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Cara McDonough

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I Don't Care How My Baby Is Born

Posted: 02/02/11 01:21 PM ET

I know. I do. I should care.

Total apathy regarding my obstetrical choices could result in a huge backlash for the feminist movement, for our collective nether regions. Or something like that.

I'm not an awful version of the fairer sex, I swear. I agree that the C-section rate -- which, in the United States, has increased from five percent in 1970 to more than 31 percent today -- is too high. I'm not a medical expert, but if all those C-sections were medically necessary, it would stand to reason that had those surgeries not been performed, those mothers and babies would have suffered disastrous medical consequences. As childbirth is a common and natural occurrence, I can hardly believe that's true.

The World Health Organization recommends a level of no more than 15 percent of Cesarean section births. That sounds about right. But when my daughter was born in the fall of 2008, I had a C-section, and now -- willing or not -- I'm involved in this discussion.

She was facing up (this is called the posterior position) with her head tilted back and stuck under my pelvic bone and had not descended into the birth canal at all, despite hours of labor and pushing.

I was fine with my doctor's decision and was fortunate that my recovery was easy.

Was mine one of the highly sought after (for purposes of maintaining street cred) "medically necessary" versions of the procedure? I don't know. Perhaps under a different moon or with a different doctor, my baby would have popped right out. Or maybe not. Maybe she would have lost oxygen.

I didn't think about it much until recently. Now pregnant with my second child, and delivering at Yale-New Haven Hospital (which offers both choices), I am faced with the decision of whether to have a repeat Cesarean, or try for a VBAC.

For the uninitiated among you, VBAC stands for "Vaginal Birth After Cesarean," and the most serious risk associated with one is a uterine rupture at the site of the previous incision. According to the most recent reports, as well as my own doctor, the likelihood of this happening is less than one percent. A repeat C-section carries it own risks, as does any major surgery.

At this particular moment in my ever-changing mind, I figure I might as well try a VBAC under the careful observation of the medical team.

But to tell you the absolute truth, I don't care how this baby arrives.

Like every parent on the planet, all I want is a healthy child (boring), and what I find strange about this experience is that I'm allowed -- and expected -- to make a decision regarding this desired outcome. I want someone else to tell me what to do.

Now, back down, tigers! I get that I'm lucky to live in this country, working with some of the best doctors in the world who can make all my specific childbirth dreams come true. Problem is, I don't think about childbirth all that often. Nor do I want to.

No, no -- t's a beautiful thing, etc. It's just that I'm as likely to talk about the beauty of squatting into a strong contraction, recognizing the incredibly hard work my body was doing in the same breath as I am I to speak -- in dulcet tones -- of the beauty of the epidural I had that day.

Listen: I know some of you are going to be mad at me when I say this, but the C-section issue? It's just not my bag. I believe that in this life you choose your battles, and this isn't one of mine.

Like the rest of you, I want to make the right decision, because I'm a strong woman who trusts her body. But then I think about that time I was jogging down a busy sidewalk near my house, tripped on a minuscule crack and went flying face first into the pavement in front of all the morning commuters. So, I guess I don't totally trust my body, if you want to know the truth.

My thoughts are fickle, irresolute. I indulge in giddy natural birth daydreams -- a soundtrack of power ballads as I push my baby into this world. The next second I'm fantasizing about the glorious two extra nights in the hospital offered to C-section patients -- having pancakes for breakfast while maternity ward nurses attend to all our needs.

Perhaps the answer, ironically, is to stay true to this indecision.

In upcoming months, I plan to remain open to the experts' advice. My personal choice is to do whatever the doctors tell me -- to force them to discuss the topic with me as much possible before kicking me out of the exam room because, yeah, I get it -- they have other patients.

I like doctors. What I don't like is getting worked up about this decision when there is a world out there beyond my uterus. But if you've chosen this battle as one of your own, well, sister, fight on.

Mostly, I think we women should be kind to one another in addressing the choices we make about childbirth and everything after. If it's the quiet certainty of a repeat C-section you want because you're scared -- or maybe because of the pancakes -- that's totally understandable. Same goes for the flip side -- if you can't stand the thought of going under the knife again, and you want the quicker recovery time of a vaginal birth.

There is, after all, enough to feel guilty about in the challenging world of parenting. When I start doubting myself, wondering if there was something I could have done better last time (pushed harder? screamed more?), I tell myself, kindly, to please shut up.

I remind myself of what's important and true. That I did -- and am doing -- a good job.

And so, my friend, are you.

 

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