sixth baby was an emergency section after over 4 hours of pushing. Turns out he had Cranio Stynostis where the skull plates are fused. There was no possibility of a vaginal birth for him.
I was traumatized. As a "natural tendencies" mom and a lactation advocate, that emergency section followed by a blood clot and weeks of appointments at the childrens hospital for his birth defect it is no wonder I had severe PP psychosis by the time he was a year. It was a long and hard recovery but we did it w/o perscription meds only supplements.
Baby #7 was a chosen c section after almost 8 months of thought research and prayer. The risks of hemmorage and death were just too high for me. I was on blood thinners for a clotting disorder. The first few days were great until the incision came open. The recovery after that was horrible and i used a wound vac for almost 2 months.
I chose to have my tubes tied for a number of reasons, One this was baby #7, two my age, three my blood clotting disorder, four the recovery.
Had either of my sections been my first few children, I would have stopped. The PPD and the recovery were major factors.
While uneccesary or unexpected sections can be deeply traumatizing and wounding sometimes the Dr. is not lying and it is medically necessary. W/O that first section both me and my baby would be dead.
My daughter's birth was intensely traumatizing. I have almost no memories of her birth or the first 18 months of her life due to a combination of PTSD and postpartum depression. I have continuing issues with pelvic pain and dysfunction. I'm terrified of ever becoming pregnant again, to the point where I've asked my doctor about a hysterectomy. All of this is due to a "textbook perfect, easy" vaginal delivery: barely 20 minutes of pushing, no tearing, very little immediate pain, no separation from the baby, breastfeeding established within 15 minutes.
I'm not suggesting that a c-section would have been less traumatic for me, especially as I have issues with anaesthesia working properly, but it's also unfair to say that vaginal birth is inherently less traumatizing because it's natural and non-surgical. Trauma is a peculiar thing. What is acceptable for some people turns into a nightmare for others. In contrast, many of my friends who have had c-sections did not have lasting issues as I've had.